11-100089 0
Electrical
City of Federal Way s
III FILE
Community Development Services Permit #: 11-100089-00—EL
i P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: 253 835-3050
Ph:(253)835-2607 Fax (253)835-2609 p q
Project Name: HEIL
Project Address: 32802 38TH AVE S Parcel Number: 614360 0571
Project Description: Electrical wiring for single family home with detatched garage.
Owner Applicant Contractor
GARY HEIL A&D ELECTRICAL SERVICES INC A&D ELECTRICAL SERVICES INC
22870 N HWY 101 6503 34TH AVENUE CT E ADELESI972DK (3/23/11)
SHELTON WA 98584 TACOMA WA 98443 6503 34TH AVENUE CT E
TACOMA WA 98443
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51.
Is Use Educational or Institutional? No
New Service: Residential 1
PERMIT EXPIRES Tuesday, January 10, 2012
Permit Issued onMonday, January 10, 2011
j I hereby certify that the above information is cor - t and that the construction on the above described property and
the occupancy and the use will be in accord- ce with the haws, rules and regulations of the State of Washington
1 d the City of Federal Way.
Owner or agent: . T1 . /_ Date: / �6' /
FW
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CITY OF A
Federal Way ELECTRICAL RECEIVED
PERMIT APPLICATION JAN 1 0 2t.1
**Most electrical sermits may be obtained on-line at www.city. '"-Jeh 1 , FERAL WA
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SITE ADDRESS: R.Q j, 3 t`" 4-0-/ s , -,e d 1 (u
SUITE/UNIT/SPACE M ASSESSOR'S TAX/PARCEL It CURRENT/PROPOSED USE
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PROJECT NAME j 1
(Tenant or Homeowner Last Name) 1 1 I d rlk Q
PROJECT DESCRIPTION N C t,J c`((Kik 4 r 46 t�t,--(,`
Detailed description of work to
be included on this permit only .-44_ ,4-r GcA_ G Q
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NAME PRIMARY PHONE
PROPERTY OWNER 6G i/ ( ,2. t ( (t d'S as el- - GI 0
MAILING ADDRESS E-MAIL
CtI,. r STA ZIP FAX
t-Q ci CAS- (J(A ( ) ----_
NAM PRIMARY PHONE
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MAILING ADDRESSMAIL
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920 ELECTRICAL &5 a3 3q.-1-c- A u k C 4-• I-e/ D ( -?Ca-6_,_cidkageS
CONTRACTOR ST TE ZIP FAX
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WA D e-�Ct'3 3,I E ^ ' /TIO DATE� FEDERAL WAY BUSINESS LICENSE#
NAME
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ILL /n `Ct C /`�' !C iJI/ PRIMARY PHONE
( )APPLICANT MAILING ADDRESS
E-MAIL
CITY STATE ZIP FAX
( ) -
N �/ PRIMARY PHONE
PROJECT CONTACT a U f C� ( )
-
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation and defense of such claim), which may made by any person,including the undersigned,and filed against the city,
but only where such claim arises out of the reliance the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of is appli r; tion.
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4 ill ,/
SIGNATURE: _ DATE
/ . /10.J(
PRINT NAME: ( Q It rt-%-e J
e
-
33325 8th Avenue South♦PO Box 9718♦Federal Way♦WA♦98063-9718♦253-835-2607♦fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160—April 9,2010 Page 1 of 2 k:\Handouts\Electrical Permit Application