13-102119 ` , • Electrical'
City of Federal Way
Community&Erne.Dev.Services Permit #: 13-102119-00-EL
33325 8th Ave S -'
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: RODRIGUEZ
Project Address: 29041 18TH AVE S Parcel Number: 546280 0060
Project Description: Replace 200-amp panel.
Owner Applicant Contractor
MARIO RODRIGUEZ MARIO RODRIGUEZ OWNER IS CONTRACTOR
GLORIA RODRIGUEZ 29041 18TH AVE S
29041 18TH AVE S FEDERAL WAY WA 98003-3825
FEDERAL WAY WA 98003-3825
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Electrical Fixtures
Alt.Serv./Feeder:0 to 200 amps(F 1
PERMIT EXPIRES Sunday, November 10, 2013
Permit Issued on Tuesday, May 14, 2013
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
,and the City of Federal Way.
Owner or agent: Niv„i„)(--- () , Date:
ri
, ‘
THIS CARD IS TO MAIN ON-SITE ,
CITY OF •
• Construction I ection Record
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 13-102119-00-EL Address: 29041 18TH AVE S
Project: MARIO RODRIGUEZ FEDERAL WAY, WA 98003-3825
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as
possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your
inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
O UFER Ground (4295) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
O Pool Bonding(4195) 0 Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
O Feeders/Sub-panels(4045) El Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055)
• Approved
y Dat4.—6
2
O Rough ElectricalEl Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
MAY 14 2013
CITY OF
11116. cm' OF FEDERAL WAY ELECTRICAL
Federal Way CDS PERMIT APPLICATION
PERMIT NUMBER /3_ / lllfff/ / 673 / / 5 _ / Z—
SUITE/UNIT/SPACE#
SITE ADDRESS: 29041 18th Ave S, Federal Way Wa 98003
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ $600.00 5 44 (7 A c 0 - CU o f, o
PROJECT NAME
(Tenant or Homeowner Last Name)
Replace old breaker panel with a new 200 amp panel, replace
all required wiring required for panel replacement
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Mario Rodriguez ( 253)569-5288
MAILING ADDRESS E-MAIL
29041 18th Ave S mcrodri98003@
CITY STATE ZIP hotmail.cortix
Federal Way Wa 98003 ( ) -
NAME PRIMARY PHONE
Homeowner ( ) _
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
( )
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
Homeowner ( ) _
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT Mario Rodriguez ( 253) 569-5288
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 be made by any person,including the undersigned,and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application.
•
•
MIOW14) )411#26.
SIGNATURE: DATE 05/06/2013
PRINT NAME: Mario Rodriguez
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application