15-100642 • Jai
0 Electrical -
City of Federal Way ILE
„ IIPermit #: 15-100642-00-E L
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 96003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p Q
.,
Project Name: MATY
Project Address: 28546 20TH AVE S Parcel Number: 422200 0210
Project Description: Wire new house to include 200amp panel.
Owner Applicant Contractor
MICHAEL G MATY ROBERT WINKELMAN BOBCAT ELECTRIC INC
28546 20TH AVE S BOBCAT ELECTRIC INC BOBCAEI952JG(4/7/15)
FEDERAL WAY WA 98003-3233 1407 S TYLER ST 1407 S TYLER ST
TACOMA WA 98405 TACOMA WA 98405
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Electrical Fixtures
New Service:Residential 1
PERMIT EXPIRES Sunday, August 9, 2015
Permit Issued on Tuesday, February 10, 2015
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
the City of Federal Way.
Owner or agent: V •A Date: —/O r 20/3
r
THIS CARD IS TOMAIN ON-SITE
FOF ,.•111`111/4111464.."'". Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-100642-00-EL Address: 28546 20TH AVE S
Project: MICHAEL G MATY FEDERAL WAY, WA 98003-3233
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.
0 UFER Ground (4295) 0Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date
By Date
Pool Bonding (4195) El Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
ill
y Date I By Date
By C. Date N..i '1C1—is
Feeders/Sub-panels(4045) `� Rough Electrical(4225) `� Ceiling Cover(4020)
f_____
Approved Approved Approved
By Date B Date
C� z ,... ..E___ Thy Date
0 Final-Electrical (4055) • ,
Approved
By Zdi
Date c-' 9,
Rough Electrical El Final Electrical Right of Way
Approved Approvedlij Approved
By Date 1 By Date
By Date
III
111116. ED E CTRI CAL
CITY OF
Federal Way FEB 1 0 2015 PERMIT APPLICATION
.-r'.-•
--' CITY OF FE E WAY
PERMIT NUMBER _ ri D 6 /
SUITE/UNIT/SPACE#
SITE ADDRESS: 75--q O- r �P
f5 15
PROJECT VALUATION GJ lVA SESSOR'S TAX/PARCEL# / CURRENT/PROPOSED USE
$ `7000 , 00 _ Q 0 - 0 J-- 0 0
PROJECT NAME /�
(Tenant or Homeowner Last Name) �/ " l
PROJECT DESCRIPTION (ti ( rn.e cJ 1-4 6 u ..e- /5-00 u6? -701-6210r65)
Detailed description of work to '7 U(' a, c-rU E
be included on this permit only
NAME PRIMARY PHONE
Y
PROPERTY OWNER /V\ I C // eGe.( viA of , eLS3 )75`rJ - ?-7(..a
MAILINNG ADDRESS E-MAIL
Z p J-1(p 2,0 Gk,L/C_... .--)
CITY STATE ZIP FAX
di.er-,k,1 (,/,-)0's (/Joy 9*(3053 ( ) -
NAME PRIMARY PHONE
S r ►��,-f-- L 1 td-r; c___, ,1�v\ c_, )-z - 7-77(07--
MAILING ADDRESS E-MAIL
ELECTRICAL }_ —r/ P • 7n( r -
ro,Ci✓
CONTRACTOR CITY
STATE ZIP FAX
—1 .CO ou ( Jct- n(40 5 3)'759' - 3)`2.-77
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
r0hl✓69E 9S2,75'"c, 09 / /6_ 201(0
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS
E-MAIL
CITY STATE ZIP FAX
( ) -
PROJECT CONTACT NAME PRIMARY PHONE
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.
SIGNATURE: L,/1k/ DATE?_—10 "7.--'0/
PRINT NAME: Jt ��P.r ( p✓� �I //V� ��
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application