14-106141 Electrical
City mofFederalD v S Permit #• 14 106141 00-EL
Comunity&Econ. ev.Services • - -
33325 8th Ave S FILE
Federal Way,WA 98003 Inspection Q
Ph:(253)835-2607 Fax:(253)835-2609 p tion Re nest Line: 253 835-3050
Project Name: PHAN SHORT PLAT LOT 2
Project Address: 31006 20TH AVE S Parcel Number: 053700 0594
Project Description: Wiring for new single family residential.200 amp service panel.
Owner Applicant Contractor
LONG VAN PHAN BRUCE LAM OWNER IS CONTRACTOR
LIEU THI NGUYEN 1047 S JACKSON
1939 LIGHTHOUSE LN NE TACOMA WA
TACOMA WA 98422
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, May 31, 2015
Permit Issued on Tuesday, December 2, 2014
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: � Date: /2- 2 — ..A
FINALED
Federal Wa Construction Intection dlecord
y INSPECTION REQUTS: (253)835-3050
PERMIT#: 14-106141-00-EL Address: 31006 20TH AVE S
Project: LONG VAN PHAN FEDERAL WAY, WA 98003
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.
❑ UFER Ground (4295) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By f ftj - Date t , s--. i s By Date By Date
E Pool Bonding(4195) El Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Q_\ Date i
•
® Feeders/Sub-panels(4045) 0 Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By 0,�` j Date h — ,� c By Date
El Final-Electrical(4055) l
Approved
By Date 3 h l I V
.
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
•
.. ELECTRICAL
CITY OF r,oAir,
Federal Way PERMIT APPLICATION
weivED
PERMIT NUMBER ) q -
1 t ! 'L 7 l - 0 o DEC 0 2 2014
SITE ADDRESS: 30756 f 4-v CITY OF FEDERAL UNIT/sPA°E#
S
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name) 7..._ PAeCA 1 f ASI .-17-,11.4--
PROJECT
/,L
PROJECT DESCRIPTION 5/I ( tF)f iQni J — Ala-4,11 Corn i�S-;-roc
Detailed description of work to (Ai �, r. I close 2 UA- r-v(�
be included on this permit only �� LA
NAME PRIMARY PHONE
PROPERTY OWNER 1--(171 f ezm (.253) p5-- --e)'0
MAILING ..f .RESS E-MAIL
CITY STATE ZIP FAX
Fc i4J, . ( ) -
NAME PRIMARY PHONE
54.,„..t. .,5 0`,b 0 dLe_ ( ) -
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
25RUe:z 1--ft-, (� 7 ) 86i - 5 So gr-
APPLICANT MAILING ADDRESS p E-MAIL
/G d{ 3 cl s a'1, i A dttYIGJgfJC/1,2gi ma J ee>11
CITY STATE ZIP �$ FAX /I/
( tv', `7r i c ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT AV 1-'911 (;,S)) %/ 51C) —
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 Iocal, 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: DATE /1-7,.2Diy
PRINT NAME:_cl, ,C
Bulletin#160-January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application