15-102848 l ELECTRICAL
C9TY OF
Federal Way PERMIT APPLICATION
Recesve
PERMIT NUMBER t 5_ j o 2 8 4- 8 - V' JUN 11
— — — — 2015
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SITE ADDRESS: ,-,'fib/, S v,�V . 3 i 3717 3-/- F 11 GZ/wa CDS
PROJECT VALUATION ASSESSOR'S TAX/PARRCCEEL# ` CURRENT/PROPOSED USE
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P O CT NA E
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PROJECT DESCRIPTIONP6VieL1").t& �i 97-�iq'`' C1-.'")"e"1-1174
Detailed description of work to
be included on this permit only
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NAME PRIMARY
PRIMARY PHONE
PROPERTY OWNER filnf AIU Ji ,. 0-0-1,f'/ L�,c,,,. ( 2� f(J- 44(74
MAILING ADD ESS E-MAIL
CITY STATE ZIP FAX
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NAME ' PRIMARY PHONE
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MAILING ADDRESS E-MAIL
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CONTRACTOR CITY STATE ZIP FAX
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WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME „ ' ”,/ PRIMARY PHONE
APPLICANT ( O441L/-T �` v 1 ( )
MAILING ADD SS E-MAIL
CITY STATE ZIP FAX
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NAME PRIMARY PHONE
PROJECT CONTACT ( )
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: !�. . DATE `�2 i� j/ 741
PRINT NAME:
Bulletin#160-January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
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.//�.�� Electrical
City of Fedeay
Communty&Econ.ral Dev.Services Permit #: 15-102848-00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q
Project Name: BUDNICK
Project Address: 4461 SW 313TH ST Parcel Number: 211650 0070
Project Description: 0-200 AMP panel replacement
•
Owner Applicant Contractor
ROBERT J BUDNICK ROBERT J BUDNICK CHARLES DEAN ELECTRIC LLC
QING)CIUJI-BUDNICK 4461 SW 313TH ST CHARLDE930LQ(6/18/17)
4461 SW 313TH ST FEDERAL WAY WA 28107 20TH AVE S
FEDERAL WAY WA 98023 98023 FEDERAL WAY WA 98003
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 Circuits-Residential 6
PERMIT EXPIRES Saturday, June 11, 2016
Permit Issued on Thursday, June 11, 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
nd the City of Fede .I Way
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Owner or agent: %�L �. � . ,// .4)- Gc,I Date: 3
FINALED
..THIS CARD IS TO REMAIN ON-SITE t
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CITY OF
Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-102848-00-EL Address: 4461 SW 313TH ST
Project: ROBERT J BUDNICK FEDERAL WAY, WA 98023-2146
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.
E UFER Ground (4295) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
10 Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) ' ❑ Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date B S Date L—a_( (e, `By Date
o Final-Electrical(4055)
Approved
-� Date 2 /
Com, 3- t_1 ,
0 Rough Electrical El Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date