14-102725 • 0 'Electrical
City ofFederal Way Permit 14-102725-00-EL
Community&Econ.Dev.Services #:
33325 8th Ave S `"
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: BRYANT
Project Address: 28613 30TH AVE S Parcel Number: 332204 9202
Project Description: Change out 125-amp panel and add generator outlet for portable generator
Owner Applicant Contractor
HARLEY BRYANT M S E ELECTRIC M S E ELECTRIC
CINDY BRYANT PO BOX 13327 MSEELE*874L8(7/2/15)
28613 30TH AVE S DES MOINES WA 98198 PO BOX 13327
FEDERAL WAY,WA 98003 DES MOINES WA 98198
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, December 7, 2014
Permit Issued on Tuesday, June 10, 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
7/17, �� and the City of Federal Way.
Owner or agent: fDate: //G' /`f
i THIS CARD IS TO RIIN ON-SITE
CITY OF ..,41m....,. .4._. '' p Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 14-102725-00-EL Address: 28613 30TH AVE S
Project: HARLEY BRYANT FEDERAL WAY, WA 98003-3345
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
Date By Date By Date
Temporary ❑Power(4275) Service(4235)
El Pool Bonding(4195) ElporApproved Approved
Approved
By Date By
Date By Date
Electrical(4225) 1 t Ceiling Cover(4020)
A
❑ Feeders/Sub-panels(4045) ElRou Rough Approved ❑ Approved
Approved
1.By Date By
Date By Date
❑ Final-Electrical(4055)
Approved
By Ci ►�— Date c\,,y.,1i.._,‘, 1
al Electrical Right of Way
0 Rough Electrical Final
Approved
Approved
Date By Date
By Date By ,
•
EL CTRICAL
Federal Way PERMIT APPLICATION
l 0 Z. ? RECEIVE
PERMIT NUMBER 4 _ I ( ��_ 00
0 JUN 10 2014
CITY CF
SIrrIAW►Y
SITE ADDRESS: s / Z ti. ' Aute S^ CDS
PROJECT VALUATION ASS ES TEL/,A EL b C�' CURRENT/PROPOSED USE
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PROJECT NAME 2
(Tenant or Homeowner Last Name) 1�/ r`�Ci.'�
PROJECT DESCRIPTION i Lr7CAy\ ov't Vic) /4r-1,N-10 P19-1`;'— 'r e/i
Detailed description of work to 6- ' era /— ;/a C/
be included on this permit only
NAMEPRIMARY PHONE
PROPERTY OWNER /-Ir /ey' 12.>9/4 -1 .1 (166 )2 y9 - g'5 �;
MAILING ADDRESS E-MAIL
CITY/ter J STATE ZIP FAX
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NAME PRIMARY PHONE
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MAILING ADDS-RESS E-MAIL
ELECTRICAL t O '-;°)4:- I .3 Z 7
CONTRACTOR CITY / STATE ZIP
I FAX
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WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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NAME / PRIMARY PHONE
APPLICANT / �'`4 ff �' 17vw1.44^ (76 ) E-MAIL /
MAILING ADDRESS
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CITY STAT�� MO/ S
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NAME PRIMARY PHONE
PROJECT CONTACT �. {-r/e, (Z06 )27/
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`72sI 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 a•plication.
SIGNATURE: 7G2c%i ` / DATE CO/ib I y
PRINT NAME: p i A---1-4 (-1-itivA,Njo.,-..
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application