15-104946 lr ctrica1
City of Federal Way JJ.��
Community&Econ.Dev.Services Permit #: 15-1049464)0-EL
33325 8th Ave S
Federal Way,WA 98003 253 Inspection Request Line:
Ph:(253)835-2607 Fax:(253)835-2609 p q (253) 835-3050
Project Name: HERNANDEZ
Project Address: 2017 S 287TH PLParcel Number: 422200 0030
Project Description: Alteration of(2)circuits for outlets/light switch in bedroom remodel.
Owner Applicant Contractor
CHACHA ANGEL HERNANDEZ CHACHA ANGEL HERNANDEZ OWNER IS CONTRACTOR
2017 S 287TH PL 2017 S 287TH PL
FEDERAL WAY WA 98003 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
Circuits-Residential 2
PERMIT EXPIRES Sunday, March 27, 2016
Permit Issued on Tuesday, September 29, 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
and the City of Federal Way.
Owner or agent: A cif
1-14 t Z- Date: /4 /LS'
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' 44..., THIS CARD IS TO RE1VWNON-SITE
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Construction InspeTrion Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT #: 15-104946-00-EL Address: 2017 S 287TH PL
Project: CHACHA ANGEL HERNANDEZ FEDERAL WAY, WA 98003-3324
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) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
O Pool Bonding(4195) ❑ Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
O Feeders/Sub-panels(4045) 0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By 4e,e,1 Date (b i lit, I ! c._. By Date
❑ Final-Electrical(4055)
Approved
By Date a-A —LS
El Rough Electrical Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
• RECEIVED !E TRI AL
CITY OF '''-`12'‘-'44.40,
E C C
Federal Way SEP 2 9 2015 PERMIT APPLICATION
CITY OF FEDERAL WAY
/
CDS
/ /
PERMIT NUMBER / S _ / O 7 7 G _ &C
` SUITE/UNIT/SPACE#
SITE ADDRESS: S
C. 2 1 t /q G e
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ '-t S )- 2 - o v - 0 0 3 0
PROJECT NAME
(Tenant or Homeowner Last Name)
adaita..,CA:94 c2 77011 () 31-1 <--e--So-
PROJECT DESCRIPTION (1,009
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER
A-11 e u e-r1 4✓t QC 114 (Z`'( )2'10 - U?-5r
MAILING ADDRESS E-MAIL
7D l-1 5 2`�� (cc
CITY STATc�E ZIP FAX
Fe c ev,.t( cat
f� O :? ( )
NAME -. PRIMARY PHONE
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE M EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE
NAME / 1 uT / / PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
_( )
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 caw,
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: ,� I DATE /2(/ / 5
PRINT NAME: A(1 e-z i N eP c,i�i?Z C--\(aC C G
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application