14-103988 f • • EiZrLtrkal
City of Federal Way ./{./J. 14-10398800-EL
Community&Econ.Dev.Services Permit #:
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 8 5-3050
Project Name: GRG,LLC
Project Address: 2014 S 280TH PL Parcel Number: 422231 0450
Project Description: Rewiring upstairs portion of home and install new home runs due to fire damage
Owner Applicant Contractor
GRG,LLC INNOVATIVE SYSTEMS TECHNOLOGY INC INNOVATIVE SYSTEMS TECHNOLOGY
26821 SE 22ND CT (ELECTRICAL) INC(ELECTRICAL)
SAMMAMISH WA 98075 6353 S ISLAND DR INNOVST881B4(1/24/16)
BONNEY LAKE WA 98391 6353 S ISLAND DR
BONNEY LAKE WA 98391
•
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Service greater than 999 Amps? No
Electrical Fixtures
Low Voltage-Other(Residential). 1
PERMIT EXPIRES Tuesday, February 3, 2015
Permit Issued on Thursday, August 7, 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: U 7
) �
FINALE®
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• THIS CARD IS TO IN.ON-SITE
CITY OF � `�''' Construction In ection Record .
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 14-103988-00-EL Address: 2014 S 280TH PL
Project: GRG, LLC FEDERAL WAY, WA 98003-3202
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) ❑ Ditch cover(4030) -0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
♦ ,
o Pool Bonding(4195) ❑ Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By 1, Date 1 o _i ti t By Date
o Feeders/Sub-panels(4045) ' ❑ Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By V Date r?)....3 b, 1. By Date
❑ Final-Electrical(4055)
Approved
Date U -7.I. /�
0 Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
!®� , .
•
'��• E CTRICA
CITY OF >
Federal Way PERMIT APPIaciA, ION
PERMIT NUMBER 14- _ 1 0 _/ 9 „:5--- ()C) AUG 0 7 2014
/^! 2 //77 CITY OF FEDERAL WAY
SITE ADDRESS' V 1 S (� P/� Fri SUITE/UNIT/SPACE#
VVVV G v
PROJECT VALUATION ASS SOR'S T ARCEL# CURRENT/PROPOSED USE
4
PROJECT NAME
(Tenant or Homeowner Last Name) l e' w r' (-r-K4
PROJECT DESCRIPTION / u r' 0 Ai
1�6 r -7- d - ti 40 s 114d
Detailed description of work to k r 't /i (21 ?-l ( _
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP ( FAX
l )
Mid NAME �/i `y S �G, PRIMARY PHONE
-I. a
VF(U yS1 /it � (,253) SSI - r9? "
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY J j/ STATE ZIP �( I FAX
(`rl/1Ci.J L�� r iU"
6J
( CI 1 ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS L CENSE#
- (c, ,;
NAME 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 Iaws 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: , yiti 1 , r" DATE7
7 / L(
PRINT NAME: 4�k eAl3 i vi
Bulletin#160—January 1,2013 Page 1 of 2 k:\HandoutsTlectrical Permit Application