14-100051 4
411
•
Eiectrca1a
City of Federal Way
Community&Econ.Dev.Services Permit #: 14-100051 -00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)
Ph:(253)835-2607 Fax:(253)835-2609 p Q 835-3050
Project Name: PARKWOOD MOBILE HOME PARK LOT 48
Project Address: 2611 S 288TH ST Unit 48 Parcel Number: 283920 0480
Project Description: Hooking up electrical to new mobile home
Owner Applicant Contractor
AFFINITY REAL ESTATE SVCS 21ST MORTGAGE GREEN LINE ELECTRIC
3110 JUDSON PMB 202 ST 620 MARKET ST GREENLE882PU 11/2/14
GIG HARBOR WA 98335 KNOXVILLE TN 37902 87 E TRANQUILITY LN
SHELTON WA 98584
Additional Permit Information
Is this an Online or O.T.C.application" Yes Is Use Educational or Institutional" No
Electrical Fixtures
Service or Feeder-Manu./Mobile I
PERMIT EXPIRES Saturday, July 5, 2014
Permit Issued on Monday, January 6, 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
nd the City of Federal Way.
Owner or agent: dy , C G�'ti Date: % - (41> 7//
•
D
1,,E
it4
THIS CARD IS TO MAIN ON-SITE
GTY OF � • Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 14-100051-00-EL Address: 2611 S 288TH ST Unit 48
Project: AFFINITY REAL ESTATE SVCS FEDERAL WAY, WA 98003-8001
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 Slab/Concrete Floor(4255) 0 Final-Electrical(4055)
Approved to place concrete Approved
By Date By WO Date 2- ( q ( (L
•
0 Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
II •
AIL, JAN 06 2014 ELECTRICA
CITY OP '"'- ,m
Federal Way Crnr OF FEDERAL PERMIT APPLICAT ON
/ 00CDS
, 7/PERMIT NUMBER _ _ CID
SUITE/UNIT/SPACE#
SITE ADDRESS: 46// S 5 r" 4) j- 2/1-
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# ��
CURRENT/PROPOSED USE
( Si /'. S/9 _ _ _
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION 729 k1/4-C,Q 4Y" /25x IJP 2*' Ad/y-) Lam_'
Detailed description of work to
be included on this permit only
NAME y� PRIMARY
PROPERTY OWNER - / �T /✓/ori rJ Q- . �-�'� (g2)Z.) 7J-S-PC C4 /
MAILING ADDRESS E-MAIL
Au v /713/J 7 S/iee7
CITY /� /�-}//e STATE ZIP �//�
//L7)< !' ;719 Y/ Vi� ( ) FAX
NAME PRIMARY PHONE
6 moi'`e. 4/r /1 E' /e& J`-xG, (T61' ,1`J 5
MAILING ADDRESS �-' E-MAIL
ELECTRICAL g'''. /cq/1 f Jr/ ,illy /,/1 e
CONTRACTOR CITY STA E ZIP
.< 4/ /i 9����� FAX
(
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
6. L c"/( 4. 7Z.'f/4 /1/ /.1C/�j
NAME / ,Q > �j PRIMARY PHONE
APPLICANT 1pr-�� 7-4ei j6� se571 (/l`').5-�/-Js 2)
MAILING ADDRESS E-MAIL
'_ fWl °* Jam_
CITY STATE ZIP _
FAR
�J)D-Y 1%/1
/�LG 9�
NAMEPRIMARY PHONE
�7
PROJECT CONTACT �C )y /2 '/-S 7,
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: / /�_d'u t,/��6) DATE / (/� ��
PRINT NAME: /` //// i' i2/)
Bulletin#160—January 1,2013 Page 1 of 2 k:\J-Iandouts\Electrical Permit Application