15-106103 •�°�.. ELECTRICAL
CITY OF ,..
Federal Way PERMIT APPLICATION
� RECEIVED
PERMIT NUMBERI c _ 1 0 t 0 3 - L-L.
DEC 03 2015
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SITE ADDRESS: 4,, 6 ^x/ 0 1 � e ol'J `'DS
PROJECT VALUATION ASSESSOR'SD TAX/PARCEL �� / CURRENT/PROPOSED USE
S ADO, `t° 1 / 8 S 0 0 - G .a 7 0 $l /Qes
PROJECT NAME
(Tenant or Homeowner Last Name) /�Y'7a K(a a i 2 A
PROJECT DESCRIPTION —iUS 7, -/in7i7 Ory U 4 ,12.,�',ue' ,>/, e}-, -.Detailed description of work to AA)s fe( 5 J) ,„}LG J /0 `� �l v I.iS 42- -
be included on this permit only
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NAME _ //�� PRIMARY PHONE
PROPERTY OWNER J(JR'N �rNG�P/9v x ( a53 9'7- 6$06
MAILING ADDRESS E-MAIL
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CITY STATE ZIP FAX
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NAME PRIMARY PHONE
14)Ce APY .A-yO-,j.AOP (206 ) s/0 - 29gi
MAILING ADD• S ' - E-MAIL
ELECTRICAL ? 3 19 'il IIP / ' S 11..4-C,aV'-a-c�eVA1c el a l„Wj
CONTRACTOR , CITY MfOrLV.JIPr STATE ZIP FAX
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WA STATE'•NTRACTOPCS LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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NAME NPRIMARY PHONE
APPLICANT jGl n,) " "c- ��' ( ) 7 IU- 79?,
MAILING ADDRESS E-MAIL
319/9 (21 P1 s j/,',t,{ 1 ice-,nein f..-1l,t
CITY STATE ZIP FAX
WA7 WA 73 'O 7 ( ) -
NAME/ PRIMARY PHONE
PROJECT CONTACT iivC, ,�/ .,.i &,�. (�) ) 6-e- 7”v
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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 Cit o • as to any claim(including costs, expenses, and attorneys'fees incurred in
the investigation and defense o -. c aim), which may •- ade by any person,including the undersigned, and filed against the city,
but only where such claim •rises out of the reli•• - of the city, including its officers and employees, upon the accuracy of the
information supplied to the ci • _ •• application.
SIGNA URE: �//� . DATE /4:;P2/0/.>
A/
PRINT NAME: AP c 4 J // Y4WC r4
Bulletin#160–January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
`' 0 I Electrical
Cityof Federal Way EPermit #: 15-106103-00-EL
Communitty$
Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line:
Ph'(253)835-2607 Fax.(253)835-2609 p Q (253)835-3050
Project Name: MORDEAUX
Project Address: 2628 S 300TH ST Parcel Number: 798500 0070
Project Description: Install generator transfer switch
Owner Applicant Contractor
JOAN W MORDEAUX VINCENT FARANDA OWNER IS CONTRACTOR
2628 S 300TH ST 37914 21ST PL S
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
Additional Permit information
Electrical Work Valuation? 400.00 Is this an Online or O.T.C.application? Yes
Is Use Educational or Institutional? No
Electrical Fixtures
Circuits-Residential 1
CONDITIONS:
A permanently installed generator is not allowed to be placed within required yards(setbacks). See Bulletin
#150 for placement details.
PERMIT EXPIRES Tuesday, May 31, 2016
Permit Issued on Thursday, December 3, 2015
I hereby certify that the above infor - n is co• t and that the construction on the above described property and
the occupancy an• a, . - - ••' •- '—'' F:ance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or a,-nt: d"4''`-'75- Date: ,016R//3,
1;:,
THIS CARD IS TO IN ON-SITE -
CITY OF
Construction In ection Record
Federal Way INSPECTION REQU TS: (253)835-3050
PERMIT#: 15-106103-00-EL Address: 2628 S 300TH ST
Project: JOAN W MORDEAUX FEDERAL WAY, WA 98003-4226
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 if 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.
CI UFER Ground (4295) 0 Ditch cover(4030) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
4
CI Pool Bonding(4195) 0 Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) 0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
0 Final-Electrical(4055)
Approved
By tot4 Date II.
1(4 f lir
El Rough Electrical El Final Electrical .� Right of Way
Approved Approved Approved
By Date By Date By Date