15-105567 • • Electrical
F City of Federal Way
Community&Econ.Dev.Services Permit #: 15-105567-00-EL
33325 8th Ave S FILE
Federal Way,WA 98003
Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax (253)835-2609 p q
Project Name: BILSKI
Project Address: 1456 S 302ND ST Parcel Number: 025300 0015
Project Description: Replace existing Mast& Mast Head
•
Owner Applicant Contractor
JOSEPH J BILSKI MARY L BILSKI OWNER IS CONTRACTOR
MARY L BILSKI 1456 S 302ND ST
1456 S 302ND ST FEDERAL WAY WA 98003
FEDERAL WAY WA 98003
Additional Permit Information
Is this an Online or O.T.C.application9 Yes Is Use Educational or Institutional? No
Electrical Fixtures
Mast or Meter Repair(Residential] 1
PERMIT EXPIRES Saturday, April 30, 2016
Permit Issued on Monday, November 2, 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: ✓/?1,:Ai 6L 64e1L, Date:
4THIS CARD IS TO RE IN ON-SITE
CITY OF `" Construction Inspffition Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT#: 15-105567-00-EL Address: 1456 S 302ND ST '
Project: JOSEPH J BILSKI FEDERAL WAY, WA 98003-4135
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.
El UFER Ground (4295) El Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
•
0 Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) El Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
0 Final-Electrical(4055)
Approved
By L Date
El Rough ElectricalCI Final Electrical Ili Right of Way -�
Approved Approved Approved
By Date By Date By Date
RECEIVED
.. ELEC'T'RICAL
CITY OF
Federal Way NOV 02 2 ERMIT APPLICATION
•
CITY OF FEDERAL WAI
PERMIT NUMBER I _ 0 55- 691
SUITE/UNIT/SPACE#
SITE ADDRESS: /
/
PROJECT VALUATION 7 C�ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name) /77/9--R
v
PROJECT DESCRIPTION "/ s7-- S D
Detailed description of work to
be included on this permit only
NAME / PRIMARY PHONE
PROPERTY OWNER )P_;,SS�`'Dfr./9,/42 6)1. W/
MAILING ABDRESS E-MAIL
CITYSTATE ZIP FAX
)
NAME PRIMARY PHONE
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY PHONE
APPLICANT .� the Cts 6 -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAMEPRIMARY PHONE
PROJECT CONTACT - � S- T,(-/ 4VS.-3) /c2O
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: GC. 1 � � DATE //-9Q " Z
PRINT NAME: PW f �/
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application