16-101870City of Federal Way
Community & Econ. Dev. Services
33325 Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: SCHANZENBACH
Project Address: 1147 S 299TH PL
Project Description: 200 amp service change
Electrical
Permit #': 16 -101870 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 515160 0440
Owner
Applicant
Contractor
EVELYN V SCHANZENBACH
K B ELECTRIC SERVICE INCORPORATED
K B ELECTRIC SERVICE INCORPORATED
1147 S 299TH ST
- PO BOX 22931
KBELEES962DN (3/15/18)
FEDERAL WAY WA 98003-3751
SEATTLE WA 98122
PO BOX 22931
SEATTLE WA 98122
Additional Permit Information
Electrical Work Valuation?....................................2500 Is this an Online or O.T.C. application? ................. Yes
Is Use Educational or Institutional?.......................No
Electrical Fbdures' -
Alt. Serv./Feeder: 0 to 200 amps (F 1
t
PERMIT EXPIRES Tuesday, April 18, 2017
Permit Issued on Monday, April 18, 2016
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
L and the City of Federal Way.
Owner or agent: I' "- " Date: Y • `� • I (.
F,NALED
THIS CARD IS TO 'MAIN ON -SIVE
CITY of
Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 16 -101870 -00 -EL Address: 1147 S 299TH PL
Project: EVELYN V SCHANZENBACH FEDERAL WAY, WA 98003-3751
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.
❑
UFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
E]
Approved
Approved
By
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By V49.7 Date 1. f (6(((,
Pool Bonding (4195)
❑
Temporary Power (4275)
E]
Service (4235)
Approved
By
Date
Approved
By
Date
.Approved
By
Date
By
Date
By
Date
❑
Ceiling Cover (4020)
❑
Rough Electrical (4225)
Feeders/Sub-panels (4045)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By V49.7 Date 1. f (6(((,
❑Final
Electrical
Approved
EJ
Right of Way
Approved
Rough Electrical
Approved
By
Date
By
Date
By
Date
C1�,oF ffimmm ELECTRICAL
Federal Way APR 18 2016 PERMIT APPLICATION
CITY OF FEDERAL WAY r l0 10 ( 8 -7C)
CDS PERMIT NUMBER
It 4+ � m j
SITE ADDRESS: GLS- �%L r1Y
SUITE/UNIT/SPACE #
OJF1CT� UOATI`O,N
ASSESSOR'S T/,$(�RCF� # � r - � /; � o
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
c1
V / ,!�.��
E?C 41—
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
(1- C -C.) 6'(k- 'Z / '7 i
MAILING ADDRESS
1 1 44-7 S 2�9`•`��
E-MAIL
CITY
STATE
ZIP
FAX
NAME
PRIMARY PHONE
ELECTRICAL
MAILING ADDRESS
P. a • e> cr.,& 7--l'13 3 1
E-MAIL
K%0 aR-' C_
CONTRACTOR
CITY
'S E 4A* k
STATE
a 0%1 ..
ZIP
2Z
FAX
(7--b L. 3t,6 - `Z 3 4 8
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
%<6 cc C- � 2 I>
APPLICANT
NAME
14-G6.,,.i , ylJ
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
11, l L J ,�, /� a-- _ ;�o S
PRIMARY PHONE
(z31�- 4 S -2-T
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 Ajay 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 apart of this application.
SIGNATURE: (%—k, DATE
PRINT NAME: 1 G.. ~ j • � f6 2
<1. 13. /b
Bulletin # 160 —April 14, 2016 Page 1 of 1 UHandoutsTlectrical Permit Application