13-105654 •
•
• • Electrical
City of Federal Way
Community&Econ.Dev.Services Permit #: 13-105654-00-EL
33325 8th Ave S
Fa , A
Ph (253)ederal 835-260W7 yFaxW:(253)98003 835-2609 Inspection Request Line: (253) 835-3050
Project Name: SCHULTZ
Project Address: 420 S 302ND ST Parcel Number: 064300 0030
Project Description: Upgrading existing panel to a new 200 amp panel and includes work on circuits.
•
Owner Applicant Contractor
MARY ELLEN SCHULTZ LEGACY ELECTRIC INC LEGACY ELECTRIC INC
420 S 302ND ST PO BOX 1693 LEGACEI962QS(1/21/15)
FEDERAL WAY WA 98003 AUBURN WA 98071 PO BOX 1693
AUBURN WA 98071
•
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps(F 1 Circuits-Residential 10
PERMIT EXPIRES Wednesday, June 18, 2014
Permit Issued on Friday, December 20, 2013
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 ashington
and the City of Federal Way.
Owner or agent: Date: �"�
THIS CARD IS TO MAIN ON=SITE
CITY OF m'�' \ Construction In ection Record
` Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-105654-00-EL Address: 420 S 302ND ST
Project: MARY ELLEN SCHULTZ FEDERAL WAY, WA 98003-4052
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 Ditch cover(4030) ❑ Service(4235) fl Feeders/Sub-panels(4045)
Approved Approved Approved
r
By Date By le-V-,M-, Date k 3 It `By Date
,
1 1
fl Rough Electrical(4225) El Ceiling Cover(4020) 0 Final-Electrical(4055)
Approved Approved Approved
By Date By Date By Vis Date I i 3 fi.+
El Rough ElectricalEl Final Electrical 111 Right of Way
Approved Approved Approved
By Date By Date By Date
RE.IVED ELECTRICAL
CITY OF , ,
Federal Way DEC 2 0 2013 PERMIT APPLICATION
CITY OF FEDEERAL/WAY
PERMIT NUMBER I 3 / /� 5- \ lam( - c
2) _
0 SUITE/UNIT/SPACE•
SITE ADDRESS: 7120 i
PROJECT VALUATION ASSESSOR'S TAX/PARCEL S CURRENT/PROPOSED USE
L
PROJECT NAME I
(Tenant or Homeowner Last Name) n"'1,'a 1 (�/ S a` 4 2
AIAP X4.4(414-0W-- W,G7�e,4 2,, ��
PROJECT DESCRIPTIONS �`�" Wim'r-Ckt)
Detailed description of work to C��`S
be included on this permit only 1
NAME • PRIMARY PHONE
PROPERTY OWNER MA-My Schtt.1$Z (;53) 59 - 0843
MAILING ADDRESS E-MAIL
I/ 2O S , 5E-.
CITY STATE ZIP FAX
lAA.A. %cV3 ( ) -
NAME PRIMARY PHONE
1--f---6-P}c f £.-&I1- L- _INC- . (`�(P ) %( -7 2700
WAILING ADDRESS E-MAIL
ELECTRICAL U 1� )c 41 (D 93 ` 2 se--L 1N.5n.6:0
CONTRACTOR CITY STATEZIP FAX
A ,,Vm VA- 984 7l ( ) -
WA STATE CONTRACTOR'S LICENSE M EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE M
L1 G-4 c-z:-% S 5 / 9 /15
NAME PRIMARY PHONE
- t-
APPLICANT ci; ( )
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAR
( )
NAMEPRIMARY PHONE
PROJECT CONTACT >c ,. y1,p ( ) - -7 l&.
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. c�
SIGNATURE! , \ An �/ DATE I o'w7O%i
PRINT NAME: Wim' U' ~c :-.7.-/-
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Bulletin
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Bulletin#160—January 1,2013 Page 1 of 2 k:\landouts\Electrical Permit Application