18-101695 RECEIVED ELECTRICAL
CITY
OF
1111^"krarrolAPR 2 0 2018
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT S
PERMIT NUMBER _ 1 U 1 t( 5 _ v
SUITE/UNIT/SPACE#
SITE ADDRESS: j 3/,o p �e�i� PL
PROJECT VALUATION `I` ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
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PROJECT NAME
(Tenant or Homeowner Last Name) -kuo�(
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PROJECT DESCRIPTION U.L 'ems' VIA �'rl
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER I t i T VCS(�( moi'" (2M Z76-
MAILING ADDRESS E-MAIL
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CITY STATE ZIP FAX
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NAME \,Y V 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 (Zo ) 276- ck t
MAILING ADDRESS E-MAIL -- ''JJ
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT _R44, oN ( )�.� - q—
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: a� DATE ° r
PRINT NAME: 7,144 .-rk , �+
Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application
City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: TRUONG
Project Address: 33400 28TH PL SW
Project Description: Extend the ground wire to bond to water main.
Electrical
Permit #:18 -101695 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 010060 0540
Owner
Applicant
Contractor
TRU QUOC TRUONG
TRU QUOC TRUONG
OWNER IS CONTRACTOR
33400 28TH PL SW
33400 28TH PL SW
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
PERMIT EXPIRES Saturday, 20 April, 2019
Permit Issued on Friday, April 20, 2018
1 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
Wa hington and the City of Federal Way.
Owner or agent: Date:
1 4%
crrlof4w&
Federal Way
PERMIT #: 18101695 00
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
Address: 33400 28TH PL SW
Project: TRU QUOC TRUONG FEDERAL WAY WA 98023-2744
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
LIFER Ground (4295)
0
Ditch cover (4030)
0
Slab/Concrete Floor (4255)
Approved
Final Electrical
Approved
Approved to place concrete
By
Date
By
Date
By
Date
®
Pool Bonding (4195)
Q
Temporary Power (4275)
®
Service (4235)
Approved
Final Electrical
Approved
Approved
By
Date
By
Date
By
�,� Date kN,. <-
E0 Final - Electrical (4055)
Approved
By Date
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
®
Ceiling Cover (4020)
Approved
Final Electrical
Approved
Approved
By
Date
By
Date
By
Date
E0 Final - Electrical (4055)
Approved
By Date
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
I
By
Date
By
Date