18-102013i
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: CHARWOOD MOBILE HOME PARK SPACE 209
Project Address: 1660 S 333RD ST
Project Description: Add circuit for pole light.
Electrical
Permit #:18 -102013 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 797880 0384
Owner
Applicant
Contractor
CHARWOOD PARK LLC
CHARLES DEAN ELECTRIC LLC
CHARLES DEAN ELECTRIC LLC
6619 132ND AVE NE PUB 254
28107 20TH AVE S
CHARLDE930LQ (6/18/19)
KIRKLAND, WA 98033-8627
FEDERAL WAY WA 98003
28107 20TH AVE S
FEDERAL WAY WA 98003
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
�'��� ° 4 3 � � � €✓s € �/�6€amu �F ��. f� ,��ta s- € �'� t '` r/F: € €
Circuits - Commercial
PERMIT EXPIRES Friday, 10 May, 2019
Permit Issued on Thursday, May 10, 2018
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: Date:
F�NpLED
cmr os THIS CARD IS TO REMAIN ON-SITE
�'
Construction
OnSECINUSInspection Record
rd
Federal Way PTOEST:(2
PERMIT #: 18102013 00 Address: 1660 S 333RD ST Space 209
Project: CHARWOOD PARK LLC FEDERAL WAY WA 98003
Scheduled inspgctions 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.
1❑
UFER Ground (4295)
®
Ditch cover (4030)
®
Slab/Concrete Floor (4255)
Right of Way
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
4❑
Pool Bonding (4195)
®
Temporary Power (4275)
®
Service (4235)
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
I
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
®
Ceiling Cover (4020)
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
ED Final - Electrical (4055)
�---� Approved
Bjv Date
Right of Way
Final Electrical
Rough Electrical
Approved
Approved
IBY
Approved
By
Date
By
Date-
Date
4%L RECEIVED
CITY OF
Federal Way MAY 01 2018
ELECTRICAL
u , DeV opm
IT NUMBER
SITE ADDRESS '
• I ��U i
SUITE/UNIT/SPACE #
PROJECT VALUATION
� �
ASSESSOR'S TAX/PARCEL #
—7 -
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
//
C�. -K A R—VJ u o t, M (3
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME J�
PRIMARY PHONE
-
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
( )
ELECTRICAL
CONTRACTOR
NAME
PRIMARY PHONE
--cwt - `S
MAILING ADDRESS
2 is l c "'
E-MAIL
CITY
V&,_N c,,.,�
STATE
k-,^
ZIP
Sri s 77
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
PRIMARY PHONE
-
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
( )
PROJECT CONTACT
NAME
WG L - � �
PRIMARY PHONE
( 3) 250 _ tT3
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: DATE
PRINT NAME:
rs
132,, --
Bulletin
3Z,"
Bulletin #160 -April 14, 2016 Page 1 of 1 k:\Handouts\Electrical Permit Application