13-100633City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2807 Fax: (253) 835-2609
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e EQctricai
Permit #: 13 -100633 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: JOHNSON
Project Address: 3914 S 322ND ST
Project Description: ADD - Installation of a new Solar PV system
Parcel Number: 236800 0025
Owner
4i uollicant
Contractor
LELAND DARRYL JOHNSON
PROSTAT ELECTRIC
PROSTAT ELECTRIC
3914 S 322ND ST
8122 NE 91ST ST
PROSTE'890ON (9/15/13)
FEDERAL WAY WA 98001
VANCOUVER WA 98662
8122 NE 91ST ST
VANCOUVER WA 98662
Is this an Online or O.T.C. application? ................. es
Service greater than 999 Amps? .............................No
Electrical Fixtures
Circuits - Residential ...................... 1
Is Use Educational or Institutional?.......................Yes
PERMIT EXPIRES Wednesday, August 7, 2013
Permit Issued on Monday, March 25, 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 Washington
and the City of Federal Way.
Owner or agent Date: ���
ti
CITY OF 49%�
Federal Waiy
PERMIT #:
Project:
• THIS CARD IS TO MAIN ON-SITE --
Construction In ection Record '
INSPECTION REQ TS: (253) 835-3050
13 -100633 -00 -EL Address: 3914 S 322ND ST
LELAND DARRYL JOHNSON FEDERAL WAY, WA 98001-9653
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.
Final - Electrical (4055)
Approved
Date
0
LIFER Ground (4295)Ditch
cover (4030)
0
Slab/Concrete Floor (4255)
Approved
0
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
Date
0
Pool Bonding (4195)
Approved
By
Date
0
Feeders/Sub-panels (4045)
Approved
By
Date
Final - Electrical (4055)
Approved
Date
0
Temporary Power (4275)
Approved
By
Date
0
Rough Electrical (4225)
Approved
By
Date
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
,By Date By Date By Date
Service (4235)
Approved
By
Date
Ceiling Cover (4020)
Approved
By
Date
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
,By Date By Date By Date
RECE D
JAN 3 0 2013
circ GF pF FEDERAL WAY
Federal W cDs
C�
ELECTRICAL
PERMIT APP IC TION
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SITE ADDRESS: <- 3
SUITE/UNPT/SPACE i
PROJECT VALUATION
ASSESSOR'S TAX/PARCEL 4
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
J
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
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PRIIfARY PHONE
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IITA')FAYE
ELECTRICAL
CONTRACTOR
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(561 171 2-
MAILING ADDRESS
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SRAL WAY SUSDPESS LICENSE f
APPLICANT
NAME /
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PRIMARY PHONE
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CITY
STATE
ZIP
FAX
PROJECT CONTACT�
NPHONE
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I certgy under penalty of perjury that I am the property owner or authorized agent of the property owner. I certVy that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I cert fij 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
v4formation supplied the city as apart of this application.
SIGNATURE: DATE
PRINT NAME: Q`
Bulletin #160 —January 1, 2013 Page 1 of 2 k.\HandoutslElcctrical Permit Application
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