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15-103934 A. ELECTRICAL CITY OF Federal Way PERMIT APPLICATION memo PERMIT NUMBER l _ l 9`/ - ` AUG 062015 SITE ADDRESS: �I-- WifeIWA C1reF�L WAY L ,4 7 N� YI_ACr C�� 0' .:3 CDS PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE S `Z.57C.,b , 5 L _ _ PROJECT NAME lVIZik-(14, 1 (Tenant or Homeowner Last Name) 1 (_) I�,/1IK_ PROJECT DESCRIPTION \l'A LL 1.=:C-,C-���\L- (- ` LST ''RO)C k kit--Pt- % Detailed description of work to V p\u_e ( f2\_'g_ ---i.e C=T5=PCi-N,CF S 17:::"m\-- be included on this permit only NAME PRIMARY PHONE PROPERTY OWNER ( ) - MAILING ADDRESS E-MAIL CITY STATE ZIP FAX ( ) NAME PRIMARY PHONE I LE. ---Mjc (? 53) 44- 54 5C MAILING ADDRESS E-MAIL ELECTRICAL 3 r -Q i\NIS VI, W V.1NV rb l -EL t- c, + CUM CONTRACTOR CITY STATE ZIP FAX --q-PE-12A1- VNAA IFC:Z--7) ( ) - WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# •M 1- x,`11C) 5 q / H / Ft ' ; _ ;C 3 `1L NAME PRIMARY PHONE APPLICANT MAILING ADDRESS ( ) E-MAIL CITY STATE ZIP FAX _ ( ) NAME PRIMARY PHONE PROJECT CONTACT ( ) 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 s plied to the city as a part of this application. SIGNATURE: �`��v DATE 2)\\A\5 PRINT NAME:___Z7)2\\,/ (� ."' CD l ys( . Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application • 411Electrical City Community &Federal Ded Permit #: 15-103934-00-EL Community 8 Econ.Dev.Services 33325 8th Ave S Federal Way,WA 98003 FILE Inspection Request Line: 2 Ph.(253)835-2607 Fax(253)835-2609 p q ( 53)835.3050 Project Name: KOEHNKE Project Address: 29914 2ND PL SW Parcel Number: 720530 0080 Project Description: Install electrical outlet box in fireplace for fire place gas insert Owner Applicant Contractor DEE ANN KOEHNKE DEE ANN KOEHNKE D&A ELECTRIC LLC 29914 2ND PL SW 29914 2ND PL SW DELEC*E897D5(4/5/17) FEDERAL WAY WA FEDERAL WAY WA 33410 30TH AVE SW 98023-3571 98023-3571 FEDERAL WAY WA 98023 Additional Permit Information Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No Electrical Fixtures Circuits-Residential 1 PERMIT EXPIRES Tuesday, February 2, 2016 Permit Issued on Thursday,August 6, 2015 I hereby certify that the above information is correct and that the construction on the above described property and the occupanc the use ill in accordance with the laws, rules and regulations of the State of Washington © and the City of Federal Way. Owner or agent: s Date: `C THIS CARD IS TO IN ON-SITE CITY OF '11A 41, Construction In ection Record Federal Way INSPECTION REQU TS: (253)835-3050 PERMIT#: 15-103934-00-EL Address: 29914 2ND PL SW Project: DEE ANN KOEHNKE FEDERAL WAY, WA 98023-3571 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 UFER Ground(4295) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255) Approved Approved Approved to place concrete By Date By Date By Date ♦ 0 , . * o Pool Bonding(4195) ❑ Temporary Power(4275) 0 Service(4235) Approved Approved Approved By Date By Date By Date , El Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020) Approved Approved Approved By Date By Date By Date o Final-Electrical(4055) Approved By o, Date % _`o_` E Rough Electrical Final Electrical Right of Way Approved Approved Approved By Date 1 By Date By Date