12-100982 •
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City&EcoFedn.al Dev. y Permit #: 12-100982-00-E L
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: MATSUZAWA ---)2(7)6`f
Project Address: 32519 2ND AVE SW Parcel Number: 926490 1810
Project Description: Install 0-200 amp transfer switch for portable generator
Owner Applicant Contractor
KEN J&CHISATO MATSUZAWA KEN J&CHISATO MATSUZAWA KEN J&CHISATO MATSUZAWA
32519 2ND AVE SW 32519 2ND AVE SW 32519 2ND AVE SW
FEDERAL WAY WA 98023-5606 FEDERAL WAY WA 98023-5606 FEDERAL WAY WA 98023-5606
Additional Permit Information
Is Use Educational or Institutional? No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps(F 1
PERMIT EXPIRES Wednesday, August 29, 2012
Permit Issued on Friday, March 2, 2012
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
nd_the_.city of Federal Way.
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Owner or agent: /117 77//Ai � r.c-7i/ Date: 2X%61/Z
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CITY OF .-°•-
Federal Way ELECTRICAL RECEIVED
PERMIT APPLICATION MAR" 0 z 2012
**Most electrical permits may be obtained on-line at www.citco, , Y .. RAL WAY
1 _ , , pRoPERTY [ FOR ATI 'a
SITE ADDRESS: ,/ 47 r'j �� •
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SUITE/UNIT/SPACE# ASSESSOR'S TAX/PARCEL# I O CURRENT/PROPOSED USE
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PIO.J ' ItFORM&`TON ,. , , 4-
PROJECT NAME
(Tenant or Homeowner Last Name) /"a I<CL2_a lra(t
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PEOPLE
NAME PRIMARY PHONE
PROPERTY OWNER �l(�ii • !L V ( . 3) 6 - .
MAILING ADDRESS _ E-MAIL
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CITY STATE ZIP FAX
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NAME / . PRIMARY PHONE
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MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
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WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME 1 PRIMARY PHONE
APPLICANT /�7-'/, /fa %Giza,, : ( ) -
MAILING ADDRESS E-MAIL
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9/Y , / STATE ZIP FAX
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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 supplied to the city as a part of this application.
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SIGNATURE: „;. ,,T'' DATE 1 /7 y. /;L
PRINT NAME: /'�l'i'1 !`�lf tckt,2-a,L, ,
33325 8th Avenue South♦Federal Way♦WA♦98003-6325♦253-835-2607•fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160—January 1,2011 Page 1 of 2 k:\Handouts\Electrical Permit Application
THIS CARD IS TO MAIN ON-SITE
CITY OFal:444...1„4„..
YT '� Construction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 12-100982-00-EL Address: 32519 2ND AVE SW
Project: KEN J & CHISATO MATSUZAWA FEDERAL WAY, WA 98023-5606
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.
❑ UFER Ground (4295) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
o Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service (4235)
Approved Approved Approved
By Date By Date By Date
❑ Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
.
❑ Final-Electrical(4055)
Approved
B Date \-2— i- f
__ ---____
,.,
0 Rough Electrical El Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date