18-102901 •
City of Federal WayFILE Permit #:18-102901Electrical-00-EL
Community Development Dept
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax(253)835-2609
Project Name: - 2Y01- TH V S` N E L S ON)
Project Address: 30521 4TH AVE SW Parcel Number: 178890 0600
Project Description: Replace existing panel with a new 200A overhead meter.
Owner Applicant Contractor
JOYCE NELSON JOHN REARDENMADSEN ELECTRIC MADSEN ELECTRIC
30521 4TH AVE SW 3939 S ORCHARD ST MADSEE•140P8(4/30/20)
FEDERAL WAY WA 98023-3912 TACOMA WA 98466 3939 S ORCHARD ST
TACOMA WA 98466
•
Additional Permit Information
Is this an Online or O.T.C.application' Yes
Alt.Serv./Feeder:0 to 200 amj 1 Circuits-Residential 5
PERMIT EXPIRES Tuesday,2 July,2019
Permit Issued on Monday,July 2,2018
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
ashington and the City of Federal Way.
Owner or age „f • Date: —l
7 �
.r. • t
• " THIS CARD IS TO REMAIN ON-SITE
"^'` Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 18 102901 00 Address: 30521 4TH AVE SW
Project: JOYCE J NELSON FEDERAL WAY WA 98023-3912
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) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date ;.By Date :j.By Date
I
® Pool Bonding(4195) 0 Temporary Power(4275) ® Service(4235)
Approved ! Approved Approved
By Date i�By Date ! By Date
0 Feeders/Sub-panels(4045) ; El Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
,
`By Date ;By Date By Date
El Final-Electrical(4055)
Approved
By (.v,04„...., Date 1._ ^-1 5t'
•
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By - Date
RECEIVED
01
cin OF
JUL 2018 ELECTRICAL
Federal Way CITY OF FEDERAL WAY PERMIT APPLICATION
COMMUNITY DEVELOPMENT
PERMIT NUMBER % _ ' 0 2 0 1 _ CL.--
SUITE/UNIT/SPACE
(/SUITE/UNIT/SPACE#
SITE ADDRESS: (..30 5 ,-- •./k-v. f'�`)
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PROJECT VALUATION ASSESS R'S TAXARCEL# CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
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PROJECT DESCRIPTION '1i Q-`) A A oV C`!'
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Detailed description of work to
be included on this permit only
AME PRIMARY PHONE
PROPERTY OWNER Ci%'c e l V �\�0 A gal)) �// - /0(7
MAILING AD KESS E-MAIL
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STATE ZI FAX
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NAME / PRIMARY PHONE
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CONTRACTORSTATE FAX i C...01.7XC= �,► �tf 66 (9s360 9 -BUY?
WA STATE CONTRACTOR'§LICENSE EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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PRIMARY PHONE
APPLICANT MAILING ADDRESS ) E-MAIL
CITY STATE ZIP FAX
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, PRIMARY PHONE
PROJECT CONTACT \j vvlQ C, ol ( )367 -)-12-7
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 sup• • • e c has a :• of this application. !
SIGNATU'4 ��2 / / ' '' - DATE 7---...2—r
PRINT N . ` t \ IN A
PERMIT CENTER+33325 8th Avenue South + Federal Way,WA 98003-6325
253-835-2607+ FAX 253-835-2609 + permitcenter@cityoffederalway.com
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application