14-104451City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
.Electrical
Permit #: 14 -104451 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: GARDNER
Project Address: 30052 6TH AVE SW Parcel Number: 039600 0160
Project Description: Extend wiring from existing outlets to (2) new gas fireplace inserts
Owner
An lin cant
Contractor
LEON R GARDNER
WENDY S GARDNER
AQUA QUIP (ELECTRICAL)
WENDY S GARDNER
30052 6TH AVE SW
AQUAQQ*878N2 (8/22/15)
30052 6TH AVE SW
FEDERAL WAY WA 98023-3520
730 SW 34TH ST
FEDERAL WAY WA 98023-3520
RENTON WA 98057
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Electll al Fixtures
Circuits - Residential ...................... 2
PERMIT EXPIRES Wednesday, February 25, 2015
Permit Issued on Friday, August 29, 2014
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:
THIS CARD IS TOrec�tion
ON-SITE
CITY OF
Construction InRecord
Federal Way INSPECTION REQU3) 835-3050
PERMIT #: 14 -104451 -00 -EL Address: 30052 6TH AVE SW
Project: LEON R GARDNER FEDERAL WAY, WA 98023-3520
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)
El
Slab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
Temporary Power (4275)
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
E:]
Ceiling Cover (4020)
Rough Electrical (4225)
Feeders/Sub-panels (4045)
Approved
Approved
Approved
By
Date
By
Date d w
By
Date
11
Final - Electrical (4055)
Approved
ByC
Date �,� _ 2q
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
clrY OF'AELECTRICAL
Federal Way PERMIT APPL I ION
V 16.10
PERMIT NUMBER 10
44 S( _ AUG 2 9 2014
i^TTY OF FEDERAL WAY
ADDRESS.' �l�
SITE (eTµ p YE
c�005 2
I����LLJJJJ SUITE/UNiTMCE #
PROJECT VALUATION
ASSESSOR'S TAX/PARCEL #
CURRENT/PROPOSED USE
$ -7g0f
-
PROJECT NAME
//rr
(Tenant or Homeowner Last Name)
folviol, I
X 1 i 1 --
�4 S%S • UPSt-nI�S + I�u t�fll(Z
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
Wmb'i 6AeDAJe*A_
( zu 3104 - U(dl:
MAILING ADDRESS
EMAIL
Ro5z WH AvE SO
CITY
�AL w�►1r
STATEZIP
wA
R�b2�-
FAX
NAME
g0Q1A GLA?
PRIMARY PHONE
2(oq- �3ss
MAILING ADDRESS
?X 5W 3+K 5i
EMAIL
ELECTRICAL
CITY
PP_ akr►C k)
STATEZIP
UJB
7$bs-2
PAX
( ) -
CONTRACTOR
WA STATE CONTRACTOR'S LICENSE #
AQ UA Q � A Q2J 1-_:�
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
UY CyA�.DVeiZ,
(2C6) 30 - 41v05
APPLICANT
MAILING ADDRESS
EMAIL
-10052- �T* AVE SO
14" -COOL
CITY
Ft -D Y -AL AY
STATE
2IP
FAX
-
PROJECT CONTACT
NAME
Llic�UDY ClimDUt�
PRIMARY PHONE
(2010) 34 - (4005
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:
PRINT NAME:
f)-zq))y
Bulletin #160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application