15-101250City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: ENGDAHL
Project Address: 30117 3RD PL SW
Project Description: Add 100v circuit for A/C unit.
0
Electrical
Permit #: 15 -101250 -100 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 259970 0030
Owner
ARplican
Contractor
SUEANN ENGDAHL
WATTS ELECTRIC SERVICE INC
WATTS ELECTRIC SERVICE INC
30117 3RD PL SW
PO BOX 46410
WATTSES1760K (12/9/15)
FEDERAL WAY WA
SEATTLE WA 98106
PO BOX 46410
98023-3907
SEATTLE WA 98106
Additional Permit Information
Is this an Online or O.T.C. application? ................. es Is Use Educational or Institutional? ....................... No
Electrical Fixtures
Circuits - Residential ...................... 1
PERMIT EXPIRES Wednesday, September 9, 2045
Permit Issued on Friday, March 13, 2015
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:
r
THIS CARD IS TO ON-SITE
CITY OF Construction In ection Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 15 -101250 -00 -EL Address: 30117 3RD PL SW
Project: SUEANN ENGDAHL FEDERAL WAY, WA 98023-3907
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)
0
Ditch cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
0
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date ` t
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
Pool Bonding (4195)
Temporary Power (4275)
0
Service (4235)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Ceiling Cover (4020)
Rough Electrical (4225)
Feeders/Sub-panels (4045)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date ` t
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF I&MAR � 3 2�
Federal Way 15
EACTRICAL
PERMIT APPLICATION
CITY OF FEDERAL WAY
PERMIT NUMBER5 e CDC
Q
F
SITE ADDRESS: -3o(17 3` �0 L
SUITE/UNIT/SPACE Y
PROJECT VALUATION
ASSESSOR'S TAS/PARCEL #
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)%
l--
- — — --
--
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
EIV6(
) -
MAILING ADDRESS
- Z 2-`" s�
E-MAIL
CITY STATE ZIP
/:iv IF 023
FAX
( ) -
NAME
C-- 15_-cXvI c_.e_
PRIMARY PHONE
X70 --*3'Y 1 1
MAILING ADDRESS
�� 44 00
E-MAIL
ELECTRICAL
CITY
STATE
FAX
2c/) 762 - 3 3S q
CONTRACTOR
WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE
f—h--m CrS7 L U 2/
FEDERAL WAY BUSINESS LICENSE M
0 sf 7 —oo_ _
APPLICANT
NAME
PRIMARY PHONE
( )
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT'
N
I
PRIMARY PHONE
(Zotp) 767
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
aII 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,
r but only wherlan—alu
arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information suity as a part of th application.
LSIGNATURE: DATE ; -13 �J
PRINT NAME: (;+u (!g ✓ 1- GW rr
Bulletin # 160 —January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application