12-105241} i Electrical
City of Federal Way
Commuhity & Econ. Dev. Services ```` ry Permit #. 12-105241 -00-EL
33325 8th Ave S
Federal Way, WA 98003Lz
Ph: (253) 835-2607 Fax: (253) 835-2609 ._ Inspection Request Line: (253) 835-3050
Project Name: BANUELOS '1j0 `
Project Address: 37104 3RD AVE SW Parcel Number: 218820 2975
Project Description: Meter repair to comply with violation notice #12-105020-00 VO
,Owner
A121211ican
Contractor
JULIAN BANUELOS
JULIAN BANUELOS
OWNER IS CONTRACTOR
37104 3RD AVE SW
37104 3RD AVE SW
FEDERAL WAY WA 98023-7336
FEDERAL WAY WA 98023-7336
Additional Permit Information
Is Use Educational or Institutional? ....................... No
Electrical Fixtures
Mast or Meter Repair (Residential/ 1
PERMIT EXPIRES Wednesday, May 15, 2013
Permit Issued on Friday, November 16, 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
and the City of Federal Way.
Owner or agent„ rf� Date: 1 2
1
CITY OF
Federal W1s� ay
PERMIT #:
Project:
THIS CARD IS TOMAIN ON-SITE
Construction In ection Record
INSPECTION REQUE TS: (253) 835-3050
12 -105241 -00 -EL Address: 37104 3RD AVE SW
JULIAN BANUELOS FEDERAL WAY, WA 98023-7336
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)
[3
Slab/Concrete Floor (4255)
0
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
0
Pool Bonding (4195)
0
Temporary Power (4275)
0
Service (4235)
Approved
Approved
Approved
By
Date
By
Date
By
Date
0
0
Ceiling Cover (4020)
Rough Electrical (4225)
0
Feeders/Sub-panels (4045)
Approved
Approved
Approved
By
Date
By
Date
By
Date
11 Final - Electrical (4055)
Approved
By G Date �„ 1
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF
Fefty
NOV 16 2012
0
ELECTRICAL
411?-- _ 10 5.2.4
PERMIT APPLICATION
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 taws 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 apart of this application. ) /�
SIGNATURE: DATE (� _ got
1
PRINT NAME:
33325 8h 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