14-1043431 Electrical
City & Federal Way Permit #: 14-104343-00-E L
Community Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003 FIL Inspection Request Liner 253 835-3050
Ph: (253) 835-2607 Fax: (253) 835-2609 p q
Project Name: ANDERSQN �yjrj 6�
Project Address: 30534 4TH AVE SW Parcel Number: 178890 0670
Project Description: Replace 200 amp 120/240 v panel
Owner
Applican
Contractor
JASON ANDERSON
LINDER ELECTRIC INC
LINDER ELECTRIC INC
30534 4TH AVE SW
7004 180TH AVE NE
LINDEEI426M8 (1131115)
FEDERAL WAY WA 98023
REDMOND WA 98052
7004 180TH AVE NE
REDMOND WA 98052
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Electrical Fixtures'
Alt. Serv./Feeder: 0 to 200 amps (F 1
PERMIT EXPIRES Saturday, February 21, 2015
Permit Issued on Monday, August 25, 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: / ,�'/�. m Date: -g-AS /y
CITY QF VA�'
Federal Way
PERMIT #:
Project:
THIS CARD IS TOMAIN ON-SITE
Construction MI.eciion Record
INSPECTION REQS: (253) 835-3050
14 -104343 -00 -EL Address: 30534 4TH AVE SW
JASON ANDERSON 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.
Pool Bonding (4195)
Approved
By Date
Temporary Power (4275)
Approved
By Date
UFER Ground (4295)Ditch
cover (4030)
By
Slab/Concrete Floor (4255)
1:1Approved
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
Approved
By Date
Temporary Power (4275)
Approved
By Date
Final - Electrical (4055)
Approved
By Date "
Service (4235)
Approved
By
Date
Final - Electrical (4055)
Approved
By Date "
Feeders/Sub-panels (4045)
1:1Approved
Rough Electrical (4225)
1:1Approved
Ceiling Cover (4020)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date "
Rough Electrical
Approved
1:1Approved
Final Electrical
1:1Approved
Right of Way
By
Date
By
Date
By
Date
40111k6
CITY OF r?^"°
Federal Way
PERMIT NUMBER t
ELECTRICAL
PERMIT APPL;ft"ON
AUG 2 5 2014
SITE ADDRESS:
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PROJECTVALUATIONASSESS
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TAXARCEL #
CURRENT/PROPOSED USE
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PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PRONE
PROPERTY OWNER
J4S4,h
32'- 0d L
MAILING ADDRESS
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CITY
STATE
ZIP
FAX
NAME
PRIMARY PHONE
„ E-MAIL
MAILING ADDRESS
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ELECTRICAL
CITY
STATE
ZIP
FAX
CONTRACTOR
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
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NAME
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PRIMARY PHONE
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APPLICANT
MAILING ADDRESS
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E-MAIL
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CITY
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FAX
PROJECT CONTACT
NAME
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PRIMARY PHONE
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: DATE
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PRINT NAME:
Bulletin #l60 —January 1, 2013
Page I of 2
UHandoutsTlectrical Permit Application
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