12-104919City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Ele'drital
t
Permit #: 12 -1049'9 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: MCELROY
Project Address: 36806 4TH AVE SW Parcel Number: 218820 0830
Project Description: Replacing an existing 200 amp panel
Owner
Applicant
Contractor
BRAD P MCELROY
BRAD P MCELROY
BRAD P MCELROY
KAREN E MCELROY
PO BOX 23024
PO BOX 23024
PO BOX 23024
FEDERAL WAY WA 98093-0024
FEDERAL WAY WA 98093-0024
FEDERAL WAY WA 98093-0024
Additional Permit Information
Is Use Educational or Institutional?.......................No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps (F 1
PERMIT EXPIRES Saturday, April 27, 2013
Permit Issued on Monday, October 29, 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 Ci of Federal Way.
Date:
Owner or agent:
CITY OF ASP
Feddral Way
PERMIT #:
Project:
THIS CARD IS TOMAIN ON-SITE
Construction In ection Record
INSPECTION REQU TS: (253) 835-3050
12 -104919 -00 -EL Address: 36806 4TH AVE SW
BRAD P MCELROY FEDERAL WAY, WA 98023-7343
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.
Final - Electrical (4055)
Approved
By Date 1 24
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
Service (4235)
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Approved
Approved
Approved
By
ry�
Datei
)5�%
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date 1 24
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
+ ' IPA—
CITY
OF
Y ELECTRICAL
29 2012 PERMIT APPLICATION
,,-ry nF FEDERAL WAY
PROJECT NAME
(Tenant or Homeowner Last )Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
ELECTRICAL
CONTRACTOR
APPLICANT
PROJECT CONTACT
ev4
NAME
MAILING ADDRESS L /4, ,C
CITY STATE I ZIP
NAME
MAILING ADDRESS
PRIMARY PHONE
p
E-MAIL
FAX
PRIMARY PHONE
E-MAIL
CITY STATE I ZIP // FAX
1 ) —
WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE N
NAME ( PRIMARY PHONE
t ) —
MAILING ADDRESS E-MAIL
CITY STATE ZIP ( FAX
t )
NAME 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 apart of this application.
SIGNATURE / .i ' �f DATE
PRINT NAME: 13 %'~CI C '
33325 8" Avenue South ♦ Federal Way ♦ WA ♦ 98003-6325 ♦ 253-835-2607 ♦ fax: 253-835-2609 ♦ www.cityoffederalway.com
Bulletin # 160 —January 1, 2011 Page I of k:\Handouts\Electrical Permit'Application
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