14-1029510 Eleci cA
City of Federal Way Permit #- 14 102951 -00 -EL
Community &Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003 25 Inspection Request Line:
Ph: (253) 835-2607 Fax: (253) 835-2609 FILE p q ( 3) 835-3050
Project Name: FEDERAL NATIONAL MORTGAGE b
Project Address: 30215 6TH AVE SW Parcel Number: 039580 0290
Project Description: Replacing panel with new 200 amp panel
Owner
A1212lican
Contractor
FEDERAL NATIONAL MORTGAGE A
ROSTIN LLC
ROSTIN LLC
350 HIGHLAND DR
7548 S 120TH ST
ROSTIL*881M7 (8/14/14)
LEWISVILLE, TX 75067
SEATTLE WA 98178
7548 S 120TH ST
SEATTLE WA 98178
Additional Permit Information
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 Tuesday, December 16, 2014
Permit Issued on Thursday, June 19, 2014
I hereby certify th the above information is correct and that the construction on the above described property and
the occupancy and se will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way..,
Owner or agent:
L-OcAd-60-4 5 -IS -C,
SVI-0 . d
-r G�Arc� w �►'Pr�l
Date: & ` o - l
THIS CARD IS TOIN ON-SITE
CITY OF Construction In ection Record
Federal Way INSPECTION REQU TS: (253) 835-3050
PERMIT #:
Project:
14 -102951 -00 -EL Address: 30215 6TH AVE SW
FEDERAL NATIONAL MORTGAGE FEDERAL WAY, WA 98023-3916
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.
Rough Electrical (4225)
Approved
By Date
Ceiling Cover (4020)
Approved
By Date
Final - Electrical (4055)
Approved
By Date
EJ
Ditch cover (4030)
Service (4235)
Electrical
Approved
Feeders/Sub-panels (4045)
E]
Approved
By
Approved
Approved
By
Date
By
Date
By
Date
Rough Electrical (4225)
Approved
By Date
Ceiling Cover (4020)
Approved
By Date
Final - Electrical (4055)
Approved
By Date
EJ
Rough Electrical
Approved
E]Final
Electrical
Approved
E]
Right of Way
Approved
By
Date
By
Date
By
Date
4
CITY OF
Federal Way
PERMIT NUMBER _
RECEIVED
f 19 2014
CITY OF FEDERAL WAY
DS
ECTRICAL
I;a 3 Z4 6 ��l I ;g I5 •
SITE ADDRESS: 3& 2- 1 % �� /L �� SVQ
SUITE/UNIT/SPACE #
PROJECT VALUATION
$ Ian
ASSESSOR'S TAX/PARCEL #_ ^ O
S 0 (�tJ
CURRENT/PROPOSED USE
PROJECT NAMEN�
(Tenant or Homeowner Last Name)
D A J L- h 0 K��&��
t' ��'S l/ 1 "
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
JAS
PRIMARY PHONE
( ) -
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
ELECTRICAL
CONTRACTOR
NAME
s v '
PRIMARY PHONE
(206 )° - 25k,?-
MAILING ADDRESS
� S t
S• C U7,
E-MAIL
Mike C dssv, ,t rete l
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
PRIMARY PHONE
( )
MAILING ADDRESS
E-MAIL
CITY
STATE
I ZIP
FAX
( )
PROJECT CONTACT
NAME
ajkc-
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 k the city as a part of this application.
SIGNATURE:
PRINT NAME:
Bulletin #160 — January 1, 2013
Pagel of 2
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k:\-Iandouts\Electrical Permit Application
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