13-100217City 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: MORRIS
Project Address: 34836 11TH AVE SW
Project Description: Adding/altering (4) circuits
lelctrical
Permit #: 13 -100217 -00 -EL
Inspection Request Line: (253) 835-3050
;d7,51
Parcel Number: 542242 0710
Owner
Al2RIican
Contractor
DAVID MORRIS
DAVID MORRIS
OWNER IS CONTRACTOR
34829 11TH AVE SW
3482911TH AVE SW
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Additional -Permit information
Is this an Online or O.T.C. application?.................Yes
Electrical f=ixtures
Circuits - Residential ...................... 4
Is Use Educational or Institutional? ....................... No
PERMIT EXPIRES Sunday, July 14, 2013
Permit Issued on Tuesday, January 15, 2013
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: Date: % Ir -
tft s/I3
C1W OF
Federal Way
PERMIT #:
Project:
THIS CARD IS TOMAIN ON-SITE .`
Construction In ection Record
INSPECTION REQU TS: (253) 835-3050
13 -100217 -00 -EL Address: 34836 11TH AVE SW
DAVID MORRIS FEDERAL WAY, WA 98023-7014
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.
❑
UFER Ground (4295)
Ditch cover (4030)
E]
Slab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By - Date
Pool Bonding (4195)
❑
Temporary Power (4275)
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
0
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
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CffyOF
Federal Way
PERMIT NUMBER I _ ( J
/ _
ELECTRICAL
PERMIT APPLICATION
RECEIVED
JAN 15 2013
CITY OF
SITE ADDRESS: ' j 44- 1
FOWRA 11VAWE #
CDS
PROJECT VALUATION
ASSESSOR'S TAR/PARCEL #
CURRENT/PROPOSED USE
$-
PROJECT NAME
(Tenant or Homeowner Last Name)
'~
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
7)�4,,, L" Ir �2,T-
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY {//1/
STATE ZIP
/ FAX
NAME
PRIMARY PHONE
i
MAILING ADDRESS -
E-MAIL
ELECTRICAL
CITY
STATE
ZIP
FAX
CONTRACTOR
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
` C
PRIMARY PHONE
) -
MAILING ADDRESS
E-MAIL
CITY
STATE I
ZIP
FAX
)
PROJECT CONTACT
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 Iaws.
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 su to thtfiva part of this application.
SIGNATURE: DATE
PRINT NAME:
Bulletin # 160 — January 1, 2013 Page 1 of 2 k\Handouts\Electrical Permit Application