15-102598City 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: HEFFRON
Project Address: 30855 10TH AVE SW
0
~Electrical
Permit #: 15 -102598 -00 -EL
Project Description: Installation outlet for fan unit of gas fireplace insert.
Inspection Request Line: (253) 835-3050
Parcel Number: 024800 0070
Owner
ARRIIcanJ
Contractor
ANNETTE H HEFFRON
ANNETTE H HEFFRON
OWNER IS CONTRACTOR
30855 10TH SW
30855 10TH SW
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional?....................... No
Circuits - Residential ...................... 1
PERMIT EXPIRES Wednesday, November 25, 2015
Permit Issued on Friday, May 29, 2015
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:
• THIS CAIS TOrection
IN ON-SITE
CITY OF RD Construction In Record
Federal Way INSPECTION REQUE(253) 835-3050
PERMIT #: 15 -102598 -00 -EL Address: 30855 10TH AVE SW
Project: ANNETTE H HEFFRON FEDERAL WAY, WA 98023-4501
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)
Temporary Power (4275)
Slab/Concrete Floor (4255)
1:1Approved
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
0
Temporary Power (4275)
1:1Approved
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
0
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
-- Date G 2
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
VCLI
EL C''T`RICAL
CITY of MAY 2 9 2015
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
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PERMIT NUMBER _ a 15
2 S _ 0
SITE ADDRESS' (� prr�
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SUITE/UNIT/SPACE #
PROJECT VALUATION
$ t� q'y
ASSESSOR'S TAX/PARCEL #
0 0 -
CURRENT/PROPOSED USE
PROJEC NAME
(Tenant or Homeowner Last Name)"`^—�
�.'(Afltf for fan
LAY Rf�
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
Ani �e',,
H
CL
yGT I ��al
(yZ
PRIMARY PHONE
)� 2 -
MAILING
MAILING ADDRESS
30� 5
10fk Av SW
E-MAIL
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CITY
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STA E
ZIPFAX
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NAME
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MAILING ADDRESS
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E-MAIL
ELECTRICAL
CITY
STATE
ZIP
FAX
CONTRACTOR
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
CA`
PRIMARY PHONE
APPLICANT
N Vler
MAILING ADDRESS
E-MAIL
CITY
STATE
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 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:
aq i 5
Bulletin # 160 —January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
Am-�
+ CI%r of
Federal Way
RECEIV(o
AUG 13 2014
PERMIT4KPPLICATION
CITY OF FEDERAL WAY
PERMIT NUMBER -/ y _ -7S O -
TARGET DATE
SITE ADDRESS
SUITE/UNIT #
PROJECT VALUATION
ZONING
ASSESSOR'S TARUPAACEL # � � � -
TYPE OF PERMIT
BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
0� 0-
i'' ,
r i�
PROJECT DESCRIPTION
Detailed description of work to
Q L
be included on this permit only
PROPERTY OWNER
E +
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b f -D
PRIMARY PHONE
MAI ING AD RES
_ /
EMAILpyh
lu-1 j \{�.LGA
1CA`TMY,�2&rdVL'1 I
N i
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAPM f
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NLrAVIn(�
RIMARY O _I . f
MAIWG ADDRESS
E („
V' 1,%�}'•{I + (' ex
(The individual to receive and
respond to all correspondencebar"
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
Required value of $5, 000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
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.
s
SIGNATURE: � �Lr� � DATED 1 ✓ .1pi `F
PRINT NAME: L"�1 • WI o 1 0
Bulletin 4 100 - January 1, 2013 Page 1 of 3 k:\Handouts\Permit Application