14-105020a Electrical
City ty & FedeEcon.ral Dev. S Permit �: 14 -105020 -00 -EL
CoinmUni &Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003 Ins ection Re uest Line: 253 835-3050
Ph: (253) 835-2607 Fax: (253) 835-2609 FIL p q
Project Name: GIBSON
Project Address: 32315 11TH AVE SW Parcel Number: 926493 0500
Project Description: Add/alter circuits for kitchen remodel.
Owner
Ap lip cant
Contractor
WILLIAM A GIBSON
OLIVER HERRIN
PEOPLE'S ELECTRIC LLC
LYNN D GIBSON
PEOPLE'S ELECTRIC
PEOPLEL890D1(3/21/15)
32315 11TH AVE SW
3912 N 31 ST ST
3912 N 31ST ST
FEDERAL WAY WA 98023-5555
TACOMA WA 98407
TACOMA WA 98407
Is this an Online or O.T.C. application?.................Yes
Electrical Fixtures
Circuits - Residential ...................... 7
Is Use Educational or Institutional?.......................No
PERMIT EXPIRES Sunday, March 29, 2015
Permit Issued on Tuesday, September 30, 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: / \ Date: >Z
THIS CARD IS TO IN ON-SITE
C,TMOF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 14 -105020 -00 -EL Address: 32315 11TH AVE SW
Project: WILLIAM A GIBSON FEDERAL WAY, WA 98023-5555
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
UFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)
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
❑
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
CITY OF "A
Federal Way
IVED EACTRICAL
SEP 3 ° z014 PERMIT APPLICATION
CITY OF FEDERAL WAY
PERMIT NUMBER Cif' _ U CDS` v � —L�
SITE ADDRESS: 3
SUITE/UNIT/SPACE #
PROJECT VALUATION
ASSESSOR'S TAS/PARCEL #
CURRENT/PROPOSED USE
$-
PROJECT NAME
(Tenant or Homeowner Last Name)
(5
PROJECT DESCRIPTION"'
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
T . l GJ .SJ .�
PRIMARY PHONE
( ) -
MAILING ADDRESS
-37-3(5- 1 P Ave- S LJ
E-MAIL
CITY . ` (S�TATE ZIP
V ± jt-
( FAX
( ) -
N P e -y `� n�-
(Z )�4M�ARY` l
•J
MAILING ADDRESS
W i,
E-MAIL
ELECTRICAL
CONTRACTOR
CITY
STATE
ZIP
AX
WA STATE CONTRACTOR'S LENSE # EXPIRATION DATE
V�Q
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
PRIMARY PHONE
MAILING ADDRESS
B -MAIL
CITY
STATE
ZIP
/ FAX
PROJECT CONTACT
NAME
c>\, • J er- f
PRIMARY PHONE
3) T-\ -
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: 1 DATE
PRINT NAME:
Bulletin # 160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application