12-103264City of Federal Way
40 Electrical
P 't #• 12-103264-00-m
Community & Econ. Dev. Sernces IL; rRIX
>1
33325 8th Ave S +
Federal Way, WA 98003 . I. 14 Inspection Request Line: (253) 835-3050
Ph: (253) 835-2607 Fax (253) 835-2609
Project Name: ISM
Project Address: 33007 11TH AVE SW
Project Description: Addinglaltering up to (4) circuits
Parcel Number: 926495 0180
Owner
Applican
Contractor
JOHN H KIM
D & A ELECTRIC LLC
D & A ELECTRIC LLC
33007 11TH AVE SW
33410 30TH AVE SW
DELEC°E897D5 (4/24/13)
FEDERAL WAY WA
FEDERAL WAY WA 98023
33410 30TH AVE SW
FEDERAL WAY WA 98023
Additional Permit Information
Is Use Educational or Institutional?.......................No
Electrical Fixtures
Circuits - Residential ...................... 2
PERMIT EXPIRES Saturday, January 12, 2013
Permit Issued on Monday, July 16, 2012
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and: will b� in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent:
Date: ( /& /
THIS CARD IS TO MAIN ON-SITE
crrY OF Construction In ection Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #:
12 -103264 -00 -EL
Address: 33007 11 TH AVE SW
Project: JOHN H KIM FEDERAL WAY, WA 98023-5335
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE TMS 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
Dat
❑
UFER Ground (4295)
Ditch cover (4030)
❑
hiab/Concrete noor (,
Service (4235)
Approved
I
I
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
Dat
❑
Pool Bonding (4195)
❑
Temporary Power (4275)
Service (4235)
Right of Way
Approved
Date
Approved
Date
Approved
By
Date
By
Date
By
Date
El
Ceiling Cover (4020)
Rough Electrical (4225)
Feeders/Sub-panels (4045)
Approved
Approved
Approved
By
Date
By
Date c� _ 3 _ 2
By
Date
Final - Electrical (4055)
Approved
Dat
❑
Rough Electrical
Approved
❑
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
CITY OF
FIR
JUL 16 2012
is
ELECTRICAL
4�z - ( C) 3-z a4
PERMIT APPLICATION
CITY OF FEDERAL electrical permits may be obtained on-line at www.cityoffederalway.com"
I certVy under penalty of pedurg 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. Z certVy that Z 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.
Z 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 jiled against the city.
but only where such claim arises out of the reliance of the city. including its offtcers and employees, upon the accuracy of the
information as a part of this application.
)
SIGNATIIRE: DATE �—Z6 /
I+1tnvT NAM: a4
/ S ton ,� /Z
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 1 of 2 k:\Iandouts\Electrical Permit Application
PROPERTY D'ORMATION
SITE ADDRESS: 3300-7 1 1 +h- A uU S W
SUITE/11NIT/SPACE #
ASSESSOR'S TAX/PARCEL #
�i 2- L4 S 0 t
CIIRRENT/PROPOSED USE
eu,L
T -PROJECT iNFOkMATION
PROJECT NAME
(Tenant or Homeowner Last Name)
�t n
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
5
PEOPL
PROPERTY OWNER
NAME
"ID H N k- l M
PRIMARY PHONE
( ) -
MAILING ADDRESS
E MAII.
CITY
STATE
ZIP
FAX
ELECTRICAL
CONTRACTOR
a
NAMEPRIMARY
PHONE
MAIIMG ADDRESS
E-MAIL
Cry
ST'AT'E
zip
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
;Son K 5
PRIMARY PHONE
( )
MAUMGADDRESSS
E -MAD.
J l ✓�[ CCK t
PL
9 9-3 6 6
( 1 FAZ
I
PROJECT CONTACT
r
6L�)'_S00
PRIMARY PHONE
(3(00 R S- 2�
I certVy under penalty of pedurg 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. Z certVy that Z 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.
Z 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 jiled against the city.
but only where such claim arises out of the reliance of the city. including its offtcers and employees, upon the accuracy of the
information as a part of this application.
)
SIGNATIIRE: DATE �—Z6 /
I+1tnvT NAM: a4
/ S ton ,� /Z
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 1 of 2 k:\Iandouts\Electrical Permit Application