16-102489Electrical
ay
Community & Econ. Deof Federalv. Services Permit #: 16 -102489 -00 -EL
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: (2
53) (253) 835-2607 Fax (253) 835-2609L p q (53) 835-3050
Project Name: SMOKE
Project Address: 30129 12TH AVE SW Parcel Number: 515320 0345
Project Description: Upgrade to 200 -amp service.
Owner
Al2RIican
Contractor
MICHAEL A SMOKE
BLUE RIBBON ELECTRIC INC
BLUE RIBBON ELECTRIC INC
3012912TH AVE SW
20032 82ND AVE W
BLUEREI161QN (2/28/18)
FEDERAL WAY WA 98023
EDMONDS WA 98026
20032 82ND AVE W
EDMONDS WA 98026
Additional Permit Information
Electrical Work Valuation?...................................2500 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, May 23, 2017
Permit Issued on Monday, May 23, 2016
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 G)GC Date: Sr 3
IL
CITY OF v -:.t
Federal Way
PERMIT #: 16 -102489 -00 -EL
THIS CARD IS TO ON-SITE
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
Address: 30129 12TH AVE SW
Project: MICHAEL A SMOKE FEDERAL WAY, WA 98023-3409
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)13
Ditch cover (4030)
Final Electrical
Approved
Slab/Concrete Floor (4255)
Approved
E]
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
o
Final Electrical
Approved
Right of Way
Approved
E]
Temporary Power (4275)
Service (4235)
Date
Approved
By
Date
Approved
Approved
By
Date
By
Date
By 0
vX, Date 1
0
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date a
Final - Electrical (4055)
Approved
By
Date 2
Rough Electrical
Approved
o
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
OCEIVED
MY OF A ELEC'T'RICAL
Federal Way MAY 23 2016 PERMIT APPLICATION
CITY OF FEDERAL WAY
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PERffiIT NumBER / _ _ 0 %
SITE ADDRESS: 2 I Z ve-
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PROJEEC�T VALUATION
ASSESSOR'S TAR/PARCEL R
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— — — — — — — — — —
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
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PROPERTY OWNER
NAME
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PRIMARY PHONE
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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: t!—:7DATE .�Z" ?.' 11'f-
AT.
NAME:
Bulletin #160— April 14, 2016 Page 1 of 1 k:\Handouts\Electrical Permit Application
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