14-103833Electrical
City of Federal ay
Community & Econ. Dev. Services Permit #: 14 -103833 -00 -EL
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: 2
Ph: (253) 835-2607 Fax (253) 835-2609 p eq (53) 835-3050
Project Name: CRELENCIA
Project Address: 34820 13TH AVE SW Parcel Number: 542242 0160
Project Description: Add circuit for A/C unit
Owner
AP lid cant
Contractor
RIZALINO C CRELENCIA
OVERLAKE ELECTRICAL INC
OVERLAKE ELECTRICAL INC
PATRICA CRELENCIA
PO BOX 40614
OVERLEI017I J (6115115)
3842013TH AVE SW
BELLEVUE WA 98015
PO BOX 40614
FEDERAL WAY WA 98023
BELLEVUE WA 98015
Additional Permit Information
Is Use Educational or Institutional?.......................No
Electrical Fixtures
Circuits - Residential ...................... 1
PERMIT EXPIRES Monday, January 26, 2015
Permit Issued on Wednesday, July 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: 7 .1" 9
THIS CARD IS TO MAIN ON-SITE ie
crn oP THIS
In ection Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 14 -103833 -00 -EL Address: 34820 13TH AVE SW
Project: RIZALINO C CRELENCIA FEDERAL WAY, WA 98023-7016
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
0
UFER Ground (4295)
0
Ditch cover (4030)11
Temporary Power (4275)11
Slab/Concrete Floor (4255)
❑
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By V4 Date i 13 ( t+
Pool Bonding (4195)
0
Temporary Power (4275)11
❑
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By V4 Date i 13 ( t+
Rough Electrical
Approved
Final Electrical
Approved
❑
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF A
Federal Way
ELECTRICAL
PERMIT APPLON
PERMIT NUMBER( JUL 3 0 2014
CITY OF FEDERAL WAY
2�Au ,.! , /
SITE ADDRESS: 7`T �Z � vv SW
SUITE/UNI E #
PROJECT VALUATION
ASSESSO 'S TAX/PARCEL #�
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
C G t q
PROJECT DESCRIPTION
A O 10 C, " (z �_Ct ' 7 A/ �-
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
6&-r- L r_N L i 1)
PRIMARY PHONE
(05,3) 370 - J 0
MAILING ADDRESS
3`Wo —13 hnvz S�
E-MAIL
CITY
STATE
ZIP
FAX
irai�fILOl. tA
%,)d3
c ) -
NAME
PRIMARY PHONE
ELECTRICAL
MAILING ADDRESS
`0� G^ q o(om-
� f r - a l.A KCZ-MAIL
e r,z;c-«�`c 40117SN .LDM
CIT
STATE
ZIP
FAX
CONTRACTOR
13�u �V�
1n�
e- l
( ) -
WA CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
,S.TTATE
OQ ULL C 1 (90 L_ Co
NAMES M
FOA-) G {
PRIMARY PHONE
( )
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
BG1,LC
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: ��� DATE
PRINT NAME:
Bulletin # 160 —January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application