12-102823f' Electrical
City of Federal Way � D • }
Community & Econ. Dev. Services p. r ermit #. 12-
'10A23 -00 -EL
33325 8th Ave S
Federal Way, WA 98003 E
Ph: (253) 835-2607 Fax: (253) 835-2609, v Inspection Request Line:. (253) 835-3050
Project Name: GRU%IES a °! 4
Project Address: 32040 16TH PL SW Parcel Number: 010450 0780
Project Description: Replace 200 -amp panel.
Owner
Auolicant
Contractor
NANCY GRIMES
INFUSE ELECTRIC
INFUSE ELECTRIC
3710 STAR LAKE RD
25409 52ND AVE E
INFUSEI949JL (8/10/12)
AUBURN WA 98001
GRAHAM WA 98338
25409 52ND AVE E
GRAHAM WA 98338
Additional Permit information
Is Use Educational or Institutional?.......................No
Electrical Fixtures
Alt. Serv./Feeder. 0 to 200 amps (F 1
PERMIT EXPIRES Monday, December 17, 2012
Permit Issued on Wednesday, June 20, 2012
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. 1
Owner or agent: .�...-� Date: U I La `tiZ
�M��ZI�IY
THIS CARD IS TO ON-SITE
Construction In ecti4 Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 12 -102823 -00 -EL Address: 32040 16TH PL SW
Project: NANCY GRIMES FEDERAL WAY, WA 98023-5415
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.
13 Final - Electrical (4055)
Approved
By Date - Z (—
LIFER Ground (4295)
❑
Ditch cover (4030)
❑
lab/Concrete Floor (4255)
By
Approved
By
Approved
By
Approved to place concrete
By
Date
By
Date
By
Date
13 Final - Electrical (4055)
Approved
By Date - Z (—
Pool Bonding (4195)
Approved
1:1Approved
Temporary Power (4275)
Approved
Service (4235)
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Approved
0
Rough Electrical (4225)
Approved
0
Ceiling Cover (4020)
Approved
By
Date
By
Date
By
Date
13 Final - Electrical (4055)
Approved
By Date - Z (—
Rough Electrical
Approved
1:1Approved
Final Electrical
Right of Way
Approved
By
Date
By
Date
By
Date
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:
PRINT NAME:
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:\Handouts\Electrical Permit Application