15-102636City of Federal way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
0
FILE
0 � Electrical
Permit #; 15-102636-00-F L
Inspection Request Line: (253) 835,3050
Project Name: IHS PROPERTY WASHINGTON LP
Project Address: 32644 20TH AVE SW Parcel Number: 010456 0300
Project Description: alter feeder
Owner
ARRIlicant
TIMOTHY KROUSE
Contractor
KROUSE'S ELECTRIC INC
KROUSE'S ELECTRIC INC
KROUSEI853KA (5/1/17)
10741 A ST S UNIT A
PO BOX 1213
TACOMA WA 98444
ROY WA 98580
Additional -Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Alt. Serv./Feeder: 0 to 200 amps (F 1
PERMIT EXPIRES Sunday, November 29, 2015
Permit Issued on Tuesday, June 2, 2015
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 ag t: Date:
R� L
-3s
THIS CARD IS TOrectio-n
ON-SITE
C"Y OFConstruction In Record
Federral Way INSPECTION REQ3) 835-3050
.. 10
PERMIT #: Address:
Project:
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.
Prior to scheduling a Framing inspection;T
Electrical, Plumbing & Mechanical Rough in Fire/Draft Stop inspections must be signed -off approved. IBC 1093.4 `, Date h , .1 t,` I
Rough Electrical
Approved
Final Electrical
\ Approved
1:1Approved
Right of Way —�
By
Date
By 0 Date
By
Date
TRI
C C
CITY OF E AL
Federal Way PERMIT APPLICATION
P== NuMSER L
JUN 0 2 2015
8ITE ADDRESS: 33 &31e� >
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9
FEDERAL WAY
PROJECT VALUATION
ASSESSOR'S TAX/PARCEL #
CURRENT/PROPOSED USE
G S�
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRnfARY PHONE
PROPERTY OWNER
>7 ,-�
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MAILING ADDRESS
EMAIL
ar &i
CITY
ZIP
FAX
�"ATM
NAME
PRIMARY PHONE
MrA,use"s►
-
MAIIAfG ADDRESS
E-MAIL
ELECTRICAL
CITYSTATE
ZIP
`7-e5A-D
FAX
Is3) 3 - 3=> i
CONTRACTOR
WA STATE C R'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE •
D ivi l
NAME
PRD[ART PHONE
APPLICANT
1'1
) q�- 5Ll a8
WAILING ADDRESS
,E-MAIL y
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CITY
Rcu
STATE
WA
ZIP
FAX
3
PROJECT CONTACT
NAME j
dc
PRIMARY PHONE
.31-
(063) 15-S, 1 - ZRIA)
1 certgy under penalty of perjury that 1 am the property owner or authorised agent of the property owner. I cw tVy that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certVy that I wiII comply with
all applicable City of Federal Way regulations pertaining to the work authorised 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.
1 feather agree to hold harmless the City of Federal Way as to any claim (including costs, expos, and attorneiis'fess 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 kers and employees, upon the accuracy of the
Wormation supplied to the city as a part of this application.
SIQNA DATE /
PRINT NAME:' r e
Bulletin #160 —January 1, 2013 Page 1 of 2 k:llandoutsElectrical Permit Application
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