15-100516ay bectrical
Community ity ty & E� Dev. Services Permit #: 15 -100516 -00 -EL
33325 8th Ave S
federal way, WA 68003 Inspection Request Line: 2
Ph: (253) 835-2807 Fax (253) 835-2809 P eq (53) 835-3050
Project Name: SHERLES
Project Address: 29830 23RD. AVE SSV Parcel Number: 012103 9152
Project Description: Low voltage speaker wire
Owner
GREG SHERLES
ARgIficant
CRIMSON ELECTRIC LLC
Contractor
CRIMSON ELECTRIC LLC
2515 S 283RD PL \
1226 LOUISE CT
CRIMSEL938C2(2/22/15)
FEDERAL WAY WA 98003
ENUMCLAW WA 98022
1226 LOUISE CT
ENUMCLAW WA 98022
i4cditttt3nai Emit information
Is this an Online or O.T.C. application?.................Yes
Is Use Educational or Institutional? ....................... No
EiecWal Fixtures '
Low Voltage - Other (Residential). 1
CONDITIONS:
** Please review document in AD #13-104926 for Public Works development requirements **
PERMIT EXPIRES Sunday, August 2, 2015
Permit issued on Tuesday, February 3, 2015
I hereby certify that the above information is correct and that the construction on the above described properly and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
he City of Federal Way. r^
Owner or agent: �� Date:
FxgNALED
crrr of VA�
Federal Way
PERMIT #:
15 -100516 -00 -EL
THIS CARD IS TO ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
Address: 29830 23RD AVE SW
Project: GREG SHERLES FEDERAL WAY, WA
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CAR . 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.
❑
U Ground (4295)1:1
Ditch cover (403)
Temporary Power (4275)
lab/Concrete Floor ( 255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
❑
Pool Bonding (4195)
1:1Approved
Temporary Power (4275)
Service (4235)
By
Approved
By
Approved
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date .S
By
Date
Final - Electrical (4055)
Approved
By
V-4 Date
❑
Rough Electrical
Approved
1:1Approved
Final Electrical
Right of Way —^
Approved
By
Date
By
Date
By
Date
WEIVED !
CITY of
FEB 03 2015 ELECTRICAL
Federal Way MY OF FEDERAL WAY PERMIT APPLICATION
CDS
PERMIT NUMBER
SITE ADDRESS'Gy�(,y��
SUITE/UNIT/SPACE#
PPR06JE�-C^T--IUU<ATION
AS ESSIR'S TAX/PARCEL # - � �
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
IL° r—
PROPERTY OWNER
NAME j
�YG Sn L✓��
PRIMARY PHONE
(ZI•'�) 22 - 2-77-) -7
MAILING ADDRE1W r
Z 1 � o 22,- 106A , ,� S4/
E-MAIL
CITY / j ��r�
rz,
'^STATE
ZIP j���
FAX
ELECTRICAL
CONTRACTOR
NAME
r.i m o-�,
PRIMARY PHONE
3 �,7 - A6,
MAILING ADDRESS
122-& 4 oVi S E—
E-MAIL
CITY
STATE
ZIP
FAx
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
C wi G A G?, 2 zz / Ar -
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
I 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. j
SIGNA �� DATE
L
Z 13/
h —
PRINT NAME: d �► D -
Bulletin # 160 – January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application