15-104720Electrical
City of Federal way Permit #: 15-1 04720 00 EL
8th
Community 8 Eev. Services
33325 8th Ave SFILE
Federal Way, WA 98003 Inspection R Line: (2
53) (253) 835-2607 Fax: (253) 835-2609 Request (53) 835-3050
Project Name: TUFF
Project Address: 29815 23RD AVE SW
Project Description: WIRE NEW ELECTRIC WATER HEATER
Parcel Number. 012103 9034
Owne
BECKY J TUFF
ARpjicant
NANCY BABST
Contractor
PROVIDENT ELECTRIC INC
DONALD TUFF
PROVIDENT ELECTRIC INC
PROVIEI103C2 (2/22/16)
30071 10TH AVE SW
17615 SE 252ND ST
PO BOX 7087
FEDERAL WAY WA 98023-2308
COVINGTON WA 98042
COVINGTON WA 98042
;Additlonat Permit Information
Is this an Online or O.T.C. application?.................Yes
hiectdcat FbItures
Circuits - Residential ...................... 1
Is Use Educational or Institutional?.......................No
PERMIT EXPIRES Monday, March 14, 2016
Permit Issued on Wednesday, September 16, 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 bei accordance witt thl IaWL rules and regulations of the State of Washington
toNrato
l Way.
Owner or agent: 0 mDate:
�FlNALED
CITY of
Federal Way
THIS CARD IS TO IN ON-SITE - v
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
PERMIT #: 15 -104720 -00 -EL Address: 29815 23RD AVE SW
Project: BECKY J TUFF FEDERAL WAY, WA 98003-4252
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.
EJ
UFER Ground (4295)Ditch
cover (40 0)
0
Slab/Concrete Floor (4255)
❑
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
EJ
Pool Bonding (4195)
1:1Approved
Temporary Power (4275)
❑
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
Date z 7
EJ
Rough Electrical
Approved
1:1Approved
Final Electrical
1:1Approved
Right of Way
By
Date
By
Date
By
Date
&CEIVED
PERMIT APPLICATION
CITY OF JUN 2 4 2016
Federal �� f PERMIT CENTER + 33325 811 Avenue South +Federal Way, WA 98003-6325
�f ay CITY OF FEDERAL WAY 253-835-2607 + FAX 253-835-2609 + permitcente aicityoffederalwa'
CD^J�S
�/J� (p
PERMIT NUMBER ! _ O �/ "'
TARGET DATE
SITE ADDRESS
Z9 90Y Z3Ro 6o:�- S C&/
SUITE/UNIT X
PROJECT VALUATION
$ 11%3-7J
ZONING
ASSESSOR'S TAIL/PARCEL -
O
— {I/Z
- -9
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING AFIRE PREVENTION
NAME OF PROJECT
1419 ez, l a IT— /
PROJECT DESCRIPTION5�
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
CITY STATE ZIP
NAME�t
M01VAat_N P(,vm isIivw
PHONE
ZS3-77a" Z�(ncu
MAILING ADDRESS
nv refL Aviz
E-MAIL
CONTRACTOR
CITY
Pv velli,
STATE
W�-
ZIP
�7Z-
AX
3-77 V -0,6316
WA STATE CONTRACTOR'S LICENSE N
MON AX `0(�,I-r0S
EXPIRATION DATE
63i z3 i70,
FEDERAL WAY BUSINESS LICENSE M
NAME
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
2IP
FAX
PROJECT CONTACT
��� � OQ�`v
PRIMARY PHONE
Kt 770_ ZYCO
MAILING ADDRESS
Z��� t r �-
EMAIL
t eir
(The individual to receive and
respond to all correspondence
CITY STATE
wu� W�A-
ZIP
Ifs7;--
FAX
zs3-77v-.0636
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5, 000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
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 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.
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 citty as a part of this application.
/ /
SIGNATURE: ' " / DATE 061 e)Yl
PRINT NAME: _
Bulletin #100 -January 29, 2016 Page I of 2 k:\Handouts\Pennit Application
A