12-10291041ectrical
City of Federal Way Permit #: 12- 102910- 00-E L
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: 253 835050
Ph: (253) 835-2607 Fax: (253) 835-2609 p G
Project Name: WHITE '�1
Project Address: 30212 24TH AVE SW Parcel Number: 893750 0130
Project Description: Upgrade electrical service to 200 -amp.
Owner
ARRIican
Contractor
HOWARD H WHITE
HELMAN ELECTRIC
HELMAN ELECTRIC
30212 24TH AVE SW
18328 129TH PL
HELMAE'906BG (3/12/14)
FEDERAL WAY WA 98023-2314
BOTHELL WA 98011
18328 129TH PL
BOTHELL WA 98011
Additional Permit Information
Is Use Educational or Institutional? ....................... No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps (F 1
PERMIT EXPIRES Saturday, December 22, 2012
Permit Issued on Monday, June 25, 2012
I hereby certify that the information is correct and that the construction on the above described property and
the occupancy an a usq w I be in a ordanc i the laws, rules and regulations of the State of Washington
a e/ ty of Federal Way.
owner or age '`` l /`'�� �� Date: C �— 2�7/ �L
e012*112.
d
OF
CITY
tay
PERMIT #:
Project:
. THIS CARD IS TOMAIN ON-SITE
Construction In ection Record
INSPECTION REQUE TS: (253) 835-3050
12 -102910 -00 -EL Address: 30212 24TH AVE SW
HOWARD H WHITE FEDERAL WAY, WA 98023-2314
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.
E]
LIFER Ground (4295)
Ditch cover (4030)
❑
Slab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
pproved
Date -moi
❑
Pool Bonding (4195)
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)
pproved
Date -moi
❑
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF -ws'
Feder ELECTRICAL
G
yti%P, PERMIT APPLICATION
\ �+e\-
*
t electrical permits maybe obtained on-line at www .cityo ederalway.com**
A
SITE ADDRESS:
,/lJ L C T G<-
SUITE/UNIT/SPACE #
ASSESSOR'S TAX/PARCEL # CURRENT/PROPOSED USE
PROJECT NAME
" ff
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
.
<-
Detailed description of work to
be included on this permit only
NAME ,1
PRIMARY PHONE
PROPERTY OWNER
' ` C 1 'rr , 1
-
MAILING ADDRESS
\J
E-MAIL
CITY
STATE
ZIP
FAX
NAME R
I \ T \
PRIMARY PHONE
MAILING ADDRESS t
E -MAH,
ELECTRICAL
CONTRACTOR
CITY ._.� _
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME ;
PRIMARY PHONE
APPLICANT
1
MAILING ADDRESS
E -MAH,
CITY 7STATE
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 clairN, which may be made by any person, including the undersigned, and filed against the city,
but only where such,�iTn-arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information suppliecI'to the cit* as a part of this application.
I
SIGNATURE:-''�✓l�✓ l DATE
PRINT NAME:
33325 8h 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