15-101269T
City of Federal way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
• Electrical
Permit #: 15 -101269 -00 -EL
C" = Inspection Request Line: (253) 835-3050
Project Name: HILLMAN
Project Address: 30006 24TH AVE SW
Project Description: Replace 200 amp panel and install 4 GFI's
Parcel Number: 893750 0190
Owner
ARRlicant
Contractor
EUGENE R IMBRO
MICHAEL HOFMANN
HI AMP ELECTRIC
30006 24TH AVE SW
HI AMP ELECTRIC
HIAMPAE942DM (3/14/14)
FEDERAL WAY WA
31919 TISCH RD S
PO BOX 196
98023-2313
ROY WA 98580
ROY WA 98580
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps (F 1
PERMIT EXPIRES Saturday, September 12, 2015
Permit Issued on Monday, March 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 be in accordance with the laws, rules and regulations of the State of Washington
and the ty of Federal Way.
Owner or agent: Dater/�
V
CITY CW
Federal Way
PERMIT #:
Project:
. THIS CARD IS TO ON-SITE
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
15 -101269 -00 -EL Address: 30006 24TH AVE SW
EUGENE R IMBRO FEDERAL WAY, WA 98023-2313
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
LIFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)Service
Slab/Concrete Floor (4255)
Approved
(4235)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
Temporary Power (4275)Service
Right of Way
Approved
(4235)
Date
Approved
By
Date
Approved
By
Date
Approved
By
Date
By
Date
By
Date
E]
0
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By
Date
Rough Electrical
Approved1:1
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
REOV ED
WY OF MAR 16 2015 EL C'T'RICAL
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
CDS
PERMIT NUMBERje�_ Z— 0— 1 -2— &— f— _ 6 �—
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SITE ADDRESS: � � lJ � 1 � ► 1 1 � J "V �� � �J� .
SUITE/UNIT/SPACE #
PROJECT VALUATION
$ .2- fk)-
ASSESSOR'S TAX/PARCEL # %
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
/n�
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
f�p,ry U
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l
PROPERTY OWNER
NAME __ 11
PRIMARY PHONE
MAILING ADDRESS
30
E-MAIL
CITY
WAy
STATE
ZIP
FAX
ELECTRICAL
CONTRACTOR
NAME/
/ /�� P/ �, & �
PRIMARY PHONE
&
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MAILING{{MWRRESS %�
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ZIP C,cJ
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WA STATE C NT CTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME V
PRIMARY PHONE
( )
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
( )
PROJECT CONTACT
NAME� - /
/ ` 1(/'✓N /
PRIMARY PHONE
(� ���) V613-
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.
M
SIGNATURE:/
PRINT NAME:
Bulletin # 160 — January 1, 2013
Page 1 of 2
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