14-100304City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
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Elee&ical
Permit #: 14 -100304 -00 -EL
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Y _ Inspection Request Line: (253) 835-3050
Project Name: HALL
Project Address: 32027 26TH AVE SW
Project Description: Altering a circuit for furnace replacement.
Parcel Number: 873190 0330
Owner
Applicant
Contractor
GLORIA C HALL
OLSON ENERGY SERVICE (GENERAL)
OLSON ENERGY SERVICE (ELECTRICAL)
32872 8TH CT SW
4415 LEARY ST NW
OLSONES88OMT (8/2/14)
FEDERAL WAY, WA 98023
SEATTLE WA 98107
4415 LEARY ST NW
SEATTLE WA 98107
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Electrical Fixtures
Circuits - Residential ...................... 1
PERMIT EXPIRES Sunday, July 20, 2014
Permit Issued on Tuesday, January 21, 2014
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 agent: lid Date:
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rr
VeaF feral Way
PERMIT #:
14 -100304 -00 -EL
THIS CARD IS TOAIN ON-SITE *-
Construction In ection Record
INSPECTION REQUE TS: (253) 835-3050
Address: 32027 26TH AVE SW
Project: GLORIA C HALL FEDERAL WAY, WA 98023-2509
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.
0
Rough Electrical (4225)
Ceiling Cover (4020)Final
Final Electrical
Approved
- Electrical (4055)
Approved
By
Approved
Approved
By
Date
By
Date
By
Date � _ z W ' 1 $
FJ
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
ELIC'TRICAL
CITYof ����!�
Federal Way SAN 7 M4 PERMIT APPLICATION
14- C
OF FEDERAL WAY
PERMIT NUMBER j
SITE ADDRESS' 39 o a g q„,e sL,) , Feala wL-i q1a�3
SUITE/UNIT/SPACE #
PROJECT VALUATION
$ a 56 6,0
ASSESSOR'S TAR/PARCEL #
_L� v- b 3 3
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit onlyIL
V
PROPERTY OWNER
NAME
I
PRIMARY PHONE
(Z ) -33-21
MAILING ADDRESS
20
E-MAIL
tfry
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STATE
w
ZIP
FAX
NAME
PRIMARY PHONE
2ZMAII5Ln S577-
MAILING
LING ADDRESS `` j
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E-MAIL
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ELECTRICAL
CITY
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sT?�E
ZIPP)U
FAX
(f ) Z - [303
CONTRACTOR
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
NcbAe,�)
FEDERAL WAY BUSINESS LICENSE #
zO - l3 -[05312 -W-Q.
APPLICANT
NAME r
1 '�� ✓�
PRIMARY PHONE
( ) �6Z - 53772
MAILING ADDRESS
q L-< [ 5 (O✓i-r,L&
E-MAIL
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CITY
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STATE
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FAX
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PROJECT CONTACT
N
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PRIMARY PHONE
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I certify under penalty of perjury that I am the property owner or authorised 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 of and employees, upon the accuracy of the
igformation supplied to the city as apart of this application.
SIGNATURE: DATE
19 IRE FW Id
PRINT NAME: V d `A- Y� er rk.117
Bulletin #160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
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