14-105983►' Electrical
City of Federal Way
Community & Econ. Dev. Services Permit #: 14 -105983 -00 -EL
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (2
53) 835-3050
Project Name: ROUSSEAU
Project Address: 32800 29TH AVE SW Parcel Number: 894520 0680
Project Description: Rewire fire damage portion as needed and add/alter up to (4) circuits
Owner
Applican
Contractor
MICHAEL ROUSSEAU
POWER INNOVATIONS
POWER INNOVATIONS
KRISTIE ROUSSEAU
22521 1ST DR S
POWERI*917D3 (3/29/15)
32800 29TH AVE SW
BOTHELL WA 98021
22521 IST DR S
FEDERAL WAY WA 98023-2768
BOTHELL WA 98021
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Electrical Fixtures
Circuits - Residential ...................... 4 Low Voltage - Other (Residential). 1
PERMIT EXPIRES Saturday, May 16, 2015
Permit Issued on Monday, November 17, 2014
1 hereby certify that the abov information is correct and that the construction on the above described property and
the occupancy and the u will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way. �r
Owner or age Date:
A,� 1 'LA C�%
Will
CITY OF
Federal Way
PERMIT #:
• THIS CARD IS TOMAIN ON-SITE
Construction In ection Record
INSPECTION REQUE TS: (253) 835-3050
14 -105983 -00 -EL
Address: 32800 29TH AVE SW
Project: MICHAEL ROUSSEAU FEDERAL WAY, WA 98023-2768
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.
El
UFER Ground (4295)1:1
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
El
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]
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
vkj_/ Date
By
Date
` Y
o
Final - Electrical (4055)
Approved
By
\Ck__ Date
El
Rough Electrical
Approved
1:1Approved
Final Electrical
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF
Federal Way
� E&CTRICAL
PERMIT APPLIION
PERMIT NUMBER Il _ 10 -5 9 F✓ _ 0 O
NOV 17 2014
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SITE ADDRESS: a a q T W_'5j /
SUITE/UNIT/SPEC$ M
PROJECT VALUATION
ASSES,� �
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CURRENT/PROPOSED USE
_
PROD - NAME
rr
(Tenant or Homeowner Last Name)
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME II
PRIMARY PHONE
MAILINGADDR$S '�' }" 5 W /
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E-MAIL
CITY
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STATE
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ZIP `�
FAX
NAME, �//J ��y�
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MAILING ADDRESS s �"
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ELECTRICAL
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STATE
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FAX
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CONTRACTOR
WA STATE C
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TRACTO'S LICENSE # EXPIRATION DATE
J. ISG( 15
FEDERAL WAY BUSINESS LICENSE #
NAME
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PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
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PROJECT CONTACT
NAME
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PRIMARY PHON
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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 off this application.
/ - _/ V
SIGNATURE LL a/
� DATE IV
PRINT NAME:
Bulletin 4`160 — January 1, 2013 Page I of 2 k:\Handouts\Electrical Permit Application