14-102405' *Electrical
City of Commune & Econ. Dev. Services Permit #: 14 -102405 -00 -EL
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line:
Ph: (253) 835-2607 Fax: (253) 835-2609 pe q (253) 835-3050
Project Name: TEWLETON ryjzl`�0
Project Address: 32117 33RD AVE SW
Project Description: Replace 200 -amp service panel.
Parcel Number: 873190 0670
Owner
nlicant
Contractor
MARK TEMPLETON
EMERALD ELECTRIC
EMERALD ELECTRIC
32117 33RD AVE SW
14720 SE 63RD PL
EMERAEI913R2 (12/30/15)
FEDERAL WAY WA 98023-2275
BELLEVUE WA 98006
14720 SE 63RD PL
BELLEVUE WA 98006
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 Wednesday, November 19, 2014
Permit Issued on Friday, May 23, 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
d the City of Federal Way.
Owner or agent: 4Date: 5. 2 3 - 20t Y
��J
CITY OF
Federal Way
• THIS CARD IS TO MAIN ON-SITE
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
PERMIT #: 14 -102405 -00 -EL Address: 32117 33RD AVE SW
Project: MARK TEMPLETON FEDERAL WAY, WA 98023-2275
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.
UFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
1:1Approved
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
1:1Approved
Temporary Power (4275)
1:1Approved
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
By
Date _ Z�
Rough Electrical
Approved
1:1Approved
Final Electrical
1:1Approved
Right of Way —�
By
Date
By
Date
By
Date
I * s
CITY of 's MAY 2 3 2014
Federal Wcn
OF FEDERAL WAY
CDS
PERMIT NUMBER J
E&CTRICAL
PERMIT APPLICATION
SITE ADDRESS' �� � � � � 3�
• F wd 7 a�3
SUITE/UNIT/SPACE B
PROJECT VALUATION
$C)OOO
1
ASSESSOR'S TAR/PARCEL i
1-�,73_L _
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
Ti? vw (C �✓`Gi S�?�-�7
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
Z 0 O (1 C)
PROPERTY OWNER
NAME
PRIMARY PHONE
0535
MAILING ADDRESS
5 Z 117 33,E
19-KAL
CITYSTATE
�J
ZIP
x`023
FAX
( )
ELECTRICAL
CONTRACTOR
NAME
►ne.� L
PRIMARY PHONE
( Zs) y - so
MAILING ADDRESS �j
1 q 7 7,oS. 6 3`� (� "�
E-MAIL 1
` '� �. � r'� � �LS� 4"1 "",1, co
CITYQ f
S+TTAA%T�E
ZIP r
/ FAX
WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE
1�5MP C1 `11382
FEDERAL WAY BUSINESS LICENSE 9
APPLICANT
NAME� � C
PRIMARY PHONE
(yZs) 6 - 5 c) -2-0
MAILING ADDRESS
f K 7 zo
E-MAIL.
CITY Od
STATE
ZIPS
( FAX
PROJECT CONTACT
NAME,. `-1 -�
a,.- fi
PRIMARY PHONE
(253) 6`f l - 63to
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.
SIGNATURE: , / DATE
I
PRINT NAME: u ' ` "� tom'' �, T,
Bulletin # 160 — January 1, 2013 Page 1 of 2 k:\Ilandouts\Electrical Permit Application