14-101691,I
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: AUGUSTINE
40 FILE
0 t Electrical
Permit #: 14-10691
Inspection Request Line: (253) 835-3050
Project Address: 33133 30TH AVE SW Parcel Number: 9542801000
Project Description: Installing wiring for remodeled room; reroute feeder to subpanel for hot tub. JZAa
Owner
►:A B.QI1can
Contractor
BETH E AUGUSTINE
BERQUIST ELECTRIC INC
BERQUIST ELECTRIC INC
33133 30TH AVE SW
PO BOX 1993
BERQUEI92OM5 (7/28/14)
FEDERAL WAY WA 98023
ORTING WA 98360
PO BOX 1993
ORTING WA 98360
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 Hot Tub .......................................... 1
PERMIT EXPIRES Saturday, October 11, 2014
Permit Issued on Monday, April 14, 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: Date:
fqt4ALED
CITY OF
Federal C,14
THIS CARD IS TO MAIN ON-SITE
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
PERMIT #: 14 -101691 -00 -EL Address: 33133 30TH AVE SW
Project: BETH E AUGUSTINE FEDERAL WAY, WA 98023-2721
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.
13
Ditch cover (4030)
1
Pool Bonding (4195)
Final Electrical
Approved
Service (4235)
R
Approved
By
Approved
Approved
By
Date
By
Date
By
Date
0 Feeders/Sub-panels (4045) 0 Rough Electrical (4225) Ceiling Cover (4020)
Approved Approved Approved
By Date Date— l5 — ( By Date
13 Final - Electrical (4055)
Approved
By lk� Date
AM -
Rough Electrical
Approved
Final Electrical
Approved
R
Right of Way —�
Approved
By
Date
By
Date
By
Date
CITY OF FEDERAL WAY
PERMITNumBER�� _ -LL S_�2 ql
SITE ADDRESS: S� -33
S A- Ave— S t,J
SUITE/UNIT/SPACE #
PROJECT VALUATION
ASSESSOR'S TAR/PARCEL #
CURRENT/PROPOSED USE
— — — —
—
— — —
PROJECT NAME
—
(Tenant or Homeowner Last Name)
r
PROJECT DESCRIPTION
f �'
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
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PRIMARY PHONE
MAILING ADD
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CITY
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STATE
ZIP
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FAX
NAME
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CONTRACTOR
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STATE
ZIP
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FAX
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WA STATE CO CTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
APPLICANT
( )
MAILING ADDRESS
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CITY
STATE
ZIP
FAX
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PROJECT CONTACT
NAME
PRIMARY PHONE
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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
construction or environmental laws.
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
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:
PRINT NAME:
Bulletin # 160 —January 1, 2013 Pagel of 2 kMandoutsTlectrical Permit Application