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17-105697t City of Federal Way Community Development Dept. 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 835-2607 Fax: (253) 835-2609 t • t . Electrical Permit #:17 -105697 -00 -EL 'F Inspection Request Line: (253) 835-3050 Project Name: KAKUSCHKE Project Address:9TPL SW Project Description: Remove anreplace electrical breaker box. Parcel Number: 189870 0270 Owner Applicant Contractor JAMES KAKUSCHKE JAMES KAKUSCHKE OWNER IS CONTRACTOR 31404 49TH PL SW 31404 49TH PL SW FEDERAL WAY WA FEDERAL WAY WA 98023-2003 98023-2003 Additional Permit Information Is this an Online or O.T.C. application? .................. Yes Alt. Serv./Feeder: 0 to 200 am] 1 PERMIT EXPIRES Wednesday, 28 November, 2018 Permit Issued on Tuesdav, November 28, 2017 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: ``JJ Date: �YayZ a THIS CARD IS TO REMAIN ON-SITE crrr of Federal Way Construction Inspection Record y INSPECTION REQUESTS: (253) 835-3050 a) PERMIT #: 17105697 00 Address: 40TH PL SW Project: CATHERINE KAKUSCHKE FEDERAL WAY WA 98023-2003 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. 1❑ UFER Ground (4295) El Ditch cover (4030) FAI Slab/Concrete Floor (4255) Approved Approved [By Approved to place concrete By Date By Date By Date ® Pool Bonding (4195) 0 Temporary Power (4275) ® Service (4235) Approved Approved [By Approved By Date By Date By Date 1t) Final - Electrical (4055) Approved By Date k rD — Feeders/Sub-panels (4045) ® Rough Electrical (4225)9❑ Final Electrical Ceiling Cover (4020) Approved Approved Approved By Date By Date By Date 1t) Final - Electrical (4055) Approved By Date k rD — Rough Electrical Final Electrical Right of Way Approved Approved Approved By Date I By Date By Date 40k CITY OF Federal Way RECEIVED ELECTRICAL Nov 2 2017 PERMIT APPLICATION CITY OF FEDF.PAL WAY COMMUNITY DEVELOPMENT PERMIT NUMBER _ o {Q J 7 _ SITE ADDRESS' r� �(( �I G IIS �1 5 VVV —I ITAR/PARCEL/# SUITE/UNIT/SPACE # PROJECT VALUATION $ 3d�, od ASSESSOR'S U v CURRENT/PROPOSED USE PROJECT NAME (Tenant or Homeowner Last Name) PROJECT DESCRIPTION Detailed description of work to be included on this permit only 'g- hi0 VE )' 95- A-( 4E Z- C, < A L PROPERTY OWNER NAME � ft SC PRIMARY PHONE ( 3) 7y© 2.Zq MAILING ADDRESS yo y gT1-� eL .� �AGA EMAIL r.►M�,r- , CITY ® 1L STATE7 ZIP / FAX ELECTRICAL CONTRACTOR NAME PRIMARY PHONE MAILING ADDRESS E-MAIL CITY STATE ZIP FAX WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE # APPLICANT NAME _.) i7-�� PRIMARY PHONE ( ) MAILING ADDRESS E-MAIL CITY STATE ZIP / FAX 1 ) PROJECT CONTACT NAME PRIMARY PHONE ( ) 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 suppli to the city as a part of this application. SIGNATU DATE PRINT NAM . Bulletin # 160 - April 14, 2016 Page 1 of I k:\Handouts\Electrical Permit Application