18-104980Ctiry of Federal way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 836-2607 Fax (253) 8355-2609
Project Name: BELMOR MOBILE HOME PARK SPACE 106
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Electrical
Permit #:18 -104980 -00 -EL
Inspection Request Line: (253) 835-3050
Project Address: 2101 S 324TH ST Parcel Number: 162104 9037
Project Description: Installation of heat pump disconnect and low -voltage wiring.
Owner
Applicant
Contractor
BELMOR MOBILE HOME PARK LP
MICHAEL L ERICKSON (GENERAL)
MICHAEL L ERICKSON (ELECTRICAL)
2101 S 324TH ST
26834 MILITARY RD S
MICHAE•837KD (5/4/19)
FEDERAL WAY WA 98003
KENT WA 98032
26834 MILITARY RD S
KENT WA 98032
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
Circuits - Residential 1 Low Voltage - Other (Resident 1
PERMIT EXPIRES Tuesday, 22 October, 2019
Permit Issued on Monday, October 22, 2018
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
Washin n radty of Federal Way.
Owner or agent: Date:
THIS CARD IS TO REMAIN ON-SITE
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Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 18104980 00 Address: 2101 S 324TH ST Space 106
Project: BELMOR MOBILE HOME PARK LP FEDERAL WAY WA 98003
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
UFER Ground (4295)
F31
Ditch cover (4030)
®
Slab/Concrete Floor (4255)
Approved
1BY
Approved
1BY
Approved to place concrete
By
Date
By
Date
By
Date
0
Pool Bonding (4195)
F11
Temporary Power (4275)
0
Service (4235)
Approved
1BY
Approved
1BY
Approved
By
Date
Date
By
Date
El
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
0
Ceiling Cover (4020)
Approved
1By
Approved
1By
Approved
By
Date
Date
By
Date
1� Final - Electrical (4055)
Approved
By Date 1
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
CITY OF
Federal Way
RECEIVED
OCT 2 2 2018
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
ELECTRICAL
PERMIT APPLICATION
PERMIT NUMBER
SITE ADDRESS: /v r s s 1- rTC�T�tiI I�G,�
SUITE/UNIT/SPACE #
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PROJECT VALUATION
PPROJECTVALUATION
$ 7�/ O
/TAR/PARCEL # A
ASSESSOR'S`//i
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
1
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME `
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PRIMARY PHONE
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MAILING ADDRESS
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ZIP
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NAME
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PRIMARY PHONE
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ELECTRICAL
CONTRACTOR
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ZIP
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FAX
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WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
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FEDERAL WAY BUSINESS LICENSE #
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NAME
PRIMARY PHONE
APPLICANT
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STATE
ZIP
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PROJECT CONTACT
NAME
PRIMARY PHONE
I certib 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 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, andfiled 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 assaapart of this application.
SIGNATURE:�'—� / DATE .;?y Oe 7—
PRINT NAME:_nlebr,X5-c+,
Bulletin # 160 — April 14, 2016 Page 1 of l kAHandouts0ectrical Permit Application