18-104969t n' '
Electrical
City ofFed" Way Permit #:18 -104969 -00 -EL
Community Development Dept.
33325 8th Ave S
Federal way, WA 98003 Inspection Request Line: (253) 835-3050
Ph: (253) 8355-2607 Fax (253) 835-2609
Project Name: BELMOR MOBILE PARK LOT 133
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 (Residem 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
Washington and the City of Federal Way.
1;11Owner or agent: Date:
THIS CARD IS TO REMAIN ON-SITE
��� THIS
Inspection Record
Fec: ral Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 18104969 00 Address: 2101 S 324TH ST Space 133
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 TRIS 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
LIFER Ground (4295)
0
Ditch cover (4030)
®
®
Slab/Concrete Floor (4255)
Approved
Approved
Approved
Approved
Approved
By
Approved to place concrete
By
Date
By
Date
By
Date
®
Pool Bonding (4195)
0
Temporary Power (4275)
®
®
Service (4235)
Approved
Approved
Approved
Approved
Approved
By
Approved
By
Date
By
Date
By
Date
7❑
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
®
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
10 Final - Electrical (4055)
Approved
By Date `
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
CITY OF 4A
Federal Way
RECEIVED
ELECTRICAL
OCT 2 2 2018 PERMIT APPLICATION
CITY OF FEDERAL WAY
COMMUNfTY DEVELOPMENT
PERMIT NUMBER _Z _ v _
SITE ADDRESS: / r
/v/ S' 3�'V s1� I�rCrt✓y� We, `
SUITE/UNIT/SPACE #
I33
PROJECT VALUATION
$ C) �
PROJECT NAME
(Tenant or Homeowner Last Name)l
ASSESSOR'S TAR/PARCEL #
�� l U `�- 1 O 3 -
CURRENT/PROPOSED USE
%
l 11 U✓� ✓E' � 3 3
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
fir 4 -r 'j— GW L1012 *
PROPERTY OWNER
NAM
-:F-W"4cv- �lorC
PPJMARY PHONE
(2-o� )6'730 -037
MAILING ADDRESS
E.MAiL
CITY
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STATE
6ti�
ZIP
GX�
FAX
( ) '
ELECTRICAL
CONTRACTOR
oZ3 O 4 l �j �
NAME
PRIMARY PHONE
:3 7V -0O3 --0
MAILING ADDRESS
12D 5
E-MAIL
CITY
1I",
STATE
Svc,
ZIP
9bo.3:
FAX
( )
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
y
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
PRIMARY PHONE
( )
MAILING ADDRESS
E-MAIL
CITYSTATE
ZIP
FAX
PROJECT CONTACT
NAM
1 L L c st
PRIMARY PHONE
zt,� 3v - O 2
1 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 authorised 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 held harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and dSfense 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
& formation supplied to the city as a part of this application.
SIGNATURE:�� ��C--� DATFi�� U 4C --
PRINT NAME.• MIC / *'r-/ L t / c It se y
Bulletin # 160 — April 14, 2016 Page 1 of 1 k: flandouts0ectrical Permit Application