18-104895City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 8352609
FILE
Project Name: ALPINE HERITAGE ADULT FAMILY HOME
Electrical
Permit #:18 -104895 -00 -EL
Inspection Request Line: (253) 835-3050
Project Address: 31224 10TH AVE S Parcel Number: 787540 0075
Project Description: Hardwiring of smoke and carbon monoxide detectors.
Owner
Applicant
Contractor
JAMES MWANTHI
JAMES MWANTHI
OWNER IS CONTRACTOR
31224 10TH AVE S
31224 10TH AVE S
FEDERAL WAY WA 98003
FEDERAL WAY WA 98003
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
Circuits - Residential 2
PERMIT EXPIRES Thursday, 17 October, 2019
Permit Issued on Wednesday, October 17, 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. �n
Owner or agent: Date: C�✓ ��
MIVAW��w
f a.
errr oW
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 18104895 00 Address: 3122410TH AVE S
Project: JAMES MWANTHI' FEDERAL WAY WA 98003-5305
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)
®
0
Ditch cover (4030)
3
Slab/Concrete Floor (4255)
Approved
Approved
Approved
1By
Approved
1BY
Approved to place concrete
By
Date
By
By
Date
By
Date
El
Pool Bonding (4195)
®
Temporary Power (4275)
®
Service (4235)
Approved
Approved
1By
Approved
By
Date
By
Date
By
Date
El
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
®
Ceiling Cover (4020)
Approved
Approved
1By
Approved
By
Date
By
Date
By
Date
0 Final - Electrical (4055)
Approved
By Date t Q
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
w
CITY OF
Federal Way
RECEIVED
OCT 17 20%
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
ELECTRICAL
PERMIT APPLICATION
PERMIT NUMBER _/_ _Z a _ ,�i - Et—
SITE ADDRESS: �1 22(.}, (0 `iH 4A/�S ' Eb&PjV ._OAV,L; A 61 SM3
SUITE/UNIT/SPACE #
PROJECT VALUATION
$ ?00 do
ASSESSOR'S TAX/PARCEL #
O _
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
/1 N��TfK� �tF{{
li
PROJECT DESCRIPTION
clvd owc. ';MO6 061A CgkAlll Wvx; (i L (JQJV 6k .
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAMEeI �,�f 1� ��
V
PRIMARY PHONE
(Zai) 32-6 - $4V,,2
MAILING ADDRESS 31 22Lf, (0 h' A4E
E-MAIL
CITY
STATE
ZIP }
( ) FAX
NAME J(-�ri1E5 M,Mw)- a TH (
PRIMARY PHONE
ELECTRICAL✓+
MAILING ADDRESS/5' ? Zq- I o /�,w 5
GG �` iG
E-MAIL
�,�ffl�C1IL-Cc
CONTRACTORCITY
P^`' I.lAy
WA -STATE
ZIP ��3
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAMEr
) o*s m. f V,�q*-ii f /
PRIMARY PHONE
( 205) I S - 056
MAILING ADDRESS
3122W (Ot'' A s
E-MAIL
AInEStx F.titt}(9 Gw�Rit.•C� r�
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME -)A.VA&S M. V tIW NTltl
PRIMARY PHONE
a(s - 4,156
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 a part of this application.
SIGNATURE:
PRINT NAME:
TE j (1O (2,018
Bulletin #160 —April 14, 2016 Page 1 of I k:\Handouts\Electrical Permit Application
CITY r
]Federal Way
RECEIVED
OCT 17 2018
CITY OF FEDERALWAY
COMMUNITY DEVELOPMENT
r , _
a
Property Owner
Electrical Work Permit Application
In Washington, only licensed electrical contractors may perform electrical work. Property owners
may apply for an exemption from these requirements by completing this application and signing
the affidavit below before beginning electrical work.
As authorized under RCW 19.28.261, 1, 5AMC—S 01' ww l R hereby apply
(Printed name ofproperty owner, renter, or lessee)
for an exemption from the electrical licensing and certification requirements of RCW 19.28 by
submission of this affidavit.
❑ I own this property.
Your name or your company's name must be shown on the deed to the property. Real estate agents' property
management companies, relatives, etc. cannot purchase permits for the property owner.
�Y I rent or lease this property.
We need a copy of your rental agreement showing you have permission to perform electrical work.
❑ I am an officer for a 501(c)(3) nonprofit corporation, or a nonprofit religious organization.
The total market value of electrical work must be $30, 000 or less and all electrical work must be done by a
non -compensated appropriately certified electrician.
❑ New single family residence that is not intended for rent, sale, or lease, where I will be living for
at least 24 months after completing the electrical work. I will be personally doing the electrical
work.
❑ New 2, 3, or 4 unit residential building, owned by me, that is intended for rent, sale, or lease. I
will be living in one of the units for at least 24 months after completing electrical work. I,
personally, and/or a regularly employed employee(s), will be doing the electricalwork.
❑ New place of business, farm, or other property: Any new structure that is not intended for rent,
sale, or lease. I, personally, and/or a regularly employed employee(s), will be doing the electrical work.
E� Existing residential property, place of business, or farm. I, personally, and/or a regularly
employed employee(s), will be doing the electrical work.
DEPARTMENT OF COMMUNITY DEVELOPMENT / 33325 8TH AVENUE SOUTH/ FEDERAL WAY, WA 98003-6325
253-835-2607 -6L www.cityoffederalway.com -rn, permitcenter(Mcityoffederalway com
Bulletin #080 — June 6, 2018 Page 1 of 2 k:\Handouts\ Property Owner £electrical Work Application
❑ 501(c)(3) or nonprofit religious organization owned property: The total market value of the
electrical work must be $30,000 or less, and all electrical work will be performed by appropriately
certified electricians, or certified and properly supervised trainees, who are volunteering and not
being compensated for the electrical work per RCW 19.28.091(7).
Four signlature;is required? below:
I believe I should be exempt from the requirements to obtain an electrical license, or use a certified
electrician, as provided under RCW 19.28.261.
By signing below, I certify the information I am providing on this affidavit is true and accurate. I
understand that if I make false statements or misrepresentations, I may be assessed penalties.
Printed Name of Prc
1 ra Z)/8
Date
, Renter, or
X^N, YUQuN
Property Owner's Name (Last, First ) or Company Name
31ZZ,4- Oto }due S 4=m— A-V- LAY
Mailing Address Unit/Apt.# City
206-3�6 $6b�
Daytime Phone Email Address
Inspection Site Address (if different)
NI.1C
County
Unit/Apt.# City
FLY -SEI swiz e1jFfly'
Electrical Power Company / Serving Utility
wA q=3
State Zip
State Zip
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DEPARTMENT OF COMMUNITY DEVELOPMENT/ 33325 8TH AVENUE SOUTH / FEDERAL WAY, WA 98003-6325
253-835-2607 2s www.cityoffederalway.com -, permitcenter@cityoffederalwa .com
Bulletin #080 — June 6, 2018 Page 2 of 2 k:\Handouts\ Property Owner Electrical Work Application