13-103853 CITY OF REA' ''D`'����TRICAL
Federal WayPERMIT APPLICATION
/ _3- / 0 3 F 3 - E__(___ SEP 03 Z013
PERMIT NUMBER 1 3 - / O I L7 a - 0 CITY OF FEDERAL WAY
/ / V CDS
SITE ADDRESS: 30 /6 < 1,i 3 3b-t-u, p`/" I`1 /e (/p SUITE/UNIT/SPACE#
,.
VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
500 ) 6' 6' L 0 - 0 G-, / O lOi
PR 6'+ - •.r,
(Tenant or Homeowner Last Name) C./ 1(-a ✓^
PROJECT DESCRIPTION 1 il s 40 II IU w Pct 0 I
Detailed description of work to
be included on this permit only
NAMEPRIMARRYY PHONE
J`
PROPERTY OWNER f' A eye, C- t C/Ci,I�y/ (,ZS-) ,?,S6 003c
MAILING ADD ✓ E-MAIL
3016 s iv 3 OutL, PZ,
-61 (A)0 STATETY Aiq1>b�3 ( ) FAX
NAME / PRIMARY PHONE
SG/t1, ( ) _
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
( ) -
WA STATE CONTRACTOR'S LICENSE A EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE N
/ /
NAME PRIMARY PHONE
APPLICANT ' l ( ) -
MAILING ADDRESS E-MAIL -
CITY STATE ZIP FAX
( ) -
NAME PRIMARY PHONE -
PROJECT CONTACT S Ci YYL {j ( ) -
I certify 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,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 part of this application.
J Q
SIGNATURE: DATE Q /
PRINT NAME: ✓ c-/-z'tOA r l eV ,
Bulletin#160—January 1,2013 Page 1 of 2 k:'Handouts\Electrical Permit Application
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
F
Electrical
Permit #: 13 -103853 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: CLEARY
Project Address: 3016 SW 300TH PL Parcel Number: 416660 0210
Project Description: Installation of new panel, electrical work for addition and remodel.
Owner
ARRlicant
Contractor
STEPHEN J CLEARY
STEPHEN J CLEARY
OWNER IS CONTRACTOR
3016 300TH PL SW
3016 300TH PL SW
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Electrical Fixtures-
Alt
ixturesAlt. Serv./Feeder. 0 to 200 amps (F 1 A >/
PERMIT EXPIRES Search 2, 2014
Permit Issued on Tuesda eptember 3, 2013
I hereby certify that the above information is correct an at the
the occupancy and the use will De inja ccordance wi a laws,
.� and theCitv of Feder
Owner or agent:
<4;
truction on the above described property and
and regulations of the State%Washington
yDate:U
THIS CARD IS TO REMAIL ON-SITE
CITY of
Construction Inspection Record
Federal Wad/ INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 13 -103853 -00 -EL Address: 3016 SW 300TH PL
Project: STEPHEN J CLEARY FEDERAL WAY, WA 98023-2327
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
UFER Ground (4295) 0 Ditch cover (4030)Slab/Concrete Floor (4255)
Approved Approved ] Approved to place concrete
By C Date — — / 3 By V-46Date j b' 2� I' y yr Date 7 2
-lk ROVA%V-Vd CC,41 F;r rA&VrAg{ "PVTV Q C3•� 4'tluv �v�s�O�c�lw.
Pool Bonding (4195)0
Temporary Power (4275)
Final Electrical
Approved
Service (4235)
Right of Way
Approved
Approved
Date
Approved
By
Date
Approved
By
Date
f
By
Date
By
Date
By
( Date 2.12,V1
E]
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
c.J Date
By
µ,4 Date '1
Ct
zr
By
Date
Final - Electrical (4055)
Approved
By
Date
-lk ROVA%V-Vd CC,41 F;r rA&VrAg{ "PVTV Q C3•� 4'tluv �v�s�O�c�lw.
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
10(4 ji3 Vu 15 Ffw+ia 1 Pass - l-eiv Powee - Pv-e Go v►s
A
CITY OF Building Division
33325 Eighth Avenue South
Federal Wa Federal Way, 98003-6325
y Phone 253-835-2607 Fax
253-835-2609
CORRECTION NOTICE
IF YOU HAVE QUESTIONS CALL V"Vc4(253) 835- -I--S
WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE -INSPECTION. SEE BACK OF CARD
FOR DETAILS. NOTE: ELECTRICAL CORRECTIONS ARE REQUIRED TO BE MADE WITHIN 15 DAYS.
114
DATE INSPECTOR
DO NOT REMOVE THIS NOTICE
Page of
CITY OF Building Division
33325 Eighth Avenue South
Federal Wa Federal Way, WA 98003-6325
4:�k� y Phone 253-835-2607 Fax 253-835-2609
CORRECTION NOTICE
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i� (%v�uy.pIF YOU HAVES CALL (25, 835- '?.t, Z3
WHEN CORREVE BEEN MADE, CALL (253) 835-3050 FOR RE -INS CTION. SEE BACK OF CARD
FOR DETAILS.TRICAL CORRECTIONS ARE REQUIRED TO BE MAD ITHIN 15 DAYS.
BATE INSPECTOR
DO NOT REMOVE THIS NOTICE
1M a r,C (y�✓w c G� ( s '� b ?'IS:." b
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