16-102715• ,T
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2807 Fax: (253) 835-2809
Project Name: ARBUCKLE
Project Address: 31309 41ST PL SW
Project Description: Install new 200amp Panel
0 EIecfricAR
Permit #: 16 -102715 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 873199 0150
Owner
TODD & ELVIRA ARBUCKLE
A nl� icant
EMERALD STATE ELECTRIC LLC
Contractor
EMERALD STATE ELECTRIC LLC
BRUCE & LINELL ARBUCKLE
PO BOX 708
EMERASE854DB (7/20/17)
31309 41 ST PL SW
PUYALLUP WA 98371
PO BOX 708
FEDERAL WAY WA 98023-2114
PUYALLUP WA 98371
Additional Permit Information
Electrical Work Valuation?...................................2000 Is this an Online or O.T.C. application? ................. Yes
Is Use Educational or Institutional?.......................No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps (F 1
PERMIT EXPIRES Saturday, June 3, 2017
Permit Issued on Friday, June 3, 2016
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use wil in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way. h
Owner or agent: Date: ��3,o) U
,L
cmr e>F 0&
Federal Way
PERMIT M
16 -102715 -00 -EL
THIS CARD IS TO ON-SITE
Construction In ectian Record
INSPECTION REQ S: (253) 835-3050
Address: 31309 41ST PL SW
Project: TODD & ELVIRA ARBUCKLE FEDERAL WAY, WA 98023-2114
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
Final - Electrical (4055)
Approved
By Date (a
Ground
Ditch cover (
Temporary Power (4275)
Slab/Concrete Floor (4255)
Approved
Approved
0
Approved
By
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date (a
Pool Bonding (4195)
Approved
Temporary Power (4275)
Date
Approved
Right of Way
Approved
0
Approved
By
Date
Date
By
Date
Date
Rough Electrical (4225)
Feeders/Sub-panels (4045)
Approved
Approved
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date (a
Service (4235)
Approved
By
Date
Right of Way
Approved
0
Ceiling Cover (4020)
Approved
By
Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
AE ECTRI CAL
CITY of RECEIVED
Federal Way PERMIT APPLICATION
IUN o 14 2016 �% / %
CITY OF FEDERAL WAY PERMIT NUMBER f _ / O 2 -7/ -
CDS -- ------ --
SITE ADDRESS'
31�09 1415i NSo
SUITE/UNIT/SPACE #
PROJECT VALUATION
$ a000
ASSESSOR'S TAR/PARCEL #
7 3! 9_ 0! d
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
( J G IL 1
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
N E 1
PRIMARY PHONE
MAILING ADDRESS
330 Ll114 Q) SL-,�
E-MAIL
S ATE
ZIP
FAX
ELECTRICAL
CONTRACTOR
NAME
PRIMARY-
RIMARY PHO7�NE
(1,3)3) 363-53
ING ADDRESS
- o,c -70,0
E-MAIL
TY
STATE
ZIP
FAX
WA ST TE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME p
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
t )
PROJECT CONTACT
I r _
YP
t �3) 34 io �.l
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 qfty alAayart of this application.
SIGNATURE:
PRINT NAME:
Bulletin # 160 - April 14, 2016
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