18-105392MENOM
City of Federal Way
Community Development Dept
33325 8th Ave S ith
Federal Way, WA 98003-'
Ph: (253) 8355-2607 Fax (253) 8352609
Project Name: HABITAT FOR HUMANITY
Project Address: 33317 23RD AVE SW
Electrical
Permit #:18 -105392 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 932090 1240
Project Description: Electrical work to include replacement of outlets, installation of AFCI per code, move (2) 220V
circuits and replace ventilation fan.
Owner
Applicant
Contractor
HABITAT FOR HUMANITY OF SEA
DEREK DOMINGOINFINITY ELECTRICAL
INFINITY ELECTRICAL LLC
15439 53RD AVE S STE B
LLC
INFINEL8250L (9/13/20)
TUKWILA WA
4821 HYADA BLVD NE
98188
TACOMA WA 98422
4821 HYADA BLVD NE
TACOMA WA 98422
Additional Permit information
Is this an Online or O.T.C. application? .................. Yes
Circuits - Residential 4
PERMIT EXP S Wednesday, 13 November, 2019
T"Iff-it Issued oA Tuesday, November 13, 2018
I hereby certify thate above information is rrect a t the construction on the above described property
and the occupa y and the use will be ' a ance voth the laws, rules and regulations of the State of
Was '�on a�ndthee of Federal Way. // / /
Owner or agent: Date:/l `3 l�
THIS CARD IS TO REMAIN ON-SITE "
Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERNIIT #: 18105392 00 Address: 33317 23RD AVE SW
Project: HABITAT FOR HUMANITY OF SEA FEDERAL WAY WA 98023-2809
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 insure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
El
UFER Ground (4295)
0
Ditch cover (4030)
0
Slab/Concrete Floor (4255)
Approved
Approved
Approved
By
Approved to place concrete
By
Date
By
Date
By
Date
D
Pool Bonding (4195)
0 Temporary Poorer (4275)
®
Service (4235)
Ceiling Cover (4020)
Approved
Approved
lBy
Approved
By
Date
By Date
Date
Date
n
Feeders/Sub-pmels (4045)
®
Rough Electrical (4225)e❑
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
10 Final - Electrical (4055)
Approved
By Date y
ri
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
RECEIVED
carr of NOV
13 2018 ELEC'T'RICAL
Federal Way CRY OF FEDERAL WAY PERMIT APPLICATION
COMMUNfTY DEVELOPMENT
PERMIT NUMBER
SITE ADDRESS: 3-3 31.7 3 P -y AWC W
SUITE/UNIT/SPACE #
PROJECT VALUATION
$
ASSESSOR'S TAR/PARCEL #CURRENT/PROPOSED
O (�- O - i 2- q a
USE
PROJECT NAME
(Tenant or Homeowner Last Name)
nn
AA 3 _^ ( (^T T rig F Nu riA b) --r
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
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PROPERTY OWNER
NAME
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PRIMARY PHONE
( ) -
MAILING ADDRESS
E-MAIL
CITY
STATE
I ZIP
FAX
( )
ELECTRICAL
CONTRACTOR
NAME
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PRIMARY PHONE
MAILING ADDRESS
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MAIL
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CITY
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STATE
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ZIP
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FAX
( ) -
WA ST� . E CONTRACTOR'S LICENSE #o ERPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
"L 1✓ (IU 7l"f' "Tl2 164 U�Cr
PRIMARY PHONE
MAILING ADDRESS
SAMFj AS cG�n4ti(,f2
E-MAIL
CITY
STATE
ZIP
FAX
( )
PROJECT CONTACT
NAME
PRIMARY PHONE
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 harmles City of Fe rat Way as to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and defense such claim), whic t ade by any person, including the undersigned, and filed against the city,
but only where such cla�ses out of the an
of t city, including its officers and employees, upon the accuracy of the
information supplied to t apes
a part of pplicatio
SIGNATURE:
PRINT NAME:
Bulletin # 160 —April 14, 2016 Page I of 1 k:\Handouts\Electrical Permit Application