13-103208r i
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax (253) 835-2609
Project Name: HANKINS
Project Address: 5104 SW 320TH ST
Project Description: 0-200 AMP panel change
Electrical
Permit #: 13 -103208 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 102103 9030
Owner
ARolicant
Contractor
BRUCE HANKINS
BRUCE HANKINS
OWNEf IS CONTRACTOR
PO BOX 23911
PO BOX 23911
FEDERAL WAY WA 98093
FEDERAL WAY WA 98093
`
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Educational o'nstotnal?.......,....... No
I hereby certify that the above information is correct and th�th nstru n -the above described property and
the occupancy and the use will be in accordance with therules ulations of the State of Washington
and the Citv al
Owner or agent &ucct L4A,kA w, %" flz Date: 77— l I — a d 13
It
CITY OF
Federal Way
PERMIT #:
Project:
• TMS CARD IS TO ON-SITE
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
13 -103208 -00 -EL Address: 5104 SW 320TH ST
BRUCE HANKINS FEDERAL WAY, WA 98023-1931
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.
Pool Bonding (4195)
Approved
By Date
Temporary Power (4275)
Approved
By Date
❑
UFER Ground (4295)Ditch
cover (4030)
By
Slab/Concrete Floor (4255)
1:1Approved
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
Approved
By Date
Temporary Power (4275)
Approved
By Date
❑
Service (4235)
Approved
By
Date
Final - Electrical (4055)
Approved
Date /7S
Feeders/Sub-panels (4045)
Rough Electrical (4225)
1:1Approved
Ceiling Cover (4020)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
Date /7S
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
r
CITY OF A
Federal Way
0
ELECTRICAL
PERMIT APPLICATION
� � 0 � �� g RECEIVED
I
PERMIT NUMBER CO
JUL 19 2013
i ,A/
SITE ADDRESS: Sl O Y SW `20 4 C - f,
/
CITY OF FEDERAL
CDS
TE/UNIT/SPACE #
PROJECT VALUATION
$ OO
ASSESSO✓R'S TAX/PARCEL #J
� � 2 _L d 3 - _I _0
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeoumer Last Name)
5'
PROJECT DESCRIPTION
Detailed description of uAork to
be included on this permit only
200 c
PROPERTY OWNER
NAME
RrUCea S
PRIMARY PRONE
(�3) Z18 - l?C 1 S
MAILING ADDRESS
P 2 3 9 11
E-MAIL
CITY
ef
'SST/ATNF
ZIP
FAX
ELECTRICAL
CONTRACTOR
NAME
PRIMARY PHONE
(
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE i EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
�3 ince Not k ;l
PRIMARY PHONE
MAILING ADDRESS
0 3 2 3911
E-MAM
CITY
STATE
ZIP
FAR
PROJECT CONTACT
NAME
13 u c e c l lv i 5
PRIMARY PHONE
( 25.3) `L I - ye 1 S
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 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.
1 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 flied against the city,
but only where such claim arises out of the reliance of the city, including its oj)icers and employees, upon the accuracy of the
information supplied to the city as apart of this application.
SIGNATURE: os*"q )icytA DATE 17 1 -2-0/3
PRINT NAME:
Bulletin #160 — January 1, 2013 Page I of 2 k:\Handouts\Electrical Permit Application