13-104939t
r
.1 1
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: QUALLS
Project Address: 623 SW 316TH ST
Project Description: 200 amp service change
Electrical
Permit #: 13 -104939 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 072104 9195
Owner
APnlicant
Contractor
MICHAEL QUALLS
PUGET SOUND ELECTRIC COMPANY
PUGET SOUND ELECTRIC COMPANY
623 SW 316TH ST
2661 N PEARL ST SUITE 409
SO&TSE902KK (5!12/14)
FEDERAL WAY WA 98023
TACOMA WA 98407
61 N PEARL ST SUITE 409
TACOMA WA 98407
Is this an Online or O.T.C. application? .................Yes
EI
Alt. Serv./Feeder: 0 to 200 amps (F 1
PERMIT EXPIR
Permit Issued on
1 hereby certify that the above information is
the occupancy and the use will be in accor�
Owner or agent:
Is lice Uffational or Institutional? ....................... No
' aturday, 3, 2014
nday, Nov r 4, 2013
and that nstruction on the above described properly and
)h the la , rules and regulations of the State of Washington
'it ral Way.
�--- 3 Date: Z// 0 y/ L->
1
1
CITY OF
Federal Way
PERMIT #:
♦ r
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
13 -104939 -00 -EL Address: 623 SW 316TH ST
Project: MICHAEL QUALLS FEDERAL WAY, WA 98023-4635
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.
0
LIFER Ground(4295)11
Ditch cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
11 Final - Electrical (4055)
Approved
By Date
Pool Bonding (4195)
0
Temporary Power (4275)
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
11 Final - Electrical (4055)
Approved
By Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
C1W OF Building Division
33325 Eighth Avenue South
Federal Wa Federal Way, 98003-6325
4:�A�Ly Phone 253-835-2607 Fax
253-835-2609
CORRECTION NOTICE
ADDRESS: lOS3 5w 2612' St• PERMIT#: 13 - 1 - oo -15L
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IF YOU HAVE QUESTIONS CALL W -Alt
(253) 835- ZV 13
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.
it 1,1:5- ! 3
DA E
INSPECTOR
DO NOT REMOVE THIS NOTICE
Page of
QTY OF
Federal Way
PERxff NUMBER I
ELECTRICAL
\1S�l�,�t•�1��
� 4 � j9 _ M NOV 442013
CITY OF FEDERAL WAY
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SITE ADDRESS: 3 s w -3 / CO S� ,
111111���
SUITE/ PACE f
PROJECT VALUATION
$ ( ov0
ASSESSOR'S TJ 7 PAR EL f
0 7-Z2
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
CSU 4 (' N L �t
PROPERTY OWNER
NAME '
&//(/-o Qc�e e l l S
PRIMARY PHONE
(2 S) _s% - CP q q
MAILING ADDRESS
E-MAIL
CITY
STATE
ZII'
FAX
( )
ELECTRICAL
CONTRACTOR
NAME
LS -C, Liki
PRIMARY PHONE
MAIIJNG ADDRESS
i'� '���
E-MAIL
✓(� u �`•Gv-*�Pc`7�c ,
CITY
STATE
s
ZIP
I $ v
FAX
( ) -
WA STATE CONTRACTOR'S LICENSE M EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE A
APPLICANT
NAME
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PRIMARY PHONE
( )
MAILWG ADDRESS
Ce 1,-e /tr
E-MAIL
CITY
STATE
ZIP
( FAX
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PROJECT CONTACT
NAME
PRIMARY PHONE
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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 apart of this application.
D'
SIGNATURE:
PRINT NAME: C
Bulletin #160 —January 1, 2013
Page l of 2
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k:\Handouts\Electrical Permit Application
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