13-105436Electrical
City of Federal Way Permit #: 13-105436-
00-E L
Community &Econ. ev. Services
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: 253 83
Ph: (253) 835-2607 Fax (253) 835-2609 p a 5-3050
Project Name: WESTBORO CONDOMINIUMS BUILDING 3 UNIT C
Project Address: 145 S 329TH PL Unit C Parcel Number: 928870 0510
Project Description: Modifying (2) existing circuits
Owner
Applicant
Contractor
GEOFFREY KELLY
GEOFFREY KELLY
OWNER IS CONTRACTOR
312 SW 325TH PL
312 SW 325TH PL
FEDERAL WAY WA 98023-5639
FEDERAL WAY WA 98023-5639
I hereby certify that the above information is correct and that
the occupancy and the use will be in accordance withh���
AA and 8'(��o,k
Owner or agent :��C
the above described property and
tions of the State of Washington
Date: Vic- ' " J1
AV
THIS CARD IS TO REMAIN ON-SITE
CITY OF'''~-' Construction Inspection Record
Federal Wad/ INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 13 -105436 -00 -EL Address: 145 S 329TH PL Unit C
Project: GEOFFREY KELLY FEDERAL WAY, WA 98003-6317
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
UFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)Service
Slab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
0
Pool Bonding (4195)
0
Temporary Power (4275)Service
(4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
0
0
0
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
P4 Date 17 - Cl
13
By
Date
0
Final - Electrical (4055)
Approved
By
Date
1_1Rough
Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF
Federal Way
PERMIT NUMBER I
ELECTRICAL
PER;f�WIAFPLICATION
_00 DEC 062013
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SITE ADDRESS' S 3ZJ �l CDS
1
SUITE/UNIT/SPACE i
PROJECT VALUATION
ASSESSOR'S TAX/PARCEL i r�
—0� - v_
CURRENT/PROPOSED USE
c1 raR,1i7 is L,
PROJECT NAME
Tenant or Homeowner Last Name)
"� CptjM Ut m- G
l.- V � � N�
PROJECT DESCRIPTION1�(�
Detailed description of work to
be included on this permit only
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OWNER
NPRIMARY
,L r �V`� It ¢ Lt v�4
PHONE`
`PROPERTY
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MAILING ADDRESS
3 )Z s t>3 3 L5;
E-MAIL
CITY
Re, ��h>,Lw,o
STATEZH'
w�
FAX
-
ELECTRICAL
CONTRACTOR
NAME
PRIMARY PHONE
-
MAILING ADDRESS
gMAII,
CITY
STATE
ZIP
/ FAX
1 ) -
WA STATE CONTRACTOR'S LICENSE i EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE 8
APPLICANT
NAME
PRIMARY PHONE
MAILING ADbRESS
E-MAIL
CITY
STATE
ZIP
( FAX
1 ) -
PROJECT CONTACT
N (�,11.J 1.)C �,
PRIMARY HONE
p 6 ) 2l t+- 7740
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.
SIGNATURE: fir~
PRINT NAME:
TE I %i' b ` 2a ,�!_
Bulletin # 160 —January 1, 2013 Page I of 2 k:\Handouts\Electrical Permit Application