14-102259i
e
4 - ,
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
FILE
Electrical
Permit #: 14 -102259 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: BURPEE
Project Address: 28715 11TH AVE S Parcel Number: 5152% 0420
Project Description: Adding/altering (2) circuits for associated masterbath remodel
Owne
A121211cant
Contractor
DENNIS R BURPEE
EAGLE ELECTRIC OF AUBURN LLC
EAGLE ELECTRIC OF AUBURN LLC
PAMELA W BURPEE
PO BOX 1422
EAGLEEA91ILC (6/6/15)'
28715 11TH AVE S
AUBURN WA 98071
PO BOX 1422
FEDERAL WAY WA 98003
AUBURN WA 98071
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Edtional or Institutional? ....................... No
Service greater than 999 Amps? .............................No fA
Circuits - Residential ...................... 2
PERMIT EXPIRES
Permit Issued i
I hereby certify that the above it
the occupancy and the use will
Owner or agent:
Gal Fbdu
It and
with tl
1, 2014
Mstruction on the above described property and
rules and regulations of the State of Washington
al way. l� C.c.
Date: Y -(/ /
CITY OF `� i
Federal Way
PERMIT #: 14 -102259 -00 -EL
Project: DENNIS R BURPEE
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
Address: 28715 11TH AVE S
FEDERAL WAY, WA 98003-3141
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.
El Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
LIFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)
lab/Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
El Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
Pool Bonding (4195)
Temporary Power (4275)
Service (4235)
Approved
Approved
Approved
By
Date
By
Date
By
Date
❑
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date -
By
V-0 Date $- 10 l y
By
Date
Final - Electrical (4055)
Approved
By
Date
El Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
cir%,'O'FBuilding Division
Federal
Way
33325 Eighth Avenue South
Federal Way, WA 98003-6325
Phone 253-835-2607 Fax 253-835-2609
CORRECTION NOTICE
IF YOU HAVE QUESTIONS CALL
(253) 835- -, b 2 -A
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.
S-1\er1L 0
DATEI INSPECTOR
DO NOT REMOVE THIS NOTICE
Page of
CITY OF
Federal Way
Priam NuxBER A _ I o `-Z 2 ✓ q _ o
ELECTRICAL
PERMIT APPLICATION
PJXEM
MAY 15 2014
SITE ADDRESS: c�— G%/
11-t 4 v e c
. e
CDS WAY
PROJECT VALUATION
ASSESSOR'S � PARCEL / � � -
2
� � � JL/1
CURRENT/PROPOSED USE
PROJECT NAME—
(Tenant or Homeowner Last Name)J
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
%f �i e
PRIMARY PHONE
{ ) _
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
( FAX
l ) -
ELECTRICAL
CONTRACTORC
NAME
PRIMARY PHONE
X30
MAILING AD�j RES3
PO 77
E-MAIL
;, j,/-,
STATE
1fe-,
ZIP
q �%1
FAX
{ ) -
WA STATF CONTRACTOR'S LICENSE N E%PIRATION DATE
FEDERAL WAY BUSINESS LICENSE t
APPLICANT
NAME
PRIMARY PHONE
)
MAILING ADDRESS
F-KAI .
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 federallaws 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 t of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city apart of this application.
SIGNATURE:
PRINT NAME:
Bulletin # 160 — January 1, 2013 Page 1 of 2 LWandoutsUectrical Permit Application