14-105634P - A
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
0
Electrical
WEIVED Permit #: 14 -105634 -00 -EL
OCT 2 9 2014 Inspection Request Line: (253) 835-3050
Project Name: NIELSEN CITY OF FEDERAL WAY ,7 y
Project Address: 2809 SW 347TH ST CDS Parcel Number: 502946 0060
Project Description: 1 outdoor circuit and receptacle and 1 circuit for microwave.
Owner
RONALD SCOTT NIELSEN
ARR111cant
AZTEC ELECTRICAL SERVICES LLC
Contractor
AZTEC ELECTRICAL SERVICES LLC
KELLY NIELSEN
25314 45TH AVE S
AZTECES021DT (3/30/16)
2809 SW 347TH ST
KENT WA 98032
25314 45TH AVE S
FEDERAL WAY WA
KENT WA 98032
98023
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes
Electrical Fixtures
Circuits - Residential ........... :.......... 2
Is Use Educational or Institutional? ....................... No
PERMIT EXPIRES Monday, April 27, 2015
Permit Issued on Wednesday, October 29, 2014
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: �s•�• - Date: Z
Z34�—
[FINALED
CITY OF
Federal Way
PERMIT #:
Project:
THIS CARD IS TOMAIN ON-SITE
Construction In ection Record
INSPECTION REQUE TS: (253) 835-3050
14 -105634 -00 -EL Address: 2809 SW 347TH ST
RONALD SCOTT NIELSEN FEDERAL WAY, WA 98023-3038
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.
Final - Electrical (4055)
Approved
C Date R01 t
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
UFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)Service
Slab/Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
C Date R01 t
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
Date
By
Date
Final - Electrical (4055)
Approved
C Date R01 t
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
CITY OF
9 ELEC'T'RICAL
Federal Way CITY OF FEDERAL WAY PERMIT APPLICATION
CDS FaCEM
PERMIT xUMSER ` _ -5&3y_ 0 C T 2 9 2014
T/SPACE #
SITE ADDRESS e 0(7 CDS
PROJECT VALUATION
ASSESSOR'S TAR/PARCEL # CURRENT/PROPOSED USE
PR NAME-
Homeowner
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PROJECT DESCRIPTION
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Detailed description of work to
be included on this permit only 14
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Of my �under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
ledge, 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 supplie� a part of this application.
SIGNA
PRINT NAME:
Bulletin # 160 —January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application