14-105843i 1+
City of Federal Way
Community & Econ Dev Services
•
Electrical
33325 8th Ave S Permit tt. 14-105843-00-E L
Federal Way, WA 98003 inspection Request Line: (253) 835,3050Ph: (253) 835-2607 Fax: (253) 835-2809
F L LIM
Project Name: BENSON
Project Address: 1324 SW 353RD ST Parcel Number: 502860 0960
Project Description: Installation of a wall oven, 2 outlets in kitchen island and kitchen exhaust fan hood.
Owner
AU1211cant
Contractor
SURANG M BENSON
DAVID H BENSON
OWNER IS CONTRACTOR
DAVID H BENSON
1324 SW 353RD ST
1324 SW 353RD ST
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes
Is Use Educational or Institutional? ....................... No
Electrical Fixtures .
Circuits - Residential ...................... 1
PERMIT EXPIRES Saturday, May 9, 2015
Permit Issued on Monday, November 10, 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: Date: / `�0 "/ Y
CITY OF VA - -
Federal Way
• THIS CARD IS TOrection
ON-SITE
Construction In Record
INSPECTION REQU3) 835-3050
PERMIT #: 14 -105843 -00 -EL Address: 1324 SW 353RD ST
Project: SURANG M BENSON FEDERAL WAY, WA 98023-6948
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.
UFER Ground (4295)
Ditch cover (4030)
Temporary Power (4275)11
Slab/Concrete Floor (4255)
Approved
Service (4235)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
11
Temporary Power (4275)11
Right of Way
Approved
Service (4235)
Date
Approved
By
Date
Approved
By
Date
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
By
VA Date 11 2-
I
Rough Electrical
Approved
11
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF 'A
Federal Way
PERMIT NUMBER 1
NOV 10 2014
CITY OF FEDERAL WAY
CDS
ELECTRICAL
PERMIT APPLICATION
SITE ADDRESS: 3.� w 3 S--? � IWC '003
SUITE/UNIT/SPACE #
PROJECT VALUATION
TU()
ASSESSOR'S TAX/PARCEL R
-
CURRENT/PROPOSED USE
11101oY-CN �XActfIYav
PROJECT NAME
(Tenant or Homeowner Last Name)
S Q Al
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
o V40", Zl
(
PROPERTY OWNER
NAME
� C d.Q R S J M
PRIMARY PHONE
(29 ) 8 TY - 2
MAILING ADDRESS /
q � V/, 3 e--7
E-MAIL
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CITY --
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STATE
ZIP
Z2
FAX
( ) -
ELECTRICAL
CONTRACTOR
/t
u
NAME I
PRIMARY PHONE
( )
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
( ) -
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAM n
Q y(' /� �3'P��t)
PRIMARY PHONE
(2% l:?y - e77'?--
MAILING ADDRESS
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E-MAIL
phi N j.32f (3L(,' .c4
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 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
Qcit✓y as apart of this application. j
SIGNATURE: K R� t �r DATE �l U
PRINT NAME:
Bulletin
Bulletin # 160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
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