14-102442Electrical
City of Federal Way
Community & Econ. Dev. Services Permit #: 14 -102442 -00 -EL
33325 8th Ave S
Federal way, WA 98003 Ins ection Re uest Line: 253 835-3050
Ph: (253) 835-2607 Fax: (253) 835-2609 P q
FILE
Project Name: GUSE
Project Address: 3616 SW 330TH ST Parcel Number: 873213 0770
Project Description: Replace 200 -amp panel and lower meter.
Additional Permit Inforinaion
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional?....................... No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps (F 1
PERMIT EXPIRES Sund
Permit Issued on Tue:
I hereby certify that the above information is correcjipj/tt
the occupancy 7�7
ill be in acco the
P
'a,_ City of
Owner or
V'/
Q
2014
fry, May 27, 20
the co c on the above described property and
nd regulations of the State of Washington
Ray.
.0
Date: 9i
Owner
ARRlicant
Contractor
NANCY GUSE
CHIN'S ELECTRIC LLC
CHINS ELECTRIC LLC
JAMES A GUSE
34102 13TH PL SW
CH NSEL908BD (1/6/16)
21901 NE 11TH ST
FEDERAL WAY WA 98023
3410213TH PL SW
SAMMANHSH WA 98074
FEDERAL WAY WA 98023
Additional Permit Inforinaion
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional?....................... No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps (F 1
PERMIT EXPIRES Sund
Permit Issued on Tue:
I hereby certify that the above information is correcjipj/tt
the occupancy 7�7
ill be in acco the
P
'a,_ City of
Owner or
V'/
Q
2014
fry, May 27, 20
the co c on the above described property and
nd regulations of the State of Washington
Ray.
.0
Date: 9i
CITY OF IN�1p!
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
14 -102442 -00 -EL Address: 3616 SW 330TH ST
NANCY GUSE FEDERAL WAY, WA 98023-2633
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
By Date
❑
UFER Ground (4 5)11
Ditch cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
❑
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date
❑
Pool Bonding (4195)
El
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
Final - Electrical (4055)
Approved
By Date
❑
Rough Electrical
Approved
Approved
El
Electrical
Approved
❑
Right of Way
Approved
By
Date
By
Date
By
Date
CITY of
Federal Way
PERMIT NUMBER —/Y
RECEIVED
MAY 272014
CITY OF FEDERAL WAY
CDS
C/ 0? �y � -
ELEC'T'RICAL
PERMIT APPLICATION
SITE ADDRESS: 6 / �, c / '1 e,4-,
SUITE/UNIT/SPACE i
PROJECT VALUATION
ASSEESSOWS TAR/PARCEL 8
C)
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
J C
Ct G
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
� d
PROPERTY OWNER
NAM
P�'v
( 3P tD - PHONE
MAILING ADDRESS
E-MAM
CITY
STATE
ZIP
FAX
ELECTRICAL
CONTRACTOR
NAME
/ l d l,�n /tel'
PRIMARYPHONE
-
MAILING ADDRESSE-MAH,
102 SWl
CITY
STATE
ZIP
FAX
(25-3)2-35- 536
WA STATE CONTRACTOR'S LICENSE 8 EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE N
APPLICANT
a/'" - v
PRIMARY PHONE
(2"5-- 3 -`-:?3
MAIIdNG ADDRESS
Ski - f�5
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
DlqPRIMARY
JZ2
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 city as apart of this application.
SIGNATURE:
PRINT NAME: C I&//I/
Bulletin # 160 — January 1, 2013 Page 1 of 2 Ul-landoutsElectrical Permit Application