15-103384City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: HIGINBOTHAN
Project Address: 30923 36TH AVE SW
Electrical
Permit #: 15 -103384 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 058755 0470
Project Description: Addinglaltering (4) circuits for kitchen and masterbath. Adding(3) can lights and rear
deck.
Owner
Altman
Contractor
MARK HIGINBOTHAN
JAMES DORROUGH
KANON ELECTRIC
30923 36TH AVE SW
KANON ELECTRIC
KANONEI947BE (1/14/16)
FEDERAL WAY WA 98023
805 N 10TH AVE
PO BOX 1745
MILTON WA 98354
MILTON WA 98354
PERMIT EXPIREESSrday, JaQuary 9, 2016
Permit Iss Monday, JulyJL3, 2015
I hereby certify that the above i
the occupancy and the use wil
Owner or agent:
and
O�
ct and th coon on the above described property and
with the I s and regulations of the State of Washington
a Ci eral Way.
Date:
'4
CITY or
Federal Way
PERMIT #:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
15 -103384 -00 -EL Address: 30923 36TH AVE SW
Project: MARK HIGINBOTHAN FEDERAL WAY, WA 98023-2177
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 (4 5)1:1Ditch
cover (403)
Temporary Power (4275)
Slab/Concrete Floor (4255)
Approved
Service (4235)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
EJ
Pool Bonding (4195)
❑Final
Temporary Power (4275)
Right of Way
Approved
Service (4235)
Date
Approved
By
Date
Approved
By
Approved
By
Date
By
Date
By
Date
0
0
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
B� Date +� , S ��
By
Date
Final - Electrical (4055)
Approved
By
Date
EJ
Rough Electrical
Approved
❑Final
Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF V& ELECTRICAL
Federal Way PERMIT APP ION
PERMIT NUMBER 10 -j j- �� _ 00 JUL 13 2015
eft ()F Er-nFRAL AY
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SITE ADDRESS: 3 0 g 2 5 3 TY � S
B E/UNI�
it JgIIACEM
PRQ)ZCT VALUATION
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ASSESSOR'S
0 5 TARa �- = O O
y
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeoumer Last Name)
PROJECT DESCRIPTION
Detailed description of u)ork to
be included on this permit only
PROPERTY OWNER
NAME _ 'n '1�� (� -
OW
PRIIIIARY
�,�,I� c7
A /�� _ Pao4(t % 0
MAII,DIG ADDRESS
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CITY
STATE
ZIP
FAX
ELECTRICAL
CONTRACTOR(/
N
a L C-
PR MARY PHONE
(2B3(7-- 7171
G ADD 8
E-MAU,
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,
l Oft
STATE
ZIP
`q 351
FAX
- 7 ` ,?Ir
Wp STATE CONTRACTOR'S LICENSE Y EXPIRATION DATE
FEDERAL WAY BUSDIESS LICENSE •
APPLICANT
NAME
PRBIARY PHONE
( )
MAILING ADDRESS
R-MAU,
CITY
STATE
ZIP
FAS
PROJECT CONTACT
NAME
PRIMARY PHo E
96 ]
I certify under penalty of perjury that I am the property owner or authorised 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 authorised 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 -she city as a part of this aDDlication.
SIGNATURE:
PRINT
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3 Pae 1 of 2 Ul-landouts
arY, g Tlectncal Permit Application
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