15-103509City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Electrical
Permit #: 15 -103509 -00 -EL
FILE Inspection
Request Line: (253) 835-3050
Project Name: GABIUELSON
Project Address: 30236 21ST AVE S Parcel Number: 798290 0100
Project Description: REP - Permit to complete work originally began under 10-104715-00 EL "Remove existing
30 space 200A panel and replace with a 40 space 200A panel to accommodate 7 new
circuits."
Owner
Au lig cant
Contractor
MICHAEL T GABRIELSON
MICHAEL GABRIELSON
MICHAEL GABRIELSON
KATRIN GABRIELSON
30236 21 ST AVE S
30236 21 ST AVE S
30236 21 ST AVE S
FEDERAL WAY WA
FEDERAL WAY WA
FEDERAL WAY, WA 98003
980034249
980034249
Additional F
Is Use Educational or Institutional?.......................No
7n iior� " •
Electrical Fixtures`
Alt. Serv./Feeder: 0 to 200 amps (F 1 Circuits - Residential... 7
PERMIT EXPI
Permit
I hereby certify that the above infor
the occupancy and the use will be
Owner or agent:
of
Amps? ............................. N o
Wesday, Janu 1 6
n Friday, July 17,
-t and that the co Fonn the above described property and
with the laws, nd regulations of the State of Washington
7%9,,City of Fede ay. '] %
1 Date: / — /7— ^
L6 -
CITY OF
Federal Way
THIS CARD IS TO REMAIN ON-SITE '
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 15 -103509 -00 -EL Address: 30236 21 STAVE S
Project: MICHAEL T GABRIELSON FEDERAL WAY, WA 98003-4249
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 (42 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
Pool Bonding (4195)
1:1Approved
Temporary Power (4275)
Service (4235)
By
Approved
By
Approved
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
B� Date ,/,
By
Date
Final - Electrical (4055)
Approved
By
Date
Rough Electrical
Approved
1:1Approved
Final Electrical
Right of Way -^
Approved
By
Date
By
Date
By
Date
CITY OF
Fed
1 4
eral Way
Building Division
333 Eighth Avenue South
Fe ral Way, WA 98003-6325
Phone 250-835-2607 Fax 253-835-2609
CORRECTION NOT17E
ADDRESS: 36231. 2tsT LSV<-• 5. PERMIT#: X453 N��- 337'. t o F3 9- - "T' e- sG7 �.Li1L 4 o1 i3S••c, k-c.A 9-1
IA yW� W`!s •� �S' LIS-i� I K �r� G�,G 33
nA N ta_- 40q--'+ - P•'.".`I <gkyl 1 L�.' r-- ; n e_A O V 4 - .
N IFL 210 • $ � (z� - I� N R�uc �I c s L � G G-va .c SL�.c�. � 1 8 c, G FL 1
*12- 5V,41%
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N 1�Z 2Sb ?1(- !a - F�td u� Vkfiu + ✓vuw� S a 11 N o �- B G
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V 14 10c i ct- '
ELI
IF YOU HAVE QUESTIONS CALL vvv4+� (253) 835- 1-W-3
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.
-3 11 e
DATE INSPECTOR
DO NOT REMOVE THIS NOTICE
Page of
CITY OF
Federal Way
PERMIT NUMBER (� _ l 0 J 0 q O
ELEC'T'RICAL
PERMIT APPIiLQ&Tjf?N
JUL 17 2015
CITY OF FEDERAL, WAy
,-
SITE ADDRESS: 3O Z�3 6
SUITE/UNI CE M
PROJECT �
3 O O I
A�ESSOI� TAX/_PAR�� � � _ iy� � O O
/� l(r��l (`/J
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION'S
Detailed description of work to
be included on this permit only
/ 0 - 10,q7 1_5_- 00 -
it
PROPERTY OWNER
NAME �/ r^ ,E� n / / �' �i /� /
�,% /ter/ /lyt/� l( -J v'V
PRIMARY PHONE
(ZOfj) �% 757
MAILING ADDRESS
3o2-3 b 2-
CITY
STATE
44
ZIP
4 V02
( FAX
c )
ELECTRICAL
CONTRACTOR
NAME S 4Z 7-
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE k EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE M
APPLICANT
NAME ' "/ �` `� ��� ✓
�Z 0 e� 143 PH7`
�T�
MAILING 2 /
E-MAIL
C��JJ /� i✓
T E
"TAPROJECT
o V
l ) FAR
CONTACT
N �l G R� F/—, 5,
�Z 06) 4/ 7PRIMARY 41%PHONE JT"7
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 applic 'on.
SIGNATURE: /46? DA %/TE /
PRINT NAME:
Bulletin # 160 —January 1, 2013 Page 1 of 2 k: llandoutsTlectrical Permit Application