14-102181City 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: LEWIS
Project Address: 828 SW 305TH ST
Project Description: Add 20 -amp circuit for septic pump.
• Electrical
Permit #: 14-102181 -00*
Inspection Request Line: (253) 835-3050
Parcel Number: 178870 0075
Owner
A nlicant
Contractor
KIMBERLY LEWIS
KIMBERLY LEWIS
OWNER IS CONTRACTOR
828 S 305TH ST
828 S 305TH ST
FEDERAL WAY WA 98023-8234
FEDERAL WAY WA 98023-8234
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes
Electrical Fixtures
Circuits - Residential ...................... 1
Is Use Educational or Institutional?.......................No
CONDITIONS:
Inspection approval is required prior to covering or concealing any portion of the septic electrical system,
including the pump. New septic & effluent tanks containing electrical wires and equipment MUST be
inspection and approved PRIOR to being loaded with sewage. (Per 296-46B-501-001(b)(7)WAC)
PERMIT EXPIRES Saturday, November 8, 2014
Permit Issued on Monday, May 12, 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 CiV Federal Way.
Owner or agent: Date: l L2- U( Y
CITY OF rMwiiw� ..
Federal Way
PERMIT #:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
14 -102181 -00 -EL Address: 828 SW 305TH ST
Project: KIMBERLY LEWIS FEDERAL WAY, WA 98023-8234
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
LIFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
0
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
0
Pool Bonding (4195)
0
Temporary Power (4275)
0
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
❑
Ceiling Cover (4020)
❑
Rough Electrical (4225)
0
Feeders/Sub-panels (4045)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date (l V 1
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
emmm 0,
Cf" Or ELECTRICAL
Federal Way MAY 12 2014 PERMIT APPLICATION
CITY OF FEDERAL WAY
PERT NWUR - l b A 18' L-1 L 15
SUITE/UNIT/SPACE #
SITE ADDRESS: � � C � � �t' �----
PROJECT VALUATION.��
s�
ASSESSOR'S TAR/PARCEL # CURRENT/PROPOSED USE
C)
— — — —
PROJECT NAME
—
(Tenant or Homeowner Last Name)
co
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
\\'�'� '� � J
PRIMARY PHONE
(zJ'J) A _ z(l CJ
MAILING ADDRESS
E-MAIL
CITY STATE ZIP
FAX
NAME
PRIMARY PHONE
(
MAILING ADDRESS
E-MAIL
ELECTRICAL
CONTRACTOR
CI'T'Y
STATE
z(P
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL, WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
APPLICANT
335- Zell O
MAILPGADDRESS
5 \
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LMAIL
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7JP`J
FAX
i
PROJECT CONTACT
NAME
�� \Z" \ Lc,-�v5
PRIMARY PHONE
(2-5.3] 335- Eck I O
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 mg knowledge, the information submitted in support of this permit application is true and correct. I certgy 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 oftkvrs and employees, upon the accuracy of the
information supplied to the city as a part of this application. „
SIGNATURE:
PRINT NAME:
Bulletin #160 — January 1, 2013 Page l of 2 k:\Handouts\Electrical Permit Application