14-103295City of Federal Way Electrical
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Community & Econ. Dev. Services Permit tf: 14 -103295 -00 -EL
33325 8th Ave S
Federal Way, WA 98003FILE
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050
Project Name: PETERSON
Project Address: 2234 S 292ND ST Parcel Number: 422290 0030
Project Description: Addinglaltering up to (4) circuits and rewire for associated bath and kitchen remodel
Additional Permit information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Electrical Fixtures
Circuits - Residential ...................... ' 4
PERMIT EXPIRES Saturday, January 3, 2015
Permit Issued on Monday, July 7, 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: -7 - 7-1
Owner
ARRlican
Contractor
ERIC M PETERSON
ERIC PETERSON
OWNER IS CONTRACTOR
2234 S 292ND ST
2234 S 292ND ST
FEDERAL WAY WA 98003-3822
FEDERAL WAY WA 98003
Additional Permit information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Electrical Fixtures
Circuits - Residential ...................... ' 4
PERMIT EXPIRES Saturday, January 3, 2015
Permit Issued on Monday, July 7, 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: -7 - 7-1
cm OF
Federal Way
PERMIT #:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
14 -103295 -00 -EL Address: 2234 S 292ND ST
Project: ERIC M PETERSON FEDERAL WAY, WA 98003-3822
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.
Pool Bonding (4195)
UFER Ground (4295)
Ditch cover (40 0)
❑
Slab/Concrete Floor (4255)
Service (4235)
Approved
By
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
Rough Electrical
Approved
Temporary Power (4275)
Final Electrical
Approved
Service (4235)
Approved
By
Date
Approved
By
Date
Approved
By Date
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By Date
By
v J Date rL— rk, .,
By
Date
Final - Electrical (4055)
er _ 1 Approved
�Ma,
ByCW Date
❑
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF I&
Federal Way
ELEC'T'RICAL
PERMIT NUMBER 14 _ t o � z(�1'1 5 _
co—
JUL 07 2014
CITY OF FEDERAL WAY
SITE ADDRESS: �� 3 !�
- 67
(;-+
SUITE/uNliCME #
PROJECT VALUATION
A37OR'S TAX/PARC s
� O _
O O
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CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
1 /
O
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
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Ze L '
PROPERTY OWNER
NAME
PRIMARY PHONE
7 - q
MAILING ADDRES
S
E-MAIL
CITY
STATE
ZIP
FAX
ELECTRICAL
CONTRACTOR
NAME
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
Q
PRIMARY PHONE
)
MAILING ADDRESS
E-MAIL
CITY -
STATE I
ZIP
( FAX
l ) -
PROJECT CONTACT
NAME
Q J21e
1,
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 city as apart of this application.
SIGNATURE:
PRINT NAME:
Bulletin # 160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application