14-104478City 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: VOLLMER +_..
Project Address: 31718 42ND AVE;j
r
tlectr`ical
Permit #: 14 -104478 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 8731981660
Project Description: Remodel work to move lights, outlets and switches; no additional circuits
Owner
ARRlicant
Contractor
STEVEN E VOLLMER
PACIFIC NORTHWEST INDUSTRIES INC
E R ELECTRICAL
31718 42ND AVE SW
21414 30TH AVE S
ERELERE861D8 (3/28/16)
FEDERAL WAY WA 98023
SEATAC WA 98198
807 S 10TH AVE
MILTON WA 98354
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Electrical Fixtures
Circuits - Residential ...................... 2
PERMIT EXPIRES Sunday, March 1, 2015
Permit Issued on Tuesday, September 2, 2014
I hereby certify Kat the above information is correct and that the construction on the above described property and
the occupancy 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:
T ,
CITY OF
Federal Way
PERMIT #:
is THIS CARD IS TO ON-SITE
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
14 -104478 -00 -EL Address: 31718 42ND AVE SW
Project: STEVEN E VOLLMER FEDERAL WAY, WA 98023-2174
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.
Slab/Concrete Floor (4255)
11
Rough Electrical (4225)
Ceiling Cover (4020)
Approved to place concrete
Approved
Approved
Right of Way
Approved
By
By Date
B Date '3--A-1
By Date
Final - Electrical (4055)
Approved
By Date `
Rough Electrical
Approved
0
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF 'A
Federal Way
� ECTRICAL
PERMIT APPLICATION
PERMIT NUMBER , q
SITE ADDRESS: Z17/f- Z- J A U e- :SLD po
SUITE/UNIT/SPACE#
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PROJECT VALUATION
$ .r,
ASSESSOR'S TAX/PARCEL #
8- --7 -: l Ct _
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
rO w` �-� r` `"
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PROPERTY OWNER�
NAME
ems- �® f w`' '"�
PRIMARY PHONE
(05 3) Z 3j,
MAILING ADDRESSE-MAIL
In c.�e_ S
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CITY
STAT/JE�
ZIP
FAR
ELECTRICAL
CONTRACTOR
NAME DD
PRIMARY PHONE
Z
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
PRIMARY PHONE
MAILING ADDRESS
2/yw r3 -
E-MAIL
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ZIP^ /�x
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) FAX
PROJECT CONTACT
NA*r-S I /k
Jo fl ,w5
PRIMARY PHONE
(004) g1/ 3/
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 sup d to the city as apart of this application.
SIGNATURE: DATE
PRINT NAME: 9 L ^-
Bulletin # 160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
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