16-101657City 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: TRAN
Project Address: 33043 22ND PL S
Mdcal
Permit #: 16 -101657 -00 -EL
FILE Inspection Request Line: (253) 835-3050
Parcel Number: 241260 0080
Project Description: REP - Rewire areas in home damaged by fire to (3) bedrooms, bathroom and kitchen.
Altered 0-200 amp service.
Owner
THAO TRAN
AR Ila cant
MADSEN ELECTRIC
Contractor
MADSEN ELECTRIC
12 WALNUT FARMS PKWY
3939 S ORCHARD ST
MADSEE* 1401`8 (4/30/16)
FREDERICKSBURG VA 22405
TACOMA WA 98466
3939 S ORCHARD ST
TACOMA WA 98466
PERMIT EXPIRES Wed
Permit )j�sss/vo�I hereby certify that the above informati the occupancy and the use will Aba an,
Owner or agent INk ftb
`y7
V
it 5, 2017
2016
duction on the above described property and
%s and regulations of the State of Washington
Way.
Date:
L,1� 3S9 -v
4%
CITY OF
Federal Way
PERMIT NUMBER j (
ELECTRICAL
PERMIT APPLI N
10� l0 5 7- 00
APR 05 2016
CITY OF FEDERAY
SITE ADDRESS: `
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SUITE/UNIT/ SpA61Ivrg[11
PROJECT VALUATION
$ L 00 w
A� 80 'S TA�/PARC
-
# � � —
-
Q O � O
- - -
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
r
CJ -TA 0
PROJECT DESCRIPTION
Detailed description of work to
In
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
/ FAX
l
NAME
MxLgrll
C� PRIMARY PlHONE
NG ADDRESS
_ E-MAIL
ELECTRICAL
�T
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) FAX t/
CONTRACTOR
WA STATE CONTRACTORR'SSC LICENSE #
AAA
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
E
V
V\
PRIMARY PHONE
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I certify under penalty of pedury 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:
L -/-S l6
Bulletin #160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspectiofn Record
INSPECTION REQUESTS: (253) 835-3050
16 -101657 -00 -EL Address: 33043 22ND PL S
THAO TRAN FEDERAL WAY, WA 98003-6856
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 if 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 (4295)Ditch
cover (4030)
Power (4275)
Slab/Concrete Floor (4255)
Approved
By
Approved ,
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)1:1Temporary
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
By
v44 .s Date b
By
Date
❑
Final - Electrical (4055)
Approved
By
Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF Building Division
33325 Eighth Avenue South
Federal Wa Federal Way, 98003-6325
y Phone 253-835-2607 Fax
253-835-2609
CORRECTION NOTICE
ADDRESS: 3 3 O k� 3 R 1 PERMIT#: l la- 1 ci i\A �7 -E�--
�iL
211111110
IF YOU HAVE QUESTIONS CALL
(253) 835-
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.
1A -1 - lo� C ij-y
DATE INSPECTOR
DO NOT REMOVE THIS NOTICE
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