14-102687Y of federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 fax: (253) 835-2609
F 'leetrical
FILE Permit #: 14 -102687 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: HOFFLER
Project Address: 33239 36TH AVE SW Parcel Number: 10"611280
Project Description: Replace electrical panel
Owner
DYLAN HOFFLER
A Ino icant
DYLAN HOFFLER
Contractor
OWNER IS CONTRACTOR
33239 36TH AVE SW
33239 36TH AVE SW
FEDERAL WAY WA 98004
FEDERAL WAY WA 98004
Additional Permit Information`
Is this an Online or O.T.C. application?.................Yes
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps (F 1
Is Use Educational or Institutional?.......................No
PERMIT EXPIRES Wednesday, January 28, 2015
Permit Issued on Friday, August 1, 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 b ' accordance with the laws, rules and regulations of the State of Washington
and th ity of Federal Way. �(
Owner or agent Date: v � G
THIS CARD IS TMAIN ON-SITE
CITY OF 0 Construction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 14 -102687 -00 -EL Address: 33239 36TH AVE SW
Project: DYLAN HOFFLER FEDERAL WAY, WA 98023-2903
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.
11
Service (4235)
Feeders/Sub-panels (4045)
Final Electrical
Approved
Rough Electrical (4225)
1:1Approved
Approved
By
Approved
Approved
By QLLV
Date
By
Date
By
Date
Ceiling Cover (4020)
Approved
By Date
Final - Electrical (4055)
Approved
By Date
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
CITY OF
Federal Way
�RBCMM
E 'CTRICAL
JUL 31 iMERMIT APPLICATION
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CITY OF CDS
PERMIT NUMBER � � _ / D � � U
SITE ADDRESS: ' J -2 An 7� b An 4/ f- .s..ay i 14
SUITE/UNIT/SPACE #
PROJECT VA/LUUATION
$ t10��
ASSESSOR'S TAR/PARCEL #
_
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)j�
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PROJECT DESCRIPTION
Detailed description of work toP�3
be included on this permit only
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PROPERTY OWNER
NAME r f�}
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PRIMARY PHONE
(Zo6) ` ?-- 75'55
MAILING ADDRESS
35 36 s �^✓
33XCITY
EMAIL
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STATE
V �
ZIP
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( ) FAX
ELECTRICAL
CONTRACTOR
NAME
PRIMARY PHONE
MAILING ADDRESS
EMAIL
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
hyG/L' ����✓
PRIMARY PHONE
( ) -
MAILING ADDRESS
EMAIL
CITY
STATE
ZIP
( FAX
t ) -
PROJECT CONTACT
NAME
D �40W/,�
PRIMARY PHONE
(,)Ob)
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 nse of such claim), which may be made by any person, including the undersigned, and filed against the city,
but only where suc clai arises ou f the reliance of the city, including its officers and employees, upon the accuracy of the
information sv ,pli d to t city as of this application.
SIGNATURE: DATE � A/
PRINT NAME:
%e—
Bulletin # 160 -January 1, 2013 Page 1 of 2 UHandoutsTlectrical Permit Application
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