15-1005904 r * J if Z
E. ;R • • '
_ Electrical
am n3o5cc W Permit #: 15 -100590 -00 -EL
Federal Way, WA 98003
Ph: 4253) 835-2607 Fax: (253) 835-2809 Inspection Request Line: (253) 835-3050
Project Name: CELVER
Project Address: 33559 36TH AVE SW Parcel Number: 109960 0500
Project Description: Install GFI for both bathrooms. Move fanlight wiring for switch to outside wall. Move
vanity lightswitch neat to new door wall.
Owner
CELVER REBEKAH
ARRlicant
CELVER REBEKAH
Contractor
OWNER IS CONTRACTOR
33559 36TH AVE SW
33559 36TH AVE SW
FEDERAL WAY WA
FEDERAL WAY WA
Additional Permit Information
Is this an Online or O.T.C. application? ................. es Is Use Educational or Institutional? ....................... No
Electrical Fbdures
Circuits - Residential ...................... 3
PERMIT EXPIRES Wednesday, August 5, 2015
Permit Issued on Friday, February 6, 2015
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 accordangS with the laws, rules and regulations of the State of Washington
e City of Fede I Way.
Owner or agent Date:
VA�cr" of
Federal Way
PERMIT #:
15 -100590 -00 -EL
THIS CARD IS TO ON-SITE
Construction InYs7
on Record
INSPECTION REQ:(53) 835-3050
Address: 33559 36TH AVE SW
Project: CELVER REBEKAH FEDERAL WAY, WA 98023-2904
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 Final - Electrical (4055)
Approved
By Date _ s
UFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)1:1
Slab/Concrete Floor (4255)
Approved
Service (4235)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
0 Final - Electrical (4055)
Approved
By Date _ s
Pool Bonding (4195)
0
Temporary Power (4275)1:1
Right of Way
Approved
Service (4235)
Date
Approved
By
Date
Approved
By
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
E] Rough Electrical (4225)Ceiling
Cover (4020)
Approved
Approved
Approved
By
Date
By�
Date 2 ` - (
By
Date
0 Final - Electrical (4055)
Approved
By Date _ s
Rough Electrical
Approved
1:1Approved
Final Electrical
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF 'A
Federal Way
RECEIVED
FEB 0 6 2015
CITY OF FEDERAL WAY
CDS
ECTRICAL
PERMIT APPLICATION
PERMIT NUMBER _ O O
SITE ADDRESS 33 5 5 y 64 � S ) 9PZ-3
///
SUITE/UNIT/SPACE #
PROJECT VALUATION
oV
ASSESSOR'S T PARC L #
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
;
F, TL
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
I �'� 1 r,j4 46- SLw&L, 4v ol. Si
I yam`
1
PROPERTY OWNER
NAME
, C,
PRIMARY PHONE
ZS i G
MAILING ADDRESS
3S57 3G A— k"
E-MAIL
rrc,e,(\Ier®Ott looL.
CITY/
STAATEE
T
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
PRIMARY PHONE
( )
MAILING ADDRESS
E-MAIL
CITY
STATE I
ZIP
FAX
PROJECT CONTACT
NAME/
�j� Ic -� 1 ✓a �--
PRIMARY PHONE
2.4
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 %plication.
SIGNATURE:
PRINT NAME:
Bulletin # 160 —January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application