15-102868i -�- Electrical
s City of Federal Way
Community & Econ. Dev. Services`~ Permit #: 15 -102868 -00 -EL
33325 8th Ave S IL
Federal Way, WA 98003 Inspection Request Line: 253 835-3050
Ph: (253) 835-2607 Fax: (253) 835-2609 p q
Project Name: HICKS
Project Address: 33735 37TH PL SW Parcel Number. 9211510130
Project Description: Install new panel in existing single family residence.
Owner
CHARLES L HICKS
AR12licant
M S E ELECTRIC
Contractor
M S E ELECTRIC
33735 37TH PL SW
PO BOX 13327
MSEELE" 874L8 (7/2/15)
FEDERAL WAY WA 98023-2958
DES MOINES WA 98198
PO BOX 13327
DES MOINES WA 98198
Additional Permit Information
Is this an Online or O.T.C. application? ................. es
Electrical Fixtures
Alt. %erv./Feeder: 0 to 200 amps (F 1
Is Use Educational or Institutional? ....................... No
PERMIT EXPIRES Wednesday, December 9, 2015
Permit Issued on Friday, June 12, 2015
I hereby certify that the above information is correct and that the construction on the above described properly 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: Z
THIS CARD IS TO ON-SITE
CITY OF Construction In ection Record
Federal Way C INSPECTION REQ TS: (253) 835-3050
PERMIT #: 15 -102868 -00 -EL Address: 33735 37TH PL SW
Project: CHARLES L HICKS FEDERAL WAY, WA 98023-2958
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.
Feeders/Sub-panels (4045)
Approved
By Date
0 Final - Electrical (4055)
Approved
By Date _ 1
Rough Electric
Approved
;25) 0 Ceiling Cover (4020)
Approved
By Date
LIFER Ground (4295)
0
Ditch cover (4030)
Final Electrical
Approved
Slab/Concrete Floor ( 55)
Approved
By
Approved
Temporary Power (4275)
Approved to place concrete
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Approved
By Date
0 Final - Electrical (4055)
Approved
By Date _ 1
Rough Electric
Approved
;25) 0 Ceiling Cover (4020)
Approved
By Date
Rough Electrical
Approved
Final Electrical
Approved
0
Service (4235)
By
0
Temporary Power (4275)
0
Pool Bonding (4195)
Approved
Date
Approved
Approved
By
Date
By
Date
Dates ��
Feeders/Sub-panels (4045)
Approved
By Date
0 Final - Electrical (4055)
Approved
By Date _ 1
Rough Electric
Approved
;25) 0 Ceiling Cover (4020)
Approved
By Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF
Federal Way
PERMIT NUMBER 1 5 -1 D 4 <� & � _
ECTRICAL
PERMPLICATION
G 0 JUN 12 2015
CITY OF FEDERAL WAY
�J�� 2 -^ P / ^ S rL�J\ /�
SITE ADDRESS:
(77//7 �
SUITE/UNIT/SPACE N
PROJECT VALUATION
$ ��00
ASSESSOR'S TAR/PARCEL M
CL- "z 1 l 5)- 1 3 O
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
I
A(��Z u j, ` e / S "�� ✓� 7-&0 l q u ,
PROPERTY OWNER
NAME c
C
PRIMARY PHONE
- 6
MAILING ADDRESS
373 37
E-MAIL
C17n , C
ZIP
( ) FAX
ELECTRICAL
CONTRACTOR
NAME r-
S� CIleC
PRIMARY PHONE
O 3(5- 70
MAIL G ADD7!s
0 ((/cam 3 Z
E-MAIL
CIT
STATE
ZIP p a q
FAX
WA STATE CONTRACTOR'S LICENSE MEXPIRATION DATE
R 4F L 7L m
FEDERAL WAY BUSINESS LICENSE M
APPLICANT
NAME
R�
PRIMARY PHONE
(Z�) 20- 3 7 -
MAILING f�
E-MAIL
CITY /�
STAT
ZIj;� �
FAX
PROJECT .CONTACT
NAME
a X01
PRIMARY PHONE
c zj )7 3 — 6,J76,
I certify under penalty of per, jury 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 th p,city as apart of tyis application.
SIGNATURE:
PRINT NAME:
,c)tiy W
Bulletin # 160 —January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application