12-104909City 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: VANDER WAL
Project Address: 2203 SW 342ND ST
Project Description: Change service from 100 to 200 amp.
Electrical
Permit #: 12 -104909 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 330630 0630
Owner
ARlic�ant
Contractor
DON VANDER WAL
WINONA FURGISON
SHOCKING DIFFERENCE LLC
461 W NAHWATZER BEACH DR
SHOCKING DIFFERENCE LLC
SHOCKDL938KB (5/2/13)
SHELTON WA 98584
5329 NE LEMON RD
5329 LEMON RD NE
OLYMPIA WA 98506
OLYMPIA WA 98506
CITY OF 40�&
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
12 -104909 -00 -EL Address: 2203 SW 342ND ST
DON VANDER WAL FEDERAL WAY, WA 98023-7740
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.
Rough Electrical (4225)
Approved
By Date
Ceiling Cover (4020)
Approved
By Date
LIFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
Approved
11
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Rough Electrical (4225)
Approved
By Date
Ceiling Cover (4020)
Approved
By Date
Pool Bonding (4195)
Approved
Temporary Power (4275)
Date
Service (4235)
11
Approved
Approved
Approved
Date
By
Approved
By
Date
By
Date
By
Date
Rough Electrical (4225)
Approved
By Date
Ceiling Cover (4020)
Approved
By Date
Feeders/Sub-panels (4045)
Approved
By
Date
Right of Way
Approved
11
Final - Electrical (4055)
Approved
By
Date
Rough Electrical (4225)
Approved
By Date
Ceiling Cover (4020)
Approved
By Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF I
Fed � ELECTRICAL
00 29 202 PERMIT APPLICATION
CIT`( OF FEDVML WAY
09'Most electrical permits may be obtained on-line at www.cityo ederalway.com**
SITE ADDRESS: 220 3 S tj J? yZ /uol s
SUITE/UNIT/SPACE A ASSESSOR'S TAR/PARCEL it CURRENT/PROPOSED USE
33oO�a
PROJECT NAME
(Tenant or Homeowner Last Name) We r [A_% ` '
PROJECT DESCRIPTION rl/tC
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER DO Al V0,_ IV q`ei- &UL / {�O )W&- -off
MAILING ADDRESS E-MAIL
CITY r A STATE
W& ZIP
q ( ) FAX
NAME PRIMARY PHONE
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MAILING ADDRESS E-MAIL
ELECTRICAL S.3Z- /ted N�C
CONTRACTOR CITY w STATE ZIP FAX
al ol/ l a ?8TO 6 ( ) 7sY/ Z �' 2
WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE N
5NOC-K U-7,38 K9 7 l3
NAME %� PRIMARY PHONE
APPLICANT �haG l.N Dl eV-e (fLLC ( ) - t1-T``-12
MAILING ADDRESS E-MAIL
S'3 2-f L emote W Affi-
CITY STATEZIP FAX
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NAME r PRIMARY PHONE
PROJECT CONTACT D"re-11' F(_k !�ISo N S� �
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 a part of this application.
SIGNATURE: DATE
PRINT NAME: J�*" ry es F-tAJCq1_50JV
33325 8'h Avenue South ♦ Federal Way ♦ WA ♦ 98003-6325 ♦ 253-835-2607 ♦ fax: 253-835-2609 ♦ www.cityoffederalway.com
Bulletin ##160 —January 1, 2011 Page I of 2 k:\Handouts\Electrical Permit Application