13-102836I , V
City of Federal Way •
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
L E;
r r
Electrical
Permit #: 13 -102836 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: CHAN ' j 105 a3
Project Address: 31601 41ST AVE SW Parcel Number: 873198 2660
Project Description: Remove and replace 200 amp panel
Owner
Annlicant
Contractor
HENRY CHAN
AYSHA PIKO
D & A ELECTRIC LLC
3160141ST AVE SW
D & A ELECTRIC LLC
DELEC*E897D5 (4/5/15)
FEDERAL WAY WA 98023
33410 30TH AVE SW
33410 30TH AVE SW
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Electrical Fixtures
Alt. Serv./Feeder. 0 to 200 amps (F 1
PERMIT EXPIRES Friday, June 26, 2015
Permit Issued on Wednesday, June 26, 2013
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 accordance with the laws, rules and regulations of the State of Washington
nd the City of Federal Way.
Owner or agent: '' Date: vZ
OF
Federal Way
PERMIT #:
Project:
TRIS CARD IS TOrZ:
ON-SITE
Construction Inon Record
INSPECTION REQ 3) 835-3050
13 -102836 -00 -EL Address: 31601 41ST AVE SW
HENRY CHAN FEDERAL WAY, WA 98023-2117
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.
Service (4235) Final - Electrical (4055)
Approved Approved
By O kA _ Date `�'—` 1�3 By �� Date cl_j 1`3
❑
Rough Electrical
Approved
Final Electrical
Approved
Right of Way -^
Approved
By
Date
By
Date
By
Date
A RECEIVE
.., of
Federal Wayq 16 2013
CITY OF FEDERAL W�
PERMIT NUMBER
ELECTRICAL
PERMIT APPLICATION
v_s(-e-.Uo
SITE ADDRESS: 3 i , r 5+ A-v�
SUITE/UNIT/SPACE #
PROJECT/�VAL%U�ATION
ASSESSOR'S TAR/PARCEL #
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
#Q!'Q
PROPERTY OWNER
NAME
C
G°G 6 )-7-722-q
MAILING ADDRESS
3 t � a q1f)+ Av - sv3
$_KAIL
CITY
.(
STATEZIP
`,, t
13302-3
FAX
c ) —
ELECTRICAL
CONTRACTOR
NAME
E Laic-
PRIMARY PHONE
-?q— 5
MAILING ADDRESS
I'D
&- �
Com_ L
CITY
STATE
Z>p
�'l F6 23
FAX
( ) -
WA STATE CONTRACTOR'S LICENSE # IRATION DATE
L,Ec- * 1 `t i j40 il(P
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
P Y PHONE
) � - 1f 0
MAD.IN ADDRESS
E-KAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME ^ y
PRIMARY PHONE
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 VN fhe city as 9(iiaft-'bf this application.
n
SIGNATURE: -
PRINT NAME: A145 PF t ie6
Bulletin # 160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application