12-104007t
,electrical
City of Federal Ways, Permit #: 12 -104007 -00 -EL
Community &Econ. Dev. Services , . � ra �;, _
33325 8th Ave S i
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 8352609 Inspection Request Line: (2
53) 835-3050
Project Name: BURKM MER
Project Address: 32833 39TH AVE SW Parcel Number: 873213 1240
Project Description: 200 -amp panel change and (1) 20 -amp circuit.
Owner
A o�
Contractor
IAN M BURKHEIMER
EMERALD CITY ELECTRIC
EMERALD CITY ELECTRIC
YOKO INABA BURKHEIMER
317 S 120TH ST
EMERACE901JZ (4/17/14)
32833 39TH AVE SW
SEATTLE WA 98168
317 S 120TH ST
FEDERAL WAY WA
SEATTLE WA 98168
98023
Additional Permit Information
Is Use Educational or Institutional?.......................No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps (F 1
PERMIT EXPIRES Monday, February 25, 2013
Permit Issued on Wednesday, August 29, 2012
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use ill be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way. c�
Owner or agent: Date:Z! lZ
THIS CARD IS T(*MAIN ON -SIVE
CITY OFV;h� �
Federal V�/a Construction Inspection Record
Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 12 -104007 -00 -EL Address: 32833 39TH AVE SW
Project: IAN M BURKHEIMER FEDERAL WAY, WA 98023-2620
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.
LIFER Ground (4295)
Ditch cover (4030)
E]
Slab/Concrete Floor (4255)
0
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
1:1Approved
Temporary Power (4275)
0
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
Date q _ ( ( —
Rough Electrical
Approved
1:1Approved
Final Electrical
1:1Approved
Right of Way
By
Date
By
Date
By
Date
CITY OF
Fed
\,, %j 2012 PERMIT APPLICATION
K
i
ELECTRICAL
!a_10 V�o �
`
-wPY
F FV ost electrical permits may be obtained on-line at www.cityo ederalway.com"
EMEMEMEEIM
SITE ADDRESS: 3?"' 4td,SCS
SUITE/UNIT/SPACE #
ASSESSOR'S TAX/PARCEL #
CURRENT/PROPOSED USE
PROJECT NAME
Name)'L1
r
(Tenant or Homeowner Last
��
(. C'Q `i
f (t
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAIL,
PRIMARY PHONE
MAILING ADDRESS
N, 3 3 39' S-6/STATEZZZIIIppp
E-MAIL
FAX
r
t�V
( )
NAME /.4 /i,, 1, l� let , lL
\ ) C- Y7
MAILING ADDRESS
3I ZU '4)
E-MAIL
ELECTRICAL
J _
CONTRACTOR
C ;
T T
ZIB- 4�^
FAX
WA STATE CONTRACTOR'S LICENSE #TITi
E C
fN DATE '
FEDERAL WAY BUSINESS LICENSE #
/Z-` O
NAME
PRIMARY PHONE
APPLICANT
( )
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
/ FAX
l )
PROJECT CONTACT
N
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 ses out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to ity as apart of this application.
SIGNATURE:
PRINT NAME:
TE
33325 8h Avenue South ♦ Federal Way ♦ WA ♦ 98003-6325 ♦ 253-835-2607 ♦ fax: 253-835-2609 ♦ www.cityoffederalway.com
Bulletin #160 — January 1, 2011 Page 1 of 2 kAHandouts\Electrical Permit Applicai