19-100167-ems- ,
Electrical
C—tyDeaereveloalWay
CPermit #:19 -100167 -00 -EL
ommunity Dpmmt Dept.
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: (253) 835-3050
Ph: (253) 835-2607 Fax (263) 8352609
Project Name: NG
Project Address: 31359 12TH PL S Parcel Number: 787520 0170
Project Description: Install new circuit and book up new furnace.
Owner
Applicant
Contractor
PHILLIP NG
PHILLIP NG
OWNER IS CONTRACTOR
31359 12TH PL S
3135912TH PL S
FEDERAL WAY WA 98003
FEDERAL WAY WA 98003
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
Circuits - Residential 1
PERMIT EXPIRES Friday, 10 January, 2020
Permit Issued on Thursday, January 10, 2019
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 and the City of Federal Way.
Owner or agent: Date: L(�
.• v ,
THIS CARD IS TO REMAIN ON-SITE
�� Construction Inspection Record
Fedeml Way INSPECTION REQUESTS: (253) 835-3850
PERMIT #: 1910016700 Address: 3135912TH PL S
Project: KARRIF. NGO FEDERAL WAY WA 98003-5311
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.
I❑
Service (4235)
FeederwSub-panels (4045)
Q
Rough Electrical (4225)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date
13 Rough Electrical 13 Final Electrical ❑ Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF A
Federal Way
RECEIVED ELEC'T'RICAL
JAN $0 2019 PERMIT APPLICATION
CITY OF FEDERAL WAY
COMMUNfTY DEVELOPMENT / j /
PERMIT NUMBER _ /
SITE ADDRESS: •3� i Z -PL
SUITE/UNIT/SPACE#
PROJECT VALUATION
Z l
ASSESSOR'S TAX/PARCEL #
-7-7'��✓2,0—
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
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✓lG�� —�
PROPERTY OWNER
NAME
pt --m �,p
PRIMARY PHONE
( ) -
MAILING ADDRESS
l•iU
E-MAIL
i M
CITY STATq
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
ZIP
FAX
( )
PROJECT CONTACT
NAME
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 to the city as a part of this application.
SIGNATURE: `
PRINT NAME: ('
Bulletin # 160 —April 14, 2016
Page 1 of 1
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