14-1003283
City 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: N[AXWELL
Electrical;
Permit #: 14 -100328 -00 -EL
Inspection Request Line: (253) 835-3050
Project Address: 31454 47TH PL SW Parcel Number. 211572 0310
Project Description: Adding a receptical for a gas insert, fan, and electronic ignition.
wn r
Al2plican
Contractor
DONNA M MAXWELL
SUNDANCE ENERGY SERVICES INC
SUNDANCE ENERGY SERVICES INC
31454 47TH PL SW
(MECHANICAL)
(ELECTRICAL)
FEDERAL WAY WA 98023-2093
10228 MAIN ST
SUNDAES062J8 4/28/14
BOTHELL WA 98011
10228 MAIN ST
BOTHELL WA 98011
Additional Permit information
Is this an Online or O.T.C. application? ................. es
Electrical Fixtures
Circuits - Residential ...................... 1
Is Use Educational or Institutional?.......................No
PERMIT EXPIRES Monday, July 21, 2014
Permit Issued on Wednesday, January 22, 2014
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:
AL'D
• THIS CARD IS TOMAIN ON-SITE
CITY OF Construction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #:
14 -100328 -00 -EL
Address: 31454 47TH PL SW
Project: DONNA M MAXWELL FEDERAL WAY, WA 98023-2093
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)Ceiling
Cover (4020)
Final - Electrical (4055)
Approved
Right of Way
Approved
Approved
Approved
By
Date
By
Date
Date Z ...
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
RECEIVED
EL CTRICAL
1TM o� AN 2 2 2014
Federal Way CITY OF FEDXWI'T APPLICATION
CDS
PERMIT NUMBER
SITE ADDRESS: 3/ ySk/ 'J? �'q /I- 5 u)
SUITE/UNIT/SPACE#
PROJECT VALUATION
$ 2-Z5."b
ASSESSOR'S TAX/PARCEL #
Z 1 l 5 i
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
/�� AY—w�,
/"4
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
rA AJ AAA ELEC4—di4A-'`L /60J/17�bA)
PROPERTY OWNER
NAME
401JAIA %MA)CLVCL-4-
PRIMARY PHONE
( 7-53)717-5fa`7-7
MAILING ADDRESS
3 /qsq y? J( Sr.,,,
E-MAIL
CITY
WA
y
S��
ZIP �� ��
FAX
( )
ELECTRICAL
CONTRACTOR
NAME
! �MA84rvc� C"� SrW ICES
PRIMARY PHONE
(94) YS7 - W C-)
MAILING ADDRESS
/►,
107-29 )ru W
E-MAIL
5U 1JD AtiCCF— .
CITY
TA✓�
STATE
wA
ZIPFAX
q 800
(yls) W1- s
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
564Mt,4oF-So('0-2:rg Y i 2i�i 0�l
FEDERAL WAY BUSINESS LICENSE #
20-ao-/o6,,(05-oo-
APPLICANT
NAMEPRIMARY
lj6
AJ_A ��
PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
( )
PROJECT CONTACT
NAME
Albw(C
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 tirylcity Vs apart of this application.
SIGNATURE:
PRINT NAME:
t-L2L-Iq
Bulletin #160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application