14-102495City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
FILE
Electrical
Permit #: 14 -102495 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: PELLICER
Project Address: 114 SW 292ND ST Parcel Number: 11%00 0008
Project Description: Install 60 amp generator subpanel and 240v 30a HP circuit
Owner
JAMES S PELLICER
ARolicant
J& D ELECTRIC
Contractor
J& D ELECTRIC
RACHEL PELLICER
4309 236TH ST E
JDELEDE92ICO (2/20/16)
114 SW 292ND ST
SPANAWAY WA 98387
4309 236TH ST E
FEDERAL WAY WA 98023
SPANAWAY WA 98387
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes
6lect0lcat Fixtures
Alt. Serv./Feeder. 0 to 200 amps (F 1
Is Use Educational or Institutional?.......................No
PERMIT EXPIRES Wednesday, November 26, 2014
Permit Issued on Friday, May 30, 2014
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy n e use will be in accordance with the laws, rules and regulations of the State of Washington
d the City of Federal Way.
Owner or agent Date:��� /�/
Federal Way
PERMIT #:
Project:
THIS CARD IS TO MAIN ON-SITE
40 Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
14 -102495 -00 -EL Address: 114 SW 292ND ST
JAMES S PELLICER FEDERAL WAY, WA 98023-3501
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.
Final - Electrical (4055)
Approved
By Date
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
UFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
Pool Bonding (4195)
Temporary Power (4275)
Service (4235)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)13
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF � ELECTRICAL
Federal Way PERMIT APP ION
PERMIT NUMBER
(D 2, 4 Gl.5_ 00 MAY 3 0 2014
CITY OF FEDERAL WAY
SITE ADDRESS: 1 4
VV Z
SUITE SPACE #
OJEC/P �VALUATIOIf
ASSIES SOR'8 TA�/PARCE # O O
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O O ^
CURRENT/PROPOSED USE
-
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
X2
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
�T es
7 S -
MAIdNG ADDRESS
i/ Z -5Wa
57
E-MAIL
CITY
Lj,�-41i
%STATE ZIP
FAX
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NAME
PR[KARY PHONE
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NAILING ADDRESS
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E-KAIL
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ELECTRICAL
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ZIP���
4 FAR
CONTRACTOR
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WA STATE NTRACTOR's LI SE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
TNS a
NAND
PRIMARY PHONE
APPLICANT
N[AII,IN aREss / /
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CITY�A'TE
ZIP %P
FAX
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PROJECT CONTACT
NAME
Veit(k -yl�
PRIMARY PHONE
7,z) - S33
I cert(fy under penalty of perjury that I am the property owner or authorised agent of the property owner. I certVy 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 flied 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. rr��
SIGNATURE: G"t� DATE CJ =21-3 C�
PRINT NAME: D a � V c &1/(/ Li_ tr oe
Bulletin #160 - January 1, 2013 Page 1 of 2 k:\IIandouts\Electrical Permit Application
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