13-103725% 0
0 Electrical
City of Federal Way
Community & Econ. Dev. Services
HEIDI C MERRIFIELD
Permit #: 13 -103725 -00 -EL
33325 8th Ave S
MICHAEL C MERRIFIELD
PO BOX 1213
Federal Way, WA 98003
Ph: (253) 835-2607 Fax. (253) 835-2609
Inspection Request Line: 2
pe eq (53) 835-3050
Project Name: MEMUTIELD
PO BOX 1213
Project Address: 306 SW 293RD ST
Parcel Number: 119600 0665
Project Description: Extending (1) circuit
Owner
Al2Rlican
Contractor
HEIDI C MERRIFIELD
C & S ELECTRIC INC
C & S ELECTRIC INC
MICHAEL C MERRIFIELD
PO BOX 1213
CSELESET949W (12/3/13)
306 SW 293RD ST
ROY WA 98580
PO BOX 1213
FEDERAL WAY WA 98023
ROY WA 98580
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Electrical Fixtures
Circuits - Residential ...................... 1
PERMIT EXPIRES Wednesday, February 19, 2014
Permit Issued on Friday, August 23, 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 in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner ora nt: Date:
THIS CARD IS OMAIN ON-SITE
CITY CW
Federal Way Construction In ection Record
y INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 13 -103725 -00 -EL Address: 306 SW 293RD ST
Project: HEIDI C MERRIFIELD FEDERAL WAY, WA 98023-3536
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 — I
❑
UFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
Approved
Service (4235)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date — I
❑
Pool Bonding (4195)
El
Temporary Power (4275)
Right of Way
Approved
Service (4235)
Date
Approved
By
Date
Approved
By
Date
Approved
By
Date
By
Date
By
Date
El
Feeders/Sub-panels (4045)
Rough Electrical (4225)Ceiling
Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date — I
❑
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY of
Federal Way
PERMIT NUMBER I
0 ELECTRICAL
-10372-0c-'
PERMIT APP�JPON
AUG 2 3 2013
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SITE ADDRESS: 30 �
S(,(/ � G�` ?j � �
ST
SUITE/UN�RACE #
ITT::VVJJ
PROJECT VALUATION
ASSESSOR'S TAX/PARCEL #
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
�T
h
PROJECT DESCRIPTION
�' T
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS �_
E-MAIL
CrrY
STATE
zip
FAX
NAME
CRL5'a
PRIMARY PHONE
-
MAILING ADDRESS
E-MAIL
i
ELECTRICAL
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CrIT
STATE
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CONTRACTOR
WA sTArE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
/0?-
NAME
PRIMARY PHONE
APPLICANT
( )
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.
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Bulletin # 160 —January 1, 2013 Page 1 of 2 k\Handouts\Electrical Permit Application
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