13-101967Project Name: LANCASTER
Project Address: 521 SW 293RD ST
Project Description: Alter circuits for kitchen lighting.
0 "electrical
Permit #: 13 -101967 -00 -EL
Inspection Request Line: (253) 835-3050
�0-7 4
Parcel Number: 11 1650
Owner
ARRIlcant
Contractor
City of Federal Way
OLD TIME ELECTRIC INC
OLD TIME ELECTRIC INC
Community & Econ. Dev. Services
33325 8th Ave S
PO BOX 39745
, �1
w
Federal Way, WA 98003
LAKEWOOD WA 98498
6
Ph: (253) 835-2807 Fax: (253) 835-2809
it%a
Project Name: LANCASTER
Project Address: 521 SW 293RD ST
Project Description: Alter circuits for kitchen lighting.
0 "electrical
Permit #: 13 -101967 -00 -EL
Inspection Request Line: (253) 835-3050
�0-7 4
Parcel Number: 11 1650
Owner
ARRIlcant
Contractor
AL & BEA LANCASTER
OLD TIME ELECTRIC INC
OLD TIME ELECTRIC INC
521 SW 293RD ST
PO BOX 39745
OLDTIEI021LB (6/2/14)
FEDERAL WAY WA 98023
LAKEWOOD WA 98498
PO BOX 39745
LAKEWOOD WA 98498
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 Saturday, November 2, 2013
Permit Issued on Monday, May 6, 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 be in accordance with the laws, rules and regulations of the State of Washington
i and the City of Federal Way.
Owner or agent: Date:
CITY of 0
All�-
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
41 Construction InU�ection Record
INSPECTION REQ TS: (253) 835-3050
13 -101967 -00 -EL Address: 521 SW 293RD ST
AL & BEA LANCASTER FEDERAL WAY, WA 98023-3537
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
UFER Ground (4295)
❑
Ditch cover (4030)
0
Slab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date
Pool Bonding (4195)
0
Temporary Power (4275)
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Rough Electrical (4225)
❑
Feeders/Sub-panels (4045)
0
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY (W 4011k�
Federal Way
ELECTRICAL
PERMIT APRFaC ON
PwmT NvmB= l _ I `� ! l `(� 7— 00
MAY 0 6 2013
CITY OF FEDERAL WAY
SITE ADDRESS: 5a ` 5W 9q3 r6 Sr 1 Fcck o -Q- gn)33
SUITE/ I /SPACE #
P O VALUATION
A88yBBpR'8 T�AR¢EI. # 0 O - � 5-C)
— — — — —
CURRENT/PROPOSED UM
PROJECT NAMES
(Tenant or Homeoumer Last Name)
�,r
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
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PROPERTY OWNER
NAME
A L L ayNQ ib4e-r
PRMARY PHONE
05-3) 9 q t.- q i co
MAILWG ADDR888
5� 1 Su-� a93 rc� ' -VV
MAH,
wATE
ZIP
FAX
ELECTRICAL
CONTRACTOR
CONTRACTOR
NAME
Wic-
"Mm"PHONE
(0453) SSgf5- 3l -L5
MAD.DIO ADSS DRE
97yS-
PD (v mL 39-7(-4S-
E-MAM
Crry
Loxe e �
G 'r
I"Cif
I 'L 9 �p
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
pLOTTr::=oa'Lt-e> (, /2- /I
FEDERAL WAY BUSINESS WCEME #
o70 -0t. -two IT-ooBL
APPLICANT
1IMM
PRIMARY PHONE
( )
MAUMG ADDRESS
E-MAIL
CIT4
STATE
ZIP
FAX
)
PROJECT CONTACT
NAME 6e"O � kl
"j
PRntARY PHONE
(�S3)
I certify under penalty of perjury that I am the property owner or authorised agent of the property owner. I cert(fy that to the best
of my knowledge, the iiVormation submitted in support of this permit application is true and correct. I cart(& that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorised 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 apart of this application.
SIGNATURE:
PRINT NAME:
S' &' L3
Bulletin #160 — January 1, 2013 Page 1 of 2 k:\landouts\Electrical Permit Application