14-103816r
-Electrical
City of Federal Way
Community & Econ. Dev. Services Permit #: 14 -103816 -00 -EL
33325 8th Ave S
Federal Way, WA 9e003
Ph: (253) 835-2607 Fax: (253) 835-2609 FILE Inspection Request Line: (2
53) 835050
Project Name: BERGGREN
Project Address: 1012 SW 296TH ST Parcel Number: 119600 4755
Project Description: 200 Amp Panel Upgrade and altered circuit for ductless heat pump
Owner
A o�
Contractor
CARA E BERGGREN
CHAD NOEL
SUPERIOR HVAC & ELECTRICAL
1012 S 296TH ST
SUPERIOR ENGINEERING SERVICES
(ELECTRICAL)
FEDERAL WAY WA 98023
14900 INTERURBAN AVE S
JSBMAMS894QA (12/14/15)
SEATTLE WA 98168
14900 INTERURBAN AVE S
TUKWILA WA 98168
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ..... .................. No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps (F 1 Circuits - Residential ...................... 1
PERMIT EXPIRES Monday, January 26, 2015
Permit Issued on Wednesday, July 30, 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 accordance with the laws, rules and regulations of the State of Washington
0�rand the City of Federal Way.
Owner or agent: Date: 7�d ��
THIS CARD IS TO MAIN ON-SITE
ti
CITY CIF Construction In ction Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 14 -103816 -00 -EL Address: 1012 SW 296TH ST
Project: CARA E BERGGREN FEDERAL WAY, WA 98023-8216
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.
E]
UFER Ground (4295)Ditch
cover (40 30)
Temporary Power (4275)Service
Slab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
11 Final - Electrical (4055)
Approved
By Date 1
Pool Bonding (4195)
Temporary Power (4275)Service
(4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
11 Final - Electrical (4055)
Approved
By Date 1
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF A
Federal Way
PERMIT NUMBER I A
9 E&,CTRICAL
PERMIT APPLICATION
_i03g1 (0 co
JUL 30 2014
SITE ADDRESS: /p�� Ef, �JL CM,
UFTIDS��-EWAY
PROJECT VALUATION
$ Zeo;a4 . d O
ASSESSOR'S TAR/PARCEL #
_
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
/�
/,J L i- q 2rte
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
Jf- lo-
PROPERTY OWNER
NAME
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIPS
FAX
ELECTRICAL
CONTRACTOR
NAME J S r A/�f�y`�
PRIMARY PHONE
MAILING ADDRESS /
E-MAIL
CITY /^4 �//
STA
ZIP
/EEXPIRATION
( ) FAX
T'
WA STATE CONTRACTCONTRACTOR'SACTOR'S LICENSE # DATE
FEDERAL WAY BUSINESS LICENSE #
-/,2-/0oG
APPLICANT
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
STATE
ZIPp
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 flied against the city,
but only where such claim arises of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the ci part of this application.
SIGNATURE: DATE
PRINT NAME:
Bulletin # 160 —January 1, 2013 Pagel of 2 UIIandoutsTlectrical Permit Application
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