15-102391City of Federal Way
Community & Econ. Dev. Services
33325 8th gAlfe S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: ROBINSON
Project Address: 416 SW 297TH ST
0
Electrical
Permit #: 15 -102391 -00 -EL
Inspection Request Line: (253) 836-3050
Parcel Number: 720510 0090
Project Description: Install 50 amp subpanel for associated elevator shaft addition and installation
Owner
CLARENCE R ROBINSON
ARRIOcant
MIDNIGHT SUN ELECTRIC LLC
Contractor
MIDNIGHT SUN ELECTRIC LLC
PAULA E ROBINSON
PO BOX 2492
MIDNISE875LL (6/13/15)
416 SW 297TH ST
WOODINVILLE WA 98072-2492
PO BOX 2492
FEDERAL WAY WA 98023
WOODINVILLE WA 98072-2492
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Electrical Fbdures
Alt. Serv./Feeder: 0 to 200 amps (F 1
PERMIT EXPIRES Sunday, November 15, 2015
Permit Issued on Tuesday, May 19, 2015
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: Z,=- - ' Date: is
THIS CARD IS TO 121MAIN ON-SITE
Construction Inection Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 15 -102391 -00 -EL Address: 416 SW 297TH ST
Project: CLARENCE R ROBINSON FEDERAL WAY, WA 98023-3553
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.
❑
UFER Ground (4295)
❑
Ditch cover (40 0)
Electrical
Approved
Slab/Concrete Floor (4255)
❑
Approved
Service (4235)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Date
F1
Pool Bonding (4195)
❑
Electrical
Approved
❑
❑
Temporary Power (4275)
Service (4235)
Date
Approved
By
Date
Approved
By
Date
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)1:1Rough
Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
Date 5—_ ZO _ �
By
Date
10
Fina Electrical (4055)
Approved /
Date
F1
Electrical
Approved
1:1Final
1:1
Electrical
Approved
❑
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF aA
Federal Way
PERMIT NUMBER 15
ELECTRICAL
MAY 191015
CITY OF FEDERAL
SITE ADDRESS: L/ / J 5- � q 7; CDS
SUITE/UNIT/SPACE #
PROJECT VALUATION
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ASSESSOR'S TAX/PARCEL #�
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CURRENT/PROPOSED USE�
PROJECT NAME
(Tenant or Homeowner Last Name)
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
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MAILING ADDRESS
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E-MAIL
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STATE
ZIP
FAX
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NAME
PRIMARY PHONE
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MAILING ADDRESS
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E-MAIL
ELECTRICAL
CITY
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STATE
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FAX
CONTRACTOR
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
M''0N15C- 97.5L.L
NAME
PRIMARY PHONE
APPLICANT
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(ZcJ ) 3/ - `+� SS
MAU.ING ADDRESS
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CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
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PRIMARY PHONE
(75-3) 10 - 32 �
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 Iaws regulating
construction or environmental taws.
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 apart of this application.
SIGNATURE:a. �h - �i� z, DATE
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