14-100458City of Federal Way Electrical
Community & Econ. Dev. Services Permit #: 14 -100458 -00 -EL
33325 8th Ave S
Federal Way, WA 98003 —
Ph: (253) 835-2607 Fax: (253) 835-2609 R .- Inspection Request Line: (253) 835-3050
Project Name: MATTSON
Project Address: 2412 SW 307TH ST Parcel Number: 416770 0110
Project Description: Add circuit for gas furnace replacement.
Additional Permit Information
Is this an Online or O.T.C. application? ................. es Is Use Educational or Institutional?....................... No
Electrical Fixtures
Circuits - Residential ...................... 1
PERMIT EXPIRES Monday, July 28, 2014
Permit Issued on Wednesday, January 29, 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 be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date: ��' oZq, ao/y
F�NP�O
Owner
ApRlican
Contractor
WESLEY P MATTSON
WESLEY P MATTSON
OWNER IS CONTRACTOR
2412 SW 307TH ST
2412 SW 307TH ST
FEDERAL WAY WA 98023-7848
FEDERAL WAY WA 98023-7848
Additional Permit Information
Is this an Online or O.T.C. application? ................. es Is Use Educational or Institutional?....................... No
Electrical Fixtures
Circuits - Residential ...................... 1
PERMIT EXPIRES Monday, July 28, 2014
Permit Issued on Wednesday, January 29, 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 be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date: ��' oZq, ao/y
F�NP�O
PERMIT NUMBER 14 —1-0 O 45 5— _c O
JAN 2 9 2014
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SITE ADDRESS: L� �� ��,v "? Q `7 � ! G� �� 7
/
SUITE/UN CE t
PROJECT VALUATION
$ j o a�
ASSESSOWS/TAX/PARCEL /
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CURRENT/PROPOSED USE
PROJECT NAME—
[Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
L ter Fu2niAt� �x��r
PROPERTY OWNER
NAME
UI S L E "/
PRIMARY PHONE
P? 3 ) F7r/ - p �/ 2,
MAILING ADDREss
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E-MAIL
CITY
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STATE
ZIP
FAX
ELECTRICAL
CONTRACTOR
NAME
PRIMARY PHONE
(
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
l � -
WA STATE CONTRACTOR'S LICENSE i EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE R
APPLICANT
NAME
'SL '" '� i 4�/V
PRIMARY PHONE
PR
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MAILING ADDRESS
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MAIL
CITY
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STATE
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FAX
PROJECT CONTACT
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PRIMARY PHONE
I certify under penalty of perjury that I am the property owner or authorised 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 claiml, 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:L10 DATEy r
PRINT NAME: l; SL -C fiS 0�1/
Bulletin # 160 - January 1, 2013 Pagel of 2 k:lHandouts\Electrical Permit Application
` ` THIS CARD IS TO AIN ON-SITE4
`
CITY OF THIS
In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 14 -100458 -00 -EL Address: 2412 SW 307TH ST
Project: WESLEY P MATTSON FEDERAL WAY, WA 98023-7848
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.
0
LIFER Ground (4295)
❑
Ditch cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
0
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
0
Pool Bonding (4195)
0
Temporary Power (4275)
0
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
0
Ceiling Cover (4020)
❑
Rough Electrical (4225)
0
Feeders/Sub-panels (4045)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
B , s Date
L— �L
Rough Electrical
Approved
1:1Approved
Final Electrical
1:1Approved
Right of Way
By
Date
By
Date
By
Date