17-1051714 . m )
City otFederal Way
Community Development Dept
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax (253) 835-2609
Project Name: PATE
Project Address: 222 SW 293RD ST
Electrical
Permit #:17 -105171 -00 -EL
FILE Inspection Request Line: (253) 835-3050
Project Description: Install feeder for lights, outlets and switches in detached garage.
Parcel Number: 119600 0945
Owner
Applicant
Contractor
JANICE PATE
JANICE PATE
OWNER IS CONTRACTOR
222 SW 293RD ST
222 SW 293RD ST
FEDERAL WAY WA 98023-3535
FEDERAL WAY WA 98023-3535
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
Alt. Serv./Feeder: 0 to 200 ami 1
PERMIT EXPIRES Friday, 26 October, 2018
Permit Issued on Thursday, October 26, 2017
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
ad the City of Federal Way.Owner oragent:Z44�e`eje"W
Date: 1"O'
THIS CARD IS TO -REMAIN OMSITE
CM or
Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERAM #: 1710517100 Address: 222 SW 293RD ST
Project: CLAYTON L PATE FEDERAL WAY WA 98023-3535
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 appmpiate. 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 aro logged on the back of this card.
ril UFER Ground (4295)
ID
Ditch cover (4030)
FAI
SlablConcrete Floor (4255)
Approved
JBy
Approved
JBy
Approved to place comxete
Date ( (ej
Date
Date
Date
Date
®
Pool Bonding (4195)
Temporary Power (4275)
® Service (4235)
Ceiling Cover (4020)
Approved
rBy
Approved
Approved
By
Date
By
Date
By Date
I
Feeders/Sub-panels (4045)
Rough Ekcical (4225)
tr
Final Electrical
Ceiling Cover (4020)
JEI
Approved
Approved
Approved
By
Date,6
By
Date tL
By
Date
Q Final - Electrical (4055)
Approved
By Date
Rough Electrical
E]
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
L By •
Date
By
Date
41k
CITY OR
Federal Way
RECEIVED
OCT z 6 2017
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
ELECTRICAL
PERMIT APPLICATION
PERMIT NUMBER
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SITE ADDRESS: 2 Z Z J W 2.,/ -
SUITE/UNIT/SPACE#
PROJECT VALUATION
ASSESSOR'S TAX/PARCEL #
CURRENT/PROPOSED USE
Cvct
PROJECT NAME
(Tenant or Homeowner Last Name)
f G
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
J -44f c e
PRIMARY PHONE
j 3 Y--7,5 0 (7
MAILING ADDRESS 1
y2 (.j2`r 3 rd 5+
E-MAIL
' n,'Ce a fc
CITY
-F�1��
STATE
ZIP
FAX
ya.�
ELECTRICAL
CONTRACTOR
NAME
PRIMARY PHONE
)
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
t)Q fn < as awldek-
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME/
C isV k AJ
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.
SIGNATURE:
PRINT NAME:
i
/ P
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
Bulletin #160 — April 14, 2016 Page 1 of 1 k:\Handouts\Electrical Permit Application