16-100122City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 88003
Ph: (253) 835-2607 Fax: (253) 835-2609
06 4
0 Electrical
Permit #: 16 -100122 -00 -EL
Iii �' ■r Inspection Request Line: (253) 835-3050
Project Name: MARTIN
Project Address: 2800 SW 300TH PL
Project Description: Add (1) circuit for transfer switch for generator
Parcel Number: 012103 9014
Owner
ARnlicant
Contractor
MICHAEL J MARTIN
BRIAN MURRAY
CLOVER CREEK ELECTRIC
PAMELA M MARTIN
CLOVER CREEK ELECTRIC
CLOVECE293LA (4/30/16)
2800 SW 300TH PL
1413 S CENTER ST
1413 CENTER ST
FEDERAL WAY WA 98023-2325
TACOMA WA 98409
TACOMA WA 98409
Additional Permit Information
Electrical Work Valuation?....................................3180 Is this an Online or O.T.C. application? ................. Yes
Is Use Educational or Institutional?.......................No
Electrical Fixtures
Circuits - Residential ...................... 1
PERMIT EXPIRES Saturday, July 9, 2016
Permit Issued on Monday, January 11, 2016
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: ! I ► / 6
f
r
CITY OF i
Federal Way
PERMIT #:
16 -100122 -00 -EL
THIS CARD IS TO MAIN ON-SITE "
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
Address: 2800 SW 300TH PL
Project: MICHAEL J MARTIN FEDERAL WAY, WA 98023-2325
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
B Date Z
❑
UFER Ground (4295)11
Ditch cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
E]
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
B Date Z
❑
Pool Bonding (4195)
E]
Temporary Power (4275)
E]
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
E]
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
B Date Z
❑
Rough Electrical
Approved
E]
Final Electrical
Approved
E]
Right of Way--
Approved
By
Date
By
Date
By
Date
CITY OF
Federal Way
RECEIVED
JAN I 12016 ELECTRICAL
CM of E[)ERALW`PERMIT APPLICATION
COS
' Z
PERMIT NUMBER
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: DATE
PRINT NAME: ) r n 1q. ! _'vrl
Bulletin #160 - January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
SUITE/UNIT/SPACE #
SITE ADDRESS: O� ,Soo 5L-� 3064- ` 14C�
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PROJECT VALUATION
ASSESSOR'S T ARCEL #
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CURRENT/PROPOSED USE
L4 30, � o
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PROJECT NAME
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(Tenant or Homeowner Last Name)
,� ' 1 ; fit!
I
PROJECT DESCRIPTION
! '
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME ./ /�,
M r� / "1a,/41 (1
PRIMARY PHONE
(A53203 3 - 12"
MAILING ADDRESS
Sw 3�o Old C,- c.-
E-MAIL
N/A
CITY
STATE
ZIP
FAX
NAME /I �
PRIMARY PHONE
3) 6-z-7- 4,G V
MAILING ADDRESS
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E-MAIL
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ELECTRICAL
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CONTRACTOR
CITY
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STATE
L/VA
ZIP
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FAX
S3)6.d- - 64 11
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
CC CLOV CC E Z 1 3 L- 4 1130
FEDERAL WAY BUSINESS LICENSE #
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91- (o,6k% -od—
NAME/ -
PRIMARY PHONE
,K "-L- a`S J'etl rt-�
( ) -
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
I ZIP
FAX
PROJECT CONTACT
NAME
S q
PRIMARY PHONE
( 53 8 - 5-111d
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: DATE
PRINT NAME: ) r n 1q. ! _'vrl
Bulletin #160 - January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application