15-101855 Electrical
City
Of Federal Way ILEPermit #: 15-101855-00-EL
Community 8 Econ.Dev.Services
33325 8th Ave S til
Federal Way,WA 98003 „w Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax(253)835-2609 I �l
Project Name: CLEMENT
Project Address: 4113 SW 315TH ST Parcel Number: 873198 2830
Project Description: Permit to complete work under expired permit 12-1042320-00-EL.Work is adding/altering
up to(4)circuits for new outlet/switches.
Owner Applicant Contractor
ALBERT CLEMENT ALBERT CLEMENT OWNER IS CONTRACTOR
4113 SW 315TH ST 4113 SW 315TH ST
FEDERAL WAY WA 98023-2131 FEDERAL WAY WA 98023-2131
•
Additional Permit Information
Is Use Educational or Institutional? No
Electrical Fixtures
Circuits-Residential 4
PERMIT EXPIRES Monday, October 12, 2015
Permit Issued on Wednesday,April 15, 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.
C.LOwner oragent Date: ‘3/ l
' THIS CARD IS TO REMAIN ON-SITE
CITY
cr of ��
sp
Federal WayConstruction Inection Record
INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-101855-00-EL Address: 4113 SW 315TH ST
Project: ALBERT CLEMENT FEDERAL WAY, WA 98023-2131
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.
O UFER Ground(4295) 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
• • • ,
O Pool Bonding(4195) 0 Temporary Power(4275) D Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) El Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
O Final-Electrical(4055)
Approved
By Date
O Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
MCEM
CFr„OF ELECTRICAL
Federal WayAPR 15 2ot5
CITY OF FEDERAL WAY PERMIT APPLICATION
CDS _
PERMIT NUMBER / — L �(� 6
SITE ADDRESS: �- % / 3 ���
tl 7 �
SUITE/UNIT/SPACE #
PROJECT VALUATION
N\
ASSESSOR'S TAX/PARCEL
_
CURRENT/PROPOSED USE
PROJECT NAME
Homeowner
(Tenant or Last Name)
% %K t Vkk
PROJECT DESCRIPTION
__T �
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
�E.' +ti'�`
PRIMARY PHONE
a1- (VSG-?
MAILING ADDRESS
'4..k13 Sc�
E MAII
crrY
F� STATE ZIP
FAX
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NAME
PRIMARY PHONE
)
MAILING ADDRESS
E-MAIL
ELECTRICAL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE R EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE Y
NAME
PRIMARY PHONE
APPLICANT
54 �
( )
RES$
E-MAIL
CITY
STATE
ZIP
FAX
)PRIMARY
PROJECT CONTACT
NAME
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 thathe
issuance of this permit does not remove the owner's responsibility for compliance with local state, or federal laws regulating t
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 t"tr#A" part of this application.
SIGNATURE:
PRINT NAME:
Bulletin # 160 —January 1, 2013 Page 1 of 2 UHandoutsTlectrical Permit Application