16-104678T 7
City of Federal Way
Community & Eoon. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2807 Fax (253) 835-2809
Project Name: ENGLISH
Electrical
F -LE Permit #: 16 -104678 -00 -EL
Inspection Request Line: (253) 835-3050
Project Address: 32121 8TH AVE S
Project Description: Alter service riser for meter
Parcel Number: 1502410060
Owner
AR lin cant
Contractor
ANN ELIZABETH ENGLISH
DAVID WOLF
D & A ELECTRIC LLC
MICHA ENGLISH
D & A ELECTRIC LLC
DELEC*E897D5 (4/5/17)
32121 8TH AVE S
11909 VICKERY AVE E
11909 VICKERY AVE E
FEDERAL WAY WA 98003
TACOMA WA 98446
TACOMA WA 98446
Additional Permit Information
Electrical Work Valuation?...................................A50 Is this an Online or O.T.C. application? ................. Yes
Is Use Educational or Institutional?.......................No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps (F 1 Mast or Meter Repair (Jesitja
PERMIT EXPIRES 1
Permit Issued on
I hereby certify that the above information is correct that the
the occupancy and the use will be in accordance the law
a City of Fed19
Owner or agent.
'apt
7
ion on the above described property and
regulations of the State of Washington
Date: 9 / ZO / ! (o
urr or 4&
F'iii� W,W
PERMIT #:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record `
INSPECTION REQUESTS: (253) 835-3050
16 -104678 -00 -EL Address: 32121 8TH AVE S
Project: ANN ELIZABETH ENGLISH FEDERAL WAY, WA 98003-5916
Scheduled inspections may be failed if this card is not on-site. DO NOT i_.OS ; TRIS CA". . 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
Ground
Ditch cover (
Temporary Power (4275)Service
Slab/Concrete Floor (4255)
Approved
(4235)
Approved
Approved to place concrete
By
Date
By
Date
By
Date
0
Pool Bonding (4195)
0
Temporary Power (4275)Service
(4235)
Approved
Approved
Approved
By
Date
By
Date
By
Date
0
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
0
Final - Electrical (4055)
Approved
By
Date
13 Rough Electrical Final Electrical Right of Way
Approved 13 Approved Approved
By Date By Date By Date
CITY OF 'A
Federal Way
R erVED ELECTRICAL
SEP 19 2016 PERMIT APPLICATION
CITY OF FEDERAL WAY /_
CDS PERMIT NUMBER I _ I O -/ 7g
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 apart of this application.
SIGNATURE:
PRINT NAME: +k V � d' L'i d `
Bulletin #160 —April 14, 2016 Page 1 of 1 k:\Handouts\Electrical Permit Application
,1,�
``}�' _
SUITE/UNIT/SPACE#
SITE ADDRESS:
'3 21 2 � S 5
PROJECT VALUATION
ASSESSOR'S TAX/PARCEL #
1
o
CURRENT/PROPOSED USE
s a/_
O
PROJECT NAME
(Tenant or Homeowner Last Name)
r/^ C_
(Y1 1 k— V\ S Yl
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
M� E1�gL�sh
PRIMARY PHONE
(W6) 775 - 75 �'5
MAILING ADDRESS
,7�2lZI & Cid
s
E-MAIL
CITY
STATE
ZIP
FAX
NAME
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
ELECTRICAL
I t 9 0
CONTRACTOR
CITY
STATE
ZIP
J, 4� 6
FAX
( ) -
WA STATE CONTRACTOR'S LICENSE #
E C
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
L F t7t 817b
y 7
NAME
_5 o �` Q.5
PRIMARY PHONE
-
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
( )
PROJECT CONTACT
NAME1
j
PRIMARY PHONE
(1-53) ?3Z - 9'q7
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 apart of this application.
SIGNATURE:
PRINT NAME: +k V � d' L'i d `
Bulletin #160 —April 14, 2016 Page 1 of 1 k:\Handouts\Electrical Permit Application