16-102456City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: DIXON
Electrical
Permit #: 16-1O 456 -00 -EL
FILE
Inspection Request Line: (253) 835-3050
Project Address: 1923 SW 352ND ST
Parcel Number: 787960 0040
Project Description: ALTERED 0-200 AMP SERVICE TO REPOWER HOME ***REVISED TO ADD
SUBPANEL, ON 5= 6***
3r
Owner
AR IIS
Contractor
JARRAD DIXON
JARRAD DIXON
OWNER IS CONTRACTOR
1923 SW 352ND ST
1923 SW 352ND ST
FEDERAL WAY WA 98023-3152
FEDERAL WAY WA 98023-3152
Alt. Serv./Feeder. 0 to 200 amps (F 2
PERMIT EXPIRES
Permit Issued on
1 hereby certify that the above information is
the occupancy and the use will be in accor(
Owner or agent:
V�
i
11110 r
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CW
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City of F
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Pity, May 20, 20
May 20,V
the construthe above described property and
vs,v�uul� egulations of the State of Washington
derA160ay.
Date: S I 2 3 I I
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253)835-2807 Fax: (253) 835-2809
Project Name: DIXON
Electrical
Permit #: 16 -102456 -00 -EL
Inspection Request Line: (253) 835-3050
Project Address: 1923 SW 352ND ST Parcel Number: 787%0 0040
Project Description: ALTERED 0-200 AMP SERVICE TO REPOWER HOME
Owner
Anulicant
Contractor
JARRAD DIXON
JARRAD DIXON -
OWNER IS CONTRACTOR
1923 SW 352ND ST
1923 SW 352ND ST
FEDERAL WAY WA 98023-3152
FEDERAL WAY WA 98023-3152
Additional Permit Information
Electrical Work Valuation?....................................500 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
PERMIT EXPIRES Saturday, May 20, 2017
Permit Issued on Friday, May 20, 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
a City of Federal Way.
Owner or agent: Date:
wil
• ° - THIS CARD IS TO REMAIN ON-SITE "
CITY of
CITY CW l Way Construction Inspection Record
Fedy INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 16 -102456 -00 -EL Address: 1923 SW 352ND ST
Project: JARRAD DIXON FEDERAL WAY, WA 98023
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.
LIFER Ground (4295)13
Ditch cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
1:1Approved
Temporary Power (4275)
Right of Way
Approved
By
Service (4235)
Approved
Date
Approved
Date
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By
Date
Rough Electrical
Approved
1:1Approved
Final Electrical
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF Building Division
33325 Eighth Avenue South
Federal Wa Federal Way, 98003-6325
y Phone 253-835-2607 Fax
253-835-2609
CORRECTION NOTICE
ADDRESS: 3 s PERMIT#:_ (Co-1oz4s�-- EZ
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C.A., Jr v '`�-
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IF YOU HAVE QUESTIONS CALL (253)835-
WHEN
253)835-
WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE -INSPECTION. SEE BACK OF CARD
FOR DETAILS. NOTE: ELECTRICAL CORRECTIONS ARE REQUIRED TO BE MADE WITHIN 15 DAYS.
s - zc- (c,
DATE INSPECTOR
DO NOT REMOVE THIS NOTICE
Page � f
ciry OF
^�. Federal Way
Building Division
33325 Eighth Avenue South
Federal Way, WA 98003-6325
Phone 253-835-2607 Fax 253-835-2609
CORRECTION NOTICE
ADDRESS: I Q 5 3 g vn `3S 2 PERMIT#:
'NIIIIIInjum! RID
elk
IF YOU HAVE QUESTIONS CALL
(253) 835- X. L 2`i
WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE -INSPECTION. SEE BACK OF CARD
FOR DETAILS. NOTE: ELECTRICAL CORRECTIONS ARE REQUIRED TO BE MADE WITHIN 15 DAYS.
• J N /L J ��
DATE
INSPECTOR
DO NOT REMOVE THIS NOTICE
Page of
CITY OF
Federal Way
RRINM ELEC'T'RICAL
MAY 2 0 2016 PERMIT APPLICATION
CITY OF FEDERAL WAY /
CDS PERMIT NUMBER _ J O� 00
N73 SITE ADDRESS:
� � �
�3
SUITE/UNIT/SPACE #
OJECT V/AALUATION
PROJECT
v
ASSESS C TA
_
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)(
r
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME �
PRIMARY PHONE
MAILING ADDRESS
/claS
E-MAIL
0 L'
TY
SS,T,A�T�E,
ZIP 3�
FAX
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 � V v � � ^
� )PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
)
PROJECT CONTACT
NAME
)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 irtformation 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 clairN, 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 p 's ap lica
SIGNATURE: DATE
PRINT NAME:
Bulletin # 160 — April 14, 2016 Page 1 of 1 k:\Handouts\Electrical Permit Application