19-102298 Electrical
Cit ofFederal Wry Permit #:19-102298-00-EL
Community Development Dept
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: WAIRIMA
Project Address: 2008 S 372ND ST Parcel Number:721265 1710
Project Description: Altering up to 2 circuits for new switches and outlets.
Owner Applicant Contractor
PERPETUA WAIRIMA PERPETUA WAIRIMA OWNER IS CONTRACTOR
2008 S 372ND ST 2008 S 372ND ST
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
Additional Permit Information
Is this an Online or O.T.C.application9 Yes
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Circuits-Residential 2
PERMIT EXPIRES Saturday,9 May,2020
Permit Issued on Friday,May 10,2019
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
X11 Washington and the City of Federal Way.
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Owner or agent: i' Date: /10 .
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THIS CARD IS TO REMAIN ON-SITE
441A0Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 19 102298 00 Address: 2008 S 372ND ST
Project: PERPETUA WAIRIMA FEDERAL WAY WA 98003-7570
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.
0 Rough Electrical(4225) z❑ Final-Electrical(4055)
Approved Approved
By Date By Date J 13,49
Rough Electrical Final Electrical LJ Right of Way
Approved Approved Approved
By Date By Date By Date
ELECTRICAL
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CITY OF RECEIVED
Federal Way PERMIT APPLICATION
MAY 10 2019
CITY OF FEDERAL lh':a'f PERMIT NUMBER ( c3 - 1 a q -
COMMUNITY DEVELOPMENT On
SUITE/UNIT/SPACE#
SITE ADDRESS: 2'0 b i- d, -1-a. (Id (Y e f,4- ?FJe fa1( I
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PROJECT VALUATION ASSESSOR'S TAX/PARCEL# wl l CURRENT/PROPOSED USE
$ Roo - V
PROJECT NAME 1,
(Tenant or Homeowner Last Name) aQD� cc 372.114) �f
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PROJECT DESCRIPTION
Detailed description of work to Mo V CI CfW 1 1—
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER �a t Yi•ma (ID 6) Yet - 14"'?7 7
MAILIN ADDRESS E-MAIL
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CI7 STATE ZIP 1 FltXX
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NAME - - _ - - - - - PRIMARY PHONE
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MAILING ADDRESS E-MAIL
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CONTRACTOR CITY STATE ZIP FAX
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WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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E PRIMARY PHONE
APPLICANT Vtr 0 �.1\vi`rvi , (RD6 ) 4'g8 - 13-71MAILIN ADDRESS E-MAIL
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NAME PRIMARY PHONE
PROJECT CONTACT jpfa , VV a ht i Ma , (2o6 )44i - 1.511
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.
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SIGNATURE: DATE Li IVO 6-o,, •
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PRINT NAME: G VOa 7`0 MA
Bulletin#160—April 14,2016 Page 1 of 1 k:U-Iandouts\Electrical Permit Application
8-to?I-0)Y-(xD ,
RECEIVED
`` n 19 Property Owner
CITY a� � -- MAY 1 20 p y -
Federal ' — CITY OF FEDERAL WAY Electrical Work Permit Application
COMMUNITY DEVELOPMENT
Applying Fob- four Electrical' "er it . " :4°-4
In Washington, only licensed electrical contractors may perform electrical work. Property owners
may apply for an exemption from these requirements by completing this application and signing
the affidavit below before beginning electrical work. I.
Affidavit . >; :
As authorized under+RCW 19.28.261, ¶iQkv G ut . hereby apply
(Printe name ofproperty owner,renter,or lessee)
for an exemption from the electrical licensing and certification requirements of RCW 19.28 by
submission of this affidavit.
;I
Which statement describes you? (Mark only one.If none apply,you may not take out this permit.). ,."
1 I own this property.
i ' Your name or your company's name must be shown on the deed to the property. Real estate agents'property
management companies, relatives, etc. cannot purchase permits for the property owner.
t
❑ I rent or lease this property.
We need a copy of your rental agreement showing you have permission to perform electrical work.
❑ I am an officer for a 501(c)(3)nonprofit corporation,or a nonprofit religious organization.
t The total market value of electrical work must be$30,000 or less and all electrical work must be done by a i
non-compensated appropriately certified electrician.
t - - i
t Select your property type(Mark only one:If none apply,you may not take out this permit.)
❑ New single family residence that is not intended for rent, sale, or lease,where I will be living for I
at least 24 months after completing the electrical work. I will be personally doing the electrical I
work.
❑ New 2,3,or 4 unit residential building,owned by me,that is intended for rent, sale, or lease. I g
will be living in one of the units for at least 24 months after completing electrical work. I, r
personally, and/or a regularly employed employee(s),will be doing the electrical work.
t ❑ New place of business, farm,or other property: Any new structure that is not intended for rent, i
sale,or lease. I,personally,and/or a regularly employed employee(s),will be doing the electrical work. 4
r
❑ Existing residential property,place of business,or farm.I, personally,and/or a regularly
employed employee(s),will be doing the electrical work.
DEPARTMENT OF COMMUNITY DEVELOPMENT/33325 8TH AVENUE SOUTH/FEDERAL WAY,WA 98003-6325 ,
253-835-2607 zs.www.cityoffederalway.com zs permitcentert citvoffederalway.com
Bulletin#080—June 6,2018 Page 1 of 2 k\Handouts\Property Owner Electrical Work Application
❑ 501(c)(3) or nonprofit religious organization owned property:The total market value of the
electrical work must be$30,000 or less,and all electrical work will be performed by appropriately
certified electricians,or certified and properly supervised trainees, who are volunteering and not
being compensated for the electrical work per RCW 19.28.091(7).
Your signature is required below:
I believe I should be exempt from the requirements to obtain an electrical license,or use a certified
electrician, as provided under RCW 19.28.261.
By signing below,I certify the information I am providing on this affidavit is true and accurate. I
understand that if I make false statements or misrepresentations, I may be as ed penalties.
Ve( ofy G V� i I m a
Printed Name of Property Owner,Renter,or Lessee Signature
LSItJ ,2al9i •
Date
ry. - ----Prope-rty wnerand-inspectr ite In1ormatzon
�Q Ibook ^c I•rn G
Property Owner's Name(Last,First)or Company Name
9oo8 U 37 t (rk'iea 'Ie.1)e>:~) WALI wri '-
: Mailing Address Unit/Apt.# City State Zip
a foto- 3t171 W 61' 1 ma r,Tz ,c - o rvlGil' oom
Daytime Phone Email Address
906-03-*9'11 i;de'' 1 w bJA 11801)3.
• Inspection Site Address(if different) Unit/Apt.# City State Zip
LICA
County Electrical Power Company/Serving Utility
Description of work being done(Example:adding outlets in the kitchen,second floor break area,etc)
Mo w 1`a--ct,
DEPARTMENT OF COMMUNITY DEVELOPMENT/33325 8TH AVENUE SOUTH/FEDERAL WAY,WA 98003-6325
253-835-2607 zs.www.cityoffederalway corn zs permitcenterAcityoffederalway.com
Bulletin#080-June 6,2018 Page 2 of 2 k:\Handouts\Property Owner Electrical Work Application