19-102395 . -»
Electrical
City of Federal Way Permit #:19-102395-00—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: CARBONI
Project Address: 30847 13TH PL S Parcel Number:401540 0050
Project Description: Altering up to 4 circuits to replace lights damaged by water leak.
Owner Applicant Contractor
DEBRA CARBONI NORTH POINTE ELECTRIC LLC(01) NORTH POINTE ELECTRIC LLC(01)
30847 13TH PL S UNIT 5 3519 N BENNETT ST NORTHPE901ML(7/13/20)
FEDERAL WAY WA 98003 TACOMA WA 98407
3519 N BENNETT ST
TACOMA WA 98407
Additional Permit Information
Is this an Online or O.T.C.application's Yes
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Circuits-Multi-family 4
PERMIT EXPIRES Friday,15 May,2020
Permit Issued on Thursday,May 16,2019
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy an If the use will be in accordance with the laws, rules and regulations of the State of
Washington and City of Federal Way.
Owner or agent: Date:
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• THIS CARD IS TO REMAIN ON-SITE
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CO Inspection RecordFederal way INSPECTION ON REQUESTS:( 85-33
PERMIT#: 19 102395 00 Address: 30847 13TH PL S Unit 5
Project: DEBRA CARBONI FEDERAL WAY WA 98003-4700
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.
•
El Service(4235) '�•ID Feeders/Sub-panels(4045) ' Q Rough Electrical(4225) '
Approved Approved
Approved
BY Date By Date By e, Date J -ogi-/9
El Ceiling Cover(4020) '70 Final-Electrical(4055)
Approved Approved
BY Date , By Date_f2 '/lb S
Rough Electrical Final Electricalj 1 Right of Way
Approved Approved
Approved
By Date 1 By Date
BY Date
CITY OF _A. ELECTRICAL
Federal Way RECEIV PERMIT APPLICATION
MAY 162019
CITY OF FEDERAL viliimpT NUMBER / / 67
QOMMUNfTY DEVELOPME': ( — - ,?� 1 ✓ - 00
SUITE/UNIT/SPACE#
SITE ADDRESS: 3 D z-/7' /31(-2 /,7Z
31G/, /L 5,
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ IQb° R. o _
PROJECT NAME /�
(Tenant or Homeowner Last Name) -5L a6,€ .N Q ec5.V Ciskl Or)
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PROJECT DESCRIPTION ic HP,,k) ��'N.( (t( 4 5 )
Detailed description of work to
be included on this permit only
NAME/1 . PRIMARY PHONE
PROPERTY OWNER ,7A CD 4 ( ) -
MAILING ADDRESS E-MAIL
.50)74÷- /3*-_ (rpt, s
CITY ,( J` STATE ZIr �'X')//yam) s-� ( FAX
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NAME \ PRIMARY PHONE
0° Q 1 P 1�1 Q t C. e.63 )759- v7`.1
MAILING ADDRESS E-MAIL
ELECTRICAL Cr N y--.r e7exii-e- i S / m Avec li c lets J..CO)'/I
CONTRACTOR CITY STATE ZIP/7FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAMEPRIMARY PHONE
APPLICANT .70') 12___. G' 1G" 45kC3 )3010 - .56.16
MAILING ADDRESS E-MAIL
.5--/ AU, (5e/7/2-e/ ./ 5r
CITY STATE ZIP FAX
T� C.6e'�' °7 ( ) -
NAME 1.. 561".....-l� PRIMARY PHONE
PROJECT CONTACT L/G' ( )
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 • - less the City of Federal Way as to any claim(including costs,expenses, and attorneys'fees incurred in
the investigation and def se of such claim), which may be made by any person,including the undersigned, and filed against the city,
but only where such cl im • ses out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied t t city as a part of this application.
SIGNATURE: DATE 5/61-! `
PRINT NAME: C Ia._ , Y'2 (_-
Bulletin#160-April 14,2016 Page 1 of 1 k:\Flandouts\Electrical Permit Application