15-105015 .. • Electrical f
Cityof Federal Way Permit #: 15-105015-00-EL
Community&Econ"Dev.Services " '
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2807 Fax:(253)835-2809 P q
Project Name: FILLER
Project Address: 4138 SW 328TH ST Parcel Number. 873203 0380
Project Description: Add 120-v 20-a circiot for deck alteration; move(2)outlets for addition of slider.
Owner Applicant Contractor
DONALD J FILLER PRECISION CONSTRUCTION PRECISION CONSTRUCTION
4138 S 328TH ST MANAGEMENT(ELECTRICAL) MANAGEMENT(ELECTRICAL)
FEDERAL WAY WA 98023-2628 10604 22ND PL S PRECICM883K5(5/27/16)
SEATTLE WA 98168 10604 22ND PL S
SEATTLE WA 98168
Additional Permit information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Electrical Fixtures
Circuits-Residential I
PERMIT EXPIRES Tuesday, March 29, 2016
Permit Issued on Thursday, October 1, 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
-nd the City of Federal Way.
Owner or agent: T. c i l,P Date: 10 - t— IS
`J
r
THIS CARD IS TO RE ON-SITE
•0A.. Co
CITY�'
Construction Insp ion Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-105015-00-EL Address: 4138 SW 328TH ST
Project: DONALD J FILLER FEDERAL WAY, WA 98023-2628
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) ❑ Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
0 Pool Bonding(4195) ❑ Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
El Feeders/Sub-panels(4045) El Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date Bj- Date to_ 6_ 1. ., By Date
0 Final-Electrical(4055)
Approved
By , l�I .� Date L_-21-15
❑ Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
•ECEIVED
LECTRI CAL
CITY OF OCT 01 2015
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
` CDS
PERMIT NUMBER /5 - / OS 6 / 5 -
[ SUITE/UNIT/SPACE#
SITE ADDRESS: 1_C 13 g sw -52,t4\4(..0\_ e ckv4 I w
/I
PROJECT VALUATION ASSESSOR'S TAX/PARCEL
# CURRENT/PROPOSED USE
$ 1 2L,,,0 '3' 7 3 a0 3 - 0 3 & 0
PROJECT NAME
(Tenant or Homeowner Last Name) ei ID
�i(/
AJcl 1Zo\ 20A CVL * aleck 414-urctqofr..
PROJECT DESCRIPTION IAtimV2 (2) S(,Iftv fluor- sk:, le-e ck lel t)
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER 1)t9sA TTIfev- ( ) -
MAILING ADDRESS E-MAIL
L)R$ Sw .13204 S--
CITY STATE ZIP FAX
}-ecitylk l Wet y W tt. ( ) -
NAME PRIMARY PHONE
ecsf9h l y- +/4,n tA4 . - (3CQ )'-j?( - q3 R
MAILING ADDRESS `(� E-MAIL
ELECTRICAL L O 6°LI 22 ' r S.
CONTRACTOR CITY STATE ZIP FAX
Se Rt wa cRi&c ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE S
PIZC-5604%S 31(c S / / 16
NAME PRIMARY PHONE
APPLICANT (r'(n.�.f (.O V ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME / PRIMARY PHONE
PROJECT CONTACT 16" 1Le6 E-(- (3Ct 1131 - 93 9 e
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.
SIGNATURE: I - DATE 101 I r ( C
PRINT NAME:
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application