19-102648 Electrical
City of Federal Way Permit #:19-102648-00-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: AMBERSON
Project Address: 30921 26TH AVE S Parcel Number:798440 0170
Project Description: Change a 125-amp split buss panel to a 125-amp main breaker panel.
•
Owner Applicant Contractor
MARY HELEN AMBERSON TRACE ELECTRIC LLC TRACE ELECTRIC LLC
30921 26TH AVE S 19904 SE 242ND PL TRACEEL904D4(3/26/20)
FEDERAL WAY WA 98003 MAPLE VALLEY WA 98038
19904 SE 242ND PL
MAPLE VALLEY WA 98038
Additional Permit Information
Is this an Online or O.T.C.applications Yes
Alt. Serv./Feeder:0 to 200 ami 1
PERMIT EXPIRES Tuesday,2 June,2020
Permit Issued on Monday,June 3,2019
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
✓� /� Washington and the City of Federal Way. ,r
Owner or agent:: ," 10,4!i,..4.-.,• Date: 0 '/c/
n
THIS CARD IS TO REMAIN ON-SITE
F`""°' Construction Inspection Record
ederal vvay INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 102648 00 Address: 30921 26TH AVE S
Project: MARY HELEN AMBERSON FEDERAL WAY WA 98003-5001
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 UFER Ground(4295) •❑ Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved ! Approved to place concrete
By Date By Date ' By Date
,,
GI Pool Bonding(4195) 0 Temporary Power(4275) s❑ Service(4235)
Approved Approved Approved
By Date .1 By Date 1<BY Date
•
0 Feeders/Sub-panels(4045) 0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
0 Final-Electrical(4055)
' ./i.
Approved
By Date 7:674"/
.
0 Rough Electrical ❑ Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date
By Date
A. RECEIVED ELECTRICAL
CITY OF -
Federal Way JUN 0 3 2019 PERMIT APPLICATION
t,1 lY OF FEDERAL WAY
;OMMUNITY DEVELOPMEN-PERMIT NUMBER / _ / D A „, 54-1,54-1, r- Gy /
/ `SUITE/UNIT/SPACE#`i f/
SITE ADDRESS:
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
PRdJECT NAME
(Tenant or Homeowner Last Name)
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PROJECT DESCRIPTION /2-5- 'IAA-, ."1- r e keen mac/i. �
Detailed description of work to
be included on this permit only
yi4/NAAME / PRIMARY PHONE
PROPERTY OWNER Mac �e ii, Am �j e,r- co,'- (Z;'3) S3- J )
MAILIN ADDRESS E-MAIL
30307 2_ 1 ' Alic c
CITY STATE ZIP FAX
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NAME PRIMARY PHONE
l rccc_.Q, e/ec.-jr, a 1-1-- C (Y2, -)69/ -O2 6
MAILING ADDRESSpp - E-MAIL
ELECTRICAL /�'C C f SE z-i J/- / Trticee le iric4 copy--
CONTRACTOR CITY STATE ZIP FAX
0/e V/a/ley 6-/4 �g03h ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
TRA CEgL ?vya y
NAME PRIMARY PHONE
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APPLICANT MAILING ADDRESS E-MAIL
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CITY STATE ZIP FAX
/Y le 16//-ey u44 9g.oS$ ( ) _
NM1E PRIMARY PHONE
PROJECT CONTACT 4 y e.S q cl (y2s-)6e/ -oZsde
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 thishiapplication.apI� �J
SIGNATURE: �=�'C�o� // /y —_.i DATE ✓ . -- /
PRINT NAME: .4. +►c4:t4 1/ /191044-6 CI •—
PERMIT CENTER+ 33325 8th Avenue South + Federal Way,WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenteri;cityoffederalway.com
Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application