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18-104423 •• Electrical �,�ofFederalwa, F I LEPermit #:18-104423-00-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: ANDERSON Project Address: 31332 13TH AVE S Parcel Number:787520 0035 Project Description: Add power to the home addition • Owner Applicant Contractor JENNIFER ANDERSON JENNIFER ANDERSON OWNER IS CONTRACTOR 31332 13TH AVE S 31332 13TH AVE S FEDERAL WAY WA 98003-5313 FEDERAL WAY WA 98003-5313 Additional Permit Information Is this an Online or O.T.C.application? Yes PERMIT EXPIRES Wednesday,18 September,2019 Permit Issued on Tuesday,September 18,2018 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. Owner or agent: ?/p4( .1 (/2/ 1 er Date: 42 —at7 - 1 ir.(7 I on) . 1. 404 THIS CARD IS TO REMAIN ON-SITE Construction Inspection Record I INSPECTION REQUESTS:(253)835-3050 PERMIT 8: 18 104423 00 Address: 31332 13TH AVE S Project: JENNEFER ANDERSON FEDERAL WAY WA 98003-5313 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) 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255) Approved Approved Approved to place concrete By Date By Date By Date El Pool Beading(4195) ® Temporary Power(4275) © Service(4235) Approved Approved Approved By Date By Date By Date 0 Feeders/Sub-panels(4045) ® Rough Electrical(4225) ❑ Ceiling Cover(4020) Approved Approved Approved By 4 __ Date -9, By C 4-ct Date i 1---AZT--Arli By Date MI -Electrical(4055) pproved(ji ....zip., ��f By Date /''1i. Rough Electrical El Final Electrical ❑ Right of Way Approved Approved Approved By Date By Date By Date RECEIVED AELECTRICAL CITY SEP 1 8 2O\ Federal Way PERMIT APPLICATION AY Gm(OF FEDEKALOMENT PERMIT NUMBER I U — 1 0 7 an 3 - E-L.) SUITS/UNIT/SPACE s SITE ADDRESS: 3 )33 D )3 r ('° PROJECT VALUATIONASSESSOR'S TAX/PARCEL v CURRENT/PROPOSED USE $ 30U � +7 $ 1 5 2 O n o 3 .S PROJECT NAME /� J (Tenant or Homeowner Last Name) �1VZCe ( S C5Y1 PROJECT DESCRIPTION Q ctadP O(--)-€{" 1-e5 -}& Leimx geld',-Iv,v‘ q on De iled description of work to j be included on this permit only NAME ((11 PRIMARY PRONE PROPERTY OWNER Aell ri:.- -{ , -tde-Irte (.23) c...( - o71(0 MAILING ADDRESS E-MAIL 3 3 3 �/�)r STS ZIP FAX eh,,7n .Q nel rsni�a ,I CITYcoon reA)erc Lrct. j i,,,4 °Roo 3 _ NAME /' PRIMARY PRONE 0U•Diner ( ) - MAILING ADDRESS E-MAIL ELECTRICAL CONTRACTOR CITY STATE ZIP FAX ( ) WA STATE CONTRACTOR'S LICENSE i EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE If „I PRIMARY / APPLICANT NAME --L `fin,' Ad PSI s '- ( ) rsoNE MAILING ADDRESS E-MAIL CITY STATE ZIP FAX ( ) NAME PRIMARY PHONE PROJECT CONTACT evi h fi i Ci-¢T sefr- ( ) I certify under penalty of perjury that I am the property owner or authorised 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 cert{lt that I will comply with all applicable City of Federal Way regulations pertaining to the work authorised 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. i SIGNATURE: Aft,, _,i :' n DATE Ill .3 A g' PRINT NAME: AgL I : it PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325 253-835-2607+FAX 253-835-2609 +permitcente ncityofederalway.com Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application CITY OF Property Owner Federal Way Electrical Work Permit Affidavit Applying For Your Electrical Permit In Washington, only licensed electrical contractors may perform electrical work. Property owners may apply for an exemption from these requirements by completing and signing the affidavit below before applying for an electrical permit or beginning electrical work. Affidavit rr a As authorized under RCW 19.28.261, I, �eph; And e,tso (Printed name of property owner,renter,or lessee) hereby apply for an exemption from the electrical licensing and certification requirements of RCW 19.28 by submission of this affidavit. Which statement describes you? (Mark only one.If none apply,you may not take out this permit.) I own this property. 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. ❑ I rent or lease this property. We need a copy of your rental agreement showing you have permission to perform electrical work. 0 I am an officer for a 501(c)(3)nonprofit corporation,or a nonprofit religious organization. f, The total market value of electrical work must be$30,000 or less and all electrical work must be done by a non-compensated appropriately certified electrician. 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 at least 24 months after completing the electrical work.I will be personally doing the electrical work. 0 New 2,3,or 4 unit residential building,owned by me,that is intended for rent,sale,or lease. I will be living in one of the units for at least 24 months after completing electrical work. 1,personally,and/or a regularly employed employee(s),will be doing the electrical work. 0 New place of business,farm,or other property:Any new structure that is not intended for rent, sale, or lease.I,personally,and/or a regularly employed employee(s),will be doing the electrical work. ' 0 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 STH AVENUE SOUTH/FEDERAL WAY,WA 98003-6325 253-835-2607 za.www.cityoffederalway.com zi.permitcenterna cityoffederalway.com Bulletin#170—July 27,2018 Page 1 of 2 k:\Handouts\Property Owner Electrical Work Affidavit o 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 assessed penalties. 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