14-100090 • ' "` Electrical
City of Federal Way
Community 8 Econ.Dev.Services Permit #: 14-100090-00-EL
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 ‘,ta. — - Inspection Request Line: (253)835-3050
Project Name: COATES '271
Project Address: 1817 SW 352ND PL Parcel Number: 926975 0730
Project Description: Installing a new circuit for microwave/hood fan
•
•
Owner Applicant Contractor
MICHELLE L COATES OLD TIME ELECTRIC INC OLD TIME ELECTRIC INC
1817 SW 352ND PL PO BOX 39745 OLDTIEI021LB(6/2/14)
FEDERAL WAY WA 98023 LAKEWOOD WA 98498 PO BOX 39745
LAKEWOOD WA 98498
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Electrical Fixtures
Circuits-Residential 1
PERMIT EXPIRES Monday, July 7, 2014
Permit Issued on Wednesday, January 8, 2014
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and t use will be in accordance with the laws, rules and regulations of the State of Washington
and theCiof Federal Way.
Owner or agent �.�-e- Date: \- g— 1`�
e
1 (Act
• THIS CARD IS TO ON-SITE # it •
II
CITY Of Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 14-100090-00-EL Address: 1817 SW 352ND PL
Project: MICHELLE L COATES FEDERAL WAY, WA 98023-3102
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) ❑ Final-Electrical(4055)
Approved Approved
By Date By VIA. 6 Date t It, [
0 Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
•
• RECEIVED
ELECTRICAL
CITY OF
Federal Way JAN 0 8 2014 PERMIT APPLICATION
CITY OF FEDERAL WAY
PERMIT NUMBER I 1 - / D 0 o /D6. - 0-0
'3(� c p\o ci` SUITE/UNIT/SPACE s
SITE ADDRESS:
\$A1 35a� , � t� q$oa 3
PROJECT VALUATION ASSESSOR'S TAX/PARCEL• CURRENT/PROPOSED USE
$ 3(4->c
PROJECT NAME �.{ l-
1
(Tenant or Homeowner Last Name) ` `�C.\' t\\t Ats n
( 1 ) G r'c�u; - , r - \c,r0 taxi--e.J IfkoorJ n
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME �+ PRIMARY PHONE
PROPERTY OWNER M►C)•' \\� Coo- -s (0 53 ) aa t - 5-go I
MAILING ADDRESS E-MAIL
sw 3s-ana \0.C.42—
CITY STATE ZIP FAX
Fecliera. W l3P, q(&o a3 ( ) -
NAME PRIMARY PHONE
'�"DI& `�fSE-MAIL
►r1n e I�c�4-Ytc \rc (c 3) $ - 3'z\S
ELECTRICAL V' D 60D s.. 3`\-7�{ 5--
n
CONTRACTOR
L C)OC STATE
IL C1 99lp ( ) FAX
WA STATE CONTRACTOR'S LICENSE• EXPIRATION DATE FEDERAL WAY RUSIIESS LICENSE F
OL- 7.-1-E / a- il'/ ao-O ,-JOoOSS -0a-6L_
NAME PRIMARY PHONE
APPLICANT
MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( ) -
PROJECT CONTACT N b� PRIMARY PHONE
A17 �\\ (c3S3 ) VI? - 3(0ai
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 certify that I will comply with
ail 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 oof this application.
SIGNATURE: � DATE —7 ^ )y
PRINT NAME: Z�PJlJF1l� �(�j�\
D 6 - 7 v
Bulletin#160–January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application