16-101037 .
` Electrical
City of Federal Way
Community a Econ.Dev.Services Permit #: 16-101037-00-EL
333258th Ave S FILE Line: (253)835-3050
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609InspectionRequest
' Project Name: HERSHMAN
Project Address: 1212 SW 354TH PL Parcel Number: 502860 1970
Project Description: (1)40amp Circuit&(1)Low Voltage for Stat for(1)Gas Furnace&(1)Heat Pump
Owner Applicant Contractor
JANE P HERSHMAN ALEX BURKHART EVERGREEN REFRIGERATION LLC
DANIEL P HERSHMAN EVERGREEN REFRIGERATION (ELECTRICAL)
1212 SW 345TH PL 727 S KENYON ST EVERGRL882JB(4/2/16)
FEDERAL WAY WA 98023 SEATTLE WA 98108 727 S KENYON ST
SEATTLE WA 98108
Additional Permit Information
Electrical Work Valuation 500.00 Is this an Online or O.T.C.application? Yes
Is Use Educational or Institutional? No
Electrical Fixtures
Circuits-Residential 1 Low Voltage-Other(Residential). 1 Thermostat
PERMIT EXPIRES Saturday, February 25, 2017
Permit Issued on Friday, February 26, 2016
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: cN L I >a Y E Date:
IN FALEt)
• THIS CARD IS TO ON-SITE e
CITY Or.41A
Coistrnction In ection Record
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 16-101037-00-EL Address: 1212 SW 354TH PL
Project: JANE P HERSHMAN FEDERAL WAY, WA 98023-6960
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) El 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) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
El Feeders/Sub-panels(4045) .0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
,
Final-Electrical(4055) .
Approved
By iwj. Date 3 ( to (I Jo
El Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date