19-104637 r
Electrical
City of Federal Way Permit #:19-104637-00-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: SMITH
Project Address: 32612 16TH CT SW Parcel Number:010453 0530
Project Description: Wiring for heat pump
Owner Applicant Contractor
JOHN SMITH CESAR GARCIANORTH POINTE NORTH POINTE ELECTRIC LLC(01)
32612 16TH CT SW ELECTRIC LLC NORTHPE90IML(7/13/20)
FEDERAL WAY WA 3519 N BENNETT ST
98023-5438 TACOMA WA 98407 3519 N BENNETT ST
TACOMA WA 98407
Additional Permit Information
Is this an Online or O.T.C.application? Yes
sz ;-;
PERMIT EXPIRES Friday,25 September,2020
Permit Issued on Thursday,September 26,2019
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy a the use will be in accord nce with the laws, rules and regulations of the State of
Washington a the City of Federal Way.
Owner or agent: Date: .16.// 7
,,
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 104637 00 Address: 32612 16TH CT SW
Project: JULIE E SMITH FEDERAL WAY WA 98023-5438
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.
® UFER Ground(4295) 2❑ Ditch cover(4030) ® 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
•® Feeders/Sub-panels(4045) ® RoughElectrical(4225) ,• 9 ,
❑ Ceiling Cover(4020)
Approved Approved Approved
By Date 4., i.Date ,�By Date
3 o Final-Electrical(4055)
By 4e, Approved
Date 7'"a17/7
0 Rough Electrical ❑ Final Electrical ❑ Right of Way
Approved Approved Approved
By Date By Date By Date
A
curt OF RECEIVED ELECTRICAL
Federal WaySEP 26 2019 PERMIT APPLICATION
NT
comm... DEVE�PMPERMIT NUMBER 19 - 1 0 l Co 3 7 _ L
SUITE/UNIT/SPACE#
SITE ADDRESS: 3,2._6 f"') wit-6 Cr (3 K�
, 1
PROJECT VALUATION / ASSESSOR'S TAX/PARCEL#/ CURRENT/PROPOSED USE
$ .,moo. o1vW5 - 05- 3a
PROJECT NAME t c� /
(Tenant or Homeowner Last Name) o� k) �`� T" 6
PROJECT DESCRIPTION
Detailed description of work to Q A.4,t72be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNERJO4;� / /11 ) 5i7 5CI
MAILING DRESS E-MAIL
52 & (2 l6 Cr 9J
CIT7,.._, TE ZI � �� FAX
NAN E PRIMARY PHONE
/Jc9ft*,) P9 i itic, cd.et.'C 4 3 ) 2-o - 1'6
MAILING ADDRESS E-MAIL
ELECTRICAL �JCj-( ( 0, (12e1 t / 7"
CONTRACTOR CITY STATE ZIP FAX
`-�f Cl/r-04- LL 9o7 ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
No 6-1-, To 1 M 1✓ / /
NAM \ PRIMARY PHONE
APPLICANT lA� 6'/4)C-41 . ( )
MAILING ADDRESS E-MAIL
'5--17' N t 13Er4i•P9/7Cs r.
CITY STATE ZIP FAX
..--fi-r4-6914A el C -9 1t7 ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT - lL 0/91C4 a 455 ) 0?6
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 arty claim(including costs, expenses,and attorneys'fees incurred in
the investigation and defense of su h claim),which may be made by any person,including the undersigned,and filed against the city,
but only where such claim ari- •ut of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the c• • a part of this application.
SIGNATURE: DATE
g/26/(9
PRINT NAME:' ( /,i (o/A/C-fa
Bulletin#160—April 14,2016 Page 1 of 1 k:\}Iandouts\Electrical Permit Application