19-103045 \. ,S
Electrical
City of Federal Way Permit #:19-103045-00-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: SABOL
Project Address: 2219 S 304TH ST Parcel Number:053700 0115
Project Description: Lighting and outlets for deck and shop beneath deck.
Owner Applicant Contractor
MARK&SUSAN SABOL MARK&SUSAN SABOL OWNER IS CONTRACTOR
2219 S 304TH ST 2219 S 304TH ST
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
Additional Permit Information
Is this an Online or O.T.C.application9 Yes
, t ' . 111
PERMIT EXPIRES Tuesday,23 June,2020
Permit Issued on Monday,June 24,2019
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 -ccor,- ce with the laws, rules and regulations of the State of
Washi a, , he City of Federal Way.
l
Owner or agent: Date: -z Y-/ 7
1
THIS CARD IS TO REMAIN ON-SITE f r
FeCITY
deral Wa Construction Inspection Record
y INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 103045 00 Address: 2219 S 304TH ST
Project: MARK& SUSAN SABOL FEDERAL WAY WA 98003-4807
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) ® Ditch cover(4030) I ® Slab/Concrete Floor(4255) ,
Approved Approved i Approved to place concrete
By Date , By Date
.. .•By Date
® Pool Bonding(4195) 1 ® Temporary Power(4275) ED Service(4235)
Approved Approved
Approved
By Date By Date ! By Date
® Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved By Date By Approved Approved
�P/e Date 9 l S
v- pie, Date 9/Gi -19
••
f• •
El Final-Electrical(4055)
Approved
By /�-(/ Date i''''',-.1
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date
By Date By Date
RECEIVED ELECTRICAL
�,TYOF
Federal WayJUN 2 s 2019 PERMIT APPLICATION
CITY C.r FEDF.SAL 4V Y
COMMUNITY DEVELOrF rl T NUMBER I q _ I V 3 0 c( � L 1.
SUITE/UNIT/SPACE#
SITE ADDRESS: /2' 119 S ..41.1 .
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# �� � CURRENT/PROPOSED USE
$ Z Go _a S_ 7_ O O - _ .4 L S_-01/
PROJECT NAME
(Tenant or Homeowner Last Name) SI 6 Q I
PROJECT DESCRIPTION !��1�i" C `t u d A11,5' ire rQ � an-Q ���� �jc,ne,ct� �Cc�
Detailed description of work to V
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ✓2-7d r/\ J-G 6 t / ( Z`'() Z3 iI- 6'67(
MAILING ADDRESS ( E-MAIL
2.217 S 304:11(_
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CITY STATEZIP FAX
1CQer.t GJ y W. 1g 3 ( ) -
NAME PRIMARY PHONE
0 1..1/4)11(1/ 5C I t ( )
-
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
( ) _
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#/ /NAME ... .._-PRIMARY PHONE
APPLICANT /;ice/< s cts‘" ( (Zo4) 2.3 Y- 6 f-I 7k
MAILING ADDRESS I E-MAIL
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CITY STATE ZIP FAX `J
ted,( cam, 6L)) re:.-"E ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT 5d ll't ( ) -
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 r ance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a p• of t • •• ication.
SIGNATURE: - -- DATE ‘- /
PRINT NAME: /rI R/ 'C 6 c
Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application
:411446 .
CITY CFF 's '^"= ,,,,,' Property Owner
Federal Way Electrical Work Permit Application
`- S TY - RE ":1,11,:.'..Z—'- i 4
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 this application and signing
the affidavit below before beginning electrical work.
} 21
, >, q i Afft lav-it .: G 3a 4 : 3i
N
hereb apply
f
As authorized under RCW 19.28.261, 1, Kqc �b� Y pP Yl
I (Printed name of pro)5erty owner,renter,or lessee)
for an exemption from the electrical licensing and certification requirements of RCW 19.28 by ,
1 submission of this affidavit.
,,
Which statement describes you? (Mark only one If none apply,you may not take out this permit)
:fil
1 -Ili- I own this property.
Your name or your company's name must be shown on the deed to the property. Real estate agents'property$
1 management companies, relatives, etc. cannot purchase permits for the property owner.
k ❑ I rent or lease this property.
We need a copy of your rental agreement showing you have permission to perform electrical work.
❑ I am an officer for a 501(c)(3)nonprofit corporation,or a nonprofit religious organization.
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.
li, Select your property,type (Mark only:one.If none,apply,you may not take out`this Permit.);,.
1 ❑ 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.
❑ 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. I,
personally,and/or a regularly employed employee(s),will be doing the electricalwork.
❑ New place of business,farm,or other property: Any new structure that is not intended for rent, 1
sale,or lease. I,personally,and/or a regularly employed employee(s),will be doing the electrical work.
1 ItS Existing residential property, place of business,or farm.I, personally,and/or a regularly
k employed employee(s),will be doing the electrical work.
I
DEPARTMENT OF COMMUNITY DEVELOPMENT/33325 8TH AVENUE SOUTH/FEDERAL WAY,WA 98003-6325
253-835-2607 zs www.cityoffederalway.com permitcenteracityoffederalway.com
Bulletin 11080—June 6,2018 Page 1 of 2 k:\Handouts\Property Owner Electrical Work Application
" ❑ 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.
I By signing below,I certify the information I am providing on this affidavit is true and a ate. I
- understand that if I make false statements or misrepresentations,I may be asse ed pe alties.
/ 1
Printed Name of Property Owner,Renter,or Lessee Si atur//
Date
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Propei1 Ow.ner�£aiid Inspection Sits Information` 1 4 ,
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Property Owner's Nafie(Last,First)or Company Name
Z217 S 3 (3 S-( . fie ('.( 1`) C.J
1 Mailing Address . Unit/Apt.# City / State Zip
K ao6 23 7" ,<o7r4 a r t5.\L( Qn-�..
Daytime Phone Email Address
1 Inspection Site Address(if different) Unit/Apt.# City StateZip
County Electrical Power Company/Serving Utility 2
r Description of work being done(Example:adding outlets in the kitchen,second floor break-area,etc.)
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DEPARTMENT OF COMMUNITY DEVELOPMENT/33325 8TH AVENUE SOUTH/FEDERAL WAY,WA 98003-6325
253-835-2607?Ii,www.citvoffederalway.com Is.permitcenter(a�cityoffederalway.corn
Bulletin#080—June 6,2018 Page 2 of 2 k:\Handouts\Property Owner Electrical Work Application