19-102796 Arr
Electrical
City of Federal Way Permit #:19-102796-00-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: WILLMOREIWEBB
Project Address: 28944 11TH PL S Parcel Number: 720570 0080
Project Description: Add(2)circuits and replace(2)existing circuits as part of basement remodel. '
Owner Applicant Contractor
JOHN WILLMORE JOHN WILLMORE OWNER IS CONTRACTOR
28944 11TH PLS 28944 11TH PL S
FEDERAL WAY WA 98003-3706 FEDERAL WAY WA 98003-3706
Additional Permit Information
Is this an Online or O.T.C.application9 Yes
Circuits-Residential 4
PERMIT EXPIRES Wednesday, 10 June,2020
Permit Issued on Tuesday,June 11,2019
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 accordance with the laws, rules and regulations of the State of
W hington and the City of Federal Way.
Owner or agent: _ Date: 4'A/2a(9
, nom
1
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THIS CARD IS TO REMAIN ON-SITE
CITY OP
`' 44 Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 102796 00 Address: 28944 11TH PL S
Project: DIANNE WEBB FEDERAL WAY WA 98003-3706
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.
1❑ UFER Ground(4295) El Ditch cover(4030) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date Date
.• •
.
0 Pool Bonding(4195) 1 ID Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date � By Date By Date
� .
`
0 Feeders/Sub-panels(4045) i ®Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date 1 By Date 5-1-,807-1 : By Date
El Final-Electrical(4055)
By eleDra"teed,"aC/'/,
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
.� IVSD ELECTRICAL
CITY OF REQ
Federal Way PERMIT APPLICATION
JUN 11. 2019
LIC FEDF:S1P,,L.
IT NUMBER / q — L D z ?GQgAUAITY LEVELo it b -
- SUITE/UNIT/SPACE#
SITE ADDRESS:28944 11th PL S
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
250 720570-0080
$ - Residential
PROJECT NAME
(Tenant or Homeowner Last Name) Webb/VViIlmore
Add two circuits(20A and 15A)as part of finishing basement rooms, replacing two
PROJECT DESCRIPTION existing circuits in the space.
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Diane Webb and John Willmore (253 ) 529 -7853
MAILING ADDRESS E-MAIL
28944 11th PL S mgmt@bizint.com
CITY STATE ZIP FAX
Federal Way WA 98003 ( ) -
NAME PRIMARY PHONE
-- owner -- ( ) -
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY PHONE
John Willmore (949 )295 -8248
APPLICANT MAILING ADDRESS E-MAIL
28944 11th PL S mgmt@bizint.com
CITY STATE ZIP FAX
Federal Way WA 98003 ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT John Willmore (949 ) 295 -8248
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 reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the ci as a art of this application.
SIGNATURE: - DATE 6/10/2019
PRINT NAME: Jillmore
PERMIT CENTER+33325 8th Avenue South + Federal Way,WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application
.. 4....,
CITY OF Property Owner
Federal Way Electrical Work Permit Affidavit
f Applying For Your Electrical Permit
t
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
-
As authorized under RCW 19.28.261, I,John Willmore
(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.
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it W,
Which statement describes you? (Mark only one. If none apply,you may not take out this permit.) I
i
I own this property.
Your name or your company's name must be shown on the deed to the property. Real estate agents,
M property management companies, relatives, etc. cannot purchase permits for the property owner. c
0 I rent or lease this property.
We need a copy of your rental agreement showing you have permission to perform electrical work.
i
s 0 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
n a non-compensated appropriately certified electrician.
• Select your property type (Mark only one. If none apply,you may not take out this permit.)
t
,
i t
i
❑ 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 electrical work.
1
I. 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.
i J
2 Existing residential property,place of business,or farm.I,personally,and/or a regularly employed
l employee(s),will be doing the electrical work.
1 ,
DEPARTMENT OF COMMUNITY DEVELOPMENT/33325 8Th AVENUE SOUTH/FEDERAL WAY,WA 98003-6325
253-835-2607 2s,www.cityoffederalway.com zfa.permitcenterecityoffederalway.com
Bulletin#170—July 27,2018 Page 1 of 2 k:\Handouts\Property Owner Electrical Work Affidavit
,
I CI 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
i being compensated for the electrical work per RCW 19.28.091(7).
k
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
i
i understand that if . e,.: s- .temen . or misrepresentations, I may be assessed penalties.
6/10/2019 is
i
Si:;' 're Date 1
1
John Willmore
t Printed Name of Property Owner,Renter,or Lessee
f
f
Property Owner and Inspection Site Information
I Diane Webb and John Willmore
1 Property Owner's Name and/or Company Name
28944 11th PIS Federal Way WA 98003
Mailing Address Unit/Apt.# City State Zip
949-295-8248 mgmt@bizint.com
Daytime Phone Email Address
28944 11th PI S
Inspection Site Address Unit/Apt.#
i
c
e PSE
i Electrical Power Company/Serving Utility
i
1 Description of work being done(Example:adding outlets in the kitchen,second floor break area,etc.)
I.
Add two circuits for remodeled space (20A and 15A), replacing two existing
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circuits in the space, for outlets and lights.
/ P,.
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A
DEPARTMENT OF COMMUNITY DEVELOPMENT/33325 8T"AVENUE SOUTH/FEDERAL WAY,WA 98003-6325
253-835-2607 z9.www.cityoffederalway.com is permitcenter@cityoffederalway.com
Bulletin#170—July 27,2018 Page 2 of 2 k:\Handouts\Property Owner Electrical Work Affidavit