19-105825 i r
Electrical
City of Development
Way Permit #:19-105825-00-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: SI1 PROPERTIES
Project Address: 32644 49TH PL SW Parcel Number: 873219 0790
Project Description: Service panel change.
Owner Applicant Contractor
MAURICE SKOGSTADSII PROPERTIES A&D ELECTRICAL SERVICES LLC A&D ELECTRICAL SERVICES LLC
25838 68TH AVE S 6503 34TH AVENUE CT E ADELEES818D2(3/22/21)
KENT WA 98032 TACOMA WA 98443
6503 34TH AVENUE CT E
TACOMA WA 98443
Additional Permit Information
Is this an Online or O.T.C.application'? Yes
''x
Alt. Serv./Feeder:0 to 200 ami 1
PERMIT EXPIRES Saturday, 12 December,2020
Permit Issued on Friday,December 13,2019
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 a %rdance with the laws, rules and regulations of the State of
_•'and the City of Federal Way. L
Owner ora ent:��Zsehei
Date: �3' �3"�7g ,
1
4 , .
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 105825 00 Address: 32644 49TH PL SW
Project: MAURICE SKOGSTAD FEDERAL WAY WA 98023-1927
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.
El UFER Ground(4295) 0 Ditch cover(4030) ® Slab/Concrete Floor(4255)
Approved ' Approved Approved to place concrete
By Date It,By Date ' By Date
.
•
Q Pool Bonding(4195) 0 Temporary Power(4275) ; ® Service(4235)
Approved Approved Approved
By Date .By Date :;`By ,A9le Date/a:1247
'
® Feeders/Sub-panels(4045) ` ® Rough Electrical(4225) ! ® Ceiling Cover(4020)
Approved Approved Approved
By Date '•By Date ABY Date
El Final-Electrical(4055)
A proved
By Ric Date/2/7/,
0 Rough Electrical ❑ Final Electrical Right of Way
Approved Approved Approved
•
By Date By Date By Date
RECEIVED
ELECTRICAL
"T"°F DEC 13 2019
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
COMMUNI'iY DEVELOPMENT
PERMIT NUMBER) _ .l 0 5 a ��- 0 o
SUITE/UNIT/SPACE#
SITE ADDRESS: 3l I l l ifs 4 k /..., s co
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ /5611-) _ _ _
PROJECT NAME (�,� + -
(Tenant or Homeowner Last Name) l C&t 1' I�U se. 5( 1 43 41:41_,4
S'Q�^u'��e G.r.z I C Au,A r�s i
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME + PRIMARY PHONE
PROPERTY OWNER Nil aur i Ce S �D3STcj (,20CiG30 - 3 3
MAILING ADDRESS E-MAIL
ST1 OY( ' c9S,F3& CIPPfk 4,,, g' •
CITY, 0 /`4- ZE(A. Z / 03 ( ) FAX
NAME ff PRIMARY PRONE
691-d) glec`ir,' «-( ��-PV'U1-eJ LSC (1-53)3��`(-S i.
MAILING ADDRESS r EMAIL
ELECTRICAL (c$c 3 3t--(t‘- Amie e 6 4 _ tilbrlecir icA( 'u-)ri,<6S'�,A-4-
CONTRACTOR
tit-CONTRACTOR F'rY— ,STATE FAX
-^ ( u(-0 646^ WC( . 1 P f'-iS ( ) -
j ] S I/ ATE CONTRACTOR'S CENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
J ` 5 1 2 3 / s /2t
NAME PRIMARY PHONE
_ C CG nktre:cte )---
( ( ) -
APPLICANT MAILING ADDRESS E-MAIL.
CITY STATE ZIP FAX
( ) -
PROJECT CONTACT PRIMARY PHONE
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 all
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 N as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation and defense of such claim),which - y made by any person,including the undersigned,and filed against the city,
but only wh_ ch claim arises out of the rel • e f the city, including its officers and employees, upon the accuracy of the
information suppli=• • the city as o his;••ligation.
SIGNATURE: - ,(1 ' DATE (d` 0 ` (5
PRINT NAME: - - • _ •I
-
PERMIT CENTER+33325 80,Avenue South+ Federal Way,WA 98003-6325
253-835-2607 +FAX 253-835-2609 +permitcenter@ncityoffederalway.com
Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application