20-100426 Electrical
City ofFederal Way Permit #:20-100426-00-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: CHUBBS
Project Address: 911 SW 365TH PL Parcel Number: 111263 0260
Project Description: Adding one circuit as a 20 amp dedicated circuit.
Owner Applicant Contractor
BRENT CHUBBS SELLARS ELECTRIC INC SELLARS ELECTRIC INC
911 SW 365TH ST 29210 3RD AVE S SELLAEI963O4(10/3/20)
FEDERAL WAY WA 98023 ROY WA 98580
29210 3RD AVE S
ROY WA 98580
Additional Permit Information
Is this an Online or O.T.C.application9 Yes
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Circuits-Residential 1
PERMIT EXPIRES Saturday,30 January,2021
Permit Issued on Friday,January 31,2020
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
Wa ington and the City of Federal Way.
Owner or agent: '��/� Date: 01A-0
' THIS CARD IS TO REMAIN ON-SITE
Federal Way/114 Construction Inspection Record
y INSPECTION REQUESTS: (253)835-3050
PERMIT#: 20 100426 00 Address: 911 SW 365TH PL
Project: TRISHA L CHUBBS FEDERAL WAY WA 98023
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.
. .4,
Rough Electrical(4225) �• `
D Final-Electrical(4055)
Approved Approved
�By Date By ‘ie Date 2.,!S'�2o.
0 Rough Electrical E Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED ELECTRICAL
CITYOF 110""oramor JAN d) 2020
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
PERMIT NUMBER C _ ) ( LI lie _ / -p�
/
SUITE/UNIT/SPACE#
SITE ADDRESS: 71! C J Jb PL
•
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowne ast Name) /C J b / S
Oredi 14%
PROJECT D SCRIPTION
Detailed descriptio wor
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER r c f �j R/2 U4.1-- (z S3 ) L(3 1--26 08
MAILING ADDRESS 1 E-MAIL
CT / t 5cJ 3 >05 P
CITY STATE ZIP FAX
,l.3 ( ) —
NAME PRIMARY PHONE
S�LC� ZZ-Ie 7 24_ i (gc-3 )? O- 79.3 3
MAILING ADDRESS E-MAIL
ELECTRICAL (b 3 RI
4� Eloitil ,ca.--
CONTRACTOR CITY STATE ZIP FAX
GSc<i4- S,ic3-413-24,
WA STA?t CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
"30
NAME
NAME PRIMARY PHONE
APPLICANT a..- Sal Lan S Cz 5'3 ) 7 20- ?X33
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
PROJECT CONTACT NAME PRIMARY PHONE
(2z3 )?aa--7.2,33
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 city as a part of this application.
//
SIGNATURE:. 0 - DATE /4% 2.-C)
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