12-101410 •
grlecttical
City of Federal Way Permit #: 12-101410-00-EL
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Ins ection Re uest Line: /253 835050
Ph:(253)835-2607 Fax (253)835-2609 p Q l
Project Name: HALL a°I 1 ba
Project Address: 30600 9TH AVE S Parcel Number: 174500 0080
Project Description: Changeout of existing 125 amp to new 125 amp panel
Owner Applicant Contractor
RONALD D HALL OMEGA ELECTRIC OMEGA ELECTRIC
30600 9TH AVE S 13337 SE 227TH PL OMEGAE*962JF(4/6/12)
FEDERAL WAY WA 98003-4117 KENT WA 98042 13337 SE 227TH PL
KENT WA 98042
•
Additional Permit Information
Is Use Educational or Institutional? No
Electrical Fixtures
Alt.Serv./Feeder:0 to 200 amps(F 1
PERMIT EXPIRES Tuesday, September 25, 2012
Permit Issued on Thursday, March 29, 2012
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 Washington
nd the City of Federal Way.
Owner or agent: (/ ''S Date: . 2 9 . LO/2
THIS CARD IS TO REMAIN ON-SITE
CITY of Construction I ection Record '
Federal WayINSPECTION RE TS: (253)835-3050
Q
PERMIT#: 12-101410-00-EL Address: 30600 9TH AVE S
Project: RONALD D HALL FEDERAL WAY, WA 98003-4117
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.
0 Service(4235) - El Feeders/Sub-panels(4045) - "0 Rough Electrical(4225)
Approved Approved Approved
`By C k� K Date ti.J-0_1 .By Date , ,By Date
o Final-Electrical(4055)
Approved
By C\ .x . Date kt `5-.i 1
•
0 Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
00 ' ----
( 0 ( 4- 1 a
carD
ELECTRICAL
MAR 29 2U`.' PERMIT APPLICATION
CITY OF FEDERAL WAY
{{ii , ost electrical permits may beoy{btained on-line at/�wwww cityoffederalway com**
C
SITE ADDRESS: 3 0 6 00 5 d-h A v LT S re,g e✓'a ( 1Verky
SUITE/UNIT/SPACE P ASSESSOR'S TAX/PARCEL S CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION Ch et n Et ec /v i'c o, ( 12,a 414 ( ( 2 5' H rr,p
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER t _ ( ) -
MAILING ADDRESS E-MAIL
(.('_C)0 (T(TS' 6Vc S
CITY �X ZIP UFAX
( )
NAMEPRIMARY PHONE
Qre7 est to /2.7-(e-C- t v'/ � . (roe ) 7PJ - 1141r
MAILING ADDRESS E-MAIL
ELECTRICAL / 333a- S t= 227 y Pt omcSa 2gyZQdomea3) , nef
CONTRACTOR CITY STATE ZIP FAX
14 end- W 9ef04Z ( zS3 )634 - 7OV9
WA STATE CONTRACTOR'S LICENSE M EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE M
OrneDate 962 JF 4i 6 / /9 20 -09 -t0/9/,-Oo -aL
NAME PRIMARY PHONE
APPLICANT ^0_ ( ) -
MAILING ADDRESS 6 /(�/'- / E-MAIL
�/ ill///
CITY ` �i�1 Y ZIP FAX
1 ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT ( ) -
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 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.
vcscJ/ovv SIQNATURE: DATE 3- 2 1.2 O 12
PRINT NAME: tJ o 4 i v i S d r8 23'1 e-C.A.3 .
33325 8'"Avenue South•PO Box 9718•Federal Way♦WA 198063-9718♦253-835-2607•fax:253-835-2609•www.cityoffederalway.com
Bulletin#160-April 9,2010 Page 1 of 2 k:\Handouts\Electrical Permit Application