19-105192 /IV lk. , , ,
Electrical
City of Federal Way Permit #:19-105192-00-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: ATKINS
Project Address: 29310 3RD AVE SW Parcel Number: 119600 1460
Project Description: Wiring addition
Owner Applicant Contractor
TIMOTHY K ATKINS OMEGA ELECTRIC LLC OMEGA ELECTRIC LLC
29310 3RD AVE SW 12140 KOEPPEN RD OMEGAEL83IKZ(5/22/21)
FEDERAY WA RAINIER WA 98576
98023 12140 KOEPPEN RD
RAINIER WA 98576
Additional Permit Information
Is this an Online or O.T.C.application? Yes
•
fWS 4$ 3 � J"1�` 1 E €a� y � � 4r my iii
° r, .,� : . 06, _ _ A�,,,�: -0:tit:' r. .<„:,, ,,___..� ,_- - ---4 .,. ,�': _" .. _ F,4; .,c t,.. 1,4, ,...e _ A ,3-%Wil,;' e,.ICEm.
Alt. Serv./Feeder:0 to 200 am] 1
PERMIT EXPIRES Wednesday,28 October,2020
Permit Issued on Tuesday,October 29,2019
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
Washin and the City of Federal Way.
:
Owner or agen Date:
e�'7--- a - /r
., =1"—p- ...--•
if )
,-,-Alk. 11111
THIS CARD IS TO REMAIN ON-SITE
CITY OP
4P*A14' Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 105192 00 Address: 29310 3RD AVE SW
Project: SHANNON A ATKINS FEDERAL WAY WA 98023-3536
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 UFER Ground(4295) ED Ditch cover(4030) ® Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
0 Service(4235) El Feeders/Sub-panels(4045) .El Rough Electrical(4225)
Approved Approved Approved
;By Date 1.By i% Date / 7,/-- /9 By j�� Date /7-1,
® Ceiling Cover(4020) ® Final-Electrical(4055)
Approved pproved
By Date ��By %��O6.Date �'�-9•^zO
0 Rough Electrical ❑ Final Electrical G Right of Way
Approved Approved Approved
By Date By Date By Date
CITY RECEIVED ELECTRICAL
Federal Way OCT 2 9 2019 PERMIT APPLICATION
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMEN RMIT NUMBER (�/ _ l ) / c2- oc
SUITE/UNIT/SPACE#
SITE ADDRESS:
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ II 0 v
PROJECT NAME
(Tenant or Homeowner Last Name) A T`< I N S
L„.., i.C)$ pr-a
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ‘c, F T C /v j I< �' S ( ) -
MAILING ADDRESS E-MAIL
.�� 3 1 v `D Av£. S
CITY STATE ZIP FAX
Fzrvt,A c, wrt •? wA f36 Z3 ( ) -
NAME PRIMARY PHONE
$3 (7 A L E'(((1. ( c LLC; ( 36O) 239- 347 1�
MAILING ADDRESS E-MAIL
ELECTRICAL /a, ( H o I( O(r( -
CONTRACTOR CITY STATE ZIP r., FAX
itZA r nV ( Ey 1kM, �� S / 6 ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
amZ•7LH/ K2 - / 22 /21 GcLI )C“,
NAME PRIMARY PHONE
APPLICANT 5A / t A S A%a J L- ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT 1 (366 ) 2 3 ?- 3 L '7 fJ
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 oft application.
7-1
SIGNATURE: `f � DATE- /1
PRINT NAME: /%',Q/L C E C
Jr
Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application