21-101473City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: MOEN
Project Address: 31425 21ST AVE SW
Project Description: one junction box and plugin
Owner
DENNIS E MOEN
31425 21 ST AVE SW
FEDERAL WAY WA 98023-7834
FILE
Applicant
DENNIS MOEN
31425 21STAVE SW
FEDERAL WAY WA 98023
Additional Permit Information
Is this an Online or O.T.C. application? ................. Yes
Electrical Fixtures
Circuits - Residential 1
Electrical
Permit #:21-101473-00-EL
Inspection Request Line: (253) 835-3050
PERMIT EXPIRES Thursday, 14 April, 2022
Permit Issued on Wednesday, April 14, 2021
Parcel Number: 122103 9057
Contractor
OWNER
OWNER
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
a in an tNt7
al Way.
Owner or agent:
Date
F, I() Ot /
_4%�
Gl7Y OF
Federal Way
THIS CARD IS TO REMAIN ON -SITE
Construction Inspection Record
INSPECTION REQUE TS. (253) 835-3050
PERMIT #: 21 101473 00
Project: DENNIS E MOEN
Address:
31425 21ST AVE SW
FEDERAL WAY WA 98023-7834
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.
❑
UFER Ground (4295) ❑
Ditch cover (4030)
❑ Slab/Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By
Date By
Date
By Date
❑
Pool Bonding (4195) ®
Temporary Power (4275)
❑ Service (4235)
Approved
Approved
Approved
By
Date By
Date
By Date
❑
Feeders/Sub-panels (4045) ❑
Rough Electrical (4225)
❑ Ceiling Cover (4020)
Approved
Approved
Approved
By
Date By
Date
By Date
❑
Final - Electrical (4055)
App;i+,ed
By
Date
❑ Rough Electrical
❑
Final Electrical
❑
Right of Way
Approved
Approved
Approved
13 v Date
B v
Date
By
Date