15-101283 • • Electrical
City&Federalon.D Wv. y
S Permit #: 15-101283-00-EL
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: WORLD VISION-BLDG 1
Project Address: 34834 WEYERHAEUSER WAY S Parcel Number: 222104 9031
Project Description: Low voltage for relocating 3 notification devices..
Owner Applicant Contractor
WORLD VISION US MATT CARLMAN FIRE SYSTEMS WEST INC(ELECTRICAL)
PO BOX 9716 FIRE SYSTEMS WEST INC FIRESWI055LW(6/16/15)
FEDERAL WAY WA 98063-9716 206 FRONTAGE RD N SUITE C 206 FRONTAGE RD N
PACIFIC WA 98047 PACIFIC WA 98047-1023
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Service greater than 999 Amps? No
Electrical Fixtures
Low Voltage-Other(Commercial 1
PERMIT EXPIRES Saturday, September 12, 2015
Permit Issued on Monday, March 16, 2015
I hereby certify that the above infor ation is correct and that the construction on the above described property and
the occupancy and the us will b in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date: 0&71,5--
tI
A
• THIS CARD IS TO MAIN ON-SITE
Feder'a1 .te, Construction Ins ection Record
INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 15-101283-00-EL Address: 34834 WEYERHAEUSER WAY S
' Project: WORLD VISION US FEDERAL WAY, WA 98001-9520
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.
O UFER Ground (4295) 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
0 Pool Bonding(4195) 0 Temporary Power(4275) 0 Service (4235)
Approved Approved Approved
By Date By Date By Date
•
▪ Feeders/Sub-panels(4045) El Rough Electrical (4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
Final-Electrical (4055)
Approved
By Date
❑ Rough Electrical • Final Electrical Right of Way
Approved Approved Approved
By Date By Date i By Date
.
•
rve)
MAR 16 2015
CITY OF ELECTRICAL
Federal Way � '� ® � A�_ WAY PERMIT APPLICATION
PERMIT NUMBER����,,,,////� /
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l� SUITE/UNIT/SPACE#
SITE ADDRESS:
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PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ WC/ .-�- -�' / 0 V - 9 o 3
PROJECT NAME
(Tenant or Homeowner Last Name) G✓oi(L p f// /
/ZC=Lr i✓c2rii
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ) `6t5 -_ti L1
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
FE )c/t,' 4-✓✓+y Li/ q ( ) -
------------ -
NAME PRIMARY PHONE
fc/0 r•75- /JCS-7- /;/L ( �S) ) KSf5 -i2
MAILING ADDRESS E-MAIL
ELECTRICAL v e AD ..(/ 54,9Tf
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
(1�Z-cS�S I 55 Cw ti (c-/ /fin / 15 19
NAME PRIMARY PHONE
APPLICANT Sysr 7"iS ��i .✓ ( - )'i33 - 11,14>
MAILING ADDRESS E-MAIL
(evA/r1=1& "" / St.,/ Tr- e cOys ',0t -(r^^A
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT J (O'3)133 - LI-4
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 • t of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city • • a •art of this application.
SIGNATURE: r DATE /G /'7 /=
PRINT NAME: /114- / r �, a ✓ —
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application