16-104436 �r Electrical
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Federal Dev.WaServices Permit #: 16-104436-00-EL
33325 8th Ave S
Federal way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q
Project Name: VELLESYS,LLC
Project Address: 33516 9TH AVE S Bldg 8 Parcel Number: 926925 0080
Project Description: Install(1)240v/20amp circuit and(1) 120v/20amp circuit.
Owner Applicant Contractor
VELLESYS LLC JOHN ISAACS UNDERGROUND POWER TECH LLC
PO BOX 2641 UNDERGROUND POWER TECHNOLOGIES UNDERPT842ML(7/13/18)
EAGLE,ID 83616 15412 266TH AVE SE 15412 266TH AVE SE
ISSAQUAH WA 98027 ISSAQUAH WA 98027
•
Additional Permit Information
Electrical Work Valuation 1200 Is this an Online or O.T.C.application Yes
Is Use Educational or Institutional? No Service greater than 999 Amps? No
Electrical Fixtures
Circuits-Commercial 2
PERMIT EXPIRES Friday, September 8, 2017
Permit Issued on Thursday, September 8, 2016
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
and the City of Federal Way.
Owner or agent: C—— Date: 9— .0-2-61
FINALE
THIS CARD IS TO REMAIN ON-SITE
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Federal Way Construction Inection Record -
y INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16-104436-00-EL Address: 33516 9TH AVE S Bldg 8
Project: VELLESYS LLC FEDERAL WAY, WA 98003-6322
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) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
El Pool Bonding(4195) 0 Temporary Power(4275) Service(4235)
Approved Approved Approved
By Date By Date By Date
,
•
0 Feeders/Sub-panels(4045) ElRough Electrical(4225) Ceiling Cover(4020)
Approved Approved Approved
By Date By Date
By Date
El Final-Electrical(4055)
Approved
By hi* Date toll(I I y
E Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
ELECTRICAL
CITY OF RECEIVED
Federal Way �E PERMIT APPLICATION
SEP o 2016
CITY OF FEDERAL PE ITNUMBER� 1.1 �/ ,� - 6 �.
CDS
SUITE/UNIT/SPACE#
SITE ADDRESS: / 9 L A 5
PROJECT VALUATION l0 ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
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PROJECT NAME
(Tenant or Homeowner Last Name)
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PROJECT DESCRIPTION /z
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Detailed description of work to `
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER 1It°Sy$ LLL ( ) -
MAILING ADDRESS E-MAIL
3 3 c/ (o `� Aru, S , Lill
CITY STATE ZIP FAX
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NAME // PRIMARY PHONE
U w fi+Otr roues 6 CG wc.i frc U.-'41/05(e S (Ll2S) `p/ - 01-7
MAILING ADDRESS E-MAIL
ELECTRICAL l 5^L1/Z 7{o6 1 s
CONTRACTOR CITY STATE ZIP FAX
1 Sq/4 QVA(.4 /,.) Oa-7
( )
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
11/4)6)E12-PT-1112. frit 7 / 13 / log 1(0-- 1O -f 2 HCl
NAME PRIMARY PHONE
APPLICANT
,..1-191.31‘)
J o�"� 15A-4 GS (112c ) � - cd/7
MAILING ADDRESS E-MAIL
/c`(12- •40:r" Ave ' `'
CITY STATE ZIP FAX
15SA (v/+ t1 1/vr4 'Sa 2-7 ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT ( )
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: DATE -zO
L 9'� l�
PRINT NAME: � A-) 1.5
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application