16-105044 Electrical
City oTFederal Way
1/41r—'711r".-' Permit #:16-105044-00-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: NEW YORK LIFE INSURANCE
Project Address: 31515 PETE VON REICHBAUER WAYS ' } O Parcel Number: 092104 9302
Project Description: Install 9 2x4 troffer fixtures; show window receptacles,switches,(1)sign circuit,exit egress
lighting
Owner Applicant Contractor
KIMCO REALTY CORP UNIVERSAL ELECTRIC CO UNIVERSAL ELECTRIC CO
3333 NEW HYDE RD 18602 37TH DRIVE SE UNIVEEI985D2(3/22/18)
NEW HYDE PARK NY 11042 BOTHELL WA 98012
18602 37TH DRIVE SE
BOTHELL WA 98012
Additional Permit Information
Is this an Online or O.T.C.application? Yes
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MON
Circuits-Commercial 4 Sign 1
PERMIT EXPIRES Tuesday, 17 October,2017
Permit Issued on Monday,October 17,2016
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
Washin• -n and the City of Federal Way.
Owner or agent: � Date /7 `1v
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16 105044 00 Address: 31515 PETE VON REICHBAUER WAY S I
Project: KIMCO REALTY CORP FEDERAL WAY WA 98003
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) Q Service(4235)
Approved Approved Approved
By Date By Date By Date
i
® Feeders/Sub-panels(4045) ® Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055)
Approved
By ('• '' :.. Date 1 .2—'c 4
III Rough Electrical ❑ Final Electrical0 Right of Way
Approved Approved Approved
By Date By Date By Date
ELECTRICAL
Federal
Federal WayRECEIVED PERMIT APPLICATION
OCT 17 2016
CITY OF FEDERAL WAY PERMIT NUMBER 1 0 50 q-1
CDS - - - -
SUITE/UNIT/SPACE#
SITE ADDRESS: 3 J /c /5 p�--- 5 co
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
1 C) -
PROJECT NAME y(4304(Tenant or Homeowner Last Name) _ p/� p � � 1 '
1 1 1
PROJECT DESCRIPTION n �" � ot L ( 11 1 LA 1 4C v\ )
Detailed description of work to 5 coI
c — Y\ C (p CIA
be included on this permit only
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NAME PRIMARY PHONE
PROPERTY OWNER ..`,• Y2-x kl i ( ) -
MAILING ADDRESS
E-MAIL
3i5 / G,t kip so
CITYSTATE ZIP
FAX
4cL �J _ ' JJ 78CC ( )
NAME PRIMARY PHONE
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MAILING ADDRESS E-MAIL
ELECTRICAL r��� 3 ,/ 510 i►4%
CONTRACTOR CITY STAT ZIP FAX eo
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME }� PRIMARY PHONE
APPLICANT V ( )
MAILING ADDRESS E-MAIL
CIT STATE ZIP FAX
( )
NAME PRIMARY j PRIMARY PHONE
PROJECT CONTACT l "(-�)
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
aN 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 /0 /
')Atul PRINT N
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application