HomeMy WebLinkAbout15-101706 • Electrical
City of l Way
Community&Econ.Dev.Services Permit #: 15-101706-00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 FILE
Project Name: PACIFIC MEDICAL CENTER
Project Address: 31833 GATEWAY CTR BLVD S Parcel Number. 092104 9137
Project Description: Electrical service for medical clinic
Owner Applicant Contractor
ANS LLC NELSON ELECTRIC INC NELSON ELECTRIC INC
PO BOX 1941 9620 STONE AVE N SUITE 201 NELSOEI132CZ(2/12/17)
AUBURN WA 98071-1941 SEATTLE WA 98103 9620 STONE AVE N SUITE 201
SEATTLE WA 98103
Additional Permit Information
Is this an Online or O.T.C.application? No Is Use Educational or Institutional? No
Service greater than 999 Amps? No
Electrical Fixtures
Alt.Srvc/Feeder 0 to 200 amps(C 4
PERMIT EXPIRES Tuesday, October 6, 2015
Permit Issued on Thursday,April 9, 2015
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
-•% the of Federal Way.
Owner or agent: Date:
4/—/4/-2 '/c
DATE INSPECTOR AREA AND TYPE O ' INSPECTION
-12.-15 0 \is to- tca\ til 2 vy3 ltf't < Lam{'
1c& L- \ � � It9 - ) r5 lig,. - 1111- 11,(1 - 1 2) r
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THIS CARD IS TO IN ON-SITE
CITY OF 0 Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
Q PERMIT#: 15-101706-00-EL Address: 31833 GATEWAY CTR BLVD S
Project: ANS LLC FEDERAL WAY, WA 98003-5420
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 3 Date t.4._9,45_, -
❑ Pool Bonding(4195) 0 Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
.
o Feeders/Sub-panels(4045) 0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By 0___.\14,– Date r.^1- %
.
o Final-Electrical(4055)
Approved
Bye Date 1-1-2•7 —l'
Rough Electrical El Final Electrical Right of Way
QApproved Approved Approved
By Date By Date By Date
II •
APR 08 2015 ELECTRICAL w
CITY OF CITY OF FEDERAL WAY
Federal Way CDS PERMIT APPLICATION
PERMIT NUMBER 1 5 _ 10 1 7 0 Y/ _ 00 T 4/'29/'i'5
,L -�} SUITE/UNIT/SPACE#
SITE ADDRESS: 3 I S 33 onzy c V - �LvD s
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ Crtam . S7 o Cr z ( o 4 _ ct (_3 7
PROJ&T NAME CAC1 FiC 1`M1J 1 cA/ cc/V1W---
(Tenant
(Tenant or Homeowner Last Name) C/1 1_L �-/,li `'ViV
1 Li e I/;\I.C --TY—
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER A tL S LLC- ( ) -
MAiLINGr o S` O� t ct� E-MAIL
CITYA ) N 8�� ZI��D FAX
( )
NAME PRIMARY PHONE
/AAle,iSON &-/L;L172i e. sill C. (Z°(o) 523- t-43.-zS
MAILING ADDRESS E-MAIL
ELECTRICAL e' �o20 57-0 �� It i-)
a V€ 4-20� Z f� S 1l42lsev,e f&C
CONTRACTOR CITY STATE ZIP FAX
,. -rT'Le- w/4 1210 ( ) - C.
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NE L50ELl'32 C.;Z Z. //2 /117 zo- 12-100741-oo-8L
NAME PRIMARY PHONE
APPLICANT d ^�` r oS 1 -(ZD� £s 7' 029(-1
MAILING ADDRESS___, .J TKrOST k)AM/SPIele/ec,CJJtti
CITY STATE ZIP FAX
( )
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.
.4000111.
SIGNATURE: DATE if./9. //C.--
PRINT NAME: IDCC`OS r
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
