HomeMy WebLinkAbout15-103994 RECEIVED
44,,,.. AUG 10 2015 ELECTRICAL
CITY OF
Federal Way CITY OF FEDERAL WAY PERMIT APPLICATION
CDS
PERMIT NUMBER 15 _ k 0 1 c q _ E
SUITE/UNIT/SPACE#
SITE ADDRESS: 53939 &--1-K ao� S +QA. 7‘D uUY - 575i0
PROJECT VALUATION J l t ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
S 5-e-) '7-) (v 0 9 LI 3 0 - 0 0 0 0
PROJECT NAME
(Tenant or Homeowner Last Name) 1 5v 1
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ( ) -
/� MAILING ADDRESS E-MAIL
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n O 0( CITY STATE ZIP / FAX
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NAME .--- i PRIMARY PHONE
L-.E.:'v 6 <c vy ( et"oi aS,`QS (ac ) 70d, did-3
MAILING ADDRESS E-MAIL
ELECTRICAL ,5-3,,,e-, Qvt cr q V L S OsGcA.,40 ea 4 to y,,cv ell
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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N` �� PRIMARY PHONE
APPLICANT /<� L3v ✓'R«ti (`'2b( )`IS - C1 �y`1.
��MAIIILIING ADDRESS E-MAIL
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50.i{-le w« ci$iG2e ( ) -
NAME PRIMARYPHONE
PROJECT CONTACT 4, Gr...,A0 f„„, (,..0) L } 7 -`!?
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 �(1 I c 5
PRINT NAME: /eel W GU ci) s
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
0 • Electrical
City Federal Way F ILEPermit #: 15-103994-00-EL
Commurli &Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Request Inspection Re t Line:
Ph:(253)835-2607 Fax:(253)835-2609 p q (253)835-3050
Project Name: 9TH AVENUE PAVILION
' Project Address: 33434 8TH AVE S Parcel Number: 609430 0000
Project Description: Install(7)valve controlers to existing boxes.
Owner Applicant Contractor
8TH&9TH LLC RON GOUDREAU LONG BUILDING TECHNOLOGY
11•100•NE 8TH SUITE 380 LONG BUILDING TECHNOLOGY LONGBBT868PT (2/9/17)
BELLEVUE WA 98004 5300 DENVER AVE S 5300 DENVER AVE S
SEATTLE WA 98108 SEATTLE WA 98108
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 7
PERMIT EXPIRES Saturday, February 6, 2016
Permit Issued on Monday, August 10, 2015
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the u will be in accor•, ce ' - the laws, rules and regulations of the State of Washington
an. - 'ity of Federal Way.
Owner or agent: ✓ G4 Date: Sffa7
• THIS CARD IS TO WIN ON-SITE y
"TM Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-103994-00-EL Address: 33434 8TH AVE S
Project: 8TH & 9TH LLC FEDERAL WAY, WA 98003-6323
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.
0 LIFER Ground (4295) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
13 Pool Bonding(4195) 0 Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
13 Feeders/Sub-panels(4045) ElRough Electrical(4225) *El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date Bit
? Date v.._ t-z_/c
o Final-Electrical(4055)
Approved
By L Date q s ` 1,S
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
