23-101293ProjectName~ JPJ>Ji;,/ A,f,
Project Address: 33702 21ST AVE SW
Project Description: Add (4) 120V quad receptacle, using (2) new circuits.
Owner Applicant
FRED MEYER INC VADIM KALCHIKKIRBY ELECTRIC INC
POBOX42121 4826 "B'' ST NW SUITF. IOI
PORTLAND OR 97242 AUBURN WA 98001
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
Circuits -Commercial
Elect.rj~al :Fi.xtd res
4
Electrical
Permit #:23-101293-00-EL
Inspection Request Line: (253) 835-3050
Parcel Number: 930100 0010
Contractor
KIRBY ELECTRIC INC
KIRBYEl809MZ (7/9/24)
4826 "B" ST NW SUITE 101
AUBURN WA 98001
PERMIT EXPIRES Wednesday, 6 September, 2023
Permit Issued on Friday. March 10, 2023
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
Owner or agent:
ON "Lrl'\JE fFederalWay Oare
·----------
<tJVOI' --= Federal Way
TIDS CARD IS TO RE:\I . .\.I~ O:\"-SITE
Construction Inspection Record
I:\"SPECTIO'.\" REQl"I:STS: (253) 835-3050
Scheduled inspections way be failed if this c~d is not on-site. DO ~OT LOSf. TffiS ('ARD. Inspections are listed as dose to sequential order as possible
(read left to right. top to bottom). Please sche<t.\le inspections as appropriate . Work must not bt' co\·ered until it is appro\'ed. Cheek with your inspector if
you are UDS\tte about any of the inspections or the inspection sequroce. On-going ilb-pections are logged on the back of this c;u-d.
ELECTRICAL
GJ UFER Ground (429S) [il Ditch c:owr (4030) ~ Slab/Concrete Floor (4255)
Approved Approved Approv'!d to place conaete
By Date By Date By Date
IT] Pool Bonding (4195) m Tempora~· Power (4275) 0 Senice (4235)
Approved ApPto,'ed Approved
By Date By Date ~· Date
IT] F eeders/Sub-paaels (4045) [!l Rough Electrical (422S) []] Ceiling Co\"er (4020)
Appro,'ed Appro,-ed Appro,-ed
By Date By Date By Date
II§] Final -Electrical (405S)
Approved
By ~ Date/-;::f,:J-:;<.J,
MECHANICAL
EJ Me<haniral Rough-in (4165) ILi Gas Piping (4125) [I] Final -:\fe-chanical (4065)
App1oved Appro\'ed to tel.ea~ test Approved
By Date By Date By Date
PLUMBING
GJ Plumbing GFound-n·ork (4190) 0 Rough Plumbing (4230) III Final -Plumbing (407S)
Appro\'td to 1;01,-er Appro~d Approved
By Date By Date By Date