12-1038001
City of Federal way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835 -2607 Fax: (253) 835 -2609
� FILE
U
r . Electrical
Permit #: 12- 103800 -00 -EL
Project Name: GROUP HEALTH CLINIC - IT ROOM UPGRADE
Project Address: 301 S 320TH ST
Project Description: Refresh low voltage (500 cables)
Inspection Request Line: (253) 835 -3050
Parcel Number: 172104 9105
Owner
Ap Iii
Contractor
GROUP HEALTH COOP
MARIANNE FOX
EVERGREEN TECHNOLOGIES INC
12501 E MARGINAL WAY S
EVERGREEN TECHNOLOGIES INC
EVERGTI929K9 (5/22/12)
TUKWILA WA 98168
3623 E MARGINAL WAY S
3623 E MARGINAL WAY S
SEATTLE WA 98134
SEATTLE WA 98134
Additional Permit Information
Is Use Educational or Institutional ? .......................No
Electrical Fixtures
Low Voltage - Other (Commercial 500
Service greater than 999 Amps? .............................No
PERMIT EXPIRES Sunday, August 17, 2014
Permit Issued on Friday, August 17, 2012
I hereby certify that the above information is correct and that the construction on the above described properly 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: 4 134 ® III N FIf Date:
i
CITY OF 4A
Federal Way
THIS CARD IS TO MAIN ON -SITE
Construction In ection Record
INSPECTION REQ TS: (253) 835 -3050
PERMIT #: 12- 103800 -00 -EL Address: 301 S 320TH ST
Project: GROUP HEALTH COOP FEDERAL WAY, WA 98003 -5200
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)
Ditch cover (4030)
Temporary Power (4275)
Slab /Concrete Floor (4255)
Approved
By
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
0
Pool Bonding (4195)
Temporary Power (4275)
Service (4235)
By
Date
Approved
By
Date
Approved
By
Date
Approved
By
Date
By
Date
By
Date
0
Feeders /Sub - panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
Ir
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Data — (�5-
FILE
Rough Electrical
Approved
Final Electrical
Approved
Right of Way -�
Approved
By
Date
By
Date
By
Date