08-1060854
{' Electrical
City of Federal Way 10 0 Q
Community Development Services Permit #. 08- 106085 -00 -EL
P.O. Box 9718
Federal Way, WA 98063 -9718 Inspection Request Line: 253 835 -3050
Ph: (253) 835 -2607 Fax: (253) 835 -2609 p q
Project Name: FOOTLOCKER
Project Address: 1928-B S COMMONS SUITE E -16 Parcel Number: 762240 0010
Project Description: Adding/altering 0 -200 amp service /feeder
Owner
Applicant
Contractor
STEADFAST COMMONS LLC
EVERGREEN ELECTRICAL SERVICES INC
EVERGREEN ELECTRICAL SERVICES INC
1928 S COMMONS
15103 60TH AVE W
EVERGES039KF 5/6/09
FEDERAL WAY WA 98003 -6013
EDMONDS WA 98026
15103 60TH AVE W
EDMONDS WA 98026
Service greater than 1000 Amps ? ...........................No
Alt. Serv./Feeder 0 to 200 amps (C 1
PERMIT EXPIRES Wednesday, December
Permit Issued on Tuesday, December 30,
I hereby certify that the above information is correct and that the construction c
the occupancy and thews will be in accordance with the laws, rules and regu
d the ty of Federal Way.
Owner or agent:
��- i /v,�
of
Date:
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1
a .
— THIS CARD IS TO MAIN ON —SITE
CITY of ommunity Developm t Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 08- 106085 -00 -EL
Owner: STEADFAST COMMONS LLC
Address: 1928 -B S COMMONS SUITE E -16
FEDERAL WAY, WA 98003
This card is part of your required inspection documents. 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)
Approved
By Date
❑
Ditch cover (4030)
Pool Bonding (4195)
Approved
By
Date
❑ Slab /Concrete Floor (4255)
Approved to place concrete
By Date
—
❑
Pool Bonding (4195)
❑
Temporary Power (4275)
❑
Service (4235)
Approved
Approved
Approved
By
Date
By
Date
By
Date
❑
❑
Feeders /Sub - panels (4045)
❑
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
❑
Final - Electrical (4055)
Approved
By
Date
For inspector reference only
❑ Rough Electrical O FINAL_- Electrical
Approved Approved
By Date By Date
arry CW 0'�'
Federal' C I E [ERMIT �`�� SF MF CO ME 6 LL DE EN FP
COMMUNITY DEVELOPMENT SERVICES
333258"' AVENUE SOUTH- PO BOX 97UEC 30 20APPLICATION
FEDERAL WAY, WA 98063 -9718
253 - 835 -2607• FAX 253 - 835 -2609
t wwAtuoffederalwau.com C �, n , A
The foilou�j-�� red ig D,F,PA La V"piete application will not be accepted. Please print legibly (in ink) or type.
C e Yid n? &
SITE ADDRESS
ASSESSOR'S TAX /PARCEL # 7-6-42-
(>{�►I V
T F-1-6 SUITE /UNIT #
- O O—/ LOT SIZE (sfi
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate P Je for Lengthy L9cd desenp�)
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION XLECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this Wrinit only)
�Dvl n �C7`i� ny CK %S`�r G Ci P C- C/)' TS
PROJECT NAME (Name of Business or Owner Last
PEOPLE •• •
PROPERTY
OWNER
CONTRACTOR
0
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME
PRIMARY PHONE -
(
MAILING ADDRESS
CITY, STATE, ZIP
E-MAIL ADDRESS
COMPANY NAME
fiver✓` ►^eE CLectrri ca SP
APPIICASVI' N`� E /+ �
vpe 1��r7Se vf�
OFFICE PHONE
� /e73 6
�' rTATE, ZIP / � a
/s
(EYE 773 -0148"
CITY OF FEDERAL BUSINESS LICENSE � � �
� EXPO TION DATE
Z
FAX NUMBER -
1E
CONTRACTOR'S REGISTRATION NUMBER
EXPIRATION DATE
-MAQ. AD/ DRESS
6-:7VI,Q Ii5 o-3 q RE
I 'oe.ee,5 tleri2o4,
COMPANY. NAME
APPLICANT NAME
OFFICE PHONE
`ADV�DREIRESSn[
PHONE
-
10ELL
MAILING
CITY, STATE, ZIP
PHONE
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
( ) -
NAME- PRIMARY PHONE E -MAIL ADDRESS
C7C_ �— lJ t am- d (
NAME
Per RCW 19.27.095:
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING ASSESSED /APPRAISED VALUE $
SPRINKLERED BUILDING?
❑ YES ❑ NO
PROPOSED USE
VALUE OF PROPOSED WORK $
FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
eT
AREA DESCRIPTION
EXISTING
FT.
PROPOSED
SQ. FT.
TOTAL
SQ. FT.
BASEMENT
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
FIRST
COMPRESSORS
FURNACES
RANGES
SECOND
GAS LAG SETS
REFRIG. SYSTEMS
ZONING DESIGNATION
THIRD
CHANGE OF USE?
❑ YES
ADDITIONAL FLOORS (DESCRIBE)
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
UP /SEPA /SU?
DECK (❑ COVERED OR ❑ UNCOVERED ?)
❑ NO
PLATTED LOT? ❑ YES ❑ NO
GARAGE ❑ CARPORT ❑
❑ YES
❑ NO
NUMBER OF FLOORS
zffisrvia
P1,010810
Tarty.
TOTAL 00"W11 6F
71WAL rsoros®sn
TorALW
` *NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Value of Mechanical Work $.
(A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS WOODSTOVES
BBQS
FANS
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS (Commercial)
COMPRESSORS
FURNACES
RANGES
DUCTS
GAS LAG SETS
REFRIG. SYSTEMS
BATHTUBS (orltrb /Shower Combo)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
LAVS (Batl,room swsa)
URINALS MISC (Describe)
RAINWATER SYST
VACUUM BREAKERS
SHOWERS
WATER CLOSETS (Touery
SINKS
WASHING MACHINES
SUMPS
BUILDING SHELL ONLY?
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 Wonnation submitted in support of this permit application is true and correct. I certify that I will comply with all applicable
City 4f 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 lgformation supplied to
the city as apart of tbie.#pplicAtion. r
SIGNATURE:
Owner and /or Authorized
FOR OFFICE USE ONLY
❑ NEW ❑ ADDITION
❑ ALTERATION
❑ REPAIR ❑ TENANT IMPROVEMENT
BUILDING SHELL ONLY?
❑ YES ❑ NO
BASIC PLAN?
❑ YES
❑ NO
ZONING DESIGNATION
CHANGE OF USE?
❑ YES
❑ NO
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
UP /SEPA /SU?
❑ YES
❑ NO
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED?
❑ YES
❑ NO
Bulletin #100 —January 1, 2008 Page 2 of 4 k\Ilandouts\Permit Application