13-103066e
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Project Name: HEALTH SOURCE
Project Address: 930 S 336TH ST Unit B
Is
Tlectrical
Permit #: 13- 103066 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 9265010080
Project Description: Install new wiring for new chiropractor office, including (9) new duplex rcpts, (5) switch
legs and 100A circuit for X -ray machine.
Owner
ApI2111can
Contractor
WASHINGTON TRUCKING ASSN
ANDREW BENTLEY
D F ELECTRIC INC
930 S 336TH ST
D F ELECTRIC INC
DFELEI'OIOD9 (3/31/15)
FEDERAL WAY WA 98003
6401 N 42ND ST
PO BOX 7205
TACOMA WA 98407
TACOMA WA 98417
Additional Permit Information
Is this an Online or O.T.C. application ? .................Yes
Service greater than 999 Amps? .............................No
Electrical Fixtures
Circuits - CommerciaL ................... 3
Is Use Educational or Institutional ? ............:..........No
PERMIT EXPIRES Friday, July 10, 2015
Permit Issued on Wednesday, July 10, 2013
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
a the of Federal Way.
Owner or agent: y Date:— / 0 —� „�
THIS CARD IS TO rZ:1(253)835-3050 IN ON -SITE
CITY Construction In tion Record /
Federal Way INSPECTION REQUE
PERMIT #: 13- 103066 -00 -EL Address: 930 S 336TH ST Unit B
Project: WASHINGTON TRUCKING ASSN FEDERAL WAY, WA 98003
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)
Ditch cover (4030)
0
Slab /Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
Temporary Power (4275)
0
Service (4235)
Approved
By
Approved
Approved
By
Date
By
Date
By
Date
Feeders /Sub - panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
B
Date 3
By
Date
Final - Electrical (4055)
Approved
By
Date g ...5 _1•�
Rough Electrical
Approved
Final Electrical
Approved
Right of Way —�
Approved
By
Date
By
Date
By
Date
CITY OF 'A
Federal Way
PERMIT NUMBER 13
E CTRICAL
PERMIT APPLICATION
RECEIVED
JUL 10 2013
SITE ADDRESS: C
E
PROJECT VALUATION
$ 4, DOU
ASSESSOR'S TAX /PARCEL 8
_ _ -
CURRENT /PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
r
li
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
°
G
PROPERTY OWNER
NAME
PRIMARY PHONE
( ) -
MAILING ADDRESS
E -MAIL
CITY
STATE
ZIP
FAX
ELECTRICAL
CONTRACTOR
NAME
PRIMARY PHONE
-
MAILING ADDRESS
a ED >i
EMAIL /
SL�
CITY
STA
ly,/
7Dw (�
2 �f /
( 2 � l Q 2Jb
WA STATE CONTRACTOR'S LICENSE CM EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE M
APPLICANT
NAME
�F A-S C
PRIMARY PHONE
( ) -
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
N
PRIMARY PHONE
(z5%) rofXo - 11 ¢ 3
I certify under penalty of perjury that I am the property owner or authorised 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 authorised 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 anisgtp out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the ci a papfof this apg)Watiorn
SIGNATURE:
PRINT NAME:
Bulletin # 160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application