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16-105135A �.. Eloctryeal ' CunityDFederal lomentWay Permit #:16 -105135 -00 -EL Community Development Dept. FILE 33325 8th Ave S Federal Way, WA 98003 Inspection Request Line: (253) 835-3050 Ph: (253) 835-2607 Fax: (253)835-2609 Project Name: INTERNATIONAL HOUSE OF PANCAKES Project Address: 178 SW CAMPUS DR Parcel Number: 415920 0720 Project Description: LED Lighting retro fit Owner Applicant Contractor KOMER JAYMARKOFFER GIRLS LLC JAY ROSANDERCUSTOM ELECTRICAL CUSTOM ELECTRICAL SERVICES LLC 630 PANA PL SERVICES CUSTOES893J2 (4/22/17) HONOLULU 11196816 16806113TH LN SE 16806 113TH LN SE USA RENTON WA 98055-6505 RENTON WA 98055 AdditionalPermit Information Is this an Online or O.T.C. application? .................. Yes PERMIT EXPIRES Tuesday, 24 October, 2017 Permit Issued on Monday, October 24, 2016 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 and the City of Federal Way. Owner or agent: Date: O�NLINE FINALED cn� r •• Federal Way • THIS CARD'S MAIN ON-SITE . '. Construction resection Record INSPECTION REQ TS: (253) 835-3050 PERMIT #: 16105135 00 Address: 178 SW CAMPUS DR Project: KOMER JAYMARK FEDERAL WAY WA 98023-7926 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 UFER Ground (4295) ® Ditch cover (4030) El Slab/Concrete Floor (4255) © Approved IBY [By Approved Approved Approved to place concrete By Date Date By Date ® Pool Bonding (4195) ® El Temporary Power (4275) Ceiling Cover (4020) © Service (4235) [By Approved Approved Approved Approved Date Approved By Date Date By Date Date By Date 10 Final - Electrical (4055) Approved By : j Date 11 1 (,!. E] FeedeWSub-panels (4045) ® Rough Electrical (4225) ® Ceiling Cover (4020) Approved [By Approved Approved Approved By Date Date By Date 10 Final - Electrical (4055) Approved By : j Date 11 1 (,!. E] Rough Electrical Final Electrical Right of Way Approved J Approved Approved By Date By Date By Date RECEIVE® CITY OF � ELECTRICAL Federal Way ocr 2 Y 2016 PERMIT APPLICATION CDS CM OF RAL WAY PERMIT NUMBER 1 la _ / 0 5 ( —57 SITE ADDRESS: 1-7 g S W (,a r,.1 u D SUITE/UNIT/SPACE# P S PROJECT VALUATION ASSESSOR'S TAX/PARCEL # CURRENT/PROPOSED USE PROJECT NAME (Tenant or Homeowner Last Name) PROJECT DESCRIPTION Detailed description of work to be included on this permit only b ,, �• NAME PRIMARY PHONE PROPERTY OWNER Td tA nC d61 - -7 3aG MAILING ADDRESS E-MAIL t -� F SW Kh-k,� v-- CITYn STATE ZIP FAX ,L- f. fk W 1, W IT 762-S ( ) - NAME f PRIMARY PHONE uS 4 r- 196- 37 MAILING AD16RESS 3 v h W a N E-MAIL /I (�s� j�� �,; c.(sem t ELECTRICAL CONTRACTOR CITY STATE ZIP FAX nVWA I IC' b, v n \.l � 1? ao Z ( ) - WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE # CCAS q-?>' Z q iZz ij7 NAME Lo PRIMARY PHONE APPLICANT I "s (2-5:5 ) 39 1 - 35 qq MAILING ADD SS V E-MAILl- C o pC :5vv/(o(fu6-�unCIejV4, 01 CITY ZIP FAX Sem e Q(�iNd1 ,ST 1ATE W 1� -1 46 ( ) - PROJECT CONTACT NAME PRIMARY PHONE 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 t o/ 2 `{ l 6 PRINT NAME:C S Bulletin # 160 - April 14, 2016 Page 1 of I UHandouts\Electrical Permit Application c®