15-105018 4 • I Electrical
l City of Federal Way Permit �/
Community&Econ.Dev.Services I ermit #: 15-105018-00-EL
33325 8th Ave S
Federal Way,WA 96003 Inspection Request Line: (253)835-3050
Ph.(253)835-2607 Fax.(253)835-2609 p q
Project Name: VERIZON SHELL
Project Address: 35007 ENCHANTED PKWY S Parcel Number: 185295 0020
Project Description: Low-voltage wiring for telecommunications.
Owner Applicant Contractor
A THOUSAND HILLS LLC J A G CONSTRUCTION& J A G CONSTRUCTION&
362 N HERBORN COMMUNICATIONS INC COMMUNICATIONS INC
POST FALLS ID 83854 8210 MUKILTEO SPEEDWAY UNIT B JAGCOCC861CO(2/20/16)
MUKILTEO WA 98275 8210 MUKILTEO SPEEDWAY UNIT B
MUKILTEO WA 98275
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Service greater than 999 Amps? No
Electrical Fixtures
Low Voltage-Other(Commercial 1
PERMIT EXPIRES Tuesday, March 29, 2016
Permit Issued on Thursday, October 1, 2015
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 in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: >- Date: ( 04Xs
k"Box tbSt aQ c- of co-o i T Do 0 if- A'1 Go+-4 Ica-.
i P,/;%Ill ig
ke
THIS CARD IS TO ON-SITE 1 ; ,
4IA CITY OF • Construction Ins ction Record
Federal Way INSPECTION REQUE TS: (253)835-3050 ■
PERMIT#: 15-105018-00-EL Address: 35007 ENCHANTED PKWY S
Project: A THOUSAND HILLS LLC FEDERAL WAY, WA 98003-8359
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.
o UFER Ground (4295) Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
o Pool Bonding(4195) ❑ Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
o Feeders/Sub-panels(4045) • '0 Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
. ,
o Final-Electrical(4055)
Approved
17--- —
Datet ` c3 ( —
El Rough Electrical Final Electrical _ Right of Way
Approved Approved Approved
By Date By Date By Date
SECEIVED
�► EtECTRICAL
CITY OF
Federal Way OCT 01 2015 PERMIT APPLICATION
CITY OF FEDERAL WAY
CDS
PERMIT NUMBER / S ( U 5 0 / Cr Et...-
1
SUITE/UNIT/SPACE#
SITE ADDRESS: 3 iv D 7 e 1,1 c ct(Z i-{d Pk 14.1 14.1
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
PROJECT NAME Ve ?‘;r0 h $4zl/
(Tenant or Homeowner Last Name)
1 ok, vo 1 - VIA /
✓ 3 7 cubre_S' CC,?LS
/
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME /(r PRIMARY PHONE
PROPERTY OWNER //[/�`� C /�oi'csa Ilti ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME / PRIMARY PHONE
3 e (� 0 � �h;1,j f ( 25)77, - 0007
T MAILING ADDRESS tJ E-MAIL
ELECTRICAL /76 23 6 S+i` ` 4 147 /uQ J gic-0,45 ,di cony-c`3i
CONTRACTOR CITY STATE ZIP FAX
t. j$t h.o tJ 1 tv/4 . q 60 3 7 ( ) - rs
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# G
/ /
NAME PRIMARY PHONE
(101-11C4 CI 0 r
( ) -
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME _-(u' I Y PHONE
PROJECT CONTACT' s ,,.e, - _O00 7
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 ses out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied tot city as a part of this application. i
SIGNATURE: DATE ` 7�7�5
PRINT NAME: .v\ ji-ki Y! c
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application