13-100261 • Electrical
City of Federal Way *
Community&Econ.Dev.Services [ Permit #: 13-100261-00—EL
33325 8th Ave S !; I.e i +L-
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: THE COMMONS AT FEDERAL WAY
Project Address: 1928 S COMMONS Parcel Number: 762240 0010
Project Description: Replace 200-amp panel;add lights&outlets. Install low-voltage voice/data cabling.
Owner Applicant Contractor
STEADFAST COMMONS LLC EVERGREEN ELECTRICAL SYSTEMS EVERGREEN ELECTRICAL SYSTEMS
18100 VON KARMAN SUITE 500 1900 W NICKERSON ST SUITE 116-9 EVERGES904CH(2/13/14)
IRVINE CA 92612 SEATTLE WA 98119 1900 W NICKERSON ST SUITE 116-9
SEATTLE WA 98119
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
Alt.Srvc/Feeder 0 to 200 amps(C 1 Low Voltage-Other(Commercial, 1
PERMIT EXPIRES Tuesday, July 16, 2013
Permit Issued on Thursday, January 17, 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
and the City of Federal Way.
Owner or agent: 17� Date: /— l 7— /3
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THIS CARD IS TO MAIN ON-SITE
■CITY OF Construction In ection Record -
Federal Way INSPECTION REQUE TS: (253)835-3050
1 PERMIT#: 13-100261-00-EL Address: 1928 S COMMONS
Project: STEADFAST COMMONS LLC 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) - ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date _ 1 _.1...— •
By Date
El Pool Bonding(4195) ,❑ Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By �- r Date `a `t�
❑ Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date Bye Date t _ I By Date
CI Final-Electrical(4055)
,cl LE........> Approved
Da t .___ __/
❑ Rough Electrical
El Final Electrical `El Right of Way
Approved Approved Approved
By Date By Date By Date
• • RIVED `
ELECTRICAL
CITY
Federal Way I^N 17 2013 PERMIT APPLICATION
CITY OF/F�EDERAL WAY
PERM /IT NUMBER / 3_ // D u Da o / - 6-L._
SITE ADDRESS: /q01 0 5 - C OrVi/ f)bd SUITE/UNIT/SPACE I
t g a 8- s c. " Ole/Pk s
PROJECT VALUATION ASSESSOR'S TAX/PARCEL I CURRENT/PROPOSED USE
$ 2I i7341.9 ' 2 aZ 4 o - 0 Q (_ n
PROJECT NAME y f . Q
(Tenant or Homeowner Last Name) �0 yyl yYtpLyl$ C, Fe C:. //ex fia f vi Tn�,cc..e f' rim t*i v-c',/ [\»'(
/ p l'i c � tx.,,,,, ("9 yt A ( lv /nL� , Add 1o7 kcs
PROJECT DESCRIPTION a- /11 S SA p I 0 p-e r" 9 2a".
Detailed description of work to
be included on this permit only
NAME / PRIMARY PHONE
PROPERTY OWNER j't—PAC ` / ( ) -
MAILING ADDRESS /� �/ - E-MAIL
i l ` /
CITY I ST. ' ZIP ( FAX
l
NAME f / PRIMARY PHONE
Ei/`44'Y re e in r(eCfri"ca 1 ` /_sr`e.444 $ ( Y2s) 77f{71 Vk-
MAILING ADDRESS E- ,..„
ELECTRICAL J q� Gil, �'c L'rSscpel S r .n li H . ,--10.... ee s �n-r)-ei- ,eC,z
CONTRACTOR C STATE ZIP FAX
at,-1 `�"�I (,.M ? .--s'q/
WA STATE CONTRACTOR'S LICENSE I EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE I
EVE 6-E. S 9 'YC y IV i- ,y
NAME PRIMARY PHONE
APPLICANT 4 4-4v ( vs-i 773 -�/21r
MAILING ADDRESS // E-MAIL
1919(Q 41 ,/,64.c•4 rso.n St
CI1N1 STATE ZIP FAX
r -t4. t'i 4 q'S—i'l 9 ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT 4-642- 6/Se), U ri, ( )
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.
__.._7 Q 1 7 SIGNATURE: DATE /-./6-/3
PRINT NAME: 'O`Q. at c/r I ,I"7/
Bulletin#160-January 1,2013 Page 1 of 2 k:\HandoutsiElectrical Permit Application