13-102592 r
Electrical
City of Comm nity&33325 Eco8th n�AveDe VSerViCeS a , ; Permit #: 13-102592-00-EL
.S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: THE COMMONS-KOHLS SHELL& CORRIDOR
Project Address: 2101 S COMMONS Parcel Number. 762240 0010
Project Description: Install(2)4"conduits for secondary(no wire)uffer,kiosk power conduit,hall light,wall
packs
Owner Applicant Contractor
STEADFAST COMMONS LLC EVERGREEN ELECTRICAL SYSTEMS EVERGREEN ELECTRICAL SYSTEMS
1928 S COMMONS 1900 W NICKERSON ST SUITE 116-9 EVERGES904CH(2/13/14)
FEDERAL WAY WA 98003-6013 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
Circuits-Commercial. 6
PERMIT EXPIRES Monday, December 9, 2013
Permit Issued on Wednesday, June 12, 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 /1._);" Date: '—/s2 ' /3
Vkk f
DATE INSPECTOR AREA AND TYPE (,. INSPECTION
( 0-4-1 3 (R.r.A./ t/._ Ati 1.-eA,--den.-4:7-4--
Pew.�— we s 1 ►,. �.�, Q — � —�
11) SC 13 1‹..)1) V C (Iv+ ,-Jvp
THIS CARD IS TO MAIN ON-SITE
CITY OF' Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
I
PERMIT#: 13-102592-00-EL Address: 2101 S COMMONS
Project: STEADFAST COMMONS LLC FEDERAL WAY, WA 98003
Scheduled inspections may be failed if this card is not on-site. PO 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) U Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place co rete
By 'CS Date - (',( 3 Dat (-3,../ .� `, Dates, ?2 l 3
❑ Pool Bonding(4195) 0 Temporary Power(4275) El Service( 235)
Approved Approved Approved
By Date By Date By Date
El Feeders/Sub-panels(4045) El Rough Electrical(4225) ' Ceiling Cover(4020)
ILI Approved Approved Approved
i By Date 111Z* Date(.6 _/ ~ Date I 0—2 -(
El Final-Electrical(4055)
Approved
By V.,0 Date 12_ ( 111( (I
1
1
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
•
S. ID EL C'T'RICAL
CITY OF •
Federal Way PERMIT APP N
PERMIT NUMBER l 2 _ 1 0 2 S Z _ 00 JUN 12 2013
CITY OF FEDERAL WAY
SUITE/UNITe E#
SITE ADDRESS: 1 9 s S Cc�✓ 'P,YI S `�..ttrJ..�'
PROJECT VALUATION 7 U ASSESSOR'S TAX/PARCEL S CURRENT/PROPOSED USE
$ OZ1 .754i2 —
PROJEeT NAME I/� J / r(Tenant or Homeowner Last Name) /"\ I"( /� 5 r1 �i /J
G2 � V if Cd7/lJv;TS -Per sEc.Dn414 nI $ Cnv Cv/n )) 9J24'H
PROJECT DESCRIPTION k7cri5k ir(t.,ti'"r (^m 4�v, ha 1( I r 147`i Lt./0��12 i c.k.5
Detailed description of work to
be included on this permit only
•
NAME PRIMARY PHONE
PROPERTY OWNER $7-e aA 5-r" < U 177 m(0-7-1 S ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP / FAX
(
i. )
NAME PRIMARY PHONE
F S ( '7 773- C'/97,
MAILING ADDRESS E-MA L
ELECTRICAL 1 roe2 4.2 /11"che"'Scull Sr Sr )/
CONTRACTOR C J CZ / STATE I Z�j,8/` t FAX
E 7`T e `l ( )
WA STATE CONTRACTOR'S LICENSE E EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE N
'=V / �-E 'a� �/I . ' i s 'r -
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( )
NAME Ps PRIMARY PHONE
vl
PROJECT CONTACT U77 (Li-Z5-773 c7/1-7,
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 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: )'?"d DATE 6— /
— g
PRINT NAME: .?- ` Cis- /O
r 7 ,
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application