16-103576 A
Electrical
City of Federal Way .{.�,
Community&Econ.Dev.Services Permit #: 16-103576-00-EL
33325 8th Ave S
Federal Way,Fax: 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q ( �
Project Name: SECOMA LANES
Project Address: 34500 PACIFIC HWY S Parcel Number: 889700 0005
Project Description: Adding/altering(1)circuit for exterior lighting,low voltage voice and data cabling and(1)
subpanel
Owner Applicant Contractor
SECOMA LANES INC CLOVER CREEK ELECTRIC CLOVER CREEK ELECTRIC
34500 PACIFIC HWY S 1413 CENTER ST CLOVECE293LA(4/30/18)
FEDERAL WAY,WA 98003 TACOMA WA 98409 1413 CENTER ST
TACOMA WA 98409
•
Additional Permit Information
Electrical Work Valuation? 15600.00 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 201-600 amps(( 1 Circuits-Commercial 1 Low Voltage-Other(Commercial
PERMIT EXPIRES Tuesday, July 25, 2017
Permit Issued on Monday,July 25, 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: /1/e1114.- Date: 7/2 5-h
THIS CARD IS TO REMAIN ON-SITE
ct Construction Inspection Record
Federal VVay INSPECTION REQ TS: (253)835-3050
PERMIT#: 16-103576-00-EL Address: 34500 PACIFIC HWY S
Project: SECOMA LANES INC 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.
LIFER Ground(4295) El Ditch cover(4030) - "❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date Date 7-2 By Date
—
0 Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) 0 Rough Electrical(4225) Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
Q Final-Electrical(4055)
Approved
By P lt+,, Date .1. 4 —, v) ,
0 Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
1
RECEIVED ELECTRICAL
Federal Way JUL 2 5 2016 PERMIT APPLICATION
CITY OF FEDERAL WAY ( �- T 0 _35 % 00
CDS PERMIT NUMBER
SUITE/UNIT/SPACE#
SITE ADDRESS: -�_r �) �.l�,r f�,
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PROJECT VALUATION ASSESSOR'S T— P R #O O f O O CURRENT/PROPOSED USE
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PROJECT NAME
(Tenant or Homeowner Last Name) ae,L (s"C� Let M r'
stx lr O.) n,t„� -e, ,,, ,., (_;n, (,lilts' (3)
PROJECT DESCRIPTION I ip + (tLt$ t- ✓i .,J 614116'in rr'1(VI et re art
Detailed description of work to (t.4 C1bk. e . -A )i i I4l'.1C ( )�ti.J+
be included on this permit only - J'
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NAME '� PRIMARY PHONE
PROPERTY OWNER St,f-c 1V10,. Leo-t. (, ----3)9.21- )f I1
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
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NAME PRIMARY PHONE
&0V-v- -z,k. ELIC 4-ri z. 6153)627 4643'
MAILING ADDRESS Cpl E-MAIL
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ELECTRICAL �{ - >c'��CtZ l���'r� •C#�►Ne�5� l Z
CONTRACTOR CIT STATE FAX 'A
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WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
21.011
. ,yvC C'6 9' 3LA X36 i IF rfrri g-104 _ct,18L
NAME : PRIMARY PHONE
APPLICANT rl kn 11 ' ./'l L'(EA'.1 s3)4(7 - Ll yy
MAILING—ADDRESS j E-MAIL
f h/13 ( e-, 4'v Driv,„ c:/Overt! ,e6'111
CITY STATE ZIP FAX
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ti11 a. L4I' )Q9 / 0-s34.2-,-) - !ff/
Ni& PRIMARY PHONE
PROJECT CONTACT —17i41.4 AN nA , gi y Ps'3) a'? - 6 4'Y
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 ity as a part of is application.
r /
SIGNATURE: ti I/J� �Id`��`Qi DATE 7 ®' Y
PRINT NAME:, -1/ I" 'i - I e'l Lii, i''
1
PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
253-835-2607+ FAX 253-835-2609 +permitcenter(acityoffederalway.com
Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application