15-104443 0 S
' Electrical
City of Federal Way
^Community&Econ.Dev.Services ira Permit #: 15-104443-00-EL
33325 8th Ave S
Federal Way,WA 98003 253 Inspection Request Line:
Ph;(253)835-2607 Fax (253)835-2609 p q )835-3060
Project Name: WALGREENS
Project Address: 28817 MILITARY RI)S Parcel Number: 042104 9030
Project Description: Low voltage wiring for sound masking,ceiling speaker and volume control system
Owner Applicant Contractor
28817 MILITARY RD S LLC INTELLIDWELLING INTELLIDWELLING
PO BOX 3130 6715 NE 56TH AVE INTEL**910KN(6/23/17)
ROLLING HILLS ESTATES CA VANCOUVER WA 6715 NE 56TH AVE
90274 VANCOUVER WA
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 I
PERMIT EXPIRES Monday, February 29, 2016
Permit Issued on Wednesday, September 2, 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 be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: � �� '�--- Date: Dq/ 2/Zd1
( 1' r 1� t,
.., A. THIS CARD IS TO REMAIN ON-SITE _ ,
Federal WayConstruction Insp€ion Record
INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-104443-00-EL Address: 28817 MILITARY RD S
Project: 28817 MILITARY RD S LLC FEDERAL WAY, WA 98003-7912
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) El Ditch cover(4030) -❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
• - • .
o Pool Bonding(4195) 0 Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
'
O Feeders/Sub-panels(4045) CI Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055)
' Approved
By
Date
® Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
SEP 022015 LECTRICAL
CITY OF A w
Federal Way crrY of FEDERAL WAY PERMIT APPLICATION
•
CDS
PERMIT NUMBER f S ( 0_ 4-ei 43 DO
— —
SUITE/UNIT/SPACE#
SITE ADDRESS: 2 g g i 1 PI in-
/ C2.OI dSv q 8003- 7/2
PROJECT VALUATION AS` SS TAX/PARCE # CURRENT/PROPOSED RRENT/PROPOSED USE
YOu . 'n Z / O - ®9, 0 , 0
PROJECT NAME .
(Tenant or Homeowner Last Name) �Ilt L C2`ol M i \A e/`,, ' S LLC
PROJECT DESCRIPTION s0un al �C s k.-N 51- C--e ,/,N C Sv k-e/ �a 1 c_oNVO 1
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP ( FAX
)
NAME PRIMARY PHONE
id-di,RdL) e- 11't (36° )635 - 5-333
MAILING ADDRESS E-MAIL
I A/ -Ctk;c�µ.C t I:i
-
ELECTRICAL ( I J A S - Vl W ope c i h b ms's`"' o CO lav\
CONTRACTOR CITY STATE ZIP FAX
Vatice 00-C-' 114 li 64 (5-03 ) 9 22. 232./
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
sAR L`- (..- P i 9/n KA) / /
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ) E-MAIL
CITY STATE ZIPFAX
//
1 )
NAMEPRIMARY PHONE
PROJECT CONTACT I i i CA4 0`co ,vA-e- (3 13?2-- 3 3Y,
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 ci a part of this application.
SIGNATURE: _''-- _ DATE 9 — " 20/S/
PRINT NAME: ' 1GI0I4S S tr\)i- -1--c
•
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application