14-103419 6 . s • 0 44
E `ectrcal
.______v
C Cityof&FederalWay Permit #: 14-103419-00-EL
Community Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q
Project Name: MICHELLE NELSON CPA
Project Address: 33650 6TH AVE S Unit 230 F 1 LE Parcel Number: 926480 0210
Project Description: Install low voltage voice and data cabling
Owner Applicant Contractor
SUN LIFE ASSURANCE COMPANY OF ACKER ELECTRIC ACKER ELECTRIC
CANADA 22024 260TH AVE SE ACKERE*077PM(10/14/15)
•777 108TH AVE SUITE 103 MAPLE VALLEY WA 98038 22024 260TH AVE SE
BELLEVUE WA 98004 MAPLE VALLEY WA 98038
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 Tuesday, January 6, 2015
Permit Issued on Thursday,July 10, 2014
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: ��' G �/� Date: ? —/D - V/
0 THIS CARD IS TO MAIN ON-SITE y
CI OF
r , ' t
Construction In ection Record
Federal Way INSPECTION REQU TS: (253)835-3050
PERMIT#: 14-103419-00-EL Address: 33650 6TH AVE S Unit 230
Project: SUN LIFE ASSURANCE COMPANY 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.
El UFER Ground(4295) El Ditch cover(4030) '0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
♦ . . . I
,El Pool Bonding(4195) '0 Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
.
El Feeders/Sub-panels(4045) ,El Rough Electrical(4225) ' ti Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date '"1 [ )4 I 14
o Final-Electrical(4055) '
Approved
By t J Date 1 �D 4-14
❑ Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
4
4 v A. 0
E1CTRI AL-
CITY OF
Federal Way PERMIT APPLICATION
j RECEIVED
PERMIT NUMBER l 1 _ I h�/ ✓ 4q _( Ci ° O
1111 JUL 10 2014 A�
SITE ADDRESS: 3 3 6 6.v �� 6C,CITY OF FEDERAL Y9KGITE/UNIT/SPACE#
CDS ��/ Z 3 O
PROJECT ASSESSOR'S TA /PAR�L# CURRENT/PROPOSED USE�Ol �� �\� � 0 _ U O
PROJECT NAME
(Tenant or Homeowner Last Name) /-6.A,..)/e f3- l01/€15, K/, 212 G f1
PROJECT DESCRIPTION Tiii(57-J-L Z C-4' 6 :,,,,,Z71700, f-y,- Nle-'4 / t"'-ig
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
796- '. t/ -e-="7-/-,c (a,6 ) 3 9‘- 3 S6' ?
MAILING ADDRESS E-MAIL
ELECTRICAL 2-2 4,Z 7 2 6!? 7i ii-�o'e- $'�
CONTRACTOR CITY STATE ZIP FAX
m p/-- )42//‘7 a/ 9f7 3 ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
..4 o-2-7fm /d /`6 '/C
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( ) -
NAME PRIMARY PHONE
PROJECT CONTACT ( ) -
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 taws 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: 34:2V DATE 7—/P—/K
PRINT NAME: ti-e4:2 e -C��e- -- _
Bulletin#160-January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application