13-101273 • Electrical
City of Federal Way Permit #: 13-101273-00-EL
Community&Econ.Dev.Services E _
33325 8th Ave S I t ,
Federal Way,WA 98003 4i E.1k. i Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q
Project Name: CHEAP SMOKESHOP
Project Address: 30315 PACIFIC HWY S Parcel Number: 042104 9237
Project Description: Service inspection to activate power for new tenant in suite F.Includes replacement of light
fixtures.
Owner Applicant Contractor
VAN VUONG O M S CONSTRUCTION O M S CONSTRUCTION
VC INVESTMENTS LLC 32840 41ST WAY S OMSCOCI881R7(12/27/14)
2101 SE 2ND PL FEDERAL WAY WA 98001 32840 41ST WAY S
RENTON WA 98056-8864 FEDERAL WAY WA 98001
•
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
PERMIT EXPIRES Monday, September 16, 2013
Permit Issued on Wednesday, March 20, 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 th City of Federal Way.
Owner or agent / Date:
A„
THIS CARD IS TO MAIN ON-SITE
CITY OF . • Construction In ection Record '
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-101273-00-EL Address: 30315, PACIFIC HWY S
Project: VAN VUONG FEDERAL WAY, WA 98003-4124
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) 0 Ditch cover(4030) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
❑ Pool Bonding(4195) ❑ Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By ,-,,rA Date t,..)...t_
�0 Feeders/Sub-panels(4045) ' 0 Rough Electrical(4225) E Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
.
O Final-Electrical(4055)
Approved
By N1► * l5 Date 4-6- Vin,'i
Rough ElectricalEl Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF
ELECTRICAL
TRICAL
Federal Way PERMIT APPLICATION
RECEIVED
PERMIT NUMBER 1 _ \/ 1 Z 3 0
MAR 202013
CITY OF FEDERA„¶AVUNIT/sPACE i
SITE ADDRESS: 30) / p# r L , 1 wy 5 ; ` CDS
PROJECT VALUATION ASSESSOR'S TAX/PARCEL i/ CURRENT/PROPOSED USE
�a a t� — �— 4„
PROJECT NAME
(Tenant or Homeowner Last Name) /eek, D k.
PROJECT DESCRIPTION 7' �- C� 6-15'""1-
Detailed description of work to / L b U� LP, 5 r (A 4- I-e 5
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNERz55< 1.p a `e- �� (ZSR ) 1D 1ov.`-
MAILING ADDRESS 6 E-MAIL
CITY STATE ZIP FAX
( )
NAME / PRIMARY PHONE
l )
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
( )
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE S
NAME ,.` PRIMARY PHONE
APPLICANT Pn (�4 ("F ( ZC ) 3. -.5t—`?”
MAILING ADDRESS E-MAIL
3) qv tit __s4 Gtv't/ 5 DittS(-0A/5�J/liF.A ,ce. r..�
CITY STATE ZIP FAX
w6t7 W//J- Moo/
b Do/ ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT Ox)t
(-7-4) 3
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 of this application. 77
SIGNATURE: DATE J/ Ao /(5
PRINT NAME: / A
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application