15-100829 Electrical
City of&FEcon.
Way Permit #: 15-100829-00-EL
Communitycon.Dev.Services
33325 8th Ave S
Federal Way,WA 98003
Request Inspection Line:
Ph:(253)835-2607 Fax (253)835-2609FILE p (253)835-3050
Project Name: POLE FITNESS
Project Address: 30315 PACIFIC HWY S Unit B Parcel Number: 042104 9237
Project Description: 200 amp service to reconnect power and to include(10)outlets for new lighting and outlets
Owner Applicant Contractor
V C INVESTMENTS LLC GOLD ELECTRIC LLC GOLD ELECTRIC LLC
14349 SE 92ND ST PO BOX 2156 GOLDEEL870JZ(4/9/15)
NEWCASTLE WA 98059 AUBURN WA 98071 PO BOX 2156
AUBURN WA 98071
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 Circuits-Commercial 10
PERMIT EXPIRES Saturday, August 22, 2015
Permit Issued on Monday, February 23, 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
theof Federal Way.
Owner or agent: � � � Date:
2
ft°
k\o„ .
THIS CARD IS TO AIN ON-SITE .
CITY of •
Federal WayConstruction In ection Record
INSPECTION REQUE TS: (253)835-3050
PERMIT#: 15-100829-00-EL Address: 30315 PACIFIC HWY S Unit B
Project: V C INVESTMENTS LLC FEDERAL WAY, WA 98003
Scl_Auled 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.
❑ 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) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date 7„12./e I t 4
.
o Feeders/Sub-panels(4045) Rough Electrical(4225) ti Ceiling Cover(4020)
Approved Approved Approved
By Date Bey--�5 Date 3 �z-----,By Date
%
Cl Final-Electrical(4055)
Approved
.
By Date 3 12l, 1 l r'
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date i By Date By Date
•
�►. EeECTRICAL
CITY OF
Federal Way PERMIT APPLICATION
Reccervec}
*It
PERMIT NUMBER 15 _ 1 0 0 5 2�l _ 00
FEB 232015
SITE ADDRESS: 3 (S pct i C l�W0 4_ CDs
�WAY
PROJECT VALUATION ASSESSO 'S TAX/PARCEL# CURRENT/PROPOSED USE
7--
PROJECT NAME /
(Tenant or Homeowner Last Name) �1 � 77/ Ti V 5._5
GLTL / �Ztl v
) /
PROJECT DESCRIPTION
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
(?66 ) (ta r7zz
MAILING ADDRESS MAIL
ELECTRICAL /) &)C ��le/ �'ic/�G `�
CONTRACTOR _ /Q 1�
CITY STATE ZIP FAX
/ 6U/'77 G2/ -� ` - Lam'�� ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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 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: A / ✓�Ls' " DATE
PRINT NAME: I" ` ,I - e��y/J____
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application