15-106416 • I Electrical
' C &EFco .alD Way Permit #: 15 106416 00= L
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line:
Ph:(253)835-2607 Fax:(253)835-2609 p q (253)835-3050
Project Name: DAVITA REDONDO HEIGHTS
Project Address: 27320 PACIFIC HWY S Parcel Number: 872992 0020
Project Description: Install low voltage emergency call system
Owner Applicant Contractor
KARL EDMARK JOSEPH STEVENSON STEVENSON TECHNOLOGIES INC
2701 CALIFORNIA AVE SW SUITE 124 STEVENSON TECHNOLOGIES INC STEVETI850KE(5/5/17)
SEATTLE,WA 98116 2538 N NE EVERETT ST 2538 N NE EVERETT ST
CAMAS WA 98607 CAMAS WA 98607
Additional Permit Information
Electrical Work Valuation? 4500 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 1
PERMIT EXPIRES Sunday, June 26, 2016
Permit Issued on Tuesday, December 29, 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: I2"Z 9- l
t iiL, /44)
Es
rt
4416.. • THIS CARD IS TO REIN ON-SITE
CITY OF Construction Inspection Record
r Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-106416-00-EL Address: 27320 PACIFIC HWY S
Project: KARL EDMARK 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.
❑ UFER Ground (4295) CI Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
. . .
CI Pool Bonding(4195) `0 Temporary Power(4275) CI Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) 0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
,
Final-Electrical(4055)
• Approved
1
BL.c3----------
Date v___(34/\
0 Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date •
i RECEIVED
CITY OF DEC 2 9 2015 LECTRICAL
Federal Way CITY OF FEDERAL WAY PERMIT APPLICATION
CDS
PERMIT NUMBER ts
_ l O ct I _ Q 0
l SUITE/UNIT/SPACE#
SITE ADDRESS: 2:7 2.0 pAtpt ,me- sourt±
PROJECT VALUATION ASSESSOR'S TAN/PARCEL# CURRENT/PROPOSED USE
$ )S c)O. C)C7 Z _ O 0
PROJECT NAME S7A\ (4
(Tenant or Homeowner Last Name) Q' (Sl S
PROJECT DESCRIPTION L1( tt' s/Ste`1n CN s- C o< ``vo t- t.)
Detailed description of work to -i��,, v p t.,7•Ac Ca er PM G Q-Cn i✓NC y PcLL sy s TE—Ark !-ms TALL_
be included on this permit only
'9F New sycmrn � l PMJ-e'1,J
NAME PRIMARY PHONE
PROPERTY OWNER k-ARL eptvkA42-1L ( 2-CG) 611J,j- Si
MAILING ADDRESS . E-MAIL
2104 ckut F-0Q4.s1 eN SQL) I Z`-
CITY STATE ZIP FAX
w,A- 9R11
NAME PRIMARY PHONE
CTE E /vSb.N- WOOL- /i�S c ( 3b6 )‘. - 2f2.3
MAILING ADDRESS E-MAIL pQ�
ELECTRICAL �5 �� Sicv2 nu' h+lJic�J°h s�+he,A•0-1°
CONTRACTOR CITY STATE ZIP FAX
(MM/cs wA- ?&601 ( )— -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NAME `` PRIMARY PHONE
APPLICANT Jp E fkAtrvsdS A-) (N6 )6;,5 5_- Z 3
MAILING ADDRESS E-MAIL
2.;373 `Il;(' `� S"� falsJ AAA IAZS M!IS
CITY STATE ZIP FAX
CAMAS WA– "18(,0- ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT J67 V`.NS U (%('- )1 -
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: DATE 121 21/1 5
PRINT NAME: ,O Z STX-
Bulletin#160-January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application