16-10523146 9 0
f-:
City of Federal Way
Community Development Dept.
33325 8th Ave S ' 3
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: CITY MD
Project Address: 31675 PACIFIC HWY S
Electrical
Permit #:16 -105231 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 082104 9077
Project Description: Install low voltage, fire alarm, 35 SLC devices, 3 U NAC devices and (1) panel
Owner
Applicant
Contractor
HARSCH INVESTMENT PROPERTIES
TROY JOHNSONSEACOM CABLING INC
SEACOM CABLING INC
PO BOX 2708
3014 W HOYT AVE
PORTLAND OR
EVERETT WA 98201
3014 W HOYT AVE
97208
EVERETT WA 98201
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
Alt. Srvc / Feeder 0 to 200 aml 1 Low Voltage - Fire Alarm (Co 1
PERMIT EXPIRES Saturday, 28 October, 2017
Permit Issued on Friday, October 28, 2016
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:nh,11 I Ki F; Date:
crrr os 44A
Federal Way
PERMIT #: 1610523100
U
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
Address: 31675 PACIFIC HWY S
Project: HARSCH INVESTMENT PROPERTI FEDERAL WAY WA 98003-5407
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)
El
Ditch cover (4030)
F11
Slab/Concrete Floor (4255)
Approved
Approved
Approved
Approved
By
Approved to place concrete
By
Date
By
Date
By
Date
®
Pool Bonding (4195)
El
Temporary Power (4275)
®
Service (4235)
Approved
Approved
Approved
Approved
By
Approved
By
Date
By
Date
By
Date
®
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
® Ceiling Cover (4020)
Approved
Right of Way
Approved
Approved
By
Date
By
Date
Date k l i? (7
Elo Final - Electrical (4055)
Approved
By Date
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
P03am ELECTRICAL
OCT 2 8 2016 PERMIT APPLICATION
CITY OF FEOcERAL WAY C)
CDS PERMIT NUMBER J
SITE ADDRESS: S-
SUITE/UNIT/SPACE S
PROJECT VALUATION G
ASSESSOR'S TAXRCEL - 9CURRENT/PROPOSED
`TvS �: /)
USE
PRO CT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
3s s4 C K
PROPERTY OWNER
NAME
PRIMARY PHONE
( ) -
MAILING ADDRESS
E-MAIL
CITY
STATE
I ZIP
( FAX
1 ) -
ELECTRICAL/t��
CONTRACTO, u
�IV `
AWA
xC
NAME
PRIMARY PHONE
E-MAIL
MAILING ADDRESS
�O O
CITY
"�T7
STATE
j/4
ZIP
I 9q.�u
FAX
( s) 317 - i '
STATE CONTRACTOR'S``LICENSE !, EXPIRATION DATE
J C
FEDERAL WAY BUSINESS LICENSE N
APPLICANT
NAME
LIESS
PRIMARY PHONE
( )
MAILIN ADDRESS
E -MAH,
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
//' �- ���
PRIMARY PHONE
(y )247-O L
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 apart of this application.
SIGNATURE:
PRINT NAME: O !/�(lJ���J/✓
TE %9- rI a - 14
PERMIT CENTER + 33325 811, Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permiteenter!iucityoffederalway.com
Bulletin 4160 -April 14, 2016 Page 1 of I kMandoutsTlectrical Permit Application