13-103926 s
s *.
r 0 •I Iectr`ical
City of cWay Permit #: 13-103926-00-E L
Community&Econ.Dev.Services
33325 8th Ave S 'p i
Federal Way,WA 98003 1,": i i.
Ph:(253)835-2607 Fax:(253)835-2609 �.. Inspection Request Line: (253)835-3050
is
Project Name: STARBUCKS MODULAR
Project Address: 28722 PACIFIC HWY S Parcel Number: 332204 9119
Project Description: Install(1)400 amp service,(4)pole lights,(4)ballard lights,for drive thru lighting and
directional signs
Owner Applicant Contractor
POLL FEDERAL WAY LLC MOON ELECTRIC CO MOON ELECTRIC CO
8915 SE 44TH ST 17804 SIMON RD MOONEC*994MC(7/9/15)
MERCER ISLAND WA SNOHOMISH WA 98290 17804 SIMON RD
98040 SNOHOMISH WA 98290
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
Circuits-Commercial 4 New Service:201-400 amps(Con 1
PERMIT EXPIRES Tuesday, March 4, 2014
Permit Issued on Thursday, September 5, 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 the City of Federal Way.
Owner or agent--2-9/,e101?-7-72O-61-11 Date: ' S7/3
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THIS CARD IS TO IN ON-SITE '
city OF Construction In ection Recoi`d '
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-103926-00-EL Address: 28722 PACIFIC HWY S
Project: POLL FEDERAL WAY LLC FEDERAL WAY, WA 98003-3224
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) - 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) 0 Service(4235)
Approved Approved Approved
By Date By Date By C. kL,, Date 1 is _Li_l a
❑ Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
o Final-Electrical(4055)
Approved
By Q . r Date
1\-22.--1?,
❑ Rough Electrical Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
.
i .
A ELECTRICAL
CITY O
Federal Way PERMIT A,PPLICATION
RECEI
VED
PERMIT NUMBER ( _ [ 0 ✓ g z (O - 0 0 SEP 0 5 2013
CITY OF CDSr
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SITE ADDRESS: d$-�
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PROJECT VALUATION ASSESSOR' TAX/PARCEL# 4._ CURRENT/PROPOSED USE
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PROJECT NAME {�
(Tenant or Homeowner Last Name) c �b(A.cE;.S r-en �m fP L t HOb"LAP-*
PROJECT DESCRIPTION 4 A I*, S.c,r v1 c.Q 1 C)t' i-.1 ei 1\1, ) c Wf TA/it
Detailed description of work to (Thlt '
be included on this permit only r pC Ind s n
NAME PRIMARY PHONE
PROPERTY OWNER ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
.___. .. .. NAME .. - —. PRIMARY PHONE
✓Yl(t)p•-1 '.\-Qc AiC_ ( ) -
MAILING ADDRESS :^� 11 E-MAIL
ELECTRICAL 1`1 $0y r
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CONTRACTOR CITY STATE ZIP FAX
int))-(oicnls!-\. wa 98d9O ( ) -
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 rri tCl da d-Q` amn 0,-lr (4-1A5-1 a l - p3g5
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 Q C.i C r/COY\ DATE 5.4124-5'-Elo0
PRINT NAME:
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application