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15-104872 4110 Electrical City ofFederal Way Community 8,Econ.Dev.Services Permit #: 15-104872-00-EL 33325 h Ave S Federal Way8t,WA ssoo3 Insection Request Line: (253)835-3050 , Ph:(253)835-2607 Fax:(253)835-2609 , p Q Project Name: UKRAINIAN FEDERAL CREDIT UNION Project Address: 1414 S 324TH ST Unit B108 Parcel Number: 150050 0080 Project Description: Wiring for(1)new illuminated channel letter sign Owner Applicant Contractor UKRAINIAN FEDERAL CREDIT UNION BRUCE POITRAS POITRAS SIGN&LIGHTING(ELECTRICAL 824 EAST RIDGE RD POITRAS SIGN&LIGHTING 04) ROCHESTER OR•97229 • 8515 189TH AVE SE POITRSL881LG(6/7/16) SNOHOMISH WA 98290-3207 8515 189TH AVE SE 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 1 PERMIT EXPIRES Tuesday, March 22, 2016 Permit Issued on Thursday, September 24, 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 a - dance with the laws, rules and regulations of the State of Washington and the City of Federal Way. Owner or agent Date: 7-4/ Y��� THIS CARD IS TO REI�N ON-SITE "TM of f Construction InspeZtion Record X Federal Way INSPECTION REQUESTS: (253) 835-3050 PERMIT#: 15-104872-00-EL Address: 1414 S 324TH ST Unit B108 Project: UKRAINIAN FEDERAL CREDIT UN 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. 0 UFER Ground (4295) El Ditch cover(4030) 0 Slab/Concrete Floor(4255) Approved Approved Approved to place concrete By Date By Date By Date 0 Pool Bonding(4195) El Temporary Power(4275) 0 Service(4235) Approved Approved Approved By Date By Date By Date 0 Feeders/Sub-panels(4045) 0 Rough Electrical(4225) El Ceiling Cover(4020) Approved Approved Approved By Date By Date By Date , Final-Electrical(4055) Approved By WO Date Gl IVA I ler D Rough ElectricalEl Final Electrical CI Right of Way Approved Approved Approved By Date By Date By Date J • _.I 4111 RECEIVED •• ELECTRICAL CITY OF A SEP 2 4 2015 a Federal Way PERMIT APPLICATION CITY OF FEDERAL WAY r i CDS PERMIT NUMBER 1 ''1 _ ) 0 `-1 1 2- _ 111/// SUITE/UNIT/SPACE# SITE ADDRESS: /'//7' —s _ 3 a © 7`y S t - 9 L[ `c 51 PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE $ 5 ,6_ dc 1 5 © 0 5 ° - d d S 0 PROJECT NAME /� (Tenant or Homeowner Last Name) iO )^01 , 2-'7 a 4.- f e . /of / c- ' 4 7 ''/ 7'"I ' PROJECT DESCRIPTION x514/7 / —e-1-1---- ,S'''S r-7 Detailed description of work to be included on this permit only NAMEPRIMARY PHONE PROPERTY OWNER U/LL/( '4 rn/O.t., r- o 6rez-4,7e/,e0,y- v4., ',J'Z- 3) .5-.,2. 'a // MAILING ADDRESS E-MAIL /(//- 3 -. 3z y14 S .f CITY STATE ZIP FAX - 'ra J / Isv- fO 3 ( ) - NAME PRIMARY PHONE . / -Q , c s.)h 0, L,,S f'tib ( f/zs) 3fil_f57‘?..s9 MAILING ADDRESS , E-MAIL ELECTRICAL 15/.5' '/�l 9pyo s- /D/iz/-4-c 2 1xCO- CONTRACTOR CITYSTATE ZIP FAX S/z ahamj-4 w 4 9,'� ( ) - WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# Pe/ /P'S i :8/Z y 6' / 7 0/L NAME PRIMARY PHONE APPLICANT ' ' 'C' //4iu S* (9,X) ss-'- .4(/CI- MAILING ADDRESS .e. CITYSTATE ZIP FAX S`tii'4c�x SL) k-e, 78a9G ( ) - NAME PRIMARY PHONE PROJECT CONTACT /,G C e A .7/,,,,- I (yz S) 3 ',5:-?96"/Ir-- I '?96/ -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 asoma •../offthis application. SIGNATURE: /�'`—r DATE 9 -,.2 ... /5 PRINT NAME: /S/z---c r ! v/21' a/ Bulletin#160-January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application