14-103080 •
Electrical
City of FederalFay L
Comm my&Econ.De.Services E Permit #: 14-103080-00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: 253 835-3050
Ph:(253)835-2607 Fax(253)835-2609 SSIVE p
Project Name: PROGRECLAIMS OFFICE nsecq
Project Address: 34001 PACIFIC HWY S Parcel Number: 202104 9051
Project Description: Install fire alarm system to new 24,793 square foot commercial building
Owner Applicant Contractor
PROGRESSIVE CASUALTY INSURANCE KIRBY ELECTRIC INC KIRBY ELECTRIC INC
PO BOX 89429 4826"B"ST NW SUITE 101 KIRBYEI077BN(1/13/15)
CLEVELAND OH 44101 AUBURN WA 98001 4826"B"ST NW SUITE 101
AUBURN WA 98001
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
Low Voltage-Fire Alarm(Comm( 1
PERMIT EXPIRES Monday, December 22, 2014
Permit Issued on Wednesday, June 25, 2014
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the u will be in accordance with the laws, rules and regulations of the State of Washington
and City of Federal Way.
Owner or agent: Date: C9 - 25 - ) �,
• THIS CARD IS TO MAIN ON-SITE
CITY OLS Construction In ection Record
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 14-103080-00-EL Address: 34001 PACIFIC HWY S
Project: PROGRESSIVE CASUALTY INSUR 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) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
❑ Pool Bonding(4195) ❑ Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
.0 Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020) '
Approved Approved Approved
By Date By Date By Date
Final-Electrical(4055)
Approved
.:::- , Date k.t. (
0 Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
111 •
41116. ELECTRICAL
carr of 11111111
Federal Way PERMIT APPIION
PERMIT NUMBER I4 _ / 0 3c 7L/ 0 _ L:...-...t...- JUN 2 5 2 014
CI-Y OF FEDERAI WAY
SUITE/UTRACE#
SITE ADDRESS: 3qQ) 1 l Fie, v LLJJ
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
/S a a z r a - c' e $ 1_
PROJECT NAME
(Tenant or Homeowner Last Name) p I V F {i u CE
PROJECT DESCRIPTION A/t`t'P-1'1A.-
Detailed description of work to
be included on this permit only
Nps ..— PRIMARY PHONE
PROPERTY OWNER � -ESS(U1 OAP- c .( ) -
MAILING ADDRESS E-MAIL
f PACT , -i6�f .
CITY STATE ZIP FAX
CSL LLJI 4r t A 9 3 ( ) -
NAME PRIMARY PHONE
12(34 't..r;CT C ( Ct2spc:Dc
MAILING ADDRESS / E-MAIL
ELECTRICAL �,a > ST IL�.� /C I
CONTRACTOR CITY STATE ZIFAX
Aum. L� C (. :3)&71-23t...7.3
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
VIlaaYErco7.7 1344 1 ' 13 'i5 1/-90-/6/89 7-&-
NAME
/9o-/6/897-6-
NAME PRIMARY PHONE
( )
APPLICANT "" "I� M CC,
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT A 14 LEP Mitic KI 43)2S9-2
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: 5tCUiJ ._, tirizji -.....-,..-./ 612.4-1 , 4
DATE
PRINT NAME: CSAi,t LE-4/"t 4a
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application