13-101124 ` • • • Electrical
City of Federal Way " " fiermit
[ Commun &EconDevSerlces ( #: 13-101124-00-E L
33325 8th Ave S
Federal way,WA 98003li - '' ,.; Ins ection Re uest Line: 253 835-3050
Ph:(253)835-2807 Fax(253)835-2609
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Project Name: RED CANOE CREDIT UNION
Project Address: 33616 PACIFIC HWY S Parcel Number: 212104 9058
Project Description: Install low voltage wiring for voice/data cabling
Owner Applicant Contractor
RED CANOE CREDIT UNION JERRY'S TELEPHONE SERVICE JERRY'S TELEPHONE SERVICE
PO BOX 3020 1105"D"15TH AVE SUITE 430 JERRYTS885DW(3/20/14)
LONGVIEW WA 98632 LONGVIEW WA 98632 1105"D"15TH AVE SUITE 430
LONGVIEW WA 98632
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-Other(Commercial; I
PERMIT EXPIRES Saturday, September 7, 2013
Permit Issued on Monday, March 11, 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: Date: 7 - I ) - )-3
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THIS CARD IS TO MAIN ON-SITE
CITY OF Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-101124-00-EL Address: 33616 PACIFIC HWY S
Project: RED CANOE CREDIT UNION FEDERAL WAY, WA 98003-6810
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) 0 Ditch cover(4030) 0 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 Date
❑ Feeders/Sub-panels(4045) 0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date 1311-�5 Date 3,/S/3 By� (S Date 3-2 9/.
O Final-Electrical(4055)
Approved
•401111.
Dat — (C.,
Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF EL CTRICAL
Federal Way PERMIT APPLICATION
PERMIT NUMBER I�j 24 RECEIVED
- - - - MAR112013
SUITE/UNIT/SPACE#
SITE ADDRESS: 336 l Q(�1�i c I4 w CITY OF FEDERALCCDDSSWAY
PROJECT VALUATION ASSESSOR'S AX/PARCEL# 3 CURI2Eft'1')PROPOSED USE
$ 5()C z ( rz, _a 1= o
PROJECT NAME ate^ \I`�(OE N c o N
(Tenant or Homeowner Last Name)
Jo i(,0_ W x V'►)(5
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER e C- o i? ( ) -
MAILING ADDRESS// cckc,11:ttc
E-MAIL
336 lO
CITY STATE IP FAX
D--ro,,L UJ W g 8033 ( ) -
NAME 1 PRIMARY PHONE
cC0 l�v �V‘ (360)4-/7/ - 52.2o
MAILING ADDRESS E-MAIL
ELECTRICAL 0 S \) 1< k A-02 L( o JC.t'ir4P.\) r f,�s'+.�1 �1,,c
FAX C..
CONTRACTOR CITY ATE ZIP
L v c W c1 C( T-z (3 O ) 5.7`7 - -389 6
WA STATE NTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
\AAMIOV. Y\ BS6, 0 / / 13 - 1a\\\ _06_ S3L
NAME - - PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( )
PROJECT CONTACT NAME,
J
PRIMARY PHONE
INbLi:\ 1 .0c
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: .-)-C4:1-' DATE '3-1A - l I
PRINT NAME: SCO * \ J j c)y1
Bulletin#160-January 1,2013 Page 1 of 2 k:\landouts\Electrical Permit Application