15-103124 ierica1
-Ciay 41' F I LE
Community&Econ.DeFederalv.Services Permit #: 15-103124-00-EL
33325 8th Ave S
Federal Way,WA 98003Inspection Request Line: (253)
Ph:(253)835-2607 Fax:(253)835-2809 p Q 835-3050
Project Name: M I GROVEL INC
Project Address: 33324 PACIFIC HWY S Unit 201 Parcel Number: 797820 0025
Project Description: Walk-in cooler wiring and outlet.Walk-in cooler and freezer wiring.
Owner Applicant Contractor
ARTHUR&SHIRLEY INC DANNY C TAYLOR GOLD ELECTRIC
5636 E MERCER WAY GOLD ELECTRIC GOLDEEL870JZ(5/17/16)
MERCER ISLAND WA 98040 PO BOX 2156 PO BOX 2156
AUBURN WA 98071 AUBURN WA 98071
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. 10
PERMIT EXPIRES Saturday, December 26, 2015
Permit Issued on Monday, June 29, 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 accordance with the laws, rules and regulations of the State of ashington
and ity o ederal Way.
Owner or agent Date:
f‘t%1
THIS CARD IS TO IN ON-SITE
c °c irmConstruction Inspection Record
Federal Way INSPECTION REQUIN,'STS: (253)835-3050
,
PERMIT#: 15-103124-00-EL Address: 33324 PACIFIC HWY S Unit 201
Project: ARTHUR & SHIRLEY INC 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.
O UFER Ground (4295) ❑ Ditch cover(4030) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
❑ Pool Bonding(4195) Ei Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
❑ Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
❑ Final-Electrical(4055)
Approved
By vip, Date � (3 ((S"'
0 Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
• ReCeIVED
•
AIL 'N 2 9 2015 ELECTRICAL
CITY OFii, rf,.ice
Federal Way CM OF FEDERALPERMIT APPLICATIOII
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DS
PERMIT NUMBER I S _ ( O n—' j V` _
— —
SUITE/UNIT/SPACE#
SITE ADDRESS: $ 33 25z
pA_Ct F 1 HLU( .2c, /
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
O6 _
PROJECT NAME
(Tenant or Homeowner Last Name) e_.),l//*
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l'„a/, 4, / of (/i'#// -
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PROJECT DESCRIPTION 4 '/ /" - /ti/r/?),
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME „e)L 0 C� / PRIMARY PHONE
MAILING ADDRESS J p� //' j E-MAIL
ELECTRICALL/�7J�C 2( `� (1
CONTRACTOR CITY STATE ZIP FAX
''44' 1(24 9"8a7) ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
.oG/• - G 6 7. )L./z_
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
�-�47
PROJECT CONTACT p /-0 (20 6) 0_0- ,..5`72 Z
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 Iaws 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.
/ /9/v
SIGNATURE: /`yt/ DATE
PRINT NAME: /r 4 ' / C>f
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application