15-100050 • Electrical
City of Federal Way •
Community&Econ.Dev.Services Permit #: 15-100050-00-EL
33325 8th Ave S
Ph:(253)
Fed835era-2607 WayFax:(25,wa, 983)800335-2609 FILE p Ins ection Request Line: (253)835-3050
Project Name: CAFE NOIR
Project Address: 33304 PACIFIC HWY S Unit 301 Parcel Number: 797820 0025
Project Description: Adding/altering(2)circuits for(5)lights and(5)outlets
Owner Applicant Contractor
ARTHUR&SHIRLEY INC N W ELECTRIC SERVICES INC N W ELECTRIC SERVICES INC
PO BOX 3858 32419 3RD AVE SW NWELEES925DL(3/27/16)
FEDERAL WAY WA 98063 FEDERAL WAY WA 98023 32419 3RD AVE SW
FEDERAL WAY WA 98023
•
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. 2
PERMIT EXPIRES Sunday, July 5, 2015
Permit Issued on Tuesday, January 6, 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 Washington
and the City of Federal Way.
Owner or agent: Date: of 06 —020/.x``-
o
f‘x%11''‘-'
• ,, ,A.
THIS CARD IS TO MAIN ON-SITE ,
•CITY OF Construction In ection Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT#: 15-100050-00-EL Address: 33304 PACIFIC HWY S Unit 301
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.
El UFER Ground (4295) "❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
. . , .
0 Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
•
0 Feeders/Sub-panels(4045) El Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055)
Approved
By Uk.6 Date 113 O 1((,---
❑ Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
• ELEC'T'RICAL
CITY OF
Federal Way PERMIT APPLICATION
r� RECEIVED
I
PERMIT NUMBER ` 5 _ 1 0 0 0 5- 0_ v 0 JAN 0 6 2015
CMGMFREDERAL WAY
SITE ADDRESS: 333°1 ,p 4 c,'f is/71uyS SL( 4.4 3./ CDS
PROJECT VALUATION ASSESSOR'S T ARCED z _ O CURRENT/PROPOSED USE
$ 1 cop - (��`
____ _
PROJECT NAME Ca.Pe(Tenant or Homeowner Last Name) Calc. v 0 :r
ot{/.e- S- c.,'94 rot:17
PROJECT DESCRIPTION Z G j r[t..e,_-_f
Detailed description of work to
be included on this permit only
NAME P PRIMARY PHONE
PROPERTY OWNER Cc( e N��'r ( ) -
MAILING ADDRESS ��,�y E-MAIL
333• / !c `t41 1�n` c /. 34 `' Ca,ye 4 3 D/
,C6ITyeel6rex coal__ ATE ZIP FAX
CAJ ( ) -
NAME PRIMARY PHONE
NW t-i�-crAJc ‘6,- euicc s Avc 3 ) tei-sV j
MAILING ADDRESS E-MAIL
ELECTRICAL 3.2 If/9 Sri .o-I'& f NA)6 5•/Nc e)//070,4%/.4
CONTRACTOR C / STATE ZIP FAX
Leder -Q 47 W gfoL 3 ( ) -
WA STATE CONTRACTOR' LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
-G:u4t-0..Q_ rtvi ( ) -
APPLICANT MAILING ADDRESS E-MAIL
32c/P Ord A✓f CiJ
CITY STATE/ ZIP FAX
NAME W, A 7d°0 2-3 ( ) PRIMARY PHONE
PROJECT CONTACT ( )
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: Imo' DATE �/- (7 '-w1 J
PRINT NAME: ....----:C,-../ 474-e ( r' r7
Bulletin#160—January 1,2013 Page 1 of 2 10Handouts\Electrical Permit Application