15-105913 RECEIVED
CITY OF „ ELECTRICAL
Federal Way Nov 19 zo15 PERMIT APPLICATION
CITY OF FEDERAL WAY
CDS
PERMIT NUMBER / 5 _ / 63-9 / 3
33 ) S7' SUITE/UNIT/SPACE#
SITE ADDRESS: w S " WA 99003
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ Li--;,500 . cc; 7 _5- 0 r _ 0 0 / 0
PROJECT NAME L 1
(Tenant or Homeowner Last Name) Yi i 0 UU M 01-1 4 U 4r ( G t� G
n•ii E)c -rovJ To N \) Srl4 T-u t '(t
PROJECT DESCRIPTION )-4-- --t--i r0Mr
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER \'i RG l 1,)(A- ASO i EP( 1-L-Ca.! i ( ) -
MAILING ADDRESS E-MAIL
3'3,70i ISTWilir5
CITY STATE ZIP FAX
UdAl f WA C eoo 3 ( )
NAME PRIMARY PHONE
�-r°s SG 0 _EI.-k=C-TLC (1,-2: ) )(o -
MAILING ADDRESS E-MAIL
ELECTRICAL 106--C-0 t 0 V( L 1 cOb 11)
CONTRACTOR CITY STATE ZIP FAX
i�c�(7(1 /VI (-�- � A 01'8O7Z- ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
S4Scc) ' 65.1_ _ )2/ -i / `-T 2o-6(% - A;
NAME PRIMARY PHONE
APPLICANT ) 60p PA (] )6t79- (63(L/'
MAILING ADDRESS E-MAIL
isol OVt ko 9 Zi) - kov i , 45"C,0 4i M
CITY STATE ZIP
WOOP(N\t/tt . WA 9'6003 ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT1°.101"- NI 60r PO(37 (. &) l&4
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 sjsch claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information slied to the city as a part of this application.
SIGNATURE: "`� DATE ((A&/-C
PRINT NAME: N W f of
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application
I- • .
s ° - 0 • Electrical
City of FeWay Permit #: 15-105913-00-EL
Community&Econ.n.Dev.Services
33325 8th Ave S
Federal Way,ax9soo3 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:: ec
(253)835-2609 p p
Project Name: VIRGINIA MASON
Project Address: 33501 1ST WAYS Parcel Number: 926504 0010
Project Description: Provide power for new split-unit heat pump.
Owner Applicant Contractor
VIRGINIA MASON CLINIC SASCO ELECTRIC SASCO ELECTRIC
1100 9TH AVE S PO BOX 3887 SASCOE*051R6(12/26/15)
SEATTLE WA 98101-2756 SEATTLE WA 98124-3887 PO BOX 3887
SEATTLE WA 98124-3887
Additional Permit information
Electrical Work Valuation? 4500 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 I
PERMIT EXPIRES Tuesday, May 17, 2016
Permit Issued on Thursday, November 19, 2015
I hereby certify that the above information is correct and that the construction on the above described property and
the occupan nd the • .e will be in accordance with the laws, rules and regulations of the State of Washington
and the •f F ral Way. IS
Owner or a ent: _.. r i, `. Date:
• �
Ni
• THIS CARD IS TO AIN ON-SITE •
CITY OF • -
Federal WayConstruction In ection Record
INSPECTION REQUE TS: (253)835-3050
PERMIT#: 15-105913-00-EL Address: 33501 1ST WAY S
Project: VIRGINIA MASON CLINIC FEDERAL WAY, WA 98003-6208
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
o Pool Bonding(4195) I❑ Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
/ . .
❑ Feeders/Sub-panels(4045) El Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
o Final-Electrical(4055)
Approved /
By ,,S S Date 24000c
O Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date