14-100108 Electrical
J* City of Federal Way d
Community&Econ.Dev.Services Permit #: '14-100108-00-EL
33325 8th Ave S
Federal Way,WA 98003 �253 Request 835-3050 Inspection Line:
Ph:(253)835-2607 Fax:(253)835-2609 p
Project Name: VIRGINIA MASON- GENERAL INTERNAL MEDICINE (GIM)
Project Address: 33501 1ST WAY S Parcel Number: 926504 0010
Project Description: Install(24)low voltage data cables and (12)low voltage voice cables
Owner Applicant Contractor
VIRGINIA MASON CLINIC SEACOM CABLING INC SEACOM CABLING INC
1100 9TH AVE S 4003 SMITH AVE SEACOCI944DO(3/20/14)
SEATTLE WA 98101-2756 EVERETT WA 98201 4003 SMITH AVE
EVERETT WA 98201
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 Tuesday, July 8, 2014
Permit Issued on Thursday, January 9, 2014
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
a d the City of Federal Way.
E 2-O
Owner or agent: C.Q.e-tre.„„4_, )" Date: t -9 t
INALED
• THIS CARD IS TO MAIN ON-SITE t
Construction Inection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT#: 14-100108-00-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) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
El Pool Bonding(4195) El Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
El Feeders/Sub-panels(4045) '' El Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date ..S Date f Z_ l
o Final-Electrical(4055)
Approved
By Date lZ
ElRough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
,
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CITY aF ., ELECTRICAL
Federal Way PERMIT APPLICATION
PERMIT NUMBER ( I _ I O O 1, 0 7 _ ��
....
— — — — JAN 0 9 2014
33 so( 1 Sfi w 41 s SUITE/UNIT/SPACE#
SITE ADDRESS: J 7 1 CITY OF FEDERAL WAY
PROJECT VALUATION �� ASSESS Ti�/PARCEL# O _ � � `PRftENT/PROPOSED USE
PROJECT NAME .,p e CLy"1✓iii 0\6-San 1)r IA (Z.E(1000-4-1 en
(Tenant or Homeowner Last Name)
�S-1-6L1 Z4 bA-k jIes a etc /2- L✓z ii;e 6,t S
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER �; ,�y- I.ti icy A 04CIA ( �j(.}_&ZS-7-730
4...-
MAILING ADDRASS E-MAIL
/ 3,co C i 54" o k� , I r+y(04-i gc..:1ki®V1,,,,,, . 16,7
CITY vv STATE ZIP FIX
NAME f PRIMARY PHONE
864Coc�V- Cei-Z7 �-��..s�� -iC •• ( 4 J- 14,3Y
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MAILING ADDRESS ,�] J E-MAI !
ELECTRICAL YY�o3 �• r ( �e� e ? 6 �/sea-�Lv 1 Gut
CONTRACTOR CITY /f STATE ZIP ! FAX
c_c1e Le-71 t� `l Z1'( ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
SrCC> �i�f 5�
NAME'C, PRIMARY PHONE
APPLICANT `""''�`' CU P (
MAILING ADDRESS E-MAIL
4-/003 S i i A 4 xz-e
CITY STATE ZIP FAX
( )
PROJECT CONTACT NAME PRIMARY PHONE
---7--,1/0.‘ (�? 4 ) = 773eg
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.
2C
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SIGNATURE: DATE 1 - 1 1
PRINT NAME: CIl1C_J.S" �k e
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application