15-103252 Electrical
FILECity of Federal Way .//../�,
Community&Econ.Dev.Services Permit #: 1 5-103252-00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
lrih.(253)835-2607 Fax.(253)835-2609 p q
Project Name: 7-11 #27284
Project Address: 32935 1ST AVE S Parcel Number: 182104 9037
Project Description: Replace existing slurpee(drink machine)machine with new
Owner Applicant Contractor
CGL PACIFIC LLC JANET SIMMONS POINTER ELECTRIC INC
376 EL EDCANTO DR POINTER ELECTRIC INC POINTEI148DE(5/31/17)
PASADENA,CA 91107 13845 E RECTOR RD 13845 RECTOR RD
BOW WA 98232 BOW WA 98232
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, January 3, 2016
Permit Issued on Tuesday, July 7, 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 ill b in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date: -777//
• THIS CARD IS TO RE ON-SITE
CITY Construction Inspe tion Record . . .
Federal'Way INSPECTION REQUESTS: (253)835-3050 .
PERMIT#: 15-103252-00-EL Address: 32935 1ST AVE S `
Project: CGL PACIFIC LLC FEDERAL WAY, WA 98003-6304
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) '❑ Temporary Power(4275) CI Service(4235)
Approved Approved Approved
By Date By Date By Date
o Feeders/Sub-panels(4045) ' 0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055)
Approved
By Q.)44...„, Date t-I._ 1 p_`,s
k.
ID Rough ElectricalEl Final Electrical ❑ Right of Way
Approved Approved Approved
By Date By Date By Date
• RECD ID
1► ELECTRICAL
CITY OF w1= JUL 07 2015
Federal Way PERMIT APPLICATION
�j CITY OF FEDERAL WAY
PERMIT NUMBER ' ✓ _ ) 0 , 2- Scit _
SUITE/UNIT/SPACE#
SITE ADDRESS: 3 a g 3 5- !St Ave S
PROJECT VALUATION A$3E38�'S TAX/PARCEL# D � - � � � � CURRENT/PROPOSED USE
PROJECT NAME (?-11ila 7 a&'y
(Tenant or Homeowner Last Name) F s 5/ j
PROJECT DESCRIPTION ' ../v
Detailed descriptionof work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER C 671L PG.C,,c7L. LLQ ( )
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PDir1 clec. 1C,.TNCI (360 ) '5F)- (30c)
MAILING ADDRESS n pp \\ E-MAIL
ELECTRICAL ►3 F ti-S- Rec-+O r CC pOVVer P/r)�(`A-iet C.wf,\
CONTRACTOR CITY STATE ZIP !FAX
t3oAJ WA I a-3a ( 30 )?5) - t t/
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
PeTAreX lye-b E. S i 3 i /s 7 ao-oa-sorF6a-oo ea..
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS p'C ( ) E-MAIL
CITY / STATE ZIP FAX
( )
NAME 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 Iaws.
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 a part of this application.
a a
S
8IGNATURE: DATE 7/7//
PRINT NAME: /16;..,/ `5" //i
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application