15-102941 • Electrical
City of Federal Way
Community&Econ.Dev.Services FILE Permit #: 15-102941-00-EL
33325 8th Ave S
Federal Way,WA 98003 253 Request
Inspection Line:
Ph:(253)835-2607 Fax:(253)835-2609 (253)835-3050
Project Name: 34834 WEYERHAEUSER WAY S
Project Address: 34834 WEYERHAEUSER WAY S Parcel Number: 222104 9031
Project Description: Relocation of 3 existing thermostats.Add 5 new low voltage VAV controllers and
thermostats.
Owner Applicant Contractor
WORLD VISION US SUPERIOR HVAC&ELECTRICAL SUPERIOR HVAC&ELECTRICAL
PO BOX 9716 (ELECTRICAL) (ELECTRICAL)
FEDERAL WAY WA 98063-9716 14900 INTERURBAN AVE S SUPERHE869LQ(6/18/16)
SEATTLE WA 98168 14900 INTERURBAN AVE S
SEATTLE WA 98168
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 5 Thermostat. 8
PERMIT EXPIRES Monday, December 14, 2015
Permit Issued on Wednesday,June 17, 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
• - sera!Way.
Owner or agent: Date: /�/�
•
e THIS CARD IS TOOMAIN ON-SITE
"TM OFConstruction Inspection Record ._. v
Federal Way INSPECTION REQUESTS: (253)835-3050
I
PERMIT#: 15-102941-00-EL Address: 34834 WEYERHAEUSER WAY S
Project: WORLD VISION US FEDERAL WAY, WA 98001-9520
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.
❑ UFER Ground(4295) 0 Ditch cover(4030) 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
El
Feeders/Sub-panels(4045) 0 Rough Electrical(4225) CICeiling Cover(4020)
Approved Approved Approved
By Date By Date .�y G-c - Date L _'r-'_ (
o Final-Electrical(4055)
Approved
By nAtkrai Date ly`1 es,_t S
A
ElRough ElectricalEl Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
I
CITY OF
. E 1 CTRICAL
Federal Way PERMIT APPLICATION
M
RECEIVED
PERMIT NUMBER I 5 — ) 0 Z LI I - d� JUN 1 I 2015
CITY OF FEDtPJIWW IT/SPACE#
SITE ADDRESS: 3 4 311 •/t S �� J
ye( Ick ( \./.,� ." CDS 11,.e-
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
1c0°
PROJECT NAME \ / V
(Tenant or Homeowner Last Name) .. o ( 11 S :.-1 5
PROJECT DESCRIPTION A 1 : '�"' ✓� ,,..c......-- )n.. �• I f� VA ✓ e---,)-(4))((5 „��
Detailed description of work to 1-1,4r„w4 q fes,
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER \J,f)a V75,>-, kA. 5 ( ) -
MAILING ADDRESS E-MAIL
ro �3.x 17!6
CITY STATE ZIP FAX
Fc�r�‘ w�, "A- /1'063'1714 ( ) -
NAME
9 / / 1 q- /I 1 7 /P,RIIMARY PHONE
<;,(1 c2'f ADDRESS 4 i-d l' ie./'-+' G-,I (`n(' ) t!7�-T&16
L
ELECTRICAL )Ijiva Z-,.,�r/.4(&5AK (4..•c.. 5-4-� ,I4,..:r., 5�.,:_i I�✓,�c-c/ec.r.-.
CONTRACTOR CITY STATE ZIP FAX
5-,1'4-)4 ! v,4— '141 (vS (Zob) (07' - 4406
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
\i
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( ) -
NAME PRIMARY PHONE
PROJECT CONTACT
/g.•� � n�� (Zo6) 671'- 7oa �
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: �// DATE ( ("(71/ /
PRINT NAME: e p.-� )Z )l-,......
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Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application