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15-105942 RELtivc ' '' Nov 23 2015 CITY OF A. EDERP,L V AY ELECTRICAL Federal Way `m OF CDS PERMIT APPLICATION PERMIT NUMBER 1 5 _ 3 ® S ` l 4 2 _ L-- i_ SUITE/UNIT/SPACE# SITE ADDRESS: 3e o ve e"-✓1 i _.,. ,P-io 0 r PROJECT VALUATION ASSESSOR S TAX/PARCEL# CURRENT/PROPOSED USE S i,j 00 '2 1 5 (4 (4... — 0 0 L.1-0 PROJECT NAME (Tenant or Homeowner Last Name) O(4Iti- 1244,4 /'t /i�.. PROJECT DESCRIPTION - -i«// E16-04Ca e``' � -k jr` ®fit .,C440/6/6- . Detailed description of work to C,0 n ki c h d), 419 &I,/(ui9 ©Et[,. .- Li -7-1" at-civicI AA_ be included on this permit only / NAME PRIMARY PHONE PROPERTY OWNER ( ) - MAILING ADDRESS E-MAIL CITY STATE ZIP FAX ( ) NAME PRIMARY PHONE -5, 1t(- ( ).1(41 - 34,86 MAILING ADDRESS E-MAIL e ELECTRICAL tgD2 4/644 /41/ 7( j 3py0ou�, [ Cvrncu57i.jtrz CONTRACTOR CITY /l STATE ZIP / FAX Ad' Gkc1 C�1�i� 2-- ( ti 3)£i01 - 511(? a WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# -- .6C-5 1'41 t A `tCiC)7141 l l /,Y l / /5 O-& -/1)0'613 -00-r i- NAM PRIMARY PHONE APPLICANT iiki /4g6/6' ( )1/4 - 3 'e6. MAILING ADDRESS ,// 7 E-MAIL /%f d 4 Ad lti 1 ida y/ , L / a l�J� o(2 &&tIC�'1,71, CI ( STATE ZIP FAX �eo-i(! OSA '&,O-- ( AS' )561 - 3268 NAME PRIMARY PHONE PROJECT CONTACT - /11433 /c ( VP)fief 3`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 aII 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: / I� /6l ��(i`ofDATE `/7; .://- - PRINT NAME: i 4(/ /OIuf C. diatiore Bulletin#160—January 1,2013 Page 1 of 2 k\Handouts\Electrical Permit Application • .. Electrical City ofEca .al Dev. y Permit #: 15-105942-00-EL Community&Econ.Avev.Services 33325 8th vS = Federal Way,WA 98003 Inspection Request Line: (253)835-3050 Ph:(253)835-2607 Fax (253)835-2609 • p Q Project Name: PROMINENCE HEALTH PLAN SERVICES Project Address: 33820 WEYERHAEUSER WAY S Parcel Number: 215466 0040 Project Description: Install electrical components in office cubicles. Owner Applicant Contractor MJRDEVELOPMENT SESINC SESINC 6725 116TH AVE NE 1402 AUBURN WAY N UNIT 371 SESIN**990RA(12/1/15) KIRKLAND WA 98033 AUBURN WA 98002 1402 AUBURN WAY N PMB 371 AUBURN WA 98002 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 Alt.Srvc/Feeder 0 to 200 amps(C 1 PERMIT EXPIRES Saturday, May 21, 2016 Permit Issued on Monday, November 23, 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 an th City of Federal Way. Owner or agent: ‘4 e Date: 1/// f/' r - ' "t1S1...._ THIS CARD IS TO MAIN ON-SITE CITY OF Construction In ection Record - - Federal Way INSPECTION REQUE TS: (253)835-3050 PERMIT#: 15-105942-00-EL Address: 33820 WEYERHAEUSER WAY S Project: M J R DEVELOPMENT 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. o 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) '0 Temporary Power(4275) El Service(4235) Approved Approved Approved By Date By Date By Date •® Feeders/Sub-panels(4045) 0 Rough Electrical(4225) ❑ Ceiling Cover(4020) Approved Approved Approved By Date By Date By Date o Final-Electrical(4055) Approved te, Date (2 1 t (S------ O Rough Electrical Electrical Right of Way Approved Approved Approved By Date By Date By Date