13-103868City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Electrical
Permit #: 13 -103868 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: WEST CAMPUS SPORTS & ORTHOPEDIC PHYS THERAPY
Project Address: 32717 1ST AVE S Unit 7
Project Description: Lighting retrofit.
Parcel Number: 697900 0050
Owner
ARI21ican
Contractor
SANDRA FRIEDMAN
M JONES ELECTRIC
M JONES ELECTRIC
RICHARD L BUSHEY
27726 131ST CT SE
MJONEJE90400 (9/20/14)
30506 12TH PL SW
KENT WA 65080
27726 131 ST CT SE
FEDERAL WAY WA
KENT WA 65080
98023
Additional Permit Information
Is this an Online or O.T.C. application? ................. es
Service greater than 999 Amps? .............................No
Electrical Fixtures'
Circuits - Commercial ....................
Is Use Educational or Institutional? ....................... No
PERMIT EXPIRES Sunday, March 2, 2014
Permit Issued on Tuesday, September 3, 2013
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
anCity of Federal Way.
Owner or agent: Date:
THIS CARD IS TOMAIN ON-SITE
"TM OF
Construction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 13 -103868 -00 -EL Address: 32717 1ST AVE S Unit 7
Project: SANDRA FRIEDMAN 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.
❑
UFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
❑Right
Approved
Service (4235)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
❑
Pool Bonding (4195)
Temporary Power (4275)
❑Right
of Way
Approved
Service (4235)
Date
Approved
By
Date
Approved
By
Date
Approved
By
Date
By
Date
By
Date
E]
❑
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
❑
Final - Electrical (4055)
Approved
By
X13 Date Cj 1 O 1 3
❑
Rough Electrical
Approved
Final Electrical
Approved
❑Right
of Way
Approved
By
Date
By
Date
By
Date
My OP
Federal Way
RECEIVED
SEP 0 3 2013
CITY OF FEDERAL WAY
CDS
P==r NMMER_� Z? _ _(_D_3�(O?
ELECTRICAL
PERMIT APPLICATION
SITE ADDRESS: 7 1 A vF- 58 urrq �
SUITE/UNIT/SPACE #
�' % - cl
PROJF= VALUATION
$ /q/b
ASSESSORS TAWPARCEL #
- _
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
_
W CRPUS PU 7S )146 PHY
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
PRIMARY PHONE
( ) -
MAKMM ADDRESS
E-MAIL
CITY
STATE
ZIP
(/ FAX
l � -
ELECTRICAL
CONTRACTOR
APPLICANT
NAM
�10tSLE�T1� t C
PRIMARY PHONE
(z53) 6C- t Z33
MAILING ADDRESS
' 277 /,31 c I S F --
E-atAD,
CITYKe �,
!V 1
STATE
WA
ZIP
9840 le4n
FAX
c )
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
t2tjQ rJEF,16a:0YQ0 9 i zo it y
NAME
FEDERAL WAY SUSDQES8 LICENSE #
-7-0-11-LOC 7 -,Sd-ffL
PRIMARY PHONE
( )
MAILING ADDRESS
E -MAH,
CITY
STATE I
ZIP
FAX
1 _
1 1
PROJECT CONTACT
NAME 11� R A PH 6PM ER
PRIMARY PHONE
1 cerdjly under penalty of perjury that I am the property owner or authorized agent of the property owner. 1 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 finchrding 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 apart Vhis appli n.
000,
SIGNATURE: DATE
PRINT NAME: ia L...
Bulletin #160 —January 1, 2013 Page 1 of 2 k_ HandoutsTlectdcal Permit Application