15-105249 • Electrical
City of FeWay Permit #: 15-105249-00-EL
Community&Econ.
Dev.Services
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph.(253)835-2607 Fax:(253)835-2609 p 4
Project Name: PROMINENCE HEALTH PLAN SERVICES
Project Address: 33820 WEYERHAEUSER WAY S Parcel Number: 215466 0040
Project Description: Low voltage access control system.
•
Owner Applicant Contractor
PROMINENCE HEALTH WEST COAST SECURITY WEST COAST SECURITY
33820 WEYERHAEUSER WAY S PO BOX 2304 WESTCCS940K5(5/28/16)
FEDERAL WAY WA 98001 ORTING WA 98360 PO BOX 2304
ORTING WA 98360
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 Monday, April 11, 2016
Permit Issued on Wednesday, October 14, 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 W in a •r'•ance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent ,400 042/(1-
FIP4A, it
- - — THIS CARD IS TO REAMIN ON-SITE
•
CITY OF • Construction Insp ion Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-105249-00-EL Address: 33820 WEYERHAEUSER WAY S
Project: PROMINENCE HEALTH 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.
0 UFER Ground (4295) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
o Pool Bonding(4195) 0 Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) 0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date - ------CDate t 4\ ,(---
0 Final-Electrical(4055)
Approved 1
44111‘...... Date 1 k 1 j
1
❑ Rough Electrical El Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
ACITYECEIVED
OF
OCT 14 2015 ECTRICAL
Federal Way CITY OF FEDERAL WAY PERMIT APPLICATION
CDS �}
PERMIT NUMBER /51 - ( &5' ( 7/5 - 1 w w l L r-/
I/ SUITE/UNIT/SPACE#
SITE ADDRESS: 330,-,z., -- L kye r� 'i..S''
a e 5
PROJECT VALUATION ASSESSOR'S TAR/PARCEL CURRENT/PROPOSED USE
$ 4/6 ',�C] ( c y` 6 6 - D o y 0
PROJECT NAME fa 1 I /(G //'&/7'<7 ! va�'1. t/l PAS[.0 qc 'r
(Tenant or Homeowner Last Name) Ci / i'1�! C7' 6
1-kcta lalioLL G, hi 14/ i - d-/^ /-e-
PROJECT DESCRIPTION ---51 �
Detailed description of work to
be included on this permit only
NAM( i44'c
PRIMARY PHONE
PROPERTY OWNER (i /77e- 714 ( ) -
MAILING ADDRES E-MAIL
335 (A/e/Ye ' ci'I rVat/5,
CITYSTATE ZIP FAX
1e� 41/17)/ wA l'a I ( )
NAMEPRIMARY PHONE
v t �&&,f 54--6zii 'lfy 0.55)2 el(I6'
MAILING ADDRESS j� E-MAIL
ELECTRICAL I' j' x 11:0
CONTRACTOR CITY STATE ZIP FAX
Oti / 6 1J Q#16& ( ) -
WA STATE CONT1CTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
144"fC-S q Ca/5
NAME( `rain 7 ,,,c& i PRIMARY PHONE
APPLICANT " ! Ver' ( ) -
MAILIN/9,8 / &a. E-MAIL
CITY���! STATE ZIP ^_b3 ( ) FAX
NAME a` A (G/J PRIMARY PHONE
PROJECT CONTACT JrGL lig• / ( 1 r i ,,/ rl))c5 4f(J
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),w ich may be made by any person,including the undersigned,and filed against the city,
but only where such claim arises out o� reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to - ity as a p;;r of this application.
SIGNATURE: 4 DATE /(/`/ //l
PRINT N. e "7/ , -171:'Ve[
Bulletin 1(160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application