15-101807 w • •
Tleetrical
City of FeWay Permit #: 15 .101807 00 EL
Community&Econ.Dev.Services
33325 8th Ave S
Federal way,Fax
96003 Inspection Re Request Line: (253)835-3050
Ph:(253):835-2607 Fax:(253)835-2609q
Project Name: CHEVRON EXTRA MILE
Project Address: 34727 PACIFIC HWY S Parcel Number: 202104 9133
Project Description: LED cooler lights;LED lighting refit.
• Owner Applicant Contractor
CHEVRON TEXACO INTEGRITY ELECTRIC AND LIGHTING INTEGRITY ELECTRIC AND LIGHTING
P O BOX 1392 GROUP GROUP
BAKERSFIELD CA 11410 NE 124TH ST SUITE 716 INTEGEG851CF(2/16/17)
93302 KIRKLAND WA 98034-4305 11410 NE 124TH ST SUITE 716
KIRKLAND WA 98034-4305
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. 5
PERMIT EXPIRES Saturday, October 10, 2015
Permit Issued on Monday, April 13, 2015
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and t - use will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent Date: ' )‘\,‘\\:3I l5
FIMALED.
.,
CITY
• THIS CARD IS TO MAIN ON-SITE -
TY OF Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 15-101807-00-EL Address: 34727 PACIFIC HWY S
- Project: CHEVRON TEXACO 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) Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
0 Pool Bonding(4195) 0 Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055)
Approved
ri Date—\S— c
El Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
• ° •
NPR 13 2015 ELECTRICAL
CITY OF
Federal Way CrrY ®F FEDERALVIAPERMIT APPLICATION
cos
PERMIT NUMBER J 5 _ ` /1 / Q v 7 - J�, y
V OU v SUITE/IINIT/SPACE#
SITE ADDRESS: 311 /17 Pa(c:P;c 1-1 w I/ S -t 75 QO 3
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
8 q $o , •2_v / v 5'- / 3
PROJECT NAME t
(Tenant or Homeowner Last Name) cn{V ro r Gk-rq p".1 4,-
XX
Z o L.e cA Cep`e c 1:631,0-s
PROJECT DESCRIPTION L.eA 1,..`9 at.4-:_rt t il A-re's:+-
Detailed description of work to
be included on this permit only
NAME PRIMARY.PHONE
PROPERTY OWNER Sa•n c 0-5 $;4 e.. &GU[{S S ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP / PAX
l )
NAME PRIMARY PRONE
'IDJT662.tTY CI-tc-rRzc-- (y25)3'f'f Al SO
MAILING ADDRESS E-MAIL
ELECTRICAL 1"N I t, N t 0-94*" ST * t(,
CONTRACTOR CITY STATE ZIP FAX
KieVtand ‘14 ill 9$031f (112,5)163 - 6355
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE t
mArt-e tie-a ZS I C-F 2.464 rr IV Zo -is-‘016gi-oc-OL
NAME PRIMARY PHONE
APPLICANT Elec#t".co,l cohr+ ac}tc r ( ) -
MAILING ADDRESS E-MAIL
60.me%` aS abtvt
CITY STATE ZIP PAR
( ) -
NAME PRIMARY PHONE
PROJECT CONTACT 9.c Inot et n (a y cur c lAv (tf 25) 3&fY -4 f d D
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 lank regulating
construction or environmental Imus.
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 part of this application.
a SIGNATURE: DATE 11L 4/i 5
+ PRINT NAME: Rt.,n)It41 &t17arc-hvk
Bulletin#160—January 1.2013 Page 1 of 2 k:\Handouts\Electaical Permit Application