17-103057 • a «
• a G
Electrical
con,m, ryiiei ral Way
Permit #:17-103057-00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609
Project Name: INSTITUTE FOR FUNCTIONAL MEDICINE-SUITE 600
Project Address: 505 S 336TH ST Parcel Number:926480 0270
Project Description: Install electrical components into modular furniture system. (Power Wiring By Others)
Owner Applicant Contractor
FSP FEDERAL WAY CORP S E S INC S E S INC
401 EDGEWATER PL SUITE 200 1402 AUBURN WAY N PMB 371 SESIN**990RA(12/1/17)
WAKEFIELD MA 01880-6207 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
Low Voltage-Other(Commel I
PERMIT EXPIRES Tuesday,26 June,2018
Permit Issued on Monday,June 26,2017
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
Washingt n nd the City of Federal Way.
Owner or agent: / /� Date: 1p bra 7/7
THIS CARD IS TO REMAIN ON-SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 103053 00 Address: 2109 SW 336TH ST
Project: SAFEWAY INC STORE 3501 FEDERAL WAY WA 98023-2847
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.
El Initial Erosion Control(4365) ® Footings/Setback(4110) 1:1 Re-steel(4215)
To be done PRIOR to breaking ground Approved to place concrete Approved to place concrete or grout
By Date By Date By Date
• .1
® Slab/Concrete Floor(4255) ® Underfloor Framing(4285) El Floor Sheathing(4105)
Approved to place concrete Approved to sheath floor Approved to install flooring
By Date By Date By Date
7❑ Fire/Draft Stops(4095) El Interim Erosion Control(4370) Prior to scheduling a Framing inspection;
Approved Approved Electrical,Plumbing&Mechanical Rough-in
and Fire/Draft Stop inspections must be signed-
By Date By Date off and approved. IBC 109.3.4
El Framing(4120) El Insulation(4150) , El Gypsum Wallboard Nailing(4130)
Approved to insulate Approved to install wallboard Approved to install mud&tape
By Date By Date By Date
/
�� Suspended Ceiling Grid(4265) El Final-SKF&R(4060) ® Final Erosion Control(4375)
Approved to drop tile Approved Approved
By Date .'k By Date ��By Date
• '
El Final-Building(4050)
Approved
By 6 AL, Date 4't was_ n
El Rough Electrical ❑ Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED ELECTRICAL
cirr OF
Federal Way JUN 2 6 2017 PERMIT APPLICATION
CITY OF FEDERAL WAY /0 0 0
COMMUNITY DEVELOPMENT PERMIT NUMBER
SUITE UNIT/SPACE#
SITE ADDRESS: J00
PROJECT VALUATION ASSESSOR'S TAX/PARC # CURRENT/PROPOSED USE
$ ih-1 '�' 2 6 80 - 0 2 72C oris
PROJECT NAME /'
(Tenant or Homeowner Last Name) S i fzt E' Y l (d 4I,� a pie
PROJECT DESCRIPTION Q ���� �C`�" fes+ ,fs� e( j oDt 14�V k/L1 t -e
Detailed description of work to �,/�s yl� ( ()J 13 I VT iA' l 1-)•-5)
be included on this permit only ( ►"
NAME PRIMARY PHONE
PROPERTY OWNER ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP // FAX
( )
NAME PRIMARY PHONE
`J . Jjtl C' ( ) -
MAILING ADDRESS E-MAIL
ELECTRICAL /10-2- 4/4 (a34( f - ?7 r awi0614 c e0141CCI.Si•
CONTRACTOR CIT STATE 211:5 FAX
pm- ocy2--
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
i‘53-it), ggo,�,4 Ii/ o / (1 b-O'L- /iZ) t5 -co &
NAME PRIMARY PHONE
APPLICANT l i 144-61(-01t (21 i
- -5 '8
MAILING ADrDRESF E-MAIL
" �
STATEZIP +� FAX
,
�""�►V l
PROJECT CONTACT NAME y PRIMARY PHONE
lint/ ialoe (2)04) 11<i-
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: 'r. DATE / z
ii
1/7
PRINT NAME: & , /445/CQf
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application