17-103312 , d r `
Electrical
City of Federal Way Permit #:17-103312-00-EL
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: CELLFIX MOBILE
Project Address: 31515 PETE VON REICHBAUER WAY S Parcel Number:092104 9302
Project Description: Install lighting and receptacles-(3)circuits
Owner Applicant Contractor
H-TOWN PLAZA GOLD ELECTRIC LLC GOLD ELECTRIC LLC
31515 PETE VON REICHBAUER WAY S PO BOX 2156 GOLDEEL870JZ(4/9/19)
FEDERAL WAY WA 98003 AUBURN WA 98071 PO BOX 2156
USA
AUBURN WA 98071
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Circuits Commercial 3
PERMIT EXPIRES Wednesday, 11 July,2018
Permit Issued on Tuesday,July 11,2017
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 7,.. - the laws, rules and regulations of the State of
Washington and the City Federal Way. �7
Owner or agent: ,,,../...,,„,;,:..,,,,,,,,,_ G Date: ....,/,/ ,/
1 t r
THIS CARD IS TO REMAIN ON-SITE
CITY OF 0a4 Construction Inspection Record
Federal Way INSPECTION REQUESTS :(253)835-3050
PERMIT#: 17 103312 00 Address: 31515 PETE VON REICHBAUER WAY S I
Project: H-TOWN PLAZA 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) 4,0
Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
Q Pool Bonding(4195) El Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date �`By Date By Date
® Feeders/Sub-panels(4045) ', ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
`By Date ...BY Date '.BY Date
.
l Final-Electrical(4055) •
Approved
8 Date l 7— t\— t`-"L„
0 Rough Electrical 0 Final Electrical fl Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF '` ELECTRICAL
Federal Way PERMIT . .P CATION
t�ED
PERMIT NUMBER LI I V �/ tz _ co JUL 1 1 2017
` CITY OF FEDERAL WAY
COMMUNITY D$ ►ijpCE#
SITE ADDRESS: 34s4---/ - /2e/ v ,-) K?/C'�/4:7z et. , $ /62.7
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
/(7, C o 9 2 a .+ _ 3 ° 2
PROJECT NAME
(Tenant or Homeowner Last Name) e l//
) 7 f v Hal)b (. C -Ip
z__/ ,442--,2,5 alef / i^�/�f c-/e /7.- 4//
PROJECT DESCRIPTION /
Detailed description of work to
be included on this permit only
NAME i.te
PRIMARY PHONE
PROPERTY OWNER ( )
MAILING ADDRESS E-MAIL
CITY STATE ZIP // FAX
( )
NAME
CJ-
�� Z..-&. .7.-72�72 l C PRIMARY PHONE
(2‘,6)(2‘,6) Se--7ZZ
MAILING ADDRESS L
ELECTRICAL o. )C S eVq/e(P /'�e/lam s 7 2/'d
CONTRACTOR CITY STATE ZIP / �^
/it /.ft.7') //U - V`g°7/ ( ) FAX
-
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
6alie) &j:"--- 7&J / / //
NAME
PRIMARY PHONE
APPLICANT �O G� ill c '� C ( )
MAILING ADDRESS E-MAIL
Me, ti-30 ' z.-/S
CITY
Al / STATE ZIP FAX
LA.bIArr) bt'4 ?g 07 / ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT 17/9/vti y
/ (206) :0- <-7 ZZ
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.
4 SIGNATURE: �„.._ / DATE --7///./.. -C--?/7
PRINT NAME: 12 ' i1/Jl/X 7A/f /.2
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application