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16-104483 • I Electrical Community DevelopmenCity of Federal t Way ept. •Permit #:16- 104483-00—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: FEDERAL WAY ENDOSCOPY CENTER Project Address: 34503 9TH AVE S 3 p� - ' k ' Parcel Number:750451 0050 Project Description: Electrical work for thenant improvements creating endoscopy suite,including outlets,lighting, and equipment;low-voltage wiring for security panel and nurses call station. Owner Applicant Contractor CHI-FRANCISCAN HEALTH SYSTEM NORTHSTAR ELECTRICAL LLC NORTHSTAR ELECTRICAL LLC 1623 MARTIN LUTHER KING WAY PO BOX 1909 NORTHEL878QF(11/6/17) TACOMA WA 98405 BOTHELL WA 98041 PO BOX 1909 BOTHELL WA 98041 Additional Permit Information Is this an Online or O.T.C.application? No ;dt 2 _ 'O , Alt.Srvc/Feeder over 1000 as 1 Low Voltage-Other(Commei 1 Low Voltage-Burglar Alarm i 1 PERMIT EXPIRES Friday,3 November,2017 Permit Issued on Thursday,November 3,2016 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 -•+ the City of Federal Way. // 2 Owner or agent: � _ Date: I l ��7 Z l(/ �Q_4 TE INSPECTOR AREA AND TYPE OF INSPECTION a-5-lkk:. Q--Nk„a 3a b^ 3pi. cfi-^`--,D Com 3 1:44i^t`l C IA.', t a e , L THIS CARD IS TO REMAIN ON-SITE �m� Construction Inspection Record Federal Way INSPECTION REQUESTS:(253)835-3050 PERMIT#: 16 104483 00 Address: 34503 9TH AVE S Unit 300 Project: CHI-FRANCISCAN HEALTH SYST 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. ,Q UFER Ground(4295) ..® Ditch cover(4030) „� Slab/Concrete Floor(4255) . Approved Approved Approved to place concrete By Date By Date By Date ® Pool Bonding(4195) ® 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 1 ,.1. . Approved t, ` 1....1_1 Approved By Date C,S Date la—z—(67 By is, j144 r� Date 2_ -1/'-( 90 Final-Electrical(4055) Approved By C _ _ s Date 2.-$-, 0 Rough Electrical El Final Electrical ❑ Right of Way Approved Approved Approved By Date By Date By Date e1�„ k.", .s ELECTRICAL OF i Federal Way PERMIT APPLICATION SEP 0 9 2016 CITY OP FEDERAL L WDAY PERMIT NUMBER / _ 2 0 / i'5.?3 - ±L r SITE ADDRESS: 34.3-0,9 /('j ' �.. ' 5- FE'lleV.,� W�� Cyt cj o3 SUITE/UNIT/SPACE# PROJECT VALUATION ASSESSOR'S TAX/PARCEL I I dvv�t'� vv f IA/14 0 CURRENT/PROPOSED USE $ 20 602- 1 5 0 it S l _ 0 0 5 0 M+;®1G4-C. PROJECT NAME /J ) ,p,�� ( EN�osw Q M (Tenant or Homeowner Last Name) G/ ® '�An G s � WY CCW TT N4Ms 1 Milky M1V?s or PROJECT DESCRIPTION ONO®,qf ck rf ��R) IA/ -kX4AA r eo� ( , o 1�)t' ( Detai ed description of work to "( 0 V(11 �1C- be included on this permit only NAME PRIMARY PHONE PROPERTY OWNER G 1k) 6-e(1-w Gr c G N (253 ) 21 1i- 14 g6 MAILING ADDRESS 16 z3 M z k 3 g wAAr E MAII CITY STATE A ST A tt O5 ( ) - ZIP FAX NAME „'o k '+ J• A-R, - e_,- izi LW,, LL c PRIMARY PHONE MAIL G ADDRESS y� q E- L ELECTRICAL O• 'J Ox I ®J CONTRACTOR oI I �,o ErrATE zIPIc)g OLO ( ) FAX WA STATE CONTRACTOR'S LICENSE t EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE s 11108 4fL g7s QF / / 20,4-104itZ -ob-3L - - PRIMARY PHONE _ NAME fro 1 fRA s` NoJ fcrH-g e'S,1*L(Zo6 ) 4Z3. 3Co� APPLICANT MAILIN ADDE-MAIL p ©�_—lox i g 0 g Bogie"µof t aitrrtrivz- CIT ®J ' �4 STATE ZIP n® ) FAX cT L/ - COM W )U( ( ) - PROJECT CONTACT NAME 40/41,1 L 1 v 6 0 PRIMARY-PH2gONE (Zoc )18b 83 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 s out f the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to tcity p this application. (3) ° i i c SIGNATURE: I/� DATE i PRINT NAME: ed$6z- 1./-*- T*-e N* c PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325 253-835-2607+ FAX 253-835-2609 +peiuiitcenter@cityoffederaiway.com Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application