16-105714Electrical
CityofFederWWaCo—unity Development DW. Permit #:16 -105714 -00 -EL
33325 8th Ave S
Federal way; WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050
Project Name: GRAVITY COFFEE
Project Address: 35007 ENCHANTED PKWY S Parcel Number: 185295 0020
Project Description: Electrical connection and wiring for coffee kiosk.
Owner
Applicant
Contractor
A THOUSAND HILLS LLC
AMPED ELECTRIC & MECHANICAL LLC
AMPED ELECTRIC & MECHANICAL LLC
362 N HERBORN
POST FALLS ID 83854
PO BOX 868
AMPEDEM907D4 (4/3/18)
EVERETT WA 98206
PO BOX 868
EVERETT WA 98206
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
Add'1 New Feeder(s) 201-400: 1
PERMIT EXPIRES Friday,1 December, 2017
Permit Issued on Thursday, December 1, 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 and the City of Federal ,.----
Owner or agent: Date:
crrr w
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
16105714 00 Address: 35007 ENCHANTED PKWY S
A THOUSAND HILLS LLC FEDERAL WAY WA 98003-8359
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)
Q Ditch cover (4030)
Slab/Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By (}yJ Date 21 1
Date 12_
B Date
®
Pool Bonding (4195)
®
Temporary Power (4275)
®
Service (4235)
Approved
Approved
Approved
By
Date
By
Date
By
Date 2 ^ 3 ^ 1''7
10 Final - Electrical (4055)
Approved
By Date :L -.2
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
®
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date Z_ / &�
By
Date
10 Final - Electrical (4055)
Approved
By Date :L -.2
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
4 4k
CITY OF
Federal Way
DEC Q 12016
CITY OF FEDERAL WAY
CDS
ELEC'T`RICAL
PERMIT APPLICATION
PERMIT NUMBER 2j - L U 5� -7 1
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SITE ADDRESS:j �cr")
SUITE/UNIT/SPACE#
PROJECT VA�L�UjAATIO�.N%
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ASS SO/R(�'/�S�TAXVPARCEL #
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CURRENT/PROPOSED USE
PROD CT NAME
(Tenant or Homeowner Last Name)
6,c, -u4 t:—
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
( ) -
MAILING REBS
E-MAIL
CITY
STATE
ZIP
FAX
( )
PRIMARY PHONE
MAILIN DRESS
E-MAIL
ELECTRICAL
CONTRACTOR
CITY
STATE
ZIP
FAX
STATE CO TRA'CnnT��OR'S ICENSE # (r
W1 10?® [_1
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAM �
PRIMARY PHONE
( )
ING ADD S
E-MAIL
CITY
of
STATE
ZIP
4 moo`-,
FAX
PROJECT CONTACT
NAME
114 —\
PRIMARY PHONE
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 the city as a part of this a
SIGNATURE:
PRINT NAME:
Bulletin # 160 —April 14, 2016 Page 1 of 1 k:\Handouts\Electrical Permit Application