16-105043t
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City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: CLICK TOUR
.01
Electrical
Permit #:16 -105043 -00 -EL
Inspection Request Line: (253) 835-3050
Project Address: 31515 PETE VON REICHBAUER WAY S It ( OZ Parcel Number: 092104 9302
Project Description: Install 9 2x4 troffer fixtures; show window receptacles, switches, (1) sign circuit, exit egress
lighting
Owner
Applicant
Contractor
KIMCO REALTY CORP
UNIVERSAL ELECTRIC CO
UNIVERSAL ELECTRIC CO
3333 NEW HYDE RD
18602 37TH DRIVE SE
UNIVEEI985D2 (3/22/18)
NEW HYDE PARK NY 11042
BOTHELL WA 98012
18602 37TH DRIVE SE
BOTHELL WA 98012
Additional Permit )information
Is this an Online or O.T.C. application? .................. Yes
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.a�Circuits - Commercial 4 Sign
PERMIT EXPIRES Tuesday, 17 October, 2017
Permit Issued on Monday, October 17, 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 Way.
Owner or agent:
Date: � / ?
,d&Crrr OF
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
16105043 00
KIMCO REALTY CORP
Address: 31515 PETE VON REICHBAUER WAY S I
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)2❑
®
Ditch cover (4030)
Q
Slab/Concrete Floor (4255)
E]
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
®
Pool Bonding (4195)
®
Temporary Power (4275)
®
Service (4235)
E]
Approved
Approved
Approved
By
Date
By
Date
By
Date
❑
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
®
Ceiling Cover (4020)
E]
Approved
Approved
Approved
By
Date
By
Date
By
Date
Fo Finan - Electrical (4055)
Approved
By Date _ S
Rough Electrical
El
Final Electrical
E]
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
4%
CITY OF +�t.- RECEIVED
Federal Way
OCT 17 2016
CITY OF FEDERAL WAY
CDS
ELEC'T'RICAL
PERMIT APPLICATION
PERMIT NUMBER "a lo 0 45 cO
SITE ADDRESS' 3 �^ j ` 2o" r� 7
SUITE/UNIT/SPACE�Q�
PROJECT VALUATION
ASSESSOR'S TAX/PARCEL #
CURRENT/PROPOSED USE
PROJECT NAME
ru r 1
(Tenant or Homeowner Last Name)
_ C LvCr V
PROJECT DESCRIPTION
_
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
-
MAILING ADDRESS � �O
/
E-MAIL
CITY
STATE
ZIP
coo
FAX
( ) -
NAME
PRIMARY PHONE
( )
_)4,Sac
MAILING ADDRESS
„2 � i.
E-MAIL
ELECTRICAL
CONTRACTOR
CITY
STATE
W
ZI
FAx
WA STATE CONTRACT&VS LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
// FAX
1 )
PROJECT CONTACT
NAME ( i
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 to the city as a part of this appWation.
SIGNATURE:
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Bulletin # 160 —April 14, 2016 Page 1 of 1 k:\Handouts\Electrical Permit Application