17-102478 Electrical
City of Federal way Permit #:17-102478-00-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: FEDELTA HOME CARE
Project Address: 505 S 336TH ST Parcel Number:926480 0270
Project Description: Wire new fire alarm notification devices for tenant improvement.
Owner Applicant Contractor
RH FOUNTAIN PLAZA ASSOC LLC MATT CARLMANFIRE SYSTEMS WEST FIRE SYSTEMS WEST INC
PO BOX 5003 INC (ELECTRICAL)
BELLEVUE WA 98009 206 FRONTAGE RD N SUITE C FIRESWI055LW(6/16/17)
PACIFIC WA 98047 206 FRONTAGE RD N
PACIFIC WA 98047-1023
Additional Permit Information
Is this an Online or O.T.C.application Yes
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Low Voltage-Fire Alarm(Co 1
PERMIT EXPIRES Thursday,24 May,2018
Permit Issued on Wednesday,May 24,2017
I hereby certify that the above i ormation is correct and that the construction on the above described property
and the occupancy - d the ,se will be int accordance with the laws, rules and regulations of the State of
Washington and the City of Federal Way.
Owner or agent: Date: f. /
4 .0
O
THIS CARD IS TO REMAIN ON-SITE
. . ..
CITY OF
Construction Inspection Record
Federal Way' INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 102478 00 Address: 505 S 336T11 ST Unit 100
Project: RH FOUNTAIN PLAZA ASSOC LLC 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.
LIFER Ground(4295) Ditch cover(4030) ® Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date A By Date By Date
121 Pool Bonding(4195) Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
Feeders/Sub-panels(4045)
® I
Rough Electrical(4225) ' ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
•90 Final-Electrical(4055)
Approved
/'<. Date L-\, -l ,..,,
0 Rough ElectricalElFinal Electrical 12 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
� MAY 2 4 2017 ELECTRICAL
CITY OF
Federal Way QOM'OF oEv OPWAY MENT PERMIT APPLICATION
PERMIT NUMBER ) _ 1 0 2 L 1 7 S _ C!,
SUITE/UNIT/SPACE#
SITE ADDRESS: 505 S 33 6th St 10 0
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
500 9 2 6 4 8 0 _ 0 2 7 0
PROJECT NAME
(Tenant or Homeowner Last Name) Fedelta Home Care
Install new Fire Alarm notification devices for tenant
PROJECT DESCRIPTION
improvement.
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER RH Fountain Plaza Assoc . LLC. ( ) -
MAILING ADDRESS E-MAIL
PO Box 5003
CITY STATE ZIP FAX
Bellevue WA 98009
NAME PRIMARY PHONE
Fire Systems West, Inc. ( 253)833 _ 1248
MAILING ADDRESS E-MAIL
ELECTRICAL 206 Frontage Rd N, Suite-C service@firesystemswest.com
CONTRACTOR CITY STATE ZIP FAX
Pacific WA 98047
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
FIRESWI055LW 06/ 16 / 17 19-87-000014-00-BL
NAME PRIMARY PHONE
Fire Systems West, Inc. (253 ) 833 - 1248
APPLICANT MAILING ADDRESS E-MAIL
206 Frontage Rd N, Suite-C service@firesystemswest.com
CITY STATE ZIP FAX
Pacific WA 98047 ( )
NAME PRIMARY PHONE
PROJECT CONTACT Matt Carlman (253 ) 951 - 6005
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 .ses out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied t he ty as a part of this application.
SIGNATURE: DATE 05/24/2017
PRINT NAME: Mat Cariman
PERMIT CENTER+33325 8th Avenue South + Federal Way,WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permncenterucitoffedeiahva\ con:
Bulletin#160—Apnl 14,2016 Page 1 of 1 k.\Handouts\Electncal Permit Application