16-104741 Electrical
coCity f ece, " , Permit #:16-104741-00-EL
33325 8th Ave S
L
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609
Project Name: SPINECARE CHIROPRACTIC
Project Address: 33130 PACIFIC HWY S 1 Parcel Number:797880 0240
Project Description: Relocation of switches and outlets for tenant improvements.
Owner Applicant Contractor
PUGET SOUND COMMERCIAL REAL C M E ELECTRIC LLC C M E ELECTRIC LLC
ESTATE SERVICES 30262 225TH AVE SE CMEELEL865QE(11/5/16)
33919 9TH AVE S SUITE 201 BLACK DIAMOND WA 98010
FEDERAL WAY WA 98003 30262 225TH AVE SE
BLACK DIAMOND WA 98010
Additional Permit Information
Is this an Online or O.T.C.application9 Yes
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Circuits-Commercial 4
PERMIT EXPIRES Friday,22 September,2017
Permit Issued on Thursday,September 22,2016
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 Q the City of Federal Way.Owner or agent:' T' Date: -t /ZF7(c
e,
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Val
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• DE INSPECTOR ikRE \DIN PI OT INSPECTION
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THIS CARD IS TO REMAIN ON-SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 16 104741 00 Address: 33130 PACIFIC HWY S Unit 4
Project: PUGET SOUND COMMERCIAL RE, 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) 0 Ditch cover(4030) ® Slab/Concrete Floor(4255)
UFER Ground(4295) Ditch cover(4030) Slab/Concrete Floor(4255)
By Date By Date By Date
El Pool Bonding(4195) CI Temporary Power(4275) ® Service(4235)
Pool Bonding(4195) Temporary Power(4275) Service(4235)
By Date By Date By Date
® Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Feeders/Sub-panels(4045) Rough Electrical(4225) Ceiling Cover(4020)
By Date By (`f ..) Date t°i .,7-f` By Date
i Final-Electrical(4055)
Final-Electrical(4055)
By (0 if"0 Date \\ k g'-k b
Rough Electrical •0 Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
41/4. RE!CEIVED ELECTRICAL
CITY OF SEP �fi ,ti 2016
Federal WayPERMIT APPLICATION
CITY OF FEDERAL WAY
PERMIT NUMBER / 6 1
_ / 0 1 C / _ a L.
SUITE NIT/SPACE#
SITE ADDRESS: 3 3 is Q '� . i 41L5 itPROJECT VALUATION J ASSESSOR'S TAX/PARCH.# < CURRENT/ ROPOSED USE
$ I000``O 1 7 2 g 0 - o ki 0 C,,Yropr&th '
PROJECT NAME (('' �� O Y c'�
, —� C. C,t+
(Tenant or Homeowner Last Name) CANI 1 r Et, t Ai L
PROJECT DESCRIPTION12-1211:1C.0.-4 V L ''' L-'SS I
Detailed description of work to
be included on this permit only
NAM S- c PRIMARY PHONE
PROPERTY OWNER � c U v W1 144-1,-I Ct 4 1 (ZCS ) 711 - 5S'202_
MAILING ADDRESS i E-MAIL
-3� [q c[T esti Sud. i —
CITY STATE ZIP FAX
c- USA UtN q 46a03 (zs'3) �1-- t Lr o
NAME • PRIMARY PHONE
C Nk•L-`=� lea--y c,- ( ) o - ,i '
MAILING ADDRESS E-MAIL SS
ELECTRICAL 'P. O . Sc A C
CONTRACTOR CITYf STA`T,E ZIP FAX
TS(64,1(-7ctmti �, 1,.�-i. Cl 0 l C) ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
LkkL LLM✓(C(,c (z\ 3 /1/ ' )1 ICo• (000453
NAME PRIMARY PHONE
CAA f)s \1>.l-er ( ) -
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( ) -
NAME PRIMARY PHONE
PROJECT CONTACT ( )
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 Iocal, 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 'ty as a part of this applica
SIGNATURE: ) Kill
_/ DATE ZI/
41
PRINT NAME: G'PC ri S [✓ t ct Lj 6
Bulletin#160—January 1,2013 Page 1 of 2 k:\landouts\Electrical Permit Application