16-104971 Electrical
City of Federal way Permit #:16-104971-00-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: TWIN LAKES DENTAL PLAZA
Project Address: 2335 SW 320TH ST Parcel Number: 873209 0030
Project Description: Replacement of(7)metal halide parking light fixture heads with(7)LED fixture heads.
Owner Applicant Contractor
TWIN LAKES DENTAL PLAZA KIRBY ELECTRIC INC KIRBY ELECTRIC INC
2335 SW 320TH ST 4826"B"ST NW SUITE 101 KIRBYEI077BN(1/13/17)
FEDERAL WAY WA 98023 AUBURN WA 98001 4826"B"ST NW SUITE 101
USA
AUBURN WA 98001
Additional Permit Information
Is this an Online or O.T.C.application? Yes
PERMIT EXPIRES Wednesday, 11 October,2017
Permit Issued on Tuesday,October 11,2016
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: �/ y'- Date: lo-ii- 20)(Q.
ç4PLED
THIS CARD IS TO REMAIN ON-SITE
`�~ Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 16 104971 00 Address: 2335 SW 320TH ST Unit 1
Project: TWIN LAKES DENTAL PLAZA FEDERAL WAY WA 98023-2569
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.
.I
UFER Ground(4295) ® Ditch cover(4030) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
. I.
.I .I .
® Pool Bonding(4195) ® Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
. I. •
® Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date , By Date
El Final-Electrical(4055)
Approved
By frib Date ID (t1 11 b
Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED ELECTRICAL
Cit,►oF PERMIT APPLICATION
Federal Way QCT Y 12016
CITY OF FEDERAL WAY / ( / /�j
CDS PERMIT NUMBER / / _ / 0 F- -/ 7 / _ —
(l(/ L / SUITE/UNIT/SPACE/ #
SITE ADDRESS: 2335 SW 320th St
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 1,700 ' --7- 3 a 6 - 0 0 3-o
PROJECT NAME Twin Lakes Dental Plaza
(Tenant or Homeowner Last Name)
Replace (7) metal halide parking light fixture heads with (7) LED fixture
PROJECT DESCRIPTION heads.
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Twin Lakes Dental Plaza ( ) -
MAILING ADDRESS E-MAIL
2335 SW 320th St
CITY STATE ZIP FAX
Federal Way WA 98023 ( ) -
NAME PRIMARY PHONE
Kirby Electric Inc. (253 )859 - 2000
MAILING ADDRESS E-MAIL
ELECTRICAL 4826 B St. NW, Suite 101
CONTRACTOR CITY Auburn WAAX
ZIP 98001
( 253) 859 - 2363
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
KIRBYEI077BN / / 19-90-101897-00-BL
NAME PRIMARY PHONE
Vadim Kalchik ( 253) 859 - 2000
APPLICANT MAILING ADDRESS E-MAIL
4826 B St. NW, Suite 101
CITY STATE ZIP FAX
Auburn WA 98001 ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT Rex Collins
(253 )213 -3255
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 art of this application.
SIGNATURE: d4' 7t--1------ DATE 1 0/11/2016
PRINT NAME: Vadim alchik
PERMIT CENTER+33325 80,Avenue South + Federal Way,WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application