16-104896 Electrical
City of Federal way Permit #:16-104896-00-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 _ ...,:1 Air^4
Project Name: SEATTLE PAIN RELIEF
Project Address: 35002 PACIFIC h WY S Parcel Number: 185295 0050
Project Description: Add (12)outlets and move(8)lights.
Owner Applicant Contractor
FANA FED WAY CROSSINGS LP ANTHONY A E S ELECTRICAL A E S ELECTRICAL CONTRACTORS LLC
10655 NE 4TH ST SUITE 700 CONTRACTORS LLC AESELEC875DO(3/20/17)
BELLEVUE WA 98004 10207 184TH AVE E
BONNEY LAKE WA 98391 10207 184TH AVE E
BONNEY LAKE WA 98391
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Circuits-Commercial 4
PERMIT EXPIRES Friday,6 October,2017
Permit Issued on Thursday,October 6,2016
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 ' accordance with the laws, rules and regulations of the State of
Was ington and the City of Federal Way.
I
Owner or agent �• •""`�}��ld✓L �� �-` 7j �— _ Date: t r';-( )a"4,
1
4
. THIS CARD IS TO REMAIN ON-SITE
Federal Way Construction Inspection Record ' -
INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16 104896 00 Address: 35002 PACIFIC HWY S Unit A-105
Project: FANA FED WAY CROSSINGS LP 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.
0 UFER Ground(4295) El Ditch cover(4030) El Slab/Concrete Floor(4255)
UFER Ground(4295) Ditch cover(4030) Slab/Concrete Floor(4255)
By Date ��By Date By Date
® Pool Bonding(4195) ® Temporary Power(4275) ® Service(4235)
Pool Bonding(4195) Temporary Power(4275) Service(4235)
By Date By Date By Date
0 Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Feeders/Sub-panels(4045) Rough Electrical(4225 / Ceiling Cover(4020)
By Date „Bj Date 7t) J! l�/ By Date
El Final-Electrical(4055)
Final-Electrical(4055)
By ...1.4i, Date,vk—L3- t(i
0 Rough Electrical El Final Electrical E Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
AI. OCT Q6 2016 ELECTRICAL
CITY OF
Federal Way Crr'OF FEDERAL WAPERMIT APPLICATION
CDS
PERMIT NUMBER 1A". _ I 0 q g 1� (: _ e L/
��CCC//J
e
SUITE/UNIT/SPACE#
SITE ADDRESS: 35 ova 7 _
L. ,c Nvt) i S l[5J�>j 1 a5 A
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# ( CURRENT/PROPOSED USE
$ X166)4) �� 1 g 5 q 5 - a 0 5 a
PROJECT NAME e
(Tenant or Homeowner Last Name) X'i>'f`1 I Q- `Pst. ;1\ V---e (I L
PROJECT DESCRIPTION i� '^eti e -p r U e` cA )- t
Detailed description of work to ,n,,p7,) J� ..(-S
be included on this permit only Mot
` `-' `� I
NAME PRIMARY PHONE
PROPERTY OWNER ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
c,-,75 ,ec..:�f c�z C (.ev► fCC4/ Ll-( 2 `)26- a5 -`
MAILING ADDRESS ` E-MAIL
ELECTRICAL 160-07 (5 v.,/\ .4<--eG .- e r _ i 1 i.
CONTRACTOR r l STA? ZIP FAX
c71r1 Let 14e 'N '7 ( ( ) -
WA STATE CONT CTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
ACTS E1-17& g7S- 1)D3 / )0 /
NAME1- J, PRIMARY PHONE
APPLICANT ✓``""D )A/VL. ... gu ( 5 ) -DL(�S 5
MAILING ADDRESS / E-MAIL
3 . v A 0 5 r,L j'-1-32----
CITY I STATE ZIP a FAX
NAME { )PRIMARY PHONE
PROJECT CONTACT t ( )
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 off tht,city, including its officers and employees, upon the accuracy of the
information suppid to the city as a part of this applicati•n.
SIGNATURE: k711) V A/ ' -r4"1--- • J. i . DATE l b C/ (lam
'lr.re w(, C,-), �.C<--I2i�. 5 1
..4PRINT NAME: � y
Page 1 of 2 k:\Iandouts\Electrical Permit Application