16-103532 Electrical
City of Federal Way
Community&Econ.Dev.Services Permit #: 16-103532-00-EL
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: AT&T WIRELESS SERVICES
Project Address: 2420 S 320TH ST Parcel Number: 092104 9172
Project Description: Relocate power&data for new sales furniture
Owner Applicant Contractor
ALEX POLSON JASON VANDER VEEN VALLEY PLUMBING&ELECTRIC INC
720 3RD AVE SUITE 2112 VALLEY PLUMBING&ELECTRIC INC (ELECTRICAL)
SEATTLE WA 98104 910 W FRONT ST VALLEPI141LJ(10/31/17)
FEDERAL WAY WA 98295 910 W FRONT ST
FEDERAL WAY WA 98295
•
Additional Permit Information
Electrical Work Valuation? 3000 Is this an Online or O.T.C.application? Yes
Is Use Educational or Institutional'? No Service greater than 999 Amps? No
Electrical Fixtures
Circuits-Commercial 2
PERMIT EXPIRES Friday, July 21, 2017
Permit Issued on Thursday, July 21, 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: 1--, 1- Date: -7/2/`/6,
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THIS CARD IS TO REMAIN ON-SITE
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CITY OF , Construction InspFeuerai Way INSPECTION REQI TS t(253)835-3050 rd
PERMIT#: 16-103532-00-EL Address: 2420 S 320TH ST
Project: ALEX POLSON FEDERAL WAY, WA 98003-5419
Scheduled inspections may be failed if this card is not on-site. p0 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.
O LIFER Ground(4295) 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
O Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
O Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
•
O Final-Electrical(4055)
pproved //
B \ Date)1 l/ l
O Rough Electrical El Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED ELECTRICAL
CITY OF
Federal Way ���F E
2016 PERMIT APPLICATION
OFDE_PAL WAY
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CDS PERMIT NUMBER )
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SUITE/UNIT/SPACE C
SITE ADDRESS: aq1120 3264' 5/--
PROJECT VALUATION ASSESSOR'S TAX/PARCEL C CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name) 4 7 T
peidca Aver 4 do+c ` )1 ;erg S(4/e S re.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME - PRIMARY PHONE
PROPERTY OWNER A� T ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
Va (IQ PILkmk n3 Eiec--►-t-c (Az -CRP
MAILING ADDRESS E-MAIL
ELECTRICAL C110 w. S+ pone valleli pe.Corn
CONTRACTOR CI STATE ZIP FAX
dumas WA q Lg5 ( )14g g --10*
Li Lc) 0 WA STATE CONTRACTOR'S
VA Ltcp-E. 51 BM
LICENSE if EXPIRATION�� FEDERAL WAY BUSINESS LICENSE#
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
,/j Z(/2, C1 / CITY STATE ZIP
FAX
- N1 ( )
NAME PRIMARY PHONE
PROJECT CONTACT �aSon VanderVeen (3(co)gtc -
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 authorised 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 c ty as a part of this application.
SIGNATURE: DATE 7/21 /260
PRINT NAME: \lenevi 1414v- v'u"
PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenteiii cityoffederalway.com
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Elect ical Permit Application