16-103068 Electrical
City of Federal Way
Community&Econ.Dev.Services Permit #: 16-103068-00-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: EVERGREEN CORPORATE CENTER
Project Address: 33405 8TH AVE S SUITE 200/2-fS' Parcel Number: 926500 0060
Project Description: Demise(12)circuits between suites 200 &275
Owner Applicant Contractor
LBA REALTY FUND II-CO I LLC DENNIS WEBB ELECTRIC INC DENNIS WEBB ELECTRIC INC
PO BOX 847 702 220TH SW DENNIWE031C4(2/24/17)
CARLSBAD CA 92018 BOTHELL WA 98003 702 220TH SW
BOTHELL WA 98003
Additional Permit Information
Electrical Work Valuation? 3000.00 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 12
PERMIT EXPIRES Saturday, June 24, 2017
Permit Issued on Friday, June 24, 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 e ity of Federal Way.
Owner or agent: Date: a'ZL(_ l&'
'N Pa+
THIS CARD IS TO REMAIN ON-SITE
CITY OF ` � Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 16-103068-00-EL Address: 33405 8TH AVE S SUITE 200
Project: LBA REALTY FUND II-CO I LLC FEDERAL WAY, WA 98003-6305
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) ❑ Ditch cover(4030) Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
Pool Bonding (4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
❑ Feeders/Sub-panels(4045) Rough Electrical (4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
0 Final-Electrical(4055)
Approved
By Date
Rough Electrical Final Electrical I=1Right of Way
❑ Approved I=1Approved Approved
By Date By Date By Date
RECEIVED
Nh. ELECTRICAL
CITY OF 411111 JUN 2 4 2016
Federal Way OF FEDERAL WA'+ PERMIT APPLICATION
CDS
PERMIT NUMBER /w / 0 3 0& 00
SUITE/UNIT/SP CE#
SITE ADDRESS: 1-31-16 5 �� �� i\ >
1-7PROJECT VALUATION ASSESSOR'S TAX/PARCELP4! � O - � � Co O CURRENT/PROPOSED USE
3 U/5'0ci 2 S-
PROJECT NAME O c 1
(Tenant or Homeowner Last Name) 6\) &-v_02_66,0 W� � �vrita6
PROJECT DESCRIPTION /''•=-. k.ke t) 2002 7 S
Detailed description of work to
be included on this permit only
NAMED Iz�//,/��� ! `A PRIMARY PHONE
PROPERTY OWNER ,�(�/) ( ) -
MAILING ADDREr.O 63+7_ E-MAIL
C k ATE ZIP Aw(s FAX
NAME i, / N ti b / L)A �J I �^ 6_046
( ///6" (IN 2 )pAR1
Y Pc.°" (,. G-.V
MAILING ADDD, �/✓� IP�1�'CL/,C/'` '� E-MAIL
erp
ELECTRICAL 145 0 G ) ` C 2K(4'C,to ollr:Lt etc.c1k,'G-C.otb(
CONTRACTOR / CITY���������VIM 4 1�� 2IP/�`���`JG.' r�J g �9f�
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
1►.l l u) ( `7i�L!- /1.-11 — ?)?ICC -6t
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( )
E-MAIL
CITY STATE ZIP FAX
( )
PROJECT CONTACT NAME PRIMARY PHONE
I<I,p P€15Deii (24,)'M -9
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 relic ce of the city, including its officers and employees, upon the accuracy of the
information supplied to„the city as a part o his pli ation.
01
SIGNATURE: /C C,� ,l DATE i 01 /j
PRINT NAME: H& t—i 6 k) O1N
PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
253-835-2607 + FAX 253-835-2609 +permitcenter'u cityoffederalway.com
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application