17-102643 f
Electrical
City ofFederal Way ) Permit #:17-102643-00-EL
Community Development Dept. L
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax(253)835-2609
Project Name: KWA(KOREAN WOMEN'S ASSOCIATION)SENIOR CITY
Project Address: 31635 23RD AVE S Parcel Number:092104 9299
Project Description: Install a 208v 15amp A/C circuit
Owner Applicant Contractor
SENIOR CITY LP GARRET BALTAZARCONNECTECHS LLC CONNCTECHS LLC
123 E 96TH ST 5009 PACIFIC HWY E SUITE 15 CONNEL*883J5(5/30/18)
TACOMA WA 98445 FIFE WA 98424
5009 PACIFIC HWY E SUITE 15
FIFE WA 98424
Additional Permit Information
Is this an Online or O.T.C.application? Yes
ate.. .... �, • � � F
Circuits-Commercial 1
PERMIT EXPIRES Saturday,2 June,2018
Permit Issued on Friday,June 2,2017
• 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.
( &)T f9 i7-
Owner or agent: Date:
THIS CARD IS TO REMAIN ON-SITE Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 102643 00 Address: 31635 23RD AVE S
Project: SENIOR CITY LP FEDERAL WAY WA 98003-5425
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) 0 Ditch cover(4030) ® Slab/Concrete Floor(4255)
Approved Approved - Approved to place concrete
By Date ! By Date �•By Date
® Pool Bonding(4195) : Q 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
i
By Date .`By Date By Date
El Final-Electrical(4055)
Approved
By G ...1 Date tr,. ut..1 i
•
Rough Electrical ❑ Final Electrical 0 Right of Way
Approved Approved Approved
By Date . . By •
Date By Date
CITY OF RECEIVED ELECTRICAL
Federal Way JUN 0 2 2017 PERMIT APPLICATION
comCfTY OF FEDERAL WAY //``�� /'�
N�r(�EVEI.CPMENTPERMIT NUMBER ) .7 _ / 0 2 1(1 3 - V
SITE ADDRESS: SUITE/UNIT/SPACE#
�, i��,S N9 M\IC 5 1e4ej6 t ` WA � t too'
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 5Q(Y aC\ - °I d1 e
PROJECT NAME
(Tenant or Homeowner Last Name) G
cow/ CM LP
PROJECT DESCRIPTION n Up 208v i51iv►ip 1\/C Chtu
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER 5(nOti ail LP ( s3) C 4yiq
MAILING ADDRESS E-MAIL
3163s '? ' Ave 6 0100
CITY STATE ZIP FAX
r(CleiC41 � YVA 41 3003 c )
NLoy u;}ccs LLQ, (95)21 17110 3
MAILING ADDRMS
(r�
i � E-MAILr j
ELECTRICAL $ ( 1-G t� � �1" I i (*act (Deil✓ c .�( 1
CONTRACTOR C STATE ZIP FAX
1'C WA Gigli-PA ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
r N E arid, P//RRIMARY PHONE
APPLICANT tUUt ✓ c')5 ) "I,5•-51L\
LING ADDRESS
� E-MAIL
5WPati(((K. M t
CI STATE ZIP FAX
rift VSA �171-)
NAME PRIMARY PHONE
PROJECT CONTACTa 61I�� ��/ (,` ) ✓f
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.
•---J
SIGNATURE: DATE (pi 31 r
PRINT NAME: e1t (.iM
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application