17-103814 ti
Electrical
City of Federal way Permit #:17-103814-00-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: AGIT CAFE
Project Address: 33310 PACIFIC HWY S Parcel Number: 797820 0025
Project Description: Meter base replacement,200 amp single phase
Owner Applicant Contractor
ARTHUR&SI-IIRLEY INC GOLD ELECTRIC LLC GOLD ELECTRIC LLC
PO BOX 3858 PO BOX 2156 GOLDEEL870JZ(4/9/19)
FEDERAL WAY WA 98063 AUBURN WA 98071 PO BOX 2156
AUBURN WA 98071
Additional Permit Information
Is this an Online or O.T.C.application? Yes
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Mast or Meter Repair(Comme 1
PERMIT EXPIRES Thursday,9 August,2018
Permit Issued on Wednesday,August 9,2017
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.
Owner or agent: t" � Date: (1 7 -^c.:1<7
A
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 17 103814 00 Address: 33310 PACIFIC HWY S Unit 404
Project: ARTHUR& SHIRLEY INC 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.
® UFER Ground(4295) ® Ditch cover(4030) I Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
® Pool Bonding(4195) ❑ Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
.
,
LI Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
LI Final-Electrical(4055)
Approved
By Date ;
. ,:'
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El Rough ElectricalI=1Final Electrical ❑ Right of Way
Approved Approved Approved
By Date % By Date By Date
CITY OF ELECTRICAL
Federal WayRECEIVED
PERMIT APPLICATION
AUG 092017 �jR
CITY OF FEDERAL.WAY PERMIT NUMBER I -- _ t ✓ / 1 1-
COMMUNITY DEVELOPMENT
SUITE/UNIT/SPACE#
SITE ADDRESS: 333 O 7 9e 1 1 c /47 S ;
PROJECTVALUATION ASSESSOR'S TAX CERN � _ O O CURRENT/PROPOSED USE
PROJECT NAME f(c- F
(Tenant or Homeowner Last Name) ( t�
PROJECT DESCRIPTION «i, ,N7 /" -} -)
Detailed description of work to X22) p z""/ . "D/O5
be included on this permit only
NAME
PROPERTY OWNER C_ t_ k -e,vtd a. PRIMARY PHONE
( )
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
cam« (2OO ) - 7 �
MAILING ADDRESS .MAIL
ELECTRICAL /), m X 2/5Z. ,e/JelF'ctr/c/!c a � q��
CONTRACTOR CITY STATE ZIP l FAX l �e
/14t t$6 /' 144 9-r(:) '2/ ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
OLP g 0 J �f i / //
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( `7�) a`��' 7ZcZ___
E-MAIL
Pr, PI Roy- 2-/5
CITY STATE ZIP
FAX
414,41r9'7 w4 q26)7/ ( ) -
PRIMARY PHONE
PROJECT CONTACT NAME `7 , ,v v y4An� ( )
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 Ly 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 as a part of this application.
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SIGNATURE: ,,afar"�/y DATE 0 d `r/2O 2
PRINT NAME: #4
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application