16-101650 --� • Electrical
City &FederalWay Permit #: 1 6.101650-00-EL
CommunityEcon.on.Dev.Services
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: GNC LIVE WELL
Project Address: 1413 S 348TH ST Unit L-102 Parcel Number: 185295 0090
Project Description: New lighting& receptacles
Owner Applicant Contractor
G N C LIVE WELL SHANE JOHNSON STATIC ELECTRIC INC
300 6TH AVE STATIC ELECTRIC INC STATIEI951C8(2/25/17)
PITTSBURGH PA 15222 34009 48TH AVE E 34009 48TH AVE E
EATONVILLE WA 98328 EATONVILLE WA 98328
Additional Permit Information
Electrical Work Valuation? 5000 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 15
PERMIT EXPIRES Tuesday, April 4, 2017
Permit Issued on Monday, April 4, 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: == Date: q 6
VdL14130% C-4)
ALED
• THIS CARD IS TO 'MAIN ON-SITE s
`ni ofir, Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT #: 16-101650-00-EL Address: 1413 S 348TH ST Unit L-102
Project: G N C LIVE WELL 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.
o UFER Ground (4295) - 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By fir:, Date 4-I L [(L By Date
❑ 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) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By ' Date 4 (i (I By -p-4072Date 4-; ?3,
0 Final-Electrical(4055)
Approved
By t -' Date 4124,1 (3,, 4.
•
El Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
•
dO
RECIVED
CITY OF ELECTRICAL
Federal Way APR 0 4 2016 PERMIT APPLICATION
(�_}
CITY
OFFEDERAL WAY
PERMIT NUMBER ) CC' Q ( (!/ 5 ( DS C/
SUITE/UNIT/SPACE#
SITE ADDRESS: 114 3 '5 \"- '3L 81--- 9r I?_d / - j V Z
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
s 5lo0o, o ! Q S - $ _ ' 0
PROJECT NAME
(Tenant or Homeowner Last Name)
New 5 4
PROJECT DESCRIPTION Pec,P0--.dens
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER C-1(JC- ( UC i 3CAf (i-(l_?) ? 5- '/(,oD
MAILING ADDRESS E-MAIL
,3 O v Co P .)(
CITY STATE ZIP FAX
\''H-5hkr pA 15 2-Z 2 ( ) -
NAME PRIMARY PHONE
3,64- ec+c tc ( Z5 ) Hl,�-31A
MAILING ADDRESS n E-MAIL
ELECTRICAL '3460 it H - E c,'t. (;.l'Z
CONTRACTOR CITY STATE ZIP FAX
,i..E5„, e 9?537 ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
51-TT t: rS -_c.; ? /2 / t 7
NAME PRIMARY PHONE
APPLICANT 'rn ( )
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT Skcir,e anSa-� ( 2- 3H(OS- 3Z9(0
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 as a part of this application.
SIGNATURE: DATE `� 1 (D
PRINT NAME: (9.141 2 d kYISC
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application