12-101615 T•
%; .Lit 1 45 AM Laser Electric 1\1o, 253 535 1 91 i P. 031
RECEIVED
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LAI Y vr- 1 APR 10 Z`32
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Federal Way DE TRICAL �(i?�
CITY 0 Y
M T APPLICATION Cn(
**Most electrical ermits ma be obtained on-line at www.cityoffederalwa .corn**
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SITE ADDRESS: 34509 9th Ave.S. , Federal Way,WA 98003
SUITE/UNIT/SPACE M As8Fs6OR'e TAX/PARCEL# CURRENT/PROPOSED USE
Suite 2038 7 L _ 00 l D
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PROJECT.NAt E
(Tenant Dr r-IorneownerLast Marne) St.Francis Weight Loss Surgery Clinic
Relocate existing lighting, receptacles and data,
PROJECT DESCRIPTION
Detailed description of work to
be included on This permit only
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NAME PRIMARY PRONE
PROPERTY OWNER Franciscan Medical Group (425 ) 428 - 8340
MAILEI 4WPRRBS E-MAIL
1149 Market Street
CITY }STATE ZIP FAX
Tacoma WA 98402 ( )NAME PRIMARY PRIMARY PRONE
Laser Electric,Inc. ( 253 ) 535 - 1900
MAILING ADDRESS it-MAIL.
ELECTRICAL 9523 19th Ave E.
CONTRACTOR crrr erATS art. mut
Tacoma WA 98445 ( . 1911
1911 .A
WA STATE CONTRACTOR'S LICENSE* MXPTItATION DATer RDERAL WAY BUSINESS LICENSE ft
LASERE1952DH 3 / 8 / 1 .1 OS-40(W-00— s L
NAME PRIMARY PROBE
APPLICANT Tracy Ketchum ( 253 ) 535 - 1900
MAIZJNGADDReas 8 illdlr.
9523 19th Ave E tketchum@laserelectricwa.com
CITY - I STATE MMP PAX
Tacoma WA 98445 ( 1
PROJECT CONTACT NAME PA. ^pY exoyG
Robert Benson ( 253 ) 720 - 1240
r certjy Rndcrprealty of perjury that X em the property owner or authorized went of the property owner.I.rtoi that to the beat
of my knowledge,the information submitted in support glade permit application'Is true and correct.T cert that Y will comply with
all applicable City of?sclera!Way regulations pertaining to the work authorized by the issuance of a permit.I understand that the
issuance of this permit does not remova the °Wrier's responsibility for compliance with local, state, or federal lows regulating
construction or environmental lanes.
I further agree to hold harmless the City of Federal Way as to any claim(Including costs,expenses,and attorneys'fbes Incurred in
the lnueettyation and defense ofeuah claim),urhiala 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, inctudtny its officers and employees, upon the accuracy of the
inforntattan supplied to the lig as a part of th application.
&MATURE: 0,4 .r' /tiv-- DATE 4/3112
PUNT NAME: Tracy Ketchum
33325 8°i Mecum South•Federal Way 4 WA 4 98003.6325♦253.35.2607 9 Pax:253-835-2609♦www.cltyofXedutAlway.com
Bulletin 9160—January 1,2011 Page 1 of 2 k:11-TandoutilEleatrical Permit Application
'' • 'Electrical
City of Federal Way '�`� K Permit #: 12-101615-00-EL
CommunityE
&Econ Services
33325 8thth Ave S
Federal Way,WA: 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609 pecq
Project Name: ST FRANCIS WEIGHT LOSS SURGERY CLINIC
Project Address: 34509 9TH AVE S Suite 203B Parcel Number: 750451 0010
Project Description: Adding/altering(5)circuits to relocate existing lighting,receptacles and data
Owner Applicant Contractor
ST FRANCIS MEDICAL CENTER LASER ELECTRIC(GENERAL) LASER ELECTRIC(ELECTRICAL)
ASSOCIATION 9523 19TH AVE E LASEREI952DH(3/8/13)
1717 S J ST TACOMA WA 98455 9523 19TH AVE E
TACOMA WA TACOMA WA 98445
98405-4933
Additional Permit information
Is Use Educational or Institutional? No Service greater than 999 Amps No
Electrical Fixtures
Circuits-Commercial 5
PERMIT EXPIRES Sunday, October 7, 2012
Permit Issued on Tuesday, April 10, 2012
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
d t i o eral Way.
Owner or agent: Date:
Co9
t •
4/c/u
THIS CARD IS TO MAIN ON-SITE
CITY OF Construction I ection Record i
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 12-101615-00-EL Address: 34509 9TH AVE S Suite 203B
Project: ST FRANCIS MEDICAL CENTER A: 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.
0 UFER Ground (4295) 0 Ditch cover(4030) Ei Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
El Pool Bonding(4195) 0 Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
•
0 Feeders/Sub-panels(4045) CI Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date B3Cc Date.4_"......(2_ By Date
❑ Final-Electrical(4055)
Approved
B --(....S Date 1_ S-- (Z__
FILE
El Rough Electrical Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date