17-101220 • . 'Electrical
City of Federal Way Permit #:17-101220-00-EL
Community Development Dept, to
33325 8th Ave S
Federal Way,WA 98003 4 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: WEST GREEN CONDOMINIUMS BLDG C
Project Address: 421 S 321ST PL Parcel Number:926660 0270
Project Description: Install fire alarm system wiring to include pull stations,notification and detection
Owner Applicant Contractor
WENDI SIMPSON NORTHWEST FIRE SYSTEMS NORTHWEST FIRE SYSTEMS
420 S 321ST PL UNIT C-7 7815 S 180TH ST NORTHFS875MJ(8/10/17)
FEDERAL WAY WA 98003 KENT WA 98032 7815 S 180TH ST
KENT WA 98032
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Low Voltage-Fire Alarm(Co 1
PERMIT EXPIRES Thursday, 15 March,2018
Permit Issued on Wednesday,March 15,2017
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: l� Date: J/ iS/ /7
c � ,
I a
THIS CARD IS TO REMAIN ON-SITE ` `
"�' Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 101220 00 Address: 421 S 321ST PL Unit C-07
Project: WENDI SIMPSON FEDERAL WAY WA 98003-5805
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) ,•® Ditch cover(4030) ,'0 Slab/Concrete Floor(4255) ,
Approved Approved PP Approved to place concrete
By Date By Date By Date
.• ••
® Pool Bonding(4195) 0 Temporary Power(4275) ® Service(4235)
Approved Approved Approved
4 By Date By Date By Date
•. •.
® Feeders/Sub-panels(4045)
4.0 ••
Rough Electrical(4225) "® Ceiling Cover(4020) '
Approved Approved Approved
4 By Date ..By e, Date ti _41 , l 1 •.By 0AAW Date (4 c-11-,1 I) .
0 Final-Electrical(4055)
Approved
By 04_36,,,1/41„.4 Date ts,21-1 r1
`
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
441k. ELECTRICAL
CITY OF
Federal Way PERMITPPLICATION
RECEIVED
PERMIT NUMBER ( :-- I 0 ) 2 2 0 00 MAR 15 2017
CITY OF FEDERAL WAY
�/ COMMUNITY lr�IrACE#
SITE ADDRESS: -l 2 1 (' 3211 /1L FEor f AL VIS Y Vet 06-.
PROJECT VALUATION l l J ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 3Doi^> . 00 R° Z- 6 6 6 0 - o o 0 6
PROJECT NAME
(Tenant or Homeowner Last Name) QQ E$r 6426 EA' co N/.0
lA104104/6- , F'FZe )1-144/4 s yla/11 !.✓cc�Dl��r
PROJECT DESCRIPTION /9(/44 T/oaf, .vr f fie4 71.0/ 4.-!J /E'l cc r/U.✓
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
/VOA 71/wEsr 044. syilE'1 S (10C )Yrs'- �'�YG
MAILING ADDRESS E-MAIL
ELECTRICAL 7A/- sir-01w s'r F/4 r.soTEAts p cow
CONTRACTOR CITY STATE ZIP FAX
(,)A 'W03 Z (206 ) 772.-7ro G/
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/1/OKv'f/FS75-44 '/ 14 /17 24?-to-to/'/2? -oo-&.
NAME PRIMARY PHONE
=0E541�'Lpoi� ( )
APPLICANT MAILING ADDRESS
E-MAIL
SA/Ptt 45 ca/14-442o/Z
CITY STATE ZIP FAX
( ) -
NAME PRIMARY PHONE
PROJECT CONTACT ' .Shtei f al/ (2 )'j 6--- C3 416'
I certify underenalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, a information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City o 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 3l/c/17
PRINT NAME: Z E SN6CQQ4,-
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application