16-105161 IS. , 4,2
Electrical
City of Federal Way Permit #:16-105161=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: ANYTIME FITNESS
Project Address: 1614 SW DASH POINT RD Parcel Number: 189880 0010
Project Description: Disconnect and reconnect(1)circuit to replace rooftop unit and add new thermostat
Owner Applicant Contractor
ANYTIME FITNESS JESSICA BRUCEAIR SYSTEMS AIR SYSTEMS ENGINEERING INC
223 SW 327TH PL ENGINEERING (ELECTRICAL)
FEDERAL WAY WA 98023 3602 S PINE ST AIRSYEI009KS(5/10/18)
TACOMA WA 98409 3602 S PINE ST
TACOMA WA 98409
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Circuits-Commercial 1 Thermostat 1
PERMIT EXPIRES Wednesday,25 October,2017
Permit Issued on Tuesday,October 25,2016
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
Washinntton and the City of Federal Way.
Owner or agent: 1 "( 6-(Sb-f-jel Date:g � 16 `Y
FINALED
,.
THIS CARD IS TO REMAIN ON-SITE
`""O` Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 16 105161 00 Address: 1614 SW DASH POINT RI)
Project: ANYTIME FITNESS FEDERAL WAY WA 98023
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) Ei Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
® Pool Bonding(4195) El Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
• ...
Feeders/Sub-panels(4045) „ 8 Rough Electrical(4225) „ 9 CeilingCover 4020 ,
P ❑ g ❑ ( )
Approved Approved Approved
By Date `By Date ��By Date
El Final-Electrical(4055)
Approved
itriC Date l Z —Z—/
0 Rough Electrical ❑ Final Electrical ❑ Right of Way
Approved Approved Approved
By Date By Date By Date
„, RECEIVED ELECTRICAL
CITY OF
Federal Way OCT 25 2016 PERMIT APPLICATION
CITY OF FEDERAL,WAY '( - / 0 5 (/ (v l _ 00
CDS PERMIT NUMBER
P ' +•J
SITE ADDRESS: n i L- O Com,�/] SUITE/UNIT/SPACE#
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PROJECT VALUATION V 6 ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED UBE
PROJECT NAME � �
(Tenant or Homeowner Last Name) All
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PROJECT DESCRIPTION
r w-1-opU i* ' n�,uu r
Detailed description of work to
be included on this permit only
NAME I PRIMARY PHONE
PROPERTY OWNER DCL. h NC) f}-- VI') le a )1,?}a- RI- (-Z)"6 IMAILING DRr ^. 1 4 C ' Vee 1 V� E-MAIL
CITY STATE ZIP � 1 ) FAX
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NAME Al r S Ln ' 05... PRIMARY
``LING ADDS E-MAIL
ELECTRICAL "J�6 - P'� �J r- • 3- .,G t'c,Oue)4 cx,- it.liy
CONTRACTOR CITY STATE ZIP AX
La Lii
LOA
NT �pPir �L�EcIE 5 / TION/ E� FEDERAL WAY BUSINESS LICENSE#
NAME `GJ PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
)
NAME /� • PRIMARY PHONE
PROJECT CONTACT 45 LL&e2( , 3)� ;q
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 suppliiee to the
?�city
�as a part of this application. �j
SIGNATURE: V - Po �`'^ I I/��� ”`� DATE t " ✓ `
PRINT NAME: "�/JAtL V)(1JJ j
PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
253-835-2607 + FAX 253-835-2609 +permitcenter@cityoffederalway.com
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application