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16-105229 Electrical City of Federal Way Permit #:16-105229-00-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: LIFE CARE CENTER OF FEDERAL WAY Project Address: 1045 S 308TH ST Parcel Number:082104 9042 Project Description: Adding(1)circuit for main entrance accessibility door Owner Applicant Contractor FEDERAL WAY CONVALESCENT CENTER FARMERS ELECTRIC DESIGN& FARMERS ELECTRIC DESIGN& 3001 KEITH ST NW CONSTRUCTION LLC CONSTRUCTION LLC CLEVELAND TN 37312 2020 MALTBY RD SUITE 102 FARMEED904B1(1/21/18) BOTHELL WA 98021 2020 MALTBY RD SUITE 102 BOTHELL WA 98021 Additional Permit Information Is this an Online or O.T.C.application? Yes �ra l� k % �aa � p ay yysis ' Ea a baa F € Circuits-Commercial 1 PERMIT EXPIRES Saturday,28 October,2017 Permit Issued on Friday,October 28,2016 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 Wash' gto and the City of Federal Way. ,J Owner or agent: Date: (o/Z 7S/i (0 THIS CARD IS TO REMAIN ON-SITE "�°� Construction Inspection Record Federal Way INSPECTION REQUESTS:(253)835-3050 PERMIT#: 16 105229 00 Address: 1045 S 308TH ST Project: FEDERAL WAY CONVALESCENT 4 FEDERAL WAY WA 98003-4706 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. E UFER Ground(4295) Q Ditch cover(4030) El Slab/Concrete Floor(4255) Approved Approved Approved to place concrete By Date By Date By Date ® Pool Bonding(4195) 0 Temporary Power(4275) ® Service(4235) Approved Approved Approved By Date By Date By Date .. N.A. . ® Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020) Approved Approved Approved By DateI*By Date By Date 10 Final-Electrical(4055) Approved By n ,y , Date 11—%, (, . • 0 Rough Electrical 0 Final Electrical 0 Right of Way Approved Approved Approved By Date By Date By Date , RECEIVED ELECTRICAL CITY OPr,�!:�►r Federal Way OCT 28 2016 PERMIT APPLICATION CITY OF FEDERAL WAY J Q ---C7---C7U IZ CDS PERMIT NUMBER O ,-3 _ J SITE ADDRESS: / 9 4f'5- 5 . 3 0 uT' f- SUITE/UNIT/SPACE# PROJECT VALUATION , ASSESSOR'�AX PAROL#� � - � �� CURRENT/PROPOSED USE AOS ' �!//vv''�� PROJECT NAME / � /, d iz cal 1 '] e �' F-IA/A / (Tenant or Homeowner Last Name) L 1 FL Ci fir J 17�-7Z Vv ct ' c �,-+ ripr mala 6/.41<rfy P©ar--" PROJECT DESCRIPTION Detailed description of work to be included on this permit only NAME{ l PRIMARY PHONE PROPERTY OWNER L►! CC Ca.IA*e.- Celli r"0+ 'refs etu! IA" (25') )9y6 `Zz I.3 MAILING ADDRESS / E-MAIL I ( sfc .S(0. 36? 4-''1/4 CITY STATE ZIP FAX eieflaI Lo l& 7e,3 (253) 9yF , f5 76 NAME j 4.7,( ,t PRIMARY PHONE cad) 4 ,ers 6[rc�'ti•�. Dos rq.vgC,il6td,4oc40,l(36D ) 64'= g6y42 MAILING ADDRESS I. E-MAIL �1 11 ELECTRICAL 20 L0 M G°i[ '#^ba l D 1-- ' ieiZ Ca rS4eC' t;(..,�et CONTRACTOR C Y 7 STATE ZI FAX i3©a-1.....e-l l //AtT''z l (340 )66(<- ,t(94/ WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# Km. 56D 919V ? '2/ /219l ' NAME PRIMARY PHONE APPLICANT MAILING ADDRESS ( ) E-MAIL CITY STATE ZIP FAX ( ) NAME PRIMARY PHONE PROJECT CONTACT ( ) 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 a••lication.illE SIGNATURE 1&' �� •• CIL �� Z+,l i��- `. DATE / // PRINT NAME:_`gA, _ 3 Ina, 0 e 2—. Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application