16-105397 Electrical
City of Federal Way Permit #:16-105397-00-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: CHAMPS
Project Address: 1803 S COMMONS Parcel Number:762240 0010
Project Description: Pulling new thermostat wiring.
Owner Applicant Contractor
CHAMPS METRO TECH SERVICE CORP METRO TECH SERVICE CORP
1803 S COMMONS 1827 WALDEN OFFICE SQUARE SUITE 304 METROTS849O3(9/23/18)
FEDERAL WAY WA 98003 SCHAUMBURG IL 60173 827 WALDEN OFFICE SQUARE SUITE 30'
USA
SCHAUMBURG IL 60173
Additional Permit Information
Is this an Online or O.T.C.application? Yes
i
Thermostat 1
PERMIT EXPIRES Thursday,9 November,2017
Permit Issued on Wednesday,November 9,2016
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. /L
Owner or agent: /1' . 6 Date: ( ! 9-7/
FINALED
THIS CARD IS TO REMAIN ON-SITE
"�� Construction Inspection Record
Fede eral Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 16 105397 00 Address: 1803 S COMMONS
Project: CHAMPS 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) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
, "
® Pool Bonding(4195) ® Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date s By Date By Date
0 Feeders/Sub-panels(4045) i Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
•
,
Final-Electrical(4055)
Approved
ik Date ((( // . •
❑ Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
.
1111111. RECEIVED ELECTRICAL
CITY OF
Federal Way NOV 0.9 2016 PERMIT APPLICATION
/ CITY OF FEDERAL WAY
PERMIT NUMBER 1 6 _ / 03 CD fi /1 o
SUITE/UNIT/SPACE#
SITE ADDRESS: (I g 0 3 S , C 0 k U V_ r
PROJE. 'ALUATION l/ ASSESSOR'S TAX/PARCEL# v CURRENT/PROPOSED USE
'. plea 7 6 A 02 VO - O d l a
•ROJECT NAME CAA
(Tenant or Homeowner Last Name) IAA-CS
PROJECT DESCRIPTION f u i L I,'1 C- ,kJ6(Ai TA C-R.U S f r [N1 l'.
Detailed description of work to
be included on this permit only
NAME j' PRIMARY PHONE
PROPERTY OWNER C a A M (>_5 ( ) -
MAILING ADDRESS E-MAIL
/103 S COAA M d, ':.s
CITX_ STATE ZIP FAX
t(0 11'4L Li ),v4 C1Lo 3 ( ) -
NAME I PRIMARY PHONE
aaSM r of � d s£� Iii s
MAILING ADDRESS c ,7) 1' 5'=Savo
'\ E-MAIL
ELECTRIC ( � U✓AL3y04 cifxC t_ saw4 KL
CONTRACTOR CITY STATEZIP FAX
OG
5 ffAV M 4 - 4, . to/73 ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRAT ON DATE FEDERAL WAY BUSINESS LICENSE#
PA LTi'LTSi`I ` 03 09 ,p3 //6
NAME �Z8 ',/�/� PRIMARY PHONE /
APPLICANT -TPM I`I L (-2I0O )STS/ - nOet
MAILING ADDRESS E-MAIL
ir 1 %/ i2 Gui l ", Sc, 4r-fae Bi c&pL�T, STS ',
` .
CITY STATE ZIP FAX
01 41A ISA wit) q g= r ? ( ) -
NAME PRIMARY PHONE ,
PROJECT CONTACT -1-1/11R,1 iL 3�< (30)_S - 7ô 'J
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: ,�r�i'L-� ! ('
DATE
PRINT NAME: -JT/4M A g B E('
Bulletin#160-January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application