16-105456City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835.2609
Electrical
Permit #:16 -105456 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: WINCO FOODS
Project Address: 160 SW CAMPUS DR Parcel Number: 415920 0710
Project Description: Tie new hood system into fire alarm control panel
Owner
Applicant
Contractor
WINCO FOODS
MATT CARLMANFIRE SYSTEMS WEST
FIRE SYSTEMS WEST INC
PO BOX 5756
INC
(ELECTRICAL)
BOISE ID 83705
206 FRONTAGE RD N SUITE C
FIRESWI055LW (6/16/17)
PACIFIC WA 98047
206 FRONTAGE RD N
PACIFIC WA 98047-1023
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
PERMIT EXPIRES Wednesday, 15 November, 2017
Permit Issued on Tuesdav, November 15, 2016
1 hereby certify that the ab a information is correct and that the construction on the above described property
and the occupanry an 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: Date: i ��
City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: WINCO FOODS
Project Address: 160 SW CAMPUS DR
Project Description: Tie new hood system into fire alarm control panel
Electrical
Permit #:16 -105456 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 415920 0710
Owner
Applicant
Contractor
WINCO FOODS
MATT CARLMANFIRE SYSTEMS WEST
FIRE SYSTEMS WEST INC
PO BOX 5756
INC
(ELECTRICAL)
BOISE ID 83705
206 FRONTAGE RD N SUITE C
FIRESWI055LW (6/16/17)
PACIFIC WA 98047
206 FRONTAGE RD N
PACIFIC WA 98047-1023
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
PERMIT EXPIRES Wednesday, 15 November, 2017
Permit Issued on Tuesday, November 15, 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.
Owner or agent: Date: 'Id /5F—a
CITY OF
Federal Way
PERMIT #:
Project
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
16 105456 00 Address: 160 SW CAMPUS DR
WINCO FOODS 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)
®
Ditch cover (4030)
®
Slab/Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Q
Pool Bonding (4195)
®
Temporary Power (4275)
0
Service (4235)
Approved
Approved
Approved
By
Date
By
Date
By
Date
0
Feeders/Sub-panels (4045)
0
Rough Electrical (4225)
Q
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
El Final - Electrical (4055)
Approved
By Date ! l4 L
Rough Electrical
F]
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
RECEIVE®
NOV 1.5 2016
clrY OF ELEC'T'RICAL
Federal Way CII OF FEDERAL WAY
PERMIT APPLICATION
CDS
PERMIT NUMBER ( �o _ I 5
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 cit s apart of this application.
SIGNATURE:
PRINT NAME: -- / /14 —ff - Cy t L i-gli /1/
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter(i cityoffederalway.com
Bulletin #160 – April 14, 2016 Page 1 of 1 k:uHandouts\Electrical Permit Application
SUITE/ UNIT/ SPACE #
SITE ADDRESS:
PROJECT VALUATION
ASSESSOR'S TAX/PARCEL #
CURRENT/PROPOSED USE
-11--L 1 i `? (-
0-- - -9t
7
PROJECT NAME
(Tenant or Homeowner Last Name)
Nom,
s
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
(,�,,,�•� �., �� �, ).
( ) -
MAILING ADDRESS
E-MAIL
C) i,
CITY
STATE
ZIP
FAX
SIG-
,D
1 %3
( ) -
NAME
PRIMARY PHONE
A?
MAILING ADDRESS
E-MAIL
ELECTRICAL
2 �,, C ,2 ,� 6- it a
A) S,/,77 --C
CITY
STATE
ZIP
FAX
CONTRACTOR
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
- vy' -/4- -%C,..
---�
NAME
PRIMARY PHONE
APPLICANT
� (
( )
MAILING
AILING ADDRESS
E-MAIL
CITYSTATE
ZIP
FAX
( )
PROJECT CONTACT
NAME
,^x'1.!) -r1- C �ct.� � n
PRIMARY PHONE
( :) �I
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 cit s apart of this application.
SIGNATURE:
PRINT NAME: -- / /14 —ff - Cy t L i-gli /1/
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter(i cityoffederalway.com
Bulletin #160 – April 14, 2016 Page 1 of 1 k:uHandouts\Electrical Permit Application