16-101199 Electrical
City of Federal ay
Community&Econ.Dev.Services Permit #: 16-101199-00-EL
33325 8th Ave S
Federal Way,Fax
s8003F1L
Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p Q
Project Name: NATURAL HEALTH CENTER ACUPUNCTURE
Project Address: 33650 6TH AVE S Unit 100 Parcel Number: 926480 0210
Project Description: Re-locate light switch,add(1)duplex receptacle.
Owner Applicant Contractor
SUNLIFE ASSURANCE CO CANADA DEREK MCCOY J N M ELECTRIC INC
600 UNIVERSITY ST SUITE 503 J N M ELECTRIC INC JNMELEI87104(9/24/17)
SEATTLE WA 98101 PO BOX 7059 PO BOX 7059
BONNEY LAKE WA 98391 BONNEY LAKE WA 98391
Additional Permit Information
Electrical Work Valuation9 500 Is this an Online or O.T.C.application? Yes
Is Use Educational or Institutional? No Service greater than 999 Amps? No
No Fixtures Associated With This Permit!!
PERMIT EXPIRES Thursday, March 9, 2017
Permit Issued on Wednesday, March 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.
a i
Owner or agent: 6a/��4 Date:
4^1'- c-Cc)
` r ,
. THIS CARD IS TO REMAIN ON-SITE ' . - m.
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16-101199-00-EL Address: 33650 6TH AVE S Unit 100
Project: SUNLIFE ASSURANCE CO CANAD 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.
❑ UFER Ground (4295) ❑ Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
'0 Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
❑ Feeders/Sub-panels(4045) 0 Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By 44 Date 31 i4 ( I f. By 41.4 Date 3,1I+1 j(e
.
0 Final-Electrical(4055)
Approved
By '1,,44 Date N,;1_, ei LL..
0 Rough ElectricalEl Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
► ELECTRICAL
CITY OF 4111 MAR 0 9 2016
Federal Way PERMIT APPLICATION
CTCV OF FEDERAL WAY
PERMIT NUMBER 1 CO - I 0 i l qf—
_ SUITE/UNIT/SPACE#
SITE ADDRESS: 33 6�j t� i Ta ANl) 0
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 5 CI L-1 C — - 1
PROJECT NAME
(Tenant or Homeowner Last Name) /J A L/ 11aL-114
PROJECT DESCRIPTION kg- s L0GATf_ LlL►-14T 0170 4 APO (1) PLA7C-1
Detailed description of work to %f rj, °4,E /
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER AL151'' MAL, ATE ( ) -
MAILING ADDRESS E-MAIL
121 3-1" AVE e .
CITY STATE ZIP FAX
A 9i)a ( ) -
NAME PRIMARY PHONE
7 .4A. f,��G —sZ.r C- (2S3 )01 - 8T<1 2—
MAILING ADDRESS EMAIL
ELECTRICAL j`l). )' � C,j9
CONTRACTOR CITY ATE ZIP FAX
OAjve'' LA 1n A 't 1 ( ) -
WA STATE CONTRACTOR'S LICENSE it EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE N
f&'4 LP 31D I CSI /2J-1 /17
APPLICANT N �`44'7 S �T� 'C IAL- ( 1 PRIMARY PHONE
MAILING ADDRESS EMAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT .- )11§1
J§1 - rq2
I certify under penalty of perjury that I am the property owner or authorised 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 authorised 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.
y Q ��//
SIGNATURE: A _
DATE 3 ! -2i0
PRINT NAME: _J )1�/ 0
Bulletin#160-January 1,2013 Page 1 of 2 k:\Flandouts\Electrical Permit Application