16-105702 Electrical
City of Federal Way Permit #:16-105702-00-EL
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 d-- Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 -
Project Name: CITY MD
Project Address: 31675 PACIFIC HWY S Parcel Number: 082104 9077
Project Description: Installation of a new security system.
Owner Applicant Contractor
CITY MD D.PATRICK HERBERT- ELECTRONIC DETECTION SYSTEMS
1345 AVENUE OF THE AMERICAS OWNERELECTRONIC DETECTION LLC
NEW YORK NY 10105 SYSTEMS LLC ELECTDS987DF(3/1/18)
PO BOX 526 PO BOX 526
WOODINVILLE,WA 98072-0526 WOODINVILLE WA 98072
Additional Permit Information
Is this an Online or O.T.C.application? Yes
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Low Voltage-Other(Commei 1
PERMIT EXPIRES Friday, 1 December,2017
Permit Issued on Thursday,December 1,2016
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
Was . gton and the City of Federal Way.
Owner or agent: Date: �d7�-/4(
THIS CARD IS TO REMAIN ON-SITE 1
Federal WayConstruction Inspection Record r `
INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16 105702 00 Address: 31675 PACIFIC HWY S
Project: CITY MD FEDERAL WAY WA 98003-5407
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) ® Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
.
® Pool Bonding(4195) s❑ Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
,
® Feeders/Sub-panels(4045) fit® Rough Electrical(4225) 'r® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
. .. ,. ,
El Final-Electrical(4055)
Approved
By clAkw Date 1 2v`40.4L44 ,
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
- .�,, ELECTRICAL
CITY OF ",H,yr RECEIVED
Federal Way PERMIT APPLICATION
DEC 012016
CITY OF FEDERAL WAYPERMIT NUMBER ) r, _ 1 0 5 7 0 2 _ L-
CDS - - - -
SITE ADDRESS: 21 L , - J? (.-f(C {��� J
` SUITE/UNIT/SPACE#
c
PROJECT VALUATION, V ASSESSOR'S/TAX/PARCEL i CURRENT/PROPOSED USE
$ / oo0 0 L a o 4 - 1 CD -1
PROJECT NAME
(Tenant or Homeowner Last Name) .i r/ /9 P 6ra v
PROJECT DESCRIPTION -Zedif fie chi-ii r -1/
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER C-14-1/4/\ ( ) -
MAILING ADDRESSE-MAIL
CITY STATE ZIP / FAX
( )
NAME PRIMARY PHONE
the. hic �e�ec "oh .Syr erns61a( )51O6 - S/V.L
MAILING ADDRESS '// Ji E-MAIL
ELECTRICAL ,J?0 S,. S-aZi e cU he je6 i h-Co/i
CONTRACTOR CITY / STATE ZIP FAX
W' m `/le 1/t/n 9 Fe 7-0), (36`0 )6/T= ‘riS'
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
a EcT,0S 9r? Of 3 / 6 //- - x-13-las,3040;BC.
NAME P PRIMARY PHONE
APPLICANT �' 'I O �Q 6 r'r (2G' ) 4'Vr� - Kt
MAILING ADDRESS
/01 Y, f" dam'Y 44 SI St eats Aehe6rtm„ci✓�r
CITY
S4G `G f A STATE ZIP 140- et Yo�� FAX
PROJECT CONTACTNAME PRIMARY PHONE
re der--� Pg(') (- ,37W
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 a part oft s application.
SIGNATURE: DATE 1,— J i(
�I P. Neer "
PRINT NAME: �(h Vl d t
Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application