16-105937 •
Electrical
n ; Permit #:16-105937-00-ELCo,muityD pm
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: TIGER TAEKWONDO ACADEMY INC
Project Address: 32901 1ST AVE S Parcel Number:697900 0030
Project Description: Adding/altering(1)circuit to retrofit existing sign board from T12 to LED
Owner Applicant Contractor
HENRY FRIEDMAN GREEN TECHNOLOGY INC GREEN TECHNOLOGY INC
8803 SE 78TH ST 4325 S ALDER ST UNIT A GREENTI883C7(2/27/18)
MERCER ISLAND WA 98040 TACOMA WA 98409 4325 S ALDER ST UNIT A
.
TACOMA WA 98409
Additional Permit Information
Is this an Online or O.T.C.application? Yes
P �
[ i
Circuits-Residential 1
PERMIT EXPIRES Friday, 15 December,2017
Permit Issued on Thursday,December 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: I 2-i C ' 201
THIS CARD IS TO REMAIN ON-SITE
Federal Wa Construction Inspection Record
INSPECTION REQUESTS:(253)835-3050
PERMIT#: 16 105937 00 Address: 32901 1ST AVE S Unit D
Project: HENRY FRIEDMAN 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 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) El Ditch cover(4030) � Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
Igo
0 Pool Bonding(4195) El Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
u Feeders/Sub-panels(4045) ® Rough Electrical(4225) •,® Ceiling Cover(4020)
Approved Approved Approved
•By Date �� •
By Date By Date
1:1 Final-Electrical(4055)
Approved
By hif6 Date 13-Ilq I I V
Rough Electrical 0 Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
' .. RECEIVED ELECTRICAL
CITY OF 11111% ."'
Federal Way DEC 15 2016 PERMIT APPLICATION
'ITT )F FEDERAL WAY (n <�
PERMIT NUMBER `(� _ 0 37 �`
SUITE/UNIT/SPACE#
SITE ADDRESS: 3 Z`1 o S{ Ave Sv. Fede(-0-A W Al
PROJECT VALUATION ASSESSOR'S TAX__/PARCEL# - Q CURRENT/PROPOSED USE
$
9, q00
0 . 0
PROJECT NAME
(Tenant or Homeowner Last Name) I,'a� -T-,4 oK� ��4e ,i
J
PROJECT DESCRIPTION �+
o -r-N2._description of work to .4- C i�'�'✓�
� a1 Ki‘s�' Si,t. -t�r,
. Le-ea }o LC 0
be included on this permit only .J
NAME PRIMARY PHONE
PROPERTY OWNER ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( ) -
NAME PRIMARY PHONE
("7 ew T Ko 'j L\ �Lv.L. (2A-3) 2.-2.1-- 6- -
MAILING ADDRESS VV E-MAIL
ELECTRICAL iI 3 is 5c.. ,j-1 cX s-1/2-_ 4ivil
CONTRACTOR CITY STATE ZIP FAX
\Kra w..4%.. w 6 e=ttqcel ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
01hTtW1C.I 2 /24 /IP I2)e41ol-�
NAME PRIMARY PHONE
APPLICANT 711 0M.,a.S P )1-4-•.. ( ) 226- 6'y8
MAILING ADDRESS E-MAIL
L{3 7/5 So. 41Jer S . ti-1i ..1,Irww,..scks,liem0114111#:.Jt,.Con.,
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT k Gin; (14-3 ) 'z.ZS--z-(r6(
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: .---1JtoDATE (2 —1 S —Z W
0
PRINT NAME: /h n A4 it S t>_ y ' Yi'Vl
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application