16-100979 FINALED Electrical
CommuniCity&Econ.of Dv.ev.aServices Permit #: 16-100979-00-EL
33325 8th Ave S
Federal Way,WA 98003 Request Inspection Line:
Ph:(253)835-2607 Fax:(253)835-2609 p (253)835-3050
Project Name: SEA-MAR CLINIC
Project Address: 31405 18TH AVE S Parcel Number: 092104 9233
Project Description: Adding/altering(15)low voltage thermostats for associated tenant improvement work
Owner Applicant Contractor
SEA-MAR COMM HEALTH CENTER ECO-TECH MECHANICAL LLC ECO-TECH MECHANICAL LLC
1040 S HENDERSON ST (ELECTRICAL) (ELECTRICAL)
SEATTLE WA 98108 8218 171 AVE SE ECOTEML895W1(1/21/17)
SNOHOMISH WA 98290 8218 171 AVE SE
SNOHOMISH WA 98290
Additional Permit information
Electrical Work Valuation? 2500.00 Is this an Online or O.T.C.application? Yes
Is Use Educational or Institutional? No Service greater than 999 Amps? No
Electrical Fixtures
Thermostat 15
PERMIT EXPIRES Wednesday, February 22, 2017
Permit Issued on Tuesday, February 23, 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 beirraccordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
.
Owner or agent: rDate: c "--0Z 27 L=
FINALED
THIS CARD IS TO REMAIN ON-SITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 16-100979-00-EL Address: 31405 18TH AVE S
Project: SEA-MAR COMM HEALTH CENTEF FEDERAL WAY, WA 98003-5404
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) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
• • •
® Pool Bonding(4195) ❑ Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) 0Rough Electrical(4225) Ceiling Cover(4020)
Approved Approved Approved
By Date \C Date S_ ( s_ (�' •By Date
® Final-Electrical(4055)
Approved
Date `� � - (&
n Rough Electrical `® Final Electrical Right of Way
Approved Approved Approved
By Date By • Date By Date
• •
CITY OF ELECTRICAL
Federal Way PERMIT APPLICATION
° _6( _- 9 _ co RECEIVED
PERMIT NUMBER
_ — FEB 232016
SITE ADDRESS: 31405 18th Ave So. CIEVAX
CDS
PROJECT VALUATION ASSESSOR'S TAR/PARCEL# CURRENT/PROPOSED USE
$ r � , i 0 9 2 1 0 1 - 9 2 3 3
PROJECT NAME
(Tenant or Homeowner Last Name) Sea Mar Federal Way Clinic
Install ( 15) low voltage thermostats
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Sea Mar Community Health Center ( ) -
MAILING ADDRESS E-MAIL
1014 So. Henderson Street.
CITY STATE ZIP FAX
Seattle WA 98108 ( ) -
NAMEPRIMARY PHONE
ECO C14' /Y)c'c��a,ir�/ L-L ('tel ,/f/ - 8'9e79
MAILING ADDRESS E-MAIL
ELECTRICAL ` 2 t.2( [71 -C+ ,'h'C
CONTRACTOR CITY STATE ZIP FAX
5�i�bl�►.orv�is - 1J/)- ?2-5 d ( ) - N/•3-
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
L-C 07-6 41 L 7595--w / fill // 7
NAME PRIMARY PHONE
APPLICANT �cJ � M -L`.`z (1,2r )4/V - eye,..
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
S,�►.3vlwrv.'S W✓- 9 L10 ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT /Y)(-Le-4
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: DATE 2—.2/—/4
PRINT NAME: �re✓%e./ /YI CLE o
Bulletin#160-January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application