16-101270 E1ectY ica?_
Cio&Federal D Way Permit #. 16-101270-00- ,�
Community&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: VICTORY GET FIT CLUB
Project Address: 34303 PACIFIC HWY S Unit 116 Parcel Number: 202104 9068
Project Description: Moving existing outlets and switches. Altering up to(3)circuits
Owner Applicant Contractor
YRV LLC CHARLES JEFFRIES SPARKEY'S ELECTRIC LLC
1830 Marion St SPARKEY'S ELECTRIC LLC SPARKEL954RH(12/11/17)
Enumclaw,WA 98022-3109 6826 20TH ST E UNIT 4 6826 20TH ST E
FIFE WA 98424 FIFE WA 98424
Additional Permit Information
Electrical Work Valuation? 1000 Is this an Online or O.T.C.application? Yes
Is Use Educational or Institutional? No Service greater than 999 Amps? No
Electrical Fixtures
Circuits-Commercial 3
PERMIT EXPIRES Wednesday, March 15, 2017
Permit Issued on Tuesday, March 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 Fe ral Way.
Date: .�
Owner or agent: ���
r / �
® THIS CARD IS TO REMAIN ON-SITE .
OF _, Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT#: 16-101270-00-EL Address: 34303 PACIFIC HWY S Unit 116
Project: YRV LLC 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.
O UFER Ground (4295) 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
O Pool Bonding(4195) Ei Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) 0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By IMI3 Date !.k 12-Iii, By Date
❑ Final-Electrical(4055) •
Approved
By a Date 93. _1_‘ ‘,..
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
RceWD
MAR 1 6 2016
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ernro� Fc�, ELECTRICAL
CITY OF '.\..-------',:-:.,_---' FEDERAL W/ie
Federal Way Cos I1/il. YY/ti PERMIT APPLICATION
PERMIT NUMBER ' _ 0 2 7C) QC
SITE ADDRESS' s SUITE/UNIT/SPACE l
S l .3" ? ( � : ( 4_ /I1t1 5; f/
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# Cr 0 67 p CURRENT/PROPOSED USE
PROJECT NAME \ % ICTO V11-- Fi �- C , , e
(Tenant or Homeowner Last Name) pI� l
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PROJECT DESCRIPTION '
Detailed description of work to I\'I CU I NJ( 00'i 1...t.:1 ' C C I1)T- 7�/iNJ1
he included on this permit only ill••• t '
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NAME
NAME
PROPERTY OWNER c) c- L PRIMARY PHONE kit„�
MAILING ADDRESS ii E-MAIL
CITY STATE ZIP FAX
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r NAME PRIMARY PHONE
MAILING ADDRESS /�,/ E-MAIL
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ELECTRICAL C� (�2- c 3'(-1--:1 ' �'` U— `()'2,1)<,,P,-e4Pc.±`v iLL/yJCONTRACTOR CI STATE ZIP
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W �T°ATE CONTRACTOR'S LIC E M ,�/ f� EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE k
7/j�lf 26.-.1e 'C. 9 > Y/ )/4-l` / // / /7f :�O-/.7-/037%Li-OO-(31-
NAMEV
JJ PRIMARY PHONE
APPLICANT /`MAILING o ler t� l'i - j rt i✓G�.r1 (Z C:la) !�/ /` 3
1 MAIL
/ C-'77— FS c'-' AJa f 5pi.f&.7 s .C/&r•;,.rC)CV,.(2,3 t, e1"
QTY STATE ZIP FAX
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PROJECT CONTACT NAME` / ? ,, i CC� PRIMARY PHONE
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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 fired 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.
C
SIGNATURE: - I 0 1 • // — f
ter- \ -* DATE 3
PRINT NAME: C V 1 _f l'411111
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Bulletin#160-January 1.2013 Page 1 of 2 kaHandouts\Electrical Permit Application
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