17-104326 B
Electrical
City ofFederalWay Permit #:17-104326-00-EL
CommunityDevelopment Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: PLANET FITNESS
Project Address: 1211 S 320TH ST Parcel Number: 150050 0030
Project Description: Install CCTV network audio TV
Owner Applicant Contractor
MGP IX SUNSET SQUARE LLC LARRY NORLINULTIMATE SECURITY& ULTIMATE SECURITY&SOUND
425 CALIFORNIA ST FLOOR 11 SOUND ULTIMSS932JO(4/20/19)
SAN FRANCISCO CA 94104 7710 53RD ST CT W
UNVIERSITY PLACE WA 98467 7710 53RD AVE SW
UNIVERSITY PLACE WA
J
Additional Permit Information
Is this an Online or O.T.C.application Yes
Low Voltage-Other(Commei 1
PERMIT EXPIRES Friday,7 September,2018
Permit Issued on Thursday,September 7,2017
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy and the .e will be in accordance with the laws, rules and regulations of the State of
ngton and the City of Federal Way./
Owner or agent: Date: `q
/7 // 7
i
THIS CARD IS TO REMAIN ON-SITE
`�� Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 104326 00 Address: 1211 S 320TH ST
Project: MGP IX SUNSET SQUARE LLC FEDERAL WAY WA 98003-5339
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
El Pool Bonding(4195) ® Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
® Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
•
El Final-Electrical(4055)
Approved
By Date I(2/2.-1(l
0 Rough Electrical 0 Final Electrical El . Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
CITY OF 2017 ELECTRICAL
SEP 07
Federal Way CITY OF FEDERAL WAY PERMIT APPLICATION
COMMUNITY DEVELOPMENT
PERMIT NUMBER 1 7 _ , b 3 2 ( _ 6- (—
L SUITE/UNIT/SPACE#
SITE ADDRESS: / i i ( S . 3 2.,D-f ,'F
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ / 2oO ) ,5-- 0 0 5 0 _ .0 0 -b 3
PROJECT NAME
(Tenant or Homeowner Last Name) nL--+'//L-7 ,C/9-Ad S S-
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PROJECT DESCRIPTION C L NC7w°.r��_ �"`� D 7
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Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ,LI--,,,C7 A 74,74-,J (Z04 ) 9 f- 7 5/
MAILING ADDRESS E-MAIL
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CITY STATE ZIP FAX
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NAME PRIMARY PHONE
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MAILING ADDRESS E-MAIL
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CONTRACTOR CITY FAX g0 kn�ray�„l fi• e)AA r,�tjt/�
STATE ZIP FAx d,(tr✓1
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WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
Gi/-7/isl5S 932- 7-1) of/ Zo // e
NAME PRIMARY PRIMARY PHONE
APPLICANT [�k-r1 Ai Or `I n (20 ) ,4-- 3F 33
MAILING ADDRESS
• E-MAIL
17/o c )-/ Sf coor� w
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NAME PRIMARY PHONE
PROJECT CONTACT G L SM /-rig ( 3 3) YM - ySy
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 . ch claim), which may be made by any person,including the undersigned,and filed against the city,
but only where such claiits
s ou •f the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to ts I';