17-103429 R )
Electrical
City of Federal Way Permit #:17-103429-00-EL
Community Development 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: MADERA WEST, BUILDING A-201
Project Address: 31500 33RD PL SW Parcel Number: 500790 0000
Project Description: Replace damaged wiring.
•
Owner Applicant Contractor
MADERA WEST LLC KENMORE ELECTRIC KENMORE ELECTRIC
2125 WESTERN AVE SUITE 400 PO BOX 1913 PO BOX 1913
SEATTLE WA 98121 BOTHELL WA 98041
BOTHELL WA 98041
Additional Permit Information
Is this an Online or O.T.C.application' Yes
Alt.Serv./Feeder:0 to 200 ami 1
PERMIT EXPIRES Wednesday, 18 July,2018
Permit Issued on Tuesday,July 18,2017
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy alike use will be in accordance with the laws, rules and regulations of the State of
\ 1Al�shington and the City of Federal Way.
Owner or agent: Date: 1
r
THIS CARD IS TO REMAIN ON-SITE
"�� Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 103429 00 Address: 31500 33RD PL SW Bldg A
Project: MADERA WEST LLC FEDERAL WAY WA 98023
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) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
® 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 Q i.., Date 11 .. l-' _,n e.By 0 AzSo..h--_ Date '- ,,,ZA.,- 9 ..By Date
El Final-Electrical(4055)
Approved
By C, Date 1 t--I1-1`I
.
Rough Electrical 0 Final Electrical Q Right of Way
Approved Approved Approved
By Date By Date By Date
1► ECEIVED ELECTRICAL
CITY of
Federal Way JUL s 2017 PERMIT APPLICATION
CITY OF WAY — it 0 -
COMMUNITY DEVELOPMENT PERMIT NUMBER / �' _ � ® 3
SUITE/UNIT/SPACE#
SITE ADDRESS: ,ZU
PROJECT VALUATTI�ONN ASSESSOR'S TAX/PARCEL# CURRENT ROPOSED USE
PROJECT NAME week— /} (/ "
(Tenant or Homeowner Last Name)
/ ,
PROJECT DESCRIPTION ' . L �--- G W
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER `\Q ujWit) ( C 7 ( ) -
MAILING RESS E-MAIL
\ 6c.› 55 /24 pL,
CIT ' /1X�t STATE ZIP ( FAX
NAM ` PRIMARY PHONE
- VVt c1e -
MAILING AD RESS E-MAIL
ELECTRICAL P l
C(
CONTRACTOR cl \\ S� zI FAX
41.•
WA STATE CONTRACT R'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
6r2.Vl iM Fyr�y�Tpc-1/1/x.
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACTvlA
( 3 E.3
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 arty 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 suppli:' to th as a part of this application.
SIGNATURE: e DATE
7 -��
PRINT NAME:
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application