17-104257 •
Electrical
City of Federal Way Permit #:17-104257-00-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: MARINE HILLS DENTISTRY-DENNIS HAHN DDS
Project Address: 1500 S DASH POINT RD Parcel Number:052104 9027
Project Description: Adding(9)circuits for new outlets and equipment for associated tenant improvement
Owner Applicant Contractor
DENNIS J HAHN HOLBROOKS ELECTRIC CO HOLBROOKS ELECTRIC CO
1500 S DASH POINT RD 10002 AURORA AVE N SUITE 36 HOLBREC859C5(2/25/19)
FEDERAL WAY,WA 98023 SEATTLE WA 98133 10002 AURORA AVE N SUITE 36
SEATTLE WA 98133
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Circuits-Commercial 9
PERMIT EXPIRES Wednesday,5 September,2018
Permit Issued on Tuesday,September 5,2017
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.
�►1
Owner or agent: Date: 9 S—
,- ' - z
THIS CARD IS TO REMAIN ON-SITE f '
Federal Wa Construction Inspection Record
INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 104257 00 Address: 1500 S DASH POINT RD
Project: DENNIS J HAHN FEDERAL WAY WA 98003-3753
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
' `•
® Pool Bonding(4195) ® Temporary Power(4275) El Service(4235) '
Approved Approved Approved
By Date By Date By Date
® Feeders/Sub-panels(4045) ® Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Datei.By Date By Date
.E .
Final Electrical(4055)
Approved
Byl' Date / 4-1- 7
E Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
iA„ , RECEIVED ELECTRICAL
crnr OF
Federal Way SEP 0 5 2012 PERMIT APPLICATION
CITY NI FEDERAL PWAY
ME ( - / O ����- rJ�--�
COMMUNITY DEVELOPMENT PERMIT NUMBER 00
SITE ADDRESS: 'S00 5 ' " 1:""1.v/1. T 444/ 'T^'«� tj L WA 98 003 SUITE/UNIT/$PACE#
PROJECT VALUATION ASS SOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 12000 , '• O5Zt O — _ � oZ --
PROJECT NAME
(Tenant or Homeowner Last Name) PGhv1i S i44,1ny\ POs
1
PROJECT DESCRIPTIONI q 2,,,,....„)--5
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Den nt, 144.6v. 2)D5 (253) S3t- 26'0o
MAILING ADDRESS E-MAIL
1500 S . D.41t. ?ow- ( ,
CITY STATE ZIP FAX
Fd .t �� � 9#00 3 ( ) -
V NAME PRIMARY PHONE
/40/400.46 1444-Ptak' 0_0,7m i, (3G° ) 52`1 -1.0 2-S
MAILING ADDRESS E-MAIL
ELECTRICAL PO &ioe 301(16. .kiM»pi G k•/.10.QCs ett.oly PC.ei
CONTRACTOR CITY STATE ZIP FAX
4. 781o3 ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
g.a"RecgS1 C. 5 2 /z5 /PM
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT J nn �'1 to J ( 3&O ) Sud - Cd 2.5
s)
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.
SIGNATU DATE 5 6c."3- Z'1-1
PRINT NAME: J�.,� Ale d gg
PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
253-835-2607+ FAX 253-835-2609 +permitcenter@cityoffederalway.com
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application