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City of Federal way Permit #:17-104069-00-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: ST FRANCIS HOSPITAL-CARDIAC REHAB
Project Address: 34503 9TH AVE S Parcel Number:750451 0050
Project Description: Relocate existing data cables to new locations.Install(1)nurse call cabling and(2)card
reader/camera cabling.
Owner Applicant Contractor
WSC MEDPAV LLC LARRY INTRACOMMUNICATION NTWK SYS IN
1700 7TH AVE SUITE 1800 HOWSERINTRACOMMUNICATION NTWK (INSI)
SEATTLE,WA 98101 SYS IN(INSI) INTRANS994JL(4/10/19)
4922 N PEARL ST 4922 N PEARL ST
TACOMA WA 98407 TACOMA WA 98407
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Low Voltage-Other(Commei 3
PERMIT EXPIRES Thursday,23 August,2018
Permit Issued on Wednesday,August 23,2017
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 ' accordance with the laws, rules and regulations of the State of
a Ington and the City of Federal Way. �j
Owner ora• --. 6,_.„.--- Date: Jr'- .2 3.- / /
THIS CARD IS TO REMAIN ON-SITE
CITY404
dir Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 17 104069 00 Address: 34503 9TH AVE S Unit 208
Project: WSC MEDPAV 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.
® UFER Ground(4295) 0 Ditch cover(4030) ® Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
,® Pool Bonding(4195) El Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date•
By Date
0 Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By � x Date it-...9,14,„t c•1 .
El Final-Electrical(4055)
Approved
,B '5 Date ct_(4_ 1"j •
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
NIL.
CITY OF AUG 23 2017 ELECTRICAL
Federal Way OF FEDERAL
WAYPERMIT APPLICATIONTY
PERMIT NUMBER I I _ l 0 LI 0 G q _ E L
SITE ADDRESS: �� SUITE/UN-IT/SPACE#
j ySD3 9 ropy. �� ,4/-G w o• Ls-4,i,7/-.", X08
PROJECa r0 O • �O' ASSESSOR'S TAX/PARCEL# s- 1 _ 0 d 5- CURRENT/PROPOSED USE
PROJECT NAME 5 (,-(fV\
(Tenant or Homeowner Last Name) ...5-2i,----7.-e 02 D
/E7.ci?�o - ,e,t' .5-74477 aev 7� ah.rsctr
PROJECT DESCRIPTION A/e ,GDC.P 9ion f
Detailed description of work to .,pew p4. / ,t./Le.ege c l-L c,ApQ ,..?
be included on this permit only
02- C-"c,o .re40. /e. *C.c,0- C-Auf/w7
NAME PRIMARY PHONE
PROPERTY OWNER .49,(e/5C.v.I/ d, /—%/ ( =3-)14
MAILING ADDRESS E-MAIL
/7/7 ,s'®4e--p'i (7- s----/-
CITY STATE ZIP FAX
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( 4/ if��/° ( ( ) -
NAME PRIMARY PHONE
...7-, /t/ S. 1" (2.3 ) ?6/ - DS//r
MAILING ADDRESS E-MAIL
ELECTRICAL yf2Z /L/°.�� ca7 Z.V.&iyissf ba•e//64 ,cop
CONTRACTOR CITY STATE ZIP / FAX
`7/,-eowr sz ` rjf'y0 7 (2P) C77- D/crC
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
7//7�4xif .i;' .9,7-z.__ ///c //7 o2a. 1,-/006f3- 8L
NAME PRIMARY PHONE
APPLICANT
,72./f
`f'. v- 3 ) 71/ - °i!/,
MAILING ADDRESS E-ln,2
CITY STATE ZIP FAX
f• w/ iYe7 (2r3)e77- 0/16
NAME PRIMARY PHONE
PROJECT CONTACT Cfr.---(;e1/f/ f ls3- 73Z-,f%/ (25-3 ) 73Z - 739/
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 r iance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of s application.
SIGNATU _ DATE 41.-2..?'a2 P/ 7-
PRINT N•1 : 2.-/d/Lyy /.
Bulletin#160—January 1,2013 Page 1 of 2 k:\Iandouts\Electrical Permit Application