12-102716 Electrical
City of Federal Way
Community&Econ.Dev.Services Permit #: 12-102716-00-EL
33325 8th Ave S
Federal Way,WA 98003
Ph (253)835-2607 Fax (253)835-2609 3 Inspection Request Line: (253) 835-3050
Project Name: ONURI PHARMACY
Project Address: 33507 9TH AVE S SUITE B-2 Parcel Number: 926500 0020
Project Description: Install new 0-200 service to new tenant
Owner Applicant Contractor
BRIAN DDS FILBERT J S ELECTRICAL LLC J S ELECTRICAL LLC
33507 9TH AVE S B1 18829 104TH PL SE JSELESE948C7(2/27/14)
FEDERAL WAY WA 98003 RENTON WA 98055 18829 104TH PL SE
RENTON WA 98055
Additional Permit Information
Is Use Educational or Institutional? No Service greater than 999 Amps? No
Electrical Fixtures
New Service: 101-200 amps(Con 1
PERMIT EXPIRES Tuesday, December 11, 2012
Permit Issued on Thursday, June 14, 2012
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
�, Sta7he City of Federal Way.Owner or agent: �"� C- ' Date: ‘71/
R 1 /ts/iz
A.,, • THIS CARD IS TO FMAIN ON-SITE
CITY OF -0' • Construction In ection Record '
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 12-102716-00-EL Address: 33507 9TH AVE S SUITE B-2
Project: BRIAN DDS FILBERT 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.
0 UFER Ground (4295) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
❑ Pool Bonding(4195) 1J Temporary Power(4275) ' El Service(4235)
Approved Approved Approved
By Date By Date By CI Date L.3 '-�,z1-t L
0 Feeders/Sub-panels(4045) % ❑ Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By c lam. Date (--2ct�1.Z By Date
Cl Final-Electrical(4055)
Approved
By C3 Date 9 - s•, _ , Z.
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
RECEI
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CITY OFos. _., ---' _ I o zri -,Aor .‘,
- Federal Way JUN 14 2012 PERMIT
COMMUA7TV DEVELOPMENT SERVICES SF MF CO ME JAL DE EN FP
33325AVENUE SOUTH• BOX 9718 P L I C A T I O N
FEDERAL WAY,WA 9806363-9718 TD / /
253-835-2607•FAX 253-835-2609 Y OF FERE
www.otuoffederahony.corn t"'nC
The following is required information-an inco .lete a..lication will not be acce•ted. Please •rint legibly in in or type.
■ PROPERTY INFORMATION
SITE ADDRESS 350---4- 9 1 H ,4\i S, `' . SUITE/UNIT# B 2-
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal descnptinn)
IN PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed descriptionofwork included on this permit only)
7l,'s •�'eirt7' l prv��l e f ,J d b `�
A 7.ee ,1 _
r .. - o , Ce-rt __ ?0b 4Y7)•) .A) ('t 1 /•ii
A) .o ku i,e t kAi ,-- (11, L ham . * a o tAi l-etc. ' //7-g96_,/
PROJECT NAME(Name of Business or Owner Last Name) ON LI R/ pH ARMA Cy S`T'Q RE
NI PEOPLE INFORMATION
PROPERTY NAME
`Hf E C PRIMARY PHONE
OWNER �--\0J-INCl (4�5) 'l'jc14 c3,�9;1,-
MAILING ADDRESS CITY,STATE,ZIP
i 0 5 I 1 .5'6` 11 Ave IA), Mu c frteo bJA R g7 -S
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
as >✓Lec1"d-i cot, LLC SGI E sS, C h o ri (�C) 69—4---33-3-6,-
MAILING ADDRESS ZIP CELL PHONE
f ca2.q c o4 PL SE- Re-n0,-n NA q.0.55 (bob) 6q--4- -33-3-6
CITY OF�FEDERALL WAY tBUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
-Q 6-1. Q 3 3 B L l '�-/ 31 12,0(x ( ) -
SlCONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANTLI] NAME �*
-J S �L.ec 'rkcect L1-� \iGk e-i 7, C v/A r OFFICE PHONE( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( } aq ( 04 PL 5e- Re-rxto-)‘ . 1A31)619D P-O6) 661'7---"---.3 -6
RELATIONSHIP TO PROJECT FAX NUMBER
o Architect ❑ Tenant 0 Agent 0 Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
'14‘,./ Lee. ("253 335- 63)4
LENDER PJ `N t ® ,%,1, g NAME
o. y�r .r/-
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) _
■ DETAILFD BUILDINGINFORMATION'
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $�-{. L
`
SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
sa.
WATER SERVICE PROVIDER o LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) •Ir
SEWER SERVICE PROVIDER 0 LAKEHAVEN . 0 HIGHLINE 0 PRIVATE(SEPTIC)
i S
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ. FT. SQ.FT.
BASEMENT ,,+
FIRST /7 776 // / ( / 7-6
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
EXISTING PROPOSED TOTAL
„,
w r
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commrciei) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(rode) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK •
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further,that I
am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of Federal Way,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.
-['S f L :If r( /'2
NAME/TITLE DATE ( !!
(Sign4gtrc) (Title)
RELATIONSHIP TO PROJECT Owner 0 Agen ❑ Contractor ❑ Architect 0 Other
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