17-103743 Electrical
City of Federal Waypt. Permit #:17-103743-00-EL
Community Development De
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax(253)835-2609
Project Name: THE HOARDERS ATTIC THRIFT SHOP
Project Address: 33320 PACIFIC HWY S Parcel Number:797820 0025
Project Description: Electrical connection for signage to existing J-box.
•
Owner Applicant Contractor
MICHAEL KENNISH POITRAS SIGN&LIGHTING POITRAS SIGN&LIGHTING
PO BOX 23334 (ELECTRICAL 04) (ELECTRICAL 04)
FEDERAL WAY WA 98023 8515 189TH AVE SE POITRSL881LG(6/7/18)
SNOHOMISH WA 98290 8515 189TH AVE SE
SNOHOMISH WA 98290
Additional Permit Information
Is this an Online or O.T.C.application Yes
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Sign 1
PERMIT EXPIRES Saturday,4 August,2018
Permit Issued on Friday,August 4,2017
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.
Owner or agent: ic aZp Date: —P-17
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THIS CARD IS TO REMAIN ON-SITE
n'� Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 103743 00 Address: 33320 PACIFIC HWY S Unit 102A
Project: MICHAEL KENNISH 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) ® Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date ..By Date
El Feeders/Sub-panels(4045) ® Rough Electrical(4225) ' ® Ceiling Cover(4020)
Approved Approved ! Approved
By Date By Date By Date
•I:1 Final-Electrical(4055)
Approved
Date 1 O 31 \'7 .
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
CITY of A AUG
0a 2017 ELECTRICAL
Federal Way CITY OF FEDERAL WAY PERMIT APPLICATION
COMMUNITY DEVELOPMENT 7 c
PERMIT NUMBER / / 0 3 T 3_ ® D
SUITE/UNIT/SPACE#
SITE ADDRESS: 3 3 3 2 0 Pa C .'F,'C /i 5
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# / CURRENT/PROPOSED USE
$ S'a C a m' — _ - 7(4ir.;f 5'I '''-e
PROJECT NAME �
(Tenant or Homeowner Last Name) l/1 'U C/-t.'7-5' /9 f 74-' C
PROJECT DESCRIPTION -''-S /7 tit /"' S , 5,-t
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER e , ( ) -
MAILI G ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
�� >f 4 S -7 - �' (92 )31/$a(7,
MAILING ADDRESS E-MAIL
ELECTRICAL &S%S/x'9'4' /9`v-C . Z
CONTRACTOR CITY STATE ZIP FAX
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WA ST E CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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NAME / PRIMARY PHONE
APPLICANT G it//'-4-S* Si,>A"1 L',rh �! ."S ( ) -
MAILING ADDRESS E-MAIL
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CITYSTATE Z FAX
sit a�n-,,f'4 P—/s' VS 2/ ( ) -
NAMEr PRIMARY PHONE
PROJECT CONTACT /3,/* C C j .; j 7- J" (V f) 3 W 7 j'/'
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 the city • • •• of this application.
49
SIGNATURE: i DATE 0
PRINT NAME: 4 Cl/0 •'C A f`4
Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application