14-106398 A.
11.•
i
• • - E lectrical
City of FeWay Permit #: 14-106398-00-EL
Community&Econ.on.Dev.Services
33325 8th Ave S
•
Federal Way,WA 98003 F ILE
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: GOLDENSTONE BUILDING
Project Address: 33400 9TH AVE S Unit 104 Parcel Number: 926501 0060
Project Description: Run 28 data cables and 73 voice cables and terminate cables.
•
Owner Applicant Contractor
GOLDEN STONE PROPERTIES LLC CLIFF RICKMERS DIVERSIFIED TELECOM
33400 9TH AVE S SUITE 114 DIVERSIFIED TELECOM DIVERTC990KH(5/21/15)
FEDERAL WAY WA 98003 1624 GLENWOOD AVE SE 1624 GLENWOOD AVE SE
RENTON WA 98058 RENTON WA 98058
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Service greater than 999 Amps? No
Electrical Fixtures
Low Voltage-Other(Commercial 1
PERMIT EXPIRES Sunday, June 14, 2015
Permit Issued on Tuesday, December 16, 2014
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
ity of Federal Way.
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Owner or agent: ��' �✓�/ _ Date: /2/6- '117
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' THIS CARD IS TO MAIN ON-SITE _ .
CITY OF 41111114164""'4"' •
Construction In ection Record r
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 14-106398-00-EL Address: 33400 9TH AVE S Unit 104
Project: GOLDEN STONE PROPERTIES LL 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) ❑ Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
.0 Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
❑ Feeders/Sub-panels(4045) ' -El Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
.By Date CDate I 7--\\'2\14C"-C..., Date l2((t/ ( c,
o Final-Electrical(4055)
Approved
By ai,xj,.✓ Date 1 1. „9„,--i I
❑ Rough Electrical Final ElectricalCI Right of Way
Approved Approved Approved
By Date By Date By Date
. .
iv..
�.. 1CTRICAL
CITY of 1 6 2014
Federal WayPERMIT APPLICATION
CITY OF FEDERAL WAY
CDS
PERMIT NUMBER / - /
SUITE/UNIT/SPACE#
SITE ADDRESS: ,1
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 3 J 9 vO . 2 0 -
PROJECT NAME ,U1�7- l/7,C c�/
��� — __ — —
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION /2 U'/ 2 6474 c� 3`l ZCs 42 3 /RC1 i C Cc',9 e f
Detailed description of work to A A/0 71/2/72/ J(/Ci 7 -4.3 L.-6-'s
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER L)r'1r /id 4Z/A/5-5 (2c3)5c rX.)16
MAILING ADDRESS E-MAIL
3 3 2-c_., 1,-ves 14 c /yeti y A7
CITY 3 ATE ZIP FAX
/144ex-in/ G v/1 rOd r ( )
NAME PH
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_PRIMARY ONE
4/1// � '//�-/,"2 �"��Cc ayr. (%2.3) 7/?- 3&C)
MAILING ADDRESS E-MAIL
ELECTRICAL , -2., -' G e--CiVi .0 4 ,4 S6
CONTRACTOR CI STATE ZIP FAX
/1'.2C4\/ 1 JCC 96---CA�( ( )
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
6 viit.. 9 96 ,(' j , iz-i //5--
NAME PRIMARY PHONE
APPLICANT 2)/1�€2.55/P./g / fes-`r"e)�'`a'\., (1/j 7(7 - . .-3U() _
MAILING ADDRESS E-MAIL
/6 z- 7 6-6 €SLI t+%t;)6 Avim`^ S zi
CITY Zirav�17\ /S•ATE Z �� ( ) FAX
NAME 40�'i/4 use_
PRIMARY PHONE
PROJECT CONTACT C-L/Fre ,Z,C-/UJ')rc (jam 3) 3-3".c.- 6 l)/ccs
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 app •tion.
SIGNATURE: ,C2%�V / DATE /Z , / l
PRINT NAME: A6eS—,-2—7 /5/(///-9,41 i / SCA,
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application