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Federal way Permit #: 13-102520 -00-EL0
Community
&Econ.Dev.Services
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: WASHINGTON STATE LOTTERY
Project Address: 33701 9TH AVE S BLDG C
Parcel Number: 926480 0190
Project Description: Installation of(4)can lights and(2)duplex receptacles for tenant improvements.
Owner Applicant Contractor
CAMPUS BUSINESS PARK D F ELECTRIC INC D F ELECTRIC INC
1019 PACIFIC AVE UNIT 1119 PO BOX 7205 DFELEI*010D9(3/31/15)
TACOMA WA 98402-4468 TACOMA WA 98417 PO BOX 7205
TACOMA WA 98417
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
Circuits-Commercial. 2
PERMIT EXPIRES Wednesday, December 4, 2013
Permit Issued on Friday, June 7, 2013
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
-id the City of Federal.Way.
Owner or agent /�/fI Date: l.�'' �� 13
THIS CARD IS TO MAIN ON-SITE
�� of Construction I ection Record
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 13-102520-00-EL Address: 33701 9TH AVE S BLDG C
Project: CAMPUS BUSINESS PARK 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.
O UFER Ground(4295) - 0 Ditch cover(4030) El 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
El Feeders/Sub-panels(4045) El Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date L-3 By Date
O Final-Electrical(4055)
Approved
B Da> v '/3 .
❑ Rough Electrical El Final ElectricalEl Right of Way
Approved Approved Approved
By Date By Date By Date
•CEIVED i tIP
CITY OF JUN 012013
ELECTRICAL
Federal WayCITYfl ERAL WAY PERMIT APPLICATION
j CDS
1
PERMIT NUMBER �j - 10 A LI - C ' 1-,,
SUITE/UNIT/SPACE*
SITE ADDRESS: 3'"740 ) ( fiur S
PROJECT VALUATION J ASSESSOR'S TAX/PARCEL• CURRENT/PROPOSED USE
$ ( /S-0 D ) — -
PROJECT NAME
(Tenant or Homeowner Last Name) LO±^7- -e./"(.7D om( Le L0 h 'G7 c)a A-
1 VI s11, ) cot , j'� A-J- .
PROJECT DESCRIPTION8 I L1 S ) a) of i )/ r 'c- kic/'J
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER C V3 g("SSS) ? rc e ._)Z. -Z 44(39
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
_ _
'1 A�' - t`',1 g X 417 c?S3 ) tqz W zZ _
- - ... NAME .. PRIMARY PHONE
. F. . tsc=-t \2 (c7 f1'J . RS-3 )S-*). _ -??-of
MAILING ADDRESS
ELECTRICAL R) W ) >c 7 Z Ds ,i e.,vet,€) Qi Pe/ee (c•"f)
CONTRACTOR CITY STATE ZIP FAX
'7:—/t-C-0/11V\- 1 - 1S41-7-- (ZS 3 )2% - Y2/
WA STATZ CONTRACTOR'S LICENSE M EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE k
D
) 1 /3.f /IS
_.r._. . _. NAME PRIMARY PHONE
APPLICANT A14)1?-F--Li g aj h { (J')''1
MAILING ADDRESS /� IT-
'ea x' . -.2-5f-
CITY
zf �y.J/
CITY STATE ZIP FAX
- �7 v lilt4J— ��'4I ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT ,Q P.7 i ' E)....21-1. 7 ( ) -
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 a part of this applic' on.
Agoe
SIGNATURE: _�r. 411! DATE �— 20
PRINT NAME: rA V. 4 . E)`-
Bulletin January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application