15-103599 Y • Eleetriehl
City of FederalWay Permit #: 15-103599-00-EL
Community&Econ.
Dev.Services
33325 8th Ave S
Federal Way,Fax:
98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2807 Fax:(253)835-2609 p q
Project Name: PEP BOYS
Project Address: 34611 16TH AVE S Parcel Number: 889700 0075
Project Description: Install(1)circuit to hook-up lift to existing disconnect.
•
Owner Applicant Contractor
HERBERT H DAVENPORT RAY SALZER IDEAL SERVICES NW LLC(ELECTRICAL)
220 8TH ST SE IDEAL SERVICES IDEALSN8764W (7/16/17)
AUBURN WA 98002 5113 PACIFIC HWY E UNIT 13 5113 PACIFIC HWY S SUITE 13
FIFE WA 98424 FIFE WA 98424-2640
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 1
• PERMIT EXPIRES Monday, January 18, 2016
Permit Issued on Wednesday, July 22, 2015
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: Date: 7/2-.1//f
THIS CARD IS TO RE ON-SITE
" °` ,, • Construction InspeTrion Record - - -
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 15-103599-00-EL Address: 34611 16TH AVE S
Project: HERBERT H DAVENPORT FEDERAL WAY, WA 98003-6803
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
O Pool Bonding(4195) ❑ Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
O Feeders/Sub-panels(4045) 0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
O Final-Electrical(4055)
Approved
By 0_16,... Date t1 _In.....1 ..
® Rough Electrical Final ElectricalEl
Right of Way
Approved Approved Approved
By Date By Date By Date
• RECEIVED
EITM oA LECTRICAL
f JUL 22 2015
Federal Way PERMIT APPLICATION
CITY OF CDERAL WAY
DS
PERMIT NUMBER 1 5 _ l d 6 �+ _ E (�
SUITE/UNIT/SPACE#
SITE ADDRESS: 3 lr/i1/
1,c71.9 Ave_ S
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ s00 9S 9 ? C70 - b 075
PROJECT NAME
(Tenant or Homeowner Last Name) 127 go,_Ij
AlL-vp I,-T/ .jam -.5cIrJ �11 io/WI L
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME p PRIMARY PHONE
PROPERTY OWNER / p D yr (Z57)517-j''r3
MAILIfiiG ADD E-MAIL
Iyill /j'kl4i-t5
CITY STATE ZIP FAX
Ic,(7 yd/ t✓/d ' 1?may ( ) -
NAME PRIMARY PHONE
fd-cal f,-v)c.t s AIW, LLC (2-37 ) /75 7774--)
MAILING ADDRESS E-MAIL
ELECTRICAL 37/3 Po c i l!L Pk#,/ 5: 5-A..13
CONTRACTOR CITY STATE ZIP FAX
f;- w,4) y y zzy (2-53 1 1-175"-P�
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
—1124744.5 / $ 76L/ly /)- ice'/ /c /9- 9 7-105-c 7-03FL
NAME r. PRIMARY PHONE
APPLICANT `�4 Myra (2-0) 1/75 7. -z-/
MAILING ADDR SS E-MAIL
57/3 /'c/ 1!-, /II"y ir /3
FAX
a a t a v STATE
F)�fr 4100 4'i 17y2v (251 ) '17f- vy./(-
NAME PRIMARY PHONE
PROJECT CONTACT _
,L,. (7_,S-1) 112 - . 9? '
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 application. /
SIGNATURE: M®/74, ( DATE 7/2-2//�
PRINT NAME: -'F //IA',
f
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application