17-102012 •
a. r
Electrical
City of Federal way Permit #:17-102012-00-EL
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
6
Project Name: FEDERAL WAY EAST/NORTHWEST KIDNEY CENTERS
Project Address: 33820 WEYERHAEUSER WAY S Parcel Number:215466 0040
Project Description: New interior lighting,site lighting,receptacles,feeders and connection to dialysis water
treatment equipment.
Owner ' Applicant Contractor
D M VENTURES FW CENTER LLC NORTHSTAR ELECTRICAL LLC NORTHSTAR ELECTRICAL LLC
6725 116TH AVE NE SUITE 100 PO BOX 1909 NORTHEL878QF(11/6/17)
KIRKLAND WA 98033 BOTHELL WA 98041 PO BOX 1909
BOTHELL WA 98041
Additional Permit Information
Is this an Online or O.T.C.application? No
a -, �,,
PERMIT EXPIRES Wednesday,20 June,2018
Permit Issued on Tuesday,June 20,2017
j 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 int accordance with the laws, rules and regulations of the State of
n� Washington and the City of Federal Way. //
Owner or agent: I�JGW" \, Date: 62- 2-(-7 li
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THIS CARD IS TO REMAIN ON-SITE `
"�� Construction Inspection Record
Federal Way INSPECTION REQUESTS :(253)835-3050
PERMIT#: 17 102012 00 Address: 33820 WEYERHAEUSER WAY S
Project: D M VENTURES FW CENTER LLC 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) u Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved J Approved to place concrete
By Date By tAlb Date ' (p 11 By Date
0 Pool Bonding(4195) 0 Temporary Power(4275) 0 Service(4235)
Approved ( Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) 0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date ,,By Q ..„, Date V..%1/4.6....%?s B e () Date l Z Z i I
1U Final-Electrical(4055)
Approved
By Gin Date �,,,l 1:1.1
El Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
5 24- I7-
CITY OFr _ ELECTRICAL
Yli Federal Way PERMIT APPLICATION
MAY 0 3 2017 _ \ 0 Z o 12 - 00
PERMIT NUMBER
CITY OF FEDERAL WAY 1 — —
COMMUN(TY DEVELOPMENT SUITE/UNIT/SPACE#
SITE ADDRESS: 33820 Weyerhaeuser Way S, Federal Way WA 98001 Suite 100
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 450,000.00 2 1 5 4 6 6 _ 0 0 4 0 Office Building
PROJECT NAME NORTHWEST KIDNEY CENTERS
(Tenant or Homeowner Last Name)
Tenant Improvement for (16) station dialysis center with staff support
PROJECT DESCRIPTION areas. Includes new interior lighting, site lighting, receptacles, feeders
Detailed description of work to and connection to dialysis water treatment equipment.
be included on this permit only
PHONE
PROPERTY OWNER NAME DM Ventures Federal Way, LLC (425) 822 -PRIMARY466
E-MAIL
MAH,6725 116TH AVE NE #100 MIKEM@MJRDE ELv OPMENT.COM
CITY STATE ZIP FAX
KIRKLAND WA 98033 ( ) -
NAME Northstar Electrical, LLC PRIMARY PHONE
(206) 329 - 1596
MAILING ADDRESS E-MAIL
ELECTRICAL 16934 NE 131st PL adamc@northstar-electrical.com
CONTRACTOR CITY STATE ZIP FAX
Redmond WA 98041 ( ) _
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
EC NORTHEL878QF 11 / 06 / 17 20-16-104472-00-BL
Y PHONE
NAME Northstar Electrical, LLC ( 206) 3P 29- 1596
APPLICANT MAILING ADDRESS E-MAIL
16934 NE 131st PL adamc@northstar-eiectrical.com
CITY STATE ZIP FAX
Redmond
WA 98041 ( ) _
NAME PRIMARY PHONE
PROJECT CONTACT Adam Chudoba (206) 786 - 2983
I certify under penalty of perjury that I am the property owner or authorised 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 authorised 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 ci•_ a partof application.
—
SIGNATURE: DATE 513/2
PRINT NAME: 4104N C-f-1(,O 064
PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609+permitcenrera.citVoticd r.,' zv . rn
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application