16-102146 • •
• Electrical
City of Federal Way
Community&Econ.Dev.Services Permit #: 16-102146-00-EL
33325 8th Ave S
Federal Way,W98003 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q
Project Name: AESTHETIC DENTAL
Project Address: 34700 11TH PL S Parcel Number: 215470 0040
Project Description: Connection of electrical sign to existing J-box
Owner Applicant Contractor
VC INVESTMENT LLC NORMAN DOMINGO NORTECH ELECTRIC
14349 SE 92ND ST NORTECH ELECTRIC NORTEE*851QE(11/5/17)
NEWCASTLE,WA 98059 9630 49TH AVE S 9630 49TH AVE S
SEATTLE WA 98118 SEATTLE WA 98118
Additional Permit Information
Electrical Work Valuation? 1600 Is this an Online.or O.T.C.application? Yes
Is Use Educational or Institutional? No Service greater than 999 Amps? No
No Fixtures Associated With This Permit !!
PERMIT EXPIRES Friday, May 5, 2017
Permit Issued on Thursday, May 5, 2016
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:
•
1
'" • THIS CARD IS TO AIN ON-SITE
CITY OF Construction In ection Record '
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 16-102146-00-EL Address: 34700 11TH PL S
Project: VC INVESTMENT LLC FEDERAL WAY, WA 98003-6715
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) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
.
0 Feeders/Sub-panels(4045) 'El Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
0 Final-Electrical(4055)
Approved
By Q "'-' Date - ,l q_l t
t
0 Rough Electrical Final Electrical CI Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF �• �I EI' .�.�CTRI CAL
Federal Way MAY 05 2016 PERMIT APPLICATION
Cp'y OF FEDERAL WAY y /
COS PERMIT NUMBER 1 ( - l 0 ^� L/ c _
_�
700__i 1 ( ( lei — —
SITE ADDRESS: SUITE/UNIT/SPACE#
E S-04 t y 1C1� i t L
PROJECTVALUATION A�SO�S TAX/PARCEL# � 0 � 0 � (f � CURRENT/PROPOSED USE
$
•PROJECT NAME __L ( _ _ -
(Tenant or Homeowner Last Name) k -S l•{-1.6, � l G
PROJECT DESCRIPTION 1 To Q./" ' sc
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER '/C- in VC SV vl LL C/ ( ) -
MAILING ADDRESS E-MAIL
I L5L/ / 92 Ad s -
CITY STATE ZI FAX
Aria
NAME PRIMARY PHONE
MAILING ADDRESS ( E-MAIL
ELECTRICAL (oit) 4 t' r\-Q o ✓ ,?'N I ( C Oh
CONTRACTOR CITY STATE ZIP ) FAX (f
kioik » ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NO ` 1 CE g1 / /
NAME PRIMARY PHONE
APPLICANT SCP_ to C C L t (7)-(41 966 _� �� J
MAILING ADDRESS E-MAIL
R &? 4611--. VC
CITY STATE �ZIP FAX
3) ( )
NAME PRIMARY PHONE
PROJECT CONTACT RIM f 3 DOMIIJ&D ��
(a0S oc�
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.
y,.
SIGNATURE: A1/ DATE / /44
PRINT NAME: P o p-Y V 1? p DOM frt I C S
Bulletin#160—April 14,2016 Page 1 of 1 k:AHandouts\Electrical Permit Application _