17-104537 • '. tel— IC‘3 ; 01...4- e �-
- E Electrical
City of Federal Way Permit #:17-104537-00-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
Project Name: LIFE CARE CENTER OF FEDERAL WAY
Project Address: 1045 S 308TH ST Parcel Number:082104 9042
Project Description: Replace and upgrade existing generator,automatic transfer switch and associated systems.
Owner Applicant Contractor
FEDERAL WAY CONVALESCENT CENTER KENT VANDERWEIDEZORKO ELECTRIC ZORKO ELECTRIC
3001 KEITH ST NW 26900 NE 145TH ST ZORKOEI121OK(9/12/18)
CLEVELAND TN 37312 DUVALL WA 98019 PO BOX 100
DUVALL WA 98019
Additional Permit information
Is this an Online or O.T.C.application? No
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Alt.Srvc/Feeder 201-600 am 1
PERMIT EXPIRES Saturday,20 October,2018
Permit Issued on Friday,October 20,2017
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
ashington and the City of Federal Way.
Owner or agent: Date: /40/21//7
iJ^Y‘-C,
. • 4A., _
THIS CARD IS TO REMAIN ON-SITE
��e*.at Construction Inspection Record
Fe Fai Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 104537 00 Address: 1045 S 308TH ST
Project: FEDERAL WAY CONVALESCENT 4 FEDERAL WAY WA 98003-4706
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) 0
Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
�By E Date t L "9-L-�1-i ,By 0_,,t4,,,, � Date +4\_016,1.1 ,4By Date .
® Pool Bonding(4195) , El Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
❑ Feeders/Sub-panels(4045) ® Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
4
By Date ; By Date By Date
'to Final-Electrical(4055)
Approved
By C,;xx.„ Date 1 3 O,l g
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
{ CITY OF A :1ECEIVED ELECTRICAL
Federal Way SEP 1 2017 PERMIT APPLICATION
.
•;r.►,a+,t,N!tY DE1'ELaPTAERMa'r NUMBER l — -
SITE ADDRESS:
1045 S 308th St SUITE/U11IT/SPACE.
PROJECT VALUATION ASSESSOR'S TAX/PARCEL S CURRENT/PROPOSED USE
$ l A a.� p, 0 8 2 1 0 4 98
0 4 2 Nursing Home
PROJECT E — — — —
(Tenant or HomeownNer Last Name) Life Care Center of Federal Way
Replace and upgrade existing generator, automatic transfer switch,
PROJECT DESCRIPTION and associated systems.
Detailed description of work to
be included on this permit only
NAME PRIMARY PRONE
PROPERTY OWNER Life Care Center of Federal Way (253) 946 - 2273
MAILING ADDRESS E-MAIL
1045 S 308th St
CITY STATE ZIP FAX
Federal Way WA 98003 ( ) -
NAME PRIMARY PRONE
Zorko Electric, Inc ( 425) 788 _ 7710
MAILING ADDRESS E-MAIL
ELECTRICAL PO Box 100 kentv@zorkoelectric.com
zorkoeiectric.com
CONTRACTOR CITY STATE ZIP FAX
Duvall WA 98019 ( 425) 788. 7730
WA STATE CONTRACTOR'S LICENSE* EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE■
ZORKOEI121OK 09/ 12 18 19-98-105542-00-BL
NAME PRIMARY PRONE
Zorko Electric, Inc ( 425) 788 _ 7710
APPLICANT MA/LUNO ADDRESS E-MAIL
PO Box 100 kentv@zorkoelectric.com
zorkoeiectric.com
CITY STATE ZIP FAX
Duvall WA 98019 (425) 788 . 7710
PHONE
PROJECT CONTACT NAMEKentVanderWeide ( 425) 788 7710
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 aU
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
infirmation supplied to ci as a of this iication.
SIGNATURE: DATE 9/20/17
PRINT NAME: ent VanderWeide
PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609 +permitcenter@cityoffederalway.com
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application