18-100545 ,
Electrical
City of Federal way Permit #:18-100545-00-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: FUNERAL ALTERNATIVE OF WASHINGTON-FEDERAL WAY
Project Address: 31919 6TH AVE S Parcel Number:082104 9233
Project Description: Electrical work in main building to include adding(4)circuits for(2)exterior wall signs,(2)
new outlets in break room and low volt drops for data.
Owner Applicant Contractor
FEDERAL WAY PROFESSIONAL PLAZA VICTOR FIELDNORTH PACIFIC NORTH PACIFIC ELECTRIC INC
31916 6TH AVE S SUITE A-100 ELECTRIC INC NORTHPE957JA(4/4/19)
FEDERAL WAY WA 98003 5746 BOSTON HARBOR RD NE
OLYMPIA WA 98506 5746 BOSTON HARBOR RD NE
OLYMPIA WA 98506
Additional Permit Information
Is this an Online or O.T.C.application? Yes
Circuits-Commercial 4
PERMIT EXPIRES Tuesday,5 February,2019
Permit Issued on Monday,February 5,2018
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
VLWashington and th City of Federal Way.
Owner or agent: >f Date: /--- ---' 45 i8
404.
THIS CARD IS TO REMAIN ON-SITE
Federal Way Construction Inspection Record
INSPECTION REQUESTS:(253)835-3050
PERMIT#: 18 100545 00 Address: 31919 6TH AVE S Suite 200
Project: FEDERAL WAY PROFESSIONAL PI FEDERAL WAY WA 98003-5210
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) ,./ 3❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date i By Date ' By Date
Pool Bonding(4195) Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) ' ® Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
0 Final-Electrical(4055)
Approved
By' 3.k.A Date 0_,..A„.) c< .
Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
1it...N./L.1V Li
FEB O52O18
4111140.41 „H CITY OF FEDERAL WAY ELECTRICAL
carr of COMMUNITY DEVELOPMENT
Federal Way PERMIT APPLICATION
PERMIT NUMBER IU - 1 0 0 5 q 5 _ i V
SUITE/UNIT/SPACE#
SITE ADDRESS: 3/71? 6?%vr cS'.
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 4.5�-& Q ° 0 e I 0 L q Z- 3 3
PROJECT NAME
(Tenant or Homeowner Last Name) 114 f C,Q L 4-7- 0Q/,q-7 7 v6' sp ij9,
1,141N 81-bG I. 51be 2 SiGNx a-ol-c,eDr
/ pi K 0s (Z),,,,,,es. 4_0.d vet T,cmsu'
PROJECT DESCRIPTION ! C-i f C 0 ITS
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX •
( )
NAME PRIMARY PHONE
MATT- Pik/Fic.- &tec-Wrc j /ivc (3 60 ) 993_ 6 b 'o
MAILING ADDRESS '/ E-MAIL
ELECTRICAL c57� 'b ASrro /14 o l ) 46 eco r/fr'¢`.. enc/€�'Te��
r�s7. Nc'
CONTRACTOR CITY STATE ZIP FAX
6L.yN/f4 WI- 2gs o6 (360 )94d - 686e_
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
AlOAThePe 75.7 .4
NAMEr � �7- PRIMARY PHONE
APPLICANT 1,l e.-77,e_. cle_. Fl ELI) (3e20 )7n( - /a7(
MAILING ADDRESS E-MAIL
CITY STATE, ZIIPy FAX
0 L.%'/p(/`ll q Ltf l( l-c,C' ( ) -
NAMEPRIMARY PHONE
PROJECT CONTACT V-11--Y (36O ) 70 /o ?
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 app 'cation.
SIGNATURE: ?../.2-C\r- (9- DATE S / 6 S. 6 20 /6
PRINT NAME: kit C--rO C c F(mac--D
Bulletin#160-April 14,2016 Page 1 of 1 k:AHandouts\Electrical Permit Application