18-100312 Electrical
City of Federal Way Permit #:18-100312-00-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: MULTICARE HEALTH SYSTEM
Project Address: 31861, GATEWAY CTR BLVD S Parcel Number:092104 9137
Project Description: Relocate(4)T-Stats for associated tenant improvement work.
Owner Applicant Contractor
MULTICARE INDIGO URGENT CARE TAYLOR LOWERYHERMANSON HERMANSON COMPANY LLP
PO BOX 5299 COMPANY (ELECTRICAL)
TACOMA WA 98415 1221 2ND AVE N HERMACL995DK(3/12/19)
KENT WA 98032 1221 2ND AVE N
KENT WA 98032
Additional Permit Information
Is this an Online or O.T.C.application Yes
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Thermostat 4
PERMIT EXPIRES Saturday,19 January,2019
Permit Issued on Friday,January 19,2018
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
Washington and the City of Federal Way.
Owner or agent: 1' f\---------'"----------"ZS---
Date: I / MO
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•
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
Federal Way INSPECTION REQUESTS :(253)835-3050
PERMIT#: 18 100312 00 Address: 31861 GATEWAY CTR BLVD S
Project: MULTICARE INDIGO URGENT CA 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.
I UFER Ground(4295) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date
.By Date By 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) I ® Ceiling Cover(4020)
Approved i Approved Approved
By Date ( By Date 1
1 By Date
El Final-Electrical(4055)
Approved
Date7..../
/7(2
❑ Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
llili. RECEIVED ELECTRICAL
CITY OF
Federal Way JAN 11 2018 PERMIT APPLICATION
CM!OF FEDERAL WAY 18 1 (� 0 J l 2 )V
MuN DEVELOPMENT PERMIT NUMBER
SITE ADDRESS: 3 l (y ' C101'fr NO lI SUITE/UNIT/SPACE#
J Cin�--� ��Vd S
PROJECT
O T VALUATION A3$ S3QB,S TAX/PARCEL# — /,, 1 CURRENT/PROPOSED USE
PROJECT NAME (`/► (tel 1 (//'y 3 7---
(Tenant or Homeowner Last Name) V` 1 c + ro"l e l G-u Wa--t
ro 0(.011 -5 t-��- -tt- S (V\
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME n V '^ a PRIMARY PHONE
PROPERTY OWNER I"I�t-h Ca'r e, `L4 I'f'f 1 j +Crn N (Lo�) 55‘i - °I G')
MAILING ADDRESS E-MAIL
316 Moor t r' Lu,-i-h-e- k_4(19 NA 1
CITY STATE ZIP J FAX
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NAME PRIMARY PHONE
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MAILING ADDRESS E-MAIL
ELECTRICAL 12D 7r)U (i V e l ..) tA1(0 ii•i o W c r i, e� hex ni a-t
CONTRALTO i I CITY STATE ZIP FAX J Sll N
,� IN Pt �KO3 2- ( ) .0
WA CENSE#
1 [/APA4 f4'L L TE CONTRACTOR'S
1 3j 1L. A / 12_LICENSE# T / i cl Z6 EION DATE FED _0 U (1')I�Y°Ia1WAY BUSINESS 1 oo -a L
NAME PRIMARY PHONE
APPLICANTn (LOQ )C611 - OG►`'1
LIN ADDRESS E-MAIL
121-- ` 2X)a t N 161191V. Iw cjj e Au ra:60-
CITY STATE ZIP FAX) uOYi'
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NAME PRIMARY PHONE
PROJECT CONTACT TO l 0 r i u tni (2,O(Q) %f 6logi
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certifythat to the best
P P y 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. �j
SIGNATURE: I-, i DATE t 11 t I l
PRINT NAME:�O)j(D{ L O IV
PERMIT CENTER+33325 8th Avenue South + Federal Way,WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenterracityoffederalway.com
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application