14-102681 .� (Electrical
P1
City of Federal Way
`Community&Econ.Dev.Services Permit #: 14-102681 -00-EL
33325 8th Ave S
Federal Way,WA 98003 ec
Ins tion Request Line: (253) 835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p q
Project Name: PARK 16 APARTMENTS-BUILDING S
Project Address: 35703 16TH AVE S Bldg S Parcel Number: 292104 9107
Project Description: Electrical work for new 2-unit apartment building.
Owner Applicant Contractor
PARK 16 LLC EDISON ELECTRIC INC EDISON ELECTRIC INC
11100 MAIN ST SUITE 301 2417 104TH STREET CT S EDISOEI044BR(1/19/16)
BELLEVUE WA 98004 LAKEWOOD WA 98499 2417 104TH STREET CT S
LAKEWOOD WA 98499
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Service greater than 999 Amps? No
Electrical Fixtures
New Service: 0-200 amps(Multi- 1
PERMIT EXPIRES Sunday, December 7, 2014
Permit Issued on Tuesday, June 10, 2014
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: K -70 /y
DATE INSPECTOR AREA AND TYPE l' INSPECTION
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CITY OF • THIS CARD IS TO IN ON-SITE Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050 ,
PERMIT#: 14-102681-00-EL Address: 35703 16TH AVE S Bldg S
Project: PARK 16 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.
O UFER Ground (4295) - ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By ` > Date By Date
1
' - - �, k
O Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date in–
Date 5 - S
`0 Feeders/Sub-panels(4045) ' •
El Rough Electrical(4225) ElCeiling Cover(4020) '
Approved Approved Approved
B .----1-Z.-- Date k_04r,� 1kDate -Z4"- 5— B1-C'S Date =...29—( `
.El Final-Electrical(4055)
Approved
Date L.... ( l- 1ST/
❑ Rough ElectricalEl Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
•
` E1CTRICAL
CITY OF RECEIVED
Federal Way PERMIT APPLICATION
JUN 10 2014
PERMIT NUMBER / y / /(fir Oa 1' • •L W7 L
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SUITE/UNIT/SPACE#
SITE ADDRESS: 3 S 7 0-- I L i`A v‘-(-- S- &t, Ic ` J 3
PROJECT VALUATION ASSESSOR'S TAX/PARCEL CURRENT/PR OSED USE
PROJECT NAME �`
(Tenant or Homeowner Last Name) c,,4 " IL A p4/hv,i1.--S
PROJECT DESCRIPTION — h I LLA-f, Cci J^s J r k c-"D `(-- `'1 a t `l t'{
Detailed description of work to t f..-si.( 6.-i'l .. , "'
be included on this permit only
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NAME PRIMARY PHONE
PROPERTY OWNER _ tel 1-
' LC- ( '2 S`) 1/53 - `i 5-5 /
MAILING ADDRESS E-MAIL
ID� 0G� Nh_ �' (`` .5)-: s,..:IL /2oc,
CITY STATE ZIP FAX
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NAME PRIMARY PHONE
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MAILING ADDRESS E-MAIL
ELECTRICAL0 )2 - )( LH % S C
CONTRACTOR CITY STATE ZIP FAX
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WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
12C1 1 _ 7 /Cj!I 2v r _iO �00-1L
NAME l ) ! t PRIMARY PHONE
APPLICANT -/-C-a r' 7 ( ()'•0 6 o'v;'ice' st<- f t 0'0 (x/ZS ) 4-3- L v Li i
MAILING ADDRESSE-MAIL
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CITY STATE ZIP FAX
cit e,v ii-z,. j A s71)-;00 Y ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT c_).� e, r�n c v 1/ ;V 6 ( 0 ) •75 S- q '-30
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.
SIGNATURE: 17, 2 ----/ I / _ DATE
PRINT NAME: go e--4\.- I • 4`=YcLc'�
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application