14-102709 •
•
Electrical
• City of Federal Way
Community&Econ.Dev.Services Permit #: 14-102709-00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: 253 83
Ph:(253)835-2607 Fax:(253)835-2609 p q ( ) 5-3050
Project Name: PARK 16 APARTMENTS-MAIL KIOSK
Project Address: 35703 16TH AVE S Parcel Number: 292104 9107
Project Description: Electrical work for a mail kiosk
Owner Applicant Contractor
PARK 16 LLC EDISON ELECTRIC EDISON ELECTRIC
11100 MAIN ST SUITE 301 PO BOX 44850 EDISOEI044BR(1/19/16)
BELLEVUE WA 98004 TACOMA WA 98448 PO BOX 44850
TACOMA WA 98448
Additional Permit Information
Is this an Online or O.T.C.application? No 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: tzi /
THIS CARD IS TO AIN ON-SITE is 1
C,noF "".44.,.. •; - Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 14-102709-00-EL Address: 35703 16TH AVE S
Project: PARK 16 LLC FEDERAL WAY, WA 98023
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) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
O Pool Bonding(4195) ' El Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
o Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date 11, �� Date (.--Z0—rs— By Date
❑ Final-Electrical(4055)
Approved
By< Date r--213tt—
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
41)
AN.........
EL CTRi CAL
CITY OF
Federal Way ECEIV PERMIT APPLICATION
DI.
PERMIT NUMBER l _ l 0 Z -- --, N 16
- - - - - - FF€9Efb4LWAY
CDS
SUITE/UNIT/SPACEIt
SITE ADDRESS: 3 c 7 Ci. J A V S. ,..61‘411 K�u K.
PROJECT VALUATION ASSESSOR'S TAX/PARCEL CURRENT/PROPOSED USE
' 6, _ 9 ( 0- 7
PROJECT NAME w� i ,4 P�4 5
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION F i e L\r' (4 t L/ J r k `t"D r << d l'.) 01/41_4._Detailed description of work to `'
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER _ °`►1' ( 6 16 ( '2S) <;3 - `7ry 5 S
MAILING ADDRESS E-MAIL
o 0 0 Nim C3 f" 51: S 1 /2 c;c.)
CITY STATE ZIP FAX
,C'l C-1--i�z__- .A 96700V (1775-) q s
NAME cc,,,� �f PRIMARY PHONE
("c1`Jo /"(j Cc( * t L' - .-��/�" ( )
MAILING ADDRESS E-MAIL
ELECTRICAL �� i3;��( Y� 5 ( ' r oko O ,',u.JeAwl4.t".,L41
CONTRACTOR CITY STATE ZIP FAX
7-g(..:),/,--14:1 ii-4 9 ' lyY ( ) -
WA STATE CONTRACTOR'S LICENSE @ EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE it
1.-;'d 1 5<) U tilJ'7 / /_ i'y /l t. 20 -A‘–/4705e14 -00"13'1..
NAME / ) PRIMARY PHONE
APPLICANT —/I-Co' 7 1cl�oi ( o,vc ..<__ [` t OA) ('`IZ5 ) 24-;- L I/
MAILING ADDRESS E-MAIL
j 0 i 00 NE 11. t)-. SU.{-6. )Zv 0 .xt,i111 V 9--1,PCki-kale{.s, OD"
CITY STATE ZIP FAX
Il V cf-t. j.A WOO t ( ) _-
NAME PRIMARY PHONE
PROJECT CONTACTc---) �. �'�n
Sk.. 11 ,v4,..) (7G() 7.5-S- 8 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 Iaws.
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: DATE
PRINT NAME: go be--1k'f • c der\) —_
Bulletin#160–January I,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application