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17-102289
• Electrical City of Federal way Permit #:17-102289-00-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: DUTCH BROS COFFEE Project Address: 27525 PACIFIC HWY S Parcel Number:332204 9220 Project Description: Electrical connection for coffee shop to include wiring,hooking up equipment and lighting, underground from transformer to meter. Owner Applicant Contractor ETI2 LLC BEN FABENSBENZ ELECTRIC INC BENZ ELECTRIC INC 27525 PACIFIC HWY S 3767 NE 185TH ST BENZEI*992NC(8/3/17) FEDERAL WAY,WA 98003 LAKE FOREST PARK WA 98155 3767 NE 185TH ST LAKE FOREST PARK WA 98155 Additional Permit Information Is this an Online or O.T.C.application Yes Alt.Srvc/Feeder 201-600 ani 1 Low Voltage-Other(Commei 1 PERMIT EXPIRES Wednesday, 16 May,2018 Permit Issued on Tuesday,May 16,2017 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 Washington and the City of Federal Way. Owner or agent: Date: �j f `,' r { ' " ' THIS CARD IS TO REMAIN ON-SITE cr"a Construction Inspection Record Federal Way INSPECTION REQUESTS:(253)835-3050 PERMIT#: 17 102289 00 Address: 27525 PACIFIC HWY S Project: ETI2 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. ® UFER Ground(4295) 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255) Approved Approved Approved to place concrete By Date 133G-1-. Date 1( l 7 el By Date ® Pool Bonding(4195) El Temporary Power(4275) ® Service(4235) Approved Approved Approved �By Date ��By Date 'Sy��C r . Date \\ 2�1( ? •0 Feeders/Sub-panels(4045) • 8 Rough Electrical(4225) • S CeilingCover 4020 p ❑ g O ( ) Approved Approved Approved •By Date ��By We Date l2-1 1311-1By Date El Final-Electrical(4055) Approved By ti. ,%.,v.4 Date 5..49<19 0 Rough Electrical 0 Final Electrical 0 Right of Way Approved Approved Approved By Date By Date By Date CITY OF RECEIVED ELECTRICAL Federal Way MAY 16 2017 PERMIT APPLICATION CITY OF FEDERAL WAY (� ^,QMMUNITY DEVELOPMF TRMIT NUMBER I - L_ SUITE/UNIT/SPACE# SITE ADDRESS: yz' f7 2-7 5-.2, p . S ICAC( iC -14 Li 7 PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE \ 5Q 3. 32V Et - Z_ Z PROJECT NAME (Tenant or Homeowner Last Name) L u r "- v1t (s 5 CO - /s 'i T .,^ 'vv`y i VLI r/6 ✓2.V`1Rfll+ f C t c c t -Pee. '41,0‘./SR.`�ri PROJECT DESCRIPTION 4 6 t( (U C'1 e- 1 ✓►t. ca;,vt f (671 VO i 9-ccc� 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 iL (V.©H ) y 2 3- .37 33 MAILING ADDRESS E-MAIL ELECTRICAL .3767 /V CONTRACTOR CITY STATE ZIP FAX c-‘121. �rRt ` i.S'3` (1- ) y 17 - !K 7l WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# NAME PRIMARY PHONE APPLICANT `f `1l Fb•be�1 S (ZtS4) y�3- 3733 MAILING ADDRESS E-MAIL 376,:.-7 t 1 - (d 5"± 5-i— CITY STATE ZIP FAX C- FP 15 15— (26c) 4f(7 - dy7( NAME PRIMARY PHONE PROJECT CONTACT 13-e ti FA.6 (-2,C4) /23 - 3 7 33 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: DATE 5 // 6 77 PRINT NAME: FCI;l`=L/.5 Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application