14-100695City of Federal Way
Community &Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
,. F.Jectrical
Permit #: 14.100695 -00 -EL
Project Name: PINEWOOD VILLAGE APARTMENTS - CABANA
Project Address: 33311 18TH LN S
Project Description: Replace monitoring communicator panel in cabana.
Inspection Request Line: (253) 835-3050
Parcel Number: 797820 0076
caner
Applicant
Contractor
LILY OF THE VALLEYS LLC
THE SAFETY TEAM INC (ELECTRICAL)
THE SAFETY TEAM INC (ELECTRICAL)
221 WELLS AVE S SUITE 100
670 S LUCILE ST
SAFET** 169MF (8/4/15)
RENTON WA 98055
SEATTLE WA 98108
670 S LUCILE ST
SEATTLE WA 98108
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes
Service greater than 999 Amps? .............................No
Electrical Fixtures
Low Voltage - Fire Alarm (Comm( 1
Is Use Educational or Institutional?.......................No
PERMIT EXPIRES Wednesday, August 13, 2014
Permit Issued on Friday, February 14, 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 ill( in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: l Date:
circ OF
Federal Way
PERMIT #:
14 -100695 -00 -EL
THIS CAM) IS TO MAIN ON-SITE
Construction In ection Record
INSPECTION REQUESTS: (253) 835-3050
Address: 33311 18TH LN S
Project: LILY OF THE VALLEYS LLC FEDERAL WAY, WA 98003-8916
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.
Final - Electrical (4055)
Approved
By Date
UFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date
Pool Bonding (4195)
Temporary Power (4275)
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
0
Rough Electrical (4225)
❑
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF .&
Federal Way
PERMIT NUMBER
�—
ReCEMM
ELECTRICAL
FEB 12 2014 PERMIT APPLICATION
CITY OF FEDERAL WAY
-Z 0 O�Dj -2 -�- - �� �'
SITE ADDRESS: i
1
l g / n �
SUITE/UNIT/SPACE #
t -6V 1.. 4
"
PROJECT VALUATION �'W
L cx�—;1
ASSES80R'8 TAXI/P�AR`C' L 8
— O C1�Q1pkt—
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
- — -
Detailed description of work to
be included on this permit only ,
�r `, �„n
U� lUl�1
`.
`4
PROPERTY OWNER
NAME
L,\ :A V Aij-L<,L\--
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
/STATE
T ZIPll
FAX
NAME
t:Me
PRIMARY PHONE
( )i6l- I��-o
MAILING ADDRESS
UQA\-L! i
E-MAIL
� Si I 1
ELECTRICAL
CONTRACTOR
CITY
t
STATE
ZIP
FAX
(&6 -- 174
WA STATE CONTRACTOJVS LICENSE 8 EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE M
004M� �
z�.-64 - �o MM -OL
NAM
N�
PRIMARY PHONE
APPLICANT
MAILING ADD
L UC u%
E-MAIL
i '
CITY-
ZIP
FAX
qq
PROJECT CONTACT
NAME
PRIMARY PHONE
)761, - 1 4SI)
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 clainq, which may be made by any person, including the undersigned, and filed against the city,
but only where such claim ariars out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city ftsia part of this application.
SIGNATURE:
PRINT NAME:
,,(12- liq
Bulletin #160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
V