14-101271 . • Electrical
Ciof&FEcoeral. Way Permit #: 14-101271 -00-EL
Communitycon.Dev.Services
33325 8th Ave S
Federal Way,WA 98003
Ph (253)835-2607 Fax (253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: ELIOT MANAGEMENT
Project Address: 31620 23RD AVE S Unit 101 Parcel Number: 092104 9051
Project Description: Altering up to(20)circuits for associated tenant improvement
Owner Applicant Contractor
BALLI ROAD LLC SHIMER ELECTRIC SHIMER ELECTRIC
31620 23RD AVE S UNIT 218 34820 53RD AVE S SHIMEE*931QM(11/14/15)
FEDERAL WAY WA 98003-5049 AUBURN WA 98001 34820 53RD AVE S
AUBURN WA 98001
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
Circuits-Commercial 20
PERMIT EXPIRES Tuesday, September 16, 2014
Permit Issued on Thursday, March 20, 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.
011.
Owner or agent: Date: :) //-13 //11
THIS CARD IS TO tiilAINfON-SITE
iitiCITY OF _ L-". • Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 14-101271-00-EL Address: 31620 23RD AVE S Unit 101
Project: BALLI ROAD 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.
0 UFER Ground (4295) ❑ Ditch cover(4030) ' -❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
`0 Pool Bonding (4195) ❑ Temporary Power(4275) `El Service (4235)
Approved Approved Approved
By Date By Date By Date
Feeders/Sub-panels(4045) ElRough Electrical(4225) ' Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055)
Approved
By l-J ti Date --A-1.
❑ Rough ElectricalEl Final Electrical Right of Way
Approved Approved Approved
By Date j By Date By Date
•
i ELECTRICAL
CITY OF3
Federal Way PERMIT APPLI ' ON
1 0 1 2 -- 1 00 MAR 2 0 2014
PERMIT NUMBER _ _
CITY OF FEDERAL WAY
�( 2O Z-4 K I ` SUITE/UNI1r/ �iCE i
SITE ADDRESS: L^)� '/�,1,��' 1 O I
PROJECT VALUATION -} ASSESSOR'S TAX/PARCEL I CURRENT/PROPOSEDIUSE
$ J,,=J_:;:t/( 6353•i
PROJECT NAME C L. T MA
kill
CEM E n �,7-
Tenant or Homeowner Last Name) �f V, I V C�
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PROJECT DESCRIPTION no 4 a.._..: A0), U h C JC4,1;+-") u\ 1 '1(1401/) A c rvi e.
Detailed description of work to o V t- -vvi . (20) c't:)17-S
be included on this permit only
NAME / PRIMARY PHONE
PROPERTY OWNER B. at J) ; R D a 0i LLC ( ) -
MAILING ADDRESS E-MAIL
3 / 62D 2 3RD /-L2.. 5 (if 1,1;7- 21i'
CITY STATE ZIP FAX
/-e cerAA 1 oc,i y u-AI 88003 ( ) -
NAME r ` PRIMARY PHONE
5 t'1 I M R Ie c -4 C ( 2 S5 �4- G E(
MAILING ADDRESS E-MAIL
ELECTRICAL 2)h , 7 0 S-3 rd A ✓c- 5
CONTRACTOR CITY STATE ZIP FAX
A b uk r h u'A qg 00 1 ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
APPLICANT D a ' "l 1 _el-e5 In L. vl em u Dv ( ) -
MAILING ADDRESS E-MAIL
k 0 1 3 5 `3 v0 i'^ 5i—
CITY STATE ZIP FAX
A, 0 v vi . 4-- a$oO/ ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT ( )
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. 2 //4
SIGNATURE. DATE 0 31 2 O
PRINT NAME: t 0\V1, \ T--2)e 5 li C h E N iA Q Ci
Bulletin#160—January 1,2013 Page 1 of 2 k:Af-Iandouts\Electrical Permit Application