14-104765 7 9 I I
A.t t • •
" �,lectrical
City y&Federal Way Permit #: 14-104765-00-EL
CommuAi Econ.Dev.Services FILE
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: 253 835-3050
Ph:(253)835-2607 Fax:(253)835-2609 p Q
Project Name: AMERICAN FAMILY INSURANCE
Project Address: 2158 S 314TH ST Parcel Number. 092104 9053
Project Description: Altered circuit for"Open"sign.
Owner Applicant Contractor
AMERICAN FAMILY INSURANCE B&G PROPERTY MAINTENANCE LLC B&G PROPERTY MAINTENANCE LLC
2158 S 314TH ST 533 A 6TH ST S BGPROGP906M8(7/28/16)
FEDERAL WAY WA 98003 KIRKLAND WA 98033 533 A 6TH ST S
KIRKLAND WA 98033
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 1
PERMIT EXPIRES Sunday, March 15, 2015
Permit Issued on Tuesday, September 16, 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
an- - City of Federal Way.
Owner or age • - .L Date: +
4 THIS CARD IS TO .MAIN ON-SITE
CITYIllP
"/ on ru ct o In i n e ct>!o Re n ord �'''
Construction c
Federal Way INSPECTION REQU TS: (253)835-3050
PERMIT#: 14-104765-00-EL Address: 2158 S 314TH ST
Project: AMERICAN FAMILY INSURANCE 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 LIFER Ground(4295) ❑ Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
0 Pool Bonding(4195) El Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
By Date By Date By Date
,
Feeders/Sub-panels(4045) 0 Rough Electrical(4225) 0 Ceiling Cover(4020)
❑
Approved Approved Approved
By Date By Date By Date
.
0 Final-Electrical(4055)
Approved
By a Dateet _. I
El Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
41/4. IWEIVED E&CTRICAL
CITY OF
Federal Way SEP 16 2014 PERMIT APPLICATION
CITY OF FEDERAL- WAY
PERMIT NUMBER I - I a_31S 7j -
SUITE/UNIT/SPACE#
SITE ADDRESS:2.15.8 ( ,i-1 f , -�J y-36 (2- c LkiiA-y (� )5B
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# / CURRENT/PROPOSED USE
$ - () 9 / & - 9 D s. 3
PROJECT NAME
(Tenant or Homeowner Last Name) �M A-N J‘-,u re— j C_,
i4(:1 �l-� — ailk.c_:J Osf l J _ G'v.J
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER .1 1 (LCA' .l`f S / ( ) -
MAILING ADDRESS E-MAIL
Zig S. 319' ftC r��y��6 / ( 1 �vT4E} ZIP FAX
NAMEPRIMARY PHONE
i4.Com - -U &C,-- Y. ( ) -
MAILING ADDRESS EMAIL
ELECTRICAL 5 5M c C"
ST, S '
CONTRACTOR CITY STATE z FAX
ys-S.:(Z- __L_A,k)� w-6 i18 033 ( )
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
13'6-VP-CCTV) 1056 ? / /
NAME PRIMARY PHONE
APPLICANT `-� J2SoV\'l(2-250 ( )MAILING ADDRESS EMAIL
STATE ZIP,-
CITY A ) `P' A f j). / ( ) FAX
PHONE
PROJECT CONTACT N4,,,r)(
/4_5 ( 92. ) /PRIMARY
_i 03o
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 oft is application.
SIGNA eDATE C /6 ,li
PRINT NAME:_ ` k 6- 7
Bulletin#160—January 1,2013 Page 1 of 2 k:\.Handouts\Eiectrical Permit Application