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13-104100City of Federal Way Community & Econ. Dev. Services 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 835-2607 Fax: (253) 835-2609 0 Electrical Permit #: 13 -104100 -00 -EL Inspection Request Line: (253) 835-3050 Project Name: FEDERAL WAY MEDICAL DENTAL - SUITES A,B,C,D,E,F & G Project Address: 1014 S 320TH ST Parcel Number: 082104 9234 Project Description: Lighting retrofit Owner AR12lican Contractor FW MEDICAL -DENTAL GRP LLC M JONES ELECTRIC M JONES ELECTRIC PO BOX 23314 27726 131ST CT SE MJONEJE90400 (9/20/14) FEDERAL WAY, WA 98093-0314 KENT WA 65080 27726 131ST CT SE KENT WA 65080 Additional Permit Information Is this an Online or O.T.C. application? ................. es Service greater than 999 Amps? .............................No Electrical Fixtures' Circuits - Commercial .................... 1 Is Use Educational or Institutional?.......................No PERMIT EXPIRES Sunday, March 16, 2014 Permit Issued on Tuesday, September 17, 2013 I hereby certify that the above information is correct and that the construction on the above described property and the ocl;upancy and the use will be in accordance—with the laws, rules and regulations of the State of Washington e City of Federal Way. —7 Owner or agent: Date: !Z -/L l THIS CARD IS TOMAIN ON-SITE CITY OF Federal Way Construction In ection Record INSPECTION REQUE TS: (253) 835-3050 PERMIT #: 13 -104100 -00 -EL Address: 1014 S 320TH ST Project: FW MEDICAL -DENTAL GRP LLC FEDERAL WAY, WA 98003-5344 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) Final Electrical Approved Slab/Concrete Floor (4255) (4235) Approved Approved Approved Approved Approved to place concrete By Date By Date By Date Pool Bonding (4195) Temporary Power (4275)Service Final Electrical Approved (4235) Right of Way -^ Approved Date Approved By Date Approved By Date By Date By Date ❑ E] Feeders/Sub-panels (4045) Rough Electrical (4225) Ceiling Cover (4020) Approved Approved Approved By Date By Date By Date ❑ Final - Electrical (4055) Approved By ('At Date Rough Electrical Approved Final Electrical Approved 1:1Approved Right of Way -^ By Date By Date By Date CRY OF Federal Way PERMIT NUMBER ( "/ + ELECTRICAL PERMIT AF(P�TION 10 4( SEP 17 202 CITY F FEDERAL WAY I 3 SITE ADDRESS: ` CJE"M/UNIT/SPACE # PROJECT ANION ASSESSOR'S TAX/PARCEL # - CURRENT/PROPOSED USE PROJECT NAME (Tenant or Homeowner Last Name) FE Q L u -)O MEDICAL lPENTA !� PROJECT DESCRIPTION Detailed description of work to be included on this permit only N PROPERTY OWNER ELECTRICAL CONTRACTOR APPLICANT NAME PRIMARY PHONE ( ) - MAIL IG ADDRESS E-MAIL CITY STATE ZIP ( FAX PRIAY PHONE (253) �6&7_ 1 Z3 3 MAILING ADDRESS 2,7 7Z(o P 3t CF S C E-MAIL crff 1t ANT STATE WA zIP a03© FAX ( t - WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE NAME mfl RS H A L L jot4E S FEDERAL WAY BUSINESS LICENSE # PRIMARY PHONE (Z 53 ),5'(0 l - {2.33 MAMING ADDRESS E -MAH, CITY STATE I ZIP FAX t PROJECT CONTACT NAME En PRIMARY PHONE 36 c? 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 authorised 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 claims, which may be made by any person, including the undersigned, and sled 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 theme as a paft of�thjs app altn. SIGNATURE: PRINT NAME: 9 �- /�-- 13 Bulletin #160 —January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application