14-101543�f Electrical
Community & Econ. D'ev. Services Permit #: 14 -101543 -00 -EL
33325 8th Ave S
Federal Way, wa 98003 Inspection Request Line: 253 835-3050
Ph: (253) 835-2807 Fax: (253) 835-2609 p Q
Project Name: ONURI PHARMACY
Project Address: 1014 S 320TH ST Unit G Parcel Number: 082104 9234
Project Description: Relocate existing 125 amp panel for associated tenant improvement
Owner
A1212111cant
Contractor
FW MEDICAL -DENTAL GRP LLC
NST CALL KIM ELECTRIC
NST CALL KIM ELECTRIC
PO BOX 23314
6106 S AINSWORTH AVE
JUSTCCK927CE (2/13/16)
FEDERAL WAY, WA 98093-0314
TACOMA WA 98408
6106 S AINSWORTH AVE
TACOMA WA 98408
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes
Service greater than 999 Amps? .............................No
Electrical Fixtures
Alt. Srvc / Feeder 0 to 200 amps (C 1
Is Use Educational or Institutional?.......................No
PERMIT EXPIRES Wednesday, October 1, 2014
Permit Issued on Friday, April 4, 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.
Owner or agent: Date:
14%A30001D
f THIS CARD IS TO MAIN ON-SITE
Construction In ection Record
CITY OP
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 14 -101543 -00 -EL Address: 1014 S 320TH ST Unit G
Project: FW MEDICAL -DENTAL GRP 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.
E]
UFER Ground (4295)
Ditch cover (4030)
❑
Slab/Concrete Floor (4255)
Approved
By
Approved
Temporary Power (4275)El
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date -1 Z� I
El
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Pool Bonding (4195)
Temporary Power (4275)El
Service (4235)
Date
Approved
By
Date
Approved
Approved
By
Date
By
Date
By
Date
o
E]
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date -
Date G\— lzk — L
By
Date
Final - Electrical (4055)
Approved
By Date -1 Z� I
El
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
EL C'T'RICAL
CITY OF
Federal Way PERMITR PLICATION
PERMIT NUMBER 00 APR 0 4 2014
CITY OF FEDERAL WAY
SITE ADDRESS'
- /o/
s Via. ®T� sT �� r
f
SUITE/UNIT/SPACE e
On
PROJECT VALUATION
ASSESSOQR'SS TAAX/PAR%CEL #
z
CURRENT/PROPOSED USE
00,00
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
I I D �fiV �t� C�
(
PRIMARY PHONE
( — gj ✓E- "�
MMLING'GA"ADDRESS
'/ C
�j j '(•�
MAI,
lk-(i.�
CITY STATEZIP
LPA AM w
FAX
NAME
Cc ►
PRIMARY PHONE
) �' - J a -
MAILING ADDRESS p�
S 17 r �► A �-
E -MAI,
ELECTRICAL
O T► ` S �L/c'
CONTRACTOR
CITY3TATE
TDA Cd
W
ZIP
Ljg zk Y,(
FAX
) _
WA STATE CONTRACTOR'S LICENSE M EXPIRA ON DATE FEDERAL WAY BUSINESS LICENSE N
NAME
r
(
PRIMARY PHONE
) % — �5
APPLICANT
MAILING ADDRESS
E-MAIL
o' h Ave. s
1
CITY
I STATE
ZI'
0o_
FAX
) _
PROJECT CONTACT
NAME
1-16 X ;
(
PRIMARY PHONE
) _
I certify under penalty ofperjury jury that I am the property owner or authorised 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_?fjhjs application.
$IGNATURE: , DATE d C
PRINT NAME: o KIM
/
Bulletin # 160 —January 1, 2013 Page 1 of 2 UHandoutsTlectrical Permit Application