13-103500i
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: FITNESS EVOLUTION
Project Address: 1211 S 320TH ST
Electrical
Permit #: 13 -103500 -00 -EL+
Inspection Request Line: (253) 835-3050
Parcel Number: 150050 0030
Project Description: Addingtaltering up to (50) circuits and relocate 0-200 amp panel for associated tenant
improvement
Owner
A1212lican
Contractor
MGP IX SUNSET SQUARE LLC
BEDDOW ELECTRICAL SRVS CO INC ,
BEDDOW ELECTRICAL SRVS CO INC
425 CALIFORNIA ST FLOOR 11
3722 196TH AVENUE CT E
BEDDOES973CF (2/6/15)
SAN FRANCISCO CA 94104
LAKE TAPPS WA 98391
3722 196TH AVENUE CT E
LAKE TAPPS WA 98391
Is this an Online or O.T.C. application?.................Yes
Service greater than 999 Amps? .............................No
Electrical Fixtures'
Is Use Educational or Institutional?.......................No
Alt. Srvc / Feeder 0 to 200 amps (C 1 Circuits - Commercial .................... 50
PERMIT EXPIRES Monday, February 3, 2014
Permit Issued on Wednesday, August 7, 2013
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 ' ccordance with the laws, rules and regulations of the State of Washington
the City of Federal Way.
Owner or agent: " Date: 7 ��
p
r,AIW. ll - -
FINALED
f
CVrV OF
federal Way
PERMIT #:
Project:
THIS CARD IS TOMAIN ON-SITE
Construction In ection Record
INSPECTION REQUE TS: (253) 835-3050
13 -103500 -00 -EL Address: 1211 S 320TH ST
MGP IX SUNSET SQUARE LLC FEDERAL WAY, WA 98003-5339
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)
El Ditch cover (4030)
E] Slab/Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By Date
By,(f S Date — I C)..- ! 3
By Date
Final - Electrical (4055)
Approved
By XW Date
�0 4-3,
Pool Bonding (4195)
Temporary Power (4275)
1:1Approved
Service (4235)
Final Electrical
Approved
Approved
By
Approved
ByX
By
Date
By Date
By
Date
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved .� , G
Approved
Approved
By
Date U� —�
By ��� Date q— ( U' 3
Date tc'— (C� ( -5
Final - Electrical (4055)
Approved
By XW Date
�0 4-3,
Rough Electrical
Approved
1:1Approved
Final Electrical
Right of Way —�
Approved
By
Date
ByX
Date ��
t
3
By
Date
DAT E INSPECTOF, AREA AND TYPE INSPECTION
-ftn Pz 0 t--,qAL,�A
CITY OF
Federal Way
PERMIT NUMBER i
ELECTRICAL
PERMIT APPLICATION
RECEIVED
AUG 07 2013
SITE ADDRESS: 12G ( 50. 3j 2 v tL 5t,
CDS
PROJECT VALUATION
0047
ASSESSOR'S TAX/PARCEL #
- — — —
CURRENT/PROPOSED USE
PRojEc4r NAME
(Tenant or Homeowner Last Name)
—
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
PRIMARY PHONE
( ) -
MAILING ADDRESS
E-NIAIL
CITY
STATE
ZIP
/ FAX
i )
ELECTRICAL
CONTRACTOR
NAME
PRIMARY PHONE
MAILING ADDRESS
3 7 2 Z / Y6� c�.µe C_ -C E
E-MAIL
Tq P s o N e e gp(-oc .
CITY
Z-4Ke rq ep >
STATE
I 10c.,
ZIP
I 2g3q(
FAX
(e-tV)6sz- 1,705 -
WA STATE CONTRACTOR'S LICENSE M EXPIRATION DATE
SeJ Co s Z73 CF
FEDERAL WAY BUSINESS LICENSE N
APPLICANT
NAME
�Nd
PRARY PHONE
(2� �)IM6 Z 8
MAILING ADDRESS
3 7 Z 2 l (� �'`' av C`�
EMAIL
�4/? s okl-e-& Q06CoA
CITY
Z44c S
STATE
ZIP
FAX
( &V )6 5-Z- - 07o
PROJECT CONTACT
NAME
R,a �� U
PRIMARY PHONE
( Z06) ,$7 - 6 F-6
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 Iaws 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 th�y as a part Spgtis application.
SIGNATURE:
PRINT NAME:
9-7—/---S
Bulletin # 160 — January 1, 2013 Page I of 2 k:\HandoutslElectrical Permit Application