18-100611t.
City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835.2609
Electrical
Permit #:18 -100611 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: DAIRY QUEEN
Project Address: 2305 SW 336TH ST Parcel Number: 873217 0060
Project Description: Electrical work to include replacing the disconnect on a rooftop Air Handling Unit.
Owner
Applicant
Contractor
EDITH I GOSSAN
DANIEL PETERSENKODIAK ELECTRIC
KODIAK ELECTRIC LLC
6303 NE 181ST ST UNIT 202
LLC
KODIAEL92805 (12/30/18)
KENNMORE WA 98028-8932
34419 THOMAS RD E
34419 THOMAS RD E
EATONVILLE WA 98328
EATONVILLE WA 98328
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
PERMIT EXPIRES Friday, 8 February, 2019
Permit Issued on Thursday, February 8, 2018
1 hereby certify that the above information is correct and that the construction on the above described property
and the occu cy 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: /
THIS CARD IS TO REMAIN ON-SITE
Fecler� IVa 4;&�
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 1810061100 Address: 2305 SW 336TH ST
Project: EDITH I GOSSAN FEDERAL WAY WA 98023-3823
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.
Q
UFER Ground (4295)
Q
Ditch cover (4030)
0
Slab/Concrete Floor (4255)
Approved
Approved
Approved
Approved
Approved
Approved to place concrete
Date
By
Date
By
Date
By
Date
Date
®
Pool Bonding (4195)
®
Temporary Power (4275)
®
Service (4235)
Approved
Approved
Approved
By
Date
By
Date
By
Date
101 Final - Electrical (4055)
Approved
By i,�j Date
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
Final Electrical
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
101 Final - Electrical (4055)
Approved
By i,�j Date
Rough Electrical
0
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
RECEIVED
CITY OF
Federal Way FEB p B 2"
ELEC'T'RICAL
PERMIT APPLICATION
(,QMMOF U 1 SDA PMEF.IT NUMBER _
SITE ADDRESS: S
SUITE/UNIT/SPACE #
PROJECT VALUATION
$ 2700
ASSESSOR'S TAX/PARCEL #
-3 7 3 2 1-_ 0 O (� O
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
! ,
V 0
PROPERTY OWNER
NAME
yQ f A L C n/
PRIMARY PHONE
( ) -
MAILING ADDRESS
o S Lv 3 Co
E-MAIL
CITY
t/w
�S/T�ATE
ZIP
FAX
ELECTRICAL
CONTRACTOR
NAME
o d t �-e (,0 i Q G ��
PRIMARY PHONE
�-�3) zz- Y73
MAILING ADDRESS
6 Uji1, Z �� z
E-MAIL �t
o k/ It
CITY
rk*Nva ell,w�
STATE
ZIP
FAX
-
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
�Ile)
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
Sw� I1st Q� WYE \ 1 ti►.�` Z.Y
PRIMARY PHONE
( )
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
( )
PROJECT CONTACT
NAME
PRIMARY PHONE
( )
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 hich may be made by any person, including the undersigned, and filed against the city,
but only where suc laim arises out of reli ce of the city, including its officers and employees, upon the accuracy of the
information supplie to he city as a a fthi plication.
7 1
SIGNATURE: C '�"DATE �///
PRINT NAME:
Bulletin #160—April 14, 2016 Page I of 1 k:AHandouts\Electrical Permit Application
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