14-104173, f
City of Federal Way electrical .
Permit #: 14 -104173 -00 -EL
Community &Econ. Dev. Services
33325 8th Ave SFILL:
Federal Way, WA 98003 Inspection Request Line: 253 835-3050
Ph: (253) 835-2607 Fax: (253) 835-2609 p 4
Project Name: SIGNATURE HOME HEALTH
Project Address: 909 S 336TH ST Unit 202 Parcel Number: 926480 0150
Project Description: Relocate (4) low -voltage thermostats.
Owner
ARplicant
Contractor
OMNI PROPERTIES INC
MACDONALD MILLER FAC SOL INC
MACDONALD MILLER FAC SOL INC
909 S 336TH ST SUITE 103
(ELECTRICAL)
(ELECTRICAL)
FEDERAL WAY WA 98003
7717 DETROIT AVE SW
MACDOMF972BF (1/6/15)
SEATTLE WA 98106
7717 DETROIT AVE SW
SEATTLE WA 98106
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
Thermostat ..................................... 4
PERMIT EXPIRES Wednesday, February 11, 2015
Permit Issued on Friday, August 15, 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: a—Date: ?,-/ { y � t Y
CITY OF ,
Federal Way
THIS CARD IS TO MAIN ON-SITE
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
PERMIT #: 14 -104173 -00 -EL Address: 909 S 336TH ST Unit 202
Project: OMNI PROPERTIES INC 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.
UFER Ground (4295)
❑
Ditch cover (4030)
Final Electrical
Slab/Concrete Floor (4255)
1:1Approved
Approved
Temporary Power (4275)
Approved
Date
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
1:1Approved
Final Electrical
1:1Approved
Temporary Power (4275)
Service (4235)
Date
Approved
By
Date
Approved
By
Date
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
X,
Final - Electrical (4055)
Approved
Bycop—
Dated
Rough Electrical
Approved
1:1Approved
Final Electrical
1:1Approved
Right of Way
By
Date
By
Date
By
Date
CITY OF
Federal Way
� PacemED ELICTRICAL
AUG 15 2014 PERMIT APPLICATION
CITY OF FEDERAL WAY
PERMIT NUMBER
I certify under penalty of perjury that I am the property owner or authorised agent of the property owner. I certify that to the best
of my knowledge, the Wormation submitted in support of this permit application is true and correct. I cert((y 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 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
Wormation supplied to the city as apart of this application.
8IGNATURE: �`'— DATE 08-14-2014
PRINT NAME: DARLA DOLL
Bulletin #160 — January 1, 2013 Page 1 of 2 k:\landouts\Electrical Permit Application
SUITE/UNIT/SPACE k
SITE ADDRESS: 909 SOUTH 336TH ST STE# 202 FEDERAL WAY, WA 98003
STE# 202
PROJECT VALUATION
ASSESSOR'S TAR/PARCEL Y
CURRENT/PROPOSED USE
$ 1,000.00
9 2 6 4 8 0- 0 1 5 0
HEALTH CARE
PROJECT NAME
OMNI OFFICE BLDG - SIGNATURE HOME HEALTH OFFICES
(Tenant or Homeowner Last Name)
RELOCATE 4 EXISTING LOW VOLTAGE T -STATS
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
OMNI PROPERTIES INC.
( )
MAILING ADDRESS
909 S 336TH ST
E-MAM
N/A
CITY
STATE
ZIP
FAX
FEDERAL WAY
WA
I
98003
( ) -
NAME
MACDONALD MILLER FAC SOL
PRIMARY PHONE
206) 768 - 4278
MADnQOADDREsB
j0�� LECTRICAL
3� E
7717 DETROIT AVE SW
darla.doll@macro ler.com
CITYsTATE
zIP
FAS
CONTRACTOR
SEATTLE
WA
98106
206 768 - 4279
WA STATE CONTRACTOR'S LICENSE Y ERPIRATION DATE
FEDERAL WAY BUSINESS LICENSE
MACDOMF972BF 01 / 06 /2015
20 -03 -10072 -00 -BL
NAME
PRIMARY PHONE
APPLICANT
MACDONALD MILLER FAC SOL
206 768 - 4278
MAUMO ADDRESS
E -MAH,
7717 DETROIT AVE SW
darla.doll@macmiller.com
CITY
SEATTLE
STATE
WA
ZIP
98106
FAX
( 206 768 - 4279
PROJECT CONTACT
NAME
TIM FELTON
PRIMARY PHONE
( 206 ) 396 - 9641
I certify under penalty of perjury that I am the property owner or authorised agent of the property owner. I certify that to the best
of my knowledge, the Wormation submitted in support of this permit application is true and correct. I cert((y 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 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
Wormation supplied to the city as apart of this application.
8IGNATURE: �`'— DATE 08-14-2014
PRINT NAME: DARLA DOLL
Bulletin #160 — January 1, 2013 Page 1 of 2 k:\landouts\Electrical Permit Application