18-101708t %
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 -101708 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: FEDERAL WAY EAST/NORTHWEST KIDNEY CENTERS
Project Address: 33820 WEYERHAEUSER WAY S Parcel Number: 215466 0040
Project Description: Installation of power supply and disconnect switch for scissor lift at loading ramp.
Owner
Applicant
Contractor
RANDY THOWSONNORTHWEST KIDNEY
NORTHSTAR ELECTRICAL LLC
NORTHSTAR ELECTRICAL LLC
CENTER
PO BOX 1909
NORTHEL878QF (11/6/19)
700 BROADWAY
BOTHELL WA 98041
PO BOX 1909
SEATTLE WA 98122
BOTHELL WA 98041
Additional Permit Information
Is this an Online or O.T.C. application? .................. No
Circuits - Commercial 1
PERMIT EXPIRES Tuesday, 23 April, 2019
Permit Issued on Monday, April 23, 2018
1 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: 0#Date-
FINALED
s
CITY CW
Federal Way
PERMIT #: 18101708 00
5
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
Address: 33820 WEYERHAEUSER WAY S Unit 101
Project: RANDY THOMPSON FEDERAL WAY WA 98001
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.
El
UFER Ground (4295)
Ditch cover (4030)
0
Slab/Concrete Floor (4255)
Service (4235)
Approved
Approved
Approved to place concrete
By
Date
B�, S Date--—
By
Date
®
Pool Bonding (4195)
®
Temporary Power (4275)
®
Service (4235)
❑
Approved
Approved
Approved
By
Date
By
Date .
By
Date
�o Final - Electrical (4055)
Approved
4, Date
E
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
®
Ceiling Cover (4020)
❑
Approved
Approved
Approved
By
Date
By
Date
By
Date
�o Final - Electrical (4055)
Approved
4, Date
E
Rough Electrical
El
Final Electrical
❑
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
CITY Of 'A
Federal Way
RECEIVED ELEC'T`RICAL
APR 2 0 2018 PERMIT APPLICATION
CITY OF FEDERAL My % Q
COMMUN[TY DEVELOPMENTPERuue<IT NUMBER / —
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SITE ADDRESS: 3 3 V 2.0 ,► � tn/ '� i
SUITE/UNIT/SPACE #
100
PROJECT VALUATION
ASSESSORS TAM/PARCEL #
o
CURRENT/PROPOSED USE
$ 4_S7
J
-
PROJECT NAME
(Tenant or Homeoumer Last Name)
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
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PRDEARY PHONE
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PROPERTY OWNER
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CONTRACTORc>
WA STATE CONTRACTOR'S LICENSE # � � EXPIRATION DATE
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FEDERAL WAY BUSINESS LICENSE #
NAME POW VfrA4T
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APPLICANT
MAILING ADDRESS
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EMAIL
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FAX
PROJECT CONTACT
NAME � J.F'�1/'b�S'
("Z 06) (1(1R 3 Y PHONE k Q
I cert(jy 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 to 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 clainy, which may be made by any person, including the undersigned, and jlled 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 ct apart of this application. {,
SIGNATURE: X DATE
PRINT NAME: K.. I ^
PERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
Bulletin #160 —April 14, 2016 Page I of 1 k:\Ilandouts\Electrical Permit Application
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