15-106389 -+�,�.�,• ELECTRICAL
CITY OF ...;,..,
Federal Way PERMIT APPLICATION
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PERMIT NUMBER - ) 0 63 I _ �- DEC 17 2015
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SITE ADDRESS: -Li S i a , ' LA L..1 -rte t.,)A-,-/
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
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PROJECT NAME
(Tenant or Homeowner Last Name) 1 C'.j 0 2 0 •
PROJECT DESCRIPTION R c i 0 cm-W- % e..,T► +V A Low Vo LT T-<----i-A-.
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ( t._ (t-(V,)
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MAILING ADDRESS E-MAIL
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CITY l•/ STATS ZIP FAX
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NAME PRIMARY PHONE
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CONTRACTOR CITY STATE ZIP FAX
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WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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NAME PRIMARY PHONE
APPLICANT 1 r .:AL- --,-moi ��.-1 .11 i 'NJ C ( '`'6) Tr)- 7 3 S 5
MAILING ADDRESS • E-MAIL
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CITY STATE ZIP FAX
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PROJECT CONTACT
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), 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 ity as a part of this application.
SIGNATURE: / /rl /?\:...e._ DATE l2-/I 7 //S
PRINT NAME: \ -30 S e'0 Id-
Bulletin#160—January 1,2013 Page 1 of 2 k:AHandouts\Electrical Permit Application
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Electrical
Permit #: `15 -106389 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: TESORO
Project Address: 3450 S 344TH WAY Suite 135 Parcel Number: 222104 9040
Project Description: Relocate (3) existing low voltage thermostats for associated tenant improvement
Owner
Al2 lip cant
Contractor
LBA REALTY
PERFECT CLIMATE INC (GENERAL)
PERFECT CLIMATE INC (ELECTRICAL)
600 UNIVERSITY ST SUITE 3025
4426 221ST PL NE
PERFEC1969RN (12/15/16)
SEATTLE WA 98101
REDMOND WA 98053
4426 221 ST PL NE
REDMOND WA 98053
Additional Permit Information
Electrical Work Valuation?....................................500.00 Is this an Online or O.T.C. application? ................. Yes
Is Use Educational or Institutional? ....................... No Service greater than 999 Amps? ............................. No
a
Electrical Fixtures
Thermostat ..................................... 3
PERMIT EXPIRES Tuesday, June 14, 2016
Permit Issued on Thursday, December 17, 2015
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: V Date: / — % 1 S
THIS CARD IS TOAIN ON-SITE
CITY OFOA# Construction In UE Record
Federal Way nvsPECTION REQUE TS: (253) 835-3050
PERMIT #: 15 -106389 -00 -EL Address: 3450 S 344TH WAY Suite 135
Project: LBA REALTY 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.
Final - Electrical (4055)
Approved
By Date
®
UFER Ground (4295)Ditch
cover (4030)
❑
Slab/Concrete Floor (4255)
0
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date
®
Pool Bonding (4195)
❑
Temporary Power (4275)
0
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
E]
Rough Electrical (4225)
Ceiling Cover (4020)
Feeders/Sub-panels (4045)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date
®
Rough Electrical
Approved
Final Electrical
Approved
❑
Right of Way
Approved
By
Date
By
Date
By
Date