16-101892 •-5... a-, ,;�
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City of Federal Way Permit #: 16-101892
Community&Econ.Dev.Services -60-EL
33325 8th Ave S
Federal Way,Fax
98003 F ILE
Inspection Request Line: (253)8354050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: LIFE&HEALTH CHIROPRACTIC
Project Address: 720 S 348TH ST Bldg A-1B Parcel Number: 233145 0010
Project Description: (12)CAT6 low-voltage lines for IT system.
Owner Applicant Contractor
720 SOUTH 348TH ST LLC COMPUTER SYSTEMS SERVICE CORP COMPUTER SYSTEMS SERVICE CORP
11409 GRAVELLY LAKE DR SW PO BOX 58211 COMPUSS995LR(7/11/17)
LAKEWOOD WA 98499 SEATTLE WA 98138 PO BOX 58211
SEATTLE WA 98138
Additional Permit.information
Electrical Work Valuation? 1661 Is this an Online or O.T.C.application? Yes
Is Use Educational or Institutional? No Service greater than 999 Amps? No
Electrical Fixtures
Low Voltage-Other(Commercial 1
PERMIT EXPIRES Wednesday, April 19, 2017
Permit Issued on Tuesday,April 19, 2016
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 N1 ,„\\\ Date: H/ �� /4
QJ
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THIS CARD IS TO MAIN ON-SITE '
arVar' Construction In ection Record
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 16-101892-00-EL Address: 720 S 348TH ST Bldg A-1 B
Project: 720 SOUTH 348TH ST LLC FEDERAL WAY, WA 98003-7042
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.
o UFER Ground (4295) El Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
. .
o Pool Bonding(4195) 0 Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
o Feeders/Sub-panels(4045) El Rough Electrical(4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
ID Final-Electrical(4055)
Approved
By , Date .I` ,� (o
%
1=I ' Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
EtilitECTRICAL
CITY OF
APR 19 2016
Federal Way CITY ofERAL WAYPERMIT APPLICATION
CDS
PERMIT NUMBER /Ca _ / 0 ( g 9 - 00
SUITE/UNIT/SPACE#
SITE ADDRESS: } ?/414 6+. �}.-6 41- (3
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# -�- CURRENT/PROPOSED USE
$ 1:6 cf a A 3 3 r _ 0 o / 0
PROJECT NAME 1
(Tenant or Homeowner Last Name) ( 1` f.� 3 i_t'..t l4-h C-6I 0 r p,y,G 7-f
12 ea,÷-4 le LA/ v01- (Ot\-#i iCO,.-
PROJECT DESCRIPTION d r -f y S f".t,,
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
-
NAME PRIMARY PHONE
OM(llA ill r. 'yS+t'I. i 'S-t rVi.t4 COrp ( 113 ) Yy(- *III
MAILING ADDRESS E-MAIL
p
ELECTRICAL [ ,0 , (3 0X $LI 1 fN8 mei- M (s'--4-4r✓i t4.t 4"4
CONTRACTOR CITY STATE ZIP FAX
5-ftr .41,. in/4 lit36 (''7s3 ) It/r - 96s-(
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
cG cofripmfiogcLI q / H /r} zn-IL/_fol }1-i •0Q IL
NAMEPRIMARY PHONE
J-1 “ A. Alai- !,-ii 9 (2nd) 344 - -Cc?tret
APPLICANT MAILING ADDRESS E-MAIL
;116t- F 3i1 " VC Unbrii'?, 0 4f1 _5-trv,c .c r'
CITY STATE ZIP FAX
Et d.c,.a l 1.--a 1 t,v4 94a 0 I ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT
1"
L<s An /11644 (2,4..3 ) L J.t - is N y 2
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 city as a part of this application.
SIGNATURE: (\/\ DATE 14/16f/14
PRINT NAME: J't 4°I A) r ,'n
l
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application