13-100346 • Electrical
City of Federal Way `
Community&Econ.Dev.Services Permit #: 13-10o346-00-EL
33325 8th Ave S
Federal Way,Fax
Inspection Request Line:ssoo3 (253) 835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: WORLD VISION BUILDING 2 - 1ST FLOOR LUNCHROOM
Project Address: 3455 S 344TH WAY Parcel Number: 222104 9006
Project Description: Low-voltage wiring for relocation of(2)notification devices.
Owner Applicant Contractor
WORLD VISION US FIRE SYSTEMS WEST INC(ELECTRICAL) FIRE SYSTEMS WEST INC(ELECTRICAL)
PO BOX 9716 206 FRONTAGE RD N FIRESWI055LW (6/16/13)
FEDERAL WAY WA 98063-9716 PACIFIC WA 98047-1023 206 FRONTAGE RD N
PACIFIC WA 98047-1023
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
Electrical Fixtures
Low Voltage-Fire Alarm(Comm( 1
PERMIT EXPIRES Sunday, July 21, 2013
Permit Issued on Tuesday, January 22, 2013
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use .- 'n accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way. ?
Owner or agen f�� Date: /— a 2-/J
• THIS CARD IS TO MAIN ON-SITE
CITY OF ,,,,` Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-100346-00-EL Address: 3455 S 344TH WAY
Project: WORLD VISION US 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.
LIFER Ground (4295) ❑ Ditch cover(4030) ❑ Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
O Pool Bonding(4195) 0 Temporary Power(4275) Service(4235)
Approved Approved Approved
By Date By Date By Date
o Feeders/Sub-panels(4045) El Rough Electrical (4225) to
Ceiling Cover(4020)
Approved Approved Approved
By Date By Date `By C .,Y Date . L_ \
Final-Electrical (4055)
• Approved
•<lq-- ----,_..z.: Date L5-- - / 1
❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
•
iRECEIV
` JAN 22 2013 ELECTRICAL
i CITY OF
Federal Way CITY OF FEDERAL EPRMIT APPLICATION
/n CDS
C
PERMIT NUMBER / _ // ® V a ( _ /
111 v SUITE/UNIT/SPACE#
SITE ADDRESS:34/5-5-- 5- 3 ,y4 7 i A.J ee,
PROJECT VALUATION ASSESSOR'S TAX/PARC # / CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name) fc. I/(f /0-,.? [ v4C'1 ��lr('/
PROJECT DESCRIPTION 1 /I 6-. ...7124y2 /(/.67 f-/-7"-C4:77ct �p C- c
Detailed description of work to
be included on this permit only
PRIMARY PHONE
PROPERTY OWNER NAME C f ,cr �� 0/,,c7-1
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`
MAILING ADDRESS J E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONEe X/ /te�/ e� (2.5j)fl/_ / , ill
MAILING ADDRESS
E-MAIL
ELECTRICAL 266 Fra n-f 7e ,Q ( A aple,fer re y s imiare1/,Cs/h
CONTRACTOR CI • STATE ZIP,. AX
�L'?� 609- fo Yl'1 (25) ) -3S"6 /3
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
,�o�-e y/r'orf`el• /z/ 3 ( //3 .19,7-6500( V-o6-t L
NAME PRIMARY PHONE
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APPLICANT MAILING ADDRESS;el t-Tri 1� y ( ) E-MAIL
CITY STAT ZIP FAX
��(,
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NAME ( ) PRIMARY PHONE
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 city as a part of this application. > /
SIGNATU DATE (/_ 2 v
3
PRINT NAME: //GT/1/ e( ,`/1f7,`?9
Bulletin#160—January 1,2013 Page 1 of 2 k:U-Iandouts\Electrical Permit Application