13-102157!F R
City of Federal way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: RESTORE USA 56 LLC
Project Address: 30514 7TH AVE SW
Project Description: Service panel upgrade
Ellectrcal
Permit #: 13 -102157 -00 -EL
Inspection Request Line: (253) 835-3050
$p-151
Parcel Number: 178880 0780
Own
Applican
Contractor
RESTORE USA 56 LLC
INTEGRA SERVICES INC
INTEGRA SERVICES INC
10036 VAIMAY AVE NW
26910 92ND AVE NW SUITE C5-163
INTEGSI947NJ (8/17/14)
SEATTLE WA 98177
STANWOOD WA 98292
26910 92ND AVE NW SUITE C5-163
STANWOOD WA 98292
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps (F 1
PERMIT EXPIRES Monday, November 11, 2013
Permit Issued on Wednesday, May 15, 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 will be in accordance with the laws, rules and regulations of the State of Washington
the City of Federal Way.
Owner or agent: d-�------�' ��---- Date:
THIS CARD IS TO MAIN ON-SITE
Construction In ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 13 -102157 -00 -EL Address: 30514 7TH AVE SW
Project: RESTORE USA 56 LLC FEDERAL WAY, WA 98023-3922
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
❑ Rough Electrical (4225) Ceiling Cover (4020) Final - Electrical (4055)
Approved Approved Approved
By Date By Date By �- Z Date
UFER Ground (4295)Service
(4235)
Final Electrical
Approved
Feeders/Sub-panels (4045)
Approved
By
Approved
Approved
By
Date
By
Date
By
Date
❑ Rough Electrical (4225) Ceiling Cover (4020) Final - Electrical (4055)
Approved Approved Approved
By Date By Date By �- Z Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF A.
Federal Way
0 RECEIVED 0
MAY 15 2013 ELECTRICAL
CITY FEDEPAL APPLICATION
PERMIT NUMBER 10,-9-
1 � T- C L/
4z -
SITE ADDRESS: , ` `' ® C _ \
SUITE/ UNIT/ SPACE
PROJECT VALUATION
k ASSESSOR'S TAXj PARCEL s
TENT/PROPOSED USE
$ 1100
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
4e% -4 e Gr v u v L—Now%m '_iM
PRIMARY PRONE
t2v(o) lq r 369
MAILING ADDRESS I
ibC�`3�o �i�`rv�a NW
E-MAIL
CITY
S t 0-
STATE
ZIP
FAX
+gz 89('019
NAME
Se yr v \ S
PRIMARY PRONE
Zn(o �$-
rk hc,
7020
MAILING ADDRESS
EMAIL '
ELECTRICAL
CONTRACTOR
CITY
STATE
ZIP
FAX E
WA STATE CONTRACTOR'S LICENSE f EXPIRATION DATE
1:N'TtGS . q't�j
FEDERAL WAY BUSINESS LICENSE 6
NAME
PRIMARY PRONE
APPLICANT
{
MAILINGADD s
COIn
E-MAIL
a
CITY
STAT;77E
ZIP
( } FAX
5
ROJECT CONTACT
NAME
PRIMARY PRONE
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 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 inmestigation and defense of such claiml 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 apart of this application. ((��
SIGNATURE: `� DATE -I IV) 0.
PRINT NAME:
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