12-102679Project Name: SOPHIE'S PLACE ADULT FAMILY HOME
Project Address: 31428 28TH PL SW
Project Description: INSTALL 10 SMOKE
i
Electrical
Permit #: 12 -102679 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 150330 0170
Owner
i ..
City of Federal Way
EQUITY TRUST CORPORATION
Community &Econ. ev. Services
3338th Ave S
FILF
W
Federal Way, WA 98003
37107 12TH AVE S
Ph: (253) 835-2607 Fax: (253) 835-2609
SHORELINE WA 98133
Project Name: SOPHIE'S PLACE ADULT FAMILY HOME
Project Address: 31428 28TH PL SW
Project Description: INSTALL 10 SMOKE
i
Electrical
Permit #: 12 -102679 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 150330 0170
Owner
Applicant
Contractor
EQUITY TRUST CORPORATION
FULLER ELECTRIC INC
FULLER ELECTRIC (ELECTRICAL)
2334 N 192ND ST
37107 12TH AVE S
FULLEEI027BK (1/12/14)
SHORELINE WA 98133
FEDERAL WAY WA 98003
37107 12TH AVE S SUITE A-5
FEDERAL WAY WA 98003
Additional Permit Information
Is Use Educational or Institutional?.......................No
Electrical Fixtures
Low Voltage - Fire Alarm (Resides 1
PERMIT EXPIRES Saturday, June 14, 2014
Permit Issued on Thursday, June 14, 2012
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: _ ;,. �� i ^ Date:
to-
I * RD THIS CAIS TO MAIN ON-SITE
CITY OF Construction I ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT #: 12 -102679 -00 -EL Address: 31428 28TH PL SW
Project: EQUITY TRUST CORPORATION FEDERAL WAY, WA 98023-7837
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)
E:] Ceiling Cover (4020)
Final - Electrical (4055)
Approved
Approved
Approved
By Date
By Date
By Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF
Federal Way
PERMIT NUMBER J � _
PERMIT'*APPLICATION
MAR 2 2 2016
C V 1 CtIS AY �(.t;,(.t;,, — TARGET DATE /
SITE ADDRESS
SUITE/UNIT #
11"1 i�z n`�OLSw ed Q'�oz3
ROJECT VALUATION
$
ZONING ASSESSOR'S TAR/PARCEL #
0 3 Q_
Z 65
A-5
TYPE OF PERMIT
BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
Ge u)-,5
n
I 1 h 1� eW Q DO r
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
gclva I is
PRIMARY PHONE ^�
ZS-3PROPERTY
OWNER
MAILING ADDRESS
i
E-MAIL
3 z�fi" W
C STATE
Z
NAME
17 Yi n Rlncon,411tlG
PHONE
Z;-3 -q7-3-00433
MAILING ADDRESS
0 U
E-MAIL
CONTRACTOR
TYSTATjy
rW'' (/,(�J
ZIP ^� G/
FAX
WA STATE CONTRACTOR'S LICENSE #
7�D7
EXPIRATION DATE
I
FEDERAL WAY BUSINESS LICENSE #
1Hl0lo
nrU('
i X17
NAME
m I %V1
PRIMARY PHONE
ZSr 33 7
APPLICANT
MAILIN ADD S
z WIN N arc �
E-MAIL
ro
os
lined
CITY
null
STATE
IWA
ZIP,
W � �7
FAX
NAME
PRIMARY PHONE
PROJECT CONTACT
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
OWNER -FINANCED
When value is $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
I certify under penalty of perjury that 1 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 es out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to th ity a p f this application.
SIGNATURE: DATE
PRINT NAM
Bulletin #100 — February 22, 2016 Page 1 of 2 k:\Ilandouts\Permit Application