13-100560 •
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��,��, ELECTRICAL
CITY OF I�e""'rr.n/
Federal Way PERMIT APPLICATEforD
PERMIT NUMBER ( . _ 1, 0 0 5 & 0 _ 00 FEB 0 5 2013
CITY OF FFDERA�WAY
(^ `W2_3
SUITE/UNIT/SPACE aDs
SITE ADDRESS: L J , 1 s Vim' _5 S‘ S r I' e ci y ro ( I.U,��. IA,A `7.s1�>?j 11..
PROJECT VALUATION ASSESSOR'S TAX/PARCEL F CURRENT/PROPOSED USE
$ 2,5-CC `.---- -
PROJECT NAME /J
(Tenant or Homeowner Last Name) //!i re_ i7 i { l / /
I�hd.te C- . 1.4.•1-0, Cc', i'�4(, '(c' /- t:• ,L1r).L C 1
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER A1 4 ' d (2`i3 ) 75". `2- 0)
MAILING ADDRESS E-MAIL
2 15/ SL' 136-r--' 5 7
CITY STATE ZIP FAX
NAME PRIMARY PHONE
1-} 4-0 (i,/, ),le s LLC: 021) <” /2.s3
MAILING ADDRESS / E-MAIL
ELECTRICAL 20 3 4� -e l,'At if IA:
CONTRACTOR CITY STATE ZIP FAX
6-r',,,i i-c Ao/lc W.4" q'/25-2_ ( ) -
WA STATE CONTRACTOR'S LICENSE F EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE F
H I-1 (-4 8i-f C 3g9— 6 1 7 II) i2 -io3x66 --co-ez_
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
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 cityasa part of this application.
SIGNATURE: '� /11..c. .` DATE 2 - S )"5
PRINT NAME: 1 K.'r ,- i .7 l i''�G+/ iS cn" 1
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\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
Project Name: RITE AID
Project Address: 2131 SW 336Th ST
-Electrical
Permit #: 13 -100560 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 873217 0030
Project Description: Install low voltage wiring for voice and data cabling for associated tenant improvement
Owner
ARRIicant
Contractor
RITE AID CORPORATION #5186
H & H CABLING LLC
H & H CABLING LLC
PO BOX 3165
203 ANGELINE AVE
HHCABHC895BG (IM15)
HARRISBURG PA
GRANITE FALLS WA 98252
203 ANGELINE AVE
17105
GRANITE FALLS WA 98252
Additional Permit Information
Is this an Online or O.T.C. application? ................. es Is Use Educational or Institutional? ....................... No
Service greater than 999 Amps? .............................No
Electrical Fixtures
Low Voltage - Other (Commercial 1 _ �l
PERMIT EXPIRES Sunda
Permit Issued on Tuesday,
I hereby certify that the above information is correct and tha a cons
the occupancy and the use will be in accordangeyw�lpmililqolbws, rules
th f Federal W19
Owner or agent:
s V _
OZZ )CO
I
At 4, 2013
ry5,%013
above described property and
s of the State of Washington
Date.
CITY OF
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
13 -100560 -00 -EL Address: 2131 SW 336TH ST
RITE AID CORPORATION #5186 FEDERAL WAY, WA 98023-2847
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.
Pool Bonding (4195)
UFER Ground (4295)Ditch
cover (4030)
Final Electrical
Slab/Concrete Floor (4255)
Service (4235)
Approved
By
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
Rough Electrical
Approved
Temporary Power (4275)
Final Electrical
Service (4235)
Approved
By
Date
Approved
By
Date
Approved
By Date
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By Date
By
Date
±ME�
Date _�� _
Final - Electrical (4055)
Approved
By Date
Rough Electrical
Approved
1:1Approved
Final Electrical
E:iRight
of Way
Approved
By
Date
By
Date
By
Date
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