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18-104678R City of Federal Wry Community Development Dept. 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 835-2607 Fax (253) 835-2609 Project Name: LIFE CARE CENTER OF FEDERAL WAY Project Address: 1045 S 308TH ST Project Description: Revisions to access controls. Electrical Permit #:18 -104678 -00 -EL Inspection Request Line: (253) 835-3050 Parcel Number: 082104 9042 Owner Applicant Contractor LIFE CARE CENTER OF FEDERAL WAY LIFE SAFETY SERVICES INC LIFE SAFETY SERVICES INC 1045 S 308TH ST PO BOX 831 LIFESSI077QN (11/15/19) FEDERAL WAY WA 98003 ISSAQUAH WA 98027 PO BOX 831 ISSAQUAH WA 98027 Additional Permit Information Is this an Online or O.T.C. application? .................. Yes Low Voltage - Other (Commel 1 PERMIT EXPIRES Thursday, 3 October, 2019 Permit Issued on Wednesday, October 3, 2018 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 accordanceiwith the laws, rules and regulations of the State of Washington and the City of Federal Way. Owner or agent: . � ,fie—, Date: THIS CARD IS TO REMAIN ON-SITE F� Way THIS Inspection Record INSPECTION REQUESTS: (253) 835-3050 PERMIT #: 18104678 00 Address: 1045 S 308TH ST Project: LIFE CARE CENTER OF FEDERAL FEDERAL WAY WA 980034706 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. 4❑ UFER Ground (4295) 0 Ditch cover (4030) 0 Slab/Concrete Floor (4255) 0 Approved Approved IBY Approved to place concrete By Date By Date By Date 4❑ Pool Bonding (4195) © Temporary Power (4275) © Service (4235) 0 Approved Approved IBY Approved By Date By Date By Date 7❑ Feeders/Sub-panels (4045) ® Rough Electrical (4225) Final Electrical Ceiling Cover (4020) 0 Approved Approved Approved By Date By Date By Date 10 Final - Electrical (4055) Approved By Date �, `N4t 13 Rough Electrical Final Electrical 0 Right of Way Approved Approved Approved By Date By Date By Date CITY OF Federal Way RECEIVED ELEC'T'RICAL OCT 0 3 28% PERMIT APPLICATION CITY OF FEDERAL. WAY COMMUNITY DEVELOPMENT= PERMIT NUMBER SITE ADDRESS: / Q 5 .6. S 0$?t 5T. SUITE/UNIT/SPACE # PROJECT VALUATION j� .P J ObC�. OV ASSESSOR''SyTAX/PARCEL # CURRENT/PROPOSED USE PROJECT NAME (Tenant or Homeowner Last Name) A cA 5 S � p LIE6 CAge, CeAj "rf-A IMSTA94, Ki-IfAD5 S&L khca EL-4-VL,,099Y. L -t- WIA"fSlM rTT�RS RtCL VERS PROJECT DESCRIPTION R D Detailed description of work toFxisrwc,4L be included on this permit only PROPERTY OWNER NAME L.('Fj- Zs�sR O1` >:Jt�tl� `- *y PRIMARY PHONE cz 3) 9,'(I(p" �2_Z-"3 MAILING ADDRESS 10 W508=` 5s; E-MAIL CITY STATE ZIP FAX NAME / I r �� (/ �L.^VIC.L7 IAADD, PHONE F�) PRIMARY ! ob� MAILING DRESS E-MAIL - LSSYwA ELECTRICAL 1 ©X CITY STATE ZIP FAX CONTRACTOR WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE # f S N /1 1 /S 1l ©0).0606 -ova -32j -&0 - NAME M � S'�-Dir PRIMARY PHONE (`-r �! &43 - 005 APPLICANTP MAILIN ADDRESS ' o fox S 3 t E-MAIL L_ Ssswa &COMA CITY I sS�aNArr STAT W % ZIP '(goVT FAX (yzs)1ss - 0 -00 PROJECT CONTACT NAME M A - I u F, PRIMARY PHONE (2.-T3) q 4 (,- 2'2- IS 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 apart of this application. LF, NAME: C lr1 Bulletin 4160 -April 14, 2016 Page 1 of I k:\Handouts\Electrical Permit Application