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13-101438 REc © ELECTRICAL CITY OF Federal Way MAR 22 2013 PERMIT APPLICATION CITY OF FEDERAL W / • PERMIT NUMBER /3 _ 0 �2Dy3 - a c SUITE/UNIT/SPACE# SITE ADDRESS: I g Q L Coom O S PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE $ 11 00 .00 `7Cp0)- ,)-'- Y0 - OO / 6 PROJECT NAME Va.V1A.0V E UD ' e_Ujv (Tenant or Homeowner Last Name) PROJECT DESCRIPTION ail dLo . vci, t Detailed description of work to be included on this permit only NAME PRIMARY PHONE PROPERTY OWNERF „Q L1 ( ) - MAILING ADDRESS r E-MAIL 0 CITY STATE ZIP FAX ( ) - NAME. PRIMARY PHONE MAILING ADDRESS E-MAIL ELECTRICAL S ( O 30` - SN/3 CONTRACTORC STATE ZIP FAX rel )a --k u - SO2-g 3 (2 )a'? 1 - sits? WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# D t,eC,, E $l7b5 /4 /2.3 /) s N f,, -� PRIMARY PHONE APPLICANT "` f:\ �'� ps3)�l� `fq U MAILING DRESSF.-MAIL 33�h o 3 SO avIna.C- .elrzc na— -hvia-, 1,0000 CITY STATE ZIP FAX NAME 3 -c is 4q y 6 Z 3 ( ) - - PRIMARY PHONE PROJECT CONTACT a A„ `la(Ate S caZ- )-7/0- c9 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. SIGNATURE: OA J DATE ✓/ a l /1 3 PRINT NAME: in n , 1 1c_o Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application t 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: FAMOUS FOOTWEAR a Project Address: 1804 S COMMONS j Project Description: Add 6 circuits r' Electrical Permit #: 13 -101438 -00 -EL Inspection Request Line: (253) 835-3050 Parcel Number: 762240 0010 Owner FAMOUS FOOTWEAR ARRlicant AYSHA PIKO Contractor D & A ELECTRIC LLC 1804 S COMMONS D & A ELECTRIC LLC DELEC'E897D5 (4/24/13) FEDERAL WAY WA 98003 33410 30TH AVE SW 33410 30TH AVE SW FEDERAL WAY WA 98023 FEDERAL WAY WA 98023 Additional Permit kftnnaftn PERMIT EXPIRES Sunday, Permit Issued on Friday, M I hereby certify that the above information is correct and that the occupancy and the use will be in accordance with U** Owner or agent: bove described property and of the State of Washington Date: E J d2 q 1( 3 CITY or Federal Way THIS CARD IS TO REMAIN ON-SITE Construction Inspection Record INSPECTION REQUESTS: (253) 835-3050 PERMIT #: 13 -101438 -00 -EL Address: 1804 S COMMONS Project: FAMOUS FOOTWEAR FEDERAL WAY, WA 98003 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 1:1Approved UFER Ground (429) Ditch cover (4030) Slab/Concrete Floor (4255) Date Approved Approved Approved to place concrete By Date By Date By Date Date Pool Bonding (4195) Temporary Power (4275)El Service (4235) Approved Approved Approved By Date By Date By Date 13 Feeders/Sub-panels (4045) Rough Electrical (4225) Ceiling Cover (4020) Approved Approved Approved By Date By Date By Date Final - Electrical (4055) Approved By Date Rough Electrical Approved Final Electrical Approved 1:1Approved Right of Way By Date By Date By Date