13-102845 ELECTRICAL
CITY OF
Federal Way PERMIT APPLICATION
RECEIVED
PERMIT NUMBER ' - I 0 Z 0 45- 'co
- - - - - JUN 2-62013
SITE ADDRESS: -7 �G'< 14V.9_1 orayEd6N�EeWAY
GG�'�JDD �c° S. /tco� ea� �8003 CDS
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ -
PROJECT NAME
(Tenant or Homeowner Last Name) /2imay/
1'121 Se i a/C f'- 06✓ r'l ( J&
� f
PROJECT DESCRIPTION e-c/E'_ 'X)t 5 L•c Ael 5 d/r C. /Pt Sr ee Led ,. ,,,
Detailed description of work to ,VU.7 Zo e/L e-/`'i'y-e_..
be included on this permit only N p 7e ° /O/14k) /01// gip /90-.-re, R13/41 Bite /1/
j S.
#'/03 fe de to l 1.J43y 11....s. /6,y :7"0 4n',`/dif.
NAME PRIMARY PHONE
PROPERTY OWNER A"/L i - S '#/cam 4e_I^- (ai ?) B 3B- ‘810
MAILING ADDRESS /, E-MAIL ^
/200 .9- 33& z� SL VBG ' /440 id)ftwi;`Se.4✓s`-ee CIeX ta.cci
CITY STATE ZIP FAX
//;a/e-'11=t- ( 11)m 1 Q2, 746 00 3 ( 5:3) yt - -78 1
N ME 7 lit ! IePHONE
ci"1C- (R-53)3333-1170
MAILING ADDRESSEMAIL
ELECTRICAL ,31 c 3`r' ,rj"JI"z-4 Ave., L t 1�e cr,`r #0'f04#40:),C004
CONTRACTOR CITYSTATE ZIP FAX
,4 v t,ead 'iG f',4, `1800/ ( ) _
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
7t PI **o33))f 3 / 6 //,.5' 18 /of'>z6.4 coo 0 1 91-
NAME J/ePRIMARY PHONE
APPLICANT &a� me-H '1 (2f3) e-0.8_ 90 gar
MAILING ADDRESS E-MAIL
31o3.( Jf tie ,4ie, S, er.
CITY STATE ZIP FAX
%v i7Lf/K.- (11 7 IF 0o/ ( ) _
NAME PRIMARY PHONE�p
PROJECT CONTACT h i;e k Ole 14-1 (21.3):hof'- 90 89
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 authorised 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: 0°//lerrd91
E ,J DATE ‘ - i' - `3
PRINT NAME: Jy I G K••,fe / Joie/ L�_'/
Bulletin#160-January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
Electrical
City Community& E reWay
Nices Permit #: 13 -102845 -00 -EL
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (2
53) 835-3050
Project Name: MULTI SERVICE CENTER
Project Address: 29404 PACIFIC HWY S Parcel Number. 304020 0079
Project Description: Service inspection to activate power for new tenant
Owner
Aq licant
Contractor
MULTI SERVICE CENTER
T C M ELECTRIC
T C M ELECTRIC
PO BOX 23699
31034 55TH AVE S
TCMEL"'033DF (3/6/15)
FEDERAL WAY WA 98003
AUBURN WA 98001
31034 55TH AVE S
AUBURN WA 98001
Additional Permit Information
Is this an Online or O.T.C. application? ................. es Is Use Educational or Institutional? ....................... No
Electrical Fi
Alt. Serv./Feeder: 0 to 200 amps (F 1
PERMIT EXPIRES Mon
Permit Issued on Wedi
I hereby certify that the above information is correct and
the occupancy and the use will be in acoordance with ti
and the(;itVo
Owner or agent -CA;;kK
A
,D� r23,2013
i`y, a 26, 2013
atmcons ction on the above described property and
WS, rules d regulations of the State of Washington
Federal WA
kDate: 4� - W6 - /3
%roor
e•
Q
CITY CSF
Federal Way
PERMIT #:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
13 -102845 -00 -EL Address: 29404 PACIFIC HWY S
Project: MULTI SERVICE CENTER FEDERAL WAY, WA
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.
0
UFER Ground (4295)13
Ditch cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
0 Final - Electrical (4055)
Approved
By Date
El
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
Pool Bonding (4195)
Temporary Power (4275)
Service (4235)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Ceiling Cover (4020)
Rough Electrical (4225)
Feeders/Sub-panels (4045)
Approved
Approved
Approved
By
Date
By
Date
By
Date
0 Final - Electrical (4055)
Approved
By Date
El
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date