13-103806• AIIIII 1 ,48a EESEATTLE 2067680151 p.2
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CITY OF
ELECTRICAL
Federal Way PERMIT APPkWAWg6:11%1
PERMIT NUMBER I _ 1 0 3 6 0 Co 00 AUG 2 8 2013
_� CITY OF FEDERAL WAY
SITE ADDRESS: >" kip g�TE/o EMCE# 1
l C�L� S 0( l(1 32c' .SC i=a)EgA L. A)Ay'' WA 2.0 S _
PROJECT VALUATION ASSESSOR'S TAX/PARCELS CURRENT/PROPOSED USE
500 .
l 7-- Z- I (2 zi- - 1 I ( 47-- of- 1/4).)D12_,-seAc II
PROJECT NAME + AI�r 4� C4-1.01C
tf tO1 �E `CL
(Tenant or Homeowner Last Name) �JANiT 1 —1
P-1,:N v,/ R TACktCA Ct, /REPLACE FSA I.PACAr(C.,
PROJECT DESCRIPTION sLI Q p/4/Nl l-s
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ( ) _
MAILING ADDRESS E-MAIL
QTY STATE ZIP
FAX
NAME
PRIMARY PHONE-- -- ------
et.ti -t cAA— I<?,: ^v-sS Seiertrtie. c iNi c, (20(c )7- C- 2331—
MAILING ADDRESS E-IAI1.
ELECTRICAL Po toc 4-E'6/7 EeSc-Ae-@ NOT Akk., �
CONTRACTOR CISTATE ZIP FAX
ITS'aqTrie- WA , 9S14(> (zoo )7(4 -O(cI
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE f
e i ec. - 9SS&L i2-// I( / t
NAME PRIMARY PHONE ----_-._-..
APPLICANT \ eNt4;µe>✓' R ///c!c -iC er- SUCJTc . (20(a) L 5' -2334-
' MAILING ADDRESS EMAIL
?c> l3 e)<_4lo q s carr(-W 46 mAcL-C. r
CITY STATE ZIP FAX
SC93147C GEWA ' 4(, (2-C(F' ) ($ -Di Si
NAME PR>MARY PHONE
PROJECT CONTACT
jet v Pt (2.0(p ) '-SS -2-334--
r
2334-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 that I Will comply nth withe
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 erwironmental 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: �} DATE t7-4D V
PRINT NAME. JCt').44- RY
Bu1Ietin#160 January 1,2013 Page 1 of 2 k:1EIandouts\Electrical Permit Application
A
Electrical
Comm Wily&Econ.City of �Devv..Services ay
FILEPermit #: 13-103806-00-E L
33325 8th Ave S
Federal Way,WA 98003
Ph;(253)835-2607 Fax:(253)835-2609 • Inspection Request Line: (253)835-3050
Project Name: CHOICE DENTAL LABORATORY
Project Address: 1025 S 320TH ST Suite 205 Parcel Number: 172104 9117
Project Description: Install new receptace circuits and replace subpanel
Owner Applicant Contractor
STEAD VOGEL&MOTLAND ELECTRICAL EXPRESS SEATTLE INC ELECTRICAL EXPRESS SEATTLE INC
1025 S 320TH ST SUITE 204 PO BOX 46877 ELECTES955QC(5/31/15)
FEDERAL WAY WA 98003 SEATTLE WA 98146 PO BOX 46877
SEATTLE WA 98146
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Service greater than 999 Amps? No
Electrical Fixtures
Alt.Srvc/Feeder 0 to 200 amps(C 1 Circuits-Commercial.... 1
PERMIT EXPIRES MouidgA
y, ruary 24, 2014
Permit Issued on We - , August 28, 2013
I hereby certify that the above information is correc� at e construction on the above described property and
the occupancy and the use will be in accordance w' the law rules and regulations of the State of Washington
SeeA
0 . : ,.„.r I Way.
Owner or agent: _ Date:
9 ' 1628 -,:, ,
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. THIS CARD IS TO REMAIN ON-SITE '
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 13-103806-00-EL Address: 1025 S 320TH ST Suite 205
Project: STEAD VOGEL & MOTLAND 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.
❑ LIFER Ground(4295) 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
0 Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
O Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) '❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By<, Date 7O1 Date
0 Final-Electrical(4055)
Approved
By Date
❑ Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date