16-101390Electrical
Community&E v.Services Permit #: 16 -101390 -00 -EL
33325 8th Ave S
Federal Way, WA 98003 253t Line: Request 8
Ph: (253) 835-2807 Fax: (253) 835-2809 Inspection Q 353050
Project Name: CARPET PLUS
Project Address: 34515 16TH AVE S Parcel Number: 889700 0055
Project Description: Run 20 amp 120V power from existing panel to new monument sign
Owner
ApRlicant
Contractor
KOBETS CONMERCIAL LLC
BK CHAE
AD ONE CORP (ELECTRICAL 04)
34515 16TH AVE S
AD ONE CORP
ADONEOC931DR (3/19/17)
FEDERAL WAY WA 98003
1626 S 341ST PL SUITE A-24
30833 PACIFIC HWY S
FEDERAL WAY WA 98003
FEDERAL WAY WA 98003
Additional Permit Information
Electrical Work Valuation?...................................250.00 Is this an Online or O.T.C. application? ................. Yes
Is Use Educational or Institutional? ....................... No Service greater than 999 Amps? ............................. No
Electrical -Fixtures
Circuits - Commercial .................... 1
PERMIT EXPIRES Tuesday, March 21, 2017
Permit Issued on Monday, March 21, 2016
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 accordance with the laws, rules and regulations of the State of Washington
a the City of Federal Way.
Owner or agent: Date: 1-
Cl" of
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
16 -101390 -00 -EL Address: 34515 16TH AVE S
KOBETS COMMERCIAL LLC FEDERAL WAY, WA 98003-6802
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.
UFER Ground (4295)
Ditch cover (4030)
0 Slab/Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By Date
By Maj Date 3 2- ((,
By Date
11 Final - Electrical (4055)
Approved
By Date
Pool Bonding (4195)
Temporary Power (4275)
-
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
11 Final - Electrical (4055)
Approved
By Date
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
CITY OF
Federal Way
ELECTRICAL
PERMIT APPLIC�A�TIION
-2
PERMIT NUMBER (Q9 _ 10 1 9 (D _ 00
MAR 21 2016
•/
SITE ADDRESS: 3�s i�-
(6-� Ave-,a
T
CDS.
PROJECT VALUATION
O�
A,S]IgESSQI s T Ai ik O _
(';`cam/ �``yJ(
O
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
c0ow 161+— r11 S
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
QN— I
PROPERTY OWNER
NAME
PRIMARY PHONE
-
MAILING ADD S
3 l b4(x A\,A S .
E -MAH.
CITY '' ,,__ oo
S,.TA1TE
ZIP n�j
FAX
ELECTRICAL
CONTRACTOR
NAME
AO a Nc coyT
PRIMARY PHONE
L- ; 68 ti
MAILING ADDRESS
3 �$ V _
E-MAIL
CITY G
�ew
STATE
vuA
ZIP
e 6o
FAX
WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE N
APPLICANT
NAME
0-k
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
( )
PROJECT CONTACT
NAME
�y _
PRIMARY PHONE
( ) Z - ;613d
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 taws 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 W reliance of the city, inctuding its officers and employees, upon the accuracy of the
information supplied to the city as a partof4his application.
SIGNATURE:
PRINT NAME:
4 l�
Bulletin # 160 —January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application