16-101868City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Electrical
Permit #: 16 -101868 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: GNC LIVE WELL
Project Address: 1413 S 348TH ST. Unit 1,402
Project Description: Relocate (2) fire alarm devices 10from existing location
Parcel Number: 185295 0090
Owner
A n�
Contractor
G N C LIVE WELL
FIRE SYSTEMS WEST INC (GENERAL)
FIRE SYSTEMS WEST INC (ELECTRICAL)
300 6717-1 AVE
206 FRONTAGE RD N
FIRESWI055LW (6/16/17)
PITTSBURGH PA 15222
PACIFIC WA 98047-1023
206 FRONTAGE RD N
PACIFIC WA 98047-1023
Additional Permit Information
Electrical Work Valuation?...............................::....500.00 Is this an Online or O.T.C. application?................ Yes
Is Use Educational or Institutional? ....................... No Service greater than 999 Amps? ............................. No
Electrical Fixtures
Low Voltage - Fire Alarm (Comm( 1
PERMIT EXPIRES Tuesday, April 18, 2017
Permit Issued on Monday, April 18, 2016
1 hereby certify that the above infor ation is correct and that the construction on the above described property and
the occupancy and the use will bei accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date: I
CITY CW
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUE TS: (253) 835-3050
16 -101868 -00 -EL Address: 1413 S 348TH ST Unit L-102
G N C LIVE WELL 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.
Final - Electrical (4055)
Approved
By 1% Date
UFER Ground (4295)El
Ditch cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By 1% Date
Pool Bonding (4195)
❑
Temporary Power (4275)
Service (4235)
By
Approved
By
Approved
By
Date
Approved
By
Date
By
Date
By
Ka Date y� 6
Rough Electrical (4225)
E]
Ceiling Cover (4020)
Feeders/Sub-panels (4045)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By 1% Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF
Federal Way
PERMIT NUMBER 1 0
ELECTRICAL
PERMIT APPLICATION
RECEIVED
APR 18 2016
SITE ADDRESS:
/y/S
T/p
. 3�/� -- s i
CDS
IT/SPACE #
L.
OJT VALUATION
ASSESSOR'S TAC
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.
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
/t N � r— 1 A' �
l� Vel
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
%f -C tOCr e�—
r,/1�'
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PROPERTY OWNER
NAME
PRIMARY PHONE
( ) —
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
(
-
ELECTRICAL
CONTRACTOR
NAME
r-, _ - w —
��
PRIMARY PHONE
(�S-3 e633 - 12"ICK
MAILING ADDRESS
E-MAIL
CITY
SfATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
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FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAMEPRIMARY
Si4�t
PHONE
( )
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
4— �,� A L 1,4
A /
PRIMARY PHONE
( ) '75,1 — L0
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 ofclaim), which may be made by any person, including the undersigned, and filed against the city,
but only where such claim arise o t of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to th9 city part of this application.
SIGNATURE: ^ n it DATE
PRINT NAME: { r �AL_
Bulletin # 160 —January 1, 2013 Page 1 of 2 k:�Handouts\Electrical Permit Application