14-100094f •
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: THE RETREAT
Project Address: 1901 SW 320TH ST
� Y
Electrical
Permit #: 14 -100094 -00 -EL
--J Inspection Request Line: (253) 835-3050
Project Description: Installing a new 20amp,120 volt service for cable amplifier.
Parcel Number: 132103 9102
Owner
ARRlican
Contractor
KEYBANK REAL ESTATE CAPITAL
TRI COUNTY ELECTRICAL SERVICES LLC
TRI COUNTY ELECTRICAL SERVICES LLC
11501 OUTLOOK ST STE 300
PO BOX 931
TRICOCE948DZ (3/13/14)
OVERLAND PARK, KS 66211
ANACORTES WA 98221
PO BOX 931
ANACORTES WA 98221
Additional Permit Information
Is this an Online or O.T.C. application?.................Yes. Is Use Educatio or Institutional? ....................... No
Service greater than 999 Amps? .............................No
Electrical Fb(t res
New Service: 0 - 100 amps (Comm 1
PERMIT EXPI onda
Permit Iss chi dnesday,
I hereby certify that the above information is ct and that t�;,
the occupancy and thttas�**T * a with the la ,
JJ�I nd Citi of Feditr
Owner or agent:
C
u
, JuI7, 2014
lanu 8, 2014
1W,tion on the above described property and
les and regulations of the S7;71;
ington
Way.
Date:—/
L
CITY OF
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
14 -100094 -00 -EL Address: 1901 SW 320TH ST
KEYBANK REAL ESTATE CAPITAL FEDERAL WAY, WA 98023-5165
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.
10 Service (4235) ❑ Final - Electrical (4055)
Approved Approved
By Date
By Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
RECEIVED
ELECTRICAL
CITY OF JAN 0 8 2014
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
/c I CDS y�
PERMIT NUMBER �f - I D 0 O LI�- 0 D
SITE ADDRESS:
Jap � b�
SUITE/UNIT/SPACE #
PROJECT VALUATION
$ 9 DO . ob
ASSESSOR'S TAR/PARCEL #
- _ _ _
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
La i2o�
- -
PROPERTY OWNER
NAME
PRIMARY PHONE
( ) -
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
// FAX
t ) -
ELECTRICALS
CONTRACTOR
NAME
PRIMARY PHONE
_s6p� —I -I l�
MAILING ADD a
l
E -MAH,
��� CZk� - �r_
CITYcc.)
STATE
V �l
ZIP
FIX
SM.
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
E
e- 148 D
FEDERAL WAY BUSINESS LICENSE #
NE
APPLICANT
NAME A
9
1/`-i�f/3470
PRIMAIPHONE
MAILING ADDRESS
C E- t./�
CITY
STATE
ZIP
( FAX
t ) -
PROJECT CONTACT
NAffiE
c�0 ®-��b)
PRIMARY PHONE
/_ -7-7 (�
k
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 clainq, which may be made by any person, including the undersigned, and filed against the city,
but only where such im ar*ses o t o the city, including its officers and employees, upon the accuracy of the
information su ed to the ' as a of t on.
SIGNATURE: DATE I 1
PRINT NAME: A
Bulletin # 160 -January 1, 2013 Page 1 of 2 klHandouts\Electrical Permit Application