15-100326{� Electrical
Community& Econ. D'ev. Services Permit #: 15-100326-00-EL
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: 253 835-3050
Ph: (253) 835-2807 Fax: (253) 835-2609 p q
Project Name: CELEBRATION CENTER
Project Address: 32225 PACIFIC HWY S Parcel Number: 150050 0100
Project Description: Provide power to tenant directory sign at the southeast corner of the lot of Celebration
Square Building B & Bl.
Owner
ARRIacant
Contractor
HARSCH INVESTMENT PROPERTIES
JOE GISEBURT
EVERGREEN ELECTRICAL SYSTEMS
PO BOX 2708
EVERGREEN ELECTRICAL SYSTEMS
EVERGES904CH (2/13/16)
PORTLAND OR 97208
1900 W NICKERSON ST SUITE 116-9
1900 W NICKERSON ST SUITE 116-9
SEATTLE WA 98119
SEATTLE WA 98119
Additional Permit infonnation
I hereby certify that the above inform,
the occupancy and the use will be in
Owner or agent:
City
that thenon on the above described property and
gtlawL s and regulations of the State of Washington
Date: l ` ;2,;,7 — )_57
CITY or,
THIS CARD IS TO REMAIN ON-SITE
iN�rMi,
Construction Inspection Record
Federal Wad/ INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 15 -100326 -00 -EL Address: 32225 PACIFIC HWY S
Project: HARSCH INVESTMENT PROPERTI FEDERAL WAY, WA 98003-6000
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.
11 Final - Electrical (4055)
Approved
By Date
LIFER Ground (4295)Ditch
cover ( 3)
E]
Slab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
XO , Date `!)
By
Date
11 Final - Electrical (4055)
Approved
By Date
Pool Bonding (4195)
0
Temporary Power (4275)Service
(4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Rough Electrical (4225)
Ceiling Cover (4020)
Feeders/Sub-panels (4045)
Approved
Approved
Approved
By
Date
By
Date
By
Date
11 Final - Electrical (4055)
Approved
By Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
1%
ELECTRICAL
CITY OF JAN 2 2 2015
Federal Way PERMIT APPLICATION
j /C�ITYOF FEDERAL WAY
CDS
PERMIT NUMBER 1� - / ,' 0 3 -:)L (a- CSL,
SITE ADDRESS:
SITE ADDRESS' fa)�c
SUITE/UNIT/SPACE i
PROJECT VALUATION
y � 00
ASSESSOR'S TAX/PARCEL #
-
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)�(/�
i U e TLti/v
.lCC4
ice.
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
- C-03 (,P - r{)( /Siz
1,y Q .•.
NAME
PRIMARY PHONE
PROPERTY OWNERL�(
)
-
MAILING ADDRESS
E-MAIL.
CITY
STATE
ZIP
( }}
l J
FAX
_
NAME
PRIMARY PHONE
0l � lr
MAILING ADDRhSS
-
E -MAD.
ELECTRICAL—
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STAjTTE{CONTRACTOR'S LICENSE # ,/i
f
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
�f9'�- (J"� .��'✓ U /' f .""
"_� � �
( )
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE I
ZIP
((
t
FAX
PROJECT CONTACT
NAMEPRIMARY
(cf
PHONE
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I certify under penalty of perjury that I am the prgperty 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 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
irkformation supplied to the city as a part of this application.
SIGNATURE:
PRINT NAME:
TE-
Bulletin #160 -January 1, 201.3 Page 1 of 2 k:\Handouts\Electricd Permit Application