15-103103-� Electrical
City o,Federal Way LE Permit #: 15 -103103 -00 -EL
Community &Econ. ev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835.2607 Fax: (253) 835-2609 Inspection Request Line: (253
) 835-3050
Project Name: DAVITA REDONDO HEIGHTS
Project Address: 27320 PACIFIC HWY S Parcel Number: 872992 0020
Project Description: Electrical work for tenant improvements to create 6,372 sqaure foot dialysis clinic.
Owner
ARRIOcant
Contractor
DAVITA
RANDALL DOVER
CURRENT ELECTRIC OF WA LLC
32275 32ND AVE S
RANDALL DOVER, ARCHITECT
CURREEW933DB (3/2/17)
FEDERAL WAY WA 98003
4121 HILLSBORO RDSUITE 303
14111 74TH AVE CT E
NASHVILLE TN 37215
PUYALLUP WA 98373
Additional Permit Information
Is this an Online or O.T.C. application?.................No Is Use Educational or Institutional? ....................... Yes
Service greater than 999 Amps?.............................Yes
Electrical Fixtures
Alt. Srvc / Feeder 0 to 200 amps (C 1
PERMIT EXPIRES Tuesday, March 8, 2016
Permit Issued on Thursday, September 10, 2015
I 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
Ad the City of Federal Way.
Owner or agent: � Date:
CITY OR
Federal Way
PERMIT #:
Project:
THIS CARD IS TOMAIN ON-SITE
Construction In ction Record
INSPECTION REQUE TS: (253) 835-3050
15 -103103 -00 -EL Address: 27320 PACIFIC HWY S
DAVITA 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)13
Ditch cover (4030)
Slab Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By Date
By Date
Dateg
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
0
0
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
d
CITY CW
Federal Way
ELECTRICAL
PERMIT APPLICATION
PERMIT NUMBER If _ /0 3 / V _ 6,V
SI 27320 Pacific Highway S.
SUITE/UNIT/SPACE #
PROJECT VALUATION
ASSESSOR'S TAR/PARCEL #
� 7 0
CURRENT/PROPOSED USE
(Tenant or Homeowner Last Name)
DaVita Redondo Heights Facility
Tenant Improvements for anew 6,372 sq. ft. Dialysis Clinic in an existing shell building
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
DaVita, Inc. -- Kristin Videto, Project Manager
PRIMARY PHONE
( 253) 606 -6191
MAUING ADDRESS
E.MAM
32275 32nd Ave. S.
kristin.videto@davita.com
CITY
STATE
21P
FAX
Federal Way
WA
98001
-
NAME
TBD G Tf`'_r
PRIMARY PHONE
_
MAnING ADD
E.MAU,
ELECTRICAL
CONTRACTOR
CITY
TE
aP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY NUSMWS LICENSE #
APPLICANT
NAME
Randall Dover, Architect
PRIMARY PRONE
615 ) 251 _3388
MAMMG ADDRESS
4121 Hillsboro Rd., Ste. 303
E.MAm
rd@rdover.net
CITY
Nashville
STATE
TN
ZIP
37215
FAX
( _
PROJECT CONTACT
NAME
Randall Dover
PRIMARY PHONE
1615) 251 _3388
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 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.
' DN. crrRamr oa«. o =Rayer om.. Naw.o. w..merryQimw,.nw. cws
J uam: nnis.osz iix:sosvo
SIGNATURE: DATE
PRINT NAME: Randall Dover
May 26, 2015
Bulletin #160 —January 1, 2013 Page 1 of 2 k: liandoutsUectfical Permit Application