17-100663qty of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 8352607 Fax: (253) 835-2609
Project Name: FRED MEYER
Project Address: 33702 21ST AVE SW
Electrical
Permit #:17 -10066300 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 930100 0010
Project Description: Relocate (1) 50 AMP circuit. Work to include removal, relocation and installation of a chicken
warmer.
Owner
Applicant
Contractor
FRED N EYER INC
IAN EDMUNDSSEA-TAC ELECTRIC, INC.
SEA -TAC ELECTRIC INC
PO BOX 42121
7056 S 220TH AVE
SEATAEI077RW (12/17/17)
PORTLAND OR 97242
KENT WA 98032
7056 S 220TH ST
KENT WA 98032
Additional Permit Information
Is this an Online or O.T.C. application? .............. Yes
Circuits - Commercial
PERMIT EXPIRES Friday, 9 Febp9ffiiy, 2018
Permit Issued on Thursday, Fe ary 9,1
hereby certify that the above information is corr nd the n t n on the above described property
and the occupancy and the use will b
in
a an ith the rules and regulations of the State of
Washi nd t City of Fe Way. /
Owner or agent: Date:Mar-
Cab
�{Q �v
THIS CARD IS TO REMAIN ON-SITE
arr of
Federal Way Inspection Record
y INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 17100663 00 Address: 33702 21ST AVE SW
Project: FRED MEYER INC FEDERAL WAY WA 98023-7762
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)
2❑
Ditch cover (4030)
3
Slab/Concrete Floor (4255)
Service (4235)
Approved
Approved
Approved
1By
Approved to Place concrete
By
Date
By
Date
By
Date
®
Pool Bonding (4195)
s❑
Temporary Power (4275)
®
Service (4235)
Approved
Approved
Approved
By
Date
By
Date
By
By
Date
0
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
®
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
By
Date
® Final - Electrical (4055)
Approved
By Date
Rough Electrical
'Approved
Final Electrical
Right of Way
Approved
Approved
By
Date
By
Date
By
Date
cm Of A
Federal Way
PERMIT
NUMBER
Ij
RECEIVED
FEB 09 2017 ELECTRICAL
ciTv OF FCDSRPL WAY PERMIT APPLICATION
_J00(�h3_�- �,
SITE ADDRESS: 33702 21 st Ave SW
SUITE/UNIT/SPACE #
PROJECT VALUATION
$ 500
� R'S TAX/CEL # O a o O (
3 _ (i _ _ -
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeoumer Last Name)
FRED MEYER
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
MON AND INSTALLATION OF MISQ- ELECTRICAL
SYSTEMS PERTAINING TO THE AFOREMENTIONED SCOPE OF
WORK.
PROPERTY OWNER
NAft6
FRED MEYER
PRISM" PHONE
( ► -
33702 2 ST AVE SW
FEDERAL WAY
1�Vi
8023
I I FAX
ELECTRICAL
CONTRACTORnNT
SEA -TAC ELECTRIC INC.
253-�7NAME 2 5553
'iM T TH ST
b""°
Corey.mdcinnon@seatacelectric.com
W�9032
253- 72-4112
WA 8TAT6 CONTRACTOR'S LICENSB # EXPIRATION DATE
SEATAE1077RW 12/1,6/16 i
FEDERAL WAY 8U8DNi88 LICENSE #
20-02-100376-00-131-
0-02-100376-00-BL1A
APPLICANT
1AEDMUNDS
PRIMARY PHONE
ti 130VE
a ->#An,
CITY
STATE
I ZIP
FAX
PROJECT CONTACT
NAME
DYLON PYLE
PRIMARY PHONE
(2063P50349
I cardfy under penalty of perjury that I am the property owner or authorised agent of the property owner. I certgy that to the best
of my knowledge, the h formation 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 authorised 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 ojfyicers and employees, upon the accuracy of the
Wormation supplied to the city as apart of this application.
SIGNATURE: IAN EDMUNDS DATE 2/9/2017
PRINT Nim: IAN EDMUNDS
Bulletin #160 — January 1, 2013 Page l of 2 k:\Iiandouts\Electrieal Permit Application