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17-101528City of Federal Way Community Development Dept. 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 835-2607 Fax: (253) 835-2609 Project Name: FRED MEYER . Project Address: 33702 21ST AVE SW Project Description: Install security gate at store entry t V Electrical Permit #:17 -101528 -00 -EL Inspection Request Line: (253) 835-3050 Parcel Number: 930100 0010 Owner Applicant Contractor FRED MEYER INC FOX ELECTRIC CO FOX ELECTRIC CO PO BOX 42121 PO BOX 42256 FOXELEC874BU (1/31/19) PORTLAND OR 97242 PORTLAND OR 97242 PO BOX 42256 USA PORTLAND OR 97242 USA Additional Permit Information Is this an Online or O.T.C. application? .................. Yes Circuits - Commercial 1 Low Voltage - Other (Commel 1 PERMIT EXPIRES Wednesday, 4 Ap4,20,01&1 ^ Permit Issued on Tuesday, April 4, 2017 I hereby certify that the above information is correct and the occupancy and t�asg will be in accorg Owner or agent: 411 10 - sec gvo cS (A VA _lk the couction e described property ik1 - ws, r les ations of the State of eral % '&'�rlda L P tAw14 tit bvrb J# urr or FedP,F31 Way PERMIT #: 1710152800 Project: FRED MEYER INC THIS CARD IS TO REMAIN ON-SITE Construction Inspection Record INSPECTION REQUESTS: (253) 835-3050 Address: 33702 21ST AVE SW 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. 0 UFER Ground (4295) Ditch cover (4030)El Slab/Concrete Floor (4255) Approved Approved Approved to place concrete By Date 1By W Date + I Jr,By Date ® Pool Bonding (4195) FE] Temporary Power (4275) ® Service (4235) Approved 1By Approved 1By Approved By Date By Date By Date 10 Final - Electrical (4055) Approved By Date Feeders/Sub-panels (4045) ® Rough Electrical (4225) ® Ceiling Cover (4020) Approved Approved Approved By Date By Date By Date 10 Final - Electrical (4055) Approved By Date Rough Electrical El Final Electrical Right of Way Approved Approved Approved By Date 1 By Date By Date CITY OF A Federal Way RECEIVED ELECTRICAL APR 0 4 2011 PERMIT APPLICATION CITY OF FEDERAL WAY COMMUNIZY DEVELOPMENT I PSRmT NVMBER (O I 5 z8 (�G SITE ADDRESS: 02- o2 S ave- 567 SUITE/UH T/SPACE # PROJECT 7�x� / P ASSESSO� L # © O _ 00 O C -— — — — — — — — CURRENT/PROPOSED USE PROJECT NAME (Tenant or Homeoumer Last Name) r �� PROJECT DESCRIPTION Detailed description of work to be included on this permit only %r� �-✓ ri a e - PROPERTY OWNER NAME PRDdARY PRONE ( ) - PAMUNO ADDRESS e+KAM CITY STATE ZIP FAX ELECTRICAL CONTRACTOR NAME �. &,42r C=- PRIDtARY PROn (9,7/)563 - 72/S - MAHM0_ADDRESS !' O !v k 'Y Z2 57� /E-MAIL 4�0� C� CITY P STATE I ZIP FAX - WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE 21�c_ FOK LL tC. 4S 7 L v I i 31 FEDERAL WAY SUSDnESS LICENSE # APPLICANT NAME PRIMARY PRONE ) MAD.ING ADDRESS E•MAD, CITY STATE I ZIP FAX PROJECT CONTACT NAMICPRDtARY 01CA � PRONE 7/ 563- 72i S- 1 cert(jy under penalty of perjury that I am the property owner or authorised agent of the property owner. I certify that to the beat of my knowledge, the igforination submitted in support R% this permit application is true and correct. 1 certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorised by the issuance of a permit. 1 understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, stats, or federal lawn regulating construction or environmental laws. I jiurther agree to hold harmless the City of Federal Way as to any claim (including costa, expenses, and attorneys' fees incurred in the investigation and def, of such claim), wh may lx made by any person, including the undersigned, and jlled against the city, but only where such el a* out of th re ce o e city, including its ofJleers and employees, upon the accuracy of the ififormation supj= the ei as apart of his applic o . h2 SIGNATURE: DATE PRINT NAME: 1)0,qall ALW 1r PERMIT CENTER t 33325 8th Avenue South t Federal Way, WA 98003-6325 253-835-2607 t FAX 253-835-2609 t permitcenter(if,citvoffederalway.com Bulletin #160 — April 14, 2016 Page 1 of 1 k:\I3andouts\Electrical Permit Application Lcn-