16-102483City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
4
Electrical
Permit #: 16 -102483 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: PROMINENCE HEALTH PLAN SERVICES
Project Address: 33820 WEYERHAEUSER WAYS Parcel Number: 215466 0040
Project Description: Install (4) base feed and (4) power,poles, alter/relocate (15) 20amp circuits, and panel to
panel connections for (57) work stations.
Owner
ARI?Iican
Contractor
HERON PARTNERS LLC
KENT F WILLING
RELIANT GROUP INC
PO BOX 22926
RELIANT GROUP INC
RELIAGI845D2 (3/28/18)
SEATTLE WA
360 MIDLAND DR
360 MIDLAND DR
98122
TUKWILA WA 98188
TUKWILA WA 98188
Additional Permit Information
Electrical Work Valuation?....................................3600 Is this an Online or C. application? ................. Yes
Is Use Educational or Institutional?.......................No Service greater Amps? ............................. No
b
Electrical Fixtures WWI
Circuits - Commercial .................... 15
PERMIT EXPIRES Tues, May 2
Permit Issuqd � y, Maya
I hereby certify that the above information is
the occupancy and the use will be in cVcori
40
Owner or
d that the co 4trVion on the above described property and
the laws, d regulations of the State of Washington
�d Fed y.
- —W Date: "' Z 3 /
CITY OF
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record -
INSPECTION REQUESTS: (253) 835-3050
16 -102483 -00 -EL Address: 33820 WEYERHAEUSER WAYS
HERON PARTNERS LLC 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.
UFER Ground (4295)
Ditch cover (4030)
Temporary Power (4275)El
Slab/Concrete Floor (4255)
1:1Approved
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
Temporary Power (4275)El
1:1Approved
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
❑
E]
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
1:1Approved
Right of Way
By
Date
By
Date
By
Date
CITY OF 44 -r
Federal Way
RECEIVED ELECTRICAL
MAY 23 2016 PERMIT APPLICATION
CITY OF FEDERAL WAY
CDS PERMIT NUMBER
1 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.
SIGNA
PRINT NAME:
TE ('-S/ Z j/ L'
Bulletin #160 —April 14, 2016 Page 1 of I k:\Handouts\Electrical Permit Application
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SUITE/UNIT/SPACE #
SITE ADDRESS: 7� '3 �c
z4- �] A v S J-2
PROJECT VALUATION
ASSESSOR'S TAX/PARCEL #
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
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L7
PROJECT DESCRIPTION
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Detailed description of work to
be included on this permit only
G .1
PROPERTY OWNER
NAME
f7 t�l?d'v
PRIMARY PHONE
( ) -
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
( )
NAME
PRIMARY PHONE
s- P
( )-57}- L 7�
MAILING ADDRESS
E- L
ELECTRICAL
j
iClgnt7GUR
CITY
STATE
ZIP
FAX
CONTRACTOR
WA STATE CONTRACTOR'S LICENSE
E ##
t; n
EXPIRATION DATE
12 1Y
A
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
7 —f//"
h.
PRIMARY PHONE
( ) -
MAILING ADDRESS
Kle-,j 7, / L L E-MAIL
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CITY
I
STATE
�-
ZIP
FAX
PROJECT CONTACT
NAME
ll
PRIMARY PHONE
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1 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.
SIGNA
PRINT NAME:
TE ('-S/ Z j/ L'
Bulletin #160 —April 14, 2016 Page 1 of I k:\Handouts\Electrical Permit Application
Ale?