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18-105781Electrical convn�ry Development Dept. ' Permit #:18 -105781 -00 -EL 33325 8th Ave S A E Federal Way, WA 98003 t - Inspection Request Line: (253) 835-3050 Ph: (253) 835-2607 Fax: (253) 635-2609 Project Name: PACIFIC DENTAL BUILDING SHELL Project Address: 164 SW CAMPUS DR Parcel Number: 415920 0715 Project Description: Electrical for fire alarm. Owner Applicant Contractor FEDERAL WAY COVENANT GROUP LLC SHAWN LEHMANKIRBY ELECTRIC INC KIRBY ELECTRIC INC 17000 RED HILL AVE 4826 B ST NW KIRBYEI077BN (1/13/19) IRVINE CA 92614 AUBURN WA 98001 4826 "B" STNW SUITE 101 AUBURN WA 98001 Additional Permit Information Is this an Online or O.T.C. application? .................. Yes Low Voltage - Fire Alarm (Co PERMIT EXPIRES Saturday, 7 December, 2019 Permit Issued on Friday, December 7, 2018 I hereby certify that the above information is correct and that the construction on the above described property and the occupancy an he use will be in acc9rdance with the laws, rules and regulations of the State of Washi gton the City of Federal Way. Owner oragent: Date: 2 l THIS CARD IS TO REMAIN ON-SITE em or Iii; Construction Inspection Record Federal Way INSPECTION REQUESTS: (253) 835-3M PERMIT #: 1810578100 Address: 164 SW CAMPUS DR Project: FEDERAL WAY COVENANT GROt FEDERAL WAY WA 98023 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. Worm 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. Feeders/Sub-panels (4045) UFER Ground (4295) 2 Dltcb cover (4030) 0 Slab/Concrete Floor (4255) Approved Appy , Approved Approved Approved Date Approved to place concrete By Date By Dste By Date Date Feeders/Sub-panels (4045) Pool Bonding (4195) ® Tempo",,l"atwer (4275)]BY © Service (4235) Approved Approved Appy , By Date Approved By Date By D)M(e . , „ „, Date Feeders/Sub-panels (4045) r ® Rough Er Ceiling Cover (4020) Approved A ''. Approved By Date By Date., By Date Final - Electrical (4055) Approved By L Date 3 l pr.111, , L Q Rough Electrical Final Electrical 0 Right of Way Approved Approved Approved By Date By Date By Date 4k CITY OF �/ Federal Way RECEIVED ELEC'T'RICAL DEC 0 7 2018 PERMIT APPLICATION CITY OF FEDERAL WAY / COMMUNITY DEVELOP NUMBER I _ , 5 `7 S d _ b-- { S� SITE ADDRESS: (/� L SUITE/UNIT/SPACE N PROJECT VALUATION $ J ,� ASSESSOR'S TAR/PARCEL M ► 5 C[ 2 U_ p-7 1 CURRENT/PROPOSED USE PROJECT NAME (Tenant or Homeowner Last Name) 1 I PROJECT DESCRIPTION Detailed description of work to be included on this permit only �AeE AA��- � �- PROPERTY OWNER NAME PA -Q/ ,� LtJ C6Ve.l',-,/L PRIMARY PHONE - MAILING ADDRESS_ )-1000 4bkl,l�� E-MAIL CITY ZINC_ STATE (_1 ZIP 2— FAX ( ) - ELECTRICAL CONTRACTOR NAME PRIMARY PHONE PRMA MAILING ADDRESS y (c, 6 `? %I L3 E-MAIL CITY STATE ZIP FAX WA STATE CONTRACTOR'S LICENSE S EXPIRATION DATE r /\/ ) / 13 / FEDERAL WAY BUSINESS LICENSE 8 APPLICANT5gA NAME zi —1 M A -r � r PRIMARY PHON r�) &39-- MAILI17G ADDRESS lc� E-MAIL CITY � STATE (�A ZIP 9 00 1 FAX (253)�5�-� Z,36:s PROJECT CONTACT NAME /� �� !E 44 I PRIMARY PHONE ( �) e=131 410!�!)Es 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 he city, including its officers and employees, upon the accuracy of the information supplied to �yQas a part of this applicaljCj�. SIGNATURE: PRINT NAME: )_/ / Z 7 / IS -S Bulletin 4160 —April 14, 2016 Page 1 of 1 kMandouts\Electrical Permit Application