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19-1012791 City of Federal Way Community Development Dept. 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 8352607 Fax: (253) 835-2609 Project Name: TWIN LAKES CHEVRON Project Address: 4612 SW 320TH ST Y .3 Electrical Permit #:19 -101279 -00 -EL Inspection Request Line: (253) 835-3050 Project Description: Replacing site controller for fuel dispensers and distribution box. Parcel Number: 112103 9101 Owner Applicant Contractor CMBA NO 3 LLC S M E SOLUTIONS LLC (ELECTRICAL) S M E SOLUTIONS LLC (ELECTRICAL) 13219 NE IOTH PL 10107 S TACOMA WAY SMESOSL931KI (5/21/19) BELLEVUE WA 98005-2726 TACOMA WA 98499 10107 S TACOMA WAY TACOMA WA 98499 Additional Permit Information Is this an Online or O.T.C. application? .................. Yes yal�k,�a�.. i�4 ' � �`7 r �✓e..wr - k���n . � ... � � i ., a. mfl.: „[� sr� �; , ,,,, � 1. ,.�2,�_ :aA Circuits - Commercial 1 PERMIT EXPIRES Thursday, 19 March, 2020 Permit Issued on Wednesday, March 20, 2019 I hereby certify that the above information is correct and that the c struction on the above described property and the occupancy and the use will be in cordance with a ws, rules and regulations of the State of Washing and the City o eral Way. Owner or agent: � Date: Ze �i�'O' THIS CARD IS TO REMAIN ON-SITE Cs" CW Federal W Construction Inspection Record INSPECTION REQUESTS: (253) 835-3050 PERMIT #: Project: 1910127900 Address: 4612 SW 320TH ST CMBA NO 3 LLC 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. 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) 0 Ditch cover (4030)3 ® Slab/Concrete Floor (4255) Approved Approved 1BY Approved Approved to place concrete By Date By Date By Date 0 Pool Bonding (4195) ® Temporary Power (4275) ® Service (4235) Approved Approved Approved Approved By Date By Date By Date Q Feeders/Sub-paneb (4045) ® Rough Electrical (4225)1D Final Electrical Ceiling Cover (4020) Approved Approved ]BY Approved Approved 13y Date By Date Approved Date Final - Electrical (4055) Approved By Date ^' Rough Electrical El Final Electrical Right of Way Approved I Approved Approved By Date I By Data I By Date �� RE///lI '""� j ��ERMIT APPLICATION CITY OF r'1./ � �'� PERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325 Federal Way MAR 19 2019 253-835-2607 + FAX 253-835-2609 + permitcenterc)cityoffederalway.com CITY F FEDE VyAY PERMIT NUMBER 00MMU EY LOP NT4? 1 _ � � .6 TARGET DATE SITE ADDRESS �-' 6 2 D S< SUITE/UNIT # PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL # $ �200,00 - - - TYPE OF PERMIT ❑ U4= El PLUMBING ❑MECHANICAL El DEMOLITION El ENGINEERING El FIRE PREVENTION NAME OF PROJECT PROJECT DESCRIPTION Detailed description of work to bal, 7C �✓ be included on this permit only NAME PRIMARY PHONE PROPERTY OWNER MAILING ADDRESS E-MAIL CITY STATE ZIP NAME �'ky` PHONE J JZ MAILING ADDRESS d f v -7 E-MAIL CONTRACTOR CITY �STATE ZIP _�ll FAX WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE # NAME PRIMARY PHONE APPLICANT MAILING ADDRESS E-MAIL CITY STATE ZIP FAX NAME /j - // PRIMARY PHONE PROJECT CONTACT . �C�� , / i MAILING ADDRESS // ©/ / O �y E-MAIL (The individual to receive and respond to all correspondence ITY CITY/-I $TATE- ZIP6�7 FAX concerning this application) C (Inn PROJECT FINANCING NAME ❑ OWNER -FINANCED When value is $5,000 or more (RCW 19.27.095) MAILING ADDRESS, CITY, STATE, ZIP PHONE 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 ail 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 (includin costs, expenses, and attorneys' fees incurred in the investigation and defense of such claim), which may b ads by any person, in ding the undersigned, and filed against the city, but only where such claim ari out of the reliance f the city, including its fficers and employees, upon the accuracy of the information supplied to the ci apart of this applica on. SIGNATURE: DATE 7 (z e, PRINT NAME: t n %A—e Bulletin #100 — January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application