19-101566 Electrical
City of Federal way Permit #:19-101566-00-EL
Community Development Dept
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: PEDIATRICS NORTHWEST
Project Address: 505 S 336TH ST Parcel Number: 926480 0270
Project Description: Low-voltage voice& data install.
Owner Applicant Contractor
RH FOUNTAIN PLAZA ASSOC LLC CLEARNET CLEARNET
PO BOX 5003 257 SW 41ST ST CLEAR**901PM(10/14/22)
BELLEVUE WA 98009 RENTON WA 98057
257 SW 41ST ST
RENTON WA 98057
Additional Permit Information
Is this an Online or O.T.C.application? Yes
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Low Voltage-Other(Commei 1
PERMIT EXPIRES Thursday,2 April,2020
Permit Issued on Wednesday,April 3,2019
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy and the use will be in accordance with the laws, rules and regulations if th; State of
Wa- ington and the City of Federal Way.
Owner or agent: I,If / f. 14 L Date:
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THIS CARD IS TO REMAIN ON-SITE
Federal Way' 44AConstructionIEREQUE Testi oS:(253)ft mord
CITY Of PERMIT#: 19 101566 00 Address: 505 S 336TH ST Unit 205
Project: RH FOUNTAIN PLAZA ASSOC 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.
1❑ UFER Ground(4295) El Ditch cover(4030) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
El Pool Bonding(4195) 0 Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
EI Feeders/Sob-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved ez Approved
By Date By Date By Date ii(-3 rl
® Final-Electrical(4055)
Approved
By )6( Date G— —19
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED ELECTRICAL
CITY of ^.�
Federal WayAPR 0 3 2019 PERMIT APPLICATION
CITY OF FEDERAL WAY tt�-� /
COMMUNITY DEVELOPMENT PERMIT NUMBER / q _ / a / �.J 6 - EL,
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SITE ADDRESS: / /_)�/L v1�/, T/
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PR SED USE
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PROJEICT NAME
(Tenant or Homeowner Last Name) 7,-ZdI,4 /(S �11! 4vv
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PROJECT DESCRIPTION 7-,/ �m�" Q `/,-/ ^�- J4 rg%
Detailed description of work to Y`"C i/) l , 4,47zW.61
be included on this permit only j/
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PRIMARY PHONY E
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MAILING ADD-'2 S Y/ 1 -MAIL
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CONTRACTOR � '
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WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
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NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ) E-MAIL
CITY STATE ZIP / FAX
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NAME PRI Y PHONE
PROJECT CONTACT /y �' /1
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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 the city, including its officers and employees, upon the accuracy of the
information supplied ty he city as a p of this application.
SIGNATU- /`/ o f (• DATE /*
PRINT.'AME: 3 i r1 174
Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application