11-100125 h ►
' City of Federal Way # 0 Electrical
Community Development Services Permit #: 11 -100125-00-EL
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: AVALON CARE CENTER
Project Address: 135 S 336TH ST Parcel Number: 926504 0110
Project Description: Adding/altering(2)circuits for outlet change out in private dining room area
• `
Owner Applicant Contractor
135 SOUTH 336TH STREET LLC UNITY ELECTRIC CONST INC UNITY ELECTRIC CONST INC
6380 WILSHIRE BLVD SUITE 800 3570 IRON CT UNITYEL919L9 (7/13/11)
LOS ANGELES CA 90048-5019 SHASTA LAKE CA 96019 3570 IRON CT
SHASTA LAKE CA 96019
•
Is Use Educational or Institutional? No Service greater than 999 Amps No
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Circuits-Commercial 2
PERMIT EXPIRES Wednesday, January 11, 2012
Permit Issued on Tuesday,January 11, 2011
I hereby certify that .1 = above informa#111p0:1 f,. -ridd that the construction on the above described property and
the occupancy a = - ► e win by •s-t = with , e Jaws, rules and regulations of the State of Washington
the 1 , - Federal Way. ft Owner or agent: 411116
Date:
FThL' LCD3 i /r
• waiii , THIS CARD IS TO REMAIN ON-SITE ,
•
CITY OF SConstruction I ection Record
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 11-100125-00-EL Address: 135 S 336TH ST
Project: 135 SOUTH 336TH STREET LLC FEDERAL WAY, WA 98003-6601
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) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
.0 Pool Bonding(4195) El Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
•
o Feeders/Sub-panels(4045) ❑ Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
❑ Final-Electrical(4055)
Approved
Bye Date/ /,"--//
Vo, (pt.14�0
0 Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
• - 1 0 0 '1 '25--
CITY OP
Federal Way ELECTRICAL 'RECEIVED
PERMIT APPLICATION JAN 1 1 2.
**Most electrical sermits m' be obtained on-line at w_ww.ci s `e'dir9way .,F" A L WAY
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SITE ADDRESS: ) SS 5, 3310 7 f) _Si.
SUITE/UNIT/SPACE N A38¢SSOR'S TAX/PARCEL
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PROJECT NAME
(Tenant or Homeowner Last Name) A VAL05 J C14 2d C' L:/v7`b�✓
PROJECT DESCRIPTION ,g 00 2- M
Detailed description of work to
be included on this permit only
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NAME PRIMARY PHONE
PROPERTY OWNER A`/Auv ) 19 A--6 ( )MAILING ADDRESS ADDRESS E-MAIL
ns S• 33(eT SV
CITY STATE ZIP FAX
F6" ) L 1J( (,OA /3603 ( ) -
NAME PRIMARY PHONE
t (2 ) O3 r7.5- 4-
MAILING ADDRESS E-MAIL
ELECTRICAL (Oz -S
CONTRACTOR CITY STATE ZIP FAX
5�4TfU6 t� LC6 (O8 (20G )5 5-19'35
WA STATE CONTRACTOR'S LICENSE S EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE S
1J ini 6L (91-9
NAME PRIMARY PHONE
APPLICANT � t1�v ( 2 ' )S'- )`- US 3
MAILING ADDRESS E-MAIL
( � -� SN\'-ek)uIryEt_,c-T-f e,cont,
CiTySTATE ZIP FAX
t� (. (off ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT
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 • • • fense of such claim),which may be made by any person,including the undersigned,and filed against the city,
but only where arises out •, - o - city, including its officers and employees, upon the accuracy of the
information suppli • city as a p t
SIGNATURE: 'L.& ■1611 � DATE f l)
PRINT NAME: ! � ^• 9
33325 8th Avenue South•PO Box 9718•Federal Way•WA•98063-9718♦253-835-2607•fax:253-835-2609•www.cityoffederalway.com
Bulletin#160—April 9,2010 Page 1 of 2 k:\Handouts\Electrical Permit Application