19-103964 • Z
Electrical
City of Federal Way Permit #:19-103964-00-EL
Community Development Dept
33325 8th Ave S
Federal Way,WA 98003 FILE Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: W D G DENTAL CLINIC
Project Address: 31515 PETE VON REICHBAUER WAY S Parcel Number:092104 9302
Project Description: Low-voltage wiring for fire alarm system.
Owner Applicant Contractor
YONG K PARK ANDY GUPROTECTION 24 HOUR PROTECTION 24 HOUR
2016 S 320TH ST SUITE F PO BOX 39117 PROTE2H829K5(5/29/20)
FEDERAL WAY WA 98003 LAKEWOOD WA 98496
PO BOX 39117
LAKEWOOD WA 98496
Additional Permit Information
Is this an Online or O.T.C.application? Yes
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Low Voltage-Fire Alarm(Co 1
PERMIT EXPIRES Saturday, 15 August,2020
Permit Issued on Friday,August 16,2019
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 of the State of
Washington and the City of Federal Way. /q
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Owner or agent: Date: Er
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THIS CARD IS TO REMAIN ON-SITE
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d 44.04 Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 103964 00 Address: 31515 PETE VON REICHBAUER WAY S I
Project: YONG K PARK 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.
El UFER Ground(4295) 0 Ditch cover(4030) ID Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
® Pool Bonding(4195) ' Q Temporary Power(4275) i ® Service(4235)
Approved I Approved I Approved
By Date By Date By Date
❑ Feeders/Sub-panels(4045) 8❑ Rough Electrical(4225) 9❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By / Date r--A7_19
CI Final-Electrical(4055)
er
fApproved /�ByDate r....���7
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Rough Electrical 0 Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
AIL RECEIVED ELECTRICAL
CITY OF
Federal Way AUG 16 2019 PERMIT APPLICATION
CITY OF FEDERAL WAY (� �+
COMMUNfiY DEYELOPr NUMBER
T /A - / Q 3 ! eb -
SITE ADDRESS: I SUITE/UNIT/SPACE#
5( Pette Uon re id-Lq� ek Giay 5 # (o $
PROJECT VALUATION ASSESSO 'S TAX/PARC�M 6 � - � � 0
PROJECT NAME CURRENT/PROPOSED USE
(Tenant or Homeowner Last Name) LA)p 6 pe,1 i
04,1 Tna 14,01+/SV 5e5 4 - tencvvt- ilMr k)te tr,en4
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER W t Q,,y` ( ) -
MAILING ADDRESS E-MAIL
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6 VLL
CITY STATE ZIP FAX
( )
NAME -- --- r PRIMARY PHONE
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MAILING ADDRESS E-MAIL
ELECTRICAL ,aO$ 3G t t 1, ' Pl-o{CLt,' �.4zAttoreoDw°.rl-
CONTRACTOR CITY STATE ZIP FAX
Lo.4cetaco( WA- "(BVig ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
FIZO TE 1 H (6 .61 — B�-
- - -- NAME ---- --- --_ ..-- ------ PRIMARY PHONE
( Y GtA ( 3 ) 3y$ - 3337
APPLICANT
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT Ah�� C ( )
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 to the city as a part of this application.
C261&11--SIGNATURE: n DATE /!6 /(q
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PRINT NAME: IT✓1 6-m
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application