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19-104569 4 Electrical City of Federal Way Permit #:19-104569-00-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: EVERGREEN EYE CENTER Project Address: 33600 6TH AVE S Parcel Number:926480 0205 Project Description: New circuit and wiring replaced make-up air unit;new T-stat. • Owner Applicant Contractor SHARON LACHNERAULUKISTA LLC BRETT ROEBUCKAir Systems Engineering AIR SYSTEMS ENGINEERING INC 5015 BUSINESS PARK BLVD SUITE 3000 3602 S PINE ST (ELECTRICAL) ANCHORAGE AK 99503 TACOMA WA 98409 AIRSYEI009KS(5/10/20) USA 3602 S PINE ST TACOMA WA 98409 Additional Permit Information Is this an Online or O.T.C.application? Yes 3..3c .f ._. . ,6 ,,.,.,R.. .. , , 7 �sr��� .cv�:. .�. ��!,,.,;�� ,�,en,3 '3„,; MO*34‘2V,,.. : ..,..?x. 3 a, Circuits-Commercial 1 Thermostat 1 PERMIT EXPIRES Tuesday,22 September,2020 Permit Issued on Monday,September 23,2019 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 WashingtonQ �� and the( AS () Cof Federal Way. Owner o agenZ(IPAeiyi.c � Date: Z,,2a 1 7 61WA)) THIS CARD IS TO REMAIN ON-SITE f' ' CITY4014 OF Construction Inspection Record Federal Way INSPECTION REQUESTS: (253)835-3050 PERMIT#: 19 104569 00 Address: 33600 6TH AVE S Unit 200 Project: SHARON LACHNER 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) ' Q Ditch cover(4030) •,® Slab/Concrete Floor(4255) Approved Approved Approved to place concrete By Date By Date ; By Date ® Pool Bonding(4195) j Temporary Power(4275) ; ® Service(4235) Approved Approved Approved By Date By Date By Date Q Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020) Approved Approved Approved By Date By Date By Date • El Final-Electrical(4055) Approved By €deDate/a-f....17 • 0 Rough Electrical El Final Electrical 0 Right of Way Approved Approved Approved By Date By ' Date By Date RECEIVED ELECTRICAL CITY OF Federal Way SEP 2 3 2019 PERMIT APPLICATION CITY OF FEDERAL WAY COMMUNITY DEVELOPMENT ( � - ( �i 5 (, 9 - PERCr MIT NUMBER �}' SUITE/UNIT/SPACE I SITE ADDRESS: 3 6 0 0 ' AYE So PROJECT VALUATION ASSESSOR'S TAX/PARCEL I CURRENT/PROPOSED USE $ C0 43- 0 , 00 9 2 G 4 8 0 0 2 0 5 PROJECT NAME R U 5 5 E-'L L PLAZA- aike!l? A,R ENC f i g...A Z 1. 00 AC (Tenant or Homeowner Last Name) PROJECT DESCRIPTION NEW C L R C U 17 - 1�J 1 (t IN C7 F (S Detailed description of work to 17-. P LA CE_. be included on this permit only NEW 51117 NAME PRIMARY PHONE PROPERTY OWNER iZ 1 C A t.D S AL 1 E 4tiA (901 ) 'P9 - 246 MAILING ADDRESS EMAIL 50\5 13 J51Nt PflitK DABE.I eENANt1W/NGSLu.1a" CITY STATE ZIP FAX N�r ©YLA ` kv\ 99533 ( 42S ) CA43- 9203 NAME PRIMARY PHONE WIK S\l5-TtEPc VKUINEUZ.NG- i 4(- ( 253 ) s?Z - q4$4 MAI LING ADDRESS E-MAIL ELECTRICAL 3(ofl 2 5 P i n k ST r e 1� t e A5 L I 'J S CONTRACTOR CITY STATE ZIP FAX TAC 0J'1A In.1A 140 q (Z53 ) -7)`CS - (.-W1 WA STATE CONTRACTOR'S LICENSE i EXPIRATION DATE FEDERAL WAY LICENSE P"S`1G\ 004 V.5 s i lO i 2 1c-1 000() -oo-t3L. NAME PRIMARY PRONE (;t77 APPLICANT MAILING ADDRESS < E-MAIL S tt CONT1e I;Lel CITY STATE ZIP ( FAX t ) - NAME PROJECT CONTACT Ut E 1 ROF ;UC` PRIMARY PRONE 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 authorised 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(t1"'h�e�ci�ty as a part,of this application. SIGNATURE: "i ' Rire fuck ( ASO) DATE -2 1 LL 2° 9 PRINT NAME: ¶ r e++ R o e bu c K PERMIT CENTER+33325 8th Avenue South + Federal Way,WA 98003-6325 253-835-2607 + FAX 253-835-2609 +permitcenterjcityoffederalway.com Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application