19-102167 , 4 4
Electrical
City of Federal way Permit #:19-102167-00-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: JACKSONS#636-CONVENIENCE STORE
Project Address: 1520 S 348TH ST Parcel Number: 889700 0115
Project Description: Install a 600A service.Install(2)200A feeders,(2) 100A feeders,(1)400A feeder and wire the
convenience store.
Owner Applicant Contractor
JACK DAVISPACWEST ENERGY LLC MIKE JACKSONTRI-M ELECTRIC LLC TRI-M ELECTRIC LLC.
3450 COMMERCIAL PKWY CT 21827 93RD PL W TRIMEL*981PS(10/10/20)
MERIDIAN ID 83642 EDMONDS WA 98020
3509 NE 187TH CT
LAKE FOREST PARK WA 98155
Additional Permit Information
Is this an Online or O.T.C.application9 Yes
, 3 t 33�s3 - aid '
rt as Ewa,
Add'!New Feeder(s)0-100 am 2 Add?New Feeder(s) 101-200; 2 Add'l New Feeder(s)201-400; 1
New Service:401 -600 amps l 1
PERMIT EXPIRES Tuesday,5 May,2020
Permit Issued on Monday,May 6,2019
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy and the u - will be in a core ance with the laws, rules and regulations of the State of
Was '-• • a - the City of Federal Way.
Owner or agent: / -/1\ Date: WZD
•
• .
THIS CARD IS TO REMAIN ON-SITE
cmoF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253)835-3050
PERMIT#: 19 102167 00 Address: 1520 S 348TH ST
Project: JACK DAVIS FEDERAL WAY WA 98003-6844
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) ' ® Slab/Concrete Floor(4255)
ApprovedApproved .y ed to place concrete
By ������� Date , . / l By Date By:. � ,Ci 'l 9'
•
Pool Bonding(4195) ! 0 Temporary Power(4275) 1E] Service(4235)
Approved Approved ' pproved
By Date By Date By ,Date/t i/
9
Feeders/Sub-panels(4045) ® Rough Electrical(4225) ; ® Ceiling Cover(4020)
Approved Approved Approved
By Date By deg Date f' /G~/ S By Datleigh"
Final-Electrical(4055)
Approved
By le-
o Date//i. 6.19
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.ipleA t q sty ��.,ps O� 6 Sir Tan its
OfoP Ctivcr 2 e 0
ro.f-k f f a( i h /(s 6 ,01 r.-/3 /e/e*
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0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
1
RECEIVED ELECTRICAL
CITY OF �/'
Federal Way MAY 0 2019 PERMIT APPLICATION
CITY OF FEDERAL WAY /'
COMMUNITY DEVELOPp�� T NUMBER i _ I 0 j (P 7 _ L;� L�
_ SUITE/UNIT/SPACE#
SITE ADDRESS: id) Z v . T�e r t-` S C'•5101?6
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 140, 4006 Q 1 .1 0 0 - 0 / / S ,e-iG-
PROJECT NAME
(Tenant or Homeowner Last Name) %f IQ-GK�.J OA)1 ELL•
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,n,1sTA1-4-- 6,0-Ar4r' S YiGJ.C. .r`.41/5 Mt-G.L.(z)
PROJECT DESCRIPTION2 _4$4, Frr- >g� , I00-4 ? - l)b-,-
Detailed description of work to ,.4'1? r�`'Dt� AI f2 � :0
A>E THE C-$ 1_
be included on this permit only 0 �
cµ'i PG C7re .
NAME PRIMARY PHONE
PROPERTY OWNER P/tc-W mil 4"nfe?Gr L1-G (ZA6 ) X30- i52,05--
MAILING
.,offMAILING ADDRESS E-MAIL
/KO cafrimk--;7�. ? rvy Cr
CITY STATE ZIP FAX
Nrt/?i+D PIA) X67 e_3&4tZ ( ) -_.
NAME PRIMARY PHONE
l 't- "4 T' /e• ('/ZS 773 46,77
MAILING ADDRESS ..► E-MAIL
trtC
ELECTRICAL fib' /1) - , 7 i'C f� er o„ &
CONTRACTOR
CITY STATE ZIP P'
c��tof - -telt VA f 1 (gar-) 770- 1010
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
7127.74.51-0 181P5 /o / fO / zZ zo-M-for'f7Z-00-gg_
NAME PRIMARY PHONE
....---
APPLICANT PJ- / E t - 1 jC (4'Z )173 -M677
MAILING///_��///Aggq��D�/////{///��DREss _ f 37 �� �r�y�lefe��a2
CITY ,,'V/ C T ZIP ` FAX
�K dog 4 K vt 7{ ' $>/off" (t91777 rola
NAMEA PRIMARY PHONEPROJECT CONTACT ire, T 4-5 OA) (L/Z41 773 `/ 77
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 • part of this -ppli on.
/
I /
SIGNATURE: '( , DATE 6/
PRINT NAME: f g e 6/'l
' ) 111
Bulletin#160—April 14,2016 Page 1 of 1 k:\flandouts\Electrical Permit Application
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