19-104848 Electrical
City of Federal Way Permit #:19-104848-00-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: STARBUCKS
Project Address: 33650 21ST AVE SW Parcel Number: 930100 0020
Project Description: Low-voltage wiring for fire alarm installation.
Owner Applicant Contractor
CONFLUENT DEVELOPMENT LLC GUARDIAN SECURITY SYSTEMS GUARDIAN SECURITY SYSTEMS
2240 BLAKE ST SUITE 200 (ELECTRICAL) (ELECTRICAL)
DENVER CO 80205 1743 1ST AVE S GUARDSS233K5(9/30/20)
SEATTLE WA 98134 1743 1ST AVE S
SEATTLE WA 98134
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 Tuesday,6 October,2020
Permit Issued on Monday,October 7,2019
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.
Date: �N
Owner or agent: �� ' 10*
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THIS CARD IS TO REMAIN ON-SITE
CITY
Federal Wa'4034 Construction Inspection Record
y INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 104848 00 Address: 33650 21ST AVE SW
Project: CONFLUENT DEVELOPMENT LLC FEDERAL WAY WA 98023-7762
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.
• ,• \• .
0 UFER Ground(4295) Q Ditch cover(4030) � Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date ••By Date ,I.BY Date
Pool Bonding(4195) ® Temporary Power(4275) � Service(4235)
Approved Approved Approved
By DateDate
Date
•• •ABY
.•
® Feeders/Sub-panels(4045) 0 Rough Electrical(4225) �•El Ceiling Cover(4020)
Approved Approved Approved
By Date
••BY Date •.By Date
El Final-Electrical(4055)
Approved
By `e4 . DateU y.'//
0 Rough Electrical 0 Final Electrical El Right of Way
Approved Approved Approved
By Date By Date
By Date
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Co) C:4140
RECEIVED
CITY OF �-- ELECTRICAL
Federal Way OCT 0 7 2019 PERMIT APPLICATION
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT 7 (�
PERMIT NUMBER / 9— // ) X "/2 _ L
SUITE/UNIT/SPACE#
SITE ADDRESS: 3.3/0 ,0 a :5-t A` ,e . 6\v v
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name) )g\ .�
PROJECT DESCRIPTION --W"- CA OCV\ 4 I Q��-�� t �( QS1\ j
Detailed description of work to "A(' ( .lAM
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be included on this permit only `` !
NAME PRIMARY PHONE
PROPERTY OWNER '-r'acv\larr ,o (ur cam ( i q p (G01(j
MAILING ADDRESS E-MAIL
CITY STATE ZIP - FAX
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CWOC W� r _ \ PRIMARY PHONE
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CONTRACTOR CITY STATE ZIP FAX
WA-kk--12 \NIA G%1 ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE S
NAME PRIMARY PHONE
APPLICA T ` .h �'CQ.Z�rUYc Ut�Vv\. (4V,645-1 - 4-1-Ce
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CITY STATE ZIP FAX
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NAME PRIMARY PHONE
PROJECT CONTACT 7)pAr�V -J x CO, ��)N , Z „�tiN ��,Kp
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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 to the city as a part of this application.
SIGNATURE:OR
Lx .C DATE C] l "l
PRINT NAME:DP.1 V�et, \A )V--0
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application