19-105964 Electrical
Y^it
t �
City of Federal Way Permit #:19-105964-00-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: CAFE ARIZONA
Project Address: (9 O 12— S 3 Z O+ 't CAA;^}-e U Parcel Number:
Project Description: Add stage receptacles and receptacle for freezer. oq Zl Oy' q 2--77
Owner Applicant Contractor
CRATSEBERG PROPERTIES LLC EMPOWER ELECTRIC LLC EMPOWER ELECTRIC LLC
2020 S 320TH ST SUITE A 4061 S PARK AVE EMPOWEL813L1(6/21/21)
FEDERAL WAY WA 98003 TACOMA WA 98418 4061 S PARK AVE
USA TACOMA WA 98418
USA
Additional Permit Information
Is this an Online or O.T.C.application? Yes
,fit . x S ° 3 -
.� � �.� � � tr ..�» � 'F ? � a- • ,k is
PERMIT EXPIRES Wednesday,23 December,2020
Permit Issued on Tuesday,December 24,2019
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy nd the use will be in accordance with the laws, rules and regulations of the State of
ton and the City of Federal Way.
Owner or agen • 1` Date: /0) — 7 t� C/7
j (\ oti
THIS CARD IS TO REMAIN ON-SITE 4
CITY OP Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 105964 00 Address: 2012 S 320TH ST Unit 0
Project: CRATSEBERG PROPERTIES LLC 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.
.In UFER
•
Ground(4295) `'0 Ditch cover(4030) ',® Slab/Concrete Floor(4255) '
L'� Approved Approved Approved to place concrete
By Date By Date ; By Date
0 Pool Bonding(4195) i 0 Temporary Power(4275) El Service(4235) '
Approved i Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) ',0 Rough Electrical(4225) '•® Ceiling Cover(4020) `
Approved Approved Approved
�� �> _ 40
.By Date ..By Date By Date
•
'0 Final-Electrical(4055)
e
BApprovedgBy Date/^ ! °..-a
•
0 Rough Electrical El Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
CITY
OF ELECTRICAL
Federal Way DEC 2 4 2019 PERMIT APPLICATION
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
PERMIT NUMBER , 9 _ ' 0 ,...5- q 6 q _
SUITE/UNIT/SPACE#
SITE ADDRESS: 2 0 12 5. . $+ 1( 'p . 6 C)
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
S(I j 0-0-0 D 9 2 ( o q _ `'l a q -7
PROJECT NAME
(Tenant or Homeowner Last Name) 4
PROJECT DESCRIPTION [/l (( . c.-. -Q ( //lc�` J' kiI "(CCP`JAC/-
Detailed description of work to
be included on this permit only fi,_aQ��
NAME PRIMARY PHONE
PROPERTY OWNER ( I71)4 - 6 S„
MAILING ADDRE E-MAIL
CITY STATE ZIP FAX
(
NAME PRIMARY PHONE
C ,mat- / ) - `7cfo3
MAILING ADDRESS E-MAIL
42,
ELECTRICAL n S tAf / k % �^�o�v r 4 'I
CONTRACTOR CITY STATE ZIP FAX
<t.CO �4 e70?WO ( ) -
Z �� WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
e M PCW> L �1 L1 /2\ /a I
NAME �, D l PRIMARY PHONE
APPLICANT _12._____.
��"� Ca'
k , -,- (
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NZ
/ PRIMARY PHONE
PROJECT CONTACT /�� (q/7)7/(, 3Z 3
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 defens- of such claim),which may be made by any person,including the undersigned, and filed against the city,
but only where such claiarises out o the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to t : city as a •• zs�pplication.
A, � � 4
/,
SIGNATURE: DATE ( O
JJ / f
PRINT NAME: / ?" S/t /A` 7
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application