19-105440 d^ ".--‘,
4 4Iectrical
City of Federal way Permit #:19-105440-00-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: TWIN LAKES COUNSELING
Project Address: 3430 SW 320TH ST Parcel Number: 132103 9073
Project Description: Demo and re-circuit building electrical.
Owner Applicant Contractor
TWIN LAKES PLAZA LLC CHRIS MAYEDAC M E ELECTRIC LLC C M E ELECTRIC LLC
C/O PUGET SOUND COMMERCIAL 30262 225TH AVE SE CMEELEL865QE(11/5/20)
33919 9TH AVE S SUITE 105 BLACK DIAMOND WA 98010
FEDERAL WAY WA 98003 30262 225TH AVE SE
BLACK DIAMOND WA 98010
Additional Permit Information
Is this an Online or O.T.C.application9 Yes
PERMIT EXPIRES Wednesday, 11 November,2020
Permit Issued on Tuesday,November 12,2019
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.
Owner or agent Date: ii /Z
,-
THIS CARD IS TO REMAIN ON-SITE i
CITY Of '0144 Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 105440 00 Address: 3430 SW 320TH ST Suite D2
Project: TWIN LAKES PLAZA LLC Federal Way WA 98023
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE TRIS 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.
I `• �I 4
0 UFER Ground(4295) ; 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date A By Date A By Date
\
0 Pool Bonding(4195) 0 Temporary Power(4275) �•® Service(4235)
Approved Approved Approved
By Date By Date By Date
0 Feeders/Sub-panels(4045) 0 Rough Electrical(4225) ® Ceiling Cover(4020)
Approved I Approved Approved
By Date l By Date //r/„5`/ Date
El Final-Electrical(4055)
Approved
By Date/,/,...;tri
•
Rough Electrical 0 Final Electrical JJ Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED ELECTRICAL
CITY OF 1PA.
Federal Way NOV 12 2019 PERMIT APPLICATION
CITY OF FEDERAL WAY ,
COMMUNITY DEVELOPMENT - n
PERMIT NUMBER L - _ 1 0 5 9 i 0 0 c
SUITE/UNIT/SPACE#
SITE ADDRESS:
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ `22oo / 3 2 ! o 3 _ g d 7 3
PROJECT NAME �,
n s t�
(Tenant or Homeowner Last Name) ...n..--...n..-- a �,,
jam, N. L
PROJECT DESCRIPTION n e-ln Y/-t 4 / (,lA A b L1 1 /j' j�I1‘T11 J
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER °-7k i N Lo/VC> RA ( ) -
MAILING ADDRESS E-MAIL
3y3 o S vv 3.2_041-. .5-1-
CITY STATE ZIP FAX
FcN - q 't 3 ( ) -
NAME PRIMARY PHONE
C -G- c (--6 r.,-r-e-c L (w o ) 245- 2)-tc-1
LING ADDRESS f E-MAIL
ELECTRICAL b ,RSD( '-71147.00 i �0 e Cwle e teC4-Y► L
CONTRACTOR CITY 7iI: FAX
L ( )
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
C 11A- 6LEL$Lac0E7/e-7 iv
NAME PRIMARY PHONE
APPLICANT A ( )
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
(
l )
NAME C.41 I PRIMARY PHONE
PROJECT CONTACT s 1/4-Alle_ CI-4 (144) 2M- 2,LU
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 clai 'ses out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to as a part of this application.
A "24SIGNATURE: / DATE L i 2 " i
PRINT NAME: i
Bulletin#160—April 14,2016 Page 1 of 1 k:\l-landouts\Electrical Permit Application