12-100295 EIeetric^al
City of Federal Way • � 4 '
Community&Econ.Dev.Services PerMi t #: 12-100295-00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: SHIMIZU w lig $$gl7
Project Address: 28809 14TH AVE S Parcel Number: 516210 0670
Project Description: Installing a LN security system.
Owner Applicant Contractor
RICHARD A SHIMIZU GLOBAL SECURITY&COMM OF WA INC GLOBAL SECURITY&COMM OF WA INC
KAREN V SHIMIZU 1502 PIKE ST NW SUITE 1 GLOBASCO3OLR (6/19/13)
28809 14TH AVE S AUBURN WA 98001 1502 PIKE ST NW SUITE 1
FEDERAL WAY WA 98003-3783 AUBURN WA 98001
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Is Use Educational or Institutional? No
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Low Voltage-Burglar Alarm(Res I
PERMIT EXPIRES Wednesday, January 23, 2013
Permit Issued on Tuesday, January 24, 2012
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 accordanc- - -- laws, rules and regulations of the State of Washington
• e City if Federal Wa
Owner or agent: • Date: \ aLl-
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. . THIS CARD IS TO REMAIN ON-SITE
CITY O^
i Construction Injection Record .r,
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 12-100295-00-EL Address: 28809 14TH AVE S
Project: RICHARD A SHIMIZU FEDERAL WAY, WA 98003-3783
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 Rough Electrical(4225) ❑ Final-Electrical(4055)
Approved Approved
By Date By /%__ Date '1_t —VI___
El Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
• • • .
CITY OF _OD2±DD
Federalpw ELECTRICAL
CITY of FEDE�PEAMIT APPLICATION
CDs
**Most electrical permits may be obtained on-line at www.cityoffederalway.com**
SITE ADDRESS: [3C ,�� Ci -\\-\`c_\-\
SUITE/UNIT/SPACE# �ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
xv, '^ , ± „ a r}
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detntlnd description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER 11P ` - t` `
MAILING ADDRESS E-MAIL
MalZIP FAX
L__KtMigi_ _ 116W 11.4% ) -
NAME PRIMARY PHONE
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MAILING ADDRESS E-MAIL
ELECTRICAL cj _ _• "
t G rte+ BIBLINSUI
CONTRACTOR zip
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE 'r:�v' .I i � - #
•r � ' _ a '� /t i -_ --_ o_ . -a,.
NAME - - _ - - - PRIMARY PHONE
APPLICANT • • -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
) -
NAME PRIMARY PHONE
PROJECT CONTACT -
1, 1 _ . •
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.
SIGNA ' . �o a�r_g�—� DATE 7 L4-
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PRINT NAME: C‘R1 ` 5 \
33325 8th Avenue South♦Federal Way♦WA 1 98003-6325♦253-835-2607♦fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160-January 1,2011 Page 1 of 2 k:\llandouts\Electrical Permit Application