12-100428 rotElectrical
City of Federal Way r
Community&Econ.Dev.Services Permit #: 12-10042g-00-EL
33325 8th Ave S
Federal Way,WA 98003
Ph (253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: WESTSIDE CENTER
Project Address: 33301 1ST WAY S Parcel Number: 926500 0230
Project Description: Adding/altering up to(5)circuits for lighting retrofit
Owner Applicant Contractor
STOCK FAMILY LLC C J ELECTRICAL SUPPLY&SERVICES LLC C J ELECTRICAL SUPPLY&SERVICES LLC
909 S 336TH ST SUITE 103 24317 NE 27TH PL CJELEES966M7(10/23/12)
FEDERAL WAY WA 98003 SAMMAMISH WA 98074 24317 NE 27TH PL
SAMMAMISH WA 98074
§ i tea:
Is Use Educational or Institutional? No Service greater than 999 Amps7 No
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Circuits-Commercial 5
PERMIT EXPIRES Saturday, July 28, 2012
Permit Issued on Monday, January 30, 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 accordance with the laws, rules and regulations of the State of Washington
r
and the City of Federal Way.
Owner or agent: Date: //3///
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• THIS CARD IS TO REMAIN ON-SITE �. ,
CITY OF 0 Construction Ineection Record '
Federal WayINSPECTION RE UESTS: 253 835-3050
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PERMIT#: 12-100428-00-EL Address: 33301 1ST WAY S
Project: STOCK FAMILY LLC FEDERAL WAY, WA 98003-6252
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) ❑ Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
❑ Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
,
El Feeders/Sub-panels(4045) ElRough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
CI Final-Electrical(4055)
Approved
*By 0 ti Date t-1._a141-1
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❑ Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
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0 07/ _ I 0 (7) 4:? CS7'
CITY OF
Federal Way ELECTRICAL
REt
PERMIT APPLICATIONVED
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**Most electrical permits may be obtained on-line at www'.cit o7( is . J **
SITE ADDRESS:33 3 0 S-+ tIO S ( ' o
SUITE/UNIT/SPACE# ASSESSOR'S TAX/PARCEL# W CURRENT/PROPOSED USE
`(' ___ . ___ ___CI a - o _a_ 3 0
PROJECT NAME k
(Tenant or Homeowner Last Name) -e- a • 4��
PROJECT DESCRIPTION Imir ` = /f f ith-i_ -
Detailed description of work to
be included on this permit only
NAME ` , PRIMARY PHONE
PROPERTY OWNER I l�� -F.4 a ( ) -
MAILING ADDRESS , E-MAIL
. 0 ' S
STATE ZIP FAX
( ) -
PRIMARY PHONE
j( - 1 E2-- ec.
MAILING ADDRESS
. E-MAIL
ELECTRICAL 1 6. ;7
CONTRACTOR STATE ZIP. j� FAX
WA STATE CONTRACTOR'S LICENS it_ EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE N
1 ----__ PRIMARY PHONE
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APPLICANT ���� -� �>> ( )
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( ) -
PROJECT CONTACTIMINIMEMIIIIMINI
PRIMARY PHONE
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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: ___ -- DATE 1 -3- 12—
.
PRINT NAME: �1 f k_ iCi4`i Z S
33325 8th Avenue South•Federal Way•WA•98003-6325♦253-835-2607•fax 253-835-2609•www.cityoffederalway.com
Bulletin#160—January 1,2011 Page 1 of 2 k:\Flandouts\Electrical Permit Application