12-100427 • Ectrical
• City of Federal Way �./.
Community&Econ.Dev.Services Pettit #: 12-100427-00—EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 i p q
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Project Name: WESTSIDE CENTER °I 1
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Project Address: 33305 1ST WAY S Parcel Number: 926500 0230
Project Description: Adding/altering up to(5)circuits for lighting retrofit
,
Owner Applicant Contractor
OMNI PROPERTIES INC 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 98003-6311 SAMMAMISH WA 98074 24317 NE 27TH PL
SAMMAMISH WA 98074
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Is Use Educational or Institutional? No Service greater than 999 Amps' 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
and the City of Federal Way.
Owner or agent: ` Date: 1/4/J2,--
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THIS CARD IS TO REMAIN ON-SITE
CITY OF Federal Way ` Construction Injection Record
INSPECTION RE UESTS: 835-3050
Q (253)
PERMIT#: 12-100427-00-EL Address: 33305 1ST WAY S
Project: OMNI PROPERTIES INC 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.
O UFER Ground (4295) El Ditch cover(4030) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
o Pool Bonding(4195) 0 Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By Date
El Feeders/Sub-panels(4045) 0 Rough Electrical(4225) .El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
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El Final-Electrical(4055)
Approved
By � Date
Cm\ 11^ '2 iv 17---
D Rough Electrical El Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
aTY of
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Federal Way ELEC'T`
RECEIVED
PERMIT APPLICATION
JAN 3 0 20'2
**Most electrical permits may be obtained on-line at ww . ralway.com**
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SITE ADDRESS:33305 s• / U p 1'
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SUITE/UNIT/SPACE I ASSESSOR'S TAX/PARCEL I W CURRENT/PROPOSED USE
PROJECT NAME � • % � , . �
(Tenant or Homeowner Last Name) ��
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PROJECT DESCRIPTION 111W .RffanZYM
Detailed description of work to mmimmilmirmumiiiiiiiiiimiiii
be included on this permit only
NAME , . PRIMARY PHONE . .. .
PROPERTY OWNER I,cJc -��ry^.{'k1/ ( ) -
MAILIN ADD' -" 5 E-MAIL
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STATE ZIP FAX
IPRIMARY PHONE
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MAILING ADDRESS �// E-MAIL
ELECTRICAL t 1' L-
CONTRACTOR STATE ZIP.INIIIIMEM . FAX
WA STATE CONTRACTOR'S LICENS- . , EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE k
c__---- _- -. /0 /0/? 3 r).
-- - PRIMARY PHONE- ----
APPLICANT .0k -, V>> ( ) -
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
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PRIMARY PHONE
PROJECT CONTACT _Fiffillinini (� ) / �
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
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PRINT NAME: C-h' i Sele�
33325 8th Avenue South •Federal Way 1 WA♦98003-6325•253-835-2607•fax:253-835-2609♦www.cityoffederalway.com
Bulletin#160—January 1,2011 Page 1 of 2 k:\Handouts\Electrical Permit Application