20-100044 20 I
Electrical
City of Federal Way Permit #:20-100044-00-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: KWA(KOREAN WOMEN'S ASSOCIATION)SENIOR CITY
Project Address: 31635 23RD AVE S Parcel Number:092104 9299
Project Description: Upgrading(4)cameras&adding an additional camera.
Owner Applicant Contractor
SENIOR CITY LP JEREMIE FARRELLSECURITY SECURITY SOLUTIONS NW
123 E 96TH ST SOLUTIONS NW SECURSN954JG(4/7/19)
TACOMA WA 98445 1619 N STATE ST 1619 N STATE ST
BELLINGHAM WA 98225
BELLINGHAM WA 98225
,
Additional Permit Information
Is this an Online or O.T.C.application? Yes
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Low Voltage-Other(Commei 5
PERMIT EXPIRES Tuesday,5 January,2021
Permit Issued on Monday,January 6,2020
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: (/(0 )0
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THIS CARD IS TO REMAIN ON-SITE .
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 20 100044 00 Address: 31635 23RD AVE S
Project: SENIOR CITY LP FEDERAL WAY WA 98003-5425
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) 3❑ Slab/Concrete Floor(4255)
Approved I Approved ? Approved to place concrete
.By Date ..By Date .\By Date
'
❑ Pool Bonding(4195) ' Q Temporary Power(4275) 1.® Service(4235)
Approved Approved I Approved
By Date „By Date ; By Date
•
® Feeders/Sub-panels(4045) ® Rough Electrical(4225) I El Ceiling Cover(4020)
Approved Approved Approved
By Date 1 By Date I By Date
Final-Electrical(4055)
Approved
By 36Date 3- V O
E Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
A.A. RECEIVED ELECTRICAL
CITY Of
Federal Way All 0 6 2020 PERMIT APPLICATION
CITY OF FEDERAL WAY
CQMMUNCTY DE�/ELOPME PERMIT NUMBER 0 – ' 0 0 0 c/..cz c' .6.,.
SITE ADDRESS: 31635 a 3 t k e
S SUITE/UNIT/SPACE
PROJECT VALUATION ASSESSOR'S TAX/PARCEL II CURRENT/PROPOSED USE
$ 3c125.°u Qq 2 r _v CI - 1 2 7
PROJECT NAME
(Tenant or Homeowner Last Name) Seg w(AK C as/ 'PART MENS
U •. rcc tn9 + ur cameras J, C*ic ink ars
PROJECT DESCRIPTION • Mona CAmerq
Detailed description of work to
be included on this permit only
PROPERTY OWNER NAME Ailo
o gcsA(kntCA I () PRIMARY PHONE
MAILING ADDRESS E-MAIL
1C Db Nr 2° -h St
CITY STATE ZIP FAX
P)e1(evue \ \ 61 ( )
NAMES PRIMARY adk ' D\Neons 1 V W (3106)7314—PHONE, 1 0 .
MAILING ADDRESS E-MAIL
ELECTRICAL ROI I q N Stoitt Sfi
CONTRACTORSIii ni WSTATE
Q z°^ 7Z S ( ) FAX
-
WA STATE CTOR'S LICENSE MEXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
ScU RStt g -J5� �a 4 / 1 /2021 20- 04-- 105053-Do-PL
NAME PRIMARY PHONE
APPLICANT Same as E kCP Ca\ C� rc c-ro Y ( ) -
MAILING ADDRESS ,
m
3errle-p \ usi.co
CITY STATE ZIP FAX
( )
NAME i sv� c–. �l I PRIMARY PHONE
PROJECT CONTACT J ,1? ``'GYY ( )
I certify under penalty of perjury that I am the property owner or authorised 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 authorised 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. r,� /W2J)
SIGNATURE: DATE ' (P
PRINT NAME: 3 j 'crn to vav \
PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
253-835-2607+ FAX 253-835-2609 +permitcenter@cityoffederalway.com
Bulletin#160—April 14,2016 Page 1 of 1 161-landouts\Electrical Permit Application