21-101978Electrical
City of Federal way Permit #:21-101978-00-EL
Community Development Dept.
333258thAve
FILE
S Inspection Request Line: (253) 835-3050
Federal Way,
WA98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: FEDERAL WAY DENTAL CENTER
Project Address: 30321 16TH AVE S Parcel Number: 250000 0020
Project Description: new circuit for replaced HVAC rooftop unit & new thermostat
Owner
RICHARD MITCHELLMITCHELL FAMILY
LLC
30321 16TH AVE S
FEDERAL WAY WA 98003
Applicant
BRETT ROEBUCKAI R SYSTEMS
ENGINEERING INC
3602 S PINE ST
TACOMA WA 98409
Additional Permit Information
is this an Online or O.T.C. application? .................. Yes
Electrical Fixtures
Circuits - Commercial 1 Thermostat
Contractor
AIR SYSTEMS ENGINEERING INC
(ELECTRICAL)
AtRSYE1009KS (5/18/22)
3602 S PINE ST
TACOMA WA 98409
PERMIT EXPIRES Thursday, 19 May, 2022
Permit Issued on Wednesday, May 19, 2021
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
A�'
CITY OF
Federal Way
THIS CARD IS TO REMAIN ON -SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 21 101978 00 Address: 30321 16TH AVE S Unit 3
Project: RICHARD A MITCHELL FEDERAL WAY WA 98003
Scheduled inspections may be failed if this card is not on -site. DO NOT LOST: TIIIS 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.
LIFER Ground (4295) ❑ Ditch cover (4030) 0 Slab/Concrete Floor (4255)
Approved
By Date
❑ Pool Bonding (4195)
Approved
By Date
❑ Feeders/Sub-panels (4045)
Approved
By Date
❑ Final - Electrical (4055)
Approved
By Date/A `��+Y�I
Approved
By
Date
❑
By
Temporary Power (4275)
Approved
Date
Q
By
Rough Electrical (4225)
Approved
Date
Approved to place concrete
By
Date �J
❑
By
Service(4235)
Approved
Date
❑
By
Ceiling Cover (4020)
Approved
Date
❑
Rough Electrical
❑
Final Electrical
❑ Right of Way
Approved
Approved
Approved
By
Date
BY
Date
l3r Date