16-103650Electrical
City Conwmnfty& Federal ,. Permit #: 16 -103650 -00 -EL
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2807 Fax (253) 835-2809 Inspection Request Line: (253) 8353050
Project Name: WYNSTONE EAST LOT 6
Project Address: 34129 11TH AVE SW Parcel Number: 957850 0060
Project Description: Add (30) amp circuit for heat pump.
Owner
ARRlicant
Contractor OF
STEPHEN KURIATNYK
DAVID HERMES
A & D ELECTRICALS ES INC
3412911TH AVE SW
A & D ELECTRICAL SERVICES INC
ADELESI972D 5/17)
FEDERAL WAY WA
6503 34TH AVENUE CT E
6503 34TH CT E
TACOMA WA 98443
TACO WA 98443
Adc
Electrical Work Valuation? . ......... .................400
Is Use Educational or Institutional?.......................No
El
Circuits - Residential ...................... 1
PERMIT EXPIRES
Permit Issued on A
hereby certify that the above information is
the occupancy athe use will i c
Owner or agent f
6- —
rformation
Is this gpiftlitel. . application?.................Yes
"bct"'► / z .
t �11i that the
h the� s�•�
City of FAr
0
(, July 2]k2017
, July` 16
fiction on the above described property and
and regulations of the State of Washington
IT /�
Date: � 6— / 16
crry GW4&
F
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
16 -103650 -00 -EL Address: 34129 11TH AVE SW
STEPHEN KURIATNYK FEDERAL WAY, WA 98023
inspections Y Inspections are listed as close to sequential order as
Scheduled ' 'ons ma be failed if this card isnot on-site. ]DO NOT LOSE THIS CARD.
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.
Ground (Ditch
0
cover(4030)
Temporary Power (4275)Service
Slab/Concrete13 Floor (4255)
11
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
Temporary Power (4275)Service
11
(4235)
By
Approved
By
Approval
By
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
By
Date
By
Date
By
Date
Q
Final - Electrical (4055)
Approved
By
Date
Rough Electrical
A)
Final Electrical
Approved
11
Right of Way "
Approved
By
Date
By
Date
By
Date
My of I&
Federal Way
RECEIVED
ELECTRICAL
JUL 2 7 2016 PERMIT APPLICATION
CITY OF FEDERAL WAY
CDS
PERIliT NIIMER
SITE ADDRESS:
SUITE/UNIT/SPACE #
PROJECT VALIIATI
� T � `.J - 0ol=/
CQRRgPT/PROPOSED IISE
PROJECT NAME
(Tenant or Homeoumer Last Name)
%
PROJECT DESCRIPTION
Detailed descnggtion of ujork to
be included on this permit only
PROPERTY OWNER
NAME
�Q V1
PMMMUMY PHONE
OS3) ZO Zcf
MAILING ADD ?" (+
Z-
�)
( b�
W STATE
ZIP 073
( ) FAX
ELECTRICAL
CONTRACTOR
APPLICANT
NAME
,?-.0f � K c
PRIMARY PHONE
30q - S�,q
MAILING ADDRESS
(X2)QS- A60
WA STATE CONTRACTOR'S LICENSE f2E339 CATION DATE
IF -S
NAME
FEDERAL WAY BUSINESS/ LICENSE r
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
& v -e- 4,v� f ,� rl /! L (
FRIMAIM MOM
(9, 3) 3
I certft under penalty of perjury that I ant the property owner or authorised agent of the property owner. I cer tVy that to the beat of
my knowledge, the information submitted in support of this permit application is true and correct. I cortVy 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 attwwejW fees incurred in
the investigation and defense of such ciabah w h may be made by any person, including the undersigned. and ftled against the city,
but only where each claim arises out of the of the city, including its officers and emplogees, upon the accuracy of the
d m
information stthe city as a pmt of *t application.
SIGNATURE:
PRINT NAME:
PERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcentcl@cityoffederalway.com
Bulletin #160 — April 14, 2016 Page I of 1 k:\Handouts\Electrical Permit Application