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07-102451 Ci of Federal •..JJ��.[ CornrnunZDevefr,prnentLMces Electrical Permit tt. 07-102451-00-EL P.O.Box 9718 Federal Way,WA 98063-9718 Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050 Project Name: LISITSYN Project Address: 30414 24TH AVE SW Parcel Number: 889420 0020 Project Description: Add/alter up to (4)circuits. Owner Applicant Contractor ANDREY LISITSYN ANDREY LISITSYN ANDREY LISITSYN 2255 S 287TH ST 2255 S 287TH ST 2255 S 287TH ST FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 Additional Permit Information Electrical Fixtures Circuits-Residential 4 PERMIT EXPIRES Tuesday, October 30, 2007 ' emit Issued on Thursday, May 3, 2007 hereby certify that„the above infra n,is co I.- t • that the construction on the above ode ribed property and the occupancy and the use v l be in acc ce wire ,-B _ s, ruktit a eg lati ns of the State of Washington � ,,� rid"the' , • - ral Way. ' Owner or agent: I i ce! Date: /#4013/110?" ., • THIS CARD IS T(EMAIN ON-SITS CITY OF A. Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 07-102451-00-EL Owner: ANDREY LISITSYN Address: 30414 24TH AVE SW FEDERAL WAY, WA 98023 This card is part of your required inspection documents. 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. ❑ Slab/Concrete Floor(4255) ❑ Ditch cover(4030) ❑ Pool Bonding (4195) Approved to place concrete Approved Approved By Date By Date By Date - ❑ Temporary Power(4275) ❑ Service(4235) ❑ Feeders/Sub-panels(4045) Approved Approved Approved By Date By Date By Date ❑ Rough Electrical(4225) ❑ Ceiling Cover(4020) ❑ Final-Electrical(4055) Approved Approved Approved Byes Date— 4 o7 By Date Date 5-Z's -0 ❑ Under-slab groundwork(4295) Approved By Date • For inspector reference only ❑ Rough Electrical ❑ FINAL-Electrical Approved Approved By Date By Date RECEIVED - 0? CI CITY OF Federal way . P E R M I T COMMUNITY DEVELOPMENT SERVICES SF MF CO ME �'L DE EN FP F5 E8DTH E RAAL VE NWUAE Y,S OWH 98•0 P6O BO71X 8 yd{e Q 3 200 P p L I C A T I O N TD 253-835-2607•FAX 253-835-2609 !Lnui.rituoffedenziwatoorn rY OF FEDERAL WA'( mi 4�� PTa The following is req on-an incomplete application will not be accepted. Please print legibly(in ink)or type. • 0 PROPERTY INFORMATION 'SITE ADDRESS 3 o ` l 1 2 V lam - 1 SUITE/UNIT# ASSESSOR'S TAX/PARCEL# e s ` 9 2 O- 0 .0 - d LOT SIZE(sJ) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) 4 2 �frf 4 (Attach separate page for lengthy legal description) IN PROJECT INFORMATION TYPE OF PERMIT ❑ BUILDING 0 PLUMBING ❑ MECHANICAL ❑ DEMOLITIONS,ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT pCRIPTION (Provide detailed d scription of work included on this permit only) PROJECT NAME(Name of Business or Owner Last Name) G_- "✓ /7-- / S ' V • PEOPLE INFORMATION PROPERTY NAME / PRIMARY PHONE OWNER /YIe� G—/Sl 7Vt/ (-z5S) 33/ -2z2\--. MAILING ADDRESS CITY, STyG,�P � 7� E-MAIL AD S rap_©Yty 241 � s t,,1 Flo., 4/5 02. C uor 7rO Lod,_oO047-7 CONTRACTOR COMPANY NAME 0 W APPLICANT NAM OFFICE PHONE MAILING ADDRESS CITY,STATE,ZIP CELL PHONE ( ) - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER ( ) COPY of card required CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS with each application APPLICANT COMPANY NAME Oa(^J n � � APPLICANT NAME OFFICE P)ONE MAILING ADDRESS CITY,STATE,ZIP CELL PHONE ( ) RELATIONSHIP TO PROJECT FAX.NUMBER ❑ Architect ❑ Tenant ❑Agent, ❑ Other ( ) - PROJECT NAME /;r� /\ PRIMARY PHONE E-MAIL ADDRESS CONTACT /lt/) %�/1 ( ) - LENDER NAME Per RCW 19.27.095: Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) ■ DETAILED BUILDING INFORMATION'.IIIVPr EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ SPRINKLERED BUILDING? ❑ YES ❑ NO ` RE SUP' • SSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO WATER SERVICE PROVIDER ❑ LAKEHAV ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ■ PRIVATE(SEPTIC) AREA DESCRIPTION EXISTING PROPOSED TOTAL Se.FT. Se.FT. Se. FT. BASEMENT • ' 7 . FIRST SECOND THIRD ADDITIONAL FLOORS(DESCRIBE) DECK(0 COVERED OR ❑UNCOVERED?) . GARAGE ❑ CARPORT ❑ NUMBER OF FLOORS EXISTIRo PROPOSED I TOTAL TOTAL EXISTING St TOTAL PROPOSED SF TOTAL SP "NEW HOMES ONLY" NUMBER OF BEDROOMS ESTI r ED SELLING PRICE $ U FIXTURES Indicate number of each type of re to be installed or relocated as part of t project. Do not include existing fixtures to remain. • MECHANICAL I Value of Mechanical Work$ (A COPY OF BID OR ESTIM: MUST BE INCLUDED WITH APPLICATION) AIR HANDLING UNITS •ORATIVE COO ^'S GAS PIPE OUTLETS WOODSTOVES BBQS. FAN GAS WATER•HEATERS MISC(Describe) BOILERS FIREPLA■ 'SERTS HOODS(Commercial) COMPRESSORS FUR S ' RANGES DUCTS t , LOG SETS REFRIG.SYSTEMS PLUMBING BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS _ WATER CLOSETS crow) ELECTRIC WATER HEATERS SINKS WASHING MACHINES HOSE BIBBS SUMPS ' SIGNATURE I certify under penalty of perjury that the information fur ished ,y me is true and correct to the best of my knowledge, and further,that I am authorized by the owner of the above premises to per t• 'e the work for which the permit application is made. I further agree to hold harmless the City of Federal Way as to any claim(inclu• • co , expens s, and attorneys'fees incurred in the investigation and defense of such claim),which may be made by any person, cludin; dersigne• •nd filed against the City of Federal Way,but only where such claim arises out of the reliance of the city,inciudin: offs '''• employe . pon the accuracy of the information supplied to the city as a part of this application. / NAME/TITLE ,� , - DATE /I - 2 (Signatur (Title) RELATIONSHIP TO PROJECT wner O Agent ❑ Contract ❑ Architect 0 Other o NEW o ADDITION o ALTERATION o REPAIR a TENANT IMPROVEMENT BUILDING SHELL ONLY? o YES o NO . BASIC PLAN? E oY S ENO ZONING DESIGNATION CHANGE OF USE? a YES o NO NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO a Bulletin#100—April 2,2007 . Page 2 of 4 k\Handouts\Permit Application 1