16-101064,� , . • . Electrical
City of Federal Way Permit # • 16 -101064 -00 -EL
�FILE
Community & Econ. Dev. Services •
t 33325 8th Ave S
Federal Way, WA 98003 Request Inspection Ph: (253) 835-2607 Fax: (253) 835-2609 Ins p q est Line: (253) 835-3050
Project Name: KRAVCHISHIN
Project Address: 528 SW 316TH ST Parcel Number: 555920 0195
Project Description: Rewiring and adding new can lights.
Owner
is n
Contractor
VITALY KRAVCHISHIN
VITALY KRAVCHISHIN
OWNER IS CONTRACTOR
528 SW 316TH ST
528 SW 316TH ST
FEDERAL WAY WA
FEDERAL WAY WA
98023
98023
Additional Permit Information
Electrical Work Valuation?....................................2000 Is this an Online or O.T.C. application? ................. Yes
Is Use Educational or Institutional?.......................No
No Fixtures Associated With This Permit It
PERMIT EXPIRES Wednesday, March 1, 2017
Permit Issued on Tuesday, March 1, 2016
I hereby certify that the a e formation is correct and that the construction on the above described property and
the occupancy and th se in ac rdance with the laws, rules and regulations of the State of Washington
nd the City of Federal Way. L
Owner or agent: Date: 21
61 & L-;4-,.- �—, i 4 --
Bot -'�.kI
I t 4J-.
THIS CARD IS TO REMAIN ON-SITE
c,yoF Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 16 -101064 -00 -EL Address: 528 SW 316TH ST
Project: VITALY KRAVCHISHIN FEDERAL WAY, WA 98023-4634
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)
❑
Slab/Concrete Floor (4255)
El
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date ct _ i t b
N4' r-') ,
Pool Bonding (4195)
Temporary Power (4275)
El
Service (4235)
Approved
Approved
Approved
By
Date
By
Date
By
Date 8 t
Feeders/Sub-panels (4045)
E]
Rough Electrical (4225)
0
Ceiling Cover (4020)
Approved
Approved
(Ar
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date ct _ i t b
N4' r-') ,
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
CITY OF A
Federal Way
PERMIT NUMBER I
MAR 0112016
Cn-y OF FEDERAL WAY
- 1 0 1 0T q -
PLECTRICAL
PERMIT APPLICATION
Er_ L
SITE ADDRESS: I'� r(IJ �
5 'W16 sr ede
SUITE/UNIT/SPACE #
PROJECT VALUATION
$�o06
ASSESSOR'S TAR/PARCEL #
ss.�n�0_ot�S'
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
1 111 1� mr' s
U 1 1�
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
�e I r l �l Q �� W Vl
PROPERTY OWNER
NAME ` V ) 1
�(/LVG�t�� h
PRIMARY PHONE
c 4s ) 332 - 7303
MAILING ADDRESS r--•
Iu1 t5 sF 22�"
E-MAIL
W
ZIP �
� ) 11 -PUL
-
ELECTRICAL
CONTRACTOR
NAME
vL on
PRIMARY PHONE
) -
MAILING ADDRESS
EMAIL
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
PRIMARY PHONE
-
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
Su rn P
PRIMARY PHONE
)
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 def. se of such claim), which may be made by any person, including the undersigned, and filed against the city,
but only where such la arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information sup
t t�f city as apart of this application. �f i f
SIGNATURE: "� (/( V LDATE J ` ` � 1 v
PRINT NAME:
Bulletin # 160 — January 1, 2013 Page 1 of 2 k:\I-landouts\Electrical Permit Application
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