17-102124 •
• . * •
I
Electrical
City of Federal way Permit #:17-102124-00-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: BALIKA
Project Address: 4002 S 329TH ST Parcel Number:618141 0430
Project Description: Electrical wiring for addition.
Owner Applicant Contractor
ANDRIYAN BALIKA ANDRIYAN BALIKA OWNER IS CONTRACTOR
4002 S 329TH ST 4002 S 329TH ST
FEDERAL WAY WA 98001 FEDERAL WAY WA 98001
Additional Permit Information
Is this an Online or O.T.C.application? Yes
CONDITIONS:
PERMIT EXPIRES Wednesday,9 May,2018
Permit Issued on Tuesday,May 9,2017
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
1 Washington and the City of Federal Way.
Owner or agent: Date: 0 5/09) Oi.—
' THIS CARD IS TO REMAIN ON-SITE
Federal Way111.11 Construction Inspection Record
INSPECTION REQUESTS:(253)835-3050
PERMIT#: 17 102124 00 Address: 4002 S 329TH ST
Project: CRISTINA BALIKA FEDERAL WAY WA 98001-5164
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.
® UFER Ground(4295) 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
® Pool Bonding(4195) •121 Temporary Power(4275) ,•® Service(4235) ,
Approved Approved Approved
By Date By Date By Date
. ..
• .. .
® Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Q, Date rt.... "-c--1 .,By � „._,1 Date 1.- 2.)_ i ei,
El Final-Electrical(4055)
Approved
,By P4 le, Date 10 l 3 I t,--1
• r
❑ Rough Electrical D Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
A► ELE RECEIVED
CITY OF �,f CTRICAL
Federal Way MAY 0 9 2017 PERMIT APPLICATION
CITY OF FEDERAL WAY
/COMMUNfl DEVELOPM ITEMIT NUMBER ( D _
SUITE/UNIT/SPACE#
SITE ADDRESS: (-1 G2 S 32_9Tk Sr F F°PRA L (AA y (AA 3604
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ $ /(cG0 G -I 'i (1 /1 _ 0 'I 3 0
PROJECT NAME
(Tenant or Homeowner Last Name)
(3 U II-0 Di N) N G kooN a.nct PA i i 01 KCON as
PROJECT DESCRIPTION C(C.L L&o r1 t o -65 C( S�t t73 - &ti.r S Z e {ci
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ANORNflN 84L ) r ( 4-'5323e - 6Y9 J
MAILING ADDRESS E-MAIL
q002 S 3e 9TH ser
«IlaPl�o,,�bca I KQ.
CITY .541,c-t )- win
STATE ZIP FAX
FLUE L WAV ik)A- 9gOoI ( ) -
NAME PRIMARY PHONE
C(-) )rt-eti ( ) -
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME ] PRIMARY PHONE
APPLICANT f't N kI YAK/ i3A L 1 I ( 53)23e - CY 5.9
MAILING ADDRESS E-MAIL
`f f � 3 T{P 5T an Clef i yr7�tpbR J r ICA-
cy na.l►. cwrri.
CITY STATE ZIP FAX
FEDe 1,- WA(I (A)0 080) 1 ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT A N pg 1 ,/l)n/ f3 A L(K1-i- 05-3) 3e- C,Y 98
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 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.
SIGNATURE: . -r"r DATE 05/Os le o j -
PRINT NAME: 4) 0 t f. ( Y O u 13PiL 11C-12t--
Bulletin
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Bulletin#160-April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application