15-101997 • •• Electrical
City of Federal Way +
Community&Econ.Dev.Services Permit #: 15-101997-00-EL
33325 8th Ave S
Federal Way,WA 98003 n Inspection Request Line: 25
Ph:(253)835-2607 Fax:(253)835-2609 p q ( 3)835-3050
Project Name: GRUY
Project Address: 29630 22ND AVE S Parcel Number: 879800 0075
Project Description: Changing out service, updating to 200-amp,new meter,new mast.
Owner Applicant Contractor
VIKTOR P GRUY VIKTOR P GRUY OWNER IS CONTRACTOR
29630 22ND AVE S 29630 22ND AVE S
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Electrical Fixtures
Alt. Serv./Feeder: 0 to 200 amps(F 1
PERMIT EXPIRES Wednesday, October 21, 2015
Permit Issued on Friday, April 24, 2015
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: +rZ V /S
• THIS CARD IS TO MAIN ON-SITE
"TM OF Construction Ins ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 15-101997-00-EL Address: 29630 22ND AVE S
Project: VIKTOR P GRUY FEDERAL WAY, WA 98003-4251
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.
O UFER Ground (4295) El Ditch cover(4030) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
O Pool Bonding(4195) ❑ Temporary Power(4275) ❑ Service(4235)
Approved Approved Approved
By Date By Date By ei�..'*,...— Date7'oqA.-"-1
❑ Feeders/Sub-panels(4045) El Rough Electrical (4225) ❑ Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055)
Approved
'By Date -i�1-1 ,•z, ,
0 Rough Electrical111 Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
• RECEIVED •
-410*,..„.CITY OF
APR 24 205 E CTRICAL
Federal Way CITY OF FEDERAL WAY PERMIT APPLICATION
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PERMIT NUMBER /5-_ / v / / / _ E_jz____-
/ SUITE/UNIT/SPACE#
.—V- SITE ADDRESS: 2 9 3 0 ,2 2,,,d ,9t/€ S Fe ��Q(-1 I y
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PROJECT VALUATION ASSESS,9$1 /PARg# 0 — y, s__ CURRENT/PROPOSED USE
PROJECT NAME O lTAX �,(
(Tenant or Homeowner Last Name) 6"I�kit I
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PROJECT DESCRIPTION Mte 1-c r I Ne',-) p NO f vim..' 5*
Detailed description of work to
be included on this permit only
. NAME PRIMARY PHONE
PROPERTY OWNER (/ (�) k- ` r G ' 3 ..___()s 5)337 - /P'j_ f
MAILING ADDRESS E-MAIL
Z163c2 aand 4/C S
CITY STATE ZIP FAX
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NAME ( AA),, 111'
j// PRIMARY PHONE
(AV �/ ( )
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
( )
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME 0PRIMARY PHONE
APPLICANT 0
( )
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( )
NAMEPRIMARY PHONE
PROJECT CONTACT ,?�'i(ij(-- 6'r -1 -, (453)DY- 7Y d 4
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: / /� DATE ,Ql, / L y ( / S
PRINT NAME: U I,IC r ,('K`� 1
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application