14-100187 • Electi-ica
City of Federal Way
Community&Econ.Dev.Services Permit #: 14-100187-00-EL
33325 8th Ave S
Federal Way,WA 98003
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253)835-3050
Project Name: KURKOV DUPLEX-UNIT A
Project Address: 28804 28TH PL S Parcel Number: 029450 0200
Project Description: Install new wiring to existing home
Owner Applicant Contractor
GARY J ARNEY N W ELECTRICAL LLC N W ELECTRICAL LLC
PAUL KURKOV 8507 LUZADER LN SW NWELEEL886NP(8/22/14)
PO BOX 833 LAKEWOOD WA 98499 8507 LUZADER LN SW
GRAHAM WA 98338 LAKEWOOD WA 98499
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional9 No
Service greater than 999 Amps? No
Electrical Fixtures
New Service:Residential 1
PERMIT EXPIRES Sunday, July 13, 2014
Permit Issued on Tuesday, January 14, 2014
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 C.ty of Federal Way.
Owner or agent: Date: (`( 72-0/V
,,,,,e0„,...., ,,-.44*.t.
0 , THIS CARD IS TO AIN ON-SITE
CITY
OF Construction Ins ection Record
Federal Way INSPECTION REQUE TS: (253) 835-3050
PERMIT#: 14-100187-00-EL Address: 28804 28TH PL S
Project: GARY J ARNEY FEDERAL WAY, WA 98003-7901
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) 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
0 Pool Bonding(4195) 0 Temporary Power(4275) 0 Service(4235)
Approved Approved Approved
.By Date By Date .By Date ` - '1 `i +
.0 Feeders/Sub-panels(4045) * 0 Rough Electrical(4225) �0 Ceiling Cover(4020)
Approved Approved Approved
By Date By (I Date ` ` VI _l LI 'By Date
0 Final-Electrical(4055)
Approved
By e UVJ Date 6. ,3_1
❑ Rough ElectricalEl Final Electrical El Right of Way
Approved Approved Approved
By Date By Date By Date
0
CITY OF Nib. 1110
ELECTRICAL
Federal Way PERMIT APPLICION
PERMIT NUMBER ( _ I 0 0 ( S 7 _ 00 JAN 14 2014
CI1Y OF FEDERAL WAY
SITE ADDRESS: 2 SUITE/UNI1'j3PE#
PROJECTA
VALUATION A�SOR'S2 T�PA
/ RCEL# � � � � M CURRENT/PROPOSED USE
$PROJECT NAME )' (). /D l/ )P UN
^, (T A
(Tenant or Homeowner Last Name) X 5� %v _�/ ,`E I
(. i^=`t7 f i - c ee 'i 1 L a? j ( (i a -$9--• -(1, (.-{Yl( ' -
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER paLA.. 1 (k ( kU (2_63) 732- 2 3S2
MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
( ) -
NAME
PRIMARY PHONE
W E1G -1rica \ lrtC (2__ 1ZDB- 13 '3
MAILING ADDRESS E-MAIL
ELECTRICAL g 3 7 Z---i4 2 a c4 o- /VI S t.L.:,
CONTRACTOR CITY STATE ZIP FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
1J 'Wt= 1.--- L L 3YsAUP t /22i/y
NAME
PRIMARY PHONE
APPLICANT 1,1 1.--tct. ( /�/ E vel 44 Q vl e.i4 c) (2 3)2 ID 8- 6 3 6
MAILING ADDRESS E-MAIL
eD7 44.1 7 ac, r- 7 L S cc
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT Po`uk�
( r k O tJ (2-5 )
?5 ) 7 3` _ 2 3 1'Z
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 ///41 /2 C> 1
PRINT NAME: C e ice(i')et di Y QD,/1/JG n e n k o
Bulletin#160—January 1,2013 Page 1 of 2 k:Wandouts\Electrical Permit Application