17-105958 Electrical
City of Federal Way Permit #:17-105958-00-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
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Project Name: SIM I^ate _.
Project Address: 303 S 302ND PL Parcel Number: 795450 0240
Project Description: Rewire existing single family residence
Owner Applicant Contractor
VATHANA SIM VLAD BONDARENKO EMMANUEL ELECTRIC
303 S 302ND PL 13450 NE 177TH PL EMMANE*831P7(10/27/19)
FEDERAL WAY WA 98003-4078 WOODINVILLE WA 98072
6245 COTTON DR SE
OLYMPIA WA 98513
•
Additional Permit Information
Is this an Online or O.T.C.application? Yes
No Fixtures Associated With This Permit!!
PERMIT EXPIRES Thursday, 13 December,2018
Permit Issued on Wednesday,December 13,2017
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
Washington and the City of Federal Way.
Owner or agent: / Date:
THIS CARD IS TO REMAIN ON-SITE
Fe:)- "Z-----'4„
deral Wa Construction Inspection Record
y INSPECTION REQUESTS: (253)835-3050
PERMIT#: 17 105958 00 Address: 303 S 302ND PL
Project: VATHANA SIM FEDERAL WAY WA 98003-4078
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) Q Slab/Concrete Floor(4255)
Approved Approved
Approved to place concrete
By Date By Date
BY Date
0 Pool Bonding(4195) 0 Temporary Power(4275) ® Service(4235)
Approved Approved
Approved
By Date By Date
BY Date
® Feeders/Sub-panels(4045) ® Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By C �.w Date A _a ey_)c73 By Date
10 Final-Electrical(4055)
Approved
By L_ ;v,_ Date y -2')—, gio
0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date
By Date
......A. ELECTRICAL
CITY of
Federal Way PERMIT APPLICATION
PERMIT NUMBER : J i - ! v _� 17 5 'V - (_,/
� SUITE/UNIT/SPACE#
SITE ADDRESS: 303 —S, 3 o & n ci PL
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ l' i3Oe. 5 'I 0 _ -2
PROJECT NAME
(Tenant or Homeowner Last Name) C5/in
PROJECT DESCRIPTION R 1 Ait,CP -1‘( 114 da in a�JtL�'
Detailed description of work to •J
be included on this permit only
1 NAME n PRIMARY PHONE
PROPERTY OWNER ( ,, 5 inn ( )
MAILING ADDRESS E-MAIL
3 03 5 - c-).c9\r-v‘k P\ _
CITY STATE ZIP FAX
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Fe ' 3c )�%3 ( ) -
NAM PRIMARY PHONE
m,ri a n ve� rte, , c\ Pic (366 31- -,z87
MAILING ADDRESS E-MAIL
ELECTRICAL (-f-'<711--k C >—\t6 i1 A t^ 5 r-,
CONTRACTOR CITY \ STATE ZIP FAX
C\ '..Z b'V�in \ c--� (1 5 (. ( ) -
WA STATE C TRACTO S LICENSE# EXPIRATION DA FEDERAL WAY BUSINESS LICENSE#
/ /
NAMEPRIMARY PHONE
1/(ad '7c'AJart14lo (t.4 t- ) SS a-q- (19Sb
APPLICANT MAILING ADDRES E-MAIL
13'(5° /Ve (771'7 il I ON) g A 4c.r.usc-J.<<"
CITY STATE ZIP FAX
wCd.,rlijl[{ Vtd-- a o 7 ( ) -
PROJECT CONTACT
NAME
Vc,/14area(..) 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 arty 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 634-3/7200-
PRINT NAME:
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