16-100195City of Federal Way
` Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: KOSTENKO
Project Address: 4155 S 332ND PL
Project Description: Install transfer switch for portable generator
Electrical
Permit #: 16 -100195 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 618140 0760
Owner
A121211cant
Contractor
YELENA A KOSTENKO
DMITRY V KOSTENKO
OWNER IS CONTRACTOR
DMITRY V KOSTENKO
4155 S 332ND PL
4155 S 332ND PL
AUBURN WA
AUBURN WA
98001
98001
Additional Permit Information''`
Electrical Work Valuation?....................................500.00 Is this an Online or O.T.C. application?................ Yes
Is Use Educational or Institutional? ....................... No
Electrical Fixtures
Circuits - Residential .....:............... 1
PERMIT EXPIRES Tuesday, July 12, 2016.
Permit Issued on Thursday, January 14, 2016
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 age . Date: /Z/3 Z 16
` THIS CARD IS TO RE& ON-SITEO
`
C,n °FConstruction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 16 -100195 -00 -EL Address: 4155 S 332ND PL
Project: YELENA A KOSTENKO FEDERAL WAY, WA 98001-5154
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)
Ditch cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
1:1Approved
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
❑
Pool Bonding (4195)
Temporary Power (4275)
1:1Approved
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
E1
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
ate
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
y
CITY OF
Federal Way
PERMIT NUMBER I (4 _ L v O
ELECTRICAL
PERMIT APPLICATION
RECEIVED
JAN 14 2016
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SITE ADDRESS: � (�� � 0 3 3 2 � /�� �� �� �� 0�
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CC35
OJECT37� AT—I^ON
ASSES SOR TAB CEL # O — yc1 D
T
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
1� C)s
I
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
G-eote n`-4-i� r
PROPERTY OWNER
NAME
C�V\\,kfit'+ '�S-�e N r�
PRIMARYPHONE
(25b 632- - yg�,�
MAILING ADDRES
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E-MAIL
CITY
STATE
ZIP
FAX
ELECTRICAL
CONTRACTOR
NAME /
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
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
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 taws 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 apart of this application.
SIGNATURE:
' ^�t,�
PRINT NAME: -/3t'7 l P� l / _- - 0 S -1-e i4 v ho
Bulletin # 160 —January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application