18-101588City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax (253)835-2609
Project Name: GORETSKI
Project Address: 29854 1ST AVE S
Project Description: Install 5.31 KW photovoltaic solar system
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Electrical
Permit #:18 -101588 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 052104 9040
Owner
Applicant
Contractor
CARL T GORETSKI
DALE KRUEGERPROSTAT ELECTRIC
PROSTAT ELECTRIC
29854 1ST AVE S
1721 NE 64TH AVE
PROSTE*890ON (9/15/19)
FEDERAL WAY WA
VACOUVER WA 98661
1721 NE 64TH AVE
98003
USA
VANCOUVER WA 98661
Additional Permit Information
Is this an Online or O.T.C. application? .................. No
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1 to 200 .
PERMIT EXPIRES Tuesday, 14 May, 2019
Permit Issued on Monday, May 14, 2018
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 a he City of Federal Way. �7
Owner or agent: Date:
QTY of
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
18101588 00 Address: 298541ST AVE S
FRANCES L GORETSIU FEDERAL WAY WA 98003-3642
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.
El
UFER Ground (4295)2❑
❑
Ditch cover (4030)❑
®
Slab/Concrete Floor (4255)
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
0
Pool Bonding (4195)
❑
Temporary Power (4275)
®
Service (4235)
Approved
Approved
Approved
By
Date
By
Date
By
Date
0
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
®
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
Date
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
(�- RECEIVED ELEC'T`RICAL
Federal a APR 13 2018 PERMIT APPLICATION
1 \ CITY OF FEDERAL WAY
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PROJECT VALiSATIQI�
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CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
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APPLICANT
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PROJECT CONTACT
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I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I cert} fy that to the best of
my knowledge, the information submitted in support of this permit application is true and correct. I cert(ly that I will comply with all
applicable City of Federal Way regulations pertaining to the work authorised 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 flied against the city,
but only where such c im arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to city as a p rt of this application.
3IGNATIIRE: _ .__ '�� DATE L O
PRINT NAME:
PERMIT CENTER + 33325 80, Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + peialtcentea(rt-ez>ofieeisay.com
Bulletin #160 —April 14, 2016 Page I of t UllandoutsMectrical Permit Application
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