17-105155City of Federal Way
Community Development Dept.
33325 8th Ave S
Fedeml Way, WA 98003
Ph: (253) 835-2607 Fax (253) 835-2609
Project Name: RBCB INVESTMENTS & VERISTONE FUND 1 LLC
Project Address: 533 SW 293RD ST
Electrical
Permit #:17 -105155 -00 -EL
Inspection Request Line: (253) 835-3050
Project Description: Rewiring for entire house with associated remodel work
Parcel Number: 119600 1680
Owner
Applicant
Contractor
JASON BRYANTRBCB INVESTMENTS &
ALEX YEVCHEVA D S ELECTRIC LLC
A D S ELECTRIC LLC
VERISTONE FUND I LLC
13312 16TH AVE CT S
ADSELEL845R3 (12123/18)
6725 116TH AVE NE
TACOMA WA 98444
KIRKLAND WA 98033
13312 16TH CT S
USA
TACOMA WA 98444
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
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'1' 1 200 aml I Mast or Meter Repair(Resider.
CONDITIONS:
Separate electrical permit.Ezisting overehead utility connections shall be placed underground, per
Federal Way Revised Code (FWRC) Section 11.05.120.A City Right of Way Permit is required to connect
the driveway to SW 293rd St. Contact Kathleen Mathena, Street Systems Engineering Technician at
(253) 835-2725 for permit requirements.
PERMIT EXPIRES Thursday, 25 October, 2018
Permit Issued on Wednesday, October 25, 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
ashin n and the City of Federal Way.
Owner or agent: Date: 10- Z S` 17
FJNAIED
4 r
crry THIS CARD IS TO REMAIN ON-SITE
FedTHIS
Inspection Record
Federal Way '
y INSPECTION REQUESTS: (253) 835-3050
PERNUT #: 17105155 00 Address: 533 SW 293RD ST
Project: JASON BRYANT FEDERAL WAY WA 98023-3537
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)
0
Ditch cover (4030)
Temporary Power (4275)
FAI
Slab/Concrete Floor (4255)
Right of Way
Approved
Approved
Approved
Approved
Approved
Approved to place concrete
By
Date
By
Date
By .UUDate
By
Date
®
Pool Bonding (4195)
®
Temporary Power (4275)
®
Service (4235)
Right of Way
Approved
Approved
Approved
Approved
Approved
By
Date
By
Date
By .UUDate
By
El
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
1D
Ceiling Cover (4020)
Right of Way
Approved
Approved
Approved
Approved
Approved
By
Date
By
By
Date
By
Date
1t) Final - Electrical (4055)
Approved
C S Date U
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
CITY OF
Federal Way
i . ELECTRICAL
OCT 2 5 2017 PERMIT APPLICATION
GI'lY N FEDERALWAY
' - I _ %' 0
COMYUNf'Y DEVE LOP'MIMIT NUMBER L�J``--��''
SITE ADDRESS: �W J�1
5 ��� S-1
SUITE/UNIT/SPACE #
PROJECT VALUATION
$ 75 -Ob. 0`�
ASSESSOR'S TAX/PARCEL /
C � �'? Cp 0 G
CURRENT/PROPOSED USE
PROJECT NAME
Homeowner Last Name)
--
Ya,(o C r-gcj3
(Tenant or
41,C err tom.,, s e
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
�� D
PRIMARY PHONE
(Zv(�) 1,55 _ t 5"7
MAILING ADDRESS
S33 S s1"
E-MAIL
CITY
STATE
ZIP
FAX
NAMEPRIMARY
hex uckt✓
PHONE
(2 ) a;l - oq
MAILING ADDRESSE-MAIL
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elec fT/T ll c( -Q
ELECTRICAL
CONTRACTOR
CITY
�dt(an�r e�
STATE
1JA
ZIP
161-1#14/
FAX
( ) -
W STATE CO TRACTOR' LICENS # EXPIRATION DATE
Sys 3 12 z /.oi
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
( )
CONTACTkt,e
NAME
ye vGPROJECT
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 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 aphis application.
SIGNATURE:
PRINT NAME: , 1 l`ex
TE 10—
Bulletin
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Bulletin # 160 – April 14, 2016 Page I of 1 k:\I-Iandouts\Electrical Permit Application