15-104591Electrical
City of Federal Way rxna
Community & Econ. Dev. Services --� Permit #: 15-104591-00-E L
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: 253 835-3050
Ph: (253) 835-2607 Fax (253) 835-2609 p Q
Project Name: TYMOS
Project Address: 35828 12TH AVE SW Parcel Number: 440560'0053
Project Description: 200 amp service for new single family residential
Owner
ARRIican
Contractor
SAM TYMOS
NW ELECTRICAL LLC
NW ELECTRICAL LLC
IRYNA TYMOS
8507 LUZADER LN SW
NWELEEL886NP (8/26/16)
3584212TH AVE SW
LAKEWOOD WA 98499
8507 LUZADER LN SW
FEDERAL WAY WA 98023
LAKEWOOD WA 98499
Additional Permit Information
Is this an Online or O.T.C. application? ................. es Is Use Educational or Institutional? ....................... No
Electrical Fixtures
New Service: Residential ............... 1
PERMIT EXPIRES Tuesday, March 8, 2016
Permit Issued on Thursday, September 10, 2015
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 regtt bons of the State of Washington
F and the City of Federal Way. _
Owner or agent ���!/ Date: e < D —
cm oP "
Federal Way
PERMIT #:
• THIS CARD IS TO *MAIN ON-SITF.f, r
Construction Inspection Record.
INSPECTION REQUESTS: (253) 835-3050
15 -104591 -00 -EL
Address: 35828 12TH AVE SW
Project: SAM TYMOS FEDERAL WAY, WA 98023
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
FJ
LIFER Ground (4295)1:1
Ditch cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
Service (4235)
Approved
jBy
Approved
Approved to place concrete
By
Date
By
Date
By
Date
FJ
Pool Bonding (4195)
Temporary Power (4275)
Service (4235)
of Way
Approved
jBy
Approved
By
Approved
Approved
Date
By
Date
By
Date
Date Ct _ _
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
S Dateq _ l�
By
Date
Final - Electrical (4055)
Approved
By
Date
FJ
Rough Electrical
Approved
Final Electrical
Approved
E]Right
of Way
Approved
jBy
Date
By
Date
By
Date
CITY OF A
Federal Way
0 0
ELECTRICAL
PERMIT APPLICATION
P=m= NuxBm � S ( 0 � 5 9 1 00
RECEIVED
SEP 10 2015
SITE ADDRESS: _� 8 ( 2 A Ue C
CDS
PROJECT V(A�LUATI"O%N\
A38ES80 'S TAX/PARCEL
CURRENT/PROPOSED USE
PRO CT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
oc� t r• 70 0 Sqr. koLAse w't -1 LA 2 0
t" C
PROPERTY OWNER
NAME
PRIMARY PHONE
( ) -
MAUAVG ADDRESS
E-MAM
CITY
STATE
ZIP
FAX
ELECTRICAL
CONTRACTOR
NAME
N UV E(ec--rc c -a ( Z -LC
PRIMARY PHONE
(z5X20t - 636
MAILING ADDRESS
$,5 D% L t4 tat cle- r 6vl • S W
E -MAH.
CITYSTATE
LA lie. L"j
LA -)A-0'?
ZIP
9
FAR
( ) -
WA STATE CONTRACTOR'S LICENSE @ EXPIRATION DATE
AIw -FI-E B�
FEDERAL WAY BUSINESS LICENSE11
APPLICANT
NAMEPRIMARY
�etitiar Wt gowovi e
PHONE
(Z53�08 - b 3 6 3
MAILING ADDRESS
CR U Q—
E-MAIL
CITY
STATE
ZIP
( FAX
1 ) -
PROJECT CONTACT
NAME
PRIBIARY PHONE
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 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 claimb 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 of and employees, upon the accuracy of the
information supplied to the city as apart of this application.
SIGNATURE: DATE
PRINT NAME: �y7lf'IIA cb (S� E' `Gl e
Bulletin 4160 — January 1, 2013 Page 1 of 2 kM-iandoutsTlectrical Permit Application .