15-103958 - ., ELECTRICAL
CITY OF
Federal Way PERMIT APP MION
PERMIT NUMBER 5 _ 10 ✓ 95 8 _ �/ " AUG 07 2015
CITY OF FEDERAL way
SITE ADDRESS: 3 p5a�'( E.44, SUITELfiP i/SPACE#
o� Ave
slot)
PROJECT UATION
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V 0 LF
O CURRENT/PROPOSED USE
-
PROJECT NAME
(Tenant or Homeowner Last Name) �/� )WI I"l 51(c..,
p
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER /I�i Ike__. Z 1 W1,ti 5k ( ;co ) 7 r`i -1S6,--).
MAILING ADDRESS E-MAIL
11
CITY STATE ZIP FAX
ede. -4 W6t--f A- cj(1-p2?-, ( ) -
NAME DRIMARY PHONE
'I71 k El ul-r�— (aS3) 'K -C4750
MAILING ADDRESS A c� E-MAIL
ELECTRICAL 3 3 410 30 *h A,l.Q O
CONTRACTOR CITY STATE ZIP FAX
Fev erc ( U)A-Y SVA- 6/N' , 3 ( ) -
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
9. -1.-D--(--15 G705 '1/ S 47
NAME _` PRIMARY PHONE
APPLICANT ���qat`) `� 0.-1,14
` eS
( ) _
MAILING ADDRESS E-MAIL
33Lifo3 Ape_ SA)
CITY STATE ZIP FAX
jcv 9'`7` WA- g irO cl ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT M ,ke 00 hno
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 a part of this application.
SIGNATURE: DATE 7/5( 15
PRINT NAME: tlQh'k 3-ctM^ ,
Bulletin#160—January 1,2013 Page 1 of 2 k*Handouts\Electrical Permit Application
—
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Electrical
Permit #: 15 -103958 -00 -EL
Inspection Request Line: (253) 835-3050
Project Name: ZIIVIINSI�E 3 (p93
Project Address: 30224 25TH AVE SW Parcel Number: 893760 0040
Project Description: Run circuit to alarm panel for septic system
Owner
ARRlicant
Contractor
MARK ZIMINSKE
AYSHA PIKO
D & A ELECTRIC LLC
30224 25TH AVE SW
D & A ELECTRIC LLC
DELEC*E897D5 (4/5/17)
FEDERAL WAY WA
33410 30TH AVE SW
33410 30TH AVE SW
98023
FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Additional Permit Information
Is this an Online or O.T.C. application?.............:...Yes Is Use Educational or Institutional? ....................... No
Electrical Factures
Circuits - Residential ...................... 1
CONDITIONS:
Inspection approval is required prior to covering or concealing any portion of the septic electrical system,
including the pump. New septic & effluent tanks containing electrical wires and equipment MUST be
inspection and approved PRIOR to being loaded with sewage. (Per 296-46B-501-001(b)(7)WAC)
PERMIT EXPIRES Wednesday, February 3, 2016
Permit Issued on Friday, August 7, 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 regulations of the State of Washington
and the City of Federal Way.
Owner or agent:
Date:
�1 TffiS CARD IS TO
CITY OF MAIN ON-SITE
Federal Way Con struction In ection Record
SPECTION REQUESTS: (253) 835-3050
PERMIT #: 15 -103958 -00 -EL Address: 30224 25TH AVE SW
Project: MARK ZIMINSKE FEDERAL WAY, WA 98023-2316
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE 'THIS CA n 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
0 UFER Ground (4295) Ditch cover (4030)
Approved Approved Slab/Concrete Floor (4255)
Approved to place concrete
BY Date By Date
BY Date
0
Pool Bonding (4195)
Approved
BY
Date
0
Rough Electrical (4225)
Feeders/Sub-panels (4045)
By
Approved
By
Date
0
Temporary Power (4275)
Approved
BY
Date
0
Rough Electrical (4225)
Approved
By
Date
0 Final - Electrical (4055)
Approved
BY Dat /U /
0
Service (4235)
Approved
By
Date
0
Ceiling Cover (4020)
Approved
By
Date
❑ Rough Electrical Final Electrical
Approved El
Right of Way
Approved
Approved
BY Date By Date
BY Date