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18-104813City of Federal Way Community Development Dept. 33325 8th Ave S Federal Way, WA 98003 Ph: (253) 835-2607 Fax (253)835-2609 Project Name: HIMICHUK Project Address: 29811 1ST AVE S Electrical Permit #:18 -104813 -00 -EL Inspection Request Line: (253) 835-3050 Parcel Number: 513710 0060 Project Description: Change feeder from meter socket to load center, including load center. Owner Applicant Contractor VALERIY HIMICHUK VALERIY HIMICHUK OWNER IS CONTRACTOR 29811 1ST AVE S 29811 1ST AVE S FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 Additional Permit Information Is this an Online or O.T.C. application? .................. Yes Alt. Serv./Feeder: 0 to 200 aml 1 PERMIT EXPIRES Saturday, 12 October, 2019 Permit Issued on Friday, October 12, 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 and the City of Federal Way. Owner or agent: Date: 1,07 . /X-/ , /L ary of THIS CARD IS TO REMAIN ON-SITE �' Federal Wa Construction Inspection Record y INSPECTION REQUESTS: (253) 835-3050 PERNIIT #: 18104813 00 Address: 29811 1ST AVE S Project: VALERIY HIMICHUK 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. In UFER Ground (4295) ID Ditch cover (4030) El Slab/Concrete Floor (4255) Approved Rough Electrical Approved Final Electrical Approved to place concrete By Date By Date By Date ® Pool Bonding (4195) ® Temporary Power (4275) © Service (4235) Approved Rough Electrical Approved Final Electrical Approved By Date By Date By Date 0 Feeders/Sub-panels (4045) ® Rough Electrical (4225) ® Ceiling Cover (4020) Approved Rough Electrical Approved Final Electrical Approved By Date By Date By Date Final - Electrical (4055) Approved By Date Rough Electrical Final Electrical Right of Way Approved Approved Approved By Date By Date By�- Date CITY OF Federal Way RECEIVED ELEC'T'RICAL OCT 12 2018 PERMIT APPLICATION CITY OF FEDERAL WAY COMMUNITY DEVELOP'T NUMBER � - _ � �% RH L _ /G� I / SUITE/UNIT/SPACE # SITE ADDRESS: DC7( OJEC�A�T© `� ASSESSOR'S TAX/PARCEL # � - � O � � CURRENT/PROPOSED USE PROJECT NAME/ (Tenant or Homeowner Last Name) t K f�i'12 f G i'�elly PROJECT DESCRIPTION Detailed description of work to be included on this permit only �o /,07 Glu t PROPERTY OWNER NAME ��� l?/% l C y 'L ^ PRIMARY PHONE c�ZS 83 6 -(0-5-4916 MAILING ADDRESS OqQ Q `I `i- E-MAIL CITY�� ' V" STATE VV ZIP P dQ � � ) FAX ELECTRICAL CONTRACTOR NAME PRIMARY PHONE ) MAILING ADDRESS /f U/ 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 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. s SIGNATURE: DATE C � f A? PRINT NAME: ci Ir t W� I G L_ Bulletin #160 —April 14, 2016 Page 1 of I k: 14andoutsTlectrical Permit Application