15-103921Electrical
cilty ity & Econ.
al Dev. y Permit #: 15 -103921 -00 -EL
Community 8 Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003 FILE
Ph: (253) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835050
Project Name: KITNA
Project Address: 29635 11TH AVE SW Parcel Number: 195460 0055
Project Description: Electrical wiring for driveway gate.
Owner
ARRlicant
Contractor
DAVID KITNA
DAVID KITNA
OWNER IS CONTRACTOR
31500 27TH AVE S
31500 27TH AVE S
FEDERAL WAY WA 98023-2267
FEDERAL WAY WA 98023-2267
Additional Permit Informati
Is this an Online or O.T.C. application?................Yes Is Use ) nal nstitutional?....................... No
Electrical Fixtureyjt
Circuits - Residential ...................... 1
PERMIT EXPIRES
Permit Issued
I hereby certify that the above informatio is
the occupancy and the use will a in ac
Owner or agent:
Tues , Fe
ea* ay, Aug
7hthte
at the
laws, rule I
City of Feral Way.
'16
Lrl511
15
it
on on the above described property and
regulations of the State of Washington
Date: 0 �� 5/
f CITY OF THIS CARD IS TO REMAIN ON-SITE'
•
I Construction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 15 -103921 -00 -EL Address: 29635 11TH AVE SW
Project: DAVID KITNA 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.
11 Final - Electrical (4055)
Approved
By Date
UFER Ground (4295)
Ditch cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4 55)
1:1Approved
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
11 Final - Electrical (4055)
Approved
By Date
Pool Bonding (4195)
1:1Approved
Temporary Power (4275)
1:1Approved
Service (4235)
By
Approved
By
Approved
By
Approved
By
Date
By
Date
By
Date
Feeders/Sub-panels (4045)
Rough Electrical (4225)
Ceiling Cover (4020)
Approved
Approved
Approved
By
Date
By
Date
By
Date
11 Final - Electrical (4055)
Approved
By Date
Rough Electrical
Approved
1:1Approved
Final Electrical
1:1Approved
Right of Way
By
Date
By
Date
By
Date
ti
4:�A�L Federal Way
Building Division
33325 Eighth Avenue South
Federal Way, WA 98003-6325
Phone 253-835-2607 Fax 253-835-2609
CORRECTION NOTICE
ADDRESS: 2 (,:;5' 1\T)�4- ASC- SW • PERMIT#: 15-103'121 - 00 -LL
t l NEt- 10.61f
3yo.S -
I2,0v Givcu� �-s R-ti,�n
(�v,d4. Lesl44-AA
D %V -e_ .mss
IF YOU HAVE QUESTIONS CALLykwt (253) 835- S-(iti
WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE -INSPECTION. SEE BACK OF CARD
FOR DETAILS. NOTE: ELECTRICAL CORRECTIONS ARE REQUIRED TO BE MADE WITHIN 15 DAYS.
to I I S
DATE
INSPECTOR
DO NOT REMOVE THIS NOTICE
Page of
CITY OF A
Federal Way
RECEIVED
AUG 06 2015
CITY OF FEDERAL WAY
CDS
ELEC'T'RICAL
PERMIT APPLICATION
PERMIT NUMBER "[ 5 _ () —3 -!� 4—k _ -E L—
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 ax part of this application.
SIGNATURE:
PRINT NAME:
t5x�, -5�r_-�
Bulletin # 160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
SUITE/UNIT/SPACE #
SITE ADDRESS: 5r
"X yr
PROJECT VALUATION
ASSESSOR'S TAB/PARCEL 9
CURRENT/PROPOSED USE
$ 1000
F
_q_&_q 1C2
(a_ tea
PROJECT NAME
(Tenant or Homeowner Last Name)
J`
Gv
lJ iL F L C-- R4
c,
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
ify Ig
17
MAILING ADDRESS
E-MAIL
35
Qvp Sud
CITY
STATE
ZIP
FAX
9 Baa
( ) -
NAME
-
PRIMARY PHONE
Y ` 1 l�
)
MAILING ADDRESS
l 1 (/l VQ .SL -J
E-MAIL
ELECTRICAL
CITY
STATE
W A
ZIP
aha
FAX
( ) -
CONTRACTOR
WA STATE CONTRACTOR'S LICEN k
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE 9
NAME
PRIMARY PHONE
APPLICANT
, >J
( J -D-
MAILING ADDRESS
E-MAIL
T- v
" ' l
-S µ�
CITY
p r Q t td -A-
STATE
ZIP
Gt 80a 3
FAX
PROJECT CONTACT
NAME_
-r)
PRIMARY PHONE
saw '�
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 ax part of this application.
SIGNATURE:
PRINT NAME:
t5x�, -5�r_-�
Bulletin # 160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application