16-100633City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: KALYTA
Electrical
Permit #: 16 -100633 -00 -EL
Inspection Request Line: (253) 835-3050
Project Address: 28922 28TH PL S Parcel Number: 029450 0130
Project Description: Fire damage repair including connecting wires in electrical box.
Owner
AAR lu ican
Contractor
VIKTOR KALYTA
VIKTOR KALYTA
OWNER IS CONTRACTOR
HALYNA KALYTA
13104 SE 279TH PL
13104 SE 279TH PL
KENT WA 98030
KENT WA 98030
Additional Permit Information
Electrical Work Valuation?....................................100
Is Use Educational or Institutional? ....................... No
Is this an Online or O.T.C. application?.................Yes
No Fixtures Associated With This Permit 11
PERMIT EXPIRES Thursday, February 2, 2017
Permit Issued on Wednesday, February 3, 2016
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
of Federal Way.
L
Owner or agent: Date� w
CITY OF
Federal Allay
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
16 -100633 -00 -EL Address: 28922 28TH PL S
VIKTOR KALYTA FEDERAL WAY, WA 98003-7902
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.
Pool Bonding (4195)
Approved
By Date
Temporary Power (4275)
Approved
By Date
LIFER Ground (4295)
Ditch cover (4030)
By
Slab/Concrete Floor (4255)
EJ
Approved
Final Electrical
Approved
Approved
By
Approved to place concrete
By
Date
By
Date
By
Date
Pool Bonding (4195)
Approved
By Date
Temporary Power (4275)
Approved
By Date
Final - Electrical (4055)
Approved
By Date a
Service (4235)
Approved
By
Date
Final - Electrical (4055)
Approved
By Date a
Feeders/Sub-panels (4045)
Rough Electrical (4225)
EJ
Ceiling Cover (4020)
Final Electrical
Approved
Approved
By
Date
Approved
By
Date
Approved
By
Date
By
Date a--ot
By
Date
Final - Electrical (4055)
Approved
By Date a
EJ
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF 'A
Federal Way
RECEIVE® ELEC'T'RICAL
FEB 4 3 2016 PERMIT APPLICATION
CITY OF FEDERAL VUAY
C) PERMIT NUMBER ' 1 _ 1 v O (D�
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SITE ADDRESS:
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SUITE/UNIT/SPACE #
PROJECT VALUATION
$ 0,z?0
ASSESSOR'S TAX/PARCEL #
-b 2 9 N 5 3 b
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
/ / 1'
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
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PROPERTY OWNER
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CONTRACTOR
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PRIMARY PHONE
MAILINGADDRESS �. / /
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WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME�
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PROJECT CONTACT
NAME
PRIMARY PHONE
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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 apart of this application.
SIGNATURE:
PRINT NAME:
I/
Bulletin # 160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
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