15-101414Cily of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
0
FILE
Project Name: GOMONAY
Project Address: 1404 SW DASH POINT RD
Project Description: 0-200 AMP service and (3) circuits
Electrical`
Permit #: 15-101414-00-E L
Inspection Request Line: (253) 835-3050
Parcel Number: 515320 0651
Owner
NATALYA GOMONAY
Aq Iicant
DANIIL GOMONAY
Contractor
OWNER IS CONTRACTOR
1404 SW DASH POINT RD
1404 SW DASH POINT DR 2520 S 3
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 Fixtures
Alt. Serv./Feeder: 0 to 200 amps (F 1 Circuits - Residential ...................... 3
PERMIT EXPIRES Sunday, September 20, 2015
Permit Issued on Tuesday, March 24, 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
d the City of Federal Way.
Owner or agent: Date:
Loc<< �C-116- c
)I253
crrr OF
Federal Way
PERMIT #:
Project:
THIS CARD IS TO MAIN O?t SITE , ,
Construction In ection Record
INSPECTION REQ TS: (253) 835-3050
15 -101414 -00 -EL Address: 1404 SW DASH POINT RD
NATALYA GOMONAY FEDERAL WAY, WA 98023-4524
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.
0, Pool Bonding (4195)
Approved
By Date
Temporary Power (4275)
Approved
By Date
Feeders/Sub-panels (4045) Rough Electrical (4225)
Approved Approved
By Date By jws Date -1
0 Final - Electrical (4055)
Approved
By 14, Date to A )"
LIFER Ground (4295)11
Ditch cover ( 03)
By
Slab/Concrete Floor (4255)
Approved
Approved
By
Approved to place concrete
By
Date
By
Date
By
Date
0, Pool Bonding (4195)
Approved
By Date
Temporary Power (4275)
Approved
By Date
Feeders/Sub-panels (4045) Rough Electrical (4225)
Approved Approved
By Date By jws Date -1
0 Final - Electrical (4055)
Approved
By 14, Date to A )"
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
Service (4235)
Approved
By
Date _l
Ceiling Cover (4020)
Approved
By
Date
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF 'A
Federal Way
ELECTRICAL
PERMIT APPLON
PERMIT NUMBER ( S _ I () t i 1+ - 00
MAR 2 4 2015
CITY OF FEDERAL WAY
CDS
SITE ADDRESS: i G O� S W Da s �1 t o%
1� fl.
SUITE/UNIT/SPACE #
%-2d et-oI
Wmj 88 0 2 3
PROJECT VALUATION
$ 1-700
ASSES R'S TAR/PARCEL #
Z
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name) .
o m p 00
c It Q
1
4 C 111 cl"e 1 V
PROJECT DESCRIPTION
OEM
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MV) Gom0VNCk
(z53) L2Z- T3 �Q
MAILING ADDRESS ``_�
1404 sW Dqs►7
POIVi+ RD,
E-MAIL
LGS,Rco60 C4
CITY
STATE
ZIP
FAX
NAME
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
ELECTRICAL
CITY
STATE
ZIP
FAX
CONTRACTOR
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
PRIMARY PHONE
APPLICANT
( )
MAILING ADDRESS
EMAIL
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 issuancd 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—) ck vi 1 t I k=>o ovi
Bulletin # 160 - January 1, 2013 Page 1 of 2 UHandoutsTlectrical Permit Application