12-103151i
191ectitical
City of Federal Way
Community & Econ. Dev. Services Permit #: 12-103151 -00-EL
33325 8th Ave S
Federal Way, WA 98003 Ins ection Re uest Line: 253` 835-3050
Ph: (253) 835-2607 Fax: (253) 835-2609 p Q
Project Name: INTERPLAST - LAKOTA
Project Address: 30404 28TH AVE SW Parcel Number: 416660 0647
Project Description: 0-200 amp service for new single family residence
Owner
Applicant
Contractor
INTERPLAST CORPORATION
ALEXEY ANCHEYEV
OMEGA ELECTRIC
30404 28TH AVE SW
978 INDUSTRY DR SUITE 210
OMEGAE" 962JF (4/6/14)
FEDERAL WAY WA 98023
FEDERAL WAY WA 98188
13337 SE 227TH PL
KENT WA 98042
Additional Permit Information
Electrical Fixtures -
New Service: Residential ............... 1 t
PERMIT EXPIRES Sunday, Janua 6 13
Permit Issued on Tuesday, July 10 12
1 hereby certify that the above information is correct and that �o ction a avve described property and
the occupancy and the use will be in a e ft r s and regi s of the State of Washington
and the I Way. ed
Owner or agent: 1�111 Date: o — e Z-
�{e
CITY OF 40'&
Federal Way
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 12 -103151 -00 -EL Address: 30404 28TH AVE SW
Project: INTERPLAST CORPORATION 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.
UFER Ground (4295)
Pool Bonding (4195)
Ditch cover (4030)
E]
Slab/Concrete Floor (4255)
Approved
❑
Approved
By
Approved to place concrete
By-ZCS Date rl_ 0-1 Z
By
Date
By
Date
❑
Pool Bonding (4195)
E]
Temporary Power (4275)
❑
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
❑
Final - Electrical (4055)
Approved
By
Date
Rough Electrical
Approved
1:1Approved
Final Electrical
1:1Approved
Right of Way
By
Date
By
Date
By
Date
CITY OF
Federal Way
RECEIVED
iz_l�� f S(
ELEC'T'RICAL
PERMIT APPLICATION
JUL 10 2012
**Most electrical permits maybe obtained on-line at www.cityo ederalway.com**
SITE ADDRESS: -1 y A uc
SUITE/UNIT/SPACE A
ASSESSOR'S TAIL/PARCEL A
CURRENT/PROPOSED USE
PROJECT NAME
Homeowner Last Name)
(Tenant or
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME ( - -
l
PRIMARY PHONE
yi0 - 66_��
MAILING �Z+ADDRESS
�
E-�L
CITY
11 ''
IST.,A..,TEE
PIP/
FAX
NAME
l^f r_ 6�--'
PRIMARY PHONE
( 0 79 - 71+4 -
ELECTRICAL
MAILING ADDRESS
ev 13 3 L 2 ` AL
E-MAIL
CONTRACTOR
CITY ��
�-moi/„,
STATE
L-) 4—
ZIP
It O Z
FAX
( ) -
WA STATE CONT OR'S LICENSE N EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE M
NAME
PRIMARY PHONE
( )
APPLICANT
MAILING ADD
E-MAIL
STATE
ZIP /
FAX
PROJECT CONTACT
NAMEPRIMARY
�/J�C bl-le-
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 Fe Eat Way as to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and defense of such claim), w ch e e ny person, including the undersigned, and filed against the city,
but only where such claim arises out oft ell of the c i uding its officers and employees, upon the accuracy of the
information supplied to the city as a application
SIGNATURE:
PRINT NAME:
33325 8° Avenue South ♦ Federal Way ♦ WA ♦ 98003-6325 ♦ 253-835-2607 ♦ fax: 253-835-2609 ♦ www.cityoffederalway.com
Bulletin 1#160—January I, 2011 Page 1 oft k:�HandoutslElectrical Permit Application