13-100393City 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: SHEVCHIJK
Project Address: 2125 SW 322ND ST
• • a
i r Electrical'
V 13 -100393 -00 -EL
°. -jrispection Request Line: (253) 835-3050
Project Description: Adding/altering 1-5 circuits for updating and adding outlets
Parcel Number: 932430 0100
Owner
Applican
Contractor
ALEKSANDRSHEVCHUK
ALEKSANDRSHEVCHUK
OWNER IS CONTRACTOR
2125 SW 322ND ST
2125 SW 322ND ST
FEDERAL WAY WA
FEDERAL WAY WA
Additional Permit information
Is this an Online or O.T.C. application?.................Yes Is Use Educational or Institutional? ....................... No
Electrical Fixtures
Circuits - Residential ...................... 5
PERMIT EXPIRES Wednesday, July 24, 2013
Permit Issued on Friday, January 25, 2013
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. 11
Owner or agent: Date: - /'3
' , , • THIS CARD IS TO MAIN ON-SITE
CITY OF Construction I ection Record
Federal Way INSPECTION REQ TS: (253) 835-3050
PERMIT #: 13 -100393 -00 -EL Address: 2125 SW 322ND ST
Project: ALEKSANDR SHEVCHUK FEDERAL WAY, WA 98023-2516
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)Ditch
cover (4030)
Final Electrical
Approved
Slab/Concrete Floor (4255)
Service (4235)
Approved
Approved
Approved
Approved
Approved to place concrete
By
Date
By
Date
By
Date
El
Pool Bonding (4195)
Temporary Power (4275)
Final Electrical
Approved
E]
Service (4235)
of Way
Approved
Approved
Date
Approved
By
Date
Approved
By
Date
By
Date
By
Date
E]
❑
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��
El
Rough Electrical
Approved
Final Electrical
Approved
❑Right
of Way
Approved
By
Date
By
Date
By
Date
CITY Of
Federal Way
PERMIT NUMBER l ✓
� ELECTRICAL
PERMIT APPLICATION
RECEIVED
JAN 2 5 2013
SITE ADDRESS: 1 125 < 3dQ wd 54 '��,� ® 3
CDS t Y
PROJECT V DATION
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ASSESSOR'S TAX/PARCEL ♦
-
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
ch etv,add,,�j
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PROPERTY OWNER
NAME ,1
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(2J�) 7e - �o
MAILIN7 1 / 1 3 ,� •� t'l/`�- / /
MAIL
CITY � � ! ' � �
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STATE
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( FAX
ELECTRICAL
CONTRACTOR
NAME
the
PRIMARY PHONE
( , _
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAME
J2 r
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
CITY
STATE I
ZIP
FAX
PROJECT CONTACT
N A (Q� h Q v 1 U k
(2�3) 7aq MARY M6
5 -
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.
E -i cei � rA WZiD;
PRINT NAME: f 41,e-& Q& 5 h P ✓C t4 Lti k_
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Bulletin # 160 -January 1, 2013 Page I of 2 k:\HandoutslElectricai Permit Application