16-104807City of Federal Way
Applicant
Community Development Dept.
ALEXANDR ZIMOGLYAD
33325 8th Ave S
SUPREME ELECTRIC
Federal Way, WA 98003
Ph: (253) 8352807 Fax: (253) 835-2609
i
Project Name: ZIMOGLYAD
Project Address: 125 SW 307TH PL
Electrical
Permit #:16 -104807 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 556000 1160
Project Description: Change panel, upgrade service to 200 AMP and add (2) circuits for the range and dryer.
Owner
Applicant
Contractor
ALEXANDR ZIMOGLYAD
NIKOLAY GORBUNSUPREME ELECTRIC
SUPREME ELECTRIC
125 SW 307TH PL
2304 FIR CT
SUPREEL94606 (9/26118)
FEDERAL WAY WA 98023
MILTON WA 98354
PO BOX 786
USA
MILTON WA 98354
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
Alt. Serv./Feeder: 0 to 200 aml 1 Circuits - Residential
PERMIT EXPIRES Fri q44
Permit Issued on Thurs
I hereby certify that the above information is correct that,
and the occupancy and the use will be in a ce with
Washin the City/
Owner or agent:
tot
4W
r •
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< 'V1
7
ruction on the above described property
rules and regulations of the State of
Way.
Date"01?
THIS CARD IS TO REMAIN ON-SITE
C" of
Construction Inspection Record
Federal W'ay INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 16104807 00
Address: 125 SW 307TH PL
Project: ALEXANDR ZIMOGLYAD FEDERAL WAY WA 98023-3924
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.
El
UFER Ground (4295)
®
0
Ditch cover (4030)
3
Slab/Concrete Floor (4255)
Feedus/Sub-panels (4(45)
UFER Ground (4295)
Rough Electrical (4225)
Ditch cover (4030)
By
SI&/Concrete Floor (4255)
By
Date
By
By
Date
By
Date
El
Feeders/Sub-panels (4045)
®
Rough Electrical (4225)
®
Ceiling Cover (4020)
D
Feedus/Sub-panels (4(45)
Rough Electrical (4225)
Ceiling Cover (4020)
By
Date
By
Date — I �
By
Date
Final - Electrical (4055)
Final - Electrical (4055)
By Date
Rough Electrical
Final Electrical
D
Right of Way
APP►m'ed
Approved
Approved
By
Date
By
Date
By
Date
CITY OF
Federal Way
RESUBMITTED
SEP 292016
CITY OF FEDERAL WAY
CDS
ELECTRICAL
PERMIT APPLICATION
PERMIT NUMBER _ ' V t C) — L
SITE ADDRESS:
SUITE/UNIT/SPACE 9
PROJECT VALUATION
$ Z150cm
ASSESSOR'S TAR/PARCEL X
S 5 0 v - _) C
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
PROJECT DESCRIPTION
a'jea %d
o p R iiw ( p —Jb
Detailed description of work to
be included on this permit only
h Uwe
2&4�� 'Ap
NAME
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Y PHONE
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PROPERTY OWNER
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NiAMING ADDRESS
E -MAD,
a,re�S
CITY
STATE
ZIP
( FAX
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NAILS
332 -- PHONE
352
D. D s
ELECTRICAL
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CITY
sT"'E
ZIP
98 3sy
FAX
_
CONTRACTOR
WA STATE CONTRACTOR'S LICENSE # PMRATION DA
126
FEDERAL WAY BUSINESS LICENSE i
NAME 1
J
PRIMARY PHONE
APPLICANT
MAD. G ADDRESS 12`
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E-MAIL
C
STATE
ZIP
FAX
PROJECT CONTACT
NAM
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PRIMARY PHONE
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I certify under penalty of perjury that I am the property owner or authorised 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 authorised 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 ci plication.
SIGNATURE: DATE /
PRINT NAM O
PERMIT CENTER + 33325 8w Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter7acityoffederalway.com
Bulletin #160 — April 14, 2016 Page 1 of 1 k:\landouts\Electrical Permit Application