19-102448 Electrical
City of Federal Way Permit #:19-102448-00-EL
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax.(253)835-2609
Project Name: POMEROY
Project Address: 817 S 317TH ST Parcel Number: 858800 0325
Project Description: Electrical work to include adding(2)circuits for walk-in tub and add a 100A subpanel.
Owner Applicant Contractor
RICHARD POMEROY ANDREY RZHISKIYAFFORDABLE AFFORDABLE ELECTRICAL LLC(020
817 S 317TH ST ELECTRICAL LLC AFFOREL842B2(1/26/20)
FEDERAL WAY WA 98003-5332 30449 103RD CT SE
AUBURN WA 98092 30449 103RD CT SE
AUBURN WA 98092
Additional Permit Information
Is this an Online or O.T.C.application's Yes
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Alt.Serv./Feeder:0 to 200 aim 1 Circuits-Residential 2
PERMIT EXPIRES Tuesday,19 May,2020
Permit Issued on Monday,May 20,2019
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 and the City of Federal Way. �y
Owner or agent: )PDate: / ct
THIS CARD IS TO REMAIN ON-SITE
� Construction Inspection Record
c ede'rai Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 102448 00 Address: 817 S 317TH ST
Project: TERRY E POMEROY FEDERAL WAY WA 98003-5332
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) , 0 Ditch cover(4030) El Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date ,
a❑ Pool Bonding(4195) 0 Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
7❑ Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
El Final-Electrical(4055)
By 2X Approved
D : J)r//
(�
Date i!�
0 Rough Electrical 0 Final Electrical ❑ Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
CITY OF f MAY 2 0 2019 ELECTRICAL
Federal Way CO CITY
OF1/DEVLPA ,- PERMIT APPLICATION
PERMIT NUMBER 1 / — I ` / (/ _ (,
Q SUITE/UNIT/SPACE#
SITE ADDRESS: O /7 5 3 e7. lA 5 C4- r-C14,/,-ot/ 44 y f?'oo3
PROJECT VALUATION ASSESSOR'S TAX/PARCEL N " CURRENT/PROPOSED USE
$ 5(90 g S ci S v c) _ v .- 2 i
PROJECT NAME
(Tenant or Homeowner Last Name)
laC K - /"n cer rt't b 2 c; 4-c r"V'S
PROJECT DESCRIPTION Sub p u kt-e L too Amp,'
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER l r ateA ho( Qo/42 r ( Z06 ) d'( - 99 q/
MAILING ADDRESS E-MAIL
.7 (7 /7th, S t-
CoITY a( 1A/� STATE ZIP
FAX
v fo 5 ( )
NAME V V V kola 6e hie�1` /(a L ( C C ( ) PRIMARY PHONE
MAILING ADDRESS E-MAIL
ELECTRICAL '---3 b `A cf /0 5 r d C60 k t S
CONTRACTOR CITY 444 �u STATE ZIP FAX
(,A X04 Z ( ) _
WA STAT CO RACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
F 0;2 E z- ey 2 E Z Dz/2U/20
- -- NAME /��� _ PRIMARY PHONE
APPLICANT
NA.'
,e .K/ �'E f 'y (2 s5) 2 vq- 32 6a
MAILING ADDRESS E-MAIL
'4,0 ((IO( /0 i-A &u(fi SE t4A(rde,p2 i-,ceFra/-4(1d,.1
CITY STATE ZI FAX
A-Al bit Wit
43c)? ( ) -
NAME �, PRIMARY PHONE
PROJECT CONTACT r al G )r ek PO /4 C4.-c)y ( a )6) g5-1 _ 5 cj (/I
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 a part of this application.
SIGNATURE: • I - DATE Y 1 a V -2O-/ 9
PRINT NAME: n d k y 1()'2 H/ 'S 4--/ Lf
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application