05-105189 1111
City of Federal Way Electrical Permit #: 05 - 105189 - 00 - EL
Community Development Services
P.O Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax.(253)835-2609 Inspection request line: (253) 835-3054
Project Name: KRYSA
Project Address: 30519 24TH SW Parcel Number: 889420 0090
Project Description:, Installing a new L/V thermostat
Owner Applicant Contractor
IGOR KRYSA IGOR KRYSA IGOR KRYSA
29409 19TH PL S 29409 19TH PL S 29409 19TH PL S
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
(253)946-4356
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Thermostat 1
PERMIT EXPIRES April 5,2006.
Permit issued on October 7,2005
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.
Owner or a:ent: 4/en At Date: /0 7/e9 S
{(3
4
1\61 141j
4k, THIS CARD IS TO REMAIN ON-SITE
CITY OF 11011 Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 05-105189-00-EL
Owner: IGOR KRYSA
Address: 30519 24TH AVE SW
FEDERAL WAY, WA 98023
This card is part of your required inspection documents. 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 Slab/Concrete Floor(4255) 0 Ditch cover(4030) 0 Pool Bonding(4195)
Approved to place concrete Approved Approved
By Date By Date By Date
❑ Temporary Power(4275) ❑ Service(4235) 0 Feeders/Sub-panels(4045)
Approved Approved Approved
By Date By Date By Date
14 Rough Electrical(4225) ❑ Ceiling Cover(4020) 0 Final-Electrical(4055)
Approved Approved Approved
li
By `` V J Date i 0\to By Date By Date
,❑ Under-slab groundwork(4295)
Approved
By Date
1
A • , - RECEIVED () _ /-05--qq-ec
. •
, .
Federal Way CO 0 7 2005PERMIT — —
COMM/NlrYDEVELOPMENTSERVNBS C 1 SF MF CO ME EL PL DE EN FP
33325 Sm AVENUE SOUTH•PO BOX 9718
FEDERAL WAY,WA 98063.971,E ITY OF FEDE 7,' 4LI C AT I O N
253-S35.2607.PAX 253-us2266d�f4 BUILDING /0 / 7 /�C C.
ynaw.dtyolfedemlway.oaq
The olio • is -• tred in ormation-an Inco •tete • ••licatton will not be acre•ted. Please •rint 1e.ibi or p •
■ PROPERTY INFORMATION
SITE ADDRESS J..,/q 02 y E4 A(/6 5- f, Fed SUITE/UNIT e
ASSESSOR'S TAX/PARCEL C - _ _ LOT SIZE(3J) 9
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Mach&ramsMe for lengehli+watd..oipoma/
-
alPROJECT INFORMATION
TYPE OF PERMIT '(BUILDING 0 PLUMBINGJcriECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlq)
7- .5910qf AO 077/".:t • . . , .
PROJECT NAME(Name of Business or Owner Last Name) ril Ca_J
II PEOPLE INFORMATION
PROPERTY NAME
PRIMARY PHONE
OWNER .1-0p 2 ' '',4 (•Z 53 7 /
L-MAII ADDRESS CITY,STATE,ZIP G^- y3 rh
02f'/09 /9 A S /7-4/ k Vgoo_ _
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
7"."G.00se. ti5,4 ( ) -
MAIUNO ADDRESS CITY,STATE,ZIP
,, 92/f#€
S r CELL PHONE
CI Y OIrFEDERAL WAY BUSINESS LICENSE NUMBER / C'c� g j��` ( H -
TION DATE FAX NUMBER
/ / ( )
CONTRACTORS REGISTRATION NUMBER(copy of earl rogairol with each Lica
aPP Moi) EXPIRATION DATE
I /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMBER
a Architect o Tenant a Agent o Other(Describe) ( ) -
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
•
( ) -
LENDER :a_ cd: , et•S,Z ,,e.,; ;,;r,,,.6.a;;,,, NAME
MAILING ADDRESS (TTY,STATE,ZIP
■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WO• $
SPRINKLERZD BUILDING? a YES a NO FIRE SUPPRESSION SYSTEM PROPOSED/• r,, t L• 'D? a YES a NO
WATER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE a TACOMA a PRIVAT- (WELL)
SEWER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE a PRIVATE(SEPTIC)
•
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT. _
BASEMENT
FIR. .
SECOND
THIRD
FOURTH .
ADDITIONAL FLOORS(DESCRIBE)
•
DECK(COVERED?)
GARAGE 0 CARPORT 0
•
NUMBER OF FLOORS snsrua raorosso OT/a.
r
**NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing furfures to remain.
MECHANICAL
Value of Mechanical Work $
•
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(c..mercl q WOODSTOVES
BOILERS • FIREPLACE INSERTS RANGES MISC(Describe)
- • COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/Shower C.mb.( SHOWERS WATER CLOSETS(rclap _ _ MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAYS(Bathreosa SWIM VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I cert(fy under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and further,that I
am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of Federal Way,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.
NAME/TITLE :-...r402 DATE l/47/4
%OS'
(Signature) (Title)
RELATIONSHIP TO PROJECT ci Owner O Agent t] Contractor a Architect O Other
tom c f `.
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Bulletin 1100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application