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19-102306 a1 Y ) Electrical City of Federal Way Permit #:19-102306-00-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: IAROSHCHUK Project Address: 30825 10TH AVE SW Parcel Number:024800 0100 Project Description: Altering up to 4 circuits to replace wiring,outlets,switches,and lights after fire damage to garage. Owner Applicant Contractor MYKHAILO IAROSHCHUK MYKHAILO IAROSHCHUK MYKHAILO IAROSHCHUK 30825 10TH AVE SW 30825 10TH AVE SW 30825 10TH AVE SW FEDERAL WAY WA 98023 FEDERAL WAY WA 98023 FEDERAL WAY WA 98023 Additional Permit Information Is this an Online or O.T.C.application9 Yes d i� , , .10 's r k^' 110,1 '" , kk, x`..:;.;,#i a'% sA Circuits-Residential 4 PERMIT EXPIRES Saturday,9 May,2020 Permit Issued on Friday,May 10,2019 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 •;;,; on and the City of Federal Way. / Owner or agent: " Date: 05. i r, . r �n • � in rA• THIS CARD IS TO REMAIN ON-SITE Federal W Construction Inspection Record INSPECTION REQUESTS: (253)835-3050 PERMIT#: 19 102306 00 Address: 30825 10TH AVE SW Project: MYKHAILO IAROSHCHUK FEDERAL WAY WA 98023-4501 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. 1❑ Service(4235) � Feeders/Sub-panels(4045) El Rough Electrical(4225) Approved Approved Approved By Date By Date By 41` Date / .''•�7 r" ® Ceiling Cover(4020) El Final-Electrical(4055) Approved Approved By Date By i / Date 7:-..211 • El Rough Electrical E Final ElectricalElRight of Way Approved Approved Approved By Date By Date By Date ELECTRICAL CITY OF RECEIVED Federal Way PERMIT APPLICATION MAY 10 2019 CITY OF FEDERAL.WArERMIT NUMBER ( / L D 3 (.9_ 2. COMMUNITY DEVELOPMENT — CCC !� SUITE/UNIT/SPACE# SITE ADDRESS: 3o 8 z S- 1p,/� Avg Sw clecu./ Wa tJP e&o23 PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE $ 3 . 000 - PROJECT NAME � (( t (Tenant or Homeowner Last Name) tk0t(is jW p.e c k S/�1 C ti eeplo.c: 1is ,S°► w,,/'t5 ,.Ind I1 %114S PROJECT DESCRIPTION Detailed description of work to be included on this permit only NAME ( PRIMARY PHONE PROPERTY OWNER ! ` to 0,110 W I b ro S he 4 (1S3) 33s= 8 8 0 Z MAILING ADDRESS E-MAIL 3�g2C 104-LI PV( 5LJ CITY ` STATE ZIP FAX L14) (. 6023 ( ) NAME d - PRIMARY PHONE D tit) MAILING ADDRESS E-MAIL ELECTRICAL CONTRACTOR CITY STATE ZIP FAX ( ) WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# -- - - NAME - --- PRIMARY PHONE APPLICANT MAILING ADDRESS E-MAIL CITY STATE ZIP FAX ( ) NAME PRIMARY PHONE PROJECT CONTACT p W ( ) 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 his application. �Q SIGNATURE: C i - f 4 DATE CS— !D' 1 PRINT NAME: f ` W.{C �ts�D 2TC r C54t 0( Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application " 444444S,,, ' RECEIVED Girt OF ',•- ,,,,,,•• Property Owner Federal Way Electrical Work Permit Applicatign10 2019 CITY OF FEDERAL WAY COMMUNITY DEVELOPMENT - k, .• - Applying For`Your Electrical Permit ' ' . ::his`'4 i In Washington, only licensed electrical contractors may perform electrical work. Property owners may apply for an exemption from these requirements by completing this application and signing fthe affidavit below before beginning electrical work. t Affidavit - As authorized under RCW 19.28.261, I, M )a Xo e`dOSk)e 14144. hereby apply (Priv ed name of property owner,renter,or lessee) for an exemption from the electrical licensing and certification requirements of RCW 19.28 by submission of this affidavit. .. . t l Which statement'describes you? (Mark only one.If none apply,you may not take out this permit.) I own this property. Your name or your company's name must be shown on the deed to the property. Real estate agents'property I management companies, relatives, etc. cannot purchase permits for the property owner. 0 I rent or lease this property. We need a copy of your rental agreement showing you have permission to perform electrical work. 0 I am an officer for a 501(c)(3)nonprofit corporation,or a nonprofit religious organization. The total market value of electrical work must be$30,000 or less and all electrical work must be done by a 1 non-compensated appropriately certified electrician. N, i Select your property type(Mark only one. If none apply,you may not takeout this permit.) lEl New single family residence that is not intended for rent, sale,or lease,where I will be living for at least 24 months after completing the electrical work. I will be personally doing the electrical 1 ( work. i ❑ New 2,3,or 4 unit residential building,owned by me,that is intended for rent, sale, or lease. I will be living in one of the units for at least 24 months after completing electrical work. I, personally, and/or a regularly employed employee(s),will be doing the electricalwork. 0 New place of business,farm,or other property: Any new structure that is not intended for rent, 1 sale,or lease. I,personally,and/or a regularly employed employee(s),will be doing the electrical work. {' personally,and/or a regularly ❑ Existing residential property,place of business,or farm. I, p y, g y employed employee(s),will be doing the electrical work. I DEPARTMENT OF COMMUNITY DEVELOPMENT/33325 8TH AVENUE SOUTH/FEDERAL WAY,WA 98003-6325 253-835-2607 2s www.cityoflederalway.com permitcenter(a)cityoffederalway.com Bulletin#080-June 6,2018 Page 1 of 2 k:\Handouts\Property Owner Electrical Work Application ❑ 501(c)(3) or nonprofit religious organization owned property:The total market value of the electrical work must be$30,000 or less,and all electrical work will be performed by appropriately certified electricians,or certified and properly supervised trainees,who are volunteering and not being compensated for the electrical work per RCW 19.28.091(7). Your signature is required below: I believe I should be exempt from the requirements to obtain an electrical license,or use a certified . electrician,as provided under RCW 19.28.261. By signing below, I certify the information I am providing on this affidavit is true and accurate. I understand that if I make false statements or misrepresentations,I may be assessed en hies. Printed Name of Property Owner,Renter,or Lessee Signature © 10, Date _.. :' ; : -Property--O v 1a1-4-nd In p ctioi t n ormation__ " . �atosilthc4k 1t-4 lelt4.11,0 Property Owner's Name(Last,Fir )or Company Name 50 $ 2 S /c 11 f Ve— Attu F.c,4zr0,� tea w igoZ3 Mailing Address Unit/Apt.# City State Zip 2S3 Daytime Phone Email Address Inspection Site Address(if different) UnitlApt.# City State Zip v Pte- S©�vrd County 0 Electrical Power Company/Serving Utility Description of work being done(Example:adding outlets in the kitchen;second floor break area;etc.) Re( /0,c ci 1; Refo.ei ll, Soo-) ddcx 1 k. DEPARTMENT OF COMMUNITY DEVELOPMENT/33325 8TH AVENUE SOUTH/FEDERAL WAY,WA 98003-6325 253-835-2607)s.www.cityoffederalway.com permitcenterAcityoffederalway.com Bulletin#080—June 6,2018 Page 2 of 2 k:\Handouts\Property Owner Electrical Work Application