19-102891 } 1
Electrical
City of Federal Way Permit #:19-102891-00-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: BARCELO HOMES SHORT PLAT
Project Address: 3811 S 326TH ST Parcel Number: 152104 9022
Project Description: Install(3)street light poles as required per frontage improvements.Connect to transformer on
my property street lights are in right of way.
Owner Applicant Contractor
BARCELO HOMES INC. BOGDAN MAKSIMCHUKBARCELO OWNER IS CONTRACTOR
PO BOX 1733 HOMES
AUBURN WA 98071-1733 PO BOX 1733
AUBURN WA 98071-1733
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Additional Permit Information
Is this an Online or O.T.C.application? Yes
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PERMIT EXPIRES Friday, 12 June,2020
Permit Issued on Thursday,June 13,2019
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
shington an a City of Federal Way.
Owner or agent: Date:
THIS CARD IS TO REMAIN ON-SITE
CITY
Construction Inspection Record
Federal Way4A
INSPECTION REQUESTS: (253)835-3050
PERMIT#: 19 102891 00 Address: 3811 S 326TH ST
Project: BARCELO HOMES INC. FEDERAL WAY WA 98003
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.
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® UFER Ground(4295) ElThigh cover(4030) �4 El Slab/Concrete Floor(4255)
Approved of 0,,e �diI 'Approved I0'(O' Approved to place concrete
By Date By Date By Date
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® Pool Bonding(4195) ® Temporary Power(4275) ' ® Service(4235)
Approved Approved Approved
By Date By Date By Date
,
❑ Feeders/Sub-panels(4045) ® Rough Electrical(4225) ® Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
E a Final-Electrical(4055)
Approved
By ‘if Date/Q'137") /
0 Rough Electrical 0 Final Electrical ❑ Right of Way
Approved Approved Approved
By Date By Date By Date
CITY OF 11111.11111ree RECEIVED IVED ELECTRICAL
Federal Way PERMIT APPLICATION
JUN 13 2019
CITY OF FEcc L �-�'r 1 j — 2 G _ C L
COMMUNiIY DEVELOr� T NUMBER— ' O -
• SUITE/UNIT/SPACE#
SITE ADDRESS
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PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
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PROJECT NAME /�/� I
(Tenant or Homeowner Last Name) 'r6 . > V e S • f �q S:AiN C k to K
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PROJECT DESCRIPTION far
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Detailed description of work to -rq4 C ! Imo✓ Oil i'1ty p ra/M - S.- -�P"r- 1.y k 711
be included on this permit only /
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NAME PRIMARY PHONE
PROPERTY OWNER Bog art h ✓"la k civic L K (253 ) .32- 48)2
MAILING ADDRESS E-MAIL
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CITY STATE ZIP FAX
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NAME PRIMARY PHONE
�C:01� dah Mryks:� cAAA k , ( ) —
MAILING ADDRESS E-MAIL
ELECTRICAL
CONTRACTOR CITY STATE ZIP FAX
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WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
BASCERT $6613q S / 22 !2.0 .
NAME Mal(
PRIMARY PHONE
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APPLICANT "'moo vv Mal( 5- ( h k ( '` ) -
MAILING AD ESS E-MAIL
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CITY STATE ZIP FAX
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NAME PRIMARY PHONE
PROJECT CONTACT PnAdr,ey r' riDVC in (2S3 ) 315- - 55 3
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 aseJ1
a part of
this application.ic /
SIGNATURE: G b DATE `17 i y
PRINT NAME: AvIdrey ✓ l0 1/C ik h
Bulletin#160–April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application
Owner
C�zY a� Property O e
Federal Way Electrical Work Permit Application
Applying For Your Electrical.Permit
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
the affidavit below before beginning electrical work.
Affidavit ,
n•
As authorized under RCW 19.28.261, I, i�og ton]n /1/Iq k S;+nn C h u hereby apply
(Printed 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.
Which statement describes you? (Mark only one.If none apply,you may not take out this permit.)
VI own this property.
Your name or your company's name must be shown on the deed to the property. Real estate agents'property
management companies, relatives, etc.cannot purchase permits for the property owner.
❑ I rent or lease this property.
We need a copy of your rental agreement showing you have permission to perform electrical work
❑ 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
non-compensated appropriately certified electrician.
{
Select your property type(Mark only one. If none apply,you may not take out this permit)
❑ 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
work.
❑ 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.
c. ❑ New place of business,farm,or other property:Any new structure that is not intended for rent,
sale,or lease. I,personally,and/or a regularly employed employee(s),will be doing the electrical work.
Existing residential property,place of business,or farm.I, personally,and/or a regularly
employed employee(s),will be doing the electrical work.
DEPARTMENT OF COMMUNITY DEVELOPMENT/33325 8TH AVENUE SOUTH/FEDERAL WAY,WA 98003-6325
253-835-2607 z9 www.cityoffederalway.com permitcenter(a.citvoffederalway.com
Bulletin#080—June 6,2018 Page 1 of 2 k:\Handouts\Property Owner Electrical Work Application
0 501(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 penalfes.
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Printed Name of Property Owner,Renter,or Lessee Signal re ;
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Property Owner and Inspection Site Information
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Property Owner's Name(Last,First)or Company Name
1411 Fasf 'des 4.r Way ce441/e gst24
Mailing Address Unit/Apt.# City State Zip t
s
253- '- 2 —`1812 t
I Daytime Phone Email Address
3 2 co 0 s 3 t 1 ave. S Pecizict I Id/c,y A/,4 91$001
Inspection Site Address(if different) Unit/Apt.# City State Zip
K,,� PSE
Count Electrical Power Company/Serving Utility `.
Description of work being done(Example:adding outlets in the kitchen,second floor break area,etc.)
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DEPARTMENT OF COMMUNITY DEVELOPMENT/33325 8TH AVENUE SOUTH/FEDERAL WAY,WA 98003-6325
253-835-2607 www.cityoffederalway.com lii.permitcenter@cityoffederalway corn
Bulletin#080-June 6,2018 Page 2 of 2 k:\Handouts\Property Owner Electrical Work Application