01-102931 City of Federal Way
Community Development Services Electrical Permit #:01 - 102931 - 00 - EL
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: TKACHUK
Project Address: 28107 28TH S.fW S Parcel Number: 231240 0030
Project Description: ELE-Install service/feeder for manufactured home.
Owner Applicant Contractor
ANATOLIY TKACHUK ANATOLIY TKACHUK ANATOLIY TKACHUK
30016 41ST AVE S 30016 4I ST AVE S 30016 41ST AVE S
AUBURN WA 98003 AUBURN WA 98003 AUBURN WA 98003
(253)945-6061
Electrical Fixtures
Description Quantity Description Quantity Description Quantity
Service and Feeder-Manu./Mobile H' 1
•
PERMIT EXPIRES January 23,2002,IF NO WORK IS STARTED.
Permit issued on July 27,2001
I hereby certify that the above information is correct and that the construction on the above described property and
•
the occupancy and the use e-irraccordance with the laws,rules and regulations of the State of Washington and
the City of Feder
Owner or agent: alo • Date: Q t' o 4‘ C
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• City Federal Way
Community Development Services Electrical Permit #:01 - 102931 - 00 - EL
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: TKACHUK
Project Address: 28107 28TH S Parcel Number: 231240 0030
Project Description: ELE-Install service/feeder for manufactured home.
Owner Applicant Contractor
ANATOLIY TKACHUK ANATOLIY TKACHUK ANATOLIY TKACHUK
30016 41ST AVE S 30016 41ST AVE S 30016 41ST AVE S
AUBURN WA 98003 AUBURN WA 98003 AUBURN WA 98003
(253)945-6061
Electrical Fixtures
Descrition IQuantity Description Quantity Description Quantity
Service and Feeder-Manu./Mobile Hi 1
PERMIT EXPIRES April 21,2002,IF NO WORK IS STARTED.
Permit issued on July 27,2001
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 agent: Date:
2- _o j
AlifL a ..cti°
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Gni;OF CONSTRUCTION PERMIT APPLICATION
APPLICATION NUMBER: Q 1 '- (0 ,L 4-3( - �6_ _/.__
`JUL
UL 2 7 ?Ofl 1 APPLICATION NUMBER: - -
APPLICATION NUMBER: - -
isg**Thcalr� HAL YVr►Y
d information—Please print(in ink)or type**
Please note: Electrical, Fire Prevention •ystems and Engineering permits may require a separate application.
• Fat PROPERTY INFORMATION
SITE ADDRESS: CgJD rad4k 08,42. ASSESSOR'S TAX/PARCEL #: 2 3 L0-46_ - 0-53O
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
,' - 71 PROJECT INFORMATION
TYPE OF PROJECT(This application): 013j1ILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
L EELECTRICAL ❑ ENGINEERING FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): EPLd—nac.L 43ervice 4r-- WIC014t PAC'4EdVert
y1,0Yne
PROJECT NAME: `J- li <C
talk
PEC 'LE IN ORMATION
4.
PROPERTY OWNER: NAME: \-lik AYTIME PHONE:
k'r, , : 3> 94 G061
MAILING ADD.• ( •DRESS;C �'IP): ar
CC'
CONTRACTOR: • 'AME: - t`, • DAYTIME_. ONE:
,se e vt ( : ) 380 - crsey
MAILING•:DRESS(ST • •D .;CITY,STATE,ZIP): 4 ?' EV. G PHONE:
K )
ITY, FEDERAL WAY BUS S LICENSE NUMBER: FAX NUMBER:
Cc, RACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
. . 111K)
(co.`>, card required)
/ /
APPLICANT: NAME: DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZI` EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) -
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT El CONTRACTOR
• DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: (LA 51.e CCtt4' L"( PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? 171 YES C�/]aNO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:CI YES ❑ NO
WATER SERVICE PROVIDER: L'J LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
•
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
■ -FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC. ( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC. (
INTERCEPTOR(S) S MP(S)
G1 >DISCLAIMER/SIGNATURE BLOCK - .
I certify 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 suppli city as a part of this application. /'
7
NAME/TITLE: �^ DATE: `) °'
:1P
PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
rnMMI INm nFVFI ORMFNT SERVICES•33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718-253-661-4000•FAX: 253-661-4129