01-102289 •
City of Federal Way
Community Development Services ~Electrical Permit #:01 - 102289 - 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: LYSYUK
Project Address: 2608 S 298TH St Parcel Number: 768380 0023
Project Description: ELE-Service for new single family residence
Owner Applicant Contractor
VLADIMIR LYSUK VLADIMIR LYSYUK VLADIMIR LYSUK
2606 S.298TH ST 2606 S 298TH ST 2606 S.298TH ST
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
(253)839-3671
Electrical Fixtures
Descrlp#ion{, „ Qu;antif ;,. � escption QuantityDescripton � �� Quantity
F
Service: -Residential 3634
PERMIT EXPIRES December 4,2001,IF NO WORK IS STARTED.
Permit issued on June 7,2001
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 W.
Owner or age . Date:
— a
Cao"f = Vir • CONSTRUCTION PERMIT APPLICATION
FIY APPLICATION NUMBER: 0 2-Z."
if 0 7 /rip„„ APPLICATION NUMBER: - -
C(i Y Car` APPLICATION NUMBER: - -
•
BUILD4..;�T,ptL VV
**The followm Qtre� iformation—Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
9 Q� till PROPLRTY INFORNATION
p
SITE ADDRESS: 9 608
s,9 9 �+ ASSESSOR'S TAX/PARCEL #: 7/ 6fr\3 /- `;9 Z3
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PI2(!3ECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBIN ❑ - •NIC• • DEMOLITION
ELECTRICAL ❑ ENGINEERI F • EVENTI• SYSTEM
PROJECT DESCRIPTION(Provide detailed description). ' C \ `S'
PROJECT NAME: s( (
PROPERTY OWNS • NAME A , r ` va/G DAYTIME PHONE: �G 7
/ ( 2 ) 'l / i
MAILING ADDRE REET Al S; ATE,Z
" ��.
CONTRACT NAM DAYTIME PHONE:
V )
M NG ADDRESS(STREET A. SS;CITY, ,ZIP): NING PHONE:
OF FEDERAL WAY BUSINESS E NUMBER: FAX ' BER:
NTRACTOR'S REGISTRATION NUMBER: EXPIRATI•' DATE:
of card required) _ _ _ _
APPLICANT:• NAM DAYTIME PHONE:
4 4c/ ' ( )
MAILING ESS(STREET ADDRESS;CITY,STATE,• . EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT OT (D- RISE): ( - )
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY 0 • ■ •PPLICANT ❑ CONTRACTOR
• DETAILED BUIh. ING INFORMATION
1 EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: g PROPOSED VALUATION FOR IMPROVEMENTS: $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 0 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) SUMP(S)
L ISCLAIMER/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 supplied to the city as a part of this application.
NAME/T DATE: 6 , 7 0 /
c
PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION Cl REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES Cl 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
reminni mI1TV nFVFI OPMFNT SFRVICFS•33510 FIRST WAY CO! rH•P O any 9718•FFI)FRAL WAY.WA 98063-9718•253-661-4000•FAX )G7-FF.1-4170