20-101110 k ,
Electrical
City of Federal
Community Development Dept. Permit #:20-101110-00-EL
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: KRAMAREVSKY
Project Address: 34608 25TH AVE SW Parcel Number:011470 0109
Project Description: Service and wiring for new single family residence.
Owner Applicant Contractor
GALINA KRAMAREVSKY GALINA KRAMAREVSKY OWNER IS CONTRACTOR
28134 29TH AVE S 28134 29TH AVE S
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
Additional Permit Information
Is this an Online or O.T.C.application? Yes
e ,.3,.., �ro3, ' .,
New Service:Residential 1
PERMIT EXPIRES Wednesday, 10 March,2021
Permit Issued on Tuesday,March 10,2020
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: $/IO/CJ)
• • 4.
.-4 b
THIS CARD IS TO REMAIN ON-SITE
CITY OF ,ou,4 Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 20 101110 00 Address: 34608 25TH AVE SW
Project: GALINA KRAMAREVSKY FEDERAL WAY WA 98023
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.
El UFER Ground(4295) I 2❑ Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date ! By Date By Date
1,1 ,• '
El Pool Bonding(4195) Temporary Power(4275) s' Service(4235)
Approved Approved Approved
By Date By Date ,.By? f `� Date y,>7.„)D .
0 Feeders/Sub-panels(4045) El Rough Electrical(4225) ® Ceiling Cover(4020)
Approved �� n 1.Approved p� AM a,Approved
1.�By Date �`By 9 Date yj".� ,.By` RR Date 41.017_az
•
El Final-Electrical(4055)
e ee n M 1aApproved
By` 11‘p., Date 9.y S`a)a ,
.
0 Rough Electrical 0 Final Electrical ❑ Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
Or ? ` MAR 20 2020 ELECTRICAL
CITY OF
Federal Way s CITY
OFLOP
FEDEADEVLWAAEY rVi' PERMIT APPLICATION
PERMIT NUMBER .A 0 / C) / / / 0 — Ja -f'
SUITE/UNIT/SPACE#
SITE ADDRESS: N(005 _A`)`' , ) A-L. 1.4443 , 1, l� 'r /( o 3
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# �v CURRENT/PROPOSED USE
$ t1 000 O / Y -7 0 _ o / D �
PROJECT NAME �n
(Tenant or Homeowner Last Name) Vleft YY'X C,ETV
vv-Ati- )C Ski' frsy ne(A ) 5t ie
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER 61a-t.-rra n'viA Y YS 14 (Z ) jY - 3(3
MAILING ADDRESS E-MAIL
cr S 4 wC1-t int 6? C yu:Trnst12,fe)
CITY STATE ZIP FAX
r
y gIgODD ( ) -
NAME •, ` PRIMARY PHONE
MJA ( )
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 al/tflal )
MAILING ADDRESS ( E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT 4- '114r1 ho rykii $ctl/5 1 (c -? )3 -30f3
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 arty 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 city as a part of this application.
SIGNATURE`, DATE 3//0/-303
PRINT NAME: 6,4 0v0 34ZA'r1' IZL-✓J/7
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application
CITY ' ECEIVED
OF 110111110114001 Property Owner
Federal Way MAR 2 0 202OElectrical Work Permit Affidavit
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
I ;F`or Your tiecttteai�e
In Washington, only licensed electrical contractors may perform electrical work. Property owners
may apply for an exemption from these requirements by completing and signing the affidavit
below before applying for an electrical permit or beginning electrical work.
. Affidavit
As authorized under RCW 19.28.261, I, 4,la. eNA Vii-YYw1`1JLeVS I' ,
(Printed name of property owner,renter.o•lessee)
hereby apply 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.)
I 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.
O 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.
SelecSelect 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
t
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 I
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 electrical work.
❑ 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. i
❑ Existing residential property,place of business,or farm.I,personally,and/or a regularly employed
employee(s),will be doing the electrical work.
I
I
DEPARTMENT OF COMMUNITY DEVELOPMENT/33325 8TH AVENUE SOUTH/FEDERAL WAY,WA 98003-6325
253-835-2607 www.citvoffederalway.com zs permitcenteraaa..citvoffederalway.com
Bulletin#170—July 27,2018 Page 1 of 2 k:\Handouts\Property Owner Electrical Work Affidavit
. 1
❑ 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
understanc}.that if I make false statements or misrepresentations, I may be assessed penalties.
1 /N-----'-------- 3//0/00D
i 'S'gnature Date
i
iak }L
Printed Name of Property Owner,Renter,or Lessee
a
Property Owner and Inspection Site Information
4.11 JA .`(CA rY l\ \Z�-VS 9
Property Owner's Name or Company Name
k ja 3Y (14 AAE -.0-" � vi I 6/8 vo3
1 Mailing Address Unit/Apt.# City State Zip i
3 3q--1- 3Q 6r�zoc+t �� C� -n ,eo�
Daytime Phone Email Address
3'4600a 2 -1"" INE c w I f %n/ I vvtn q8.003
, Inspection Site Address Unit/Apt.#
PSC
Electrical Power Company/Serving Utility
Description of work being done (Example: adding outlets in the kitchen,second floor break area,etc.)
1
DEPARTMENT OF COMMUNITY DEVELOPMENT/33325 8T"AVENUE SOUTH/FEDERAL WAY,WA 98003-6325
253-835-2607 www.citvoffederalway.com permitcenter(a)cityoffederalway.com
Bulletin#170—July 27,2018 Page 2 of 2 k:\Handouts\Property Owner Electrical Work Affidavit