13-100912 ` t( 'Electrical
ti City of Federal Way ( " Q Q
Community&Econ.Dev.Services .�. Permit #: 13-100912-00-EL
33325 8th Ave S
Federal Way,WA 98003,✓' R 'f
Inspection Request Line: (253)835-3050
Ph.(253)835-$607 Fax:(253)835-2609 Q
Project Name: DASH POINT STATE PARK
Project Address: 5700 SW DASH POINT RD Parcel Number: 102103 9002
Project Description: Add RV pedestals,800-amp service&(2) 400-amp panels; underground conduit and wire.
Owner Applicant Contractor
WASHINGTON STATE PARKS HAGGARD ELECTRICAL CONTRACTORS HAGGARD ELECTRICAL CONTRACTORS
PO BOX 42668 AVE SE 16702 65TH AVE SE HAGGAEC960DA (3/1/14)
OLYMPIA WA 98504 SNOHOMISH WA 98296 16702 65TH AVE SE
SNOHOMISH WA 98296
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Service greater than 999 Amps? No
Electrical Fixtures
Alt.Srvc/Feeder 601- 1000 amps 1
PERMIT EXPIRES Sunday, August 25, 2013
Permit Issued on Tuesday, February 26, 2013
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: C. Date: .Zb• 1'7?
p1 Al A
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DATE INSPECTOR AREA AND I I PE OF __,SPEC IO\
raIs-VI) , (12110-...v 0.A.:-cam e, (14_, a- 14 '"9N.A
0 THIS CARD IS TO MAIN ON-SITE
an,OF Construction In ection Record `r
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-100912-00-EL Address: 5700 SW DASH POINT RD
Project: WASHINGTON STATE PARKS FEDERAL WAY, WA 98023-2045
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.
0 UFER Ground (4295) - 0 Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
• . . . .
o Pool Bonding(4195) 0 Temporary Power(4275) CI Service(4235)
Approved Approved Approved
By Date By Date B Date (42-3
•
❑ Feeders/Sub-panels(4045) El Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
O Final-Electrical(4055)
Approved
Date 3 f 7_/3
1
❑ Rough Electrical Final Electrical Right of Way '
Approved Approved Approved
By Date By Date By Date
• • • • e
RECEIVED
i,rr o> .a -EB 2 6 2013 ELECTRICAL
Federal Way PERMIT APPLICATION
CITY OF FEDERAL WAY
// / CDS
PERMIT NUMBER / 3_ / O 0 / 7 OR _ L
/ O 0 +Y�` SUITE/UNIT/SPACE#
SITE ADDRESS: 5700 SW ASH NA,V et
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ 75o / 0 ; / G 3 _ ` e a
PROJECT NAME ` 1
(Tenant or Homeowner Last Name) D CjsV{ Po��, 1 i`1r" ?ark
PROJECT DESCRIPTION RN) 12*9pstrk S d- Sao SA-Ar4, (21 Yoo Pa•44hs
Detailed description of work to Lail. /vd ca,.a-wqk t lti t rq,
be included on this permit only •
N S�l�� PRIMARY PHONE
PROPERTY OWNER NAM NA p.....v14.0 ( )
■ MAIJLLII/NGG/ADDRESS E-MAIL
CITY ' STATE ZIP FAX
( ) -
NAME PRIMARY PHONE
Ei
C �4p a-X E1t_c T cci Cw.'Jk15 ( )
MAILING ADDRBl1S/ E-MAIL
ELECTRICAL 1(1.7o 2_ u2.54` G4'✓& 5 e-
CONTRACTOR CITY STATE ZIP FAX
SIM k0,,,,,•`5 h wet f92_1(4 ( ) -
WA STATE CONTRACTOR'S LICENSE 4 EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
NC '�AEA ci-o 0%i
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS ( ) E-MAIL
CITY STATE ZIP FAX
( )
NAME PRIMARY PHONE
PROJECT CONTACT �4 ti' V\451.55Q4 (3(44 ) -7
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 s ch claim), which may be made by any person,including the undersigned,and filed against the city,
but only where such clai ■ ari is out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to if cit •• a part of this application.
0202-_ ,3
SIGNATURE: a �� DATE e/ '
PRINT NAME: "/ P A
Bulletin#160—January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application
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