15-106099City of Federal Way Electrical
Community & Econ. Dev. Services Permit #: 15 -106099 -00 -EL
33325 8th Ave S
Federal Way, WA 98003 Inspection Request Line: 2
Ph: (253) 835-2607 Fax: (253) 835-2609 p q (53) 835-3050
Project Name: IING COUNTY AQUATIC CENTER
Project Address: 650 SW CAMPUS DR Parcel Number: 192104 9051
Project Description: Replace existing control panel
Owner
KING COUNTY -PARKS
AnRlicant
PAT BOYD
Contractor
LAKES ELECTRIC INC
500 4TH AV
LAKES ELECTRIC
LAKESEI101MC (7/3/16)
SEATTLE WA 98004
PO BOX 7060
PO BOX 7060
COVINGTON, WA 98092
COVINGTON WA 98042
Additional Permit Information
Electrical Work Valuation?...................................A140 Is this an Online or O.T.C. application?................ Yes
Is Use Educational or Institutional?.......................No Service greater Amps? ............................. No
Electrical Fixtures
Ah. Srvc /Feeder 0 to 200 amps (C 1
PERMIT EXPIRES
Permit Issued on Thi
I hereby certify that the above information is
the occupancy and the use will be in qgcorl
Owner or agent:
Nq�
t
Il that the
the laws'
OR'
May 31, 2
ce r
ons on the above described proporty and
regulations of the State of Washington
i Date:
CITY OF ASP
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
15 -106099 -00 -EL Address: 650 SW CAMPUS DR
KING COUNTY -PARKS FEDERAL WAY, WA 98023-8425
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.
❑
UFER Ground (4295)Ditch
cover (4030)
Temporary Power (4275)Service
Slab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
Final - Electrical (4055)
Approved
By Date
Pool Bonding (4195)
Temporary Power (4275)Service
(4235)
By
Approved
By
Approved
By
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
Final - Electrical (4055)
Approved
By Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF A
Federal Way
SG:)
AVM 1V'd9(J3=1 :10 KU:)
5toz E 0 330
ELECTRICAL
PERMIT APPLICATION
PERMIT NUMBER _ , S0 D
SITE ADDRESS: ,S`� O f 0- G �GyJI/S ,��
SUITE/UNIT/SPACE #
PROJECT VALUAATTTION
ASSESSOR'S TAX/PARCEL #
CURRENT/PROPOSED USE
PROJ or H NAME
r Last Name)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
O / ✓ G �� / -�✓i�� �i�G�PC� /�% /-
PROPERTY OWNER
NAME
PRIMARY PHONE
-
MAILING ADDRESS
E.MAIL
CITY
STATE
ZIP
FAX
ELECTRICAL
CONTRACTOR
NAME
PRIMARY,PHONE
(a
MAILING ADDRESS n
D <f 0 X
F -MAIL
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
/�.E".r /D/ /G / 3 //&/
FEDERAL WAY BUSINESS LICENSE #
APPLICANT
NAMEy'J
� / 1,-f- U
PRIMARY PHONE
MAILING ADDRESS D i
`/h �7/
E-MAIL
CITY
STATE
ZIP
FAX
-
PROJECT CONTACT
NAME
PRIMARY PHONE
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 madeyany person, including the undersigned, and filed against the city,
but only where such claim arises out of the reliance of the .ttyy, including its officers and employees, upon the accuracy of the
information supplied to the city as apart of phis application.
SIGNATURE: �DATF � � S —
PRINT NAME: le Y 7 d
Bulletin # 160 — January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application