12-102586City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Ouilding - Single Family
Permit #: 12- 102586 -00 -SF
-Y Inspection Request Line: (253) 8354050
Project Name: BELMOR MOBILE HOME PARK SPACE 79
Project Address: 2101 S 324TH ST Space 79
Parcel Number: 162104 9037
Project Description: NEW - Installation of new 1493 sqft mobile home to replace existing.
Own r
Al2RIicani
Contractor
Lende r
BELMOR MOBILE HOME PARK
AMERICAN HOME CENTER
AMERICAN HOME CENTER
2101 S 324TH CT
16311 MERIDIAN E
AMERIHC9780C (9/3/13)
FEDERAL WAY WA 98003
PUYALLUP WA 98375
16311 MERIDIAN E
Occupancy Load
PUYALLUP WA 98375
Census Category: 112 - New Manufactured/Factory -Built Home, IN PARK
Includes:
# 1
#2
#3
#4
Occupancy Class:
R-3
Construction Type:
Occupancy Load
Floor Areas . ft.
1,493
1 0
0
0
Additional Permit Information
New / Additional Sq. Feet - 1 st Floor ....................1493
New / Additional Sq. Feet - 3rd Floor ....................0
New / Additional Sq. Feet - Basement ...................0
New / Additional Sq. Feet - Garage .......................0
New / Additional Sq. Feet - Other ..........................0
Occupancy # 1 - Use ................ ............................... Residence (1 or 2
family)
New / Additional Sq. Feet - 2nd Floor ...................0
Occupancy # 1 - Area (Sq. Feet) .. ...........................1493
New / Additional Sq. Feet - Deck ..........................0
Occupancy # 1 - Class ................. ............................R -3
New / Additional Sq. Feet - Total .......................... 1493
No Fixtures Associated With This Permit Il
CONDITIONS:
1. Installation shall be in strict accordance with the manufacturer's installation instructions or professionally
engineered installation design, which shall remain on -site as required by Washington State law.
PERMIT EXPIRES Sunday, December 9, 2012
Permit Issued on Tuesday, June 12, 2012
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
n n I and the City of Federal Way. /
Owner o ayen �.' I , 1 lC YI ^� �� Date:
Mii W 7 /z3/iz
{
CITY OF
Federal Way
PERMIT #:
12- 102586 -00 -SF
THIS CARD IS TO MAIN ON -SITE
Construction In ection Record
INSPECTION REQUE TS: (253) 835 -3050
Address: 2101 S 324TH ST Space 79
Project: BELMOR MOBILE HOME PARK FEDERAL WAY, WA
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.
❑
SWM Precon Site Mtg (4400)
❑
Initial Erosion Control (4365)
Final Electrical
Approved
Interim Erosion Control (4370)
11
Approved
By
To be done prior to breaking ground
Approved
By
Date
By
Date
By
Date
Blocking/Tie Downs (4015) E Final Erosion Control (4375) ❑ Skirting/Final (4250)
Approved Approved Approved
By L Date 7 — /d _17,_ By Date By Date ql. , _73
Rough Electrical
Approved
Final Electrical
Approved
11
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF PERMIT
Federal Way RECEIV
COM3 -835- YDEVELOPMENT SERVICES 11PLICATION
253 - 835 -2607• FAX 253 - 835- 2609��N
wu,w.nho tderalwaLco i O 7 2012
CITY
#5MF (C..2 S Ek
CO ME PL DE EN FP
7/5//2,
SITE ADDRESS C
SUITE /UNIT N
PROJECT VALUATION
ZONING
ASSESSOR'S TAX /PARCEL M
TYPE OF PERMIT
J�9UILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name /Homeowner Last Name)
t ;i f j a y- y
PROJECT DESCRIPTION
010 TTL'r
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
E -MAIL
CITY
STATE
ZIP
NAME WaI
° 3- / oC�
ING 1DRESS Z
E -MAIL
CONTRACTOR
CI
STAT
Z
, 3 �73
FAX
ST CONTRACTOR'S LICENSE M
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE N
NAME (
PHONE
MAILING ADDRESS
E -MAIL
APPLICANT
II1CONNT�ACT
CITY
STATE
ZIP
FAX
PROJECT
N E m /G� V J o
P�
(The individual to receive and
MAILING AD S
E- L
respond to all correspondence
concerning this application)
CITY
9TATE*
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/
FAx �
I 1
AL CONTACT NAME:
-11Za3Cf-/,-_-Z&=
PHONE
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adLa-�-_"n
PROJECT FINANCING
NAME /
OWNER- FINANCED
Required value of $5,000 or more
MAILING ADDRESS, bITY, STATE, ZIP
PHONE
(RCW 19.27.095)
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. 1 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 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 the city as a part of this application.
SIGNATURE: DATE
PRINT NAME:
Bulletin #100 —January 1, 2011 U Page 1 of 3 UflandoutsTermit Application
VALUE oFMECIMMCAL WORK $ (a copy of bid or estimate must be provided)
Indicate how many of each t of fvcture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS 1commerciai)
BOILERS RNACES HOT WATER TANKS (G—) COMPRESSORS GAS G SETS REFRIGERATION SYST
DUCTING GAS PIP WOODSTOVES
Indicate how many of each type of fixture to be install r relocated art of this project. Do not include existing fixtures to remain.
BATHTUBS(wTublsh —r combo) LA�V 'andSinka) OILETS WATER PIPING
DISHWASHERS - - - -� RAINWATER SYSTEMS U S OTHER (Describe)
DRAINS ! SHOWERS VACUU REAKERS
DRINKING FOUNTAINS SINKS (Kitchen /utility WATER HEATERS (electric)
HOSE BIBBS - SUMPS WASHING MACHINES
Bulletin #100 — January 1, 2011 Page 2 of 3 k:\Handouts\Pennit Application