12-103669V . n
•
City of Federal Way
Lender
Community & Econ. Dev. Services
33325 8th Ave S
-
Federal Way, WA 98003
L LIRD
Ph: (253) 835 -2607 Fax: (253) 835 -2609
. 16311 MERIDIAN E
AMERIHC9780C (9/3/13)
Project Name: BELMOR MOBILE HOME PARK SPACE 50
Project Address: 2101 S 324TH ST SPACE 50
building - Singlp Family
Permit #:12- 103669 -00 -SF
Inspection Request Line: (253) 835 -3050
Parcel Number: 162104 9037
Project Description: NEW - Installation of new 1152 sqft mobile home to replace existing.
Owner
Applicant
Contractor
Lender
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.
1,152
0
0
0
Additional Permit information
New / Additional Sq. Feet -1 st Floor .................... 0
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 # I - Area (Sq. Feet) .. ...........................1152
New / Additional Sq. Feet - Deck ..........................0
Occupancy #I - Class ................. ............................R,3
New / Additional Sq. Feet - Total .......................... 0
Nb Fixtures Associated With This' Pormt 11
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 Wednesday, February 20, 2013
Permit Issued on Friday, August 24, 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
ano the City of Federal Way.
Owner or agen Date: Z
I \N
CITY OF
Federal Way
PERMIT #:
Project:
• THIS CARD IS TO MAIN ON -SITE
Construction In ection Record
INSPECTION REQUE TS: (253) 835 -3050
12- 103669 -00 -SF Address: 2101 S 324TH ST SPACE 50
BELMOR MOBILE HOME PARK FEDERAL WAY, WA 98003
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.
Blocking/Tie Downs (4015) Final Erosion Control (4375) Skirting/Final (4250)
Approved Approved A ve
By ��� Date/10 /1-12 By Date By Date 1
3 w�
SWM Precon Site Mtg (4400)
0
Initial Erosion Control (4365)
Final Electrical
Approved
Interim Erosion Control (4370)
Approved
By
To be done prior to breaking ground
Approved
By
Date
By
Date
By
Date
Blocking/Tie Downs (4015) Final Erosion Control (4375) Skirting/Final (4250)
Approved Approved A ve
By ��� Date/10 /1-12 By Date By Date 1
3 w�
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
w
CITY OF
Federal Way
COMMUNITY DEVELOPMENT SERVICES
253- 835 -2607• FAX 253- 835 -2609
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PERMIT �` Ie /n'iF CO ME PL DE EN FP
APPLICATI v
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SITE ADDRESS / 0: V� 6
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SUITE /UNIT #
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL/{
TYPE OF PERAUT
ASUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name /Homeowner Last Name)
t 1W J / J (4 /I �
PROJECT DESCRIPTION
Detailed description of work to
_
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be included on this permit only
PROPERTY OWNER
NAME
/
PRIMARY PHONE
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MAILING ADDRESS
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CITY
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STATE
ZIP _
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MAD.IIRG ADDRESS � �
C/O
E-MAIL
CONTRACTOR
STATE
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FAX ` _ J--U
WA STAT CONTRACT R'S LICENSE #�(, to
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
•
PHONE
MAILING ADDRESS
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E-MAIL
/ (((� t � OJ
APPLICANT
C
STATE
ZIP 1 �7
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FAX (//�{] %('�'�_
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PROJECT CONTACT
(7he individual to receive and
respond to all correspondence
concerning this application)
NAME
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PHONE
ZY
MAILING ADDRESS /
E-MAD.
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CI
STATE
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FAX (',.
ALTS E CONTACT' NANJ�;:
PHONE
E -MAIL.
PROJECT FINANCING
Required value of $5,000 or more
(RCW 19.27.095)
NAME ' `
WNER- FINANCED
MAILING ADDRESS, CITY, STATE, ZIP
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 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 d� ✓ �--
...-----
PRINT NAME:
Bulletin #100 —January 1, 2011
Page 1 of 3
k:\Handouts\Pelmit Application
;,;44
h
P"Lf
0 0
VALUE OF MECHANICAL WORK $
BATHTUBS (or t)jb /Shower Combo)
(a copy of bid or estimate must be provided)
Indicate how many of each type of fixture 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 (Commercial)
BOILERS
FURNACES
HOT WATER TANKS (Gas)
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
Indicate how many of each type of fixture to be installed or relocated as part of this project Do not include existing fixtures to remain.
BATHTUBS (or t)jb /Shower Combo)
LAVS (Hand Stnksl
TOILETS WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen /utility)
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES TOTAL FI%TURES
AREA DESCRIPTION I Area
in Square Feet
ADDITION
AREA DESCRIPTION Area
in Sauare Feet
TENANT AREA ONLY
Construction # of Additional Information
Occupancy Group(s) �,�,_
Construction # of
Occupancy Group(s) �,,,_ c.,.r:_e Additional Information
Bulletin #100 - January 1, 2011 Page 2 of 3 k:\Handouts\Perniit Application