14-102861FP11 7/i
City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835 -2607 fax: (253) 835 -2609
Project Name: CAMELOT
Project Address: 3001 S 288TH ST Space 183
fuilding- Sin ki
Permit #: 14- 102861 -00 -SF
Inspection Request Line: (253) 8354050
NW83
Parcel Number: 042104 9222
Project Description: NEW - Installation of 1344 square foot mobile home in mobile home park.
Owner
CAMELOT SQUARE INC
AR121ican t
CAMELOT SQUARE INC
Contractor
L N D SERVICES
Lender
3001 S 288TH ST
3001 S 288TH ST
LNDSEI' 173DA (8/6/15)
FEDERAL WAY WA 98003 -8019
FEDERAL WAY WA 98003 -8019
15010 74TH AVE E
PUYALLUP WA 98375
Occupancy Load-
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.
1,344
0
0
0
Additional Permit Information
CONDITIONS:
Installation shall be in strict accordance with the manufacturer's installation instructions or professionally
engineerep installation design, which shall remain on -site as required by Washington State law.
PERMIT EXPIRES Saturday, December 27, 2014
Permit Issued on Monday, June 30, 2014
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:
Federal Way
THIS CARD IS TO ON -SITE '
06struction In ection Record �.
INSPECTION REQ TS: (253) 835-3050
PERMIT #: 14- 102861 -00 -SF Address: 3001 S 288TH ST Space 183
Project: CAMELOT SQUARE INC FEDERAL WAY, WA 98003 -8019
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.
Blockingrfie Dc
Approved
1 Date 1-7— 2 __,
SWM Precon Site Mtg (4400)
Initial Erosion Control (4365)
Final Electrical
Approved
Interim Erosion Control (4370)
Approved
By
To be done prior to breaking ground
By
Approved
By
Date
By
Date
By
Date
Blockingrfie Dc
Approved
1 Date 1-7— 2 __,
Final Erosion Control (4375)
Skirting/Final (4250)
Final Electrical
Approved
Approved
Approved
By
Date
By
Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF 'A
Federal Way
PERMIT NUMBER [ - _
40 PERMIT APPLICATION
[ 0 27 9,- 6P [ --Sr TARGET DATE -7 /0 7 �j' // +
SITE ADDRESS
SUITE /UNIT #
PROJECT VALUATION
ZONING
ASSESSOR'S TAX /PARCEL #
4--R
TYPE OF PERMIT
BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
�$
Detailed description of work toGp
be included on this permit only
PROPERTY OWNER
NAME , L
rY 76
P IMARY PHONE
4,6 3 —7,S
MAILING ADDRESS / /
o v S CJ Q //!/ ,
E -MAIL
CITY
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GV
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NAME
MAILING ADDRESS (/ J
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E -MAIL
CONTRACTOR
TY
Sf�A',E�
FAX
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W STA E CONTRACT S LICENSE #
RNG aSSJ
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME
Gam► C �� �a-r=
PRIMARY PHONE
3 -? Z Z Ate? 6
LING ADDRESS
o -I3o
E -MAIL
APPLICANT
CGS- �G�'�i ✓
W
%� T`�
FAX
NAME
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PRIMARY PHONE
-m-2- c
PROJECT CONTACT
G
/8
LING ADDRESS
P �K T
E -MAIL
(The individual to receive and
respond to all correspondence
01� ]�, � >&4,r4
�iC�I�
j (� Y-6
FAX
concerning this application)
PROJECT FINANCING
NAME /'
C/
OWNER- FINANCED
Required value of $5,000 or more
(RCW 19.27.095)
MAILING ADDRESS STATE, ZIP
PHONE /
2- 2- �aJ6 G
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 oJ`tliis dppTication. _ _
�/ 41--� ! �/-
G, c)
SIGNATURE: / i, -- DATE a- /
�
PRINT NAME: ��� e-
Bulletin # 100 – January 1, 2013 Page 1 of 3 k:\Handouts\Permit Applica
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING
%'�
L.UP
Is
Indicate how many of each type offixture
to be installed or relocated as
part or this project. Do not includ-eexistingfixtures to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (comet )
BOILERS
FURNACES
HOT W TANKS (Gas)
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
/WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING
%'�
L.UP
L 0 7
.PERMIT
�.,
Type
Stories
$
�
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
Indicate how many o each type offlxture
to be n:§rf lled or relocated as
part o this project. Do not include existir�g fttures to remain.
BATHTUBS (or Tub /Shower combo)
-k6s (Hand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
,= RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
,� .T/'t
DRINKING FOUNTAINS :
SINKS (kitchen /utility)
WATER HEATERS (Electric)
Occupancy Group(s)
HOSE BIBBS %�
SUMPS
WASHING MACHINES
TOTAL FIXTURES
t',Y /,�„ r </' n�
,.. .+,�.�1.5t,'�f
Type
Stories
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
# of
L.UP
L 0 7
in Square Feet
Type
Stories
$
EXISTING /PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
'
A.je g )c 8 c.�;)
❑ Yes & No
❑ Yes ❑ 'Dto
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
.___..._._.._.__.__—.._.—
,� .T/'t
%r z: y ..,
---- __...__ _.�._.._._..___ ... _............ _
Area
Occupancy Group(s)
,r
# of
Additional Information
i:,P7�.rr.... 2r "i;,Y / /;1,e'! ✓ /:r, ;"fiK',''�rf,?'/''� /i„ ,,
t',Y /,�„ r </' n�
,.. .+,�.�1.5t,'�f
Type
Stories
FIRST FLOOR (or Mobile Home) 2e,4X- 6
3 �{
l -3
7.
5
TENANT AREA ONLY
__ ...... _ .... _._._...
._ ... ........ __..-- '-- ---._....._..._._.._....___.
COVERED ENTRY
'x
- ... . ..... . .......
'
/.! F, „rf,r,
GARAGE ❑ CARPORT ❑
/ r
r,
EXISTING
PROPOSED
TOTAL
Area Totals
ESTIMATED SELLING PRICE $ � 00-
# OF BEDROOMS
COMMERCIAL - NEW /ADDITION
AREA DESCRIPTION
Area
Occupancy Group(s)
Construction
# of
Additional Information
in Square Feet
Type
Stories
'
ADDITION
COMMERCIAL - REMODEL /TENANT IMPROVEMENTS
AREA DESCRIPTION
Area
Occupancy Group(s)
Construction
# of
Additional Information
in S uare Feet
Type
Stories
5
TENANT AREA ONLY
Ear
'x
77777 77
#100 - January 1, 2013
Page 2 of 3
k:\Handouts\Permit Application