16-101687Slilding - Single Family
City of Federal Way
Community & Econ. Dev. Services Permit #: 16-101687-00-SF
33325 8th Ave S
Federal Way, WA 98003 Ins ection Request Line: 253 835 -3050
Ph: (253) 835 -2607 Fax: (253) 835 -2609 p
Project Name: CAMELOT MHP SPACE %
Project Address: 3001 S 288TH ST Space 96 Parcel Number: 042104 9222
Project Description: NEW - Installation of a 1248 square foot mobile home
Census Category: 112 - New Manufa�tured/Factory -Built Home, IN PARK
Includes:
Owner
ARRlicant
Contractor
Lender
Occupancy Class:
CAMELOT SQUARE INC
GENE GRAF
L N D SERVICES
Construction Type:
3001 S 288TH ST
PO BOX 2322
LNDSEI* 173DA (8/6/17)
Occupancy Load
FEDERAL WAY WA 98003 -8019
TACOMA WA 98401
15010 74TH AVE E
Floor Areas . ft.
0
0
PUYALLUP WA 98375
1 0
Census Category: 112 - New Manufa�tured/Factory -Built Home, IN PARK
Includes:
#1
#2
#3
#4
Occupancy Class:
R-3
Construction Type:
Occupancy Load
Floor Areas . ft.
0
0
0
1 0
Additional Permit Information
New / Additional Sq. Feet - 1 st Floor ....................0 New / Additional Sq. Feet - 2nd Floor ................... 0
New / Additional Sq. Feet - 3rd Floor ....................0 New / Additional Sq. Feet - Basement .................. 0
New / Additional Sq. Feet - Deck ..........................0 New / Additional Sq. Feet - Garage ....................... 0
Occupancy # 1 - Class ................. ............................R -3 New / Additional Sq. Feet - Other . ......................... 1248
New / Additional Sq. Feet - Total .......................... 1248 Occupancy # 1 - Use................ ............................... Residence (1 or 2
family)
No Fixtures. Associated With This Permit 11
CONDITIONS:
Installation shall he 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, October 30, 2016
Permit Issued on Tuesday, May 3, 2016
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: 3 ��
Mm O
Federal Way
PERMIT #:
• THIS CARD IS TO rTSI(253) ON -SITE
Construction In Record
INSPECTION REQU 835 -3050
16- 101687 -00 -SF
Address: 3001 S 288TH ST Space 96
Project: CAMELOT SQUARE INC 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 Approved
By Date 2Z / (� By Date By Date
SWM Precon Site Mtg (44 0)
E]
Initial Erosion Control (4365)
Interim Erosion Control (4370)
Approved
To be done prior to breaking ground
Final Electrical
Approved
Approved
By
Date
By
Date
By
Date
Blocking/Tie Downs (4015) Final Erosion Control (4375) Skirting/Final (4250)
Approved Approved Approved
By Date 2Z / (� By Date By Date
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By ..
Date
1% PERM APPLICATION
CITY OF
Federal Way
�F APR 0 6 2016 r _
PERMIT NUMBER ` k WAY lU
Cl1 y Q M
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SITE ADDRESS %,Lf.0
SUITEMNIT M
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96
PROJECT VALUATION
ZONING
ASSESSOR'S TAX /PARCEL e
TYPE OF PERMIT
BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION [--]ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
c ~ ,/-
PROJECT DESCRIPTION
Detailed description of work to
112 5
f
be included on this permit only
NAME
e CR-w- "C7
PRIMARY PHONE
2S3 qZz Arw/G
PROPERTY OWNER
MAILING ADDRESS
1% • ,t3
E-MAIL
CITY /��
oaralo'
/S�TA�TE
W -
ZIP �/'
�v yo/
%0
g/
NAMI�'
PHONE
MAILLIIN.G ADDRESS
SC /C
E -MAIL
CONTRACTOR
CITY
1:"� ke-C 1142
STATE
Gv�-
ZIP
9a�3 7,r
FAX
WA STATE CONTRACTOR'S LICENSE M
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE A
NAME
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E -MAIL
CITY
STATE I
ZIP
FAX
PROJECT CONTACT
NAME
f S
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE -F
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
OWNER - FINANCED
When value is $5,000 or more
(RCW 19.27095)
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: q�L DATE 7 d l fO
PRINT NAME: �C N 2 A*—I
Bulletin #100 – February 22, 2016 Pagel of 2 k:\Handouts\Permit Application
•
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Indicate how many of each type offixture to be installed or relocated as part of this project. Do include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE O S OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOOD m rc;.t)
BOILERS FURNACES Hj@eWATER TANKS (Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
GENERAL LN ORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
# of
Stories
Additional Information
LUZ>
A
EXISTING /PREVIOUS USE
LOT SIZE (In Square Feet)
$
Indicate how many o each type offLxture
to b � stalled or relocated as
part of this project. Do not include existing res to remain.
BATHTUBS (or Tub /shower Combo)
VS )Hand sirilcs)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
TOTAL BUILDING
DRINKING FOUNTAINS
SINKS p wh_ /umny)
WATER HEATERS (El—trk)
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL LN ORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
# of
Stories
Additional Information
LUZ>
A
EXISTING /PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SP 7,R SYSTEM?
❑Yes No
PROPOSED FIRE SUPPRESS N SYSTEM?
❑Yes INo
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
... _ ..................... _...._.... - - - - - -- .__ ....... _ ...... ---- ..............
FIRST FLOOR (or Mobile Home) ZC( )c
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER (describe)
......... -- .... ................ _ ................... ....
Area Totals ss,a PROPOSED To
* *NEW HOMES ONLY**
ESTIMATED SELLING PRICE $ # OF BEDROOMS
COMMERCIAL — NEW /ADDITION
AREA DESCRIPTION
Area In
Square Feet
Occupancy Groups)
Construction
Type
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL — REMODEL /TENANT IMPROVEMENTS
AREA DESCRIPTION
Area In
Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 — February 22, 2016 Page 2 of 2 k: \Handouts\Permit Application