15-103111 ^y
• wilding - Single Family
City of Federal Way {/��
Community&Econ.Dev.Services Permit #: 15-103111-00-SF
33325 8th Ave S
Federal way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609. ns� q
Project Name: CHARWOOD MH PARK-SPACE 17
Project Address: 1660 S 333RD ST Space 017 Parcel Number: 797880 0081
Project Description: NEW-Installation of 784 square foot manufactured home within a manufactured home
park
Owner Applicant Contractor Lender
CHARWOOD PARK LLC PHYLLIS KETZENBERG AMERICAN MOBILE HOME
6619 132ND AVE NE PMB 254 PO BOX 713 SERVICES
KIRKLAND,WA 98033-8627 STANWOOD WA 98292 AMERIMH858DZ(3/9/17)
PO BOX 155
NORTH LAKEWOOD WA 98259
Census Category: 434-Residential alt/add-no change in number of units
Includes: #1 #2 #3 #4
Occupancy Class: R-3
Construction Type:
Occupancy Load:
Floor Area(sq.ft.) 0 0 0 0
Additional Permit Information
New/Additional Sq.Feet-1st 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 32 New/Additional Sq.Feet-Garage 0
Occupancy#1-Class R-3 New/Additional Sq.Feet-Other 0
New/Additional Sq.Feet-Total 32 Occupancy#1 -Use Residence(1 or 2
family)
No Fixtures Associated With This Permit!!
CONDITIONS:
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, January 27, 2016
Permit Issued on Friday, July 31, 2015
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 agen • �� '/4 TY• PA,Li.fee Date: 7-c.5 `/S-
r t•\A.1,1 c
.> _ . • THIS CARD IS TO ON-SITE
CITY.OF Construction In ection Record
Federal Way INSPECTION REQU TS: (253)835-3050
PERMIT#: 15-103111-00-SF Address: 1660 S 333RD ST Space 017
Project: CHARWOOD PARK LLC FEDERAL WAY, WA 98003-6434
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.
0 SWM Precon Site Mtg(4400) 0 Initial Erosion Control(4365) ❑ Interim Erosion Control(4370)
Approved To be done prior to breaking ground Approved
By Date By Date By Date
❑ Blocking/Tie Downs(4015) 0 Final Erosion Control(4375) o Skirting/Final(4250)
Approved Approved Approved
By vie, Date 412441 L By Date By j9- J Date `3)(a l lle.
1
E] Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
° ` PERIVII PL,ICATION
' 'federal Wa y ROC
•
sluN262015
PERMIT NUMBER t 5 _ I / j . _ 5 Wit-w 1 , /�" •
CITY
CDs
SITE ADDRESS SUITE/UNIT
/44OAL5. 533-pi '3 -. #17 . ?iL l y, D3 '7
TYPE OF PERMIT s BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ENGINEERING ❑ FIRE PREVENTION
0 y�NAME OF PROJECT /4 b f /( aoS .,ut IL (7-
1nnoiAs& riRl1�p6 �_`��etA P 4 ilie33�,fi 'J�C.54'/Y rLe
PROJECT description of RIPTION OVO. 1� ].• etc5e[!ID 1' :))F LP Nome pn" j
be included on this permit only f T
•
1. PRIMARY PHONE
PROPERTY OWNER , I! '— • _
MAILING ADDRESS
144,t) 5 . 33Ye Sift. .
NAME To A l Le�i9 y c� 4 3 _• PHONE
I Ali PVC"IlE—b
CONTRACTOR , " o• 1..sS rr ,e°e0
TE FAR
A STATE CONTRACTOR'S LICENSE I EXPIRATION DATE ERAL WAY BUSINESS LICENSE I
U . 003.15/6.. - AihF..>�'lnhjaSt oz__ 3 i of i/ 3 ys.ve/Al7 ciehBl•
I NAT' 115*1-A•vilyz.111 0-6114g44 iiii.. 47:111.,,INE siefeLe
APPLICANT 44
. 5 Kamd4sAWIltig
5rAiklioce5,4). sof. ?sev.,,,%
PROJECT CONTACT 1- [rt S / X.- t L ALA) ' i dA
(The individual to receive and ' ° * '
respond to all correspondence v `�'' " . 3 �] h 11 A__ /fit // I A . • .'h
concerning this application) �Al,(�(9(9L� �/ � �, 3a�"1a'�&`I317
PROJECT FINANCING NAME ti OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorised 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.
claim(including costs, and attorneys'fees incurred in
I her agree to hold harmless the City of Federal Way as to any ltti ( 9 ,expenses, rnwJ ./
.�� a9 tiJ .f y
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.
TUl . ' DATE ( ' ~,5j"15
SIGMA
PRINT NAME: i.6 I •ne.. aillir Al P t-A
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application
• ♦' VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
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(commercis�
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
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 Tub/Shower Combo) LAVS(Hand sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utz WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
I ark) Lk 7 s.1 • e_ $ 47. dt,0
IDUSTING/PREVIOUp USE 4t. LOT SIZE flit Square Feet) ..•STING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
RV-Sete-u 9-e 1 e 5- ❑Yes,/ No ❑Yes A No
Vt:pb:LE RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
.-t
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
®ar
Area Totals oma .atu ,mow
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area Occupancy Groups) Construction #of Additional Information
in Square Feet Type Stories
NEw BUILDING
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area Occupancy Group(s) Construction #of Additional Information
in Square Feet pl s 1 Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application
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