04-100292 r►
City of Federal�Vay 0 0 -
Conununity Development Services Building - Single Family Permit #: 04 - 100292 - 00 - SF
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: BELMOR MOBILE HOME PARK-SPACE 205
Project Address: 2101 S 324TH ST She11205 Parcel Number: 162104 9037
Project Description: Install 1961 National mobile home.
Owner Applicant Contractor Lender
BELMOR MOBILE HOME PARK BELMOR MOBILE HOME PARK FIAGERTY CONSTRUCTION INC NONE
2101 S 324TH ST 2101 S 324TH ST HAGERCI001MK(7/12/04)
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 19207 ROUSE RD
LONGBRANCH WA 98351 NONE
Includes:
Census category: 112-New rr #1 #2 #3 #4
Occupancy Group: HR-1
1 Construction Type:
Occupancy Load:
Floor Area(Sq.Ft.):
1st Floor Proposed Sq.Feet 616 Census Category 112-New manufactured/fact(
Occupancy Group#1 R-1 Total Proposed Sq.Feet 616
PERMIT EXPIRES August 25,2004.
Permit issued on February 27,2004
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: / ' ,, s I. «.,' _ foe , v Date: •5/o ?(G,/
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II/ COMMUNITY DEVELOPMENT SERVICES
crn,of 110"... ...." 33530 FIRST WAY SOUTH•PO BOX 9718
FEDERAL WAY,WA 98 063-9 718
Federal Way PERMIT APPLICATIO 253-661-4115•FAX-253-661-0129
uww. Y�n rder wm 7+
For Office Use Only: 1
FW File Number: /vnT,/LL/ � _ + 0 0 a 1 a. - 5 TO: J
i l) 7 / D q
The ollowin. is re.uired in ormation-an incom.fete a..lication will not be acce.ted. Please •rint le.ibl (in ink)or .•.
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7 ■ PROPERTY INFORMATION -
SITE ADDRESS: /0/S �iC � S .,,, ______ `5-
ASSESSOR'S TAX/PARCEL #: SQUARE FOOTAGE OF LOT: ✓/ /53
LEGAL DESCRIPTION (eg:Acme Estates, Lot 1) _5-e- 4, L./1.42-6_
(Attach separate page for lengthy legal description)
- ■ PROJECT INFORMATION -
TYPE OF PERMIT(This application): (`b,BUILDING ❑ PLUMBING 0 MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu): s e,15.- 14...prm/j f 2 a•T /
ReitYe-4 e- /e (/rt5'2 ` GU/1r/ �eez 7cr-/02/ akt J)t _a-ei,2.0v
PROJECT NAME(Name 0 Business/Owner Last Name): 1 o I 1r, o. /1 CA)-( a. /
■ PEOPLE INFORMATION
PROPERTY NAME: ` ,�C a,, PRIMARY PHONE:
OWNER twine r /`®/6.f e-- //D Axe ,Z . Kl�� )1,,, / -G/ 7
MAILING ITY,STATE,ZIP
z ',S,ADDRESS32 yf ET�4DDRES$;': CM eA n-4l le le / 091'i"a.�
CONTRACTOR: V4..p [ t,Gy+ (� [ W L42 i ' OFFICE PHONE:
�al ex-&-y mss'bet/4464.111w,Ivc ee-y (.6;3)X15"--/W0
M G ADDRES STREET ADDRESS;): CITY,STATE,ZIP( CELL PHONE:
CQow 7zei ,des ,d: ,"dlz , ' 6e:51, 4'.3,..
CITY OF FEDERAL WAY BUS ESS LICENSE NUMBER: EXPIRATION ATE: FFAA�X)NUMBER:
CONTRACTOR'S REGISTRATION NUMBER: / I
1 �f� /AT/
/� I_ EXPIRATION DATE:
(copy of card required with each application) ti /"t 61E. ( C I SSS"` -C -( PA k -7 / /c)• / (,
LENDER NAME: DAYTIME PHONE:
(If Proposed Valve>$5,000)
MAILING,, ( )
ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP
APPLICANT: 1(y' OFFICE PHONE:
�ei t�'AVt2&#oke-P4, 1VdetS (.26-1)1.5I - e517
MAILING ADDRESS(STREET ADD SS): CITY,STATE, IP EVENING PHONE:
Zia(--5;5. . rt /J" (�/.�' 05 (...16-3 ) %93- -mgr
RELATIONSHIP TO PROJECT: D� / FAX NUMBER:
0 Architect ❑ Tenant 0 Other (Describe it Co f l �,l p//`6" (02„1"3) 73/ -///
N a f E'veme,y rrs (o t�
CONTACT PERSON FOR THIS PROJECT: ❑ Property Owner ❑ Contractor Applicant /�MAIL ADDR S:v evaJ c
ket•
. ■- DETAILED BUILDING INFORMATION- - -
EXISTING USE: /V11.746'ie., ' ii O Y- rw:SQF PROPOSED USE: &...v id e.fa
`39EXISTING ASSESSED/APPRAISED VALUE $ q, 0 , O a: VALUE OF PROPOSED WORK: $ _, (5"O d
SPRINKLERED BUILDING? 0 YES )(NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: ❑ YES NO
WATER SERVICE PROVIDER XLAKEHAVEN ❑ HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER X LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
■ PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL
BASEMENT a ,
FIRST49 ;
SECOND
THIRD ) /e
FOURTH /(/
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS?
T AL EXISTING TOTAL PROPOSED TOTAL EXISTI G AND PROPOSED
/ 7
ONL •' D
C **NEW HOMES YNUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ OO/o
■ FIXTURES
Indicate number of each type of fixture that is to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commerdaq WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
._COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or Tub/ShowerComtw( SHOWERS WATER CLOSETS(roik() MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYS
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom sink VACUUM BREAKERS ELECTRIC WATER HEATERS
■ DISCLAIMER/SIGNATURE BLOCK •
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my
knowledge, and further, that I am authorized by the owner of the above premises to perform the work for which the permit
application is made. Ifurther 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 of Federal Way, 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.
NAME/TITLE: DATE: / .�-eO
Signature) (/I ��� y (Title)
RELATIONSHIP TO JECT: orkoperty Owners o Applicant 0 Contractor ❑ Architect 0
FOR OFFICE USE ONLY:
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? ❑YES o NO
ZONING DESIGNATION: CHANGE OF USE? ❑YES ❑NO
NEW ADDRESS REQUIRED? ❑YES o NO UP/SEPA/SU? o YES ❑NO
PLATTED LOT? ❑YES o NO DEMO PERMIT REQUIRED? ❑YES 0 NO
' ., .. ..".U,E. TRICAL NW' i"INFORMAT..rJN '
RESIDENTIAL COMMERCIAL
NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE
CISingle Family Square Feet: Service or Feeder Each Add'n
(First 1300 ft2-$87.00; Each add'n 500 ft2-$28.00) ❑ 0 to 100 amp $ 94.50 $ 58.00
❑ Detached outbuilding or garage ❑ 101 -200 amp 117.50 74.00
(Inspected with service) $36.50 ❑ 201 -400 amp 220.50 87.00
❑ Detached outbuilding or garage ❑ 401 -600 amp 256.50 103.00
(Inspected separately) $58.00 ❑ 601 -800 amp 332.00 140.50
NEW MULTI-FAMILY(three units or more) CI 801 - 1000 amp 405.50 169.50
Service Feeder ❑ Over 1000 amp 442.00 236.00
❑ Up to 200 amp $ 94.50 $ 28.00
CI Over 600 volts surcharge $74.00
CI 201 -400 amp 117.50 58.00
CI 401 -600 amp 161.00 80.00
CI Mast or meter repair $80.00
❑ 601 -800 amp 206.00 110.00
CI Over 800 amp 294.50 220.50 ALTERED.COMMERCIAL/INDUSTRIAL
Service or Feeders
ALTERED SINGLE/MULTI FAMILY U 0 to 200 amp $ 94.50
(Inspected separately from service) ❑ 201 -600 amp 220.50
Service or Feeder ❑ 601 - 1000 amp 332.00
to 200 amp $ 72.50 ❑ over 1000 amp 369.50
❑ 201 -600 amp 117.50
❑ over 600 amp 177.00 ❑ # of circuits to be added/altered
(1-5 circuits-$74.00;Add'n circuits,$6.00/ea)
❑ #of circuits to be added/altered
(1-4 circuits-$58.00;Add'n circuits$6.00/ea) COMMERCIAL/INDUSTRIAL PLAN REVIEW
❑ Service over 200 amps
❑ Mast or meter repair $43.50 ❑ Medical/Educational/Institutional Facility
SINGLE/MULTI FAMILY PLAN REVIEW $74.00 plus 35%of Permit Fee
❑ Service Over 400 amps
$74.00 plus 35%of Permit Fee
OBILE HOMES TEMPORARY SERVICE
ervice or feeder only $58.00
❑ Service and feeder $94.50 Commercial Residential
MOBILE HOME/RV PARK CI 100 $58.00 $51.00
❑ 101 -200 74.00 51.00
❑ # of service or feeders
(First service/feeder-$58.00;each add'n-$37.50) Li 201 -400 87.00 n/a
❑ 401 -600 117.50 n/a
❑ over 600 127.00 n/a
MISCELLANEOUS SERVICE/EQUIPMENT
❑ # of Thermostats LI # of Signs
(First-$43.50;add'n-$13.50/ea) (First sign-$43.50;add'n sign$20.50/ea)
❑ Low Voltage ❑ Swimming pool/hot tub $87.00
Square Feet to be served by system(s): (Includes additional circuit, if required)
❑ Fire Alarm System ❑ Yard Pole meter loops $58.00
D Security Alarm System
CI Additional Plan Review
❑ Voice Cabling $87.00/hour
❑ Data Cabling
(for modified submittals)
111
(Per System(s): l.2500 ft2-$5l.00;
Each add'n 2500 ft2-13.50) •Per WAC 296-46-970(5)(b)(&ti)