10-103255r t,
f
City of Federal Way
Community Development Services
MODERN LIVING LTD
P -O. Box 9718
LN S
Federal Way, F : (253 9718
835 -
Ph: (253) 835-2607 Fax: (253) 835-2609
6119 PACIFIC HWY E
Project Name: MARTINEZ
Project Address: 1660 S 333RD ST Space 108
Project Description: NEW - Installation of 1,456 sq ft mobile home
Building - Single Family
Permit #: 10-103255-00-S F
Inspection Request Line: (253) 835-3050
Parcel Number: 797820 0081
wn r
Applicant
Contractor
CHARWOOD PARK LLC
MODERN LIVING LTD
MODERN LIVING LTD
LN S
6619 132ND AVE NE PMB 254
6119 PACIFIC HWY E
MODERLL972DO (4/14/11)
C +-�, Sex" $
KIRKLAND, WA 98033-8627
FIFE WA 98424
6119 PACIFIC HWY E
FIFE WA 98424
Census Category: 112 - New Manufactured/Factory-Built Home, IN PARK
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Areas . ft.) 0 0 0 1 0
New / Additional Sq. Feet - Other ..........................0
Zoning Designation................................................RM 3600
- -- -- . ------------- -1. - --- ---0- ....................... _
New / Additional Sq. Feet - Total .......................... 1456
PERMIT EXPIRES Wednesday, January 26, 2011
Permit Issued on Friday, July 30, 2010
I hereby certify that the abovop in tion is correct and that the construction on the above described property and
the occupancy andAlf"'
will lf eccordance with the laws, rules and regulations of the State of Washington
/ and the -
Owner or agent: ,ME ;% Date:
City of Federal Way `
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the International Building Code certifying that
at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed byCity staff.
Tenant Name: MARTINEZ
Address: 1660 S 333RD ST Space108
Permit #: 10 -103255 -00 -SF
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area (sq. ft.) 1 0 1 0 1 0 1 0
Owner Name: CHARWOOD PARK LLC
Owner Address: 6619 132ND AVE NE PMB 254
KIRKLAND, WA 98033-8627
Building Official
Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most severty affect the health and safety of the general public. Although the City has made as complete a
review and inspection as is reasonably possible (within budgetary time and personnel limitations), the City neither guarantees nor
warrants to the owner / occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which itis situated. Such compliance is the responsibility of the owner and / or occupant of the premises.
THIS CARD IS TO REMAIN ON-SITE
cniroF Constf•uction Inspection Record
Federal Way INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 10 -103255 -00 -SF Address: 1660 S 333RD ST Space 108
Owner: 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.
E] Blocking/Tie Downs (4015)Skirting/Final (4250)
Approved Approved
By � j/� � " Date � 1_[�By Date
Rough Electrical
Approved
Final Electrical
Approved
1:1Approved
Right of Way
By
Date
By
Date
By
Date
I
4
t
FINAL INSPECTION
REQUIRED
UPON COMPLETION
2c_ c:> OF WORK
NJ
t� p 0
REVIEWED UND_F
R
2009
I -CODE
� �' PERMIT #:
10- ] 03255 -00 -St -
ADDRESS: 1660 S 333RD ST SPACE 108
0 PROJECT: INCE HOAAE 1N PARK ILE_
�
OTC DATE:
MARTIN�Z _
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COMMUNITY DEVELOPMENT SER4U L a o z; A P P L I C A T I O N
253-835-2607• FAX 253-835.2609
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CITY OF FEDERAL WAY
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S F CO ME PL DE EN FP
SITE ADDRESS nl ^ �// �j,4�K,
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SUITE/UNIT #
�� �a sa/('. ��,�./�� ftor-�� � �•-/may, ���.4
PROJECT VALUATION
ZONING - A3SESS� TAX ARCSL
TYPE OF PERMIT
XBUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Nume/Homeowner Last Narne)
✓ %'T ! !'� j
+1
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME / ? I."
/--7 .[l 4 ii��G �fS /I•/fG r' / /I� /F'
PRIMARY PHONE
�1�� �n s� 7g- y��C
,WI.ING ADDRESS
6
E-MAIL
CITY-
STA
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44
NAME
P'
MAILING
,ADDRE33
1
'T1 ,Ql1_f Al/- , 0 AOt
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # i-�
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
✓` C _.
NAME
PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACTNAME/
^'
P7
(The individual to receive and
DRESS
MAILING ADDRESS �'�
6""_7
E-MAIL
respond to all correspondence
concerning this application)
CIT
�•'/�
FAX
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
NAME
���
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 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 apart of this application.
SIGNATURE: DATES
PRINT NAME: <:1<1
c
Bulletin #100 — April 14, 2010
Page 1 of 3
k:\llandouts\Pemiit Application
0
0
VALUE OF MECHANICAL WORK $ (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 (commercieq
BOILERS FURNACES HOT WATER TANKS (ces)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING e 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-rub]show combo)
LAVS (Nandsmim)
TOILETS WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen/utility)
WATER HEATERS (mectric)
HOSE BIBBS
SUMPS
WASHING MACHINES "•>'L`1321;3Ld1>`?`••':'•'•
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No ❑ Yes ❑ No
Area Construction # of
AREA DESCRIPTION in Sauare Feet Occupancy Group(s) TV I Stories I
Additional Information
ADDITION
AREA DESCRIPTION Area Occupancy Group(s) I Construction # of I Additional Information
in Square Feet Type Stories
TENANT AREA ONLY
Bulletin #100— April 14, 2010 Page 2 of 3 k:\Handouts\Permit Application