18-104973City of Federal Wry
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 8352607 Fax (253) 835.2609
Project Name: BELMOR MOBILE HOME PARK SPACE 106
Project Address: 2101 S 324TH ST
Project Description: Installation of heat pump system.
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Mechanical
Permit #:18 -104973 -00 -ME
Inspection Request Line: (253) 835-3050
Parcel Number: 162104 9037
Owner
Applicant
Contractor
BELMOR MOBILE HOME PARK LP
MICHAEL L ERICKSON (GENERAL)
MICHAEL L ERICKSON (GENERAL)
2101 S 324TH ST
26834 MILITARY RD S
MICHAE'837JL (4/13/19)
FEDERAL WAY WA 98003
KENT WA 98032
26834 MILITARY RD S
KENT WA 98032
Additional Permit information
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
Washin ton and the ity of Federal Way.
Owner or agent: I I F Date:
THIS CARD IS TO REMAIN ON-SITE
Construction In
Federal Way Inspection Record
y INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 18104973 00 Address: 2101 S 324TH ST Space 106
Project: BELMOR MOBILE HOME PARK LP 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 aro logged on the back of this card.
ti
Mechanical Rough -in (4165)
0
Gas Piping (4125)
3❑
Final - Mechanical (4065)
El
Approved
1BY
Approved to release test
Approved
By
Date
Date
By
Date i
ti
Rough Electrical
Final Electrical
El
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
RECEIVED
CITY OF OCT 2 2 2018
Federal WaXaTY OF FEDERAL WAY
MUNfTY DEVELOPMENT
PERMIT APPLICATION
PERMIT CENTER + 33325 811, Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
PERMIT NUMBER I Jj _ , r O _y C7 -13 _ �j F, TARGET DATE
SITE ADDRESS
SUITE/UNIT #
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL# D 7—
O y 70
OF PERMIT
❑ BUILDING ❑ PLUMBING W MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
eJ KA Or P p LA- Le— 10 (P
PROJECT DESCRIPTION
l TGs / -
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
62ECI-5-17
PROPERTY OWNER
MAILING ADDRESS
/v/ s
E-MAIL
CI1�
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STATE
hi
ZIP
1C�'db3
NAME )
Wle- �/q2 r-/ c Sc
PHONE
Zvi 370 022
MAILING ADDRESS
/2D S
E-MAIL
CONTRACTOR
CITY
IK , -�--
STATE
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ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
/'Ylec efe 37JL-
EXPIRATION DATE
IV/l /I
FEDERAL WAY BUSINESS LICENSE #
772,0-/ 6-/v/ zl-�v-L3L
NAME
PRIMARY PHONE
APPLICANT-
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
NAME -
PRIMARY PHONE
PROJECT CONTACT
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5, 000 or more
(RCW 19.27.095)
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: !� DATE
PRINT NAME: / G Y / L
Bulletin #100 —January 29, 2016 Page 1 of 2 kAHandouts\Permit Application
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
TOTAL
FOR OFFICE USE
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,+ ,a `'f X
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EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
$
Indicate how many of each type offtture
to be installed or relocated as
part of this project. Do not include existing res to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
OTHER (Describe),
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (commerciai)
OTHER (Describe)
BOILERS
FURNACES
HOT WATER TANKS (Gas)
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COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
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DUCTING
GAS PIPING
WOODSTOVES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VA LUE OF PLUMBING WORK
PLUMBING PERMIT
TOTAL
FOR OFFICE USE
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,+ ,a `'f X
�t�
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
$
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existir�g fixtures to remain.
BATHTUBS (or 74b/Shoa r Combo)
LAVS (Hand Sinks)
TOILETS
- WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
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DRINKING FOUNTAINS
SINKS (Kitchen/Utility)
WATER HEATERS (Eiectric)
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HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
TOTAL
FOR OFFICE USE
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,+ ,a `'f X
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EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
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❑ Yes ❑ No
❑ Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
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_ ...... ............... _.._.......................... _ . ._ .._.__.._
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Stories
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FIRST FLOOR (or Mobile Home)
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COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
COVERED ENTRY
AREA DESCRIPTION
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............ .._...................... . ----__..... ........._......_ - —
# of
Additional Information
Square Feet
GARAGE ❑ CARPORT ❑
Stories
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#
—.__�___......_.__........ _.... _....................... _..._.___... _............................ _..
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Area Totals
ZIUSTING
PROPOSED TOTAL
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ESTIMATED SELLING PRICE $
# OF BEDROOMS
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area in Occupancy Group(s)
Construction
# of
Additional Information
S uare Feet
a
Stories
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77 xvw T-
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ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Occupancy Group(s)
Construction
# of
Additional Information
Square Feet
Stories
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TENANT AREA ONLY
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Bulletin #100 — January 29, 2016 Page 2 of 2 k:\Handouts\Permit Application