18-104967City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98103
Ph: (253) 835.2607 Fax (253) 8352609
Project Name: BELMOR MOBILE PARK LOT 133
Project Address: 2101 S 324TH ST
Project Description: Installation of beat pump system.
Mechanical
Permit #:18 -104967 -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
Met hanit al Work Valuation? ................. 2500 is thin an Online nr O_T_C_ annlication?.................. Yes
u
Furnaces
PERMIT EXPIRES Saturday, 20 April, 2019
Permit Issued on Monday, October 22, 2018
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:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
Feder sal way INSPECTION REQUESTS: (253) 835-3050
PERNM #: 18104%700 Address: 2101 S 324TH ST Space 133
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 are logged on the back of this card.
0
Mechanical Rough -in (4165)
Q
Gas Piping (4125)
El
Final - Mechanical (4065)
Approved
Approved to release test
Approved
By
Date
By
Date
By
Date 11-1 —lb
Rough Electrical
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
40k
CITY OF
Federal Way
RECEIVED
OCT 2 2 2018
PERMIT APPLICATION
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter(@.cityoffederalway.com
CITY OF FEDERAL WAY
COMMUNrrY DEVELOPMENT
PERMIT NUMBER —1 _ --/— —0 —yq 12
_ M
_L TARGET DATE
SITE ADDRESS
SUITE/UNIT #
2 v lS 3�`I-�1i sT ���rui w� C1�c�v3
133
PROJECT VcALUATION
ZONING
ASSESSOR'S TAX/PARCELO � — q
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING 10 MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
-- t 33
B fA VA.O-V- tO CLQ --
PROJECT DESCRIPTION
10 -S; 11 b"RIL1211-IJ2S >lz
10-S;611
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
-,-7,53 83 �3 v6%7
PROPERTY OWNER
MAILING ADDRESS
2 yr 5 3 114t, 5T
E-MAIL
CITY
we.,,
STATE
lv
ZIP
bv3
NAME
�141cbu1l L
PHONE
;7v6 37v C:-PDLZ'-
MAILING ADDRESS
_?-G`C3 �`/ '� /2D
E-MAIL
a.,.-PierCOK
CONTRACTOR
CITY
STATE
I wy
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
�M1lGlt 4P 37� L
/EXPIRATION DATE
l 113
FEDERAL WAY BUSINESS LICENSE #
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 1 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.
DATE
SI DATE
PRINT NAME: C ilo-r % Z—
Bulletin #100 - January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT RMIT
Occupancy Group(s)
FIRST FLOOR (or Mobile Home)
# of Additional Information
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
Indicate how man of each type offixture
to be installed or relocated as
. art of this project. Do not include existing res to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
OTHER (Describe),
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (commercial)
OTHER (Describe)
BOILERS
FURNACES
HOT WATER TANKS (G.)
_....__....___.............. _..__-----------
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VA LUE OF PLUMBING WORK
PLUMBING PERMIT
Occupancy Group(s)
FIRST FLOOR (or Mobile Home)
# of Additional Information
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
Indicate how many o each type offixture
to be installed or relocated as
part o this project. Do not include existir�g 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/utility)
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
Occupancy Group(s)
FIRST FLOOR (or Mobile Home)
# of Additional Information
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
COVERED ENTRY
❑ Yes ❑ No
❑ Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL
FOR OFFICE USE
:Fr / "I,1'y 4 }}�� ....
ki WY+r
.....................................__..........._....... .... _........ _.... _.._._...
Occupancy Group(s)
FIRST FLOOR (or Mobile Home)
# of Additional Information
S ware Feet
....................... ..... ......._ ....... ......... _............._...... _.................._........... ......
!G^.
Stories
COVERED ENTRY
y-
n
._..__.................................... ._........... _................................. _...... .._........... .... -- -- --.....
..
GARAGE ❑ CARPORT ❑
"M
_.......... _... _......... _._... ............... _............ -.-----..-...... ..- ...... - ..... _
wwwq
................... _-................... ...........................................
Area Totals EMSTING PROPOSED - TOTAL
_....__....___.............. _..__-----------
`:'
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
ESTIMATED SELLING PRICE $ ; # OF BEDROOMS
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION Area in
Occupancy Group(s)
Construction
# of Additional Information
S ware Feet
a
Stories
00
w
ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Occupancy Group(s)
Construction
# of Additional Information
Ware Feet
a
Stories
l
TENANT AREA ONLY
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Bulletin #100 —January 29, 2016 Page 2 of 2 k:\Ilandouts\Permit Application