12-104003c Building - .Single Family
ay
Comm nitty & Econ. Deof Federalv. Services a Permit #: 12 -104003 -00 -SF
33325 8th Ave S'� !
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609 2 Inspection Request Line: (253) 835-3050
6+et'�a3
Project Name: BELMOR MOBILE HOME PARK SPACE 330
Project Address: 2101 S 324TH ST Space 330
Parcel Number: 162104 9037
Project Description: NEW - Installation of new 1782 sqft mobile home to replace existing.
Owner
ARRlicant
Contractor
Lender
BELMOR HOLDINGS LTD
AMERICAN HOME CENTER
AMERICAN HOME CENTER
OWNER IS LENDER
1571 BELLEVUE AVE W SUITE 21(
16311 MERIDIAN E
AMERIHC9780C (9/3/13)
VANCOUVER CN
PUYALLUP WA 98375
16311 MERIDIAN E
PUYALLUP WA 98375
Census Category: 112 - New Manufactured/Factory-Built Home, IN PARK
Includes: # 1 #2 #3 #4
Occupancy Class: R-3
Construction Type:
Occupancy Load
Floor Areas . ft. 0 0 0 0
Additional Permit Information
New / Additional Sq. Feet -1 st Floor....................1782 New / Additional Sq. Feet - 2nd Floor ................... 0
New / Additional Sq. Feet - 3rd Floor....................0 Occupancy # 1 - Area (Sq. Feet) ............................. 0
New / Additional Sq. Feet - Basement...................0 New / Additional Sq. Feet - Deck .......................... 0
New / Additional Sq. Feet - Garage ....................... 0 Occupancy # 1 - Class ............................... ..............R-3
New / Additional Sq. Feet - Other ..........................0 New / Additional Sq. Feet - Total.......................... 1782
Occupancy # 1- Use ............................................... Residence (1 or 2 Zoning Designation...............................................RM 3600
family)
No Fixtures Associated With This Permit 11
CONDITIONS:
1. 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 Saturday, March 9, 2013
Permit Issued on Monday, September 10, 2012
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
pjLd the City of Federal Way.
Owner a ent: Date:
r ,
1 .S
Clrr of
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN bN-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
12 -104003 -00 -SF Address: 2101 S 324TH ST Space 330
BELMOR HOLDINGS LTD 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.
Blocking/Tie Downs (4015) Final Erosion Control (4375) Skirting/Final (4250)
Approved Approved T Ov,A Approved
By Date By Date By �I d Date y fG
SWM Precon Site Mtg (4400)
❑
Initial Erosion Control (4365)Interim
Final Electrical
Approved
Erosion Control (4370)
El
Approved
By
To be done prior to breaking ground
Approved
By
Date
By
Date
By
Date
Blocking/Tie Downs (4015) Final Erosion Control (4375) Skirting/Final (4250)
Approved Approved T Ov,A Approved
By Date By Date By �I d Date y fG
Rough Electrical
Approved
Final Electrical
Approved
El
Right of Way
Approved
By
Date
By
Date
By
Date
V-1
A
Federaerasl [#ECEIVED 01ERMIT
W�j
COMMUNIrY
3-835.2 07, FA PME,-8 SERPVM/ 4 2 9 2012A P P L I C A T I O N
253-835-2607 FAX 253 835 2
s)rtedr o4 at crr
CITY OF FEDERAL WAY
12 _ ( o o C�
51 'J F CO ME PL DE EN FP
SITE ADDRESS
SUITE/UNIT #
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$
j Z / _ _q_
TYPE OF PERMIT
BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT—
(Tenant Name/Homeowner Last Name)
+ _
j� f O n F.1
�l� L ✓'C G
PROJECT DESCRIPTION
Otte,(P&X bl
Detailed description of work to
/r/
be included on this permit only
PROPERTY OWNER
NAME J�
ut� � ? V e nu_ .' [
PRIMARY PHONE
-'7-3Z- 35 -ZZ --
MAILING
V 'T_•7S�
/\ /REBSq , J 5�
E-MAIL
CI
der��i Vv
STATE
�v
ZI
�ao3
NAME
./ 1(� o t C {' t —/
PHONE
;?634 { / & PP
MAILINNG ADDRESS
E
E-MAIL
CONTRACTOR
f ec
CITY,—)41 � /v
h//+STATE
113
FAX
WA
WA STATE CONTRACTOR'S LICENSE #
ME>2 o c
EXPIRATION DATE
113
FEDERAL WAY BUSINESS LICENSE #
NAME
PHONE
f/
MAIL NG ADDRESS
E-MAIL
APPLICANT
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME �� fes^ V
1 G (40 r WS,?1_%
PHONE C,`_ �`
�4i "� /5P' GW �
(The individual to receive and
MAILING ADDRESS
E-MAIL /A`
respond to all correspondence
concerning this application)
%�P e7 a ,[IJ
CITY
STATE
ZIP
F
NTA
ALTERNATE COE:
-f—" I/ YSo r7
�V �7
E-MAIL
FUL1L �S P5-8 In✓ 7,
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 a part of this application.
SIGNATURE DATE
PRINT NAME.
Bulletin #100 - January 1, 2011 Page] of 3 kAHandouts\Permit Application
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CUA
YOM
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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 icommerdal(
BOILERS FURNACES HOT WATER TANKS icas(
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING 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 fLYtures to remain.
BATHTUBS (orTub/Sh—r Combo)
LAVS (Ht dSv,ks(
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS isileneu/utairv)
WATER HEATERS (Electric(
HOSE BIBBS
SUMPS
WASHING MACHINES
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE (ln Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
L) Yes o No o Yes o No
AREA DESCRIPTIONI Area
in Square Feet
ADDITION
AREA DESCRIPTION Area
in Square Feet
TENANT AREA ONLY
Occupancy Group(s)Construction I # of I Additional Information
Tvoe Stories
Occupancy Group(s) Construction # of Additional Information
Tvne I Stories
Bulletin #100 -January 1, 2011 Page 2 of 3 k:\Handouts`.Permit Application