18-103285City of Federal way
Community Development Dept.
33325 8tb Ave S
Federal Way, WA 98003
Ph: (263) 8352607 Fax (253) 835-2609
FILE
Project Name: BELMOR MOBILE HOME PARK SPACE 59
Mechanical
Permit #:18 -103285 -00 -ME
Inspection Request Line: (253) 835-3050
Project Address: 2101 S 324TH ST Parcel Number: 162104 9037
Project Description: Gas piping test for meter to manufactured home install
Owner
Applicant
Contractor
BELMOR HOLDINGS LTD
MICHAEL ERICKSON
MICHAEL ERICKSON
1571 BELLEVUE AVE W SUITE 210
26834 MILITARY RD S
MICHAE'837JL (4/13/19)
VANCOUVER BC
KENT WA 98032
26834 MILITARY RD S
CAN
KENT WA 98032
Additional Permit Information
Mechanical Work Valuation? ............. 100 Is this an Online or O.T.C. application?.................. Yes
Gas Piping
PERMIT EXPIRES Monday, 21 January, 2019
Permit Issued on Wednesday, July 25, 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:2'f— T Z
THIS CARD IS TO REMAIN ON-SITE
CffVorrad Wa Construction Inspection Record
Fbdey INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 1810009700 Address: 2101 S 324TH ST Space 322
Project: BELMOR HOLDINGS LTD FEDERAL WAY WA 98003
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE TIDS 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 coveted 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.
❑
Mechanical Rough -in (4165)
2
Gas Piping, (4125)
Final Electrical
Final - Mechanical (4065)
Approved
Approved to release test
Approved
Approved
By
Date
By
Aj Date -%/Zj -%/Z
Date
By
4 r� Date ) 2
❑
Rough Electrical
E]
Final Electrical
❑ Right of Way
Approved
Approved
Approved
By
Date
By
Date
By Date
41k
CITY OF
Federal Way
RECEIVED
JUL 25 2018
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
PERMIT APPLICATION
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
PERMIT NUMBER I ( O 95 - /V E TARGET DATE
Nth
SITE ADDRESS
y
SUITE/UNIT #
�/v/ -5 3z�1� :,-;1- wG 3
�-S
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
TYPE OF PERMIT
1:1BUILDING 1-1PLUMBING MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
r y
PROJECT DESCRIPTION
I
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
53
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
CIS
Wu,
STATE
w
ZIP
91 aC13
NAME
/w/ C t/�c 4
PHO
52u 3;70 OX -2,
MAI ING ADDRESS
�� R n S
E-MAIL
/V/- e-1 r44,rj a, � %,%i ✓{ Gc%.
CONTRACTOR
CITY -
Iil r,,-/-
STATE
W
ZIP
seosz
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
/i1/ CH4t -N)K
NAME
W—c �rlit4✓
PRIMARY PHONE
-5;: Cj) C_Gy
MAILING ADDRESS
E-MAIL
APPLICANT-
CITY
STATE
ZIP
FAX
NAME -
PRIMARY PHONE
PROJECT CONTACT
sl mnt 4>
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
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(?CW 19.27.095)
1 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: Z,eEf DATE
PRINT NAME: Me Lt 4c-/ L- L�rtcldfSC--k
Bulletin #100 — January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application
4*
MECHANICAL PERMIT
Indicate how many of each typ
AIR HANDLING UNITS
AIR CONDITIONER
BOILERS
COMPRESSORS
DUCTING
PLUMBING PERMIT
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existing res 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/Utiiity)
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
', s a aye, f ,x,,. >
— __—_...... _............. _.._._........ ... —.._........... _._........ _............... -'-'--'--
Construction
# of
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet(
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
Stories
❑ Yes ❑ No
❑ Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING
PROPOSED TOTAL
FOR OFFICE USE
^,"w �`',. ,",� ,m x' �e
', s a aye, f ,x,,. >
— __—_...... _............. _.._._........ ... —.._........... _._........ _............... -'-'--'--
Construction
# of
Additional Information
FIRST FLOOR (or Mobile Home)
a
Stories
COVERED ENTRY
;<
ADDITION
GARAGE ❑ CARPORT ❑
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
.h2
7'
_............ -.__..._................... _..__............. _.-- ..
Construction
# of
Area Totals EXISTING
PROPOSED TOTAL
Occupancy Group(s)
Additional Information
ESTIMATED SELLING PRICE $
# OF BEDROOMS
COMMERCIAL —NEW/ADDITION
AREA DESCRIPTION Area in
Occupancy Group(s)
Construction
# of
Additional Information
Square Feet
a
Stories
ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
Area in
Construction
# of
AREA DESCRIPTION
Occupancy Group(s)
Additional Information
3 uare Feet
Stories
E yx
x
10 pm
? .
TENANT AREA ONLY
" ( .y11 •Y "� if § 3j
f � 2'M 5 ♦s4* � W�.f rr .i Yf"� �
.{w+l r
N ^ i
Bulletin #100 — January 29, 2016 Page 2 of 2 k:\l-Iandouts\Permit Application