03-105221 •
of Federal Way
Community Development Services Building - Single Family Permit #:03 - 105221 - oo - SF
33530 1st Way S
Federal Way,WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: HAGSTROM
Project Address: 3001 S 288TH ST Space335 Parcel Number: 042104 9155
Project Description: NEW-Install one Silverton,765 square foot 2-bedroom manufactured home.
Owner Applicant Contractor Lender
CAMELOT SQUARE MOBILE HOM Charlotte Hagstrom WASHINGTON HOME CENTER NONE
3001 S 288TH ST 3001 S 288TH ST UNIT 335 WASHIHM7F'OA 3/19/05
FEDERAL WAY WA 98003 PO BOX 176
\FEDERAL WAY WA 98003 CHEHALIS WA 98532 NONE
Includes:
Census category: 112-New rr #1 I #2 #3 #4
Occupancy Group: R-3
Construction Type:
Occupancy Load:
Floor Area(Sq.Ft.): �I
1st Floor Proposed Sq.Feet 765 Census Category 112-New manufactured/fact(
Occupancy Group#1 R-3 Total Building Sq.Feet 765
Total Proposed Sq.Feet. 813 Zoning Designation RM 3600
CONDITIONS:
MOBILE HOMES-ACCESSORY STRUCTURES BETWEEN UNITS Per KCZC,Sec.21.09.030,Part E.#8, there shall
be a minimum of 10 feet of separation maintained between all mobile homes on the site.Accessory structures may be located
no closer than: a)10 feet to mobile home on adjacent spaces. b)5 feet to accessory structures of mobile homes on adjacent
spaces. NOTE:Uniform Building Code overrides the 5 foot setback,per Table 5-A,"M3" and "R"in Uniform Building
Code Manual,whereby Part I,Chapter 1,Section 103,indicates that the most restrictive requirement shall govern.In this
case,a 6 foot setback is required. c)5 feet to the mobile home or other accessory structures on the same space,except that
separation may be reduced to 3 feet when the affected structures are constructed of noncombustible materials.
This decision shall not waive compliance with future City of Federal Way codes,policies,or standards relating to the
subject proposal.
PERMIT EXPIRES June 7,2004.
Permit issued on December 10,2003
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: Jot—/D—03
POS HIS CARD ON THE FRONT OF BUILDI .
CITY OF
��► Federal Wa
BUIEEING DIVISION
Y INSPECTION RECORD
INSPECTION REQUEST PHONE#: 253-835-3050
PERMIT#: 03-105221-00-SF
OWNER'S NAME: CAMELOT SQUARE MOBILE HOME PK
SITE ADDRESS: 3001 S 288TH Space335
( ) FOOTINGS/SETBACKS /,/ (, 2# # �') FOUNDATION WALL
DO NOT POUR CONCRETE UNTIL THE ABOVE IS APPROVED
( ) DRAINAGE: Line ( ) Connection
DO NOT POUR SLAB UNTIL THE ABOVE IS APPROVED
( ) UNDERFLOOR FRAMING
( ) ROUGH PLUMBING: DWV Water piping
( ) ROUGH MECHANICAL Gas piping
( ) SHEATHING Roof Floor
( ) SHEAR WALLS
( ) ELECTRICAL ROUGH-IN Ditch Cover
( ) FIRE/DRAFTSTOPS
ALL THE ABOVE MUST BE APPROVED PRIOR TO FRAMING INSPECTION
( ) FRAMING/FIRESTOPPING
THE ABOVE MUST BE APPROVED PRIOR TO INSULATING OR SHEETROCKING
( ) INSULATION: Floors Walls Attic
THE ABOVE MUST BE APPROVED PRIOR TO APPLYING SHEETROCK
( ) WALLBOARD NAILING ( ) SUSPENDED CEILING
THE ABOVE MUST BE APPROVED PRIOR TO TAPING OR INSTALLING CEILING TILE
() ELECTRICAL FINAL
( ) PLANNING FINAL
( ) PUBLIC WORKS FINAL
( ) FIRE FINAL
THE ABOVE MUST BE APPROVED OR TO BUILDIN DEP TMENT FINAL
( ) BUILDING FINAL 4' . ,4y
DO NOT OCCUPY THIS BUILDING UNTIL BUILDING FINAL IS APPROVED
C..)
lir al,
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CONSTRU N PERMIT APPLICATION 59
CITY OF ^..� APPLICATION NUMBER:Q - 0�a -QQ
Federal Way NOV 2 4 X003 APPLICATION NUMBER: - -
CITY OF FEDERAL WAY APPLICATION NUMBER: - -
BUILDING DEPT.
**The following is required information-Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application. \ \'\
0
/
• PROPE°_` INFORMATION
0,0
SITE ADDRESS: JO I J �CI t�* �00 ASSESSOR'S TAX/PARCEL#: Q 1.42, 1_ 01-( -'I L s: 5
LEQ4L DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): L&f 3J of
amehof Sante-
■ PROJECT INFORMATION
TYPE OF PROJECT(This application): X❑ BUILDING o PLUMBING o MECHANICAL ❑ DEMOLITION
o ELECTRICAL ❑ ENGINEERINGN `
o FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): 1-� t 1/ C/� 0�flt .C,, 1 Va e r /,[on
141 X SCS 2 •lam.ci.I-'O0w i Z-, ,:e'-(it 114att1,t{2acfut ,P t-kin4)
PROJECT NAME: 1\f / T fri RC,-rS TrLC�y".
• PROJECT INFORMATION
PROPERTY OWNER: NAME:eDAYTIME PHONE:
Anile lO' Se LkGt - (.2sJ) ':3r/ - 75 7S.
MAILING m ESS0(STREET1S S -4ADDRESS CICITY,T1TE IP):St R' /fi r -1 k tL( ) L. i� g'/ oc
CONTRACTOR: NAME: C, TYl ! DAYTIME PHONE:
L ItirehCC UJA. rlOw - &a . ( &I'n 24-610- `7i/ `f
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
105'1 Ili( ) Lo1.t.1, i e , ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
C.K ,rcAu.�s ( . CttirM? - ( ) -
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
/ /
(copy of card required)
APPLICANT: NAME: DAYTIME PHONE:
Charlotte P.Haastrom ( 206 ) 715 - 4268
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
21229 102nd Avenue SE, Kent,WA 98031 ( 206 ) 715- 4268
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ARCHITECT XTENANT ❑OTHER(DESCRIBE): ( 0 ) -
- E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: PROPERTY OWNER X APPLICANT o CONTRACTOR Char625tVaol.com
• PROJECT INFORMATION
ysr iU .t
EXISTING USE: S�YN.3(-Q'--}(&Y �i EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ '-
PROPOSED USE:)1 P9 I e....e....'t-u IIA.k rel toe---PROPOSED VALUATION FOR IMPROVEMENTS: $ If 7 .2 Li I'
SPRINKLERED BUILDING? ❑ YES XNO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑YES 010
WATER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE o TACOMA o PRIVATE(WELL) L�4 Tkr&t 5(f kit re-
SEWER
e_SEWER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE o PRIVATE(SEPTIC)
•
NUMBER OF BEDROOMS: 2 ESTIMATED SELLING PRICE: $ 39.000
• PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST 7 4, S 74: 5
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK 3'1
-f O
GARAGE
HOW MANY FLOORS?
TOTAL: 3 j 3 t 3
• FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING EVAPORATIVE GAS LOG(S) 1 REFRIG.SYSTEM(S)
UNIT(S) COOLER(S)
BBQ(S) 2 FAN(S) 1 HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) 1 RANGE(S) MISC.( )
COMPRESSOR(S) 1 FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: X ELECTRIC ❑ GAS
PLUMBING
1 BATHTUB(S) 2 LAVATORY(S) URINAL(S) 1 WATER HEATER(S)
DISHWASHERS) RAIN WATER VACUUM BREAKER(S) XELECTRIC o GAS
SYS.
DRINKING 1 SHOWER(S) 1 WASH MACHINE
FOUNTAIN(S) OUTLET
GAS PIPE OUTLET(S) 3 SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
• DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and
further,that I am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of
Federal Way,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 aD ,�tpart of this application. /
NAME/TITLE: Charlotte P.Haqstrom e�-et .,f-AT I .�6AtE: f / r / 7- 6
PROPERTY OWNER X APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION o ALTERATION ❑ REPAIR o TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑YES o NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? o YES o NO
PLATTED LOT? ❑ YES o NO CHANGE OF USE? ❑ YES ❑ NO