19-104575 Building - Single Family
City of Federal Way Permit #:19-104575-00-SF
Community Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609
Project Name: BELMOR MOBILE HOME PARK SPACE 151
Project Address: 2101 S 324TH ST Parcel Number: 162104 9037
Project Description: NEW-Installation of 1458 square foot manufactured home.
Owner Applicant Contractor Lender
BELMOR HOLDINGS LTD TOM FULKERSONAMERICAN AMERICAN HOME CENTER OWNER IS LENDER
571 BELLEVUE AVE W SUITE 211 HOME CENTER 406 S 108TH ST
VANCOUVER BC 406 S 108TH ST S TACOMA WA 98444
CAN TACOMA WA 98444
Census Category: 112-New Manufactured/Factory-Built Home,IN PARK
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area(sq.ft.)
Additional Permit Information
New/Additional Sq.Feet-1st Floor 1458 New/Additional Sq.Feet-2nd Floor 0
New/Additional Sq.Feet-3rd Floor 0 New/Additional Sq.Feet-Basement 0 •
New/Additional Sq.Feet-Deck. 0 New/Additional Sq.Feet-Garage 0
New/Additional Sq.Feet-Other 0 Is this an Online or O.T.C.application? No
New/Additional Sq.Feet-Total 1458
Total Valuation:8,675.10
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CONDITIONS:
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,28 March,2020
Permit Issued on Monday,September 30,2019
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• on and the City of Federal Way.
Owner 9 age _ _ / Date: Y��t
THIS CARD IS TO REMAIN ONSITE
CITY OF Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 104575 00 Address: 2101 S 324TH ST Space 151
Project: 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.
SWM Precon Site Mtg(4400) , Q Initial Erosion Control(4365) El Interim Erosion Control(4370)
Approved I To be done PRIOR to breaking ground Approved
By Date By Date By Date
Q Blocking/Tie Downs(4015) ® Final Erosion Control(4375) ® Skirting/Final(4250)
Approved Approved Approved
Bt l/S Date ic2/0, 1 By Date By A Date 1/ c /-
Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED •
SEP 2 3 2019
,Alk
PERMIT APPLICATION
CITY OF
CITY OF FEDERAL WAY PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
Federal Utlay COMMUNITY DEVELOPMENT 253-835-2607 +FAX 253-835-2609 +permitcenter@cityoffederalway.com
PERMIT NUMBER \ 1 -. t 0 9 s - S r— I
TARGET DATE
SITE ADDRESS A C O ) c j j. -/Td j SUITE/UNIT#
PROJECT VALUATION ZONING AS$ESSOR'S TAX/PARCEL#
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT 6Zi-..44,1,A- .4 l,/<% I J'1 '
•
PROJECT DESCRIPTION _,4 fA, _
Detailed description of work to ',T Al .S d .L V i : i'LA-7 LM;e b ('i 0/ViE
be included on this permit only
' NAME A PRIMARY PHONE /
PROPERTY OWNER /?i rx a aiJf"s�� 4-/ic3-_j ? Se.- 0Si 7
MAILING ADDRESS E-MAIL
I C? ---C, 32-1(7?} S-r .
CITY STATE ZIP
#-4.0a=(14 L Gam'A ,° W/) l?? d o S
NAME I • PHONE
ini/vlr it 1(#Ai 0 c peter/ (j/U l 1, 1S-3-3- Z?O-.3 Z:‘ S'
MAILING ADDRESS E-MAIL
CONTRACTOR Lid- (a S' A 3 Y 3 r t-a L,�>t i Ufa-51,10,01(,10.044
CI Y STATE ZIP FAX.
4 CA-S1114 L14,4 T?Lif%it 2 rJ F la-0i J?
WA STATE CONTRA TOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
A446e.rMC 97 oc_` / /
NAME PRIMARY PHONE
t4/1/1 AetC_Ani /4e34,05 CEet irz>e, ) '34-Z 30,(r, 2- 3'
APPLICANT MAILING ADDRESS E-MAIL
qb , !® gTY .Si s 'f ii-u IICIAJo4 estair.•areYa l
' CITY STATE ZIP FAX
''.1 9c/!1.i 253'"ge V Y.O e 3 P.
NAME * PRIMARY PHONE
PROJECT CONTACT �ey/11 .1 / f 0 L(<.. ,(i0� 2_) )-zJ c),- 6 Z 6 r
(The individual to receive and MAILING ADDRESSM�AIL
respond to all correspondence 6 /oX'T L S !s //� t J /IJfr . �L/
concerning this application) CITY STATE ZI FAX
'-1.-.7A CYJ44A WA P'o®3 rr?- 0s23 P''
NAME
PROJECT FINANCING E [D4
❑ OWNER-FINANCED
When value is$5,000 or more MAILINGDRESS,CITY,STATE,ZIP -PHONE
(RCW 19.27095) •
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: _j€4....„...4ALL6W..e.A...., DATE /2„ )9
PRINT NAME: '' 7M / It' 2.µ/� LS D4)
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
$
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(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING. WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
$
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.
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.
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes❑ No ❑Yes ❑ No
RESIDENTIAL NEW OR ADDITIOl
• AREA DESCRIPTION(in squarefeet) EXISTING PROPOSED TOTAL -' FOR OFFICE USE
BASEMENT -
FIRST FLOOR(or Mobile Home) . � Q
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE 0 CARPORT ❑
OTHER(describe)
.•;� EXISTING PROPOSED TOTAL
Area Totals 1 y,S y I yam'
**NEW HOMES ONLY**
'
ESTIMATED SELLING PRICE.$ #,OF BEDROOMS -
COMMERCIAL- NEW/ADDITION
S
Asea in_. Construction #of
AREA DESCRIPTION Occupancy Group(t) Additional Information
Square Feet Type [Stories
NEW BUILDING,
ADDITION
CO 1`I RCIAL-REMODEL/TENANT IMPROVEMENTS ,
Area in Construction #of
AREA DESCRIPTION Occupancy Group(s) Additional Information
Square Feet . Type Stories
_
TOTAL BUILDING
TENANT AREA ONLY '
PROJECT AREA ONLY
Bulletin#100''=January 29'2016 Page 2 of 2 ,.''' - i\EHandoi ts\Permit Annli'cation