19-105751 ria
Building - Single Family
City of Federal way Permit #:19-105751-00-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 161
Project Address: 2101 S 324TH ST Parcel Number: 162104 9037
Project Description: NEW-Installation of 1160 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 1160 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.application9 No
New/Additional Sq.Feet-Total 1160
Total Valuation:6,902.00
M e �..: �9 3 s � - � e ,max'�
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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 Tuesday, 16 June,2020
Permit Issued on Thursday,December 19,2019
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
Washington and the City of Federal Way.
Owner or agent: go.Y.,66
Date: h q f
THIS CARD IS TO REMAIN ON-SITE
oc Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 105751 00 Address: 2101 S 324TH ST Space 161
Project: BELMOR HOLDINGS LTD FEDERAL WAY WA 98003
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE TMS 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.
1❑ Blocking/Tie Downs(4015) 0 Skirting/Final(4250)
Approved Approved
By Date It By rk Ltd Date S •
/i
0 Rough Electrical El Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date •
•
RECEIVED
4.74.":
� PERMIT APPLICATION
CITY OF �: ' _
Federal Way DEC 0 6 2019 PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607 +FAX 253-835-2609+permitcenterncityoffederalway.com
CITY OF FEDERAL WAY
COMM NRY DEVELOPMENT
PERMIT NUMBER \ \ _. (� 5 _ 5 \-1°
G ` V III 1 5 / TARGET DATE `Z
SITE ADDRESS A C t. I C-, 2 z...:/Te s-r- SUITE/UNIT#
`1-4Ut0 ` INFI/ c//) L JAM V 'JO )J ' l6 r
PROJECT VALUATION ZONING AS ESSOR'S TAX/PARCEL#
$ / 4 Z / 6 ' - j v 7
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING D MECHANICAL ❑ DEMOLITION ❑ ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT :✓,1A444 1A- iii11, �S 0 A C 1 to ( - ,
PROJECT DESCRIPTION , 7
Detailed description of work to
be included oh this permit only
' NAME{{ •�- PRIMARY PHONE r
PROPERTY OWNER ,mi r XG ,uO eiihfa cJ /. Z S3 j 3 �.y 0si 7
• 7% I Cr I --, I .3.221 7.!:1 S-r -
CITY STATE goo_.?'
ZIPP
/' ii r i('4 L._ ul A `9 Pr1Jf1�1 /y
•NAME PHONE
/R i ,e I C ?,/J g4 c-sn.4/! ('eAJ iA 21-3, 2-?0- 6 Z4 S'
MAILING ADDRESS E-MAIL'
CONTRACTOR 116 A S. /b 5j?) Sr ercu Wu a.11piMSd.649
CITY STATE ZIP FAX
r .
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
11,44(1,e,Z Id C 9'7,4'o / /
NAME PRIMARY PHONE
• r ,�kteIC�A,� �c Gl,�' C j 1 r_'- ,21/4.'. z_30.. , 4 2'
APPLICANT MAILING ADDRESS E-MAIL
e , t e 3"- Si' s" - .)Ucc. 0'V bs-ea &),c -tel
' CITY STATE ZIP FAX
1.79c.cti1,4 23"3^kV Y e 3 P.
' NAME _.. f,,, PRIMARY PHONE
PROJECT CONTACT .4,1 . , I' i3O Lice.'/C....ro,t) ..)-Zia.- 6 :6 r
The individual to receive and MAILING ADDRESS •
E-MAIL,, i
respond to all correspondence 6 6. S t /OX'12L ---1-- 1J aJX ere/ILIs',C4i_(
concerning this application) CITY STATE ZIP FAX
-1.--AME
_A ces,74,4 tivA 9S°003 ��
oo3 '?-` Y-0 1-'3 iv
PROJECT FINANCING N , j Lit
,
0 OWNER-FINANCED
When value is$5,006 or more MAILING DRESS,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.
1
SIGNATURE: 4-i,....., ,(jlr.�-- DATE r V 3A
PRINT NAME: ,/ I if L l(/.LS O N
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 acture 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.inks) 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 ADDITION
AREA DESCRIPTION(in sgivare feet) EXISTING "PROPOSED" TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home) . : 1 I.106 f/t0 b —__....---......---.__— _......_._.... ._..___...__..._.
SECOND FLOOR
COVERED ENTRY
DECK.
GARAGE 0 CARPORT ❑
i OTHER(describe)
EXISTING PROPOSED' TOTAL
Area Totals EXISTING 6
**J W HOMES oivz.r. '] ,
ESTIMATED SELLING PRICE-$. #OF BEDROOMS
COMMERCIAL,-NEW/ADDITION
Area in .
Construction #of
AREA DESCRIPTION `' � Occupancy Group(s) :: - .. ._ Additional Information
Square Feet iype Stones
NEW BUILDINGt
ADDITION
CO -REMODEL/TENANT IMPROVEMENTS
Area in Construction #of
AREA DESCRIPTIONOccupancy 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 ,.' • kAl-landoiutsWeimit Annlication