19-105808 ti
Building - Single Family
City of Federal Way Permit #:19-105808-00-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 129
Project Address: 2101 S 324TH ST Parcel Number: 162104 9037
Project Description: NEW-Installation of 944 square foot manufactured home.
Owner Applicant Contractor Lender
BELMOR HOLDINGS LTD TOM FULKERSONAMERICAN AMERICAN HOME CENTER OWNER IS LENDER
571 BELLEVUE AVE W SUITE 21' 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 944 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 944
Total Valuation:5,616.80
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, 11 July,2020
Permit Issued on Monday,January 13,2020
I hereby certify that the above information is correct and that the construction on the above described property
and the occupanc and the use will be in accordance with the laws, rules and regulations of the State of
Vashington andel the City of Federal Way.
Owner or agent. 40.4. onCM Date: /-/3--o10
•
400 . THIS CARD IS TO REMAIN ON-SITE
Federal Wa Construction Inspection Record
y INSPECTION REQUESTS: (253)835-3050
PERMIT#: 19 105808 00 Address: 2101 S 324TH ST Space 129
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 wale covered until it
is approved.you are unsuteabeut any ofthe inspections or the inspection sequence. On-going inspections are logged on the back of this card ettour inspector if
® Footings/Setback(4110) 0 Blocking/Tie Downs(4015) ® Skirting/Final(4250)
Approved to place concrete Approved
• Approved` ry—� LODIOBy Date i By L Date 1 , 1 O By LWJ Date Q IOt l
•
•
0 Rough Electrical
ID Final Electrical Right of Way
Approved Approved Approved
By Date By Date
BY Date
�..� RECEIVED PERMIT APPLICATION
CITY OF c .•x-.
Federal Way\�[ a ` DEC i 1 2L019 PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
Y 253-835-2607 +FAX 253-835-2609+permitcenter@cityoffederalway.com
�j CITY OF FEDERAL WAY
DEVELO
PERMIT NUMBER 7
l - / 0M S 0 PWEM' S E' 2 -Z , /
TARGET DATE
SITE ADDRESS SUITE/UNIT#
6 z1_44,,c.. II1d (14zAjjz, 'AAA v !14)02 • /2,9
PROJECT VALUATION ZONING AS ESSOR'S TAX/PARCEL#
$ / 4 2— / 8 7 - q C S '7
TYPE OF PERMIT ❑BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT i d 44 li % '
PROJECT DESCRIPTION / /
Detailed description of work to i1)S14.i I d-,,i_.) A4 c.C' L-1 I,,,,,,,c 4_67 1 2 /Q
be included on this permit only
NAME - A PRIMARY PHONE
PROPERTY OWNER iry'' Ai8 Ait:-si cj-j ? s- 0577
MAILING ADDRESS E-MAIL
01 5, 3-L'17l1 S-3— .
CITY STATE ZIP
#-1150/4(741.-. U./A .1, WA FS a 03
NAME l - PHONE
01/1//4 1 r fgOi.Ai14 x,.4.15 Cu, i-x 2f3- 2-? 0s-,6t4 S"
MAILING ADDRESS E-MAIL'
CONTRACTOR `/ A S. /o YZii 3r •1 /-a WAIs0,463 eilig✓i,e014
CITY STATE ZIP FAX.
C.e l4 /14,4 tom?-/YY 2 5-1-Y,C -a 3s,
WA STATE CONTRA&TOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
A.�,1pe t 14 c t7 'oma.`
NAME - ' - PRIMARY PHONE
44/ k (c A) 1.164a Cei1 l/�,. „21/4.S'.3-!..'3- Z 3 o L 2-6,Y
APPLICANT MAILING ADDRESS E-MAIL
14--(z , 10 ETA srs• `� j q(cz,4}04 a5-' .c cd i
' CITY STATE ZIP FAX
NAME- ...+' �,. PRIMARY PHONE
PROJECT CONTACT '1-0.M .fr. t' f.I L(` �`c�t .�i1j zyi "2...7(3- 6 Z L r
(The individual to receive and MAILING ADDRESS •
E-MAIL� /
respond to all correspondence 4/.6 S; /0 .1- S-r-- /j-u�dt /I SQA)037 /U.iet V614.1
concerning this application) CITY STATE ZIP FAX
�A X13 444 WA' WO 0.3 2 - IK-0 1.23 V
NAME
PROJECT FINANCING 0 OWNER-FINANCED
•
When value is$5,000 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.
•
SIGNATURE: //e-
L/i.��-- - DATE /-2-/7// 7
PRINT NAME: V ly/ / i f I k", ,J u
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 OUTLE.TS OTHER(Describe),
a .
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 links) 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 ID Yes ❑ No
RESIDENTIAL - NEW OR ADDITION '
AREA DESCRIPTION(in sgivace'feet) EXISTING" -PROPOSED TOTAL FOR OFFICE USE
•
•BASEMENT
FIRST FLOOR(or Mobile Home) . . .. : -.. ..... ..... . ........... ... . . Cl1 y =
SECOND FLOOR
COVERED ENTRY
`DECK
GARAGE 0 CARPORT ❑
;OTHER(describe)
EXISTING PROPOSED TOTAL
Area Totals
**NEW HOMO ONLY*
I ESTIMATED SELLING PRICE$ .. #.0F BEDROOMS . Z'
COMIVIERCIALL NEW/ADDITION - ,•
Area in.. Construction #of
AREA DESCRIPTION Occupancy Group(s). Additional.Infor.•mation
Square Feet
-Type <Stories
NEW BUILDING,
ADDITION
COMi1ERCIAL-REMODEL/TENANT IMPROVEMENTS
r3
Area in Construction #of
AREA DESC32IPTd®N' Occupancy Group(s) Additional Information
Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
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Bulletin#100''=January 29 2016 Page 2 of 2 • '• k\Handoff ts\Pe mit Avnlication