09-101910City of Federal Way
Community Development Services
P.O Box 9718
Federal Way, WA 98063-9718
ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: CAMELOT SQUARE
Project Address: 3001 S 288TH Space 350
Project Description: Installation of 1,600sgft mobile home
CAMEL
300
FEDERALN
-wilding - Single Family
Permit #: 09 -101910 -00 -SF
Inspection Request Line: (253) 835-3050
Parcel Number: 042104 9155
Owner
Analicant
Contractor
L n er
DT SQUARE INC
GENE GRAF
HORSLEY'S MOBILE HOME
GENE GRAF
I S 288TH ST
8118 PACIFIC HWY E
SERVICE
8118 PACIFIC HWY E
JAY WA 98003-8019
TACOMA WA 98422
HORSLMHO74DC (3/22/10)
TACOMA WA 98422
PO BOX 764
PUYALLUP WA 98371
Census Category: 112 - New Manufactured/Factory-Built Home, IN PARK
Includes: 41 #2 #3 94
Occupancy Class:
Construction Tv e:
Occupancy Load:
Floor Area (sq. ft.) 0 0 0 0
Additional Permit Information `
New / Additional Sq. Feet - l st Floor....................1600 New 1 Additional Sq. Fest - 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 New / Additional Sq. Feet - Total.......................... 1600
No Fixtures Associated With This Permit I!
PERMIT EXPIRES Sunday, November 22, 2009
Permit Issued on Tuesday, May 26, 2009
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.
Date:
Owner or agent:��,. y�0
4,4 05/cl
THIS CARD IS TO l'EMAIN ON-SITE
CITY OF & Community Development Inspection record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 09 -101910 -00 -SF
Owner: CAMELOT SQUARE INC
Address: 3001 S 288TH Space 350
FEDERAL WAY, WA 98003
This card is part of your required inspection documents. Scheduled inspections may be failed if this. card is not on-site. rim[ -NQT LOSE TI -IIS CARa.
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.
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
❑
SWM Precon Site Mtg (4400)
❑
Initial Erosion Control (4365)
❑ Interim Erosion Control (4370)
Approved
To be done prior to breaking ground
Approved
By
Date
By
Date
By Date
—
[] Blocking/Tie Downs (4015)
❑ Final Erosion Control (4375)
❑ Skirting/Final (4250)
By
Approved
ate 5
By
Approved
Date
Approved
By 0 Date "H3 —p9
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
cern or 1� 6CET ` ,
Federal Way V' L
L1Q.HAf[7mN Inva6P.tii&YPSERVICES k R M I T
33375 879 A VEAVE &XMt • Y0 BOX 9718 SF MF CO ME EL PL DE EN FP
aeasRAL wnY, WA 980634718 AY 2 s I -P PLICATION
75.3.835?GOT• AA]Y 253 %j [� �y [-
rurpEu; gr�fr S m i � 4' � 1' �' J f
Tice following is �- }�
required ir;,�bj�M�{o�y _ �t ca late
y mP application will reat be accepteaL Pisass print isgibiy (in ink) or type.
SITE ADDRESS
ASSESSOR'S TAX/PARCEL # SUITE/UNIT
-- ~ �- - — — — — LOT SIZE TO
"GAL DESCRIPTION (e g. Acme Estates, Lot 1) �~
P"mh I T P J-h+ter1Vddaa0d q
TYPE OF PERMIT 11r-130MD1NG ❑ PLUMBING O MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGF1VEERMG ❑ FIRE PREVEIMON SYSTEM
PROJECT DESCR'MON #%uide detailed dese iption ofworkmduded on flys Hermit onlvl
PROJECT NAME (Name oflkkl Q or Owner Zmt Namel
J
PROPERTY
OWNER
NAME
E'�(.r �il�--
PSR .MtcY MUNI,
MAILING ADDRESS
Clli , STATE ZiP
EMAIL ADDRESS
CONTRACTQR
COMPANY NAME
�12o�•L-crY«
APPLICANT NAME
�/^ Q GIs Ce,.
OFFICE PHONE
MAiL[NG ADDRESS
, �/
CM. STATE. ZIP
L Gtr k
HO
CELL PHONE
O31
Cm OF DSRAL WAY BUSINESS LICENSE NUMBERc
EXPIRATION DATE
-
PAX NUMBER
CAIiTRAC-To 'S R$GIS'I'RA,TIOH Ni�ib7(88.R
s
-TIO3Y BATT
-
EMAIL ADDRES.4
yj�}
/ T'bc
�] ry rf,
APPLICANT COM NAME
�7 p.e %
lndioate number of each type of fextum to be installed or relocated as part of this project. Do not include existing jb lures to rernaiyL
mESCRxracAr_
Value of Mechanical Work $ (A COPY OF BID OR ES7ZWATE MAST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PLPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC (Descraw)
BOARS FIREPIACE'INSERTS HOODSIcae�eiq
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG. SYSTEMS
PLUMSENG
bwsCom 4 LAVS (s m e=�1 URINALS MISC (Describe)
BATHTUBS wrub/se
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS lromq
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
I earUJj wider penalty of perjury that f am the property owner or authoraaed agent of the property owner. I cert(fy duxt to the best of my
knowledge, the information submitted in support of thta permit application is true and correct I cwtVy that I cols[ comply with aU applicable
City of Bkdaao Way regubations Pertaining to the work authorized by the issuance of a pmsrdt- I understand that the issucvece of this ,permit
doss not remove the owner's responslbflftyfor comptianoa Wath foam State,laws regulating construction or envirnnmentaI laws.
f jkrther agree to hold harmless the City of Fcoria (analederal Way as to any 9 expemx=, and attarnegs' fres incurred in the
anoasUgatfon and dafense of such claimj, which may be Heade by any person, including the undersigned, and jited against the city, but only
where such. cfaim ovists out of the reliance of the City, including its o�lcers and employ" -i6 upon the accuracy of the fr{fbrmation supplied in
the city as apart of thta application.
SIGNATURE:
� DATE
Ptnperty Owner and/or Authorized Agent
a NEW a ADDITION
BU ILDING SEUML ONLY?
Z)NING DESIGNATION
b—,W ADDRESS REQUIRED?
PLATTED LOT?
a ALTERATION
a YES o NO
o YES o NO
o YES a NO
a REPAM a TENANT IMPROVEMENT
BASIC PLAN? a YES a NO
CHANGE OF USE? DYES a NO
Donn 7 ofA
DEMO PERMIT REQMRW?
o YES a NO
11 YM a NO
k RnndoutsTen- ut Annlication
I