09-100695City of Federal Way
Commqnity devetopment Services
P.D. Box 9718
Tederai Way, WA 98063-9718
Ph {253} 835-2607 Fax: {2531 835-2609
T
1'"JGUL'Name: NELSON
P
Project Address:
3001 S 288TH ST Space 198
(253) 836-3050
D_ Project
Aldi
ng - Single Family
Permit #: 09 -1006 -95 -00 -SF
Inspection Request Line:
Desenption: Installation
of a 56'x26'6" Number: 042104 9155
manufac tured home
caner
setup.
p. Decks to
o
be on Separate permit.
GLORIA NELSON
3001 S 288TH ST SPACE 198
!'c
SUPERIOR HOMESra��
4I l9
MODERN LIVING
FEDERAL WAY WA
PACIFIC I•IWY F
FIFE WA 98424
LTD
MODERLL972Dp 4/14109
{ )
6119
GLORIA NELSON
3001 S 288TH ST SPACE
PACIFIC HWY E
FIFE WA 98424
199
FCI:ERAL WAY WA
Census Category: 112 _New Manufactured/Factory-Built Home, IN PAR
ARIA
#1 #2
Orr
Class: !{' #4
Construction TvnP.
occupancy Load:
Flaorea (sq. fl.'
Q
Additional Permit Information
Newt' Additional S F ,
New 1 q• Feel- t st Floor.....................1484
Additional Sq. Peet - 3rd Floor..,.. .....0 New /Additional Sq. Feet 2nd
Basic Plan?.... - FIovr.................. Q
New/ Additional Sq. Feet - Base
New/ ....... ment............ Q
Additional Sq, l:eet _ Garage.,Ncwl Additional S F ......
.....................0 q• Feet - Deek................
New/ Additional Sq. Feet - Dther ..........................D Mechanical to be Included?....................................
New/ Additional Sq. Deet - Total...... Plcnnbing Included?..... to be I�
1484 d......No
..................................No
No Fixtures Associated With This Permit 11
PERMIT EXPIRES Monday, August 24, 2009
Permit Issued on Wednesday, February 25, 2009
1 hereby certify that the above information is correct and that the construction on the
the occupancy and the use wi be in ccordance with the laws, rules and regulations above described property and
�— and the City of Federal Way. g s of the State of Washington
Owner o ar�A *
Date: �_Icj
FINAILED S-/1 *Jt;q
city Of Federal Way
Certificate of occupancy
ordinances of the City regulating building
scant to the requirements of Section 110.2 ousthe In Building Code certifying that
This Certificate issued pur liance with the vario
at the time of issuance, thisstructurewas in ' comp Y w dorsecl l)Cit sta .
construction or use.
permit #: 09 -100695 -00 -SF
Tenant Name: NELSON
Address: 3001 S 288TH ST Space198 #3 #4
Includes:
#1 #2
Occupancy Class:
Construction T e: 0 0
Occu anc Load: 0 p
Floor Area is . ft.}
GLORIA NELSON
Owner Name: GLORIA NELSON
Owner Name:
Owner Address: 3001 S 288TH ST SPACE 198
vun. R Al. WAY WA
Date
PriorIt- was on those to issuance of this Certift the City has made a ecomplete a
rs Which
affect the health and safety of the general public. Althoughneither guarantees nor
The priority focus in the review and in, made by the City
experience has shown most sevedy possible [within budgetary tirr+e and pers°nnel lirnitations),l+a� City
each and every
review and inspection as is reasonably p arson that this Certificate evidences strict comp
warrants to the owner I occupant or to any other pe
and/or occupant of the premises.
ordinance otuated
regulation of the n city or they ofState of Washington affecting the construction or use of said structure or the land upon
which it is situated- Such compliance is the responsibility of the owner
THIS CARD IS TO- REMAIN ON-SITE
CITY OF 4� Community Development Inspection Record
Fedpra[ Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 09 -100695 -00 -SF
Owner: GLORIA NELSON
Address: 3001 S 288TH ST Space 198
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. DO NOT LOSE~ TRIS 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.
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)
Approved
Approved
Approved
By
Date Jr
By
Date
By
a W Date
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
.,.A
RECE`h t-` L) --0 cl 0 C)
Federal way v i �nm PERMIT
com,vn1TrlpvF,r pmEnrsEpvlcls FEB �,�� SF MF CO ME EL PL DE, 2N FP
31:axF O Ae;L WAVENUE SOMI 9 • ao BOX 9718 � p P.LI � AT I � 11T
FEi16lWL WAY, WR 98053.9718
253-8352607• FAX 253-835.2649 , �r C
u,�uri.hfr o,{,�i drminfnu coih �-
The following is required it formation - = incomplete application will not be accepted. Pleam print Ugtlilr fln inN or type.
PROPERTY•• •
SITE ADDRESS 6 S , 2. k T SUITE #
ASSESSOR'S TAR/PARCEL # - LOT SIZE (sf) Z 2 6
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
PROJECT INFORMATION
TYPE OF PERMIT $i -BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed descaiption of work mc[uded on
PROJECT NAME (Name ofBu ne s or Owner Last Namel
PROPERTY
OWNER
NAME
1,2 &1 /v' -4 4)/v
PRIMARY PHONE
/
MAILING ADDRESS
CITY,SfATE,ZIP.�/
E-MAIL ADDRESS
CITY STT , ZIP
�.
.e
y -
EXPIRATION DATS
( 3► vy
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
COMPANY NAME ;>;/4
APPLICANT NAME
OFFICE PHONE
/
CITY. STATE. ZIP
CELL PHONE J
"
MAILING ADD RZW
CSI
CITY STT , ZIP
�.
CELL PHONE
_s z 3 u -
CITY OF FEDERAL WAY BUS INESS ENSE NUMBER
0�-�02 --vv
EXPIRATION DATS
( 3► vy
FAX NUMBER
t ] -
Cd87'$ACTOR'S R GISTRAT1ON NUMBER
EXPIRATION DATE
E-MAILADDRCSS
COMPANY NAME
APPLICANT NAME
OFFICE PS
HONE
AILING ADD
�c
CITY. STATE. ZIP
CELL PHONE J
"
L
r��= �' x
- 4!
21
RELATIONSHIP TO PROSECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
( j -
NAME r PRIMARY PHONE r E-MAILADDR653
U I Cc' . �~ G ] 3
NAMB
Per RCW I9.27.095:
r)
Lender ir{formatian is required tfproject oelrse exceeds $5,000
G ADDR
CITY. SPATE, ZIP
/PHONE
l � -
PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE * VALUE OF PROPOSED WORT{ $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER 13 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE ISEPTICI
7
AREA DESCRIPTION
THIRD
ADDITIONAL FLOORS (DESCRIBE)
DECK ( COVERED OR NCOVERED?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS "3O 'g4? mrw
"NEW HOMES ONLY"* NUMBER OF BEDROOMS _ I �
PJMTING
PROPOSED
TOTAL
. FT.
SQ. FT.
SQ, FT.
BOILERS
FIREPLACE INSERTS
HOODS (cep, ,4
J-0
mrAa rsaebeeo w
ESTIMATED SELLING PRICE $
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to rema&L
MECFIANICAL
Value of Mechanical Work $ (A COPY OF BID OR ESML4TE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS WOODSTOVES
BBQS
FANS
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS (cep, ,4
COMPRESSORS
FURNACES
RANGES
DUCTS
GAS LOG SETS
REFRIG. SYSTEMS
PLU3f13I'MG
o ALTERATION
a YES o NO
o REPAIR a TENANT IMPROVEMENT
BASIC PLAN? o YES
BATHTUBS (erTub/m :cemnq
LAVS mdm. sky
URINALS MISC (Describe)
DISHWASHERS
RAINWATER SYST
VACUUM BREAKERS
DRINKING FOUNTAINS
SHOWERS
WATER CLOSETS (re&#
ELI+.CT12IC WATER HEATERS
SINKS
WASHING MACHINES
HOSE BIBBS
SUMPS
o YES
I cerWy under penothy of perjury that I am the property owner or authoit ted aysnt of the Pr apertY owner. I cwt(& that to the best of my
kreawtedge; the igfarmatton submitted in support of this perm{t application is true and correct. I certo that I will cwnpiy with all applicabIs
City of FtdwW WaY regulations pertaining to the work authorized by the issuance of a permit:I urrderatand that thr isxuance of this permit
does not renwrre the owner's responsibility for compliance with local, state, or federal taws regulating construction or enntranmental laws.
I frerther agree to hold harmless the City of BedirraI Way as to any claim (includhV costa &xP*ns&S, and attorneys' fees incurred In the
investigation and dRfense of such cta&4, which m -j be made by any person, tnchmti"g the unde8-s1gne4 and filed against the city, but only
where such clahn arlses out of the reliance of the city, including its Officers and erm,ployeos, upon the accuracy of the Wormation supplied to
the city as a part of this appiiccrtlfn
Owner
a NEW o ADDITION
BUILDING SR3 LL ONLY?
o ALTERATION
a YES o NO
o REPAIR a TENANT IMPROVEMENT
BASIC PLAN? o YES
a. NO
ZONING DESIGNATION
CHANGE OF USE?
o YES
a NO
NEW ADDRESS REQUIRED?
o YES o NO
IIP/SEPA/SII?
c YES
a N0
PLATTED LOT?
o YES a NO
DEMO PERMIT REQUIRED?
o YES
a NO
Bulletin #100 —January 1, 2009 Page 2 of 4 k\Handouts\Permit Application