19-100170RECEIVED
4l► PERMIT APPLICATION
PITY DP JAN 10 2019
f
a��.�%rt t PERMIT CENTER + 33325 81h Avenue youth +Federal Way, WA 98003-6325
R Way 253-835-2607 + FAX 253-835-2609 + ermitcenter(«cin-offederahcay.eom
COM U° FE WAY
` EVELOPMENT
PERMIT NUMBER V _ D / TU — 7 TARGET DATE
SITE ADDRESS e0'd -�_ - 01 V _ / ..7 _,t (-j
SUITE/UNIT #
836 SW -31'21K -St, Federal Way, WA 98023
Bldg A & B
PR ECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ 2,474.15
0 7 2 1 0 4- 9 0 8 7
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ® FIRE PREVENTION
NAME OF PROJECT
Mirror Lake Village LLC
PROJECT DESCRIPTION
Install an addressable fire alarm system in a pair of 3 floor over shared parking garage
Detailed description of work to
connected Assisted Living Buildings in Federal Way. Building is fully sprinklered.
Due to existing permitting in place, the fire alarm system has been designed to meet
be included on this permit only
R-2 occupancy requirements, not Group I, Condition 2 requirements
NAME
PRIMARY PHONE
Mirror Lake Village LLC
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
PO Box 6961
CITY
STATE
ZIP
Bellevue
WA
98008
NAME
PHONE
KLEPPS, INC.
425-223-3164
MAILING ADDRESS
E-MAIL
CONTRACTOR
13330 SE 30TH SE
phil@klepps.com
CITY
BELLEVUE
STATE
WA
ZIP
98005
FAX
425-223-3165
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
EC KLEPPI'938C6
02 26 / 2019
20 -15 -103803 -00 -BL
NAME
Phil Bonstein
PRIMARY PHONE
425-591-2850
APPLICANT
MAILING ADDRESS
13330 SE 30TH
E-MAIL
phil@klepps.com
CITY
STATEZIP
FAX
Bellevue
WA
98005
425-223-3165
NAME
PRIMARY PHONE
PROJECT CONTACT
Phil Bonstein
425-591-2850
MAILING ADDRESS
13330 SE 30TH
E-MAIL
phil@klepps.com
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
Bellevue
WA
98005
425-591-2850
PROJECT FINANCING
NAME
(� OWNER -FINANCED
When value is $5,000 or more
(RCW ]9.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
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 sup a the city as apart of this application.
SIGNATURE: DATE 01/10/2019
PRINT NAME: Phil onstein
Bulletin #100—.lanuary 29, 2016 Page I of 2 k:AI landouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing tures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial)
BOILERS FURNACES HOT WATER TANKS (Gaa)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
# of
Stories
Additional Information
NEW BUILDING
92,026
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
$
Indicate how many of each type of
ftxture to be installed or relocated as
part of this project. Do not include existinfixtures to remain.
BATHTUBS (orTub/Shower combo(
LAVS (Hand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
TOTAL BUILDING
DRINKING FOUNTAINS
SINKS )Kitchen/UtititA
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
# of
Stories
Additional Information
NEW BUILDING
92,026
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
ADDITION
iiYes X No
>(Yes iiNo
Vacant Land
COMMERCIAL— REMODFUTENANT .IMPROVEMENTS
AREA DESCRIPTION
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
NEW BUILDING
92,026
R-2
3
over common garage
ADDITION
COMMERCIAL— REMODFUTENANT .IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 — January 29, 2016 Page 2 of 2 k:\Bandouts\Permit Application