18-104451 Mechanical
City of Federal Way Permit #:18-104451-00-ME
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: MIRROR LAKE VILLAGE SENIOR HOUSING DUPLEX(R-2)
Project Address: 31015-31017 9TH PL SW Parcel Number:072104 9087
Project Description: Mechanical system for new duplex.
•
Owner Applicant Contractor
MIRROR LAKE VILLAGE LLC ALEX BURKHARTEVERGREEN EVERGREEN REFRIGERATION LLC
PO BOX 6961 REFRIGERATION (GENERAL)
BELLEVUE WA 98008 727 S KENYON ST EVERGRL954R2(1/6/20)
SEATTLE WA 98108 727 S KENYON ST
SEATTLE WA 98108
Additional Permit Information
Mechanical Work Valuation? 27206 Is this an Online or O.T.C.application? No
Air Handling Units 6 Compressors/Heat Pumps 2 Ducting 4
Fans 2
PERMIT EXPIRES Monday,3 June,2019
Permit Issued on Wednesday,December 5,2018
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: FII. E Date:
THIS CARD IS TO REMAIN ON-SITE
p"'°' N-SITE
Conon Way Inspection Record
INSPECTION REQUESTS:(253)835-3050
PERMIT#: 18 104451 00 Address: 31015-31017 9TH PL SW
Project: MIRROR LAKE VILLAGE LLC FEDERAL WAY WA 98023
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 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.
Mechanical Rough-in(4165) El Gas Piping(4125) [ Final-Mechanical(4065)
Approved Approved to release test Approved
By AI Date 9 By Date By G' Date _ -11) •;0
Rough Electrical 0 Final Electrical E Right of Way
Approved Approved Approved
By Date By Date By Date
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RECEIVED J - /0 (-f 7 la Z
CITY OF SEP 2 0 2018
PERMIT APPLICATION
Federal WayPEST CENTER a 33325 8th Avenue South+Federal Way,WA 98003-6325
CITY OF FEDERAL WAY 253-835-2607+ FAX 253-835-2609+permitcenter@cityoffederalway.com
COMMUNifl'Y DEVELOPMENT
PERMIT NUMBER / - J D 1 /L - E /O r/
TARGET DATE vv
SITE ADDRESS SUITE/UNIT#
31015 - 31017 9th PI. S Duplex R-2
PROJECT VALUATION ZONING ASSESSOR'S TAR/PARCEL#
$ 27,206.00 0 7 2 1 0 4 _ 9 0 8 7
TYPE OF PERMIT 0 BUILDING 0 PLUMBINGSIMECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT Mirror Lake Village Senior Housing - Duplex R-2
Installation of two (2) ductless split system heat pump outdoor units, six (6)
PROJECT DESCRIPTION 1
t
lit system indoor units, one electric heater, two
Detailed description of work to ductless s p y ( ) wall 2( )
be included on this permit only exhaust fans, venting of two (2) ranges, venting of two (2) dryers, and
refrigeration piping.
NAS PRIMARY PHONE
Mirror Lake Village LLC
PROPERTY OWNER MAILING ADDRESS E-MAIL
570 150th PI. NE
O17 Bellevue STATE ZIP 98007
NAME Evergreen Refrigeration PHONE 206-763-1744
MAILING ADDRESS AIL
727 S Kenyon St. alexb@evergreenhvac.com
CONTRACTOR
CITY Seattle STATE
>p 98108 FAX 206-763-2389
WA STATE CONTRACTOR'S LICENSE i EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE•
EVERGRL954R2 1 6 20 20-06-100781-00-BL
NAS ONE
Alex Burkhart Y206 -763-1744
APPLICANT
MAILING ADDRESS 727 S Kenyon St. E-MAILlexb@evergreenhvac.com
CITY Seattle STATE ZIP FAX
WA 98108 206-763-2389
PROJECT CONTACT NAME Alex Burkhart
PRIMARY PHONE
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 727 S Kenyon St. alexb@evergreenhvac.com
concerning this CITY Seattle ST TE ZIP98108 FAX
A206-763-2389
NAME
PROJECT FINANCING 0 OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorised 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 authorised 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: DATE 9/17/18
PRINT NAME: Alex Burkhart
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
G. P
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $27,206.00
Indicate how many of each type offixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
6 AIR HANDLING UNITS 2 FANS GAS PIPE OUTLETS 1 OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS icommemisl) Electric wall
BOILERS FURNACES HOT WATER TANKS(css) heater
2 COMPRESSORS GAS LOG SETS REFRIGERATION SYST
4 DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how many of each type offixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
BATHTUBS dor rub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(lUtchen/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 square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
ZXIISTING PROPOSED TOTAL
Area Totals
..ssw HOMMS ONLT
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
Square Feet Type Stories
NEW BUILDING
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100-January 29,2016 Page 2 of 2 k:\Handouts\Permit Application