19-104450 Mechanical
City of Federal Way Permit #:19-104450-00-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 BLDG A
Project Address: 31000 9TH PL SW Parcel Number: 072104 9087
Project Description: Gas piping to service(3)HVAC rooftop units,(4)water heaters and a kitchen cook line.
Owner Applicant Contractor
MIRROR LAKE VILLAGE LLC ANDY MCLEODCASHMERE PLUMBING CASHMERE PLUMBING INC
PO BOX 6961 INC CASHMPI044CL(1/17/21)
BELLEVUE WA 98008 100 A PATTON ST
CASHMERE WA 98815 100 A PATTON ST
CASHMERE WA 98815
Additional Permit Information
Mechanical Work Valuation? 17000 Is this an Online or O.T.C.application? No
fr“. ..-_F ...„..h, n, w,...: :' :-u,�"`:. _'. ,.._ '°�.: " .,y•...G. .. ..
Gas Piping 1 Gas Pipe Outlets 6
PERMIT EXPIRES Sunday,22 March,2020
Permit Issued on Tuesday,September 24,2019
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: / /J c‘ '"wQDate: (Z/ G?
THIS CARD IS TO REMAIN ON-SITE
Federal Way 41P14 Construction Inspection Record
Fed
y INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 104450 00 Address: 31000 9TH PL SW
Project: MIRROR LAKE VILLAGE LLC FEDERAL WAY WA 98023-4515
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) ® Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
�By Date ��By 4/.) Date /alai ,,By 4,r) Date a ��
. .
❑ Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED"` .:- PERMIT APPLICATION
tYF SEP 16 2019
Federal ra av PERMIT CENTER+33325 8"'Avenue South+Federal Way,WA 98003-6325
Cir(OF FEDERAL WAY 253-835-26^'+ FAX 253-835-2609 +permitcenter(alcitvoffederalway.com
' COMMUNITY DEVELOPMENT
PERMIT NUMBEI _ J
�_ `'0 Vs E„ TARGET DATE /6/02/e 9
SITE ADDRESS SUITE/UNIT#
3I DOD q - p f. 5(,O _
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL I 04 _
� -
$ 17 c�6
TYPE OF PERMIT D BUILDING ❑ PLUMBING L�MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT M 1 yr v o r I_.. k_c L ( \ l� ,— e I d /�
PROJECTT DESCRIPTION V ` `
Detailed description of work to (ji4S 91/1a/4 SCRv/C/At)V 3 /4 v,4 C ON/Lrs ON
be included on this permit only !!f. K 000 p F, L/4-/4T6i4. MCA- r(;2-}1 / f tf#& 4
C.oa/C G/tic-
NAME PRIMARY PHONE
M1RR 2 tAK6' UIU.IAG , SLC
PROPERTY OWNERMAILING ADDRESS ��`` I E-MAIL
�v/r�� ,RQJV�
CITY al,LEY V L STWA
ATE ZIP 18e08 /1 s,}- /j�
NAME CASHMERE PL MING, INC , PHONF5-0,)7 Z'/Z.t6
MAILING ADDRESS r A' E-MAIL
55Cf/.f7 ` /
CONTRACTOR ���� PArow�IV sr CP/C C4fiNerer`Ot111/Nq•�H?
CITY CA skive-Kr
SI Mr�E STATEWAZIP 4788/
�p/ FAX I
WA STATE CONTRACTOR'S LICENSE# EXPIRATIONIODATE
E FEDERAL WAY BUSIN LICENSE�] #
f 9 / C `t 9- vc.( NCASH19PI04-fCL / / /7 /7•021 14 10 ci �7 /
AME CASI�ME RE P�uM�ln/G, INC. PiB(5e y) 7B7-t210
MAILING ADDRESS E-MAIL
INA PATO sr R rocash
APPLICANT /cq/m .49/11CITY STATE ZIP�1/ Q/5
CA5I/MERE
NAME �NDy ,(^ `'/A/�/d' (j PRIMARY PHONE
PROJECT CONTACT r /I' LEo D (50 ) 669-9300
(The individual to receive and MAILING ADDRESS 04 7 l E-MAIL- /
respond to all correspondence 1, I' '"� �T'
4000CV:Aw e/Sot',�jle`J•C.atyn
concerning this application) CITY „--1 �t,�RS STATE ZIP 98815 FAX J
NAME
PROJECT FINANCING 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 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 clai arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to e ity as a part of this ap�plicatio , I/4V
SIGNATURE: _ -A �///��� " // DATE �I CjPRINT NAME: /4iA y ,i4' -61D /
Bulletin#100-January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
MECHANICAL PERMIT VALUE OF MECHANICAL WORK
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 6 GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(comm,oraq
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( LAYS(Hama Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kachen/Ut 10 WATER HEATERS(e£ortrc)
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
lait,`�Grti.,ar , a„5!,
FIRST FLOOR(or Mobile Home)
f.44a Pd"' E 1�a£` �'z °1 t is 13tt
NiNt
COVERED ENTRY
m .„ ,1,,:;201440: ;:#40'4144:43e0:4-WA','UOige`',, M, s,�. ,,,_.�, c>a.x`z•�rr:,.,
GARAGE ❑ CARPORT ❑
a`YM - 3 44•! i0�0
*11 Wer t.g::!:
EXISTING PROPOSED TOTAL
Area Totals
Cni , N lior7.t riO oiw o
ESTIMATED SELLING PRICE$ J # OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area in Occupancy Group(s) Construction # of Additional Information
Square FeetType, Stories
[ j , 'r�'
.� P E z Air
£ x a a Yk fa ur j
>,.a,r,. „�w,,,.::F� .�E =w- .as -,.: „�,;-; .,, �,.,.: �r�,...,-�.A,�.,,.:I . ..€ �F„,rte. .,., .. ,'f...,,t� �J ,,,Y Met.,,. .....» % �$.,a.,x=°d '"�h�.,,.,,:.`,f�.
r $
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area in Occupancy Group(s) Construction # of Additional Information
Square Feet Type Stories
.
4 �� a a�g�n , !G ,$ s ,yt'�' z
Is-�.=, z - ;U u�r�m,dj
TENANT AREA ONLY
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Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application