19-100172 1 t f
Electrical
City of Federal Way Permit #:19-100172-00-EL
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 BLDGS A&B
Project Address: 31000 9TH PL SW Parcel Number:072104 9087
Project Description: Installing low voltage wiring for new fire alarm system in buildings A&B
Owner Applicant Contractor •
MIRROR LAKE VILLAGE LLC KLEPPS INC KLEPPS INC
PO BOX 6961 13330 SE 30TH KLEPPI.938C6(2/26/19)
BELLEVUE WA 98008 BELLEVUE WA 98005
13330 SE 30TH
BELLEVUE WA 98005
Additional Permit Information
Is this an Online or O.T.C.application') Yes
Low Voltage-Fire Alarm(Co: 1
PERMIT EXPIRES Friday, 10 January,2020
Permit Issued on Thursday,January 10,2019
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
41111
•
Date: /dil,
Washington and the City of Federal Way.
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Owner or agent: �.__ I
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4/014THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
Federal Way INSPECTION REQUESTS:(253)835-3050
PERMIT#: 19 100172 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. Checicwrith 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.
.El Service(4235) ] Feeders/Sub-panels(4045) ED Rough Electrical(4225)
Approved Approved Approved
By Date By DateBy ,l Date
® Ceiling Cover(4020) ® Final-Electrical(4055)
ApprovedApproved
By Date By /11 Date �—.1.4.".W
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0 Rough Electrical 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date By Date By Date
RECEIVED
JAN 10 2019 ELECTRICAL
OW OF A
Federal Way OCITY UNfTYF DEVELOPMENT PERMIT APPLICATION
PERMIT NUMBER / CI_ / 0 0 / G//
` 111
3/00'0 -�-/OCi i 941- P� - - —
SUITE/UNIT/SPACE M
SITE ADDRESS:
PROJECT VALUATION ASSESSOR'S TAX/PARCEL# CURRENT/PROPOSED USE
$ y O) d� 0 7 2 1 0 4 _ 9 0 8 7 Vacant/Assisted Living
PROJECT NAME
(Tenant or Homeowner Last Name) Mirror Lake Village LLC
Install an addressahle fire alarm system in a 3 flnnr nver parking garage, pair
PROJECT DESCRIPTION of connected Assisted Living Buildings in Federal Way. Building is fully
Detailed description of work to sprinklered. Due to existing permitting in place, the fire alarm system has
be included on this permit only been designed to meet R-2 occupancy requirements.
NAME PRIMARY PHONE
PROPERTY OWNER Mirrror Lake Village LLC ( ) -
MAILING ADDRESS E-MAIL
PO Box 6961
CITY STATE ZIP FAX
Bellevue WA 98008 ( ) -
'
NAME PRIMARY PHONE
KLEPPS, INC. ( 425) 223 - 3164
MAILING ADDRESS EMAIL
ELECTRICAL 13330 SE 30TH SE CUSTOMERSERVICE@KLEPPS.COM
CONTRACTOR CITY STATE ZIP FAX
BELLEVUE WA 98005 ( 425) 223- 3165
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
EC KLEPPI*938C6 2/ 26 / 2019 20-15-103803-00-BL
NAME PRIMARY PHONE
APPLICANT Phil Bonstein ( 425) 591 - 2850
MAILING ADDRESS E-MAIL
13330 SE 30TH ST phil@klepps.com
CITY STATE ZIP FAX
BELLEVUE WA 98005 ( 425 ) 223- 3165
NAME PRIMARY PHONE
PROJECT CONTACT Phil Bonstein
( 425) 591 - 2850
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 su• • 'the city as a part of this application.
SIGNATURE: • DATE 01/10/2019
PRINT NAME: 'hil Bonstein
PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
253-835-2607+ FAX 253-835-2609 +permitcenter(acityoffederalway.com
•
Bulletin#160—April 14,2016 Page 1 of 1 k:\Handouts\Electrical Permit Application