18-105752 A
P
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Electrical
City of Federal Way Permit #:18-105752-00-EL
Community Development Dept
FILE
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: Installation of thermostats&sensors
Owner Applicant Contractor
MIRROR LAKE VILLAGE LLC ALEX BURKHARTEVERGREEN EVERGREEN REFRIGERATION LLC
PO BOX 6961 REFRIGERATION (ELECTRICAL)
BELLEVUE WA 98008 727 S KENYON ST EVERGRL882JB(4/2/20)
SEATTLE WA 98108 727 S KENYON ST
SEATTLE WA 98108
Additional Permit Information
Is this an Online or O.T.C.application Yes
Thermostat 62 ` ..
PERMIT EXPIRES Friday,6 December,2019 .
Permit Issued on Thursday,December 6,2018
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 accordan •of the laws, rules and regulations of the State of
rtto:13
114
Federal Way.
Owner or agent: c5,h
® Date:
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THIS CARD IS TO REMAIN ON-SITE
Federal Wa Construction Inspection Record
Y INSPECTION REQUESTS:(253)835-3050
PERMIT#: 18 105752 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
-yo re uacuseabout any of the inspections or the inspection sequence. On-going inspectionsare loggedon the back of this card.
0 UFER Ground(4295) El Ditch cover(4030) ID Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
El Pool Bonding(4195) ® Temporary Power(4275) ® Service(4235)
Approved Approved Approved
By Date By Date By Date
El Feeders/Sub-panels(4045) ® Rough Electrical(4225) Ceiling Cover(4020)
Approved ,f� Approved ApprovedQ
By Date By '` Date /— / "f By f� , / Date T - '.l
El Final-Electrical(4055)
By // Approved
Date - /3-20
0 Rough Electrical ❑ Final Electrical ❑ Right of Way
Approved Approved Approved
By Date By Date .By Date