20-104475-sf-Building Permit Application-10-26-2020-V1 (1)41k
CITY OF
Federal Way
PERMIT NUMBER _
PERMIT APPLICATION
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
TARGET DATE
SITE ADDRESS
SUITE/UNIT #
31000 6th Lane SW, Federal Way, WA 98023
Commons Bldg.
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ 61,600
Cottage Ho> si
� Accessory building, no separate Tax ID number
TYPE OF PERMIT
29 BUILDING El PLUMBING IS MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑FIRE PREVENTION
NAME OF PROJECT
Mirror Lake Highland
Build an accessory Commons Building
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
Mirror Lake Highland LLC
PRIMARY PHONE
253-709-8747
PROPERTY OWNER
MAILING ADDRESS
30929 37th PL SW
E-MAIL
bill@thenexusstudio
CITYFederal Way
SWp,
ZIP98023
com
NAME
The Nexus Studio Inc.
PHONE
same
CONTRACTOR
MAILING ADDRESS
(same as above)
E-MAIL
same
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
NEXUSSI839M6
EXPIRATION DATE
7 24 /22
UBI #
NAME
PRIMARY PHONE
The Nexus Studio Inc.
same
APPLICANT
MAILING ADDRESS
(same as above)
E-MAIL
same
CITY
STATE
ZIP
FAX
NAME
PRIMARY PHONE
PROJECT CONTACT
Bill McCaffrey
same
MAILING ADDRESS
same as above
E-MAIL
same
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
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 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
PRINT NAME:
Bulletin #100 —February 19, 2020 Page 1 of 2 k:AHandouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
s 4000.00
Indicate how many of each type o
Lxture to be installed or relocated
as part of this project. Do not include existin fixtures to remain.
AIR HANDLING UNITS
_ FANS
GAS PIPE OUTLETS
OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (commercial)
Gase Stove
BOILERS
FURNACES
HOT WATER TANKS (Gas)
Heater
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
1 GAS PIPING
WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
$ 5000.00
Indicate how many of each type offixture
to be installed or relocated as part of this project Do not include existing fixtures to remain.
BATHTUBS (or Tub/shower combo)
3
LAVS (Hand sinks)
9. TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen/utility)
WATER HEATERS (Electric)
2— HOSE BIBBS
SUMPS
WASHING MACHINES
13 TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
NA
Lakehaven
Lakehaven
NA
$
EXISTING/PREVIOUS USE
LOT SIZE (In Square
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION
Vacant Land
Feet) NA
❑ Yes B No
SYSTEM? ❑ Yes & No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
...............................................................................................................................
BASEMENT
...............................................................................................................................
FIRST FLOOR (or Mobile Home) 560 560
...............................................................................................................................
SECOND FLOOR
...............................................................................................................................
COVERED ENTRY
...............................................................................................................................
DECK
...............................................................................................................................
GARAGE ❑ CARPORT ❑
...............................................................................................................................
OTHER (describe)
...............................................................................................................................
Area Totals EXISTING PROPOSED TOTAL
"NEW HOMES ONLY"
LLQ---� $ - z -F "vr1R7)nMM
NA NA
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 — February 19, 2020 Page 2 of 2 k:\Handouts\Permit Application