21-102232-SF-Building Permit Application-06-09-2021-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 + permiteenter((r?cityoffederalway.com
TARGET DATE
SITE ADDRESS
SUITE/UNIT 9
309106th Lane SW, Federal Way, WA 98023
Lot 4 $1 13
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL B
$ 139,180.00
Cottage Housing
5 5 5 _7 _ 9_ 0 T 0 1 30 0
TYPE OF PERMIT
R9 BUILDING 1] PLUMBING EN MECHANICAL ❑ DEMOLITION ❑ ENGINEERING EN FIRE PREVENTION
NAME OF PROJECT
Mirror Lake Highland
Build a single familyj residence ust like one built on Lot Mt 1 Z
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
CIT"Federal Way
WSTATEA ZIP 98023
Com
NAME
The Nexus Studio Inc.
PHONE
same
MAILING ADDRESS
(Same as above)
E•MATI
same
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE N
NEXUSS1839M6
RRPIRATION DATE
7 24 ,22
UHI B
NAME
The Nexus Studio Inc.
PRIMARY PHONE
same
MAILING ADDRESS
(same as above)
E-MAIL
same
APPLICANT
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
Bill McCaffrey
PRIMARY PHONE
same
NAMING ADDRESS
same as above
E-MAIL
same
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
PAIL
concerning this application)
PROJECT FINANCING
NAME
77��,,
�I OWNER -FINANCED
When value is $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
I cert(fy 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 Wormation submitted in support of this permit application is true and correct. I cert#fy 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 a city, including its officers and employees, upon the accuracy of the
igformation suppHed�to�the city as apart of this applica o
SIGNATURE: �/` /� 'q1 + DATE C>
PRINT NAME: j LL l L vie& AqPx~)
Bulictin #100 — February 19, 2020 Page t of 2
k:lHandouts\Perinit Application
VALUE OF MECHAMCAL WORK
MECHANICAL PERMIT I m 4000.00
AIR HANDLING UNITS
3
FANS
3
GAS PIPE OUTLETS I OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODShmmeadl Gase Stove
_
BOILERS
FURNACES
_L
HOT WATER TANKS (o..) Heater
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
_
DUCTING
GAS PIPING
WOODSTOVES
VALUE OF PLUMBING WORN
PLUMBING PERMIT
$ 5000.00
Indicate how mzuty o each
tMpe o re to be installed or relocated as part of thisproject. Do not include existing fixtures to remain.
BATHTUBS (.,wbjm—c—b) iAVS Ia®d swill
9 TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS URINALS
OTHER(Dewribe)
DRAINS
L SHOWERS
VACUUM BREAKERS
_ DRINKING FOUNTAINS
SINKS (mi —tuaum
WATER HEATERS (a«wq
13
2_ HOSE BIBBS
SUMPS
1_ WASHING MACHINES
TOTAL ForruESs
GENERAL INFORMATION
carrlc L AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF P.RISTA'G IMPROVEIIENTS
NA
Lakehaven
Lakehaven
NA
$
EKSTAG/PREVIOUS USE
LOT SIDE (b Sgoue Feet)
E)DSTmG FIRE SPRINKLER SYSTEM?
PROPOSED FIRS SUPPRESSION SYSTEM?
Vacant Land
1976sf
o Yes X No
X ❑ Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT
...........................................................................................................................
...............................................
FIRST FLOOR (or Mobile Home)
684
684
........................_.............................
........................................-............. ................................................................... .
SECOND FLOOR
440
440
....................................... ................... ...... ........ ........................ ..........
COVERED ENTRY
134
134
.............. I._
DECK
35
35
GARAGE ❑ CARPORT ❑
............................................................................................................................
............................................................................................................................
OTHER (describe)
-...........................................
Area Totals
�e A�
1253
1253
..............................................................................
**NEW HOMES ONLY1e
4
ESTIMATED SELLING PRICE $ 25,000
# OF BEDROOMS 3
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Areain Feet
Occupancy Group(s)
Construction TypeSt
rolfea
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL— REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
# 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