17-105225 i J
Building - Single Family
City of Federal Way Permit #:17-105225-00-SF
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 HIGHLAND MODEL HOME(LOT 2)
Project Address: 31114 6TH LN SW Parcel Number:072104 9024-Lot
Project Description: NEW-Construction of a 1098 square foot 2-story single family residence with a 119 square
foot covered entry and an 80 square foot partially covered deck. Includes plumbing&
mechanical. ***3 bedrooms;$345,000 estimated selling price***
Owner Applicant Contractor Lender
WILLIAM MCCAFFREYMIRROR THE NEXUS STUDIO INC THE NEXUS STUDIO INC OWNER IS LENDER
LAKE HIGHLAND LLC 1911 SW CAMPUS DR SUITE 116 30929 37TH PL SW
30929 37TH PL SW FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
•
Census Category: 101 -New Single Family House
Includes: #1 #2 #3 #4
Occupancy Class: R-3
Construction Type: Type V-B
Occupancy Load:
Floor Area(sq.ft.) 1,098.00
Additional Permit Information
New/Additional Sq.Feet-1st Floor 744 New/Additional Sq.Feet-2nd Floor 354
New/Additional Sq.Feet-3rd Floor 0 Occupancy#1-Area(Sq.Feet) 1098
New/Additional Sq.Feet-Basement. 0 Basic Plan" No
Occupancy#1-Construction Type Type V-B New/Additional Sq.Feet-Deck 80
New/Additional Sq.Feet-Garage 0 Mechanical to be Included? Yes
Plumbing Work Valuation? 5000 Mechanical Work Valuation? 4000
Number of Stories 2 New/Additional Sq.Feet-Other 119
Plumbing to be Included? Yes New/Additional Sq.Feet-Total 1297
Will Certificate of Occupancy be Issued? Yes Occupancy#1-Use Residence(1 or 2
family)
Comprehensive Plan Designation SF-High-Density Zoning Designation RS 7.2
Residential
Total Valuation:131,403.25
Gas Logs 1 Gas Piping I Gas Pipe Outlets 3
Hot Water Tanks 1
Bathtubs 1 Dishwashers 1 Laundry Washer Outlets 1
Lavatories 2 Showers 1 Sinks 1
Water Closets 2 Hose Bibbs 2
t t i r
PERMIT EXPIRES Wednesday,8 August,2018
Permit Issued on Friday,February 9,2018
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 accor•-nce with the laws, rules and regulations of the State of
Washington I • the City of Federal Way.
Owner or agent: L. JV1j- 0 ` Date: 7— ( f® V
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 111 of the International Building Code or Section
R110 of the International Residential Code is certifying that at the time of issuance,this structure was in
compliance with the various ordinances of the City regulating building construction or use.This certificate is valid
ONLY when endorsed by City staff.
Tenant Name: MIRROR LAKE HIGHLAND MODEL HOME(Li Permit# 17-105225-00-SF
Address: 31114 6TH LN SW
Includes: #1 #2 #3 #4
Occupancy Class: R-3
Construction Type: Type V-B
Occupancy Load:
Floor Area(sq.ft.) 1,098.00
Owner Name: WILLIAM MCCAFFREYMIRROR LAI
Owner Address: 30929 37TH PL SW
/ FEDERAL WAY WA 98023
Building Or cial Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most severely affect the health and safety of the general public. Although the City has made as complete
a review and inspection as is reasonably possible(within budgetary time and personnel limitations),the City neither guarantees
nor warrants to the owner/occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
vIL which it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises.
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di00011,64.9: .
Building - Single`Fam',ny
Conan of
Permit #:17-105225-OO-SF
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 HIGHLAND MODEL HOME(LOT 2)
Project Address: 31114 6TH LN SW Parcel Number:072104 9024-Lot
Project Description: NEW-Construction of a 1098 square foot 2-story single family residence with a 119 square
foot covered entry and an 80 square foot partially covered deck. Includes plumbing&
mechanical. ***3 bedrooms;$345,000 estimated selling price***
Owner Applicant Contractor Lender
WILLIAM MCCAFFREYMIRROR THE NEXUS STUDIO INC THE NEXUS STUDIO INC OWNER IS LENDER
LAKE HIGHLAND LLC 1911 SW CAMPUS DR SUITE 116 30929 37TH PL SW
30929 37TH PL SW FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
FEDERAL WAY WA 98023
Census Category: 101 -New Single Family House
Includes: #1 #2 #3 #4
Occupancy Class: R-3
Construction Type: Type V-B
Occupancy Load:
Floor Area(sq.ft.) 1,098.00
Additional Permit Information
New/Additional Sq.Feet-1st Floor 744 New/Additional Sq.Feet-2nd Floor 354
New/Additional Sq.Feet-3rd Floor 0 Occupancy#1-Area(Sq.Feet) 1098
New/Additional Sq.Feet-Basement 0 Basic Plan No
Occupancy#1-Construction Type Type V-B New/Additional Sq.Feet-Deck 80
New/Additional Sq.Feet-Garage 0 Mechanical to be Included? Yes
Plumbing Work Valuation? 5000 Mechanical Work Valuation? 4000
Number of Stories 2 New/Additional Sq.Feet-Other 119
Plumbing to be Included? Yes New/Additional Sq.Feet-Total 1297
Will Certificate of Occupancy be Issued? Yes Occupancy#1-Use Residence(1 or 2
family)
Comprehensive Plan Designation SF-High-Density Zoning Designation RS 7.2
Residential
Total Valuation:131,403.25
Gas Logs I Gas Piping 1 Gas Pipe Outlets 3
Hot Water Tanks 1
v..
Bathtubs 1 Dishwashers 1 Laundry Washer Outlets 1
Lavatories 2 Showers 1 Sinks 1
Water Closets 2 Hose Bibbs 2
i
i '
• ., PERMIT EXPIRES Wednesday,8 August,2018
Permit Issued on Friday,February 9,2018 ,
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 accordance with the laws, rules and regulations of the State of
Washin t and the City of Federal Way. ( 16 Owner or agent: 0"h, 4 W��/✓IDate: 2
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 111 of the International Building Code or Section
R110 of the International Residential Code is certifying that at the time of issuance,this structure was in
compliance with the various ordinances of the City regulating building construction or use.This certificate is valid
ONLY when endorsed by City staff.
Tenant Name: MIRROR LAKE HIGHLAND MODEL HOME(Li Permit# 17-105225-00-SF
Address: 31114 6TH LN SW
Includes: #1 #2 #3 #4
Occupancy Class: R-3
Construction Type: Type V-B
Occupancy Load:
Floor Area(sq.ft.) 1,098.00
Owner Name: WILLIAM MCCAFFREYMIRROR LAI
Owner Address: 30929 37TH PL SW
FEDERAL WAY WA 98023
Building Oficial Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most severely affect the health and safety of the general public. Although the City has made as complete
a review and inspection as is reasonably possible(within budgetary time and personnel limitations),the City neither guarantees
nor warrants to the owner/occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
` which it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises.
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
Ii.e. ,yeaeralway
INSPECTION REQUESTS:(253)835-3050 -
PERMIT#: 17 105225 00 Address: 31114 6TH LN SW •
Project: WILLIAM J MCCAFFREY FEDERAL WAY WA 98023-4817
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 apprmiste.Morknuistiaotbe covered until it is approve& cheek 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.
0 SWM Precon Site Mtg(4400) 0 Initial Erosion Control(4365) 0 Footings/Setback(4110)
Approved To be done PRIOR to breaking ground Approved to place concrete
By Date By Date By Ari Date /5 .
® Foundation Wall(4115) $❑ Drainage/Downspout(4040) 0 Plumbing Groundwork(4190)
Approved to place concrete Approved to backfill Approved to cover
By Date 2 • By A111 Date Z By Date
0 Slab/Concrete Floor(4255) 0 Underfloor Framing(4285) 0 Floor Sheathing(4105)
Approved to place concrete Approved to sheath floor Approved to install flooring
By Date By . 1,J Date b Z By i _ Date = q
El Shear Walls(4245) M Roof Sheathing(4220) M Rough Plumbing(4230)
Approved to install siding Approved to install roofmg Approved
By /) Date 1/j�e By /}.J Date 11/4i$ BY<T' Dated I ($ ,
tl Mechanical Rough-in(4165) M Gas Piping(4125) M Fire/Draft Stops(4095)
Approved Approved to release test Approved
By :,. Date 5 Date Cc, k„ By ' A Date 5 ZI
Nom
•1:1 Interim Erosion Control(4370) Prior to scheduling a Framing inspection; 07 Framing(4120)
ApprovedElectrical,Plumbing&Mechanical Rough-in Approved to insulate
and Fire/Draft Stop inspections must be signed-
By Date off and approved IBC 109.3.4 By � Date 64 j /p'
•® Insulation(4150) tM' Gypsum Wallboard Nailing(4130) " Final Erosion Control(4375)
Approved to install wallboard Approved to install mud&tape Approved
By AO Date i Date By Date
I M Final-Mechanical(4065) M Final-Plumbin (4075) - En Final-Building(4050)
Approved Approved Approved
By L`�I A�►S Date ado a ,....4 i By Date B! -1 s%4,,:. By Date Ira, .. . a.r'te0
�
Air)_ ‘Af(1V- O-
O Rough Electrical . 0 Final Electrical 0 Right of Way
Approved Approved Approved
By Date , By - Date , By Date
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114
LONGITUDE
ONE TWENTY°
ENGINEERING&DESIGN
CONSTRUCTION SUPPORT SERVICES
Date: 30th day of March, 2018
Project Name: Mirror Lake Highland
Project Location:604 SW 312th ST, Federal WA,WA
Client's Name:The Nexus Studio, Bill McCaffrey(Owner/Architect)
To whom it may concern,
We were informed of a few items/issues which was brought up by the inspector during a framing/shear inspection,and we
were asked to provide structural input on the specific items below.Please see our structural response to each comment below
and let us know if you have any questions.Also,see included strap and sheathing APA documentation,sheet SK-1 to SK-9.
1. IRC 106.4—work shall match approved plans
Response:We agree
2. CS14 to be used for window strapping—CS16 installed
Response:We discussed this with client and mentioned where straps are refenced on the shear-wall and wall-
framing plan.However,for this particular inspection we re-visited the calculations and based on our required
window strap design forces,combined with the method we utilize is a bit conservative per the attached
document,we deem the CS16 straps acceptable based on the design and APA testing.However,in the future
please install straps as referenced per our shear-wall plans.
3. CMSTC16 to be used on W.windows—CS16 installed
Response:We discussed this with client and mentioned where straps are refenced on the shear-wall and wall-
framing plan.However,for this particular strap we cannot justify the 0516 strap in lieu of CMSTC16 strap @ these
affected windows.We ask that you install another CS14 at the bottom of existing straps,and extend per the
window strap detail,with an additional row of blocking,full length of straps(top and bottom as required for
proper nail penetration)
4. Page 50-2.1 missing—unable to verify the roof details
Response:lam sorry to hear this.I understand that it will be present on site for your re-inspection.
5. Page 58 calls for 23/32 roof sheathing on roof—7/16"used
Response:We will allow it for this build per the attached APA roof sheathing document.However,in the future
please accommodate requirements per our roof plan and general notes.
6. Window strap detail calls for(2)window sill framing members,only(1)installed and a row of blocks underneath.
Response:We will allow it for this build with the addition of full length blocking to assure strap/nailing
development to comply with design.However,in the future please accommodate requirements per window strap
detail with continuous plates being preferred over blocking and if you have an issue with window flashing please
add another full-length window sill plate is preferred.
Sincerely,
Mans R.Thurfjell,P.E
L120 Engineering&Design(L120)
_ y
L
E RECEIVED
' LakebavenFIOCT3 0 201?
r WATER&SEWER DISTRICT CITY OF FEDE
COMMUNflyDEyELOPMEM^
Lakehaven Water & Sewer District - Development Engineering Section
31623 - 1st Ave S . PO Box 4249 * Federal Way, WA 98063-4249
Telephone: 253-945-1581 or 253-945-1580 * Email: DE@Lakehaven.org
This certificate is intended to provide the applicant, land use agencies &/or public health departments with
information necessary to evaluate development proposals. Lakehaven Water & Sewer District, at its sole
discretion, reserves the right to delay, or deny, water service based upon capacity &/or supply limitations
in Lakehaven's or Other Purveyor's system facilities.
Proposed Land Use: ® Building Permits-SFR ❑ Building Permit-MFR 0 Building Permit-Other
❑ Subdivision 0 Short Subdivision 0 Binding Site Plan
O Rezone 0 Boundary Line Adjustment
❑ Other(specify/describe)
Tax Parcel Number(s): 072104-9024. -9109. -9110. -9111, -9114 Site Address: 310XX—6th PI SW
Ex. Bldg. Area to Remain: N/A sf New Bldg. Area Proposed: 1.295+/- ava. sf ea. (16) Lakehaven GIS Grid: H-07
Applicant's Name: McCaffrey
WATER SYSTEM INFORMATION
1. 0 Water service can be provided by service connection to an existing " diameter water main that is approximately
feet from the site.
2. ® Water service for the site will require an improvement to Lakehaven's water distribution system of:
® a. 30+/- feet of 8"diameter water main to reach the site; and/or
® b. The construction of a water distribution system on the site; and/or
❑ c. A major portion of Lakehaven's comprehensive water system plan would need to be implemented and/or
constructed; and/or
® d. Other(describe): Lakehaven Developer Extension Aareement(active. Project 6308003) required.
3. 0 a. The existing water system is in conformance with Lakehaven's Comprehensive Water System Plan.
❑ b. The existing water system is not in conformance with Lakehaven's Comprehensive Water System Plan and an
Amendment to this Plan will be required.This may cause a delay in issuance of land use approvals or permits.
4. ® a. The subject property is within the corporate limits of Lakehaven Water&Sewer District, or has been granted
Boundary Review Board approval for extension of water service outside of Lakehaven's water service area.
O b. Annexation or Boundary Review Board approval will be necessary to provide service.
5. Water service is subject to:
O a. Payment of connection charges (to be determined by Lakehaven);
O b. Proof or reservation of easement(s) as required by Lakehaven;
►5 c. Other: Water Service Connection application required,for any new/modified service connection. DE Aareement(#2
above) must be accepted by Lakehaven, prior to any new service connection activation(s).
Comments/special conditions: Some service pressure(s) greater than 80 psi indicated, some Pressure Reducing Valves indicated,
contact local building official for requirements&/or additional information.
The nearest fire hydrant will be on the Property(pending completion of DE Agreement(#2 above)).
Fire Flow at no less than 20 psi available within the water distribution system is 1,000 GPM (approximate) for two (2) hours or more.
This flow figure depicts the theoretical performance of the water distribution system under high demand conditions. Fire flow rates
greater than this may be accommodated through water distribution system improvements, contact Lakehaven for additional
information.
538 Pressure Zone Est. Meter Elevation(s)-GIS: High 366+/-, Low 332+/- Est. Pressure Range at Meter(s) (psi): 65-89
I hereby certify that the above water system Information is true. This certification shall be valid for one (1) year from the date of
signature.
Name: BRIAN ASBURY Title: DEVELOPMENT ENGINEERING SUPERVISOR
Signature: jai, Date: ( c ! 1/f
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MOTE: Lakehaven Water and Sewer M
District nether warrants nor guarantees Water Certificate of Availabiiiy
the accuracy of any facility information Parcels 072104-9024,9009 ,-91109 111, -9114
provided.Facility locations and conditions -
are subject to fieldveriication. 10/19/2017 BIA
Feel
Mirror Lake Highland wtr.docx(Form Update 1/3/17) Page 2 of 2
OCT 302017
IF
DECEIVED
CITY OF FEDERAL
ven OAMMUNfTYDEVELOPMENT
WATER&SEWER DISTRICT
Lakehaven Water &Sewer District - Development Engineering Section
31623 - 1st Ave S * PO Box 4249 * Federal Way, WA 98063-4249
Telephone: 253-945-1581 or 253-945-1580 • Email: DE@Lakehaven.org
This certificate is intended to provide the applicant, land use agencies &for public health departments with
information necessary to evaluate development proposals. Lakehaven Water & Sewer District, at its sole
discretion, reserves the right to delay, or deny, sewer service based upon capacity &/or supply limitations
in Lakehaven's or Other Purveyor's system facilities.
Proposed Land Use: ® Building Permits-SFR ❑ Building Permit-MFR 0 Building Permit-Other
❑ Subdivision 0 Short Subdivision 0 Binding Site Plan
❑ Rezone 0 Boundary Line Adjustment
❑ Other(specify/describe)
Tax Parcel Number(s): 072104-9024, -9109. -9110, -9111, -9114 Site Address: 310XX-6th PI SW
Ex. Bldg. Area to Remain: N/A sf New Bldg. Area Proposed: 1.295+/-avg. sf ea. (16) Lakehaven GIS Grid: H-07
Applicant's Name: McCaffrey
SEWER SYSTEM INFORMATION
1. 0 Sewer service can be provided by service connection to an existing "diameter sewer main that is
approximately feet from the site and the sewer system has the capacity to serve the proposed land use.
2. ® Sewer service for the site will require an improvement to Lakehaven's sanitary sewer system of:
® a. 125+/-feet of 8"diameter sewer main or trunk to reach the site; and/or
® b. The construction of a sanitary sewer collection system on the site; and/or
❑ c. A major portion of Lakehaven's comprehensive wastewater system plan would need to be implemented and/or
constructed; and/or
® d. Other(describe): Lakehaven Developer Extension Agreement(active. Project 6308003) required.
3. ® a. The existing sewer system is in conformance with Lakehaven's Comprehensive Wastewater System Plan.
❑ b. The existing sewer system is not in conformance with Lakehaven's Comprehensive Wastewater System Plan and an
Amendment to this Plan will be required. This may cause a delay in issuance of land use approvals or permits.
4. ® a. The proposed site land use is within the corporate limits of Lakehaven Water&Sewer District, or has been granted
Boundary Review Board approval for extension of sewer service outside of Lakehaven's sewer service area.
❑ b. Annexation or Boundary Review Board approval will be necessary to provide service.
5. Sewer service is subject to:
® a. Payment of connection charges (to be determined by Lakehaven);
® b. Proof or reservation of easement(s) as required by Lakehaven;
❑ c. Other: DE Aareement(#2 above) must be accepted by Lakehaven, prior to any new service connection
activation. Sewer Service Connection permit required (1 per building).
Comments/special conditions: .
I hereby certify that the above sewer system information is true. This certification shall be valid for one (1) year from the date of
signature.
Name: BRIAN ASBURY Title: DEVELOPMENT ENGINEERING SUPERVISOR q 7Signature: ,1/„�`^-- ,�-' `--�-'�-.__..__ Date: / / i /1
6,7
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Lakehaven Water and Sewer 114District neither warm nor guarantees SewerCertificate�af Av8118billrty
the accuracy of any facility information Parcels 072 004 9024,9009, -9110. 0 111, -9114
provided.Facility locations and conditions
are subject to field verification.
Feet 10/19/2017 BIA
Mirror Lake Highland swr.docx(Form Update 1/3/17) Page 2 of 2
RECEIVED .
,► PERMIT APPLICATION
"41(1111111111CITY OF +�� QCT 30 201 PERMIT CENTER+33325 8�Avenue South+Federal Way,WA 98003-6325
Federal Way WAY 253-835-2607+FAX 253-835-2609+permitcente n itvoffederalway.com
0 MUNCrf QED OR1�E� .
PERMIT NUMBER / P7 _ / 0 5 a S }� perek„f
TARGET DATE �- 3 '�`GlI�1.t � 4°tv I
SITE ADDRESS SUITE/UNIT#
kit311 l`-� •6 J II �FAD We.-WAS) WA, C o0 z
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ / tit r JUS k-i 200 _0 'l 7, C 0 4 - t 0 Z 4
TYPE OF PERMIT El BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT Ft Oa Eg, L itILIR LX41) ht17.De,L 1-1001,t- • / sic z
PROJECT DESCRIPTION M 0 gVg�� � / M O �J1 ic+ V& V A').C'f / a����g �I
Detailed description of work to If_,Q 4)RTV/�L 1.-0-1# Z ( 4\I�-1W it. ` A l
be included on this permit only fl i be Lkq PLAT-,
NAMEC'�l.[� PRIMARY PHONE
PROPERTY OWNER NII 2 L-M<L 41 a, k) U� E-MAIL
n✓1 - �M
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oq -291 311 IL 6 V w/r�t�vylt,C re(� `�l
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MAILING/ADDRESS 1003�f) L e.T
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NAME ti L.L' l4 CAV 1,�Ci 6 PRIM4RY PHONE
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ADDRESS
APPLICANT It iket Ei /1/45 A)O\t\ "AGl4A1I1'v C
CITY 7� STATE ZIP FAX
N E PRIMARY PHONE
PROJECT CONTACT
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING X 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 relian of the city, including its officers and employees, upon the accuracy of the
information supplied the city as a part of this ap. ation.
SIGNATURE: /'' " , DATE 1-9 1 ' D 111
PRINT NAME: V-1.1 L k./\. N rt E"f f L (
Bulletin#100-January 29,2016 Page 1 of 2 k:\Handouts\Pennit Application
II‘).,
VALUE OF MECHAMCAL WORK
MECHANICAL PERMIT $ 4 k
Indicate how many of each type of fiture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
AIR HANDLING UNITS 4 FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commerr )
BOILERS FURNACES T HOT WATER TANKS(Ges)
T
COMPRESSORS 1 GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUhfBING WORK
PLUMBING PERMIT $ 5 /K,
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) 2 LAVS(Hand sudco( TOILETS WATER PIPING
I DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
T
DRAINS / SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS I SINKS(Beechen/ubuy( WATER HEATERS(Electric(
1 HOSE BIBBS SUMPS I WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
.10 I.is,K(t.,1,11-\1 Vit, L ,x4t ,4kkuk
EXISTING/PREVIOUS USE LOT SIZE Ku Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE ION SYSTEM?
Rin t(c)r- Z 4_(A 3(0 4.) ❑Yes kNo ❑Yes/1k No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
1 MENT '
FIRST FLOOR(or Mobile Home) r144 If I 0 9 8
SECOND R "` `
COVERED ENTRY 1 (61 j 1 9
DEcK< 0,.,„
GARAGE ❑ CARPORT 0
EXISTING PROPOSED TOTAL
Area Totals
ESTIMATED SELLING PRICE$ 3 ti SI 0 0 0 #OF BEDROOMS 13
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area Occupancy Groups) Construction #of Additional Information
Sguare Feet Type Stories
,1 .
3i WH i NG
ADDITION ,
COMMERCIAL-REMODEL/TENAN MPROVE " 'TS
AREA DESCRIPTION Area is O• u.: . • Group(s) Construction #of Additional Information
Square Feet Type Stories
TOTAL BUILDING .
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application