20-102898-Building Permit ApplicationCITY OF
Federal Way
PERMIT NUMBER
PERMIT APPLICATION
PERMIT CENTER + 33325 811, Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcente�;cityoffederalway.com
TARGET DATE
SITE ADDRESS
Burrs/UNIT f
30914 6th Lane SW, Federal Way, WA 98023
Lot # 12
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL 8
$ 139,180.00
Cottage Housing
5 5 5 �7 , 9_ 0 _ o 12 0
TYPE OF PERMIT
® BUILDING El PLUMBING ® MECHANICAL ❑ DGMo!_ITIDN ❑ ENGINEERING 29 FIRE PREVENTION
NAME OF PROJECT
Mirror Lake Highland
Build a single family residence'ust like one built on Loth
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-KAIL
bill@thenexusstudio
�ITY
Federal Way
STATE
WA
98023
Com
NAME
The Nexus Studio Inc,
PHONE
same
MAILING ADDRESS
(same as above)
E-MAN+
same
corlTRACTOIz
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE N
NEXUSS1839M6
EXPIRATION DATE
7 24 /,22
DSI N
NAME
PRIMARY PHONE
The Nexus Studio Inc.
same
MAILING ADDRESS
(same as above)
&-MAD.
same
APPLICANT
CITY
STATE
ZIP
FAX
NAME
PRIMARY PHONE
PROJECT CONTACT
Bill McCaffrey
same
MAILING ADDRESS
same as above
EMAIL
same
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
77,,��,,
�J OWNER -FINANCED
When value is $5,000 or rnore
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW I9.2 r.o9s)
i
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 f th a piication
°� � �z zo
SIGNATURE:PVA DATE
PRINT NAME: w I i-L'A')'\ v `C
Bulletin # 100 — February 19, 2020 Page I of 2 k:IHandoutsTennit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $ 4000.00
Indicate how marty of each type of fixture to be installed or relocated as part of this project. Do not include exis ' res to remain.
AIR HANDLING UNITS 3 FANS 3 GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (Commerciai) Gase Stove
BOILERS FURNACES �� HOT WATER TANKS pas) _H ee er
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING 1 GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
$ 5000.00
Indicate how nwny of each type offacture
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) �_
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
1_
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (kitchen/utiuty)
WATER HEATERS (Electric)
13
.2 HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FUTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF VaPROVENIZI T8
NA
Lakehaven
Lakehaven
NA
$
=SMG/PREVIOUS USE
LOT M (In square Feet)
EIOSTIIRO FIRE SPRIMMER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
Vacant Land
1976sf
❑ 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
sEcorm:>ZooR _
444
440
COVERED ENTRY
134
134
DECK
35
3-rJ
GARAGE ❑ CARPORT ❑
OTHER,(descrt'be)
Area Totals
1253
_
125
*xm
:s o1*`
ESTIMATED SELLING PRICE $ 4W2000
# OF BEDROOMS 3
COMMERCIAL— NEW/ADDITION
AREA DESCRIPTION Area
i et Occupancy Group(s) Construction 0 of TypeStories Additional Information
ADDITION
Bulletin #100 — February 19, 2020 Page 2 of 2 k:lHandoutslPermit Application