HomeMy WebLinkAboutPermit M03-217 - CASTILLO RESIDENCECASTI LLO
RESIDENCE
13355 56T" AVENUE
SOUTH
M03 -27 7
Parcel No.: 2172000155
Address: 13355 56 AV S TUKW
Suite No:
Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name: OWNER AFFIDAVIT - 30SE CASTILLO
Address: 13355 56 AV S, TUKWILA WA
Contractor License No:
DESCRIPTION OF WORK:
NEW HVAC SYSTEM FOR NEW SINGLE FAMILY RESIDENCE
Value of Construction:
Type of Fire Protection:
Permit Center Authorized Signature:
Signature:
Print Name:
doc: Mech
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
CASTILLO RESIDENCE
13355 56 AV S, TUKWILA, WA
CASTILLO 3OSE & 3UN
13355 56 AV S, TUKWILA WA
3OHN 30NES
4908 22 AV NE, TACOMA WA
$4,000.00
SPRINKLERS
MECHANICAL PERMIT
M03 -217
Permit Number:
Issue Date:
Permit Expires On:
Expiration Date:
Phone:
Phone: 253 - 952 -2535
Phone: 208 869 -4783
Fees Collected:
Uniform Mechnical Code Edition:
M03 -217
04/27/2004
10/24/2004
$111.13
1997
Date: 'y .2 7 aS
I hereby certify that I have read and examined this permit and know the same to be true and correct. All provisions of law and
ordinances governing this work will be complied with, whether specified herein or not.
The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws
regulating construction or the performance of work. I am authorized to sign and obtain this mechanical permit.
Date: 1 1 [ -` 3 •
This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is
suspended or abandoned for a period of 180 days from the last inspection.
Printed: 04 -27 -2004
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City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 2172000155
Address: 13355 56 AV S TUKW
Suite No:
Tenant: CASTILLO RESIDENCE
PERMIT CONDITIONS
9: Manufacturers installation instructions required on site for the building inspectors review.
Permit Number: M03-217
Status: ISSUED
Applied Date: 12/19/2003
Issue Date: 04/27/2004
1: ** *BUILDING DEPARTMENT CONDITIONS * **
2: No changes will be made to the plans unless approved by the Engineer and the Tukwila Building Division.
3: Plumbing permits shall be obtained through the Seattle -King County Department of Public Health. Plumbing will be
inspected by that agency, including all gas piping (296- 4722).
4: Electrical permits shall be obtained through the Washington State Division of Labor and Industries and all electrical
work will be inspected by that agency (206- 835 - 1111).
5: All permits, inspection records, and approved plans shall be available at the job site prior to the start of any
construction. These documents are to be maintained and available until final inspection approval is granted.
6: Any exposed insulations backing material shall have a Flame Spread Rating of 25 or less, and material shall bear
identification showing the fire performance rating thereof.
7: All construction to be done in conformance with approved plans and requirements of the Uniform Building Code (1997
Edition) as amended, Uniform Mechanical Code (1997 Edition), and Washington State Energy Code (1997 Edition).
8: Validity of Permit. The issuance of a permit or approval of plans, specifications, and computations shall not be
construed to be a permit for, or an approval of, any violation of any of the provisions of the building code or of any
other ordinance of the jurisdiction. No permit presuming to give authority to violate or cancel the provisions of this
code shall be valid.
10: Ventilation is required for all new rooms and spaces of new or existing buildings in conformance with the Uniform
Building Code and the Washington State Ventilation and Indoor Quality Code, Chapter 51 -13 WAC.
I hereby certify that I have read these conditions and will comply with them as outlined. All provisions of law and ordinances
governing this work will be complied with, whether specified herein or not.
The granting of this permit does not presume to give authority to violate or cancel the provision of any other work or local laws
regulating construction or the performance of work.
Signature: Date:
3,4 41
Print Name:
doc: Conditions
M03 -217
Printed: 04 -27 -2004
CITY OF TUKWILA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
Applications and plans must be complete in order to be accepted for plan review.
Applications will not be accepted through the mail or by fax.
* *Please Print **
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King Co Assessor's Tax No.: 2.11 2.0 - O 1 Ss- O X
Site Address: 13355 SC1 AYE Suite Number: )1 )4 Floor:
Tenant Name: JUN C'AQiI Li- 3 A.k4. -J CACT111 -O New Tenant: f .... Yes
Property Owners Name: JOSS CST 0 2C\g- goof_ 41 3
Mailing Address: 1335 aGfl4 AYE SO - 11414w1 LA IVA
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Name:
Mailing Address: 01 2.2 Me NE
E -Mail Address: euiLphl ve cl.L . • (414
E -Mail Address: 9Ul 1.1)1) SAVEe Or/ALL.. CM
Contractor Registration Number: Ilk
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
■applicationApermit application (3.2003)
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Company Name: BU l t-O N SAI
Mailing Address: 4 4(.3 ? 220 f A'J NE
Contact Person: JOAN JONES
Page 1
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Zip
Day Telephone: 253 - 952- 2535
TAca WA 9Q-2Z-
City State Zip
Fax Number: 2-55 • e n - Vfl
- - NCtieviA WA 22
City State Zip
Day Telephone: 2 S3- -S Z - 253 S
Fax Number: 15 3 - cis 2 - 2-4-i
Expiration Date: ■114
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
C4I1!'l lblrl',VI!r 1t1'r!
PATS AVR— LEGAI2
4493 LAE t„ 1ltskti WI gad, R id I) t Q•— 1nrt�
1�u�S 2v«I
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City State Zip
Day Telephone: 25 3 -6 11 . -•530 q -1 n
Fax Number: 4•S - ?S '- X3
' GINEEIC
Company Name:
Mailing Address: 31(o 23 K.D A'l efi ' S StAri - ?2 . 21 L- w, -1 11,A '' oo3
City State Zip
Contact Person: �` Day Telephone: 2 -S3 " 'Tit - i9 21
E -Mail Address: G�t VI u� �i Qt1G�� • CD $1 Fax Number: 21 - q4.1- 49 ?al
'Gl Yyr'•'
Unit Type:
:Qty
. UnitTYpe:;.,., , , ; : : :.
- Qty:
:Unit Type.: •
, Qty .
:Boiler/Conipressor .
'"Qty
Furnace <100K BTU
Air Handling Unit
>= 10,000 CFM
Other Mechanical
Equipment
0 -3 HP /100,000 BTU
Furnace>100K BTU
Evaporator Cooler
3 -15 HP /500,000 BTU
Floor Furnace
Ventilation Fan
15 -30 HP /1,000,000 BTU
Suspended/Wall/Floor
Mounted Heater
Ventilation System
30 -50 HP /1,750,000 BTU
Appliance Vent
Hood
50+ HP/I,750,000 BTU
Heat/Refrig/Cooling
System
Incinerator - Domestic
Air Handling Unit
< =l0,000 CFM
Incinerator — Comm/Ind
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MECHANICAL CONTRA 9R INFORMATION
Company Name:
Mailing Address:
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
Contractor Registration Number: Expiration Date:
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
Valuation of Project (contractor's bid price): $ 9 600
Scope of Work (please provide detailed information): ,/
k' ,Y f- • ion, s4 // 7`+2A , /- '-�(cd .e.,
Use: Residential: New .... Q Replacement .... ❑
Commercial: New ....❑ Replacement ....❑
Other:
Fuel Type:
Electric ❑
Gas....
•
Indicate type of mechanical work being installed and the quantity below:
VppliatioaWr,.►t appliati..0-2003)
3/2003
Page 4
State
Zip
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UFRMiT;'A P ZAi 7CATi(1N 11Y Ti['.:C' =A`ririliniifile:Aci-siltpe rims faiiiti.t.tApplicaiiil ., �,
Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject
to possible revision by the Permit Center to comply with current fee schedules.
Expiration of Plan Review — Applications for which no permit is issued within 180 days following the date of application shall expire by limitation.
The Building Official may extend the time for action by the applicant for a period not exceeding 180 days upon written request by the applicant as
defined in Section 107.4 of the Uniform Building Code (current edition). No application shall be extended more than once.
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, 1 AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER OR AUTHORIZED AGENT:
Signature: 1 3
Print Name: C per` t �- j g'l joy)
Mailing Address: J 1335:5 SC3i AVS • '1\4KWI(.d Vqf1 igfl
City • State Zip
l Date: /Q 41
Jtth .oNW
Day Telephone: go‘('rig3 253 42 2535
Date Application Accepted:
/ 03
Date Application Expires:
Staff Initials:
es
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ACCOUNT ITEM LIST:
Description
doc: Receipt
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 2172000155
Address: 13355 56 AV S TUKW
Suite No:
Applicant: CASTILLO RESIDENCE
Receipt No.: R04 -00498 Payment Amount: 111.13
Initials: SKS Payment Date: 04/27/2004 03:22 PM
User ID: 1165 Balance: $0.00
Payee: JOSE T. CASTILLO, JR.
TRANSACTION LIST:
Type Method Description Amount
Payment Check 611 111.13
MECHANICAL - RES
PLAN CHECK - RES
RECEIPT
Account Code Current Pmts
000/322.100 88.90
000/345.830 22.23
Permit Number: M03 -217
Status: APPROVED
Applied Date: 12/19/2003
Issue Date:
Total: 111.13
0326 04/27 9716 TOTAL. 2462.68
Printed: 04-27-2004
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Date Called:
Special Instructions:
Date Wanted:
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Requester:
Phone No:
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
1J0 3 0.117
(206)431 -3670
Approved per applicable codes. ❑ Corrections required prior to approval.
COMMENTS:
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0 <i
Inspecto (
Date: Li_
El $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
COMMENTS:
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Type of Inspection: 1 _,
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Date Called:
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Address:
Date Called:
Special Instructions:
Date Wanted: 3
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Phone No:
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
Mop -)i7
(206)431 -3670
❑ Approved per applicable codes. ❑Corrections required prior to approval.
!Inspector: (
Date: 3 1 B-os
$47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
COMMENTS: 1
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Special structions:
Date Wanted:
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Requester:
Phone No:
Approved per applicable codes.
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nspector:
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 981 88
O3
(206)431-3670
(206)431-3670
Ea - Corrections required prior to approval.
Date:
I \
El $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
'Receipt No.:
'Date:
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Type of Inspection:
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Date C I� led: -
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Phone No:
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INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
(206)431 -3670
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
'Inspector:
(Date: 21 / -sue.
El $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
Project: . S f/
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Type of In • -- h
/
Address:
Dat alle�
Spec al
str ct
sateWanted
Requester: '
Phone No:
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
PEfi
(206)431 -3670
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Approved per applicable codes. El Corrections required prior to approval.
'COMMENTS:
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Inspector:
Date:
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El $47.00 REINSPECTION FEE RirQUIRED. Prior to inspection, fee m t be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
1Date:
Project:
5 :1/
Type of7p ction: •
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Addr `` r
Date Calle 5
Special Instructions:
Date Wanted: J'L
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P.m.
Requester:
Phone No:
Approved per applicable codes.
143
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
121 Corrections required prior to approval.
COMMENTS: / 1 A 1 €4
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(Receipt No.:
(Date:
COMMENTS: /) , O , c
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Date Wanted:
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Requester:
Phone No:
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 981 88
Approved per applicable codes.
!Inspector:
INSPECTION RECORD
Retain a copy with permit
PERM
(206)431 -3670
Corrections required prior to approval.
Date: j7��
$47.00 REINSPECTIO FEE REQUIRED. Prior to inspection, fee m t be
paid at 6300 Southcenter Blvd., Suite 100. Cali to schedule reinspection.
[Receipt No.:
'Date:
A. ❑
B. ❑
C.
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 9:
-E COPY
•
Permit Center /Building Division:
206 -431 -3670
Public Works Department:
206 - 433 -0179
lanning Division:
206 -431 -3670
RESIDENTIAL HEATING AND VENTILATION COMPLIANCE FORM
(Complete Sections I and II for Group R Occupancies 4 Stories or Less)
MECHANICAL PERMIT APPLICATION NO.: /`2'D3 - 2/ 7
BUILDING PERMIT APPLICATION NO.: J ✓ �ef7
Project Name: 4 (/ G 7 2A . C6 ✓5 077 Z1
Site Address:' 1 (e A V S
I. WASHINGTON STATE ENERGY CODE HEATING DESIGN METHOD (select A, B or C below):
System Analysis — W.S.E.C. Chapter 4 (submit documentation)
Component Performance Approach — W.S.E.C. Chapter 5 (submit documentation)
Prescriptive Option — W.S.E.C. Chapter 6 (for prescriptive, complete the following calculation):
House Square Footage (heated space): 7'7 30
X 26 BTU/h
. ?;5
❑ Heating System Installed, (check system type below):
1. ❑ Electric Resistance
2. ❑ Electric (forced air)
3. w- Other Fuels (gas, heat pump)
Maximum BTU of Heating System Output
CITY OF TUKWILA
APPROVED
MAR 1 1 2004
v AS i;ij'i tU
BUILDING DMSION
II. WASHINGTON STATE VENTILATION AND INDOOR AIR QUALITY CODE (select A or B below):
A. ❑ Ventilation by Performance or Design Method - W.S.V.I.A.Q. Section 302 (submit documentation).
B. l Prescriptive Ventilation Options - W.S.V.I.A.Q. Section 303 (select one of the following):
1. ❑ Ventilation using Exhaust Fans (Section 303.4.1.)
❑ Exception for outdoor air inlets — Forced air heating system w /interior doors undercut 1/2"
2. ❑ Ventilation integrated with Forced Air System (Section 303.4.2.)
3. ❑ Ventilation using Supply Fan (Section 303.4.3.)
4. ❑ Ventilation using Heat Recovery System (Section 303.4.4.)
111 Prescriptive Minimum /Maximum Outdoor Air Calculation specified in Table 3 -2 (see reverse side of form).
1. House Square Footage:
2. House Number of Bedrooms:'
3. Required Outdoor Air Table 3 -2: Minimum - tsd cfm
Maximum - / ?(7 cfm
Etfedive: 711102
lapplicalionsl and ventilation system - form h-6 (7.2002)
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Floor
Area, ft2
Bedrooms
0 • •
Maximum Length
Feet
2 or less
3
4
5
6
7
8
70
Min
Max
Min
Max
Min
Max
Min
Max
Min
Max
Min
Max
Min
Max
<500
50
75
65
98
80
120
95
143
110
165
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203
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Fan Tested CFM
0.25" W.G.
Minimum Flex
Diameter
Maximum Length
Feet
Minimum Smooth
Diameter
Maximum Length
Feet
Maximum
Elbows'
50
4 inch
25
4 inch
70
3
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6 inch
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'No':Limih":' :
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15
6 inch
No Limit
3
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TABLE 3 -2
VENTILATION RATES FOR ALL GROUP R OCCUPANCIES FOUR STORIES OR LESS
Minimum and Maximum Ventilation Rates: Cubic Feet Per Minute (CFM)
For residences that exceed 8 bedrooms, increase the minimum requirement listed fo 8 bedrooms by an additional 15 CFM per
bedroom. The maximum CFM is equal to 1.5 times the minimum.
TABLE 3 -
PRESCRIPTIVE EXHAUST DUCT SIZING
1. For each additional elbow subtract 10 feet from length.
2. Flex ducts of this diameter are not permitted with fans of this size.
Effective: 711102
la pplicatlonstheatinp and ventilation system —form h-6 (7.2002)
1 1ti.aa;�., ,..�...y'v' =. .. <<.vc4.... ' :civ,) ..� 1 J... rwY.:-.......,. ed.` i'', L. •:,t;;�.�.,,.,,�4.r.....Se..K.. -.
09 -07 -2004
JOHN JONES
4908 22 AV NE
TACOMA WA 98422
RE: Permit Application No. M03 -217
13355 56 AV S TUKW
Dear Permit Holder:
In reviewing our current records the above noted permit has not received a final inspection by the City of Tukwila Building Division.
Per the International Building Code and/or the International Mechanical Code, every permit issued by the Building Division under the
provisions of this code shall expire by limitation and become null and void if the building or work authorized by such permit is not
commenced within 180 days from the date of such permit, or if the building or work authorized by such permit is suspended or
abandoned at any time after the work is commenced for a period of 180 days.
Based on the above, you are hereby advised to:
Call the City of Tukwila Permit Center at 206 - 431 -3670 to arrange for the next final inspection.
This inspection is intended to determine if substantial work has been accomplished since issuance of the permit or last inspection; or if
the project should be considered abandoned.
If such determination is made, the Building Code does allow the Building Official to approve a one - time extension up to 180 days.
Extension requests must be in writing and provide satisfacton' reasons why circumstances beyond the applicants control have
prevented action from being taken.
In the event you do not call for the above inspection and receive an extension prior to 10/24/2004, your permit will become null and
void and any further work on the project will require a new permit and associated fees.
Thank you for your cooperation in this matter.
Sincerely,
Stefania Spencer,
Permit Technician
xc: Permit File No. M03-217
Bob Benedicto, Building Official
City of Tukwila
Steven M. Mullet, Mayor
Department of Community Development Steve Lancaster, Director
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
September 29, 2004
Jun Castillo
13355 56 Avenue South
Tukwila, WA 98178
City of Tukwila
Department of Community Development Steve Lancaster, Director
RE: Request for Extension — Permit No. M03 -217 —13355 56th Avenue South
Dear Mr. Castillo:
Steven M. Mullet, Mayor
This letter is in response to your written request for an extension to Permit No. M03 -217. Based on the
information received, the City of Tukwila Building Division will be extending your permit to
March 28, 2005.
Please be advised that this will be the only extension granted for this project and no further notice will
be Riven prior to the expiration date. A new permit and associated fees will be required after the
above -noted expiration date.
If you should have any questions, please contact our office at (206) 431 -3670.
Sincer
Robert Benedicto
Building Official
/sks
File: Permit No. M03 -2I7
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206-431-3665
Sep 23 2004 2:41PM HP LASERJET FAX
September 23, 2004
Stefania Spencer
City of Tukwila
Department of Community Development
Tukwila Permit Center
Dear Ms Stefania,
I am requesting an extension to Building Permit No M03 -217. Unfortunately , I did not
anticipate the building process to go beyond 180 days. Mostly due to weather and
untimely scheduling of sub contractors. The building process is well underway. Rough in
for electrical(inspection completed), plumbing, HVAC (inspection completed), gas, and
fire sprinkler system are completed. Exterior shear inspection completed. Final Framing
inspection will be requested the first week of October,
Please respond back to icastillo to confirm the receipt of this fax.
Sincerely,
un
13355 56 Ave So
Tukwila WA 98178
208 - 869 -4783
gi /go do
9 / 26/ of
p. 1
-mss -367
(-c444- 4-AAA—t 6 /V zfr
v C - 1/ '-k -t fzt /
PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: M03 -217 DATE: 12 -19 -03
PROJECT NAME: CASTILLO RESIDENCE
SITE ADDRESS: 13355 56 AVENUE SOUTH
Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter #_ Revision # after /before permit is issued
DEPARTMENTS: 0 14-01
Buildin i isi n Fire Prey tion Planning Division ❑
Public Works ❑ Structural ❑ Permit Coordinator
DETERMINATI N OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 12 -23 -03
Complete Incomplete ❑
Not Applicable ❑
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS RO TING:
Please Route Structural Review Required ❑ No further Review Required ❑
REVIEWER'S INITIALS: DATE:
REVIEWER'S INITIALS:
Documents /routing silp.doc
2.28 -02
PERMIT COORD COPY
DUE DATE: 01 -20 -04
APPROVALS OR CORRECTIONS:
Approved ❑ Approved with Conditions [V] Not Approved (attach comments) ❑
Notation:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
�ldaha
STATE OF
Adc
COUNTY OFD
JOSe (Asti LLO JP- , states as follows:
1. I have made application for a building permit from the City of Tukwila, Washington.
2. I understand that state law requires that all building construction contractors be registered with the
State of Washington. The exceptions to this' requirement are stated under Section 18.27.090 of the
Revised Code Washington, a copy of which is printed on the reverse side of this Affidavit. I have
read or am familiar with RCW 18.27.090.
3. I understand that prior to issuance of a building permit for work which is to be done by any
contractor, the City of Tukwila must verify either that the contractor is registered by the State of
Washington, or that one of the exemptions stated under RCW 18.27.090 applies.
4. In order to provide verification to the City of Tukwila of my compliance with this requirement, I hereby
attest that after reading the exemptions from the registration requirement of RCW 18.27.090, I
consider the work authorized under this building permit to be exempt under No. , and
will therefore not be performed by a registered contractor.
I understand that I may be waiving certain rights that I might otherwise have under state law in any decision to
engage an unregistered contractor to perform construction wo
AFFCONT 1/13/00
CITY OF 4 .CWILA
Permit Center
6300 Southcenter Boulevard, Suite 100, Tukwila, WA 98188
Telephone: (206) 431 -3670
ss.
•
•• • s
•• •i y `�?E p4 1w�
APPLICANT
Ci nLLo .S12 --
s
Signed and sworn to before me this
OT&RY P
re iding at
7
Name as commissioned:
My commission expires:
5 �q•oto
H -4
,2003 .
IC in and for he State of Wa hingten; lhp
County.
" C) 3
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