HomeMy WebLinkAboutPermit D12-013 - TWEET RESIDENCE - GUEST BATHROOMTWEET RESIDENCE
13212 40 AV S
EXPIRED
OS -12 -12
D12-013
City ofitukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Inspection Request Line: 206 -431 -2451
Web site: http://www.TukwilaWAlov
Parcel No.: 7340600881
Address: 13212 40 AV S TUKW
Suite No:
Project Name: TWEET RESIDENCE
DEVELOPMENT PERMIT
Permit Number: D12-013
Issue Date: 02/13/2012
Permit Expires On: 08/11/2012
Owner:
Name: TWEET JONATHAN M +TWEET THERESE G
Address: 13212 40TH AVE S , TUKWILA WA 98168
Contact Person:
Name: SIMON KENNEDY
Address: 9371 53 AV S , SEATTLE WA 98118
Contractor:
Name: RECONSTRUCT REMODEL LLC
Address: 9371 53 AV S , SEATTLE WA 98118
Contractor License No: RECONRL908PH
Lender:
Name:
Address:
Phone: 206 446 -2972
Phone: 206 - 446 -2972
Expiration Date: 10/08/2012
DESCRIPTION OF WORK:
REMODEL OF THE FIRST FLOOR GUEST BATH. REMOVE TUB, VANITY & FLOORING. INSTALL NEW FAN, CONTROL
LIGHT, 2X SCONCE LIGHTS, VANITY, STORAGE, TILE ON FLOOR, AND REPLACE EXISTING WINDOW. (PLUMBING
WORK UNDER SEPARATE PERMIT)
Value of Construction: $10,000.00 Fees Collected: $464.52
Type of Fire Protection: SMOKE DETECTORS International Building Code Edition: 2009
Type of Construction: VB Occupancy per IBC: 0022
Electrical Service Provided by: SEATTLE CITY LIGHT
* *continued on next page **
doc: IBC -7/10
D12 -013 Printed: 02 -13 -2012
Public Works Activities:
Channelization / Striping: N
Curb Cut / Access / Sidewalk / CSS: N
Fire Loop Hydrant: N Number: 0
Flood Control Zone:
Hauling:
Land Altering:
Landscape Irrigation:
Moving Oversize Load:
N
Start Time:
Volumes: Cut 0 c.y.
Start Time:
Size (Inches): 0
End Time:
Fill 0 c.y.
End Time:
Sanitary Side Sewer:
Sewer Main Extension: Private: Public:
Storm Drainage:
Street Use: Profit: N Non- Profit: N
Water Main Extension: Private: Public:
Water Meter: N
Permit Center Authorized Signature:
Date:
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 development permit and agree to the conditions attached
to this permit.
Signature: ------ Q_ ��\ Date: `3- • t 3 • tZ
Print Name:
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.
PERMIT CONDITIONS:
1: ** *BUILDING DEPARTMENT CONDITIONS * **
2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the
Building Official.
3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to
start of any construction. These documents shall be maintained and made available until final inspection approval is
granted.
4: All construction shall be done in conformance with the approved plans and the requirements of the International
Building Code or International Residential Code, International Mechanical Code, Washington State Energy Code.
5: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the City of Tukwila
Building Department (206- 431 - 3670).
6: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building
Department (206- 431 - 3670).
doc: IBC -7/10
D12 -013 Printed: 02 -13 -2012
7: VALIDITY OF PERMIT: The issuance or gra of a permit shall not be construed to be a t for, or an approval of,
any violation of any of the provisions of the biig code or of any other ordinances of the C Tukwila. Permits
presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila
shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the
Building Official from requiring the correction of errors in the construction documents and other data.
doc: IBC -7/10
D12 -013 Printed: 02 -13 -2012
CITY OFTUKTWA
Community Develop t Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http: / /www.TukwilaWA.gov
Buildlmg P tt No U.,f
Project No.
Date Application Accepted
,Date Application Expires
For office use only
CONSTRUCTION PERMIT APPLICATION
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 **
n King Co Assessor's Tax No.:
Site Address: 1 4,01-41 5 t t. z(k_L _ Suite Number: Floor:
Tenant Name: u )CP'f— f es i d eetc -2 New Tenant: ❑ Yes ❑.. No
PROPERTY:, OWNER:.
Name:
I •
Address:
3 7..1av L r k 43 8- 5
City: - `c_tok State: (Z-01 Zip: cletbg
Name: c•-•` C
Address:
c( 371 5e.1 i� 5
City: State: tok Zip: Ip
2q72- -Fax.
— (�[�
Phone: 9 ,� p
Email: �c�'�b
r• ec c 1S� rikA r &OoQ2, ciKn u \• co,v
.GENERAL CONTRACTOR INFORMATION
Company Name: Kk/)_ '-1STWuc-7 4>r OOv`Z 4..e
Address: 7 g yl ,c- 3 d'' 4-69e- .
City: g S tate: 0.J Zip: fil.ri g
S),_terrrr
Phone: ?,q_ 7_172
Contr Reg No.: QeGOM Z`9ce Exp Date: i %�, z
Tukwila Business License No.:
H: Applications'Forms- Applications On Line \2011 Applications\Permit Application Revised - 8- 9- 11.docx
Revised: August 2011
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ARCH ITECT:;OF RECORD`
Company Name:
Architect Name:
City:
State: Zip:
Phone:
E
Fax:
ENGINEER OFRECORIi
k " = " :.
Company Name:
Engineer Name:
Address:
State:
Zip:
City:
State:
Zip:
Phone:
Fax:
• .11:
tNDERfB ®ND
i SiJED (regwared for grojects$5,OUQ or
9- 7;00_ ..,-.., Y k { -
, ., , .., t .. ... r
Ere .. -PC,r
Name:
Address:
City:
State:
Zip:
Page 1 of 4
BUILDING PERMIT INFORMATION 1:206-431-3670.
Valuation of Project (contractor's bid pr $ 1 c7 (5)4a,9
i
Describ the scope of work (please provide detailed information): 4. E7vci7._
Existing lding Valuation: $
.tf' 7— FibP� ' r72.9-z_ 4.–.Ct.4i
s
c-c..,<.1/4-00
rs s
Will there be new rack storage? ❑ ....Yes
•
..No If yes, a separate permit and plan submittal will be required.
Provide All Building Areas in Square Footage,: Below:
Interior Remodel'
Addit►on to °>
Existing
Structure :;=>
Type of
onstruotion per
IBC
Type of
Occupancy.per
;'IBC
2 ac-
'7'o
Floor
Fto6rs
Basement
Accegsory •Siruc
`Detactted-aragi
Attached;-C
Detached !( arpoit°
ec
,,Uncovered'
PLANNING DIVISION:
Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): Floor area of principal dwelling: Floor area of accessory dwelling:
*Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard:
Will there be a change in use?
Compact: Handicap:
❑ Yes ❑ No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
❑ Sprinklers ❑ Automatic Fire Alarm ze None ❑ Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes No
If `yes', attach list of materials and storage locations on a separate 8-1/2" x 11 " paper including quantities and Material S ety Data Sheets.
SEPTIC SYSTEM
❑ On -site Septic System – For on -site septic system, provide 2 copies of a current septic design approved by King County Health
Department.
H:\Applications\Forms- Applications On Line \2011 Applications\Permit Application Revised - 8- 9- 11.docx
Revised: August 2011
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Page 2 of 4
PUBLIC WORKS PERMIT INFORMATION — 206 - 433 -0179
Scope of Work (please provide detailed information):
Call before you Dig: 811
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
Water District
❑ .. Tukwila ❑ ...Water District #125
❑ .. Water Availability Provided
0... Highline
Sewer District
❑ .. Tukwila ❑ ...Valley iew 0... Renton
❑ .. Sewer Use Certificate ❑ ...Sewer ailability Provided
Septic System:
❑ On -site Septic System — For on -site septic sy m, provide 2 copies of a current septic design •roved by King County Health Department.
Submitted with Application (mark boxes which a
❑ .. Civil Plans (Maximum Paper Size — 22" x 34 ")
❑ .. Technical Information Report (Storm Drainage) ❑... Geotechnical • .ort ❑ ...Traffic Impact Analysis
❑ .. Bond ❑... Insurance ❑... Ease t(s) ❑... Maintenanc• greement(s) ❑ ...Hold Harmless — (SAO)
❑ ...Hold Harmless — (ROW)
❑ .. Renton
.. • Se
Proposed Activities (mark boxes that apply):
❑ .. Right -of -way Use - Nonprofit for less than 72 hours
❑ .. Right -of -way Use - No Disturbance
❑ .. Construction/Excavation /Fill - Right -of -way ❑
Non Right -of -way ❑
❑ .. Total Cut
❑ .. Total Fill
cubic yards
cubic yards
❑ .. Sanitary Side Sewer
❑ .. Cap or Remove Utilities
❑ .. Frontage Improvements
❑ .. Traffic Control
❑ .. Backflow Prevention - Fire Protection
Irrigation
Domestic Water
❑... Rig. of -way Use - Profit for less than 72 hours
❑... R' t -of -way Use — Potential Disturbance
Work in Flood Zone
❑. torm Drainage
❑... Abandon .tic Tank
❑... Curb C
❑... Pave . t Cut
0... Loo d Fire Line
❑ .. Permanent Water Meter Size ... WO #
❑ .. Temporary Water Meter Size .. WO #
❑ .. Water Only Meter Size WO # ❑ ...De. t Water Meter Size
❑ .. Sewer Main Extension Pu c ❑ Private ❑
❑ .. Water Main Extension P .lic ❑ Private ❑
0... Grease Interceptor
❑... Channelization
0... Trench Excavation
0... Utility Undergrounding
FINANCE INFORMATION
Fire Line Size at Property Lin
❑ .. Water ■ . Sewer
Monthly Service Billing
Number of Public Fire Hydrant(s)
❑ .. Sewage Treatment
If
Name: Day Telephone:
Mailing Address:
City State Zip
Water Meter Refund/Billing:
Name:
Mailing Address:
Day Telephone:
City
State Zip
H'. \Applications\Forms- Applications On Line\2011 Applications\Permit Application Revised - 8-9-11 docx
Revised. August 2011
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Page 3 of 4
IPERMIT APPLICATION NOTES
Value of Construction — In all cases, a value construction amount should be entered by the appt,.snt. 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 grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be
requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition).
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO 13E TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING O 'ER
Signature:
IZED T:
Print Name: S,. k-1 rya
Mailing Address:
11 \ Applications \Forms - Applications On Line \2011 ApplicationsWermit Application Revised - 8-9-11 docx
Revised: August 2011
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Day Telephone:
JtZ
City
Date: / • /2.--
• i Z
Z f- 6 z. -g72,
63 :teat
St� te a Zip f .
Page 4 of 4
Citygf Tukwila
Permit Center
6300 Southcenter Boulevard, Suite, 100
Tukwila, WA 98188
(206 431 -3670)
Application #
ALTERNATE PLAN SUBMITTAL AUTHORIZATION
FOR LIMITED SCOPE OF WORK
I.B.C.& I.R.C. Section 104.1
Project name TO , h4 ,.� 17,t, �..�
Address / 3 7 -/ 7 110 74-- Atie (cd , CITY EC L)
CA
Description of work /3e:( j.16 JAN'l 7 2012
Related reference number
PR
The above project permit applicant, due to the limited scope of work is authorized to submit reduced
plan requirements described below.
1. Complete permit application required: (Note, all application must include; 1) property assessor
number, 2) copy of contractors license or completed owner waiver form.)
Building Mechanical Other P /CS ,6,%
�J
2. Minimum plan and /or specification requirement:
Site plan Floor plan Elevations Foundation
Cross sections
Roof plan W.S.E.C. Compliance
Narrative
Structural calculations (stamped by Washington State licensed engineer )
Specific required information
3. Other special instructions:
s)-7m / 12.7
)70-
Authorization by,
TBD36/96 -form 12
Date /0—/7"-1)
(Authorization void 30 days after the date is ued.)
•
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206 - 431 -3665
Web site: http: / /www.TukwilaWA.gov
Parcel No.: 7340600881
Address: 13212 40 AV S TUKW
Suite No:
Applicant: TWEET RESIDENCE
RECEIPT
Permit Number: D12 -013
Status: APPROVED
Applied Date: 01/17/2012
Issue Date:
Receipt No.: R12 -00608
Payment Amount: $283.30
Initials: WER Payment Date: 02/13/2012 11:08 AM
User ID: 1655 Balance: $0.00
Payee: RECONSTRUCT REMODEL
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd VISA
RD Pmts Re -Dist OP
Authorization No. 110070
ACCOUNT ITEM LIST:
Description
283.30
.00
Account Code Current Pmts
BUILDING - RES
PLAN CHECK - NONRES
PLAN CHECK - RES
STATE BUILDING SURCHARGE
000.322.100
000.345.830
000.345.830
640.237.114
Total: $283.30
278.80
- 181.22
181.22
4.50
doc: Receiot -06 Printed: 02 -13 -2012
•
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206 - 431 -3665
Web site: http: / /www.TukwilaWA.ov
Parcel No.: 7340600881
Address: 13212 40 AV S TUKW
Suite No:
Applicant: TWEET RESIDENCE
RECEIPT
Permit Number: D12 -013
Status: PENDING
Applied Date: 01/17/2012
Issue Date:
Receipt No.: R12 -00166
Initials:
User ID:
LAW
1632
Payment Amount: $181.22
Payment Date: 01/17/2012 03:05 PM
Balance: $283.30
Payee: RECONSTRUCT REMODEL LLC
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd VISA
Authorization No. 110844
ACCOUNT ITEM LIST:
Description
181.22
Account Code Current Pmts
PLAN CHECK - NONRES
000.345.830 181.22
Total: $181.22
doc: Receiot -06 Printed: 01 -17 -2012
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
D r� v
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451 F
Project: `_
1 t Al e Pmt fie- :6erA
Type f- Inspection%
., f' (' P\ n
Address: Ye..
/32_12;:::_ 4o "L
Date Called:
.--_
Special Instructions:
R om /` I Sr_ �vJ2
Sep- pci ,tt i
Date Wanted:. (tea •
% j �'( �. P.m.
Requester:
Phone
2 1 4 / L
Gam' '' � (p -24'7
ElApproved per applicable codes. Corrections required prior to approval.
COMMENTS:
P `$ » . Ali De-6 if_; lj
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Inspector: Date:
❑ REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
SEPARATE PER'AIT
REQUIRED FOR:
itl Mechanical
10 Electrical
Plumbing
Gas Piping
City of Tukwila
,BUILDING DIVISION
Replace existing window
with a double pane unit
Install
medicine
cabinet above
toilet
Replace existing
vanity
REVISIONS
No changes hall be made to the scope
of wor I( without prior approval of
Tukwila Building Division.
NOTE: Revis ons will require a new plan submittal
and may include additional plan review fees.
Remove existing tub and replace
with a custom shower,
Sconce Lights
to either side of
mirror over
vanity
Install floor to ceiling
cabinet.
&Prey
thc viol
of
Scope otWorks:
D_emolition:
Remove Tub, Remove drop down ceiling, Remove plywood
sheeting from all interior walls with the exception of the exterior
wall
Electrical:
Bring 2 new circuits into the bathroom. 1--heater 2= fan, light
3= GFCI
Replace fan, replace central Light, install 2 sconces to either side of
vanity mirror, install receptacle in floor to ceiling cabinet, install
additional receptacle for the vanity, replace heater.
Plumbing:
Install shower mixer and drain.
Other:
Install custom shower, install new valty, sheetrock and plaster walk
and ceiling, install new window, tile floor, paint, install medicine
cabinet, install floor to ceiling cabinet.
FILE COPY
ft No. "O\
ew approval is stied to etngs and oinfssfons.
1 of construction documents does not authcizo
of any adopted code or ordinance. Receipt
is adcnowledpd:
City OrIkitcwila
BUILDING DIVISION
REVIEWED FORCODE COMPLIAN E
1 (
APPROVED
FEB 08 2012
• OL
City of Mcwila
BUILDING DIVISION
Kivt.
,CrTY OF TUKWILA
JAN 1 7 2012
PERMIT CENTER
IT- IS
Remodel of the front of Hoses first floor both.
1 321 2 40th AVO STolovilo WA 98168
_
_ _
REVISIONS
:)1111-- 347
R EMARKS_
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-
a. ,
IMlace's Bird Bath
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REVIEWED FOR
CODE COMPLIANCE
APPROVED
FEB 08 2012
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Remodel of the front of houes first floor bath.
13212 40th Ave STukwilo WA 98168
REVISIONS
I
,
) ECQ NSTRU CT
ES,19,9R-2
REMARKS
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2
Malace's Bird Bath
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8.12 10/11/11
vv IIVVvwv. , YVVRJ R it,'.'.n- ••■••
NH - Melissa Kendrick
* ** PRICES LISTED IN USD * **
QUOTE: 00000001
QTY: 1 MARK UNIT -
INTEGRITY AWNING - ROTO OPERATING
WOOD INTERIOR - ULTREX EXTERIOR SERIES
CALL NUMBER 4127
ROUGH OPENING 41" X 27 5/8" .0616 ° 40 '`X z.-
INSULATED GLASS - 1 LITE
-LOW E II WITH ARGON
—OIL RUBBED BRONZE HARDWARE
-BINTERIOR SCREEN
ARE WOOD- VENEER SURROUND
CHARCOAL FIBERGLASS MESH
NAILING FIN .
4.9/16" JAMBS
.BARE PINE INTERIOR
STONE WHITE EXTERIOR
■
A
PAGE 1
FILE COPY
Pr°T pA P On.
AS VIEWED FROM THE EXTERIOR
REVIEWED FOR
CODE COMPLIANCE
APPROVED
FEB 0 8 2012
City of
Tukwila
LDING DIVISION
BUI
SUB TOTAL:
9.500% SALES TAX:
PROJECT TOTAL PRICE:
578.88
54.99
633.87
CONTINUED ON NEXT PAGE
14&[16sa Ve/KAgick
13a1a Lfo"` A-vc-s
WA 9.08
206— 19O4-2206
CITY OF Titvi ALA
JAN 17 2012
PERMIT CENTER
Pl2 015
Instructions for Recipient
Recipient's identification number. For your protection, this form may show
only the last four digits of your social security number (SSN), individual taxpayer
identification number (ITIN), or adoption taxpayer identification number (ATIN).
However, the issuer has reported your complete identification number to the IRS
and, where applicable, to state and /or local governments.
Account number. May show an account or other unique number the payer
assigned to distinguish your account.
Amounts shown may be subject to self- employment (SE) tax. If your net
income from self - employment is $400 or more, you must file a return and
compute your SE tax on Schedule SE (Form 1040). See Pub. 334 for more
information. If no income or social security and Medicare taxes were withheld
and you are still receiving these payments, see Form 1040 -ES (or
Form 1040- ES(NR)). Individuals must report these amounts as explained in the
box 7 instructions on this page. Corporations, fiduciaries, or partnerships must
report the amounts on the proper line of their tax returns.
Form 1099 -MISC incorrect? If this form is incorrect or has been issued in error,
contact the payer. If you cannot get this form corrected, attach an explanation
to your tax return and report your income correctly.
Box 1. Report rents from real estate on Schedule E (Form 1040). However,
report rents on Schedule C (Form 1040) If you provided significant services to
the tenant, sold real estate as a business, or rented personal property as a
business.
Box 2. Report royalties from oil, gas, or mineral properties, copyrights, and
patents on Schedule E (Form 1040). However, report payments for a working
interest as explained in the box 7 instructions. For royalties on timber, coal, and
Iron ore, see Pub. 544.
Box 3. Generally, report this amount on the "Other income" line of Form 1040
(or Form 1040NR) and Identify the payment. The amount shown may be
payments received as the beneficiary of a deceased employee, prizes, awards,
taxable damages, Indian gaming profits, or other taxable income. See Pub. 525.
If it is trade or business income, report this amount on Schedule C or F (Form
1040).
Box 4. Shows backup withholding or withholding on Indian gaming profits.
Generally, a payer must backup withhold if you did not fumish your taxpayer
identification number. See Form W -9 and Pub. 505 for more information. Report
this amount on your income tax retum as tax withheld.
Box 5. An amount in this box means the fishing boat operator considers you
self- employed. Report this amount on Schedule C (Form 1040). See Pub. 334.
Box 6. For individuals, report
(Fo ma1040).
Box 7. Shows nonemployee c•inpens:.io If are in tl rade o
catching fish, box 7 may sho r ash y•,- r eive'd u fore sale of fish.
amount in this box is SE Inco. r; , _ • .rt it Scheetti QC or F (Form
complete Schedule SE (Form '40). You received this form instead of Form W -2
because the payer did not consider you an employee and did not withhold
income tax or social security and Medicare tax. If you believe you are an
employee and cannot get the payer to correct this form, report the amount from
box 7 on Form 1040, line 7 (or Form 1040NR, line 8). You must also complete
Form 8919 and attach it to your return. If you are not an employee but the
amount in this box is not SE income (for example, it is income from a sporadic
activity or a hobby), report it on Form 1040, line 21 (or Form 1040NR, line 21):
Box 8. Shows substitute payments in lieu of dividends or tax- exempt interest {
received by your broker on your behalf as a result of a loan of your securities.
Report on the "Other income' line of Form 1040 (or Form 1040NR),
Box 9. If checked, $5,000 or more of sales of consumer products.was paid to
you on a buy -sell, deposit- commission, or other basis. A dollar amount does not
have to be shown. Generally, report any income from your sale of these
products on Schedule C (Form 1040).
Box 10. Report this amount on Schedule F (Form 1040).
Box 13. Shows your total compensation of excess golden parachute payments
subject to a 20% excise tax. See the Form 1040 (or Form 1040NR) instructions
for where to report.
Box 14. Shows gross proceeds paid to an attomey in connection with legal
services. Report only the taxable part as income on your retum.
Box 15a. May show current year deferrals as a nonemployee under a
nonqualified deferred compensation (NQDC) plan that is subject to the
requirements of section 409A, plus any earnings on current and prior year
deferrals.
Box 15b. Shows income as a nonemployee under an NQDC plan that does not
meet the requirements of section 409A. This amount is also included in box 7 as
nonemployee compensation. Any amount included in box 15a that is currently
taxable is also included in this box. This income is also subject to a substantial
additional tax to be reported on Form 1040 (or Form 1040NR), See "Total Tax"
in the Form 1040 (or Form 1040NR) instructions.
Boxes 16-18. Shows state or local income tax withheld from the payments.
tv
•
•
•
•
•
ERMIT COORD COPS
PLAN REVIEW /1tOUTING SLIP
ACTIVITY NUMBER: D12 -013
PROJECT NAME: TWEET REMODEL
DATE: 02/17/12
SITE ADDRESS: 13212 40 AV S
X Original Plan Submittal
Response to Incomplete Letter #
Response to Correction Letter # Revision # after Permit Issued
DEPARTMENTS:
Building Division
Public Works
Fire Prevention
❑ Structural
Planning Division
Permit Coordinator
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
Incomplete
DUE DATE: 01/19/12
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 ROUTING:
Please Route Structural Review Required
REVIEWER'S INITIALS:
No further Review Required
DATE:
APPROVALS OR CORRECTIONS:
DUE DATE: 02/16/12
Approved Approved with Conditions ,PJ Not Approved (attach comments)
Notation:
REVIEWER'S INITIALS:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
Documents /routing slip.doc
2 -28 -02
Contractors or Tradespeople Peer Friendly Page
•
General /Specialty Contractor
A business registered as a construction contractor with L &I to perform construction work within the scope of
its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of
account and carry general liability insurance.
Business and Licensing Information
Name RECONSTRUCT REMODEL LLC UBI No. 603051726
Phone 2064462972 Status Active
Address 9371 53Rd Ave S License No. RECONRL908PH
Suite /Apt. License Type Construction Contractor
City Seattle Effective Date 10/8/2010
State WA Expiration Date 10/8/2012
Zip 98118 Suspend Date
County King Specialty 1 General
Business Type Limited Liability Company Specialty 2 Unused
Parent Company
Business Owner Information
Name
Role
Effective Date
Expiration Date
KENNEDY, SIMON CLIVE
Partner /Member
10/08/2010
Bond Information
Page 1 of 1
Bond
Bond Company Name
Bond Account Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Bond Amount
Received Date
1
CBIC
SI7597
10/01/2010
Until Cancelled
$12,000.00
10/08/2010
Assignment of Savings Information No records found for the previous 6 year period
Insurance Information
Insurance
Company Name
Policy Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Amount
Received Date
2
Contractors
Bonding a
Insuranc
C11S17597
10/01/2011
10/01/2012
$500,000.00
10/11/2011
1
CBIC
C11517597
10/01/2010
10/01/2011
$500,000.00
10/08/2010
Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period
Warrant Information No unsatisfied warrants on file within prior 6 year period
https: // fortress .wa.gov /lni/bbip/Print.aspx 02/13/2012
1
Written dimensions on this drawing shall have precedence over
scaled dimensions. Contactor shall verify all dimensions,
conditions, etc., pertaining to the work before proceeding.
The Owner must be notified of any variations from the
dimensions and /or conditions shown on these drawings. Any
such variation shall be resolved by the Owner prior to
proceeding with the work, or the Contractor shall accept
full responsibility for the cost to rectify same.
12'-0"
ADDITION
ELEVATOR NOTES: !NALL LEC'END
DO NOT FRAME ELEVATOR SHAFT
UNTIL APPROVED ELEVATOR
SHOP DRAWINGS ARE RECEIVED
AND REVIEWED BY THE CONTRACTOR.
EXISTING
EXISTING TO REMAIN
EXISTING TO REMOVE
IMEREME NEW WALL
NOTES:
ALL EXTERIOR WARM WALLS TO SE
2 X 6 STUDS ® 16" O.G. TYPICAL.
ALL HEADERS TO BE 4 X 10 DF 4t2
UNLESS NOTED OTHERWISE.
FUR -OUT HEADERS TO MATCH 2 X 6
WALLS.
SOLID BLOCKING UNDER ALL BEARING
WALLS.
TUB /SHOWER UNITS SHALL HAVE FIRE
BLOCKING BETWEEN WALL STUDS AND
WATERPROOF SURROUNDS TO +12"
FROM DRAIN. GLAZING, INCLUDING
WINDOWS WITHIN +72" OF DRAIN,
SHALL BE SAFETY GLASS. SHOWER
FLOW IS LIMITED TO 3 GAL/MIN.
6' -6„
6
#6
ELEC..
METER
iB -S 4x12
BEDROOM
COVERED
PORCH
0
1-
I I REFG OVEN
K I TGHEN
DINING ROOM
COOKTOP
V.T.O.
7,
12' -0"
EXISTING
ADDITION
CITY o t'T(i
7 2012
PERMIT CENTER
p12 -�13
MAIN LOO FLAN
SEE GENERAL NOTES SCALE: 1/4" = 1 ' -0"
ti
GA}fTH6MAS NASH
STATE OF WASHINGTON
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date :
01-26-01
permit : 02 -25 -02
revisions:
00 -00 -00
RECEIVED
CiTY OF TUKWILA
MAR 0 7 2002
PERMIT CENTER
drawn by: LGV
checked by:
4
O1
?�4
AC-11