HomeMy WebLinkAboutPermit D13-095 - AMERICA'S BEST VALUE - TENANT IMPROVEMENTAMERICA'S BEST VALUE
14800 INTERURBAN AV S
D13-095
City oikukwila
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.TukwilaWA.gov
DEVELOPMENT PERMIT
Parcel No.: 3597000005
Address: 14800 INTERURBAN AV S TUKW
Suite No:
Project Name: AMERICA'S BEST VALUE
Permit Number: D13-095
Issue Date: 03/14/2013
Permit Expires On: 09/10/2013
Owner:
Name: KRUSSEL ROBERT H+ARLENE C
Address: 18107 NORMANDY TER SW , NORMANDY PARK WA 98166
Contact Person:
Name: JOAN KRUSSEL
Address: 14800 INTERURBAN AV S , TUKVVILA WA 98168
Phone: 206-431-6191
Contractor:
Name: OWNER AFFIDAVIT - JOAN KRUSSEL Phone:
Address: ,
Contractor License No: Expiration Date:
Lender:
Name:
Address:
DESCRIPTION OF WORK:
REISSUANCE OF EXPIRED PERMIT D12-055. 2 INSPECTIONS ONLY (GLAZING AND FINAL).
REPAIR FIRE DAMAGE TO (2) UNITS
Value of Construction: $0.00 Fees Collected: $130.50
Type of Fire Protection: AFA International Building Code Edition: 2009
Type of Construction: V -B Occupancy per IBC: 0020
Electrical Service Provided by: PUGET SOUND ENERGY
**continued on next page**
doc: IBC -7/10
D13-095 Printed: 03-14-2013
Public Works Activities:
Channelization / Striping: N
Curb Cut / Access / Sidewalk / CSS: N
Fire Loop Hydrant: N Number: 0
Flood Control Zone:
Hauling: N Start Time: End Time:
Land Altering: Volumes: Cut 0 c.y. Fill 0 c.y.
Landscape Irrigation:
Moving Oversize Load: Start Time: End Time:
Size (Inches): 0
Sanitary Side Sewer:
Sewer Main Extension: Private: Public:
Storm Drainage:
Street Use: Profit: N Non -Profit: N
Water Main Extension: Private: Public:
Water Meter:
Permit Center Authorized Signature:
N
Date: 3~ 1 L_.
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 r = -•.'t.
Print Name:
Date:
This permit shall become null and vo'd 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 mechanical work shall be inspected and approved under a separate permit issued by the City of Tukwila Permit Center
(206/431-3670).
4: 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.
5: 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.
6: Water heaters shall be anchored or strapped to resist horizontal displacement due to earthquake motion. Strapping shall
be at points within the upper one-third and lower one-third of the water heater's vertical dimension. A minimum
distance of 4 -inches shall be maintained above the controls with the strapping.
doc: IBC -7/10
D13-095 Printed: 03-14-2013
7: All plumbing and gas piping work shall bepected and approved under a separate persued by the City of Tukwila
Building Department (206-431-3670).
8: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building
Department (206-431-3670).
9: VALIDITY OF PERMIT: The issuance or granting of a permit 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 ordinances of the City of 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
D13-095 Printed: 03-14-2013
CITY OF TUKWA
Community Developm,..,t Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
Building Per No.
T'
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**
SITE LOCATION
I \ �/� {� p 1n ,n 7� Kin a Co Assessor's Tax No.:
Site Address:_`"(1�Boo 1 t { 1 1 f.O 1`, r✓ (r ' C/ 1 ° Suite Number: Floor:
Tenant Name: l T y\ ,A (. \ s y)6. V (A l ,. New Tenant: ❑ Yes No
PROPERTY OWNER
f �/ J
Name: M i ujfi /
Address: ii..ii00 \��,y, �!n/ j
�t�
Name: Otf\ (IN /t0
-i ( J }
e 1
1 ' u ire
Address: ,t11)1- , whoa l
Architect Name:
( T "
City: NAW1 91.,_ State/.
Address:
Zip/
11
CONTACT PERSON — person receiving all project
communication
f �/ J
Name: M i ujfi /
Address: ii..ii00 \��,y, �!n/ j
�t�
City: jIVJ State: Zip
1
Phone: 1* (4 3) (pJ (4/ Fax: obouc,zii to, % IAA
Email: -IT
co KiKati e »7G111 1 )
GENERAL CONTRACTOR INFORMATION
Company Name: Jo
iv
K /)
Company Name:
Address: (pAvtO j f�
copitiZzo)City:
(State:
Architect Name:
Address:
Phone:
Fax:
City:
Contr Reg No.:
Zip:
Exp Date:
Tukwila Business License No.:
Email:
H.\Applications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12. docx
Revised: February 2012
bh
ARCHITECT OF RECORD
Name:
Address:
Company Name:
Architect Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
ENGINEER OF RECORD
Name:
Address:
Company Name:
Engineer Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
LENDER/BOND ISSUED (required for projects $5,000 or
greater per RCW 19.27.095)
Name:
Address:
City: State: Zip:
Page 1 of 4
BiUILDINGPERMIT INFORMATION'_ 206 431=3670
w
Valuation of Project (contractor's bid price): $ 10
w
Existing Building Valuation: $ / (P).
Describe he scope of o k� lease provide detailed nfO� �on):
`\,hVl �� IWq // l)
�lUn
toC )1Y M°
(BS C.')
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
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? 0 Yes
FIRE PROTECTION/HAZARDOUS MATERIA
Compact: Handicap:
0 No If "yes", explain:
O Sprinklers )j Automa
O None 0 Other (specify)
Will there be storage or use of flammable, combustib e or azardous materials in the building? 0 Yes No
If `yes', attach list of materials and storage locations on a separate 8-1/2" x 11 " paper including quantities and Material Saf Data Sheets.
SEPTIC SYSTEM
O On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health
Department.
H:Wpplications\Forms-Applications On Line \2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 2 of 4
Existing
Interior model
Addition to ,''
Existing '
Structure
New
Type of
Construction per
IBC
. , Type of:
Occupancy per
` IBC •
151 Floor
..
/
i
2"d Floor• ..
3`d Floor
Floors , ' th'ni '
'
Basement
Accessory Structure*
Attached Garage
Detached Garage
Attached Carport
Detached.Carport
Covered, Deck
Uncovered Deck
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? 0 Yes
FIRE PROTECTION/HAZARDOUS MATERIA
Compact: Handicap:
0 No If "yes", explain:
O Sprinklers )j Automa
O None 0 Other (specify)
Will there be storage or use of flammable, combustib e or azardous materials in the building? 0 Yes No
If `yes', attach list of materials and storage locations on a separate 8-1/2" x 11 " paper including quantities and Material Saf Data Sheets.
SEPTIC SYSTEM
O On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health
Department.
H:Wpplications\Forms-Applications On Line \2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 2 of 4
PERMIT APPLICATION NOTES 0
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 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).
I 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, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER UTHORIZED AGENT:
Signature:
Print Name: ��" ( Jraffi
Date:
Day Telephone: Z01j2 7 ✓ /
Mailing Address:
)14 -loo 1410Aeih4,7
i,uit 06/ 0-/
H:Wpplicanons\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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City
State
Zip
Page 4 of 4
PUBLIC :WORKS PERMIT -INFO TION 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 0 ...Water District #125
❑ .. Water Availability Provided
Sewer District
❑ .. Tukwila
❑ .. Sewer Use Certificate
❑... Highline
❑ ...Valley View 0...Renton
❑ ...Sewer Availability Provided
0... Renton
0... Seattle
Septic System:
0 On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health Department.
Submitted with Application (mark boxes which apply):
❑ .. Civil Plans (Maximum Paper Size — 22" x 34")
❑ .. Technical Information Report (Storm Drainage)
❑ .. Bond 0...Insurance ❑... Easement(s)
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 0
❑ .. Total Cut
❑ .. Total Fill
cubic yards
cubic yards
❑... Geotechnical Report
0...Maintenance Agreement(s)
❑ .. Traffic Impact Analysis
❑ .. Hold Harmless — (SAO)
❑ .. Hold Harmless — (ROW)
O ...Right-of-way Use - Profit for less than 72 hours
0... Right-of-way Use — Potential Disturbance
O ...Work in Flood Zone
O ...Storm Drainage
❑ .. Sanitary Side Sewer ❑... Abandon Septic Tank 0...Grease Interceptor
❑ .. Cap or Remove Utilities 0...Curb Cut ❑... Channelization
O .. Frontage Improvements ❑... Pavement Cut 0...Trench Excavation
❑ .. Traffic Control 0...Looped Fire Line 0...Utility Undergrounding
O .. Backflow Prevention - Fire Protection "
Irrigation
Domestic Water
❑ .. Permanent Water Meter Size (1)
❑ .. Temporary Water Meter Size (1)
❑ .. Water Only Meter Size
❑ .. Sewer Main Extension Public
❑ .. Water Main Extension Public
WO # (2) " WO # (3) " WO #
WO # (2) " WO # (3) " WO #
WO # ❑ .. Deduct Water Meter Size "
Private ❑
Private 0
FINANCE INFORMATION
Fire Line Size at Property Line Number of Public Fire Hydrant(s)
O .. Water
0 .. Sewer ❑ .. Sewage Treatment
Monthly Service Billing to:
Name: Day Telephone:
Mailing Address:
City
State Zip
Water Meter Refund/Billing:
Name: Day Telephone:
Mailing Address:
City
State Zip
H:\Applications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 3 of 4
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
RECEIPT
Parcel No.: 3597000005 Permit Number: D13-095
Address: 14800 INTERURBAN AV S TUKW Status: PENDING
Suite No: Applied Date: 03/14/2013
Applicant: AMERICA'S BEST VALUE Issue Date:
Receipt No.: R13-01048
Payment Amount: $130.50
Initials: WER Payment Date: 03/14/2013 02:59 PM
User ID: 1655 Balance: $0.00
Payee: JOAN KRUSSEL
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd VISA
Authorization No. 055777
ACCOUNT ITEM LIST:
Description
130.50
Account Code Current Pmts
BUILDING - NONRES
STATE BUILDING SURCHARGE
000.322.100 126.00
640.237.114 4.50
Total: $130.50
orcn*e,1• nz_le_)n1z
At
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDINGS DIVISION
(206) 431-3670
6300 Southcenter Blvd., #100, Tukwila. WA 98188
Permit Inspection Request Line (206) 431-2451
Project:
A, -`• (A.'
Q. IA
Type of I spectio 1
(�nG
\'
Adds
nJ Ji-
Date 011e-
NnAC_.-
y
O _.
Special Instructions:
Date Wanted:
13
a.m.
p.m.
Requester:
Phone No:
2JApproved per applicable codes.
Corrections required prior to approval. 4
COMMENTS:
n,p1�
-/AA-4;17
1\
Date --3
Inspictor:CAA
n REINSPECTION FEE REQUIRED. Pr'or to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100.,Call to schedule reinspection.
INSPECTION RECORD
Retain a copy with permit.
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION,./K
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
Project:' \,. 1/4.��i
,4\ i‘€J cA s 5 s J,�j
Type of Inspection:,,
/ c it� . A6
Address:
1 1"5-'00
,,,__
c-Cri/jr /
Date Called:
Special Instructions:
Date Wanted "e�--5 -1 3
a.m.
C n
Requester:
Phone No:
9A( -24(/-2323
Approved per applicable codes.
11 Corrections required prior to approval.
COMMENTS:
� T r _ , 1-- t/�1-41_,>/re
Inspector:
Date:
ri REINSPECTION FEE REQ 1RED. Prior to next inspection, fee must be
paid at 6300 Southcente /Blvd.. Suite 100. Call to schedule reinspection.
•
CITY OF TUKWILA
Department of Community Development
6300 Southcenter Boulevard, Tukwila, WA 98188
Telephone: (206) 431-367o FAX (206) 431-3665
E-mail: tukplan@ci.tukwila.wa.us
Permit Center/Building Division
206 431-3670
Public Works Department
206 433-0179
Planning Division
206 431-3670
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
STATE OF WASHINGTON)
) ss.
COUNTY OF KING )
OZ \L'AA Sal
[please print name]
, states as follows:
PERMIT NO: 13 s-
1.
1. I have made application for a 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 of 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 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 requiremeiit of RCW 18.27.090,
I consider the work authorized under this permit to be exempt under number I , and will therefore
not be performed by a registered contractor.
5. I understand that the licensing provision of RCW 19.28.161 through 19.28.271 shall not apply to
persons making electrical installations on their own property or to regularly employed employees
working on the premises of their employer. The proposed electrical work is not for the construction
of a new building for rent, sale or lease.
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 work.
wne
wner's Agent*
Signed and sworn to before me this
day of ,2013
NOTARY PUBLIC in and for the State of Washington
Residing at
, County
Name as commissioned:AA.... r1 � .tuck
My commission expires: ID 19,- ca -e))5
•
18.27.090 Exemptions. The registration provisions of this chapter do not apply to:
1. An authorized representative of the United States
government, the state of Washington, or any incorporated
city, town, county, township, irrigation district, reclamation
district, or other municipal or political corporation or
subdivision of this state;
2. Officers of a court when they are acting within the scope
of their office;
3. Public utilities operating under the regulations of the
utilities and transportation commission in construction,
maintenance, or development work incidental to their own
business;
4. Any construction, repair, or operation incidental to the
discovering or producing of petroleum or gas, or the
drilling, testing, abandoning, or other operation of any
petroleum or gas well or any surface or underground mine
or mineral deposit when performed by an owner or lessee;
5. The sale of any finished products, materials, or articles of
merchandise that are not fabricated into and do not become
a part of a structure under the common law of fixtures;
6. Any construction, alteration, improvement, or repair of
personal property performed by the registered or legal
owner, or by a mobile/manufactured home retail dealer or
manufacturer licensed under chapter 46.70 RCW who shall
warranty service and repairs under chapter 46.70 RCW;
7. Any construction, alteration, improvement, or repair
carried on within the limits and boundaries of any site or
reservation under the legal jurisdiction of the federal
government;
8. Any person who only furnished materials, supplies, or
equipment without fabricating them into, or consuming
them in the performance of, the work of the contractor;
9. Any work or operation on one undertaking or project by
one or more contracts, the aggregate contract price of
which for labor and materials and all other items is Less
than five hundred dollars, such work or operations being
considered as of a casual, minor, or inconsequential nature.
The exemption prescribed in this subsection does not apply
in any instance wherein the work or construction is only a
part of a larger or major operation, whether undertaken by
the same or a different contractor, or in which a division of
the operation is made into contracts of amounts less than
five hundred dollars for the purpose of evasion of this
chapter or otherwise. The exemption prescribed in this
subsection does not apply to a person who advertises or
puts out any sign or card or other device which might
indicate to the public that he or she is a contractor, or that
he or she is qualified to engage in the business of
contractor;
10. Any construction or operation incidental to the
construction and repair of irrigation and drainage ditches
of regularly constituted irrigation districts or reclamation
districts; or to farming, dairying, agriculture, viticulture,
horticulture, or stock or poultry raising; or to clearing or
other work upon land in rural districts for fire prevention
purposes; except when any of the above work is performed
by a registered contractor;
11. An owner* who contracts for a project with a registered
contractor, except that this exemption shall not deprive the
owner of the protections of this chapter against registered
and unregistered contractors. The exemption prescribed in
this subsection does not apply to a person who performs
the activities of a contractor for the purpose of leasing or
selling improved property he or she has owned for less than
twelve months;
12.* Any person working on his or her own property,
whether occupied by him or her or not, and any person
working on his or her personal residence, whether owned
by him or her or not but this exemption shall not apply to
any person who performs the activities of a contractor on
his or her own property for the purpose of selling,
demolishing, or leasing the property;
13. An owner* who performs maintenance, repair, and
alteration work in or upon his or her own properties, or
who uses his or her own employees to do such work;
14. A licensed architect or civil or professional engineer
acting solely in his or her professional capacity, an
electrician certified under the laws of the state of
Washington, or a plumber certified under the laws of the
state of Washington or licensed by a political subdivision of
the state of Washington while operating within the
boundaries of such political subdivision. The exemption
provided in this subsection is applicable only when the
person certified is operating within the scope of his or her
certification;
15. Any person who engages in the activities herein
regulated as an employee of a registered contractor with
wages as his or her sole compensation or as an employee
with wages as his or her sole compensation;
16. Contractors on highway projects who have been
prequalified as required by RCW 47.28.070, with the
department of transportation to perform highway
construction, reconstruction, or maintenance work;
17. A mobile/manufactured home dealer or manufacturer
who subcontracts the installation, set-up, or repair work to
actively registered contractors. This exemption only applies
to the installation, set-up, or repair of the
mobile/manufactured homes that were manufactured or
sold by the mobile/manufactured home dealer or
manufacturer;
�rlJrdJllr,t�,�^
18. An entity who holds a lvdlidteleat lcal.contractor' s
license under chapter `084Z'CW Vrip tit's a certified
journeyman electricia1046Siteq'entiApecialty
electrician, or an electricallttain,ee.meetin t e
requirements of chapter i'9"r28'RCW to pe rm plumbing
work that is incidentally, directly, and imn diately
appropriate to the li)ze-injkind,reglacemenio ailiousehold
appliance or other smalrhousel-ii$9 utilization d'quipment
that requires limited electr'ic;power and=limited waste
and/or water connections:,Ante}"ca�trajnee must
be
supervised bya certified eleetri��ilePerforming
plumbing work.
" Per Washington State Department of Labor and Industries lessee has
been interpreted to be equivalent to owner for purposes of exemptions.