HomeMy WebLinkAboutPermit D19-0160 - SHANNON RESIDENCE - ADU AMNESTYSHANNON ADU
4526 S 14OTh ST
WITHDRWN/CANCEL
D19-0160
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Parcel No:
Address:
Project Name:
�~^�xx ^�� Tukwila
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Department of Community Development
630VSouthcenterBoulevard, Suite #1OU
Tukwila, Washington 9Q1Qg
Phune:3n6'u31'3670
Inspection Request Line: 206'438'9D5O
Web site: http://www.TukwilaWA.gov
DEVELOPMENT PERMIT
7347600647 Permit Number: D19'0160
45265140TH5T
SHANNONADU
Issue Date: 5/16/2019
Permit Expires On: 11/12/2018
Owner:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
License No:
Lender:
452GS14OTM5T,TUKVY|U\WA,
98168
FRAN[|S SHAwmQN
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Phone:
Expiration Date:
DESCRIPTION OFWORK:
ADU AMNESTY
Project Valuation: $10000
Type ofFire Protection: Sprinklers:
Fire Alarm:
Type ofConstruction: VB
Electrical Service Provided by: TUKWILA
Fees Collected: g27.50
Occupancy per IBC: R-3
Water District: 125
SewerDbthct: VALLEYV|Bw
Current Codes adopted bythe City ofTukwila:
International Building Code Edition:
International Residential Code Edition:
International Mechanical Code Edition:
Uniform Plumbing Code Edition:
International Fuel Gas Code:
2015
2015
2015
2015
2015
National Electrical Code:
vVACities Electrical Code:
YVACZ96-40B:
Code:
ublic Works Activities:
Channel ioadon/Striping:
Cvrb[ut/Acces$Sidewa|k:
Fire Loop Hydrant:
Flood Control Zone:
Hau|inQ/OveoizeLnad:
Land Altering: Volumes: Cut: 0 Fill: O
Landscape Irrigation:
Sanitary Side Sewer: Number: O
Sewer Main Extension:
Storm Drainage:
Street Use:
Water Main Extension:
Water Meter: No
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Permit Center Authorized Signature: i -
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Date: c»
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I hearby certify that I have read and examined this permit and know the same to be true and correct. All
provisions oflaw and ordinances governing this work will becomplied with, whether specified herein ornot.
The granting of this permit does not presume to give authority to violate or cancel the provisions of any other
state urlocal laws regulating construction orthe performance ofwork, |amauthorized tosign and obtain this
development permit and agree tothe conditions attached tnthis permit.
Signatue
Print Name:
This permit shall become null and void if the work is not commenced within 180 days for the date of issuance, or if
the work is suspended or abandoned for a period of 180 days from the last inspection.
PERMIT CONDITIONS:
^NOm[»
PERMIT INSPECTIONS REQUIRED
Permit Inspection Line: (2U6)438-935O
1700 gV|LD|NGF|NAL"
CITY OF TUKWII-4
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd, Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
Building Permki4o.1) q 01(06
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
Site Address:
4/3
Tenant
PROPERTY OWNER
Naz:/:,t_et/rtze.
As/
ci :
State:eziet
zip:go
CONTACT PERSON — person receiving all project
communication
State: iijet Zippe..id
ne: ,,,
27,, Fax:
Email.
,.5 A a-44 ON—
GENERAL CONTRACTOR INFORMATION
Company Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Contr Reg No.:
Exp Date:
Tukwila Business License No.:
*ng.Co Assessor's Tax No.: 21 1?Z•O
Suite Number: Floor:
New Tenant: El Yes g..No
ARCHITECT OF RECORD
Company Name:
Architect Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
ENGINEER OF RECORD
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:
HAApplicationaorms-Applications On Line \2012 ApplicationsWennit Application Revised - 2-7- 12.docx
Revised: February 2012
bh
Page 1 of 4
BUILDLNG PERMIT INFORMATION '206-431-3670
Valuation of Project (contractor's bid price): $ 0 • 06 Existing Building Valuation: $
Describe the scope of work (please provide detailed information): /9 b
Will there be new rack storage? .,..Yes L ..No If yes, a separate permit and plan submittal will be required.
Provide All Building Areas in Square Footage Below
Existing
Interior Remodel
Addition to
Existing
Structure
New
Type of
Construction per
IBC
Type of
Occupancy per
IBC
1st Floor
2"d Floor
3rd Floor
Floors thru
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: Compact: Handicap:
Will there be a change in use? Yes 0 No If "yes", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
El Sprinklers El Automatic Fire Alarm ..... .. None El Other (specify)
Will there be storage or use offlammable, combustible or hazardous materials in the building? ID Yes 0 No
If "yes', attach list of materials and storage locations on a separate 8-1/2" x 11" paper including quantities and Material Safety Data Sheets.
SEPTIC SYSTEM
El 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 2012 ApplicationsTerrnit Application Revised - 2-7-12.docx
Revised: February 2012
bh
Page 2 of 4
[PUBLIC WORKS PERMIT INFOR( ,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 ❑ ... Water District # 125
❑ .. Water Availability Provided
Sewer District
❑ .. Tukwila
❑ .. Sewer Use Certificate
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.
Submitted with Application (mark boxes which apply):
❑ .. Civil Plans (Maximum Paper Size — 22" x 34")
❑ .. Technical Information Report (Storm Drainage) ❑... Geotechnical Report
❑ .. Bond ❑... Insurance ❑... Easement(s) ❑... Maintenance Agreement(s)
❑... Highline
❑ ...Valley View ❑... Renton
❑ ...Sewer Availability Provided
❑... Renton
0... Seattle
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 0
Non Right-of-way 0
❑ .. 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
❑ .. Permanent Water Meter Size (1)
❑ .. Temporary Water Meter Size (1)
❑ .. Water Only Meter Size
❑ .. Sewer Main Extension Public 0
❑ .. Water Main Extension Public 0
❑ .. Traffic Impact Analysis
❑ .. Hold Harmless — (SAO)
❑ .. Hold Harmless — (ROW)
❑... Right-of-way Use - Profit for less than 72 hours
0...Right-of-way Use — Potential Disturbance
0... Work in Flood Zone
0...Storm Drainage
0...Abandon Septic Tank
❑... Curb Cut
0... Pavement Cut
0...Looped Fire Line
71
ff
f>
11
❑...Grease Interceptor
❑ ... Channelization
❑...Trench Excavation
0...Utility Undergrounding
WO # (2) " WO # (3) " WO #
WO # (2) " WO # (3) " WO #
WO # ❑ .. Deduct Water Meter Size
Private 0
Private 0
FINANCE INFORMATION
Fire Line Size at Property Line Number of Public Fire Hydrant(s)
❑ .. Water ❑ .. Sewer ❑ .. Sewage Treatment
Monthly Service Billing to:
Name: Day Telephone:
Mailing Address:
Water Meter Refund/Billing:
Name:
Mailing Address:
City
State
Zip
Day Telephone:
City
State
Zip
H:\Applications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.doex
Revised: February 2012
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Page 3 of 4
PERMIT APPLICATION NOTES - •
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 OWER OR AUTHORIZED
Signature: ‘-•—•:'!---f--444-4-4/4—/ •
Print Name: q A M t /IAN "I
Mailing Address: 'Y'c:Z •,///•1 -7_11•4
Date:
Day Telephone: a - i/g 9 9'
City
State Zip
H:,,ApplicationsWonns-Applications On Line‘2012 ApplicationsTermit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 4 of 4
r-N
DESCRIPTIONS
PermitTRAK
$27.50
D19-0160 Address: 4526 S 140TH ST Apn: 7347600547
$27.50
DEVELOPMENT
26.50
PERMIT FEE
R000.322,100.00.00
0.00
20,00
WASHINGTON STATE SURCHARGE
B640.237.114
0.00
$6.50
TECHNOLOGY FEE
$1.00
TECHNOLOGY FEE
R000.322.900.04.00
0.00
$1.00
TOTAL FEES PAID BY RECEIPT: R17673
$27.50
Date Paid: Thursday, May 16, 2019
Paid By: FRANCIS SHANNON
Pay Method: CASH
Printed: Thursday, May 16, 2019 11:45 AM 1 of 1
SYSTEMS