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HomeMy WebLinkAboutPermit D05-028 - LARSON RESIDENCE - RESIDENCE DEMOLITIONlarson demolition 4629 south 146th street City of Tukwila Steven M. Mullet, Mayor Department of Community Developmet :t Steve Lancaster, Director 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 -... P� e. P Web site: ci.tukwila.wa.us DEVELOPMENT PERMIT Parcel No.: 0040000610 Permit Number: D05 -028 Address: 4629 S 146 ST TUKW Issue Date: 02/11/2005 Suite No: Permit Expires On: 08/24/2005 Tenant: Name: LARSON - HOUSE DEMO Address: 4629 S 146 ST, TUKWILA WA Owner: Name: LARSON RICHARD +KAY Phone: Address: P 0 BOX 68267, SEATTLE WA Contact Person: Name: RICK LARSON Phone: 206 243 -5637 Address: P.O. BOX 68267, SEATTLE WA Contractor: Name: OWNER AFFIDAVIT IN FILE - RICK LARSON Phone: 206 243 -5637 Address: P.O. BOX 68267, SEATTLE WA Contractor License No: Expiration Date: DESCRIPTION OF WORK: DEMOLITION OF FIRE DAMAGED 1950 SQ FT SINGLE FAMILY RESIDENCE. PROJECT ON VAL VUE SEWER AND WD #125 WATER. PW ACTIVITIES INCLUDE EROSION CONTROL. Value of Construction: $1,500.00 Fees Collected: $374.72 Type of Fire Protection: N/A International Building Code Edition: 2003 Type of Construction: VB Occupancy per IBC: 0022 Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Fire Loop Hydrant: N Flood Control Zone: N Hauling: N Land Altering: N Landscape Irrigation: N Moving Oversize Load: N Sanitary Side Sewer: N Sewer Main Extension: N Storm Drainage: N Street Use: N Water Main Extension: N Number: 0 Start Time: Volumes: Cut 0 c.y. Start Time: Size (Inches): 0 End Time: Fill 0 c.y. End Time: Private: Public: Profit: N Non - Profit: N Private: Public: doc: IBC - Permit D05 -028 Printed: 08 -24 -2005 Z Z J U UO U W x" J F_' D LL . W J LL- Q. C ' H= r— O Z�_ UJI D: U� O co, 0 F-: .w w' LL O ii Z' 00 Z s City of Tukwila y o Z Department of Community Development -� 6300 Southcenter Boulevard, Suite #100 �► ,2 Tukwila, Washington 98188 Phone: 206 - 431 -3670 k « 1908 Fax: 206 - 431 -3665 Web site: ci.tukwila.wa.us E: Water Meter: N * *continued on next page ** Steven M. Mullet, Mayor Steve Lancaster, Director dom IBC- Permit D05 -028 Printed: 08 -24 -2005 City of Tukwila Department of Community Developmei :t 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: cOukwila.wa.us Steven M. Mullet, Mayor Steve Lancaster, Director 4 Permit Number D05 -028 Issue Date: 02/11/2005 Permit Expires On: 08/24/2005 I i i Permit Center Authorized Signature: L Date: i 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. i Signature: /�� Date: z` r Print Name: Z�aK { 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. I Z Or � J U' UO co CO) N LL' W O J' = d. I— W Z� w O'. 5 ' U� O co 8 W W' F U; w Z; U N; H � O .. Z doc: IBC- Permit D05 -028 Printed: 08 -24 -2005 � Ok w SZ � G1 1908 Cit y 6..�'Tukwila DEVELOPMENT PERMIT Parcel No.: 0040000610 Address: 4629 S 146 ST TUKW Suite No: Tenant: Name: LARSON - HOUSE DEMO Address: 4629 S 146 ST, TUKWILA WA Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: Address: Contractoi LARSON RICHARD +KAY P 0 BOX 68267, SEATTLE WA RICK LARSON P.O. BOX 68267, SEATTLE WA OWNER AFFIDAVIT IN FILE - RICK LARSON P.O. BOX 68267, SEATTLE WA License No: Phone: Steven M. Mullet, Mayor Steve Lancaster, Director DOS -028 02/11/2005 08/10/2005 Phone: 206 243 -5637 Phone: 206 243 -5637 Expiration Date: L/G0VRir 1 &will Vr nrvRn: DEMOLITION OF FIRE DAMAGED 1950 SQ FT SINGLE FAMILY RESIDENCE. PROJECT ON VAL VUE SEWER AND WD #125 WATER. PW ACTIVITIES INCLUDE EROSION CONTROL. Value of Construction: $1,500.00 Fees Collected: $374.72 Type of Fire Protection: N/A International Building Code Edition: 2003 Type of Construction: VB Occupancy per IBC: 0022 Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Fire Loop Hydrant: N Flood Control Zone: N Hauling: N Land Altering: N Landscape Irrigation: N Moving Oversize Load: N Sanitary Side Sewer: N Sewer Main Extension: N Storm Drainage: N Street Use: N Water Main Extension: N Number: 0 Size (Inches): 0 Start Time: End Time: Volumes: Cut 0 c.y. Fill 0 c.y. Start Time: End Time: Private: Public: Profit: N Non - Profit: N Private: Public: doc: IBC - Permit D05 -028 Printed: 02 -11 -2005 Permit Number: Issue Date: Permit Expires On: Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 -431 -3665 Web site: ci.tukwila.wa.us 4� f' Z UJI u�D _3 C.) Uo CO) J LL U11 O: :3: LL < N D. = d. t~ _, Z� �a Z t_. O w w' 3: U U . O. W Z v_ V) Z ~` I]. City 61. - wila 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 Web site: ci.tukwila.wa.us I Water Meter: N * *continued on next page ** City 0. 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 Web site: ci.tukwila.wa.us Permit Number: D05 -028 Issue Date: 02/11/2005 Permit Expires On: 08/10/2005 Permit Center Authorized Signature: Date: I hereby certify that I have read and examined s 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. Signature: Date: 2 /l OS 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. doc: IBC-Permit D05 -028 Printed: 02 -11 -2005 , f Cit y of Tukwila.-- � �' i� • r9ae Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 PERMIT CONDITIONS Parcel No.: 0040000610 Permit Number DOS -028 Address: 4629 S 146 ST TUKW Status: ISSUED Suite No: Applied Date: 01/25/2005 Tenant: ILARSON - HOUSE DEMO Issue Date: 02/11/2005 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: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of this requirement. 5: All construction noise to be in compliance with Chapter 8.22 of the City of Tukwila Municipal Code. A copy can be obtained at City Hall in the office of the City Clerk. 6: 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. 7: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * ** 8: The applicant must notify the City Utility Inspector at (206)433 -0179 upon commencement and completion of work at least 24 hours in advance. All inspection requests for utility work must also be made 24 hours in advance.' 9: Any material spilled onto any street shall be cleaned up immediately. 10: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation off -site or into existing drainage facilities. 11: From October 1 through April 30, cover any slopes and stockpiles that are 3H:1V or steeper and have a vertical rise of 10 feet or more and will be unworked for greater than 12 hours. During this time period, cover or mulch other disturbed areas, if they will be unworked more than 2 days. Covered material must be stockpiled on site at the beginning of this period. Inspect and maintain this stabilization weekly and immediately before, during and following storms. 12: From May 1 through September 30, inspect and maintain temporary erosion prevention and sediment at least monthly. All disturbed areas of the site shall be permanently stabilized prior to final construction approval. 13: The site shall have permanent erosion control measures in place as soon as possible after final grading has been completed and prior to the Final Inspection. doc: Conditions D05 -028 Printed: 08 -24 -2005 .. . • '" Y%.:. �: �� :.cl» .:.:...( uvi�i .�4..�ui..w.- ::ii: "s,.w.�l. '�..•.. �.....,. ":..�:. �:...._...... .a :'i: ....Y . u ..i..- 1._J..�:.d..:Y:.'4.:.�:L. w.,•.. �:.i.s�.4J b.:+.xl:.'�n:c '.J..t W+. [«. E`�"'ti° Z -Z` '~ w It UQ C0 LU J� RLL w J LL j. N CY = W Z� i~- 0 Z i- W. U� 0— . o H- W �- 0 ui Z 0 Z t g City of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 t Printed: 08 -24 -2005 doc: Conditions D05 -028 g Cit y of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 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: �r Z e doc: Conditions D05 -028 Printed: 08 -24 -2005 City of Tukwila iso0 Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 PERMIT CONDITIONS Parcel No.: 0040000610 Permit Number: DOS-028 Address: 4629 S 146 ST TUKW Status: ISSUED Suite No: Applied Date: 01/25/2005 Tenant: LARSON - HOUSE DEMO Issue Date: 02/11/2005 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: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of this requirement. 5: All construction noise to be in compliance with Chapter 8.22 of the City of Tukwila Municipal Code. A copy can be obtained at City Hall in the office of the City Clerk. 6: 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. 7: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * ** 8: The applicant must notify the City Utility Inspector at (206)433 -0179 upon commencement and completion of work at least 24 hours in advance. All inspection requests for utility work must also be made 24 hours in advance. 9: Any material spilled onto any street shall be cleaned up immediately. 10: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation off -site or into existing drainage facilities. 11: From October 1 through April 30, cover any slopes and stockpiles that are 3H:1V or steeper and have a vertical rise of 10 feet or more and will be unworked for greater than 12 hours. During this time period, cover or mulch other disturbed areas, if they will be unworked more than 2 days. Covered material must be stockpiled on site at the beginning of this period. Inspect and maintain this stabilization weekly and immediately before, during and following storms. 12: From May 1 through September 30, inspect and maintain temporary erosion prevention and sediment at least monthly. All disturbed areas of the site shall be permanently stabilized prior to final construction approval. 13: The site shall have permanent erosion control measures in place as soon as possible after final grading has been completed and prior to the Final Inspection. doc: Conditions D05 -028 Printed: 02 -11 -2005 Z �w D U0 J = H M LL' W O U. Q Nd =W Z F— O Z H-, LLJ W, Dp N' U o�_ W W U O ui Z O Z a Nk ) City of Tukwila Department of Community Development 6300 Southcenter BL, Suite 100 Tukwila, WA 98188 (206) 431-3670 nn;;-ngR Printed: 02-11-2005 f i city o f Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 j 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. I 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. i Date: Z 1 � 4S' doc: Conditions D05 -028 Printed: 02 -11 -2005 3 1 \U ' w as N 2 � tsoe f CITY OF TUKWILA -�) Community Development.. partment Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 Building Perm, ;o. Mechanical Permit No. Public Works Permit No. Project, (For office use only) 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 King Co Assessor's Tax No.: 40AI 000 — O& 10 — 0 4 f Z J / ° Site Address: °7 �+/' Z S . ` y Suite Number: Floor: Tenant Name: V,4 e - 1 U07 New Tenant: ❑..... Yes []..No L State Zip Property Owners Name: ,K m lz- L� �c7 A Mailing Address: a 03,er o_ &_52�Z6e,�7 City CONTACT PERSON f:. i ... Name: (Z. M k LACIP f7 Day Telephone: 706 Z Z13 - 563 7 Mailing Address: 4—;6 v v City State Zip E -Mail Address: Fax Number: GENERAL CONTRACTOR INFORMATION'. (Mechanical Contractor information on back page) Company Name: Mailing Address: City State Zip 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 ** ARCHITECT:OFRECORD All plans must be wet stamped by.Architect of Record Company Name: Mailing Address: ENGINEER.0YRECORD - All plans must be wet stamped by Engineer of Record City Day Telephone: Fax Number: Contact Person: E -Mail Address: Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: \permits plus \ice changcs \permit application (7.2004) Page 1 S. 1. .+.� cl.... r' ..i.J„ �a�� v.:P.a+.:i u.�i .�•.+.. "SV�:.. .::<ri ..:+La4 'i:Jn..u::..a..•ii..,.:i» ..+.:.:�.�. •:4,.: ...ay...� x:we.s i i �'.xKnxc� }.xF';4ir+:yFA. State Zip I Z Z W QQ JU UO Cr) CO 0 = F_ C0 U WO }} �J a. = W Z E-- Z O W �p U O N, WW �O u.i z U CO) O F ' Z BUILDING PERMIT INFORMATION - 206 - 431 -3670 i Valuation of Project (contractor's bid pricew 150 ,.— Scope of Work (please provide detailed information): Existing Building Valuation: $ 4 'Ire- Will there be new rack storage? ❑ ..Yes ❑ .. No If "yes ", see Handout No. for requirements. 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 for 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 ❑ ..No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: M.. Sprinklers ❑..Automatic Fire Alarm ❑..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 -112 x 11 paper indicating quantities and Material Safety Data Sheets. \permits plus\icc changes \permit application (7.2004) Page 2 Z z Z. W a � JU UO C 0 1— CO u. W O Q co d = W H Z P HO Z I-- U0 O CO. ❑ F— WW F- I . _ 0 Z' UN O Z Existing Interior Remodel Addition to Existing Structure New Type of Construction 2er IBC Type of 'Occupancy per IBC 1" Floor 2" Floor � 3' 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 for 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 ❑ ..No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: M.. Sprinklers ❑..Automatic Fire Alarm ❑..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 -112 x 11 paper indicating quantities and Material Safety Data Sheets. \permits plus\icc changes \permit application (7.2004) Page 2 Z z Z. W a � JU UO C 0 1— CO u. W O Q co d = W H Z P HO Z I-- U0 O CO. ❑ F— WW F- I . _ 0 Z' UN O Z I I { I PUBLIC WORKS PERMIT INF f"IMATION - 206 - 433 -0179 ---, Scope of Work (please provide detailed information): Call before you Dig: 1- 800 -424 -5555 Please refer to Public Works Bulletin 41 for fees and estimate sheet. Water District ❑ ...Tukwila ❑... Water District # 125 El.. Highline El—Renton ❑ ...Water Availability Provided Sewer District ❑ ...Tukwila El ... ValVue ❑ - Renton ❑ ...Seattle ❑ ...Sewer Use Certificate ❑ ... Sewer Availability Provided ❑ .. Approved Septic Plans Provided ❑ ...Septic System - For onsite septic system, provide 2 copies of a current septic design approval 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 ❑ ... Traffic Impact Analysis ❑ ...Bond ❑ .. Insurance El.. Easement(s) [:1.. Maintenance Agreement(s) ❑ ... Hold Harmless Pr000sed Activities (mark boxes that a ❑ ...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 cubic yards ❑ ...Total Fill cubic yards ❑ .. Right -of -way Use - Profit for less than 72 hours ❑ .. Right -of -way Use — Potential Disturbance El.. Work in Flood Zone El.. Storm Drainage ❑ ...Sanitary Side Sewer ❑ .. Abandon Septic Tank ❑ ...Cap or Remove Utilities ❑ .. Curb Cut ❑ ...Frontage Improvements ❑ .. Pavement Cut ❑ ...Traffic Control El.. Looped Fire Line ❑ ...Backflow Prevention - Fire Protection " Irrigation " Domestic Water " ❑ ...Permanent Water Meter Size...._ S I WO# El ... Temporary Water Meter Size.. WO# — ❑ ...Water Only Meter Size............ WO# _ ❑ ...Sewer Main Extension ............Public Private ❑ ... Water Main Extension .............Public Private ❑ .. Grease Interceptor ❑ .. Channelization ❑ .. Trench Excavation ❑ .. Utility Undergrounding ❑ ... Deduct Water Meter Size........ " 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: City State Zip Water Meter RefundB ill ins?: Name Mailing Address: City State Zip 1pamtits plus%icc changcslpctmit application (7.2004) Day Telephone: Page 3 N Z � Z. 1 UO N a, J l.— S2 W, WO -. u. N W Z 1-- O Z H W W. tO Ni ;O t-- W U!. H 0. O: Z: LU F= _ ; O F Z MECHANICAL PERMIT INFOI 'ATION — 206 - 431 -3670 MECHANICAL CONTRACTOR INFORMATION Company Name: Mailing Address: City. State Zip 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): $ Scope of Work (please provide detailed information): Use: Residential: New .... ❑ Commercial: New ..,. ❑ Fuel Tag Electric.....❑ Gas..,.❑ Replacement..... (i Replacement..... ❑ Other: Indicate type of mechanical work being installed and the quanti'.y below: Unit Type: Qty Unit Type: Qty Unit Type: Qty Boiler /Com pressor: Q Furnace <100K BTU Air Handling Unit >]0,000 Fire Damper 0 -3 HP /100,000 BTU CFM Furnace>100K BTU Evaporator Cooler Diffuser 3 -15 HP /500,000 BTU Floor Furnace Ventilation Fan Connected Thermostat 15 -30 HP /1,000,000 BTU to Single Duct Suspended/Wall/Floor Ventilation System Wood /Gas Stove 30 -50 HP /1,750,000 BTU Mounted Heater Appliance Vent Hood and Duct Water Heater 50+ HP /1,750,000 BTU Repair or Addition to Incinerator - Domestic Emergency Heat/Refrig/Cooling Generator System Air Handling Unit Incinerator — Comm/Ind Other Mechanical <10,000 CFM E ui ment PERMIT APPLICATION NOTES - Applicable to all permits.in this application 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 I 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. 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. ILDING OWNE R AUTI ED AGENT: f Signature: Print Name: Mailing Address: i Date: Day Telephone: 0-0& 2 Y3 Scle 3 - 7 R ), City State Zip Date Application Accepted: Date Application Expires: Staff Initials: \permits plus \ice changes \permit application (7.2004) Page 4 t Z �Z '~ W �5 UO to 0 co Lu J = CO LL W O LLQ co CY C1 UJ 1 Z � H O Z I-- W U� O -, 0 h- W W. LL O: tll Z U CO. Z A { City of Tukwila `j 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 'i RECEIPT Parcel No.: 0040000610 Permit Number: D05 -028 Address: 4629 S 146 ST TUKW Status: APPROVED Suite No: Applied Date: 01/25/2005 Applicant: LARSON - HOUSE DEMO Issue Date: j i Receipt No.: R05 -00197 Payment Amount: 260.00 Initials: SKS Payment Date: 02/11/2005 04:15 PM User ID: 1165 Balance: $0.00 Payee: RICK LARSON i TRANSACTION LIST: i Type Method Description Amount ---- - - - - -- -- - - - - -- --------------------- - - - - -- ------ - - - - -- Payment Cash 260.00 t ACCOUNT ITEM LIST: ' Description Account Code Current Pmts ------------------------ - - - - -- ---------- - - - - -- ------ - - - - -- PW BASE APPLICATION FEE 000/322.100 250.00 j .PW PERMIT /INSPECTION FEE 000/342.400 5.00 PW.PLAN REVIEW 000/345.830 5.00 Total: 260.00 i 9901 02/15 9716 TOTAL 260.00 doc: Receipt Printed: 02 -11 -2005 t. 1 19p8 7 $ City of Tukwila 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 y a RECEIPT s . Parcel No.: 0040000610 Permit Number: DOS -028 Address: 4629 S 146 ST TUKW Status: PENDING -Suite No: Applied Date: 01/25/2005 Applicant: LARSON - HOUSE DEMO Issue Date: Receipt No.: R05 -00098 Payment Amount: 114.72 Initials: SKS Payment Date: 01/25/2005 02:28 PM User ID: 1165 Balance: $0.00 Payee: RICK LARSON TRANSACTION LIST: Type Method Description Amount Payment Cash 114.72 ACCOUNT ITEM LIST: Description Account Code Current Pmts ------------------------ - - - - -- ---------- - - - - -- ------ - - - - -- BUILDING - NONRES 000/322.100 66.80 PLAN CHECK - NONRES 000/345.830 43.42 STATE BUILDING SURCHARGE 000/386.904 4.50 Total: 114.72 i 9261 01/25 9716 TOTAL 167.07 doc: Receipt "` - " "` Printed: 01 -25 -2005 . NrvM�Ylaea. : Sw�rut.• f' w.* Ye„ ri« y. eav .- .r...c. «r+r.I.n.....1.... » -. ... -�..� .r ... ........�........ ..... .. ..... ...... ..... -_. ... ...... .. ... ... ....... ... t �2 INSPECTION RECORD D I G� Retain a copy with permit INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431' 73670 Approved per applicable codes. Corrections required prior to approval. COMMENTS: 1. Pr ject: Typq of Insgectign: L o - Address: Y Date Called, Sp cial Instru tions: Date Wante . 0� M. P. Requesters, l one No: { a Z EI— W W5 v '^ o W= N u- 0 Nd t=- W Z � z o �5 �O N; W W. LL ~ Z UN Z -- - — — a Z EI— W W5 v '^ o W= N u- 0 Nd t=- W Z � z o �5 �O N; W W. LL ~ Z UN Z -- - — — 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 U" Project* / w Type of Inspection: Addre s: Date Called: Special Instructions: Date Wanted: a.m. Requester:, Phone No: J 1 Approved per applicable codes. O Corrections required prior to approval. Q OMMENTS: j ig AV 13/ G if A $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. RPcPlnt Nn_' I natp . N Z �QQ W U O W N LL : W O. LL F— W Z� Z O UJI � ' . U� O � Z U. : U - LLi Z CO) O Z INSPECTION RECORD %J Retain a copy with permit INSPECTION NO. PE IT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 ( 06)431 -3670 Project: Type of Inspection: Address• �� � �' Date Called: 0 Special Instructions: Date Wanted: a.m. v Requester: / one No: s Approved per applicable codes. El Corrections required prior to approval. COMMENTS: ot — ; [� ta- �� bf� I or: Date. _ 5 .00 REINSPECTION FE REQUIRED. Prior to inspection, fee must be a d at.6300 Southcenter vd., Suite 100. Call to sechedule reinspection. Rec t No:; Date: a Z Z: W` aate: J U U O; moo: CO) J N LL:, W } O: J LL Q N d . H =: � W I- LLI �p U , 93 H: W W . O. Z in U =, -Z CONTRACTOR LONG SERVICES JOB NAME O ' S — / v lC v % a PREZANT ASSOCIATES JOB NUMBER 21414 - 68TH AV E N U E SOUTH A21414- 68THAV SO �� 300 SIXTH AVE. SUITE 200 SEATTLE, WA 98109 KENT, WASHINGTON 98032 -2416 Phone: (253) 234 -8050 206- 281 -8858 AIHA PAT LAB NO. 11554 ADDRESS Fax: (253) 234-0034 DESCRIPTION OF 1- ENGINEERING CONTROLS 2. PROTECTIVE CLOTHING 3.RESPIRATORYPROTECTION 5• ACTIVITY t "e% 511 fat; «+ L. ISOLATION/NEGATIVEAIR COVERALLS HALF MASK SAMPLING 0 MINI- ENCLOSURE GLOVES FULL FACE 6 ' LOCATION �/'oo F"' GLOVEBAG GOGGLES PAPR NAME OF WORKER OPEN HEAD COVERING SUPPLIED AIR 7• SAMPLED ,`� �� a / f Z WET METHODS FOOT COVERING SCBA OTHER OTHER: PRESSURE DEMAND 9. �WCERTiFICATE �� �(� NUMBER .. .� 1.• - �� .. . . . .� 10. 11• 12• 13 T A R 14. TIME ON 16. 17. 18. 19. 20. 21. FORE - 22. TYPE OF SAMPLE SAMPLE PUMP PRE,PEAK,T NA,IHEPA,AREA 15. TIME OFF TOTAL FLQyyRATE AVERAGE MINUTES LITERSHANUTE FLOWRATE VOLUME LITERS FIBERS/ FIELDS MAN DETECTION FIBERS /CC INT OMIT NUMBER NUMBER CAUB ARATEO 1-,- I ©. S l I � (v 2 O0 �'� 5- l00 DZ- • CC) Z I:e a•O 100.67 � v (--x57_, ).o 104 19 , 0 a �- (CQ�a•cL �� 1 �` ►�° +7p r /c � prro T o.00� C� v • vv3 . I d�. ►a.�� ry loo RECEPAD CITY OF TUKWILA R WISHA PERMISSIBLE EXPOSURE LIMIT. 0.2 FIBERS /CC ACTIO R E CEIVED L: 0.1 ; i ` CC 26. FIELD BLANKS: S A ED LANKS: 23. CASSETTE LOT ` Ll IJ� 27. ANALYZE Y: 28• DATE 2U 24. SAMPLE Y: . SAN 2 2005 aeq�, Ing 25. DATE � TU KWI LA offnit 1 NOTES: E) W ' t)Z ff6102 LS301 r > - - IZI, - -- Y...." NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEARTHAN THIS NOTICE IT IS DUE TO THE QUALITY OF THE DOCUMENT. o ,t a N� 1908 07 -05 -2005 JO RICK LARSON P.O. BOX 68267 SEATTLE WA 98168' City Of Tukwila Steven M. Mullet, Mayor Department of Community Development Steve Lancaster, Director RE: Permit No. D05 -028 4629 S 146 ST 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 or 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 satisfactory 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 08/24/2005, 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, Brenda Holt, Permit Coordinator xc: Permit File No. D05 -028 Bob Benedicto, Building Official Z `F Z W ' U O: W =: N LL. W O J U. Q Nd H W _. Z �. 0 LU Z F-� �5 O N: W W. LL 0,. 111 Z U= Z ~` 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 -431 -3670 • Fax: 206 - 431 -3665 � COOPD COPY* PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D05 -028 DATE: 01 -25 -05 PROJECT NAME: LARSON RESIDENCE — HOUSE DEMO SITE ADDRESS: 1354652 ND AVENUE SOUTH X Original Plan Submittal _Response to Incomplete Letter # _Response to Correction Letter #_ Revision #after /before permit is issued DEPARTME -- W& -0-0s 61 n &- c -717 -0 2�� '� Sion Building D4ion i Fire Prevention Ln Planning ivi Public r s G 5� - Structural ❑ Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 01 - -05 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: TOES /THURS R TING: Please Route t Structural Review Required REVIEWER'S INITIALS: ❑ No further Review Required DATE: APPROVALS OR CORRECTIONS Approved ❑ Approved with Conditions Notation: REVIEWER'S INITIALS: DUE DATE: 02 -24-05 Not Approved (attach comments) ❑ DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: z , Z JU U OO CO) W = J � U. w O. U. ?. � =w z� Zo � o. O CO. O !— wW u. O Z' U N, Z PERMIT COORD COPY Documents /routing slip.doc 2 -28.02 ILA, p O 1905 CITY OF TUKWILA Permit Center /Building Division Community Development Department 206 - 431 -3670 Permit Center Public Works Department: 6300 Southcenter Blvd., Suite 100 206 - 433 -0179 Tukwila, WA 98188 Planning Division: 206 -431 -3670 AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION PERMIT NO.: bez STATE OF WASHINGTON) ss. COUNTY OF KING ) states as follows: [please print] 1. 1 have made application for a building permit from the City of Tukwila, Washington. 2. 1 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. 1 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, 1 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 work. APPLICANT .-JGE A. �� i .... P ��siory F�. �'� t �'�� • OTAR1. % P U B L%C .. ........ .... • • I Op Signed and sworn to before me this f'tA day of / e- brcc.aey , 20 05 NOTARY PUBLIC in and for thg State of Washington, Residing at ki ki , County. Name as commissioned Alice A. De a c y My commission expires: 9 Z �w �U 0 0 00 C0 111 JH C0 U. w �Q N D. = d. �w �0 Z F- �p U CO w ' LL O . ..Z w U =. O Z \applications \8 -2004 affidavit in lieu of contractor registration i 18.27.090 Exemptions This chapter shall not apply to: contracts of amounts less than $500.00 for the purpose of the evasion of this chapter or 1 • otherwise. The exemption prescribed in this 2. An authorized representative of the United States subsection does not apply to a person who Government, the State of Washington, or any advertises or puts out any sign or card or other incorporated city, town, county, township, device which might indicate to the public that he is irrigation district, reclamation district or other a contractor, or that he is qualified to engage in municipal or political corporation or subdivision of the business of contractor; this state; 11. Any construction or operation incidental to the 3. Officers of the court when they are acting within construction and repair of irrigation and drainage the scope of their office; ditches of regularly constituted irrigation districts or reclamation districts; or to farming, dairying, 4. Public utilities operating under the regulations of agriculture, viticulture, horticulture, or stock or the utilities and transportation commission in poultry raising; or to clearing or other work upon construction, maintenance, or development work land in rural districts for fire prevention purposes; incidental to their own business; except then any of the above work is performed by a registered contractor; 5. Any construction, repair or operation incidental to the discovering or producing of petroleum or gas, 12. An owner who contracts for a project with a or the drilling, testing, abandoning, or other registered owner; operation of any petroleum or gas well or any surface or underground mine or mineral deposit Any person working on his own property, whether when performed by an owner or lessee; occupied by him or not, and any person working on his residence, whether owned by him or not but 6. The sale or installation of any finished products, his exemption shall not apply to any person materials, or articles of merchandise which are not otherwise covered by this chapter who constructs actually fabricated into and do not become a an improvement on his own property with the permanent fixed part of the structure; intention and for the purpose of selling the improved property; 7. Any construction, alteration, improvement or repair of personal property, except this chapter 14. Owners of commercial properties who use their shall apply to all mobile, manufactured housing. A own employees to do maintenance, repair, and mobile /manufactured home may be installed, set alteration work in or upon their own properties; up, or repaired by the registered or legal owner, by a contractor licensed under this chapter, or by 15. A licensed architect or civil or professional a mobile /manufactured home retail dealer or engineer acting solely in his professional capacity, manufacturer licensed under chapter 46.70 RCW; an electrician licensed under the laws of the state of Washington, or a plumber licensed under the E B. Any construction, alteration, improvement, or laws of the state of Washington while operating repair carried on "within the limits and boundaries within the boundaries of such political subdivision. of any site or reservation under the legal The exemption provided in this subsection is jurisdiction of the federal government; applicable only when the licensee is operating within the scope of his license; j 9. Any person who only furnished materials, I supplies, or equipment without fabricating them 16. Any person who engages in the activities herein into, or consuming them in the performance of, the regulated as an employee of a registered work of the contractor; contractor with wages as his sole compensation; 10. Any work or operation on one undertaking or 17. Contractors. on .highway' projects who have been project by one or more contractors, the aggregate prequalified as'required by chapter 13 of the Laws contract price of which for labor and materials and of 1961, RCW - 47.28.070, wth the department of all other items is less than $500.00, such work, or transportation to perform highway construction, operations being considered as of a casual, minor, reconstruction, or maintenance work. j or inconsequential nature. The exemption prescribed in this subsection does not apply in all 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 \applications\8 -2004 affidavit in lieu of contractor registration :. L.., r.Y.... .'. W:4':u 1.1)..a.. .i hu l+.il. +4'.N .VJt `,na.. J:.l...vrtt... w'.L'.o .Ids hf.�*"..:. tiln.!Y. +O.i- P .-. u.: l..}, �: w' ��' �. tii4. 5Ll W.'.:. �Yf 3t✓ wir.. '�..M.'vNw.Fi..i.�.,SY.iLw'rvu' 14yr1'i+1r.tiKv tl+"..lk.+�. +�..... Z �Z '~ w JU Uo N CO) J F. CO LL W 9� LL CO =w t~ _ Z� W5 U� O N 0 F_ wW LL —O Z U= O ~. Z File: D05 -0028 35mm Drawing r L a.:, r ------------- ------------------------- ------------------- - - - - - i-N i N o eh "ges shall be matt to th SCCV4 t,; lth®ut prior appal of '' ; - L 00 Building Division, . NO`fE: Revisions will require a new plan submittal and may Include additional plan review fees. 1 F Eg 1 0 >v+ / • •' , ' , 0 • III ICI � I ., iIII� , 1,1I11��I ��II ' �I II� f�� I 1 11IL� Inch 1/16 ;� ,, . IIIIILI�II II 11111 [ 11III .111u- 1I_11II11IJ�I "1.11111 dill 1 1 nese puns have been reviewed y the Public Works Department fo r conform ee with cu rrent City standards. Acceptance is . su leMt . to errors and omissions which do not authorize. viol at - 50 - s of adopted standards or ordinancW17 te � i onsibility for the adequacy of the design �yestS tOtaIly with the designer. Additions, deletions or"*4slo®s to these drawings after this date vvill void NS: HCceptance r and will' require a resubmittal" of revised drawings for subsequent approval.' Final acceptance is subject to field inspection by the Public Works utilities inspector. Date: r Xik. BY: Tf 2 0 11-7 -1 W--' -, - &gar 1, - I 5 Ii -- - 11 6 r'hJIF �. I11II�L � IfIIILI �IIIIIIIII�IIIII . �9 N r a N l� Z H 6 N It ICITYROF rvwr PERMIT CENTER DC)s -ozs