HomeMy WebLinkAboutPermit D05-087 - MEDICA RESIDENCE - GARAGE DEMOLITIONMEDICA RESIDENCE
10808 EAST
MARGINAL WAY
SOUTH
D05 -087
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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: ci.tukwila.wa.us
DEVELOPMENT PERMIT
Parcel No.: 0323049046
Address: 10808 EAST MARGINAL WY S TUKW
Suite No:
Tenant:
Name: MEDICA RESIDENCE
Address: 10808 EAST MARGINAL WY S, TUKWILA WA
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
Contractoi
MEDICA MARIA
3014 28TH AVE W, SEATTLE WA
PAUL GOULD
601 UNION, SUITE 1725, SEATTLE WA
WOODLAND INDUSTRIES INC
10715 66 AV E, PUYALLUP WA
License No: WOODUG033JD
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Permit Number:
Issue Date:
Permit Expires On:
Phone:
Steven M. Mullet, Mayor
Steve Lancaster, Director
DOS -087
04/01/2005
09/28/2005
Phone: 206 - 623 -1633
Phone: 253 - 531 -0936
Expiration Date: 02/28/2006
DESCRIPTION OF WORK:
DEMOLITION OF A 360 SQ FT DETACHED GARAGE; REMOVE ALL DEBRIS; FILL AND GRADE TO EXISTING ELEVATION.
Value of Construction:
$3,400.00
Fees Collected: $203.19
Type of Fire Protection:
International Building Code Edition: 2003
Type of Construction:
Occupancy per IBC: 0026
Public Works Activities:
Channelization / Striping:
N
Curb Cut / Access / Sidewalk
/ CSS: N
Fire Loop Hydrant:
N
Number:
0 Size (Inches): 0
Flood Control Zone:
N
Hauling:
N
Start Time:
End Time:
Land Altering:
N
Volumes:
Cut 0 c.y. Fill 0 c.y.
Landscape Irrigation:
N
Moving Oversize Load:
N
Start Time:
End Time:
Sanitary Side Sewer:
N
Sewer Main Extension:
N
Private:
Public:
Storm Drainage:
N
Street Use:
N
Profit:
N Non - Profit: N
Water Main Extension:
N
Private:
Public:
Water Meter:
N
doc: IBC - Permit D05 -087 Printed: 04 -01 -2005
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City of Tu kwila
Department of Commui:ity Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206 - 431 -3665
Web site: ci.tukwila.wa.us
Steven M. Mullet, Mayor
Steve Lancaster, Director
Permit Number: D05 -087
Issue Date: 04/01/2005
Permit Expires On: 09/28/2005
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 wi/bec p • d with, whether specified herein or not.
The granting of this permit does nu to give authority to violate or cancel the provisions of any other state or local laws
regulating corstnK tic n orAhe perf of work. I am authorized to sign and obtain this development permit.
Dat
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- Perm(t
D05 -087
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Cit y
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Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
PERMIT CONDITIONS
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Parcel No.: 0323049046 Permit Number DOS -087
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Address: 10808 EAST MARGINAL WY S TUIKW Status: ISSUED
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Suite No: Applied Date: 03/16/2005
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Tenant: MEDICA RESIDENCE Issue Date: 04/01/2005
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1: ** *BUILDING DEPARTMENT CONDITIONS * **
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2: No changes shall be made to the'approved plans unless approved by the design professional in responsible charge and the
Building Official.
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3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to
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start of any construction. These documents shall be maintained and made available until final inspection approval is
granted.
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4: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary
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sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other
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excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of
this requirement.
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5: 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
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presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila
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shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the
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Building Official from requiring the correction of errors in the construction documents and other data.
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* *continued on next page **
doe: Conditions D05 -087 Printed: 04 -01 -2005
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g City of Tukwila
! face
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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:
Print Name:
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CITY OF TUKWIL4
Community Development L i rtment
g Public Works Department
Permit Center
1906 6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
Building Permit'"`.
Mechanical Permit No.
Public Works Permit No.
Project No.
For o ice use onl
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
King Co Assessor's Tax No.: 03 V' 0140
Site Address: 1 0000 FAS MA- V- C97ttJ6' . W o.y 500n-i- Suite Number: Floor:
Tenant Name: New Tenant: ❑ .... Yes ❑ ..No
Property Owners Name:_1Ltl/l- i 1�/�Gt�
Mailing Address: 301 ,4✓e- O�9
City State Zip
CONTACT .PERSON..
Name: ?r yt. Ca out / z_ . I? de_ Gard, I Day Telephone: 246 62-'3110-33
Mailing Address: 60� C(I� lOV1,, rS 1725 SE'CZf � LL/ GC, e lel0/
f City State Zip
E -Mail Address: Pau -Q � ��+'JC��CCIi1Gl . Coln Fax Number: 2C&
GENERAL CONTRACTOR INFORMATION (Mechanical Contractor information on back page)
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Company Name: V 00d laved fl�1Gt!
T1S'lt°S
Mailing Address: 107 (0& Ape gaSA P 1x V ll &Z,4 R� 337 J
r City V State Zip
Contact Person: Day Telephone: Z5 3 °770 - 'W 3
E -Mail Address: Fax Number: ZO'-3 — 44& - 0 1 5 - 09'
Contractor Registration Number: W 06 L,l C l o 33 oD Expiration Date: ? l 0 4;
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
ARCHITECT OF: RECORD:- All plans must be wet stamped by Architect of Record
Company Name:_
Mailing Address:
Contact Person:
.ENGINEER OF RECORD .= All plans must be wet stamped by Engineer of Record
City State Zip
Day Telephone:
Fax Number:
E -Mail Address:
Company Name:
Mailing Address:
City State Zip
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
\permits plus \icc changes \permit application (7.2004)
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BUILDING PERMIT INFORMATION.- 206 - 431 -3670
yNaluation of Project (contractor's bid pt._ ): $ 4CX� C ExistingWilding Valuation: $
Scope of Work (please provide detailed information): De_MQLi I Qn or— &A - eAC9f — _ LQC47 -64) A--r
jd$�Z lea -c+ ld at:/ 9 ClrrC/
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 P ROTECTION/14AZARDOUS MATERIALS:
❑.. Sprinklers ❑..Automatic Fire Alarm ❑..None ❑ . Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ .. Yes ❑ ..No
1f ' yes ", attach list of materials and storage locations on a separate 8 -112 x 1l paper indicating quantities and Material Safety Data Sheets.
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\pennits pluslicc changes\permit application (7.2004)
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Existin
Interior
Remodel
Addition to
Existing
Structure
New
Type of
Construction
per IBC
Type of
Occupancy per
IBC
I °` Floor
2 Id Floor
3r d 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 P ROTECTION/14AZARDOUS MATERIALS:
❑.. Sprinklers ❑..Automatic Fire Alarm ❑..None ❑ . Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ .. Yes ❑ ..No
1f ' yes ", attach list of materials and storage locations on a separate 8 -112 x 1l paper indicating quantities and Material Safety Data Sheets.
I
\pennits pluslicc changes\permit application (7.2004)
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PUBLIC WORKS PERMIT INFORMATION - 206- 433 -0179
Scope of Work (please provide detailed
Call before you Dig: 1- 800 - 424 -5555
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
Water District
❑ ...Tukwila El ... Water District # 125 ❑ .. Highline ❑ ...Renton
❑ ... Water Availability Provided
Sewer District
❑ ...Tukwila ❑... ValVue El.. Renton ❑ ...Seattle
❑ ...Sewer Use Certificate El ... 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 ❑ .. Easement(s) ❑ .. Maintenance Agreement(s) F1 ... Hold Harmless
Proposed Activities (mark boxes that a
❑ ...Right -of -way Use - Nonprofit for less than 72 hours ❑ .. Right -of -way Use - Profit for less than 72 hours
❑ ...Right -of -way Use - No Disturbance ❑ .. Right -of -way Use - Potential Disturbance
❑ ...Construction/Excavation/Fill - Right -of -way
Non Right -of -way
[]...Total Cut cubic yards
❑ ...Total Fill cubic yards
❑ .. Work in Flood Zone
❑ .. Stone Drainage
❑ ...Sanitary Side Sewer ❑ .. Abandon Septic Tank
❑ ...Cap or Remove Utilities ❑ .. Curb Cut
❑ ...Frontage Improvements ❑ .. Pavement Cut
❑ ...Traffic Control ❑ .. Looped Fire Line
❑ ...Backflow Prevention - Fire Protection "
Irrigation "
Domestic Water "
❑ ...Permanent Water Meter Size... WO# _
❑ ...Temporary Water Meter Size.. WO# _
❑ ...Water Only Meter Size............ WO#
❑ ...Sewer Main Extension ............Public Private
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❑ ... Water Main Extension .............Public Private
❑ .. Grease Interceptor
El.. Channelization
❑ .. Trench Excavation
F-1.. 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 Biliing to:
Name: Day Telephone:
Mailing Address:
City State Zip
Water Meter Refund/Billing:_
Name:
Mailing Address:
Day Telephone:
City
State Zip
%permits plus\icc changes \permit application (7.2004)
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MECHANICAL PERMIT INF& "UTION -- 206 -431 -3670
MECHANICAL CONTRACTOR INFORMATION
Company Name:_
Mailing Address:
Contact Person:
E -Mail Address:
City. State Zip
Day Telephone:
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 Type Electric ..... ❑ Gas .... ❑
Replacement..... ❑
Replacement..... ❑
Other:
Indicate type of mechanical work being installed and the quantity below:
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Boiler/Compressor:
Q
Furnace <IOOK BTU
Air Handling Unit >10,000
Fire Damper
0 -3 HP /100,000 BTU
CFM
Furnace>I OOK 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
S stem
Air Handling Unit
Incinerator — Comm/Ind
Other Mechanical
<I0,000 CFM
Equipment
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
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.
BUILDING OWNER OR AUTHORIZED AGENT:
Signature: � � �� Date: al D
Print Name: L (uLD - )1t Rr - 7d e— Lxu J Tom' Day Telephone: `?_CC ' 62-3 -/b3:
Mailing Address: rani' lki '110 l , EL 177,' Niel Vlh- 9,�5) () (
City State Zip
Date Application Accepted: Date Application Expires: f Staff Initial '
\permits plus \icc changestpermit application (7.2004)
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City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431-3670
RECEIPT
Parcel No.: 0323049046
Address: 10808 EAST MARGINAL WY S TUKW
Suite No:
Applicant: MEDICA RESIDENCE
Permit Number:
Status:
Applied Date:
Issue Date:
DOS-087
APPROVED
03/16/2005
Receipt No.: R05-00448
Payment Amount:
124.92
Initials: SKS
Payment Date:
03/31/2005 12:13 PM
User ID: 1165
Balance:
$0.00
Payee: LABONDE LAND INC
TRANSACTION LIST:
Type Method Description
---------- -------- ---------------------------
Amount
------------
III Payment Check 4619
124.92
ACCOUNT ITEM LIST:
Description Account Code
Current Pmts
---- -------------------- - - - - -- ----------------
BUILDING - NONRES 000/322.100
------ - - - - --
120.42
STATE BUILDING SURCHARGE 000/386.904
4.50
Total: 124.92
1590 03/31. 9716 TOTAL 569.28
doc: Receipt Printed: 03-31-2005
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�g City of Tukwila
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5908
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j 6300 Southcenter BL, Suite 100 ! Tukwila, WA 98188 ! (206) 431 -3670
Parcel No.: 0323049046
Address: 10808 EAST MARGINAL WY S TUKW
Suite No:
Applicant: MEDICA RESIDENCE
Receipt No.: R05 -00376
Initials: BLH
User ID: ADMIN
DOS -087
PENDING
03/16/2005
Payment Amount: 78.27
Payment Date: 03/16/2005 10:09 AM
Balance: $124.92
Payee: IABONDE LAND INC
{
TRANSACTION LIST:
Typ Method Description - - - - -- Amount
- - - - - -- -- - - - - -- --------------------------
Payment Check 4610 78.27
f ACCOUNT ITEM LIST:
Description Account Code Current Pmts
------------------------ - - - - -- ---------- - - - - -- ------ - - - - --
y PLAN CHECK - NONRES 000/345.830 78.27
Total: 78.27
1
1068 02/16 97 10 TOTAL 2 01-68
doc: Receipt Printed: 03 -16 -2005
RECEIPT
Permit Number:
Status:
Applied Date:
Issue Date:
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INSPECTION RECORD O �.
- Retain a copy with permit
INSPECTION NO. PE I
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (20 )431 -3670
1 Act
Address: Date Called
a a O '- � , 1.5 V-4' -
Specia nstructions: Date Wanted: a.m.
,S - � (Q� p.m.
Requester:
Phone No:
� s 3 - God
Type of Ins -lion:
Pro ect:
Approved per applicable
codes. � Corrections required prior to approval.
. COMMENTS:
(r7l i r� i i �t1�1
Inspec Date; �.-- --
�-
00 REINSPECTIO FEE REQUIR Prior to inspection, fee must be
0,76
at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
Receipt No.; Date;
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Type of Ins -lion:
Pro ect:
Approved per applicable
codes. � Corrections required prior to approval.
. COMMENTS:
(r7l i r� i i �t1�1
Inspec Date; �.-- --
�-
00 REINSPECTIO FEE REQUIR Prior to inspection, fee must be
0,76
at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
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:NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEARIHAN
THIS NOTICE IT IS DUE TO Q--.
- TO OF THE DOCUMENT.
PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: D05 -087 DATE: 3 -16 -05
PROJECT NAME MEDICA RESIDENCE
SITE ADDRESS 10808 EAST MARGINAL WY S
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # Revision # After Permit Issued
DEPARTMENTS
5 ?M A? 3 7,2.05
Buil4 Division Firetev ention Planning Division
P hlic Wor s Structural ❑ Permit Coordinator
QUA
DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 3 -17-05
Complete I 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 UTING:
Please Route Structural Review Required ❑
REVIEWER'S INITIALS:
No further Review Required
DATE:
1 0
APPROVALS OR CORRECTIONS
Approved ❑ Approved with Conditions d
Notation:
REVIEWER'S INITIALS:
DUE DATE: 4-14-05
Not Approved (attach comments) ❑
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
Documents /routing sllp.doc
2.28.02
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15/2005 11t39 FAX 2534460509
Q002/002
........ . ..... . . . . ............. ....... ........ ........ • -1) EPA o INDUSTR
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RE41 S7,' BRED AS PROVIDED-BY.-LAW AS'
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Look Up a Contractor, Electri!"';i or Plumber License Detail �.. Page 1 of 3
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General /Specialty Contractor .��.W.�........�._..._ ....,.._... �_._....__._._._._. �..___._...._.__.__.._..._.__ �..__.... �........_..�._m._.�..__.._...,
A business registered as a construction contractor with LEtI 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.
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License Information r
License
WOODLIG033JD
Licensee Name
WOODLAND INDUSTRIES GN CON INC
Licensee Type
CONSTRUCTION CONTRACTOR
: UBI
601739741 Verify Workers Comp ry
Status
} Ind. Ins. Account
Id
92269300
Business Type
CORPORATION
Address 1
10715 66TH AVE E
Address 2
City
PUYALLUP
County
PIERCE i
State
WA
Zip
98373
Phone
2535310936
Status
ACTIVE
Specialty 1
GENERAL
Specialty 2
UNUSED
Effective Date
4/4/1997
Expiration Date
2/28/2006
s
Suspend Date
I Separation Date
Parent Company
Previous License
I LEECOL *087N1
Next License
i
Associated ,
License
FBusiness Owner Information
https:H fortress. wa. gov /lni/bbip/Detail.aspx ?License= WOODLIG033JD 04/01/2005
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File: D05 -0087
35mm Drawing
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Phone: (425) 519 -0300
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E4nall: Usaftsessoe- 1nc.com
httpJ/www.gsassoo4nc.com
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E4nall: Usaftsessoe- 1nc.com
httpJ/www.gsassoo4nc.com
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GRAPHIC SCALE
12.5 0 6.25 12.5 25 50
(IN FEET)
1 inch = 25 ft.,
SOUND TRANSIT
SEATTLE, WASHINGTON FIGURE
PARCEL TUK -012 PHASE I ESA
SITE MAP 3
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CARRY STRUTHERS ASSOCIATES, IN
3150 Richards Road. Suite 100
Bellevue. WA 98005.4446
Phone: (425) 519 -0300
Fax: (425) 519-0309
E4nall: Usaftsessoe- 1nc.com
httpJ/www.gsassoo4nc.com
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Structures to be demolished: A
1. Garage w/ Concrete Floor
2. House B- 10808 East Marginal Way South
co 3. 4' X 6' Metel Shed
%fta Note:
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• Overhead power to House B was previously removed
• Telephone cable to house B was previously removed
• Septic Tank for House B will be pumped prior to demolition and then collapsed and filled