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HomeMy WebLinkAboutPermit D05-187 - BURROUGH RESIDENCE - IMPROVEMENTBURROUGH RESIDENCE 11685 44 AV S D05 -187 z Z Ls. RIC 6 oo coo. W I H WO g w a` =W 1- ill I; o.' z E-- O t o 0 to O H. W W. H • U O 111 U N; z w City aY Tukwila Steven M. Mullet, Mayor y o Department of Community Development Steve Lancaster Dii -ector -j ) 6300 Southcenter Boulevard, Suite #100 O Tukwila, Washington 98188 Phone: 206 -431 -3670 1908 r Fax: 206 -431 -3665 8 Web site: ci.tukwila.wa.its DEVELOPMENT PERMIT Parcel No.: 3347400570 Permit Number: DOS-187 Address: 11685 44 AV S TUKW Issue Date: 06/01/2005 Suite No: Permit Expires On: 11/28/2005 Tenant: Name: BURROUGH RESIDENCE Address: 11685 44 AV S, TUKWILA WA Owner: Name: HOFFMAN DARRELL & GAYLE Phone: Address: 11685 44TH AVE S, SEATTLE WA Contact Person: Name: MIKE BURROUGH Phone: 206 - 762 -8860 Address: 11685 44 AV S, TUKWILA WA Contractor: Name: AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION Phone: Address: MIKE BURROUGH, Contractor License No: Expiration Date: DESCRIPTION OF WORK: REPAIR AND REPLACE FOUNDATION AS SHOWN. FLOOR IN RUILITY ROOM AND EXTERIOR WALLS. SEVERAL INTERIOR WALLS. NEW FRONT DECK, NEW DRYWALL IN SAME AREA. Value of Construction: $5,000.00 Fees Collected: $280.06 Type of Fire Protection: NONE International Building Code Edition: 2003 Type of Construction: VB Occupancy per IBC: 0022 Public Works Activities: Size (Inches): 0 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 Water Meter: N Z �Z �w QQ JU UO: (/)(3 J = H CO L w O LL ¢ CO) D = �w Z �.. 1-0 w ~ W U� O CO o � W LL O tU Z UW O Z 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: .. D0 06-01-200 .�. ..�.. a + -r r.v t�:...i:�: : 4, Y .a.,:x;..:r.:.;•,:a;:;di �L'•.•'r.'rt?+;a,i5� . n.» t�lo3 :d- i.Glwcersls.s�.Lur to ,:rla:Jrt'.s:ix.`":ireti. •• rti , •.{.��Awy , ��• lW'; GI�7;, C« Y, f�. V•'..: pue;. t` .aiiaS:riki,=iti::F��tu'i;w,t.. ,�,�t►�, w City ojL Tukwila S teven M. Mullet, Mayor a '�2 Department of Community Development Steve Lancaster Director - 6300 Southcenter Boulevard, Suite #100 N= Tukwila, Washington 98188 ...... ,r Phone: 206 - 431 -3670 1908 Fax: 206 - 431 -3665 Web site: ci.tulnvilama.us Permit Number DOS -187 Issue Date: 06/01/2005 Permit Expires On: 11/28/2005 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 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 construct io th performance of work. I am authorized to sign and obtain this development permit. Signature: Date : - 7,0 0 �' Print Name- `� � IUI /.Vl M 4 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 -187 Printed: 06 -01 -2005 Z iH w y. J U UO N w= J�- 0 a_, W LL z a. �w �O. Z I— w LU �o ON 0 H W 2 O w Z U N O Z City of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 PERMIT CONDITIONS Parcel No.: Address: Suite No: Tenant: 3347400570 11685 44 " S TUKW BURROUGH RESIDENCE Permit Number: Status: Applied Date: Issue Date: DOS -187 ISSUED 06/01/2005 06/01/2005 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 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: Notify the City of Tukwila Building Division prior to placing any concrete. This procedure is in addition to any requirements for special inspection. 7: All wood to remain in placed concrete shall be treated wood. 8: 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. 9: Ventilation is required for all new rooms and spaces of new or existing buildings and shall be in conformance with the International Building Code and the Washington State Ventilation and Indoor Air Quality Code. 10: Except for direct -vent appliances that obtain all combustion air directly from the outdoors; fuel -fired appliances shall not be located in, or obtain combustion air from, any of the following rooms or spaces: Sleeping rooms, bathrooms, toilet rooms, storage closets, surgical rooms. 11: Equipment and appliances having an ignition source and located in hazardous locations and public garages, PRIVATE GARAGES, repair garages, automotive motor -fuel dispensing facilities and parking garages shall be elevated such that the source of ignition is not less than 18 inches above the floor surface on which the equipment or appliance rests. 12: 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. 13: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the Department of Public Health - Seattle and King County (206/296- 4932). 14: All electrical work shall be inspected and approved under a separate permit issued by the Washington State Department of Labor and Industries (206/248- 6630). doc: Conditions D05 -187 Printed: 06 -01 -2005 '�'a.'�.i. .1:, « t .t.:�.•.,y;z�:..�:L; i;9s tv..,,,.}. ty,'; u��.L1:u.ka;J,v��e'.c:Ylvt'�.�C N� �+ •F iSt'#Fie":.ri!2�::3rAt�.' `�i.'' r � +,�;�$,�;:.��, .:a� :is�•:r..sy 'uay., Z '~ w � D JU 00 CO co Lu J S2 LL w �Q = F w Z ►_ O. Z E_ W W U� ON 0 F_ wW LL O . z . w U= O Z i �. City of Tukwila 1908 Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 15: 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. * *continued on next page ** doc: Conditions 005 -187 Printed: 06 -01 -2005 -M Hill 1 11111 �. it z = Z JU 00 u , Cl) W Y, N LL W O'. LL Q co) _ O �W Z F— l— 0. Z I-- W LIJ Dp U O �. W u.l u. 0 W Z. U= O Z %A w "1 r City of Tukwila tae i Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 i 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 j regulating construction or the performance of work. j Signature: Date: lc l Z -0 0 1 j Print Name: - j Z. W �D UQ Cl) V) CO WO 9 :3 ? d . =w Z X . H O_ Z H W D U O O N, W W H U; !L ~O — Z O ~` Z i doc: Conditions D05 -187 Printed; 06 -01 -2005 � g 1905 SITE LOCATION CITY OF TUKWILA `,- Community Development% partment Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 Building Perm, lo. i - - ("� Mechanical Permit No. Public Works Permit No. 2 Project No. 045— (Tor qjj1ce 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 ** King Co Assessor's Tax No.: �tkI40- Site Address: `O V / k L 7 Suite Number: Floor: Tenant Name: 1 New Tenant: ❑ .... Yes []..No Property Owners Name: �D Mailing Address: City State Zip CONTACT; PERSON Name: G 7 6 7 - - U Da Telephone: Mailing Address: City State Zip E -Mail Address: Fax Number: GENERAL CONTRACTOR:INFORMATION - (Mechanical Contractor information on back page) Company Name: Mailing Address: City State "lip 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 OF RECORD — All plans must be wet stamped by Architect of Record Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: ENGINEER. OF RECORD = All plans must be wet stamped by Engineer of Record Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: \permits plus \ice changes \permit application (7.2004) Page 1 i 1\ i Z ' ~QQ w W� JU UO to c CO W J = F !2u- WO LL i2 a = W H Z F _ F_ O. W U� 0 H W W H� LO W Z CO O Z BUILDING PERMIT INFORMATION - 206- 431 -3670 Valuation of Project (contractors bid price): $ i�,000 1 i 1 I I i t i i� for requirements. Provide All Building Areas in Square Footage Below Will there be new rack storage? ❑ ..Yes 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: ❑.. 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 I1 paper indicating quantities and Material Safety Data Sheets. �pennits phulicc changes%peimit application (7 -2004) Page 2 Existing Building Valuation: $ Z ;= Z �W vo Cl) 0 C0 W J ~ C0 LL W } O �J LL ? cf)d = W H Z� E- O. W �j U� O- 0 1.— W U. O tl! Z CO O Z El.. No If "yes ", see Handout No. Existing Interior Remode Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC 1't Floor �00 2" Floor 3` 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 PROTECTION/HAZARDOUS 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 If "yes ", attach list of materials and storage locations on a separate 8 -112 x I1 paper indicating quantities and Material Safety Data Sheets. �pennits phulicc changes%peimit application (7 -2004) Page 2 Existing Building Valuation: $ Z ;= Z �W vo Cl) 0 C0 W J ~ C0 LL W } O �J LL ? cf)d = W H Z� E- O. W �j U� O- 0 1.— W U. O tl! Z CO O Z El.. No If "yes ", see Handout No. i i i j 1 PUBLIC WORKS PERMIT INFURM A TION 206- 433 -0179 Ila Scope of Work (please provide detailed information): 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 ❑ ... Va1Vue ❑ .. 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 ❑ .. Easement(s) ❑ .. Maintenance Agreement(s) ... Hold Harmless Proposed Activities (mark boxes that apply): ' l ❑ ...Right -of -way Use - Nonprofit for less than 72 hours i El ...Right -of -way Use - No Disturbance :`; ❑ ...Construction/Excavation/Fill - Right -of -way Non Right -of- -way _ ❑ ...Total Cut cubic yards ❑ ...Total Fill cubic yards 1 : i i I i i , ❑ ... Sanitary Side Sewer ❑ ...Cap or Remove Utilities ❑ ...Frontage Improvements ❑ ...Traffic Control ❑ ...Backflow Prevention - Fire Protection _ Irrigation Domestic Water ❑ .. Grease Interceptor ❑ .. Channelization ❑ .. Trench Excavation ❑ .. Utility Undergrounding ❑ .. Right -of -way Use - Profit for less than 72 hours ❑ .. Right -of -way Use - Potential Disturbance ❑ .. Work in Flood Zone ❑ .. Storm Drainage ❑ .. Abandon Septic Tank ❑ .. Curb Cut ❑ .. Pavement Cut ❑ .. Looped Fire Line 91 A ❑ ...Permanent Water Meter Size... 11 WO# ❑ ...Temporary Water Meter Size.. 91 WO# ❑ ...Water Only Meter Size............ 91 WO# ❑ ... Deduct Water Meter Size........ " ❑ ...Sewer Main Extension ............ Public Private ❑ ... Water Main Extension ............. Public Private 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 RefundBillina: Name: - -- -- Mailing Address: City State Gtp %permits plus%ice changes %permit application (7 -2014) Day Telephone: Page 3 I 1 Z ;H Z �W QQ� UO y0 CO W W = CO LL WO 2� 9Q Nd = W Z I- ZO W LLJ �0 U co 0 1- WW U H — Z LLI UN 1- _ O Z MECHANICAL PERMIT INFO: IATION — 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 Type Electric ..... ❑ Gas .­n Replacement..... ❑ Replacement..... ❑ Other: Indicate type of mechanical work being installed and the quantity below: Unit Type: Qty Unit Type: Qty Unit Type: Qty Boiler /Com pressor: Q Furnace <100K BTU Air Handling Unit >I0,000 Fire Damper 0 -3 HP /100,000 BTU CFM Furnace>I00K 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 <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 OROUTIJORIZED AGENT: Signature: Print Name: Mailing Address F Dateplication Accepted: \permits plus \ice changes\permit application (7 -2004) 6 7 ��L L'J . Date Application Expires: 12-- t-05 - Page 4 State Zip als: i Date: f Day Telephone: 2 -0 ( 7 G7i' Z W JU 00 C/) 0 CO W J = H CO U. WO Q � Q LL Q = a FW Z H F- O. Z F- U O- 0 F- WW F- �O W Z CO O Z The above project permit applicant, due to the limited scope of work is authorized to submit reduced plan requirements describe as noted below. 1. Complete permit application required: ( Note, all application must include; 1) property assessor number, 2) copy of contractors license or completed owner waiver form. ) Building Mechanical Other 2. Minimum plan and/or specification requirement: Site plan Floor plan Elevations Foundation Cross sections Roof plan W.S.E.C. compliance Narrative Structural calculations ( stamped by Washington State licensed engineer ) Specific required information / ; CITY OF 7 �I KWI LA 'w Permit Center 6300 Southcenter Boulevard, Suite 100 ' Tukwila, WA 98188 (206) 431 -3670 Application # ALTERNATE PLAN SUBMITTAL AUTHORIZATION FOR LIMITED SCOPE OF WORK U.B.C. Section 106.3.2 exception 3. kln� Authorization by, TBD3 /96 -form 12 'Z�V'e7 Al-'23 Dat Authorization void 30 days after the date issued. ) z �z '~ w tY 2 D JU 0 Cl) C0 W J = N LL w 2� 9a co = �w Z t= O. w ~ w U ON o�- w tti Z UN O Z Project name Address Description of work Other special instructions: C.> i47 t f c--T / r+ 'r '? (a /21 e,14 7 �� City of Tukwila I ISO { 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 ! (206) 431 -3670 Parcel No.: 3347400570 Address: 11685 44 AV S TUKW Suite No: Applicant: BURROUGH RESIDENCE Receipt No.: R05 -00806 Initials: BLH User ID: ADMIN RECEIPT Permit Number: Status: Applied Date: Issue Date: DOS -187 APPROVED 06/01/2005 Payment Amount: 280.06 Payment Date: 06/01/2005 03:20 PM Balance: $0.00 Payee: MIKE BURROUGH TRANSACTION LIST: Type Method Description .Amount Payment Cash 280.06 ACCOUNT ITEM LIST: Description Account Code Current Pmts ------------------------ - - - - -- ---------- - - - - -- ------ - - - - -- BUILDING - RES 000/322.100 275.56 STATE BUILDING SURCHARGE 000/386.904 4.50 Total: 280.06 Z �Z �w J U' UO N 0 C0 J � cn U. w O, L L �d W, Z �. 1— O. Z F-- U C3 O N. 0 F- W Lu H U U CO) H � O Z Si }9r/ (7u� }1 t`71 c� FO AL ?80 6 doc: Receipt Printed: 06 -01 -2005 .. _ .. r r I ' INSPECTION RECORD Retain a copy with permit L) l INSPECT ON N0. PE IT CITY OF TUKWILA BUILDING DIVISION ' 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3 7 Project: r' oii V\ Roc, Type of Inspection: �= I N �. Address: M 85 L4q ()v Date Called: Special Instructions: Date Wanted: a, 9) ��- C� p.m. Requester: Phone No: Receipt No.: Date: 7 z QQ W W� 3 UO U) o V) III J H CO) U. w J L? Cl) d = W z1! H O z >`. w LLI ON 0 I— W UJ F=— H LU Z ' UN O I... z L paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. Approved per applicable codes. Corrections required prior to approval. COMMENTS: i Receipt No.: Date: 7 z QQ W W� 3 UO U) o V) III J H CO) U. w J L? Cl) d = W z1! H O z >`. w LLI ON 0 I— W UJ F=— H LU Z ' UN O I... z L paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. INSPECTION RECORD Retain a copy with permit INSPECC[ION NO. P ER CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -36t P ; , t: � Type of Inspection: r . Addiess: V Date Called: Special Instructions: Date Wanted: a.m. Requester: Phone No: paid at 6300 S6uthcenter Blvd., Suite 100. Call to s echedule rein spection. Rec eipt No.: Date: F Z �QQ L) O� CO) C3 (1) Uj LLI X -J �- CO) LL W LL co ) CY W z z 1-0. �- LU Uj 5 Cl) 0— F- W W U. O. z cl): Z' INSPECTION RECORD Retain a copy with permit INSPECMN NO. PE CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431-3&Z0 Project: Type of Inspection: 60 n 6 ff C �� f Address: 7 Date Calle Specia Instruc Date wanted as mm. 57 -2 Req uester: / , / /, Phone No: R eceipt No.: z W LU 00 Cl) C3 C0 W W M -J I.- S2 LL W O 9:5 LL cl) CY LLI z O. W �- W LLJ 5. C0 0— C3 � WW Z. ) U- z C0 0 z paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. INSPECTION AECORD ., Retain a copy with permit �- INSPECTION N0. r. R 0. CITY OF TUKWILA, WILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (20 )431 -367 Project: Type of Inspection: /I ' i Address: Date Called: Special Instructions: Date Wanted: a. m. Requester: Phone No: El Approved per applicable codes. Corrections required prior to approval. $58.00 REINSPECTIdN FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. Z iF W J U UO W = J f- . N O w� LL Q N� = F. W Z H H O. Z 1— W U� O - ❑t- WW H� LL Q Z. co 0 f- Z A i !! , W-A IFA $58.00 REINSPECTIdN FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. Z iF W J U UO W = J f- . N O w� LL Q N� = F. W Z H H O. Z 1— W U� O - ❑t- WW H� LL Q Z. co 0 f- Z Z INSPECTION REC ORD Retain a copy with permit INSPECTION NO. PE�R CITY OF TUKWILA BUILDING DIVISION • 6300 Southcenter Blvd., #100, Tukwila, WA 98188 ( 2 06 431 -3670 Pr OM Type of Inspection: A Ad Date Called: Special liistructions: Date Wanted: 11 'I p.m. Reque M k,( Phone No: F Approved per applicable code S. MCorrections required prior to approval. COMMENTS: Receipt No.: e: Z W U 0 0 Co 0 Cl) W w:r LL Uj O. LL N UJI O. LU LU 5 U O C0 0— .0 F– :Uj W , H W Z co Z L--j paid at 6300 Southcenter Blvd., Suite 100. Call to sechedute reinspection, 0 i INSPECTION RECORD ��5'"I� Retain a copy with permit INSPECTION NO. PER I CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Project : Type of Ins ection: 1 LG/r� Addre s: y Gr '7 � Date Calle �` 7 � Gam' Special Instruction // s :: y Date Wanted: a.m: Requester: Phone o: 76 4FO- i I Approved per applicable codes. Corrections required prior to approval. C MMENTS: v l 1 i i i i I I i 1 , I i ! I i' i i I-- �O �' 58.0 REINSPECTI N FE REQUIRED. Prio to inspection, fee must be aid 6300 Southcenter Bl d., Suite 100. all to sechedule reinspection. Receipt No.: I I Date: 17 Z W Q � Q � JU 00 Cl) J F- . CO)L WO 9-J LL Q 2 C! �W Z I— F- 0. W ~ W U � E- WW h=- 0 LL ~O W z T- o ~ z INSPECTION RECORD Retain a copy with permit INSPECTION N0. PER 0. CITY OF TUKWILA BUILDING DIVISION . 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 =3670 Pro�ct: J © �� � �� Type o I W 3 . ; do A ess .� r Date Call //�� I ) (-;� / + 1../ Special Instructions: Date Ware I C) � a• Req ster. t PCL : (�q)' 4 Approved per applicable codes. ❑ Corrections required prior to approval. Z H W J UO Co o co LLJ J = LL W O �a -i . u- d U� �W Z r Z O. w U ON o � =U I— LL O .• Z W U to O Z WtLA, R% 1908 CITY OF TUKWILA Permit Center /Building Division Community Development Department 206431 -3670 Permit Center Public Works Department: 6300 Southcenter Blvd., Suite 100 206- 433 -0179 Tukwila, WA 98188 Planning Division: 206 - 431 -3 670 AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION PERMIT NO.: D STATE OF WASHINGTON) COUNTY OF KING ) ss. L) k, Gr [please print] states as follows: 1. I 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 i 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 Signed and sworn to before me this 1.4 day of June , 20 T . �10 46e A�•�FgQ �'��, N� ' PUBL%C' �2 ' ��. :. to Is 1A ��yFOF W A S N��_= lapplications\8 -2004 affidavit in lieu of contractor registration NOTARY PUBLIC in and for tKe State of Washington, Residing at )�l , County. Name as commissioned: A l - I ce, A. Deac y My commission expires: 6­ 16-09 •. s,; .'.a2,' .:i:. ,`t? ':::: �ksY�.;. C iaS r„ i:' d' ttiEix1'. �it� ;.a= +ilkiF+'S`J.A4"'9'di��' � i�i�.i� Y' r` •e . ,' MK}MYwM. nbi- ';WSwplww. Z 3:z �w QQ JU 00 Cl) 0 w J T) U_ w LLQ to = �w z H E- 0. Z H �� U� ON 0 E_ wW u. O .. Z W co Z 18.27.090 Exemptions. This chapter shall not apply to: 1. 2. 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; 3. -64 ; * hen they are acting within ttscote of1heir'offi 4. Public utilities operating under the regulations of the utilities and transportation commission in construction, maintenance, or development work incidental to their own business; contracts of amounts less than $500.00 for the purpose of the 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 is a contractor, or that he is qualified to engage in the business of contractor; 11. 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 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, 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; 6. The sale or installation of any finished products, materials, or articles of merchandise which are not actually fabricated into and do not become a permanent fixed part of the structure; 7. Any construction, alteration, improvement or repair of personal property, except this chapter shall apply to all mobile, manufactured housing. A mobile /manufactured home may be installed, set up, or repaired by the registered or legal owner, by a contractor licensed under this chapter, or by a mobile /manufactured home retail dealer or manufacturer licensed under chapter 46.70 RCW; 8. 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; 9. 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; 10. Any work or operation on one undertaking or project by one or more contractors, the aggregate contract price of which for labor and materials and all other items is less than $500.00, such work, or operations being considered as of a casual, minor, 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 12. An owner who contracts for a project with a registered owner; 13. Any person working on his own property, whether occupied by him or not, and any person working on his residence, whether owned by him or not but his exemption shall not apply to any person otherwise covered by this chapter who constructs an improvement on his own property with the intention and for the purpose of selling the improved property; 14. Owners of commercial properties who use their own employees to do maintenance, repair, and alteration work in or upon their own properties; 15. A licensed architect or civil or professional engineer acting solely in his professional capacity, an electrician licensed under the laws of the state of Washington, or a plumber licensed under the laws 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 licensee is operating within the scope of his license; 16. Any person who engages in the activities herein regulated as an employee of a registered contractor with wages as his sole compensation; 17. Contractors on highway, projects who have been prequalified.as required by chapter 13 of the Laws of 1961, RCW 47.28.070 with the department of transportation to highway construction, reconstruction, or maintenance work. 't• � .�_�_.�. _,. '' �l„- �i�fl��... �", , � 4 � � .! ?A" cMR ,'*t(F4?:Y. � {iS d i�v�+o:oY� '9 ' 9 a :�u. �..'k«.�.�.�S.��W�i'r y. Lw�"t+l�"�irs 3YI � t 1S Z 3: w Q: 2 D 00 CO a J = li— CO L w 9-J U- Q co D = �w z r`- ii— O. Z w w U� ON o t- wW H� ti O Z w U= O Z y. FILE COPY SAVA powlit NO* IDOS -AL111 IMF- Plan isylew approval Is subJW W errors and omiss;Ons. ApPoM of =010ai dovur 1=tS does not audvxtze ft vWbwn of any adapoed Dods or ordinance. P&Vpt d %WOwW PAW and =dUars Is -A I wo Dal Le L ? 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