HomeMy WebLinkAboutPermit D05-374 - CANYON ESTATES CONDOMINIUMS - WINDOW REPAIRCANYON ESTATES
15140 65 AV S
D05-374
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City o. Tukwila �
Departhnent of Conunnnity Developmew
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206 - 431 -3665
Web site: ci.tukwila.wa.us
DEVELOPMENT PERMIT
Steven M. Mullet, Mayor
Steve Lancaster, Director-
Parcel No.: 1332500000 Permit Number DOS -374
Address: 15140 65 AV S TUKW Issue Date: 10/31/2005
Suite No: Permit Expires On: 04/29/2006
Tenant:
Name: CANYON ESTATES
Address: 15140 65 AV S, #210, TUKWILA WA
Owner:
Name: CANYON ESTATES CONDO COMPL
Address: PO BOX 80764, SEATTLE WA
Contact Person:
Name: VIDA VERDIER
Address: 15136 65 AV S, TUKWILA WA
Contractor:
Name: OWNER AFFIDAVIT ON FILE
Address: ,
Contractor License No:
Phone: (206)763 -3584
Phone: 206 248 -9392
Phone:
Expiration Date:
DESCRIPTION OF WORK:
REPAIR OF WINDOW SILLS AND SHEET ROCK FROM MOISTURE LEAK FROM WINDOWS. REPLACEMENT OF INSULATION,
MAY NEED REMOVAL OF EXTERIOR SIDING (VINYL) AND REPLACEMENT OF EXTERIOR SHEETING (UNDER VINYL)
BELOW BOTH SETS OF WINDOWS IN TWO BEDROOMS
Value of Construction: $1,600.00
Type of Fire Protection: NONE
Type of Construction: VB
Fees Collected: $120.96
International Building Code Edition: 2003
Occupancy per IBC: 0021
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:
doc: IBC - Permit D05 -374 Printed: 10 -31 -2005
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Water Meter:
City 6'.Tukwila
Steven M. Mullet, Mayor
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
I
Steve Lancaster, Director
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City o. Tukwila`
Steven M. Mullet, Mayor
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. its
Permit Number:
Issue Date:
Permit Expires On:
Steve Lancaster, Directo,-
DOS -374
10/31/2005
04/29/2006
Permit Center Authorized Signature: Date: 10 (mil uc�
I hereby certify that I have read and mils 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 permi does not presume to give authority to violate or cancel the provisions of any other state or local laws
regulating construction o the performan a of work. I am authorized to sign and obtain this development permit.
' r
Signature: Date: /Q - 3l _0 S'
Print Name: re y'
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 -374 Printed: 10 -31 -2005
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City o f Tukwl l a
tons
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
PERMIT CONDITIONS
Parcel No.: 1332500000 Permit Number: DOS -374
Address: 15140 65 AV S TUKW Status: ISSUED
Suite No: Applied Date: 10/24/2005
Tenant: CANYON ESTATES Issue Date: 10/31/2005
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: 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.
5: 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.
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.
* *continued on next page **
doc: Conditions D05 -374 Printed: 10 -31 -2005
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c1ty
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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
regulating construction or the performance of work.
a.
Signature:
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Date: %o - OS — US
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doc: Conditions 005 -374 Printed: 10 -31 -2005
J�W1u• w CITY OF T UKWI LA
1. Community Development Mq?artment
Public Works Department
Permit Center
1908 6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
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"
SITELOCATION
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Site Address: 7 /5 /yal
6 S S,
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Suite Number:
Floor:
Tenant Name: e5�i V 7�
New Tenant:
❑ .... Yes []..No
Property Owners Name: y(A - A
Mailing Address: / S
5.2� S � (J e
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City
State Zip
CONTACYPERSON
Name: V/ l 4 & Ve r d[ l e r,
/'+PS , [� �OcL r
Day Telephone: 2 -o 6
2 y� c l 3 qa
Address: .5 � 6
5 t4- 4 U e S,.
Tit k
4
� Mailing
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1 ° e Pk0YL °L " 6Ct ` VC - V1
_ E-51-a -feS
City
State Zip
E�ess: 20 to - 2'Y,9
— !Z49 3
Fax Number: U&
rig ::?4 3 C9 ;
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 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 pians.must be wet stamped by Engineer of Record
Company Name:
Mailing Address:
City State Zip
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
q:\ \permits ptus\icc chanseApertnit application (7.2004)
Revised: 6.8-03 Page 1
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. i...`:u c». ......:4..a ' �d`•it�G.rT2u&J 4riuiasii.�'� .`I ,�'r $'�� ,.�,.. ' f�1fs:'Y ' �i�in:..r+«:A �C�}}
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BUILDING: PERMIT;INFORMATION - 206- 431 -3670
Valuation of Project (contractor's bid price): $ ��t? �U Existing Building Valuation: $
Scope of Work (please provide detailed information): Iq_+? ►'J n i v^ - C — t.0 i VL d 6 w s e t i4 S i1 ee ►^xp
1,
�Nct k - E row wt nd 61 W 9 0 (ac e wt E_ 1 Su
t l ' A 4 I n e a l cI C e vP1 P A f
(,� � ✓�� o t.0 s
I rk *Wd b
Will there be new rack storage? E].-Yes jD�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
*For an Accessory dwelling, provide the following:/
any decks over 18 inches and overhangs greater than 18 inches)
Lot Area (sq ft): F r area of principal dwelling: Floor area for accessory dwelling:
*Provide documentation that s s that the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls vided: Standard: Compact: Handicap:
Will there be a c ge in use? ❑ ....Yes ❑ ..No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
[I.. Sprinklers ❑ ..Automatic Fire Alarm ❑/ . ❑ . Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? El.. Yes No
If "yes ", attach list of materials and storage locations on a separate 8 -112 x 1I paper indicating quantities and Material Safety Data Sheets.
gMpermiu plus \icc changes\permit application (7.2004)
Revised 6."S Page 2
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Existing
Interior
Remodel
Addition to
Existing
Structure
New
Type of
Construction
per IBC
Type of
Occupancy per
IBC
I` Floor
2 "d Floor
3 Id 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
*For an Accessory dwelling, provide the following:/
any decks over 18 inches and overhangs greater than 18 inches)
Lot Area (sq ft): F r area of principal dwelling: Floor area for accessory dwelling:
*Provide documentation that s s that the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls vided: Standard: Compact: Handicap:
Will there be a c ge in use? ❑ ....Yes ❑ ..No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
[I.. Sprinklers ❑ ..Automatic Fire Alarm ❑/ . ❑ . Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? El.. Yes No
If "yes ", attach list of materials and storage locations on a separate 8 -112 x 1I paper indicating quantities and Material Safety Data Sheets.
gMpermiu plus \icc changes\permit application (7.2004)
Revised 6."S Page 2
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:MEC:
MECHANICAL CONTRACTOR INFORMATION
Company Name:_
Mailing Address:
Contact Pers
City
Day
E -Mail Address: Fax Number:
Contractor Registration Number: Expiration Date:
* *An original or notarized copy of current Washington State Contractor License must be presen
Valuation of Project (contractor's bid price): $
Scope of Work (please provide detailed information):
Use: Residential: New .... ❑ Replacement.....
Commercial: New .... ❑ Replacement,/
Fuel Tyne Electric ..... ❑ Gas....❑
Indicate type of mechanical work being instal
State zip
. i
at the time of permit issuance **
the quantity below:
Unit Type:
Q
T Unit e:
Q
Unit Type:
Qty
Boiler/Compressor:
Q
Furnace <IOOK BTU
Air dling Unit >I0,000
Fire Damper
0 -3 HP /100,000 BTU
C
Furnace >IOOK BTU
va orator 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 AJOtion to
Incinerator - Domestic
Emergency
Heat/Ref ' Cooling
Generator
S ste
Ai andling Unit
Incinerator - Comm/Ind
Other Mechanical
0,000 CFM
Equipment
PERMIT: APPLICATIONNOTES- :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 grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be requested
in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition).
I HEREBY CERTIF� THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJ Y BY THE �AWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNE O AUTHORI AGENT:
Signature �- Date: 41)
Print Name: I d C, �Prd i 1 P I^ Day Telephone: 2 -4 67 2 -
Mailing Address: � y /l' S %sG Ties
City State Zip
Date Application Accepted: Date Application Expires: Staff Initials:
q:\ \permits plus \icc changes \permit application (7.2004)
kNICAL PERMIT INFO"-MATION.— 206 -431 -3670
r�
Revised 6.8.05
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PUBLIC WORKS PERMIT INFQJ�MA.TION 206- 433 =0179 .
' Scope of Work (please provide detailed information):
t
1
\ Call before you Dig: 1- 800 - 424 -5555
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
Water District
❑ ...Tukwila . Water District # 125 ❑ .. Highline /ent
El ... Water Availability Provided
Sewer District
E] ... Tukwila ❑... VaIV ❑ .. Renton ❑ ...Sewer Use Certificate ❑... Sewer ilability Provided ❑ .. Approved Septic Plan ...Septic System - For onsite septic system, p vide 2 copies of a current septic design appr Health Department.
❑ ...Civil Plans (Maximum Paper Size — 22" x 34 ")
i ❑ ...Technical Information Report (Storm Drainage)
❑ .. Geotechnic ort ❑ ...Traffic Impact Analysis
+ ❑ ...Bond ❑ .. insurance ❑ .. Easeme s)
❑ .. Mainten eJ greement(s) ❑ ...Hold Harmless
Proposed Activities (mark boxes that apply):
❑ ...Right -of -way Use - Nonprofit for less than 72 hours
❑ .. Ri t f -way Use - Profit for less than 72 hours
❑ ...Right -of -way Use - No Disturbance
ig, -of -way Use — Potential Disturbance
❑ ...Construction/ExcavationfFill - Right -of -way
p!
Non Right -of -way
❑ ...Total Cut cubic yards
in Flood Zone
❑ ...Total Fill cubic yards
❑ .. Sto Drainage
❑ ...Sanitary Side Sewer ❑ .. Ab on S tic Tank ❑ .. Grease Interceptor
❑ ...Cap or Remove Utilities El.. C b Cu .
❑ .. Channelization
❑ ...Frontage Improvements ❑ . avem t Cut
❑ .. Trench Excavation
❑ ...Traffic Control Loo d Fire Line
❑ .. Utility Undergrounding
❑ ...Backflow Prevention - Fire Protection "
Irrigation "
Domestic W er "
❑ ...Permanent Water Meter Size... WO#
❑ ...Temporary Water Meter Size .. WO#
❑ ... Water Only Meter Size..... ..... WO#
❑ ...Deduct Water Meter e "
❑ ...Sewer Main Extension .......... Pu c Private
... Water Main Extensio .............P lic Private
FINANCE IN FORM ION
Fire Line Size at Pr perry Line Number of Public Fire Hydrant(s)
... Water ❑ .Sewer ❑...Sewage Treatment
Day Telephone:
Address:
City State Zip
Day Telephone:
Mailing Address:
City State Zip
q Npermits phutice ehangestpesmit application (7 -2004)
Revised: 6-E -05
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City o f Tulw l a
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6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
RECEIPT
Parcel No.:
1332500000
Permit Number
D05 -374
Address:
15140 65 AV S TUKW
Status:
APPROVED
Suite No:
Applied Date:
10/24/2005
Applicant:
CANYON ESTATES
Issue Date:
Receipt No.:
R05 -01578
Payment Amount:
75.08
Initials:
JEM
Payment Date:
10/31/2005 09:31 AM
User ID:
1630
Balance:
$0.00
Payee: VIDA VERDIER
TRANSACTION LIST:
Type Method
Payment Check
ACCOUNT ITEM LIST:
Description
BUILDING - RES
STATE BUILDING SU
Description Amount
5435 75.08
Account Code Current Pmts
000/322.100 70.58
2CHARGE 000/386.904 4.50
Total: 75.08
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City of Tukwila
, 906
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
RECEIPT
Parcel No.: 1332500000 Permit Number: D05 -374
Address: 15200 65 AV S TUKW Status: PENDING
Suite No: Applied Date: 10/24/2005
Applicant: CANYON ESTATES Issue Date:
Receipt No.: R05 -01547 Payment Amount: 45.88
Initials: 7EM Payment Date: 10/24/2005 09:57 AM
User ID: 1165 Balance: $75.08
Payee: VIDA VERDIER
TRANSACTION LIST:
Type Method Description Amount
Payment Check 5430 45.88
ACCOUNT ITEM LIST:
Description Account Code Current Pmts
------------------------ - - - - -- ---------- - - - - -- ------ - - - - --
PLAN CHECK - RES 000/345.830 45.88
Total: 45.88
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8554 10/24 9716 TOTAL 45.88
doc: Receipt Printed: 10 -24 -2005
7 7-7
INSPECTION RECORD
Retain a copy with permit o� '-5'- 3
INSPECTION NO. PE M
Rq
0
CITY OF TUKWILA BUILDING DIVISION
.6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206 431-3670
Pro{gct:
Type of jaspectidn:
Address:
Date Called:
Special Instructions:
Date Wanted: a.m.
\
Requester:1
��•C'.�( G�'t'
Ph e No:
77�
per applicable codes. Corrections required prior to approval.
Inspector Date: 12-
I —
' Pcz
$58.00 REINSPECTION F REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to sechedute reinspection.
R eceipt No.: e:
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INSPECTION RECORD
�. Retain.a copy with permit
INSPECTION NO. PERMI
CITY OF TUKWILA BUILDING DIVISION
I ..
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Pr�c�t:
Type of Inspec ion:
t~
Address:
le
1 SpecialIrfstr0ctions:.—'>
Date Called:
2
as
-Date
Wanted: 'QQ
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P.m.
Requ ter:
1 - 0 k
t
Phone �N�o:
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
Inspect9 Date: )
r$58.0 REINSPECTION FEE REQU
paid !t 6300 Southcenter Blvd., S
cell)( No.:
I. Prior t inspection, fee must be
100. Caj l to sechedule reinspection.
Date:
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INSPECTION RECORD
Retain a co py with p ermit d �S
INSPECTION NO. PERMIT
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (2 6)431 - &67
Pr)* e c t:
Type o Inspection:
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Address:
Date Called:
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Special Instructions:
Date Wa ted: a
Requ ster:
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Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
spec r: ,ate:
$ .00 REINSPECTIO FEE REQUIRED. 'or to inspection, fee must be
aid at 6300 Southcent Blvd., Suite 1 0. Call to sechedule reinspection.
Receipt No.: 7 7
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REC��
OTTO ROSENAU &ASSOCIATES, INC.
Geotechnical Engineering, Construction Inspection & Materials Testin Y
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CONCRETE REPORT
Job Number: 05 -455 Report Number: 32834 Permit Number. D04 -374
Project: Cendant Car Rental Client: Chinn Construction, LLC
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Address: 15820 Tukwila International Blvd, Tukwila Address: PO Box 2137, Redmond
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Date: 11/10/2005 Inspector: Isaac Ruoff / Larry Longnecker
Description /Location: Retaining wall — 38' and 160 S entrance west side. Sampled concrete and observed placement and
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consolidation. Resteel was inspected by ORA inspector Isaac Ruoff.
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Resteel verified: Yes Resteel grade: 60 Manufacturer: Cascade Mills and Nucor
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Placernent Data.. Design ® Actual ❑ Batch Weights/Cubic Yard
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Supplier. Stoneway Cement (Ibs. /type): 400# 1 -II
Mix Number: 4356 Fine Agg. (Ibs): 1455#
Slump Spec: 4" Coarse Agg. (Ibs /size): 1901# %
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W/C Ratio Spec: .53 Coarse Agg. (Ibs /size):
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Air Spec: - Coarse Agg. (Ibs /size):
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Total Yards: 22 Fly Ash (Ibs): 100#
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Placed Via: Chute Water (Ibs or gal): 225#
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Consolidated: Yes (vibrator) Admixtures (specify): 30 oz. WRDA -64, Veriti 80 oz
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Required Strength (psi): 4000 65 oz. Daraset
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Sam liri 'andiTestm Data;::: ::;'::Time Cubic: Ambient::': °;Truck :Ticket'.
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AS. IVI;G =1:72` C 31'. "" Yards Added C�43 ; C:231
Cast Samples: 1 -4 12:15 1 15gal 4" N/A 70° 50 451 584332
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Weather: Cloudy windy Slump Range: Air % Range:
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Date Samples Picked Up 11111/2005 Initial Curing Method: Exciu ding ASTM C -121 s Initial Curing Temp Excluding ASTM C31 - 10.1.2
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Other Test Methods / Standards Used:
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REINFORCING / PLACEMENT: Conforms X Does Not Conform
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COMPRESSIVE TEST RESULTS
Specimen Test Field Age Size Area Max Load Strength Type of Fracture
Number Date Cure (Days) (Ind S .In. Weight L( bs•) ing (other than cone)
1 11/17/05 7 6x12 28.22 29.73# 100,180 3550
Tested in general accordance to: ASTM C39 x ASTM C109 ASTM C617
Note: Type of fracture does not apply when testing in conformance to ASTM C1231
Final curing in calcium hydroxide water storage tank at 73 t 3° F
Copies to:
X Client Contractor
Architect X Building Dept. Technical Responsibility:
X Engineer X Batch Plant
ASTM C1231 x
This report applies only to the items tested or reported and is the exclusive property of Otto Rosenau & Associates, Inc. Reproduction of this report,
except in full, without written permission from our firm is strictly prohibited.
Page 1 of 1
6747 M.L. King Way S•, Seattle, Washington 98118 — Phone (206) 725 -4600 or 1- 888 - OTTO -4 -US — Fax (206) 723 -2221
Form No.: ADMIN -62 -02 (Rev 04104)
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NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEAR
THIS NOTICE IT IS DUE TO THE QUALITY OF THE DOCUMENT.
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PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: D05 -374
PROJECT NAME CA NYON ESTATES
FiA prevention
Structural ❑
SITE ADDRESS: 1514 65 AV S, #210
X Original Plan Submittal
Response to Correction Letter #
Response to Incomplete Letter #
Revision # After Permit Issued
DEPARTMENTS:
Buil g Division
Public Wo
Incomplete ❑
DETERMINATION OF COMPLETENESS (Tues., Thurs.) DUE DATE: 10-25-05
Complete M
Comments:
DATE: 10 -24 -05
7'A ` VAA' ( '
Planning Division d
Permit Coordinator ❑
Not Applicable ❑
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES/THURS ROUTING:
Please Route Structural Review Required ❑ No further Review Required ❑
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS DUE DATE: 1 1-22-05
Approved ❑ Approved with Conditions Not Approved (attach comments) ❑
Notation:
REVIEWER'S INITIALS: DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
Documenis/routing slip.doc
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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
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PERMIT NO.:
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STATE OF WASHINGTON)
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COUNTY OF KING )
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V ivo r tC- C 1 �V1G1 V eV'r
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1. 1 have made application for a building permit from the City of Tukwila, Washington.
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2. 1 understand that state law requires that all building construction contractors be registered with the State of
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Washington. The exceptions to this requirement are stated under Section 18.27.090 of the Revised Code of
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Washington, a copy of which is printed on the reverse side of this Affidavit. I have read or am familiar with RCW
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18.27.090.
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3. 1 understand that prior to issuance of a building permit for work which is to be done by any contractor, the City of
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Tukwila must verify either that the contractor is registered by the State of Washington, or that one of the exemptions
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stated under RCW 18.27.090 applies.
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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
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under this building permit to be exempt under No. 13 , and will therefore not be performed by a registered
contractor.
understand that I may be waiving certain rights that I might othe ise have under state law in any decision to engage an
unregistered contractor to perform construction work.
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A14,s h APPLICAN
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\appli cation s \5 -2004 affidavit in lieu of contractor registration
Signed and sworn to before me tthis�,
5 > day of Cf �'J-�✓ , 20
NOTARY PU
Residing at
Name as
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in and for the State of Wash
My commission expires:
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County.
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. Officers of the court when they are acting within
the scope of their office;
4. Public utilities operating under the regulations of
the utilities and transportation commission in
construction, maintenance, or development work
incidental to their own business;
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
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;
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 perform highway construction,
reconstruction, or maintenance work.
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