Loading...
HomeMy WebLinkAboutPermit D05-451 - YU RESIDENCE - DAMAGE REPAIR• 1 YU RESIDENCE 14484 58 AV S D05 -451 Z =z. rx 412 6 J U: U O. • 0 W = J H W O' L -• a z1._ • z0. W • W UC O N' O E-. W W • U F-- O. Z W U O H z City Oz Tukwila Departrnent of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: cOukwila.wa.us DEVELOPMENT PERMIT Steven M. Mullet, Mayor Steve Lancaster, Director Parcel No.: 3365901167 Permit Number: DOS -451 Address: 14484 58 AV S TUKW Issue Date: 01/03/2006 Suite No: Permit Expires On: 07/02/2006 Tenant: Name: Address: Owner: Name: Address: Contact Person: Name: Address: YU RESIDENCE 14484 58 AV S, TUKWILA WA SAFFER MICHAEL L 14484 58TH AV S, TUKWILA WA EVA TAM 504129 AV S, SEATTLE WA Contractor: Name: OWNER AFFIDAVIT - IO MAN C. YU Address: , Contractor License No: j DESCRIPTION OF WORK: REPAIR DAMAGE TO CORNER OF HOUSE CAUSED BY A CAR Phone: Phone: 206 229 -5658 Phone: Expiration Date: Value of Construction: $3,000.00 Type of Fire Protection: Type of Construction: V -B Fees Collected: $174.55 International Building Code Edition: 2003 Occupancy per IBC: 0022 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 ZZ S F' '~ w n: 6 2 , D 00 cf) CO N LL. w U. co D = �W Z f- f- O Z F— Ul5 U� 0 - O !_ W W I O Z CO) O Z city 0'. "Tukwila Department of Comimmity Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206-431-3670 Fax: 206-431-3665 Web site: cOukwilamams "continued on next page** Steven M, Mullet, Mayor Steve Lancaster, Director Z Z! D C.) 0' CI) 0� , to UJI LU r . _j F-- (n U. W O M V Cy F- z F-. 0 Z F-, UJI UJ 12 5 D a 0 to: 0 :0 F-m UJI W. 0 lil Z' O F-; Z doc: IBC-Permit D05-451 Printed: 01-03-2006 1908 e� City 0. Tukwila Steven M. Mullet, Mayor Departitietit of Coiiuuunity Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206- 431 -3670 Fax: 206 - 431 -3665 Web site: ci.tulnvilamams Permit Number: Issue Date: Permit Expires On: Steve Lancaster, Director D05 -451 01/03/2006 07/02/2006 Permit Center Authorized Signature: S Date: 0 IO (xP I hereby certify that I have read and min his 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 es not presume to give authority to violate or cancel the provisions of any other state or local laws regulating constructio th perform of work. I am authorized to sign and obtain this development permit. Signature: = Date: 3 Print Name : _QAIV I 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 -451 Printed: 01 -03 -2006 .r. ::�.: ,.w,;•i.li; };�.,, .i. .: a. Ct6..:' 4' �. er.. �+...:, �4it..... ii+: a?. isC� .;.�:�c .J J.A wcw�iL'.'p ^titSy:..0 'N » +t,.{.�d',�, .. _ci y rG' s�S,: rfi.' 4iZ�t :1;S.lii.xkox'4t..`:.;,::. Z }- Z �W 6 2 JU U ND CO) =' J ii.— CO) LL WO LE¢ UD z d. w Z� r-- 0 w 11--- w � U 0� D F— WW �P �0 ..Z W U N H � O Z . � City of Tuhwila 19C8 Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 PERMIT CONDITIONS Parcel No.: 3365901167 Address: 14484 58 AV S TUKW Suite No: Tenant: YU RESIDENCE Permit Number: Status: Applied Date: Issue Date: DOS -451 ISSUED 12/15/2005 01/03/2006 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: All wood to remain in placed concrete shall be treated wood. 6: 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. 7: 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. 8: 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). 9: 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). 10: 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 -451 Printed: 01 -03 -2006 z �W UO Co o J � N LL WO U- ? � =W Z F- z° U ON o E- W W O ..z co O z i U A W City of Tul�wila ' 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: 0 1 Print Name: ��l GL z Z. LLV JU U O CO J � CO) L W �aEi LL D a �0 z �- U� O CO D 1— w UJ _ : LL. O . Z . w CO O H Z tu. w CITY OF TUKWILA Community Developmen... partment Public Works Department Permit Center �sats 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" SITE IO;CATION CONTACT PERSON King Co Assessor's Tax No.: `�> - - 7 Site Address: i g 9 44 .S F fh I S Suite Number: Floor: Tenant Name: New Tenant: ❑ .... Yes No Property Owners Name: C,& / r ..J 4A Mailing Address: rV PC, t� �y"C— S T-t C- ,,j " L e- Z-f 6 City State Zip Name: E Nt GA, �Gt Day Telephone 2 .Z , �i Mailing Address: S DG= % 2 C 1'� V ' V•Q S . G� �2. �� � 1�> k o 42 > City State Zip E -Mail Address: Fax Number: GENERAL. CONTRACTOR- .INFORMATION - (Mechanical Contractor information on_back page) / 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" Company Name:_ Mailing Address: ARCHITECT OF RECORD —All. plans must be wet stamped by Architect of.Record u 1� City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: Company Name: Mailing Address: ENGINEER OF RECORD _ All plans.must be wet stamped by Engineer.of Record f Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: q.Upennits pluslice changes\permit application (7.2004) Revised: 6.9.03 Page t bh 0. .1. .( ". .,,k.. ;S: .4t1J4 .i«yJ�*y`.K.: ..�1..[:w!.alfyj4�1'.ir`it.� '.b1xwW. ^tMu..WhW:IC�•:: AU7L1 } ti�"Z��: Gi Sre f� kJ ;JkYi�+t.cwili.V.iJal.ai157'�ti ��wua�4.,t.LSlk .v biia; t..." ix�;i�iisi Z �W U t] W= H CO LL W �J LL N d = W 1— O W 25 U O� a I— W HF- L O W Z CO 0 F- O Z BUILDING PERMIT; INFORM ON. - 206- 431 -3670 Valuation of Project (contractor's bid price): S tom © Existing Building Valuation: $ , 00 Scope of Work (please provide detailed information): R? ..: y b V o LQ V o to e �c b•t GLGL �2tnk Will there be new rack storage? ❑ .. Yes [g.. 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): Q -5 2 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 g..No If "yes ", explain: FIRE PROTECTIONIHAZARDOUS MATERIALS- El.. 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 I I paper indicating quantities and Material Safety Data Sheets. q:Upermits plus\icc changes\permit application (7 -2004) Revised 6.8.05 Page 2 bh 1 :. 4 Z ;= Z �W Q� J 0 00 Cl) 0 J = CO W } O } 95 LL ¢ N � = O I— W Z = F- 1- O W f^ 5 U O N 0 H W 111 H LL O Z 6i 0 O Z Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC 1 ".Floor \2 0 2 ". Floor 3 Floor Floors thru Basement ` O O 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): Q -5 2 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 g..No If "yes ", explain: FIRE PROTECTIONIHAZARDOUS MATERIALS- El.. 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 I I paper indicating quantities and Material Safety Data Sheets. q:Upermits plus\icc changes\permit application (7 -2004) Revised 6.8.05 Page 2 bh 1 :. 4 Z ;= Z �W Q� J 0 00 Cl) 0 J = CO W } O } 95 LL ¢ N � = O I— W Z = F- 1- O W f^ 5 U O N 0 H W 111 H LL O Z 6i 0 O Z I PUBLIC WORKS PERMIT INI . ATION -2 06= 433 =0179 t ` Scope of Work (please provide detailed information): Call before you Dig: 1- 800 - 424 -5555 Please refer to Public Works Bulletin 91 for fees and estimate sheet. Water District ❑ ...Tukwila ❑ ... 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) El.. Geotechnical Report ❑ ... Traffic Impact Analysis ❑ ...Bond [:]..Insurance ❑ .. Easement(s) ❑ .. Maintenance Agreement(s) ❑ ... Hold Harmless Proposed 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 ❑ .. Work in Flood Zone ❑ .. Storm 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 " ❑ .. Grease Interceptor ❑ .. Channelization ❑ .. Trench Excavation ❑ .. Utility Undergrounding ❑ ...Permanent Water Meter Size... WO# ❑ ...Temporary Water Meter Size.. WO# ❑ ... Water Only Meter Size............ WO# ❑ ...Deduct Water Meter Size It ❑ ...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: Ci state Zip Water Meter Refund/Billing: Name: Day Telephone: Mailing Address: Ci State Zip y:\ \permits plus \icc ehanges\permit application (7.2004) Revised: 6.8.05 Page 3 bh _ .._._..�. - - 'r.. ■errs ■i iur �. Z �Z W QQ� JU UO N J F- F— CO LL WO La to :3 = �W Z F- F— O Z F— W W U� CO C1 W 2 F H LL F- .. Z W U= O~ Z .MECHANICAL PERMIT INF(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 Replacement..... ❑ Replacement..... ❑ Ti Other: Indicate type of mechanical work being installed and the quantity below: Unit Type: Qty Unit Type: Qty Unit Type: Q Boiler /Com pressor: Q Furnace <I00K BTU Air Handling Unit >I0,000 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 Sin le 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 I 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 Centdr to comply with current fee schedules. Expiration of Plan Review - Applications for which no permit is issued within 180 days following the date of application shall expire by limitation. The Building Official may grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition). I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNER OR AUTHORIZED AGENT: Date: l ( 1 J I -- -, .F CJ V f Print Name: 1 Day Telephone: Mailing Address: City state Date Application Accepted: Date Application Expires: Staff Initials: clA %permits plusticc changes%permit application (7.1004) Revised: 6.8.05 Page 4 bh Zip e zz Q SZ '~ W � �U UO LU to W = F- 0) LL WO . U C0 = a �W z 1- 1.- O z I- W LU � p U O� CI F- W W H LL F- O z W UN 0 FZ- O z .. Cit of Tukwila rare 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 I ' RECEIPT i { Parcel No.: 3365901167 Permit Number: DOS-451 Address: 14484 58 AV S TUKW Status: APPROVED Suite No: Applied Date: 12/15/2005 I Applicant: YU RESIDENCE Issue Date: Receipt No.: R06 -00001 Initials: 3EM User ID: 1165 Payment Amount: 94.55 Payment Date: 01/03/2006 03:25 PM Balance: $0.00 Payee: TAM DEVELOPMENT TRANSACTION LIST: Type Method Description Amount ---- - - - - -- -- - - - - -- --------------------- - - - - -- ------ - - - - -- Payment Check 1015 94.55 ACCOUNT ITEM LIST: Description Account Code Current Pmts ------------------------ - - - - -- ---------- - - - - -- ------ - - - - -- BUILDING - RES 000/322.100 90.05 STATE BUILDING SURCHARGE 000/386.904 4.50 Total: 94.55 z W J U. UO U U J = H CO U. W O U_ ¢ _° �W z �_.. H O z F- W �5 U� O SO 0 11— ! W z N O z r rr Ts. Jig.: " :yi doc: Receipt Printed: 01 -03 -2006 City o f Tukwila 1900 i i i 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 RECEIPT Parcel No,: 3365901167 Address: 14484 58 AV S TUKW Suite No: Applicant: YU RESIDENCE Permit Number: D05 -451 Status: PENDING Applied Date: 12/15/2005 Issue Date: Receipt No,: R05 -01791 i Initials: JEM User ID: i 1165 Payment Amount: 80.00 Payment Date: 12/15/2005 02:50 PM Balance: $94.55 Payee: EVA TAM TRANSACTION LIST: Type Method Description Amount - - - - -- - -- - - - - -- --------------------- - - - - -- ------ - - - - -- Payment Cash 80.00 ACCOUNT ITEM LIST: Description Account Code Current Pmts - - - - -- --------------- - - - --- ---------- - - - - -- ------ - - - - -- BUILDING - RES 000/322.100 13.01 PLAN CHECK - RES 000/345.830 66.99 Total: 80.00 z W J U: UO U W =' H N O� W }} 9 -j LL Cl) = W z F.. F O z f- W U D. O N.. 01-- WW LL —0 Z' CO U =; O ~' z j doc: Receipt Printed: 12 -15 -2005 INSPECTION RECORD Retain a copy with permit INSPW11ON NO. PE I NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Project: X U Type of Inspection: Address: Date Called: Special Instructions: Date Wanted: a. P:5 Requester: Phone No: Ra leceipt No.: Date: Z �Z �W QQ� JU UO W= U) LL W O L? � = W H- _ ` Z F- F- O R LLJ W U� O N. 13 H WW LL Z W U= O Z $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. INSPECTION RECORD Retain a copy with permit L INSPECTION NO. CITY OF TUKWILA BUILDING DIVISIO 6300 Southcenter Blvd., #100, Tukwila, WA 98188 31 -36 Project: Type of Inspection Address: f Date Called: Special Instructi ns: Date Wanted: a.m. _ Requester. Phone No: leceipt No.: Date: Z �Z `~ W JU UO W = W O 9-1 co = F.. W H O Z H W W U� O N 0I_ W W ti O .. Z. W co O Z `_ paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. a• INSPECTION RECORD Retain a copy with permit INSPECTION NO. PER CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd.. #100. Tukwila. WA 98188 (206)43'1- Proje t: z / T Type of n pection: ,+ Address: ,/ �� (J D Date Called Speci F Approved per applicable codes. Corrections required prior to approval. VPrior to inspection, fee must be 100. Call to sechedule reinspection. R Z � ; Z W QQ � UO. CO O co Ill J = �U. W O L Q co =C3 W H Z I— O W �5 U� O c. OH WW H - LL Z 111 co O Z PERMIT COORD COPY PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D05 -451 PROJECT NAME: SITE ADDRESS: YU RESIDENCE 14484 58 AV S X Original Plan Submittal Response to Correction Letter # DATE: 12 -15 -05 Response to Incomplete Letter # Revision # After Permit Issued DEPARTMENTS BuiIing Division Public Work ni1A14A P� ,1. l Z- 2 Nlc�l i qd - 5 Fire Prevention Structural ❑ Alr 1 -2 - v Planning Division Permit Coordinator ❑ DETERMINATION OF COMPLETENESS (Tues., Thurs.) DUE DATE: 12-20 -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: TUES/THURS ROUTING: Please Route M Structural Review Required REVIEWER'S INITIALS: ❑ No further Review Required ❑ DATE: APPROVALS OR CORRECTIONS DUE DATE: 01 - 17-06 Approved ❑ Approved with Conditions Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents/routing slip.doc 2.2"2 Not Approved (attach comments) ❑ z }�— 2 �w �U U U13 W = F- � w �Q U� s �w x 1-- WO W U� ON I— wW F� �- O z U W P H O z DEC 2; 'v_.S 11:25AM TLIK14ILA nCri, PW P. CITY O F WKWILA"" • ''� ermit Center /Buildins 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., po�;=LL)� STATE OF WASHINOYON) n. COUNTY OF KING ) �_-J A� states as follows: 1. 1 have made application far 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 Affidevit. I have reed 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 pmvide.ve dficabon 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 b registered contractor. 1 understand that t 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, Notary Public Stole of Wttsshkow KEVIN P RANG MVA4)poW*rw f Expkes Oeo 13, 2009 Signed and s wor n to before me this � - day of 2&4- - . 20_Z5. PUBLIC in and for lapplicatI"\B -2004 driidavk In lieu of contractor ro8ictration . • ington, Residing at County. Name as commissioned: - My commission expires: 50 GI _�1.: eUM4'.•YNGS4X'w aW +1i.Waw.nu�....�....wA.YU «�+••r • •! nriY _ •• Y•,y '.• ladu.Li.> z ;= z �w J U UO to 0 J = N LL w 0 LL Q �D LIJ = z HO z !_ w w U� 0- �H ww LL .z w U= O~ z WASHINGTON SHORT -FORM INDIVIDUAL ACKNOWLEDGMENT (RCW42.44.1001 State of Washington SS. County of KiA� I certify that I know or have satisfactory evidence that 10 1A(, , L 'N-r U Name of Signer is the person who appeared before me, and said N0kVY PtAft SMfo of Wcid*Vlon KEVIN P DANG My Appok*Wd E*100 0OC 13.2009 Place Notary Seal Above person acknowledged that he /she signed this instrument and acknowledged it to be his /her free and voluntary act for the uses and purposes mentioned in the instrument. Dated: Month /Day /Year Signature ofRotarizing Officer AO , PLC b /l ,L Title (S ch as "Notary Public ") My appointment expires la- (3 �va c Month /DayNear of Appointment Expiration OPTIONAL Although the information in this section is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document of thumb Title or Type of Document: �. 0'� ��� L �� ��� c S �✓'=� c c? Document Date: la -�.'�� Number of Pages: Signer(s) Other Than Named Above: 6 4L /1 ` L-t. n o © 1999 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313 -2402 • www.nationalnotary.org Item No. 5906 • Reorder: Call Toll -Free 1- 800. 876.6827 z �Z '~ w u� D 00 N W= J � N LL, w LLQ (D D = �w Z H O z F— w UJ �o U O C0 Q1__ LLJ LL j uL ~O .. z: w U M, 0 F z A I I PROPOSED AREA � - - - - -- - - - -,� (BROKEN CORNER TO BE REPAIRED) I • 25' -6" i I i i CD . <: IW 3 W Iz N • W r� I • Q I Ir • � I i I i I I i I i I I i i EXISTING , HOUSE 14484 58TH AVE. S, together, we go further (EXISTING GRADE, ; NO CHANGE) o i (206) 769 -6676 I I 00 I � i SEATTLE, WA 98118-9998 24 i EXIST, RODE OVERHANG ' CTYP.� I I i 2 6' L- 3' ( � m EXISTING CD DRIVEWAY 1 J T PROJECT DATA PARCEL NUMBER: PROPERTY OWNER: PROJECT LOCATION;: ZONING: DESCRIPTION: 336590 - 1167 TU K WI LA, a f:e c•h *AN be waft to the see" Vol* pry am o! REGE "VED 0T`. O� � �K�' tLA uo 1 4 PERMIT (;t--N t tH ..ei. -- ..R - .a..�.r- •,�V •••- .F.•► ••r...- ,�r .. - �.Z..1,�•. ,n.,. - �'- 5►'!�*�R...7wr „�.,�,r.s ... 'K'�1! :,R r•++. - - -•, :�..�,�.. °� • r..•w.�..- , eg•p. - �;/�•-- ..�r °. .."'�.�,•.��r- nw.r�src.e. -.- :..�r►. �r�......:..,�.a. s �"��rs•�, ► "."".. i.�:++�1* . -� ;w-� ��. ,�,'.�.. ."�+�w . y� , �...rr.w.... �'+�RM�'�" !M' ^.a+a�!► +.� .y .r.wh.�-"�:� r: 'r'�4•�'�..- _'�'4•.t`.we�.w �+- . ._��� .. "` . - ��'w„ ��. .�_.....� -. _. -_�L. An+r�'' .- i�i.,�� - .r.- �R'�1�.-.�.R+.-s ..��' -irr.. �► - "GNP"_-• � . *+�....•��!e."'�'.�.�"n� ^r'.`. J�•�. �-•'+M�, �-. "'rj,.,��- �.r.��'`+�'!a 4 0 2 PROPERTY ------±------------------- i I PROPERTY EXIST. 123.88' I I I C()Df- <IST6 C , DEC 22 ��05 � V HOUSE piTuKWiI n I 15 0r � ntnrr �t�n , I t`',111 � I I ae"-3• � I o � o I 8 1-00 Li I 10 �-- • W r GARAGE - 0- o I [I/- I I i I -3" i i i I � r NM*ft Iftlipow �e tilorlon of ON f WAI is ava"016 SITE-/PLOT PLAN VIEW scale = 1 /8 ":1'0" y Aft • TAM DEVELOPMENT together, we go further DESIGN GROUP (206) 769 -6676 P.O. BOX 28404 SEATTLE, WA 98118-9998 OD W W Q U Q z = 3 Ld A 00 in � J Li CY. 3 co V Z � � x -� a F- d ° v LETTER REVISION DATE DRAVK APPROVED DATE ET 12/13/05 SCALE NOTED DRAVm N UMBE R 1214GAV—TUO10A SHEET aF 1 1 ..ei. -- ..R - .a..�.r- •,�V •••- .F.•► ••r...- ,�r .. - �.Z..1,�•. ,n.,. - �'- 5►'!�*�R...7wr „�.,�,r.s ... 'K'�1! :,R r•++. - - -•, :�..�,�.. °� • r..•w.�..- , eg•p. - �;/�•-- ..�r °. .."'�.�,•.��r- nw.r�src.e. -.- :..�r►. �r�......:..,�.a. s �"��rs•�, ► "."".. i.�:++�1* . -� ;w-� ��. ,�,'.�.. ."�+�w . y� , �...rr.w.... �'+�RM�'�" !M' ^.a+a�!► +.� .y .r.wh.�-"�:� r: 'r'�4•�'�..- _'�'4•.t`.we�.w �+- . ._��� .. "` . - ��'w„ ��. .�_.....� -. _. -_�L. An+r�'' .- i�i.,�� - .r.- �R'�1�.-.�.R+.-s ..��' -irr.. �► - "GNP"_-• � . *+�....•��!e."'�'.�.�"n� ^r'.`. J�•�. �-•'+M�, �-. "'rj,.,��- �.r.��'`+�'!a 4 0 2 PROPERTY ------±------------------- i I PROPERTY EXIST. 123.88' I I I C()Df- <IST6 C , DEC 22 ��05 � V HOUSE piTuKWiI n I 15 0r � ntnrr �t�n , I t`',111 � I I ae"-3• � I o � o I 8 1-00 Li I 10 �-- • W r GARAGE - 0- o I [I/- I I i I -3" i i i I � r NM*ft Iftlipow �e tilorlon of ON f WAI is ava"016 SITE-/PLOT PLAN VIEW scale = 1 /8 ":1'0" y Aft •