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HomeMy WebLinkAboutPermit D05-452 - PEREZ RESIDENCE - CHIMNEYPEREZ RESIDENCE 3131 S 133 ST D05-452 z w ce 2. .6 C.) . 00. CI) 0 CO W W uj 0 g u_ — w z 0 z w 2 a 0: 0 t- w, 0. P. z co: 0. — z . C ity 0. Tukwila S teven M. Mullet, Mayor Department of Community Development Steve Lancaster, Director 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: cOukwila.wa.us DEVELOPMENT PERMIT Parcel No.: 7346600236 Permit Number D05 -452 Address: 3131 S 133 ST TUKW Issue Date: 04/28/2006 Suite No: Permit Expires On: 10/25/2006 Tenant: Name: PEREZ RESIDENCE Address: 3131 S 133 ST, TUKWILA WA Owner: Name: SWEDELIUS LAWRENCE Address: 3131 S 133RD ST, SEATTLE WA 98168 Phone: Contact Person: Name: LUIS LOPEZ Address: 3131 S 133 ST, TUKWILA WA 98168 Phone: 206 424 -3129 Contractor: Name: OWNER AFFIDAVIT - LUIS LOPEZ PEREZ Address: , Phone: Contractor License No: Expiration Date: DESCRIPTION OF WORK: REBUILD EXISTING BRICK CHIMNEY (CHANGE FROM BRICK TO WOOD FRAME) Value of Construction: $400.00 Fees Collected: $52.35 Type of Fire Protection: International Building Code Edition: 2003 Type of Construction: V -B Occupancy per IBC: 0022 * *continued on next page ** doc: IBC- PERMIT D05 -452 Printed: 04 -28 -2006 p b z U O' No J � U. W O L¢ �D = �w z _ F- � zF w W U0 0 N. o Ir-. w U u. E' Iw c U O z O O Steven M. Mullet, Mayor Steve Lancaster, Director City 0. 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 Permit Number: Issue Date: Permit Expires On: D05 -452 04/28/2006 10/25/2006 Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Fire Loop Hydrant: Flood Control Zone: Hauling: Land Altering: Landscape Irrigation: Moving Oversize Load: Sanitary Side Sewer: Sewer Main Extension: Storm Drainage: Street Use: Water Main Extension: Water Meter: Size (Inches): 0 End Time: Fill 0 c.y. End Time: Public: Non - Profit: N Public: Permit Center Authorized Signature: Date: t M I 7A UO I hereby certify that I have read and x mir1d his permit and know the same to be true and correct. All provisions of law and ordinances governing this work will be mplie with, whether specified herein or not. The granting of this regulating construct Signature: Date: 04 y 0' Print Name: �� 5 ��G���'' el 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 -452 Printed: 04 -28 -2006 N Number: 0 N N Start Time: N Volumes: Cut 0 C.Y. N N Start Time: N N Private: N N Profit: N N Private: N as not presume to give authority to violate or cancel the provisions of any other state or local laws performance of work. I am authorized to sign and obtain this development permit. Z �Z '~ w D 00 00, wi J I.- CO u-, w LL Q co �. w z r•- t- O Z I•-. w U� O N, o l- wW .Z 0 O Z r,os Ci of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 PERMIT CONDITIONS Z Parcel No.: 7346600236 Permit Number DOS-452 Z w Address: 3131 S 133 ST TUKW Status: ISSUED D Suite No: Applied Date: 12/19/2005 -' 0 Tenant: PEREZ RESIDENCE Issue Date: 04/28/2006 N 0 co W J = H 1: ** *BUILDING DEPARTMENT CONDITIONS * ** N U. w 0 2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the Building Official. LL N C7 3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to UJI start of any construction. These documents shall be maintained and made available until final inspection approval is ? i-- granted. 0 z UJ w 4: All construction shall be done in conformance with the approved plans and the requirements of the International o Building Code or International Residential Code, International Mechanical Code, Washington State Energy Code. v co 0— 5: Notify the City of Tukwila Building Division prior to placing any concrete. This procedure is in addition to any o r- w w requirements for special inspection. v 6: All wood to remain in placed concrete shall be treated wood. LL z w co 7: There shall be no occupancy of a building until final inspection has been completed and approved by Tukwila building b F- inspector. No exception. Z 8: 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. 9: Manufacturers installation instructions shall be available on the job site at the time of inspection. 10: 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. 11: 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). 12: 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 -452 Printed: 04 -28 -2006 < iiii..�a. '�$ikl..9" �M , a'. , •+ : {!. '1ki.i��m + '.drP K 1 ".�'�.:�'ia`, i City of Tukwila r Department of Community Development/ 6300 Southcenter BL, Suite 100/ Tukwila, WA 98188 / (206) 431 -3670 ( 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: © 2 Print Name: / C doc: Conditions D05 -452 Printed: 04 -28 -2006 zz Z �w �D U O �o U) N U- W O w? CO CY z� H- O z 11-- w �5 U� O CO W W , H V It. Lll z to P _' O z ILA, w 1908 CITY OF TUKWi,�-'__� Community Develop.;: epartment Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 Building Pen. 'No. d t '_� "��-- Mechanical'Perinit No. .Public Works Permit No. Project No. _ �� tj ! 1 0 For o ice use only Applications and plans must be complete in order to be accepted for plan review. Applications will not be accepted through the mail or by fax. * *Please Print ** s SITE LOCATION. King Co Assessor's Tax No.: Site Address: 3 131 S / 3 r S y W J ) 9'y16 Suite Number: Floor: Tenant Name: New Tenant: ❑ .... Yes ❑ ..No Property Owners Name: Z r 9/l L+ 112115 1411ee C C a e�✓eQ Mailing Address: 3/ 3 I S / 3 -yd S f- u {S w /ei tit/ «/ �'r / 6 y City State Zip CON TACTPERSON Name: /u" S /* 2 Day Telephone: 2 c' z X12 Mailing Address: ? / 3 / r /3 yak 51 Lt/ �✓ At i ,M� K y City State Zip E -Mail Address: Fax Number: GENERAL CONTRACTOR: INFORMATION - (Mechanical Contractor information on back page) Company Name:_ Mailing Address: Contact Person: City State Zip 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: Contact Person: E -Mail Address: tt. %iperrnits ptusUcc changestp=h application (7-2004) Revised: 6.8.05 bh Page 1 City State Zip Day Telephone: Fax Number: 34L� !'v:.......�:' Z IZ ' w � �U UO W W J (1)W W } O } �J u- = a E- w z F- ZO W W U� O- 0 F- WW HF- U- O Z W U= O Z BUILDYNG .PERMIT,INFQRMA ON 20b= 431 -3670 Valuation of Project (contractor's bid price): $__4 Scope of Work (please provide detailed information):. r0p 62:•i, Existing Building Valuation: $ t 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 PROTECTIONIHAZARDOUS MATERIALS: [I.. Sprinklers El.. 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 1I paper indicating quantities and Material Safety Data Sheets. q:l\permits pluslicc changcs\permit application (7.2004) Revised: 6.8.05 Page 2 bb Z '~ w LL g UO N Lq X CO W WO LL N � =d �W ZF F- O Z F- W 2 10 O- 07 _ Ww H� LL O •• Z U= O Z Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy.per IBC I" Floor 2" 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 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 PROTECTIONIHAZARDOUS MATERIALS: [I.. Sprinklers El.. 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 1I paper indicating quantities and Material Safety Data Sheets. q:l\permits pluslicc changcs\permit application (7.2004) Revised: 6.8.05 Page 2 bb Z '~ w LL g UO N Lq X CO W WO LL N � =d �W ZF F- O Z F- W 2 10 O- 07 _ Ww H� LL O •• Z U= O Z MECHANICAL PERMIT INFC. NATION — 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): S Scope of Work (please provide detailed information): i ` Use: Residential: New .... ❑ Replacement..... ❑ Commercial: New .... Replacement.....❑ Fuel Type Electric.....❑ Gas....❑ Other: 0 -3 HP /100,000 BTU 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 >10,000 Fire Damper 0 -3 HP /100,000 BTU CFM Furnace>100K BTU Evaporator Cooler Diffuser 3 -15 HP /500,000 BTU Floor Furnace Ventilation Fan Connected Thermostat 15 -30 HP /1,000,000 BTU to Single Duct Suspended/Wall/Floor Ventilation System Wood/Gas Stove 30 -50 HP /1,750,000 BTU Mounted Heater Appliance Vent Hood and Duct Water Heater 50+ HP /1,750,000 BTU Repair or Addition to Incinerator - Domestic Emergency Heat /Refrig/Cooling Generator System Air Handling Unit Incinerator— Comm/Ind Other Mechanical <10,000 CFM 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 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 PERJ j , y, , B THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING 0 THORIZED AGENT: Y Signature: Date: i Print Name: yi , A cpe 2 �E' >'e �= Mailing Address: Rf � / S / S 3 "Y e - / 34 - City State , 0 i Date Application Accepted: Date Application Expires: Staff Initials: ou q.Upermits plus %kc changeslpermit application (7.2004) Revised. 6.8.05 Page 4 bh y � . .,,..�. r-. ...;a:rs: . c�.. tuu; ua.►:.»: fiA: 11' w` iWl�tu.it;i�n.S+:iivi:»Ar.�3«S! s : � z p . i 3i' r r 4r• - � � f• �i�� t � Y ;,. +.:...� <t ° . :.1+:` ,- 13Y. r'. v' S:: il." e7-%. a:. f; 1+ x' E' s�+ ratya. rrxanaa:+ ue, zn+ awwa. .rwa.�+ro.,�cws«rwo.- '�-- .^•— '= �Fi *�: �t $.'t•K. "^ ti+�LSO'3t� #jY;uJ:+�t ii h7d:'F ,• C6Y n'c Day Telephone; ( Q 3 2 U 1\ W) Z ~ W Q � Q � JU UO to 0 C0 LLI W = C/) tL c W 0 L U cl)d = W H _ ? F— Z� 0 p LLI U N 0 I— W W H LL O -- Z co O Z City of Tukwila f9C6 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 i RECEIPT Parcel No.: 7346600236 Address: 3131 S 133 ST TUKW Suite No: Applicant: PEREZ & CUEVAS RESIDENCE Receipt No.: R05 -01812 Initials: JEM User ID: 1165 Payee: LUIS LOPEZ PEREZ TRANSACTION LIST: Type Method Description Amount ---- - - - - -- -- - - - - -- --------------------- - - - - -- ------ - - - - -- Payment Check 2173 52.35 ACCOUNT ITEM LIST: Description Account Code Current Pmts ------------------------ - - - - -- ---------- - - - - -- ------ - - - - -- BUILDING - RES 000/322.100 29.00 PLAN CHECK - RES 000/345.830 18.85 STATE BUILDING SURCHARGE 000/386.904 4.50 Tota 1: 5 2.3 5 Permit Number D05 -452 Status: PENDING Applied Date: 12/19/2005 Issue Date: Payment Amount: 52.35 Payment Date: 12/19/2005 01:46 PM Balance: $0.00 Z Z W QQ 5 C.) UO Co 0' w= J f -. co LL WO a LL Q co d F-W ZF F- O w ~ W UC3 O N .0 H W W H 11. 0: 111 Z U= O~ Z doc: Receipt Printed: 12 -19 -2005 INSPECTION RECORD Retain a co py p ermit ermit �i� 2 INSPECTION NO. PE I CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -367k Project: Type of Inspection: Address: 31 133.4-cZ Date Called: Special Instructions: Date Wanted: a.m. 3 .m Requester: Phone No* Receipt No.: Date: Z iH Z ' _3 U UO Cl) U) LILI J � N LL WO LL Q U � = d. �W 2 F- O W ~ W U� O� 0 H LLI =U H O W Z co O Z paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. Project: Ae� /Am Type of Inspection: 4-e- s :/ Address � 3 Z 3 63 3".,/ Date Cal lecr ", Special Instructions: Date Wanted: /"') a.. Requester' Phone No: it J INSPE&IbN RECORD INSRMON NO. Retain a copy with permit PE N CITY OF TUKWILA BUILDING DIVISION ) w 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431'-34670 &2 5g Approved per applicable codes. Corrections required prior to approval. lecelpt No.: Date: Z Tz W LU _3 0 00 (D 0 C0 LU UJ J D U. 0 2� 9-1 U- I .- LLI 0 z �- LILI L1j 5 C0 0 0 H W W F- P 0 z 0 0) H 0 Z L-i paid at 6300 Southcenter Blvd., Suite 100. Call to s echedule reinspection. INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT N CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206 431 -367 Corrections required prior to approval. 21 [.Approved per. applicable codes. i 5 R� � Receipt No.: i Proje Q n P V� 1C, idr��1 e Type of Inspection: — /kf ltJ�1 Address: �3t S -t3�s Date Called: Special Instructions: Date Wanted: a ---7 p.m. Requester: Phone No: Z �Z '~ W UO C O N LL W r 2 U � = W H Z E- H O w �5 U� O N OH WW U O Z, LLI U =; O F- Z INSPECTION RECORD Retain a copy with permit 05- L(:; Z INSPECTION NO. PERMIT CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -367 P I; ct: �Ps �c��.N�� Type of Inspection: t =C -1 ( � � A A 4 �'�Aj Address: 3 13 1 S 13 3 S - Date Called: Special Instructions: Date Wanted: - _ L a ;�": Requester: Phone No: Approved per applicable codes. r eceipt.No.: Date: 7 z �W JI U . UO ND J = C/) LL WO 9-1 LL Q = F . w . z f— I— O z F- U � O N LIJ U_ LL Z Lll UN F= _ O ~` Z Fl Corrections required prior to approval. ea r+— a... c ....- r t^. 'h"�"�"',".�.•w.-." grt ^rt. .ru;."^ «..r: - r ; 4 •• = .�r:••�,.. r; �.._.. INSPECTION RECORD. ; Retain a copy with permit INSPECTION NO. PER CITY OF TUKWILA BUILDING DIVISION • 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -36 � 0 Project: Type of Inspection: Address: Date Called: Special Instructions: Date Wanted: a.m. p.m. Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: f i nspector: a $58.00 REINSPECTION OEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Cal( to sechedu(e reinspection. ,ecelpt No.: Date: Z �W 3U UO 0 V) UJI III F- S2 U. W O LL N d. = W H Z F. I- O zH �5 U o ~. WW H H LL Z 111 to O Z 12 -06 -2006 f City of Tu"ila Steven M. Mullet, Mayor Department of Community Development Steve Lancaster, Director t e LUIS LOPEZ 3131 S 133 ST TUKWILA WA 98168 RE: Permit No. D05 -452 3131 S 133 ST TUKW Dear Permit Holder: In reviewing our current records the above noted permit has not received a final inspection by the City of Tukwila Building Division. Per the International Building Code and/or the International Mechanical Code, every permit issued by the Building Division under the provisions of this code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 180 days from the date of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days. Based on the above, you are hereby advised to: Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 to schedule for the next or final inspection. This inspection is intended to determine if substantial work has been accomplished since issuance of the permit or last inspection; or if the project should be considered abandoned. If such determination is made, the Building Code does allow the Building Official to approve one or more extensions of time for additional periods not exceeding 90 days each. Extension requests must be its writing and provide satisfactory reasons why circumstances beyond the applicants control have prevented action from being taken. In the event you do not call for the above inspection and receive an extension prior to 01/21/2007, your permit will become null and void and any further work on the project will require a new permit and associated fees. Thank you for your cooperation in this matter. Sincerely, e fe - Ma hall, P 't Te ician xc: Permit File No. D05452 Is 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206.431 -3670 • Fax: 206 - 431 -3665 Z �a. Z . � �U UO N C0 W J = H CO w w te- Q U � = �.W Z =. f—. F— O Z }— W V �. O� F- W W FZ— U �O W Z U cr) b H O Z ERMIT COORD COPS' PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D05 -452 PROJECT NAME: SITE ADDRESS: PEREZ RESIDENCE 3131 S 133 ST DATE: 12 -19 -05 X Original Plan Submittal Response to Correction Letter # Response to Incomplete Letter # Revision # After Permit Issued DEPARTMENTS Dn 1 40 0 (114 B it ing Division fr Public Works fl' ILIn _ (z - o- I qtt.' (2 -zoo Fire Prevention Structural ❑ � �� Ali 12 - /0-os Planning Division Permit Coordinator ❑ DETERMINATION OF COMPLETENESS (Tues., Thurs.) DUE DATE: 1 2-20-05 Complete d 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 ROW ING: Please Route Structural Review Required ❑ No further Review Required ❑ REVIEWER'S INITIALS: DATE: APPROVALS OR CO RRECTIONS : DUE DATE: 0 -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: Oocumenls(rouling slip.doc 2.2"2 ..:..:... �.•,� . � .....:.,. �. _...........:.....,..:,,,. �......-,.:....>: �.._, w�.„„, �: wa.. k. ia.. .�,;:...,A.a.a.,4..::�...w..... .,....�...k..:.,.;.:+.�.c.a � '..rao,<u�l.;. 'w1:.s::i„4.uaa ; w, tvr,; µw. it,< 5 =,G+a1.W.tc:�+lwnv':.>'q;lr,7r % rs` �iJr%.ka�':,l "�� 1 .�f,�.tSis.�i+ , :,riti.r a1rwJ,ttt` < "•« Not Approved (attach comments) ❑ z �z �w QQ JU 00 Cl) 0 CO III J = N LL w O LLQ = F- w z = ZO W w ULa ON C1 !r w L O w z U= O z 1906 X CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 Permit Center /Building Division: 206 -431 -3670 Public Works Department: 206 - 433 -0179 Planning Division: 206431 -3670 AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION Z ~ PERMIT NO.: �' �ISZ- 0 '~' w �D STATE OF WASHINGTON) v ss. COUNTY OF KING ) 00 w states as follows: N U. [please print] Q U. 1. I have made application for a building permit from the City of Tukwila, Washington. = Cy be �w ? 2. 1 understand that state law requires that all building construction contractors registered with the State of Washington. The exceptions to this requirement are stated under Section 18.27.090 of the Revised Code of Z � Washington, a copy of which is printed on the reverse side of this Affidavit. I have read or am familiar with RCW w W 18.27.090. v o 3. 1 understand that prior to issuance of a building permit for work which is to be done by any contractor, the City of N o Tukwila must verify either that the contractor is registered by the State of Washington, or that one of the exemptions W — stated under RCW 18.27.090 applies. v 4. In order to provide verification to the City of Tukwila of my compliance with this requirement, I hereby attest that U. O z after reading the exemptions from the registration re uirement of RCW 18.27.090, 1 consider the work authorized v to under this building permit to be exempt under No._, and will therefore not be performed by a registered ° contractor. z 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 Ni-A day of Oe- cember , 20 d 5 . `, GE A, p� Q•�ssio'rvFgC'�`�,, .� �� �' %'• ', NOTARY PUBLIC in and for the tate of Washington, 9� o NOTARY � r te. Residing at _ /t I h A _ , County. - i N pUB LIG I�� _ Name as commissioned: / ice, /�. Dea cy • �����9j� • 1 ' C? •' �' , WA My commission expires:` ... \applications\8 -2004 affidavit in lieu of contractor registration .}^ti .•L a.yn.w.t �:V�;�i,:.y:':I�.x,iY.,xW:U' tip{ ��aaxwaw :ax�eHwueWklU�ttlyaf}:�.etWyWL( an..... 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; 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; 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 or 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 perform highway construction, reconstruction, or maintenance work. 13i%�6Lk7W�+td � �••W iSi 1'i otv:�kc{' wi_ '''1..tliLS�S�1' fMxAS.�1x,+,diSA i�,�5.�:,, Z �z �w aa JU 00 CO J= H NU. w �-J u- tn :D = �w z F- H O Z w w U� O� o F- wW Ir— u' O Z w U= O Z I erg r� � r( l +I'A-r++e�+a+,�, �mm s' a � �11�t/wi11! . ML°IirT r�T.n faf�!AM alter . =� .was n � awl �� a♦ ■■rl � sl•II .,. T tlraar.lt� wwr � 1� ao 01 C� ririlR ■ hR1r ■lilt/ �0I7. ..r.rw•� / 111.1'�uJl!lr>•�tl47iltr!r` 1 r iw h t'fJ 146 7 I V, . �_ 7 f a��+ Iq.►��� lar.��ri r.=�. -- --Wad � PMoliII13wI�1��1��1' �. •4\ter i, 5:44 ! ►i! �5i, Al 1 � 1! 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