HomeMy WebLinkAboutPermit D2000-075 - OLIVER RESIDENCE - BEDROOMS AND BATHROOMOLIVER
RESIDENCE
ADDITION
D2000 -075
City of Tukwila'
Community Development / Public Works • 6300 Southcenter Boulevard, Suite 100 • Tukwila, Washington 98188
WARNING: IF CONSTRUCTION BEGINS BEFORE APPEAL PERIOD EXPIRES,
APPLICANT IS PROCEEDING AT THEIR OWN RISK..
Parcel No: 336590 -1200 Permit No: D2000 -075
Address: 14442 58 AV S Status: ISSUED
Suite No: Issued: 05/10/2000
Location: Expires: 11/06/2000
Category: ARES
Type: DEVPERM
Zoning: LDR
Const Type: Occupancy: DWELLING
Gas /Elec.: UBC: 1997
Units: 001 Fire Protection:
Setbacks: North: .0 South: .0 East: .0 West: .0
Water: TUKWILA Sewer: TUKWILA
Wetlands: Slopes: Y Streams:
Contractor License No:
OCCUPANT MARGARET OLIVER Phone:
14442 58 AVE S, TUKWILA WA 98168
OWNER McCARTHY KEVIN
14442 58th AVE SO., SEATTLE WA 98178
CONTACT SCOTT P TAYLOR Phone: 425 -235 -0237
10708 SE 186, RENTON WA 98055
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Permit Description:
ADDITION OF 300 SO FT (2 BEDROOMS) AND
REMODEL 1 BEDROOM INTO A BATHROOM
* *** * *** * ** * * *** * * * * * * ****** k* * * * *** * *** * ** ** **** k * *•k* * **•A*•k* k *** * *•k•k * *•k* **•k *•k * ** k **
Construction Valuation: $ 26,550.00
PUBLIC WORKS PERMITS: *(Water Meter Permits Listed Separate) Eng. Appr:
Curb Cut /Access /Sidewalk /CSS: N
. Fire Loop Hydrant: N No: Size(in): .00
Flood Control Zone: N
Hauling: N Start Time: End Time:
Land Altering: N Cut: Fill:
Landscape Irrigation: N
Moving Oversized Load: N Start Time: End Time:
Sanitary Side Sewer: N No:
Sewer Main Extension: N Private: N Public: N
Storm Drainage: N
Street Use: N
Water Main Extension: N Private: N Public: N
• ** ** * ** ** **** * * *•k•k******* *** * ** * * ***** * * **** ***** *•k•k• *** * * **** *•k **•k*** ***** ** ** *•k *•k
TOTAL DEVELOPMENT PERMIT FEES: $ 683.39
*************• k• k*****• k**• k• k*************• k********A k***** *** *** **•A***•k*•A* ****•k******
Permit Center Authorized Signature:
The granting of this
cancel the provisi'.
or the performance
development permi
Signature:__
Print Name:
DEVELOPMENT PERMIT
(206) 431 -3670
Date: S IQ ^0)-00e.j
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 wi '-ther specified herein or not.
resume to give authority to violate or
e or local laws regulating construction
orized to sign for and obtain this
Date: V 6316frr
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.
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Address: 14442 58 AV, $
Suite:
Tenant:
Type: DEVPERM
Parcel 4# : 336590 .1
12
''CITY OF TUKWILA
h ^' SQ";.".Vi?tlrLSFtYf' }' ms *r.wil,, Pmwo!%n fYIyTS4",.i7`V rcrl hW4Y
Permit No: D2000 -075
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Permit Conditions
I. No changes w i l l be made to the plans unless approved by the
Engineer and the Tukwila Building Division.
2. Eng t n;ecred ..truss drawings and c a l c u l a t i o n s shall be on site
and >:avai lab l e to the building inspector for inspection
purposes. . Documents shall bear the seal and signature of
Washington State Professional Engine er.
. Ariy :exposed insultions backing material shall have a Flame
Spread Rating of 2,5 or less`., and material shall bear identi-
fication showing the fire performance rating thereof.
All' construction to be done in conformance with approved
plans and requirements of the i l d i n g Uniform Bui l d i ng Code (1997
Ed•it' as amended .Uniform Mechanical Code (1997 Edition),
and .'Washington State Energy Code (1997 Edition) .
>`. Plumbingper�mits shall be obtained through the Seattle -King
Count Department. of Public Health, Plumbing will be'
inspected-by that agency, including all gas piping
(296;4722).
. 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.
L. Validity of';Perinit. The issuance of a permit or approval of
plans, specifications, and conmpuitations shall not be con-
strued to be a permit for, or an approval of, any violation
of any of the provisions of the b u i l d i n g code or of any
other ordinance of the jurisdiction. No permit presuming to
give authority to violate or cancel the provisions of this
code shall be valid.
9. Electrical permits shall be obtained through the Washington
State Division of Labor and Industries and all electrical
work will be inspected by that agency (248 -- 6630).
10. All mechanical work shall be under separate permit: issued by
the City of Tukwila.
11. All permits, inspection records, and approved plans shall be
available at the job site prior to the start of any con-
struction. These documents are to be maintained and avail-
able until final inspection approval is granted.
Temporary erosion control measures shall be implemented as
1. the first order of business to prevent sedimentation off -
site or into existing storm drainage facilities .
._._. _ . - -_12. .,._SJ.ia— ..f_t_= lti.::.3__1_..!y:uit__ 3.n:..�r_ _.._,a_tzaa.: 3__c,.,_ ......... c.u_i_rt.i L_ uuti• �i. z_ �s^_.___i-ei — ___ __...._..._._—___
Status: ISSUED
Applied: 03/06/2000
Issued: 05/10/2000
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place as soon as possible after final grading has been
completed and pri to the Final Inspection.
Project Name/Tenant: ti
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Is this site served by: X Sewer ❑ Septic (King County Health Dept. approval required - 296 -4722)
Value of Construction: q a ..6—
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Site Address:
City State /Zip:
Tax Parcel Nu e
Property Owner: Am vte
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Phone ;
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Street Address: «ydty
st Ave. 3
City State /Zip:
Fax #:
Contractor:
Phone:
Street Address:
City State /Zip:
Fax #:
Architect:
Phone:
Street Address:
City State /Zip:
Fax #:
Engineer:
Phone:
Street Address:
City State /Zip:
Fax #:
Contact Person: � _
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Phone: ' A
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Street Address: z ,
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Cit S tate /Zip:
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Fax #:
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Description of work to be done:
1 0 Gbilackl R->Pdr 0 01 " A
Type of work: ❑ New Single - Family Residence ❑ Addition - Single - Family Residence
❑ Interior Remodel- Single - Family Residence ❑ Residential Accessory Structure*
MII Remodel /Addition to Accessory Structure El Garage(s)
❑ Deck(s) - Covered & Uncovered ❑ Residential Reroof
Is this site served by: X Sewer ❑ Septic (King County Health Dept. approval required - 296 -4722)
Existing Square Footage for Structure: 9ry sq. ft. Dwelling sq. ft. Covered Deck(s)
sq. ft. Garage /Carport sq. ft. Accessory Structure(s) sq. ft. Uncovered Deck
Proposed New Square Footage: sq. ft. Dwelling sq. ft. Covered Deck(s)
sq. ft. Garage /Carport sq. ft. Accessory Structure(s) sq. ft. Uncovered Deck
Floor Area Ratio: (total floor area of all structures divided by the area of the lot) ,/C 7v
*For an Accessory dwelling, provide the following:
Lot area Floor area of principal dwelling Floor area of accessory dwelling
* Provide documentation that shows the principal owner lives in one of the dwellings as his or her primary residence.
CITY OF TL'
Permit Center
6300 Southcenter Blvd., Suite 100, Tukwila, WA 98188
(206) 431 -3670
SFPERMIT.DOC 2/13/97
" OR STAFF USE ONLY
Project Number;,'
Permit. Number:
Single - Family Residential Permit Application
Application and plans must be complete in order to be accepted for plan review.
Applications will not be accepted through the mail or facsimile.
PPLICANT FOR :PUBLIC WORKS SITE/CIVIL PLAN REVIEW OF THE; FOLLOWIN
': shall be determined by the Public Works Department)-,,,:::,:s
❑ Channelization /Striping El Curb cut /Access /Sidewalk ❑ Fire Loop /Hydrant (main to vault) #:
❑ Flood Control Zone ❑ Hauling El Land Altering: 0 Cut cubic yds. 0 Fill
❑ Moving an Oversized Load: Start Time: End Time:
El Sanitary Side Sewer #: ❑ Sewer Main Extension 0 Private 0 Public
❑ Storm Drainage El Street Use ❑ Water Main Extension 0 Private 0 Public
❑ Water Meter /Permanent # Size(s):
❑ Water Meter Temp # Size(s): Est. quantity: gal Schedule:
❑ Miscellaneous
Size(s):
cubic yds.
Value of Construction - In all cases, a value of construction amount should be entered by the applicant. This figure will be re-
viewed 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 ex-
pire 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.
Datee n cce
-tic tion ex,
Appli lion tylktials)
PLEASE SIGN BACK OF APPLICATION FORM
; NER.:OR•AUTHORIZED� GENT:
Signature:. •
. �
I,
Date: ••, .
Print riame • b°
i ar 0 e % v.
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Phone
2�- vim -u "
'fax" #: '
Address:
<G 4 1t-e 2- 5--Vi . S
City /State /Zip 40I44 /
ALL SINGLE - FAMILY RESIDENTI PERMIT APPLICATIONS MUST BE - BMITTED WITH THE FOLI2OWING:
• DRAWINGS PREPARED BY . ,3EGISTERED ARCHITECT OR PROFESSIONAL ENGINEER MAY BE
REQUIRED BY THE BUILDING OFFICIAL
D ALCDRAWINGS SHALL BE AT A LEGIBLE SCALE AND NEATLY DRAWN
• BUILDING SITE PLANS AND UTILITY PLANS ARE TO BE COMBINED
Copy of recorded Legal Description from King County
Certificate of water /fire flow availability (Form H -11 a). Contact the Public Works Department
(206) 433 -0179 for servicing district.
❑ ❑ Certificate of sewer availability (Form H -11). Contact the Public Works Department (206) 433-
0179 for servicing district.
r71 Metro: Residential Sewer Certification (if Tukwila Sewer District) (Form H -12)
❑ ❑ King County Health Department approval for septic - 296 -4722
Four (4) sets of working drawings, which include:
❑ ❑ Site Plan (see example Form H -16)
6 c4. Existing fire hydrant location
2. Proposed access road. W
3. Driveway location- driveway shall be 10' wide minimum and 20' wide maximum. If driveway is over
150' long, driveway shall be 20' wide and have an approved turnaround (City Ordinance eAti. North arrow and scale.
4Ci. Building setback from property lines. Any proposed or existing easements must be shown on plan.
/6. Public Works review requires the following on site plan: driveway location (10' min., 20' max. width),
show proposed and existing power, water and sewer lines, existing storm drainage system,
downspouts and foundation drains, and where drains tie -in.
(7f 7. Parking plan.
8. Lowest building elevation (if in Flood Control Zone).
9. Estimated /proposed topography at 2' intervals and proposed elevation of lowest floor level.
. Identify location of sensitive areas slopes 20% or greater, wetlands, watercourses and their buffers.
1. Identify location and size of significant trees that are located in sensitive areas and buffers or the
shoreline zone. Of those, identify which are to be removed (Title 18, City of Tukwila Zoning Code).
4/42. Identify location of high water mark of the Green /Duwamish River if site is located within 200' of the
high water mark.
0113. See Public Works Checklist for detailed site plan information required for Public Works Review (Form
H -9).
Foundation plan and details
Floor plan
Roof plan
Building elevations (all views)
, Building height
LJ' / Building cross - section
Structural framing plans and details necessary to completely describe construction
I Washington State Energy Code Data (Gas /Electric /Oil /Propane /Heat Pump) Form H -15 available
at Permit Center OR Prescriptive Heating System Sizing Chap 9 Form H -6.
❑ ❑ Complete Land Use Applications if not previously submitted (i.e., Reasonable Use Exception,
Variance, Shoreline or Tree Permit).
❑ ❑ Attach plans, reports or other documentation required to comply with Sensitive Area Ordinance
and other land use or SEPA decisions.
❑ -If dwelling has a septic tank, and a bedroom or bathroom are added, provide written approval
from the King County Health Department or the Tukwila Public Works Department prior to
submittal of permit application.
❑ ❑ Copy of Washington State Department of Labor and Industries Valid Contractor's License. If
not available at the time of application, a copy of this license will be required before the permit
is issued, unless the homeowner will be the builder OR submit Form H -4, "Affidavit in Lieu of
Contractor Registration ".
n
•Bulldln , Owner /Authorized Agent If' the applicant is other than the owner, registered architecbengineer, or contractor lioensed
by the State Washington, .'a notarized letter from the property owner authorizing the agent to submit this permit application and
obtain' the permit: will be :required as part of this. submittal. ;..:
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.
SFPERMIT.DOC 2/13/97
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ITY OF rUKNILA. NA '
_ |PANSMIT
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TRANSMIT Number: R980O245 A muu n t: 267.44 03/06/00 16:O4
Payment Method: CHECK Notition: SCOTT P TAYLOR Init: A[k
Permit No 02000-075 [ ype: DEVPERA DEVELOPMENT P[kNlT
Parcel No: 336590-120O
Site Address: 14442 58 AV S
Total Fees: 683.39
This Payment 267044 Tcta| ALL Pmts: 267.14
U::lncp: 415.95
*+*+ ***a*+++* ^71 ***+^*+ 71 aA^*+++* � *+^*A+ 4 *�A.A*A*+AAA*+A******+ I 4*«*
Account Code Descriytion Amount
000/345.830 PLAN CHECK - NONXES 267.44
---------- --._-------.—_---'-_---'--''--'----^_—_-~-'--'--'--
2107 03/07 9717 TOTAL 267.44
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L:IT OF NEWIL.A. 4Z0
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TRANSKIT Number: R9800281 Amou
• Payment ,.Me thod: CHECK Notati
PerMit Non D2000-075 Type: DEVPERM DEVELOPMENT PERMIT
Parrel No:336,590-1200
Site Address: 14442 58 AV 3
•
ThAs Ruym.z!nt 415.95
Balance: .00
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Account Code
000/322.100
000/386.”4
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DescripOon Amount
BUILDING -
HONES 411.45
STATE BUILDTNG SURCHARGE 4.50
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TRANSMIT
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IAYL OR In i NEP.
Total Fees: 683.29
T6ta1 ALL Pmts.,: 683.39
4222 05/11 9717 TOTAL 415.95
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INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 9818
PERMIT NO.
)431 -3670
Approved per applicable codes. 0 Corrections required prior to approval.
COMMENTS:
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$47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No:
Date:
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Phone:
INSPE ION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 9818
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
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E $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No:
Date:
INSPECTION RECORD
Retain a copy with permit
'';
PERMIT NO.
(206)431 -3670
ar /Vgl Project:
Typeef Inspection:
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INSPECTION RECORD
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INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION ch eiti
6300 Southcenter Blvd, #100, Tukwila, WA 98188 (206)431-3670
Approved per applicable codes. El Corrections required prior to approval.
COMMENTS:
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Receipt No:
Date:
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/ O � PERMIT NO. . OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 98188 (206)431 -3670
Approved per applicable codes. 0 Corrections required prior to approval.
Dat /
Ei $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No:
Date:
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Type of Inspection:
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Date called:
Special instructions:
Date wanted:
a.m.
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Requester:
Phone:
• INSPECTION NO.
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INSPECTION RECORD
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PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 98188 (206)431 -3670
0 Approved per applicable codes. 0 Corrections required prior to approval.
Inspecto
$47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No:
Date:
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Type of Inspection:
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Date called:
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INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
PERMIT NO.
6300 Southcenter Blvd, #100, Tukwila, WA 98188 (206)431-3670
0 Approved per applicable codes. 0 Corrections required prior to approval.
Inspe?pr:
In $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid'
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No:
Date:
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INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION zor
6300 Southcenter B lvd, #100, Tukwila, WA 98188 (206)431 -3670
Approved per applicable codes. ❑ Corrections required prior to approval.
Insp •
❑ $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No:
Date:
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INSPECTION RECORD
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CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 98188
PERMIT NO.
(206)431 -3670
Approved per applicable codes. RI Corrections required prior to approval.
COMMENTS:
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Inspector: j ) Date: f/
$47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No:
Date:
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March 30, 2000
Scott Taylor
10708 SE 186th
Renton, WA 98055
Dear Mr. Taylor:
Sincerely,
Brenda Holt
Permit Coordinator
encl
xc: File No. D2000 -075
City of Tukwila
RE: CORRECTION LETTER #1
Development Permit Application Number D2000 -075
Oliver Residence
14442 — 58th Avenue S
Steven M. Mullet, Mayor
Department of Community Development Steve Lancaster, Director
This letter is to inform you of corrections that must be addressed before your development permit can be
approved. All correction requests from each department must be addressed at the same time and
reflected on your drawings. I have enclosed comments from the Building Division. At this time, the
Fire Department, Planning Division and Public Works Department have no comments regarding your
application for permit.
The City requires that four (4) complete sets of revised plans be resubmitted with the appropriate
revision block. If your revision does not require revised plans but requires additional reports or
other documentation, please submit four (4) copies of each document.
In order to better expedite your resubmittal, a `revision sheet' must accompany every resubmittal. I have
enclosed one for your convenience. Corrections /revisions must be made in person and will not be
accepted through the mail or by a messenger service.
If you have any questions, please contact me at (206)431 -3672.
A42a-
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
DEPARTMENTS:
Buildin Division IN
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PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: D2000 -075
PROJECT NAME: OLIVER MARGARET
SITE ADDRESS: 14442 58 AVE S
XX Original Plan Submittal
DATE: 3 -6 -2000
Response to Incomplete Letter #
Response to Correction Letter # Revision # After Permit Is Issued
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
Comments:
TUES /THURS ROUTING:
Please Route
Approved
REVIEWER'S INITIALS:
Approved
\PRROUTE.DOC
5/99
I 1
Incomplete
Structural Review Required
REVIEWER'S INITIALS:
APPROVALS OR CORRECTIONS: (ten days)
Approved with Conditions
CORRECTION DETERMINATION:
Approved with Conditions
Fire Prevention
Structural
CANttyil ovl
REVIEWER'S INITIALS:
Plan ni�ivision
�P
44-1-00
Permit Coordinator
DUE DATE:3-7 -2000
Not Applicable
No further Review Required
DUE DATE 4 -4 -2000
■
DATE:
Not Approved (attach comments)
DUE DATE
Not Approved (attach comments)
DATE:
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PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: D2000 -075 DATE: 4 -12 -2000
PROJECT NAME: OLIVER RESIDENCE
SITE ADDRESS: 14442 58 AVE S
Original Plan Submittal Response to Incomplete Letter #_
XX Response to Correction Letter # 1 Revision # _ After Permit Is Issued
DEPARTMENTS:
BuDi Fire Prevention
AwL1 v' ion 5 —cx
Public Works Structural
DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE:4-1 3-2000
Complete Incomplete n Not Applicable
Comments:
TUES /THURS ROUTING:
Please Route t4 Structural Review Required
REVIEWER'S INITIALS:
APPROVALS OR CORRECTIONS: (ten days)
Approved
Approved with Conditions
CORRECTION DETERMINATION:
Approved
\PRROUTE.DOC
5/99
Approved with Conditions
REVIEWER'S INITIALS:
REVIEWER'S INITIALS:
Planning Division
Permit Coordinator
No further Review Required
DATE:
DUE DATE 5 -11 -2000
n
Not Approved (attach comments)
DATE:
DUE DATE
Not Approved (attach comments)
DATE:
Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted
through the mail, fax, etc.
Date: 1 - O 0
❑ Response to Incomplete Letter #
Z Response to Correction Letter # 1
❑ Revision # after Permit is Issued
Project Name: OLIVER RESIDENCE
Project Address: 14442 — 58 Avenue S
Contact Person: Scott Taylor
Su ary of Revision:
6 73
c)
City of Tukwila
Department of Community Development - Permit Center
6300 Southcenter Blvd, Suite 100
Tukwila, WA 98188
(206)431 -3670
Plan Check/Permit Number: D2000 -075
Sheet Number(s):
"Cloud" or highlight all area of revision In,ludina date of revicinli
Received at the City of Tukwila Permit Center by: I, 1 11/
1 25—Entered in Sierra on l i -- ,)--- on
Phone Number:
RECENED
CITY cTF''
1\7' tea
PERMI.T_CENTER
03/30/00
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Re, lential.Sew Use Certifit, ,ion
(To be completed for all new sewer connections, reconnections, or change of use of existing connections.
This form does not apply to repairs or replacements of existing sewer connections.)
Pursuant to King County Ordinance No. 11034, all sewer customers who establish a new service which uses metropolitan sewage
facilities after February 1, 1990 shall be subject to a capacity charge. The King County Council has established the amount of the charge
at seven dollars ($7.00) per month per residential customer or residential customer equivalent for a period of fifteen years.
The purpose of the charge Is to recover costs of providing sewage treatment capacity for new sewer customers. The charge is collected
semi - annually. All future billings can be prepaid at a discounted amount.
Questions regarding the capacity charge on this form shqpld be referred to King County Water Pollution Control Division at 684 -1740.
(Please print or type)
Owner's Name
AK- 64 t�t DL ((l
Last, First, Middle Initial)
Property Tax I.D. Number L 3Co T - i' 2-c=e) - moo
Property Legal Address:
Subdivision Name Subdiv. #
Lot # Block #
Building Name
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Date of Connection:
Side Sewer Permit #
Residential Customer
Please check appropriate box: Equivalent (RCE)
X Single- family
❑ Duplex (0.8 RCE per unit)
❑ 3 -Plex (0.8 RCE per unit)
❑ 4 -Plex (0.8 RCE per unit)
❑ 5 or more (0.64 RCE per unit)
No. of Units x 0.64 =
❑ Mobile home space (1.0 RCE per space)
No. of Spaces x 1.0=
For condominiums, please fill out Supplemental Form A in addition to this form.
I certify that the information given is correct. I understand that the capacity charge levied will be based on this information
and any deviation will require resubmission of corrected d for determination of a revised capacity charge.
Signature of Owner /Representative
Print Name of Owner /Representative
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(To be completed for all new sewer connections, reconnections, or change of use of existing connections.
This form does not apply to repairs or replacements of existing sewer connections.)
Pursuant to King County Ordinance No. 11034, all sewer customers who establish a new service which uses metropolitan sewage
facilities after February 1, 1990 shall be subject to a capacity charge. The King County Council has established the amount of the charge
at seven dollars ($7.00) per month per residential customer or residential customer equivalent for a period of fifteen years.
The purpose of the charge is to recover costs of providing sewage treatment capacity for new sewer customers. The charge is collected
semi - annually. All future billings can be prepaid at a discounted amount.
Questions regarding the capacity charge on this form shQld be referred to King County Water Pollution Control Division at 684-1740.
(Please print or type)
KING COUNTY
Owner's Name -�"'� L f (/ 61/'
Last, First, Middle Initial)
Property Tax I.D. Number L.5 3JC�'1 ZS' — 1 -C6
Property Legal Address:
Subdivision Name Subdiv. #
Lot # Block #
Building Name
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Property JWg 5
Street Address S .
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Owner's Mailing
Address S/4vn--`
(If different from
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Owner's Phone Number (Z e;16 ) Z- — 308
Property Contact Phone Number (
Party
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Party's Mailing
Address
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City or Sewer District
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Date of Connection:
Side Sewer Permit #
Please check appropriate box:
X Single- family 1.0
❑ Duplex (0.8 RCE per unit) 1.6
❑ 3 -Plex (0.8 RCE per unit) 2.4
❑ 4 -Plex (0.8 RCE per unit) 3.2
❑ 5 or more (0.64 FCE per unit)
No. of Units x 0.64 =
❑ Mobile home space (1.0 RCE per space)
No. of Spaces
For condominiums, please fill out Supplemental Form A in addition to this form.
I certify that the information given is correct. I understand that the capacity charge levied will be based on this information
and any deviation will require resubmission of corrected d— for determination of a revised capacity charge.
/ `/
Signature of Owner /Representative
Print Name of Owner /Representative
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Residential Customer
Equivalent (RCE)
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9704301543
When Recorded Return To:
MARGARET L. OLIVER
14442 68TH. AVENUE SOUTH
TUKWILA, WA. 98188
Escrow No. 971745 taJ AGE- ! Q b t ct
Reference# (if applicable) : 971745
Grantor(s): OLIVER Additional on page: 1
Grantee(s): MCCARTHY Additional on page: 1
LegalDescription (abbreviated): PARCEL L. S.P. 680 -37 -SS Full legal
on page: 1
Assessor's Tax Parcel ID#: 3365901200 - 00
THE GRANTOR KEVIN MCCARTHY AND DEBRA ANN POWLESS - MCCARTHY,
HUSBAND AND WIFE, for and in consideration of Ten Dollars and
other valuable consideration in hand paid, conveys and warrants to
MARGARET L. OLIVER, AN UNMARRIED PERSON, the following described
real estate, situated in the County of King, State of Washington:
PARCEL L, SHORT PLAT NUMBER 80- 37 -SS, RECORDED UNDER KING COUNTY
RECORDING NUMBER 8010230677, IN KING COUNTY, WASHINGTON.
ACCEPTED AS MD FORM AND CONTENT
Assessor's Tax Parcel ID #: 336590- 1200 -00
DATED: April 25, 1887
/
IN MCCAARTBY
State of Tennessee
Dated. '// /1!
STATUTORY WARRANTY DEED
2
LPB -10
DEBRA ANN POWLESS- MCCARTHY
County of }
I certify that I know or have satisfactory evidence that KEVIN MC CARTHY
DEBRA ANN POWLESS - MCCARTHY is /are the person(s) who appeared before
me, and said person(s) acknowledged that HEY signed this instrument and
acknowledged it to be THEIR free d oluntary act for the uses and
purposes mentioned in this instrume
9704301543
•O! Public in and for the state of
nnessee, residing at G f41
My appointment expires: 6/4x7
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