HomeMy WebLinkAboutPermit D04-212 - APOLLO SPAS - STORAGE RACKS•APOLLO SPAS
1233 ANDOVER PK E
D04-212
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City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 i (206) 431 -3670
DEVELOPMENT PERMIT
Parcel No.: 3523049084 Permit Number: D04 -212
Address: 1233 ANDOVER PK E TUKW Issue Date: 07/19/2004
r Suite No: Permit Expires On: 01/15/2005
Tenant:
Name: APOLLO SPAS
Address: 1233 ANDOVER PK E, TUKWILA WA
Owner:
s Name: BINAF INVESTMENTS Phone:
Address: 16400 SOUTHCENTER PARKWAY #204, TUKWILA WA
Contact Person:
Name: DON TRAFTON Phone: 206 575 -2700 X25
Address: 1233 ANDOVER PK E, TUKWILA WA
t
f Contractor:
Name: OWNER AFFIDAVIT IN FILE Phone:
Address: ,
Contractor License No: Expiration Date:
DESCRIPTION OF WORK:
ANCHORING 5 BAYS OF EXISTING RACKS WITH CONCRETE BOLTS.
Value of Construction: $0.00 Fees Collected: $188.01
1 Type of Fire Protection: SPRINKLERS Uniform Building Code Edition: 1997
Type of Construction: Occupancy per UBC: 0023
Public Works Activities:
i
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:
Water Meter: N
** Continued Next Page **
doc: Devperm 004 -212 Printed: 07 -19 -2004
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:. I City of Tukwila
1908
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Permit Center Authorized Signature: ��! Date:
I hereby certify that I have read and examine this permit and know the same to be true and correct.
ordinances governing this work will be complied with, whether specified herein or not.
All provisions of law and
The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws
regulating c action erformance of work. I am authorized to sign and obtain this development permit.
Signature: Date:
Print Name: i �Q-a�✓
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: Devperm D04 -212 Printed: 07 -19 -2004
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� 15 Cit y of Tukwila
r�os
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
PERMIT CONDITIONS
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Parcel No.: 3523049084 Permit Number D04-212
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Address: 1233 ANDOVER PK E TUKW Status: ISSUED
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Suite No: Applied Date: 06/22/2004
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Tenant: APOLLO SPAS Issue Date: 07/19/2004
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1: ** *BUILDING DEPARTMENT CONDITIONS * **
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2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the
Building Official.
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3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to
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start of any construction. These documents shall be maintained and made available until final inspection approval is
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granted.
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4: All construction shall be done in conformance with the approved plans and the requirements of the International
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Building Code or International Residential Code, International Mechanical Code, Washington State Energy Code.
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5: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of,
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any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits
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presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila
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shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the
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Building Official from requiring the correction of errors in the construction documents and other data.
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6: ** *FIRE DEPARTMENT CONDITIONS * **
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7: The attached set of plans have been reviewed by The Fire Prevention Bureau and are acceptable with the following
concerns:
8: Maintain fire extinguisher coverage throughout.
9: Clear access to fire extinguishers is required at all times. They may not be hidden or obstructed. (NFPA 10, 1 -6.5)
10: Sprinkler protection shall be extended to all areas where required, including all enclosed areas, below obstructions
and under overhangs greater than four feet wide. (NFPA 13- 4- 5.5.3.1)
11: All new sprinkler systems and all modifications to existing sprinkler systems shall have fire department review and
approval of drawings prior to installation or modification. New sprinkler systems and all modifications to sprinkler
systems involving more than 50 heads shall have the written approval of the W.S.R.B., Factory Mutual, Industrial Risk
Insurers, Kemper or any other representative designated and /or recorgnized by the City of Tukwila, prior to submittal
to the Tukwila Fire Prevention Bureau. No sprinkler work shall commence without approved drawings. (City Ordinance
#1901)
12: Contact the Tukwila Fire Prevention Bureau to witness all required inspections and tests. (UFC 10.503) (City Ordinance
#1900 and #1901)
13: This review limited to speculative tenant space only - special fire permits may be necessary depending on detailed
description of intended use.
14: Any overlooked hazardous condition and /or violation of the adopted Fire or Building Codes does not imply approval of
doc: Conditions D04 -212 Printed: 07 -19 -2004
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City of Tukwila
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Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 (206) 431 -3670
such condition or violation.
15: These plans were reviewed by Inspector 512. If you have any questions, please call Tukwila Fire Prevention Bureau at
(206)575 -4407.
* *continued on next page **
doc: Conditions 004 -212 Printed: 07 -19 -2004
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{,. City of Tukwila
teoe
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: - 7 /1 / b 1 /
Print Name: l
doc: Conditions D04 -212 Printed: 07 -19 -2004
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1908
CITY OF TUKWIL4
Community Development Department
Public Works Department
Permit Center
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 LOCATION
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King Co Assessor's Tax No.: _���(A - C)&5 I o2- (n9
Site Address: ) -2- 3 A,J 0 0VOK Per e15 Suite Number: Floor: —
Tenant Name: A Opt-Lo s ?,A s New Tenant: E] .... Yes g,..No
Property Owners Name: /11/ -T -
Mailing Address /233 �,,.Ot,2 �iC 6��'� rc,�k -/� t,.�t1 • �fs/
City State Zip
.CONTACT PERSON
Name: �t0�1 r 1 e' � " J Day Telephone: ,2 O(o- -5 - 7S• �R c1 x -aS
Mailing Address: 0 33 /�1D4v��2 W —t c e i W/1 _
City State "Lip
E -Mail Address: �\�( - -t'�� �? c���C>SI'/�S.�r''I Fax Number: ��(v-S�'7.S "ZF7a
GENERAL CONTRACTOR
Company Name:_
Mailing Address:
Contact Person:
E -Mail Address:
City State Zip
Day Telephone:
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:stainped by.Architecf of Record .
Company Name:
Mailing Address:
Contact Person:
City
Day Telephone:
E -Mail Address: Fax Number:
State Zip
ENGINEER OF RECORD . ' All plans must be wet stamped by Engineer of Record -
Company Name:
1
Mailing Address:
Contact Person:
E -Mail Address:
City State Zip
Day Telephone:
Fax Number:
\applicatian4ennit application (3.2003)
312003 Page I
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BUILDING PERMIT INFORMION 206-431
Valuation of Project (contractor's bid ice): $ C`� ,C�C� Existing Building Valuation: $
Scope of Work (please provide detailed in atio
ANCh 6- 5 -t5 or gA - sxS t_/
Will there be new rack storage? ❑ ..Yes ❑ .. No If "yes ", see Handout No. for requirements.
Provide All Building Areas in Square Footage, Below .
Addition to ;Type,of 1 Type of
Interior Existing Construction Occuparicy per
Existing Remodel Structure.:. New per Ul UBC
t— moor
2" Floor
3 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 princi dwelling: Floor area for accessory dwelling:
*Provide documentation that shows that the princip owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard: Compact: Handicap:
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Will there be a change in use? [] ....Yes E] ..No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
[..Sprinklers (]..Automatic Fire Alarm Fl.•None [] . Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? n.. Yes n ..No
If "yes ", attach list of materials and storage locations on a separate 8 -112 x 1l paper indicating quantities and Material Safety Data Sheets.
\applicatione\permit application (3.2003)
3/2003 Page 2
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PI7BhTG WORKS PERMIT I TION 206 =433 01.79
2 s � .. �.: .3 i � . ��� .• t i i � � � � s 14 � 1 1 !� } � 1 r � � i s � �.rr�' ��� -'.n� � i�
Y
Scope of Work (please provide detailed information):
Call before you Dig: 1- 800 - 424 -5555
Please . refer: to Public Works Bulletin #1 for fees and estimate sheet.
Water District
❑ ...Tukwila ❑ ... Water District # 125 ❑ .. Highline ❑ ...Renton
❑ ...Water Availability Provided
Sewer District
❑ ...Tukwila ❑... ValVue ❑ .. Renton ❑ .'..Seattle
❑ ...Sewer Use Certificate E] ... Sewer Availability Provided ❑ .. Approved Septic Plans Provided
❑ ...Septic System - For onsite septic system, provide 2 copies of a current septic design approval by King County Health Department.
Submitted with Application (mark boxes which apply):
... Civil Plans (Maximum Paper Size -22" x 34 ")
❑ ...Technical Information Report (Storm Drainage) ❑ .. Geotechnical Report ❑ ... Traffic Impact Analysis
❑ ...Bond ❑ .. Insurance ❑ .. Easement(s) ❑ .. Maintenance Agreement(s) ❑ ... Hold Harmless
Proposed Activities (mark boxes that apply):
E] ...Right -of -way Use - Nonprofit for less than 72 hours
❑ ...Right -of -way Use - No Disturbance
`! ❑ ...Construction /Excavation/Fill - Right -of -way
;i Non Right -of -way _
❑ ...Total Cut cubic yards
❑ ...Total Fill cubic yards
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❑..:Sanitary Side Sewer
❑ ...Cap or Remove Utilities
❑ ...Frontage Improvements
❑ ...Traffic Control
❑ ...Backflow Prevention - Fire Protection _
Irrigation
Domestic Water
❑ .. Right -of -way Use - Profit for less than 72 hours
❑ .. Right -of -way Use - Potential Disturbance
❑ .. Work in Flood Zone
❑ .. Storm Drainage
❑ .. Abandon Septic Tank
❑ .. Curb Cut
❑ .. Pavement Cut
❑ .. Looped Fire Line
❑ ...Permanent Water Meter Size...
WO# _
❑ ..,Temporary Water Meter Size..
WO# _
❑ ...Water Only Meter Size............
WO# _
❑ ...Sewer Main Extension ............Public
Private
❑ ...Water Main Extension ............. Public
Private
❑ .. Grease Interceptor
❑ .. Channelization
❑ .. Trench Excavation
❑ .. Utility Undergrounding
❑ ... Deduct Water Meter Size........ "
FINANCE INFORMATION
Fire Line Size at Property Line —
❑ ...Water ❑ ...Sewer
Monthly Service Billing to:
Name: -
Number of Public Fire Hydrant(s)
❑ ...Sewage Treatment
Day Telephone:
Mailing Address City State zip
Water Meter Refund/Billing:
Name:
Mailing Address:
City
State Zip
\applications \permit application (3.2003)
312003 Page 3
Day Telephone:
* •u.^ -�:an�+ x,:�• �:�ur�'a's�' " a��wxf 'tt►� "U.Eii ' btiu #.uuwia�a.��'ra:;w'.,� td::,
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MECHANICAL PEMT INFO ATION 206 4313670
low
s
MECHANICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
Contact Person: Day Telephone:
E -Mail Address: Fax Number:_
State Zip
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
Commercial:
New ....
New ....
Replacement .... F1
Replacement .... n
Fuel Type Electric ..... ❑ Gas .... R Other:
Indicate type of mechanical work being installed and the quantity below:
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty.
Boiler /Compressor:
Qty
Furnace <100K BTU
Air Handling Unit
>= 10,000 CFM
Other Mechanical
Equipment
0 -3 HP/ 100,000 BTU
Furnace >100K BTU
Evaporator Cooler
3 -15 HP /500,000 BTU
Floor Furnace
Ventilation Fan
15 -30 HP /1,000,000 BTU
Suspended /Wall /Floor
Mounted Heater
Ventilation System
30 -50 HP /1,750,000 BTU
Appliance Vent
Hood
50+ HP /1,750,000 BTU
—
Heat/Refrig /Cooling
System
Incinerator - Domestic
Air Handling Unit
<= 10,000 CFM
Incinerator - Comm /Ind
PERMIT-APPLICATION NOTES Applicable to all pelrmits in this applicat><on .
Value of Construction - In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject
to possible revision by the Permit Center to comply with current fee schedules.
Expiration of Plan Review - Applications for which no permit is issued within 180 days following the date of application shall expire by limitation.
The Building Official may extend the time for action by the applicant for a period not exceeding 180 days upon written request by the applicant as
defined in Section 107.4 of the Uniform Building Code (current edition). No application shall be extended more than once.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDIN 7
R OR AUT ZED AGENT: j
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Signature: Date :
Print Name: ..) Day Telephone: (0.
Mailing Address 1 233 i4��yE>Z � � t545T" � ule uk C-JA. S1 F 4fs�_
City state Zip
Date Application Accepted: ► Date Application Expires: Staff Initials:
A?
\applications \permit application (3.2903)
3/2003 Page 4
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City o f Tukw i l a
Igoe
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 i (206) 431 -3670
RECEIPT
j Parcel No.: 3523049084
Permit Number
D04-212
Address: 1233 ANDOVER PK E TUKW
Status:
APPROVED
I Suite No:
Applied Date:
06/22/2004
Applicant: APOLLO SPAS
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Issue Date:
i
Receipt No.: R04 -00902
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Payment Amount:
69.25
Initials: SKS
Payment Date:
07/19/2004 10:48 AM
User ID: 1165
S
Balance:
$0.00
1
i Payee: APOLLO WEST, LLC
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TRANSACTION LIST:
Type Method Description
---- - - - - -- -- - - - - -- - --------------------
Amount
- - - - -- ------ -- - - --
Payment Check 5170
69.25
ACCOUNT ITEM LIST:
Description Account Code Current Pmts
------------------------ - - - - -- ---------- - - - - -- ------ - - - - --
BUILDING - NONRES 000/322.100 69.25
Total: 69.25
- ,,.2591 07/20 9716 TOTAL 69.25
doc; Receipt Printed: 07 -19 -2004
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g Citv of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
RECEIPT
Parcel No.: 3523049084
Permit Number
D04-212
Address: 1233 ANDOVER PK E TUKW
Status:
PENDING
Suite No:
Applied Date:
06/22/2004
Applicant: APOLLO SPAS
Issue Date:
Receipt No.: R04 -00763
Initials: SKS
User ID: 1165
Payment Amount: 118.76
Payment Date: 06/22/2004 03:04 PM
Balance: $0.00
Payee: APOLLO WEST, LLC
TRANSACTION LIST:
Type Method Description Amount
---- - - - - -- -- - - - - -- --------------------- - - - - -- ------ - - - - --
Payment Check 5048 118.76
ACCOUNT ITEM LIST:
Description Account Code Current Pmts
------------------------ - - - - -- ---------- - - - - -- ------ - - - - --
BUILDING - NONRES 000/322.100 69.25
PLAN CHECK - NONRES 000/345.830 45.01
STATE BUILDING SURCHARGE 000/386.904 4.50
Total: 118.76
2112 06/23 9710 TOTAL ii8.76
doc: Receipt "' - Printed: 06 -22 -2004
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INSPECTION RECORD
Retain a copy with permit '
INSPECTION NO.
IT O.
CITY OF TUKWILA BUILDING DIVISION
.1
6300 Southcenter Blvd., #100, Tukwila, WA 98188 ( 06)431 -3670
Project:
W/Z 5� <
Type of Inspection:
Address
Called:
Special In truction . -
I l t Requester:
Date Wanted: a. m.
..� p.m.
Phone No:
Receipt No.: Date:
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tJ paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
-2— 1 INSPECTION REC(j'Ftf) ' 4
Retain a copy with permit
INSPECTION NO. OEIT NO.
'P C
CITY OF TUKWILA BUILDING DIVISION. 4.
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (2`0%431-3670
Prpject;,^
Type of Ins p c- t1op:
Address:
Date Called•
Special Instructions:
Date Wanted: a.m.
p.m.
Requester:
Phone No*
" 'P/
I Receipt No.: I Date:
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" paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
INSPECTION ^�
Retain a copy with permit
INSPE ION NO. PE T
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Pr ' cr
0 t11-1
Type of Inspection:
1 `" ra
dre s:
Date Called:
Special I structi ns:
Date Wanted:
d p.m.
to
Requester:
-�
Phone No:
; CO ce '
D Approved per applicable codes. Corrections required prior to approval.
COMMENTS: bb 11-���
G.
Inspec Date:
E] $4 .00 REINSPECTION EE 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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Permit No. L(hA 7 Z / _�—
Proj ect Name �r���0J,irS --
Address ? Aj7dCiuer Suite #
y Retain current inspection. schedule
Needs shift inspection
Approved without correction notice
455
City Of Tukwila
Steven M. Mullet, Mayor
i0
2 Fire Department Thomas P. Keefe, Fire Chief
A
TUKWILA FIRE DEPARTMENT
FINAL APPROVAL FORM
Approved with correction notice issued
Sprinklers:
Fire Alarm:
Hood & Duct:
Halon:
Monitor:
Pre -Fire:
Permits:
Authorized Signature
FINALAPP.FRM
Rev. 2/19/98
, - C r
Date
T.F.D. Form F.P. 85
Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: 206 -575 -4404 • Fax: 206.575 -4439
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NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEAR - THAN
THIS NOT CEt]S DUE TO THE QUALITY OF THE DOCUMENT
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01 -04 -2005
DON TRAFTON
1233 ANDOVER PK E
TUKWILA WA 98188
City of Tukwila Steven M. Mullet, Mayor
Department of Community Development Steve Lancaster, Director
RE: Permit No. D04 -212
1233 ANDOVER PK E 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 Permit Center at 206 - 431 -3670 to arrange 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 a one -tin►e extension «p to 180 days.
Extension requests must be in rvriti►re 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 02/22/2005, your permit will become mill 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,
i
Stefania Spencer,
Permit Technician
xc: Pemlit File No. D04 -212
Bob Benedicto, Building Official
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 * Fax: 206 - 431 -3665
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PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: D04 -212 DATE: 06 -22 -04
PROJECT NAME: APOLLO SPAS
SITE ADDRESS: 1233 ANDOVER PARK EAST
X Original Plan Submittal
Response to Correction Letter #
Response to Incomplete Letter #
Revision #_afteribefore permit is issued
DEPARTMENT�G -1-04
Build in Division 21
Public Works ❑
DUE DATE: 06 -24 -04
m, 0 (/ ���_0``
Fire Prevention 0
Structural ❑
DETERMINATION OF COMPLETENESS (Tues., Thurs.)
Complete [ Incomplete ❑
Comments:
Planning Division ❑
Permit Coordinator No
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 V Structural Review Required
REVIEWER'S INITIALS:
❑ No further Review Required
DATE:
APPROVALS OR CORRECTIONS
Approved ❑ Approved with Conditions
Notation:
REVIEWER'S INITIALS:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
DATE:
Documents /routing slip.doc
2 -28 -02
PERMIT COORD COPY
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DUE DATE: 07 -22 -04
Not Approved (attach comments) ❑
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CITY OF TL ^ "WILA
Permit Center •
6300 Southcenter Boulevard, Suite 100,
Telephone: (206) 431 -3670
,-,
Tukwila, WA 98188
STATE OF WASHINGTON )
ss.
COUNTY OF KING )
states as follows:
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 Washington. The exceptions to this requirement are stated under Section 18.27.090 of the
Revised Code Washington, a copy of which is printed on the reverse side of this Affidavit. I have
read 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 provide verification to the City of Tukwila of my compliance with this requirement, I hereby
attest that after reading the exemptions from the registration requirement of RCW 18.27.090, 1
consider the work authorized under this building permit to be exempt under No. [ — ,and
will therefore not be performed by a registered contractor.
I understand that I may be waiving certain rights that I might otherwise have under state law in any decision to
engage an unregistered contractor to perform construction work.
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ST.4
AFFCONT 1113100
APPLICANT
Signed and sworn to before me this
`cl -tv\ day of :::� � , 20
/I
NOTARY PUBLIC in ka d for the Srate of Washington,
residing at County.
Name as commissioned: C V" b °` c-r,
My commission expires:
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18.27.090 Exemptions. This chapter -'all not apply to:
1.
An authorized representative of the United States
of the operation is made into contracts of amounts
Government, the State of Washington, or any
less than $500 for the purpose of evasion of this
incorporated city, town, county, township, irrigation
chapter or otherwise. The exemption prescribed in
district, reclamation district, or other municipal or
this subsection does not apply to a person who
political corporation or subdivision of this state;
advertises or puts out any sign or card or other
device which might indicate to the public that he is a
2.
Officers of a court when they are acting within the
contractor, or that he is qualified to engage in the
scope of their office;
business of contractor;
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3.
Public utilities operating under the regulations of the
10. Any construction or operation incidental to the
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utilities and transportation commission in
construction and repair of irrigation and drainage
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construction, maintenance, or development work
ditches of regularly constituted irrigation districts or
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incidental to their own business;
reclamation districts; or to farming, dairying,
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agriculture, viticulture, horticulture, or stock or poultry
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4.
Any construction, repair, or operation incidental to the
raising; or to clearing or other work upon land in rural
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discovering or producing of petroleum or gas, or the
districts for fire prevention purposes; except when
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drilling, testing, abandoning, or other operation of any
any of the above work is performed by a registered
petroleum or gas well or any surface or underground
contractor;
mine or mineral deposit when performed by an owner
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or lessee;
11. owner who contracts a project with a
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registered contractor;
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The sale or installation of any finished products,
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materials, or articles of merchandise which are not
12. Any person working on his own property, whether
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actually fabricated into and do not become a
occupied by him or not, and any person working on
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permanent fixed part of a structure;
his residence, whether owned by him or not but this
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exemption shall not apply to any person otherwise
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6.
Any construction, alteration, improvement, or repair
covered by this chapter who constructs an
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of personal property, except this chapter shall apply
improvement on his own property with the intention
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to all mobile /manufactured housing. A
and for the purpose of selling the improved property;
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mobile /manufactured home may be installed, set up,
or repaired by the registered or legal owner, by a
14., wners of commercial properties who use their own
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contractor licensed under this chapter, or by a
employees to do maintenance, repair, and alteration
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mobile /manufactured home retail dealer or
work in or upon their own properties;
manufacturer licensed under chapter 46.70 RCW;
14. A licensed architect or civil or professional engineer
7.
Any construction, alteration, improvement, or repair
acting solely in his professional capacity, an
carried on within the limits and boundaries of any site
electrician licensed under the laws of the state of
or reservation under the legal jurisdiction of the
Washington, or a plumber licensed under the laws of
federal government;
the state of Washington while operating within the
boundaries of such political subdivision. The
8.
Any person who only furnished materials, supplies, or
exemption provided in this subsection is applicable
equipment without fabricating them into, or
only when the licensee is operating within the scope
consuming them in the performance of, the work of
of his license;
the contractor;
9. Any work or operation on one undertaking or project
by one or more contracts, the aggregate contract
price of which for labor and materials and all other
items is less than $500, such work, or operations
being considered as of a casual, minor, or
inconsequential nature. The exemption prescribed in
this subsection does not apply in any 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
AFFCONT 1113100
15. Any person who engages in the activities herein
regulated as an employee of a registered contractor
with wages as his sole compensation;
16. 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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. NOTE: Revisions will require a new plan submittal
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REVIEWED FOR
CODE COMPLIANCE
APPROVED
JUL 0 7 2004
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BUILDING DIVISION
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