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HomeMy WebLinkAboutPermit D04-337 - GROUP HEALTH COOPERATIVE - ADMINISTRATIONGROUP HEALTH ADMINISTRATION 12400 EAST MARGINAL WAY S EXPIRED D04 -337 z W _s 0: U0 CO W=• CO W00 u. Nd = W Z AL W 2o oN o1. W. W U. o WZ no: 0~ Z Cit y aY 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.iva.us DEVELOPMENT PERMIT Parcel No.: 7340600480 Address: 12400 EAST MARGINAL WY S TUKW Suite No: Permit Number: Issue Date: Permit Expires On: Steven M. Mullet, Mayor Steve Lancaster, Director D04 -337 09/29/2004 03/28/2005 Tenant: Name: GROUP HEALTH ADMINISTRATION Address: 12400 EAST MARGINAL WY S, TUKWILA WA Owner: Name: GROUP HEALTH COOPERATIVE Address: CONTROLLER, 521 WALL ST Contact Person: Name: ALEXANDER CLARK Address: 1904 THIRD AV, SUITE #500, SEATTLE, WA Contractor: Name: OWNER AFFIDAVIT IN FILE Address: , Contractor License No: Phone: Phone: 206 682 -5000 Phone: Expiration Date: DESCRIPTION OF WORK: ADDING FILE SHELVING AND WORKSTATION TO EXISTING FILES ROOM; ADD PARTITION WALLS AND DOOR TO EXISTING ROOM Value of Construction: $3,000.00 Fees Collected: $174.55 Type of Fire Protection: SPRINKLERS International Building Code Edition: 2003 Type of Construction: IV Occupancy per IBC: 0008 Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Fire Loop Hydrant: N Number: 0 Size (Inches): 0 Z Z. '~ w n 2 JU UO (/) J H �LL w J U. Q = F- w zF- 1— O LU Z F— w Do ON o E- wW U-- O ui Z U= O Z City OR Tukwila Steven M. Mullet, Mayor Departsie►it of Community Develop»ie►it 6300 Southeenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206- 431 -3670 Fax: 206 - 431 -3665 Web site: ci.tukwila.wa.its Permit Number: Issue Date: Permit Expires On: Permit Center Authorized Steve Lancaster, Director D04 -337 09/29/2004 03/28/2005 Date: e '2 /w 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 with, whether specified herein or not. The granting of this permit does pres me to regulating construction or the p ormr q Signature: I Print Name: uthority to violate or cancel the provisions of any other state or local laws �W authorized to sign and obtain this develop77 mit I —o! Date: 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 D04 -337 Printed: 09 -29 -2004 Z —Z �W JU U 00 U) J F. Co U. W O J U. co a =W Z E- O Z r•- U� O N o t- W LL O Z co O F- Z `KI ue C ity ,. Tukwila �s Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 PERMIT CONDITIONS Parcel No.: 7340600480 Permit Number D04 -337 Address: 12400 EAST MARGINAL WY S TUKW Status: ISSUED Suite No: Applied Date: 09/10/2004 Tenant: GROUP HEALTH ADMINISTRATION Issue Date: 09/29/2004 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 mechanical work shall be inspected and approved under a separate permit issued by the City of Tukwila Permit Center (206/431- 3670). 4: 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. 5: New suspended ceiling grid and light fixture installations shall meet the non - building structures seismic design requirements of ASCE 7. 6: Partition walls that are tied to the ceiling and all partitions greater than 6 feet in height shall be laterally braced to the building structure. 7: 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. 8: Ventilation is required for all new rooms and spaces of new or existing buildings and shall be in conformance with the International Building Code and the Washington State Ventilation and Indoor Air Quality Code. 9: 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. 10: ** *FIRE DEPARTMENT CONDITIONS * ** 11: The attached set of building plans have been reviewed by the Fire Prevention Bureau and are acceptable with the following concerns: 12: The total number of fire extinguishers required for a light hazard occupancy with Class A fire hazards is calculated at one extinguisher for each 3,000 sq. ft. of area. The extinguisher(s) should be of the "all purpose" (2A, 10 B:C) dry chemical type. The travel distance to any extinguisher must be 75' or less. (IFC 906.3) (NFPA 10, 3 -2.1) 13: Portable fire extinguishers, not housed in cabinets, shall be installed on the hangers or brackets supplied. Hangers or brackets shall be securely anchored to the mounting surface in accordance with the manufacturer's installation instructions. Portable Ore extinguishers having a gross weight not exceeding 40 pounds (18 kg) shall be installed so that its top is not more than 5 feet (1524 mm) above the floor. Hand -held portable Ore extinguishers having a gross weight exceeding 40 pounds (18 kg) shall be installed so that its top is not more than 3.5 feet (1067 mm) above the doc: Conditions D04 -337 Printed: 09 -29 -2004 Z ~ w � D UO CO J = F— N LL w 9� LL¢ co 1 f _ w z F_ �O Z w U� ON o ff wW F- P LL ..z w U= O Z �. ;.J,.c ,�.3i..!•R', u.. taYrS :. ::w..:ia,i�W:c'�,ifL::::M`�`.:S iri,�4`:'+:t.�:x' � r a t :t ::�[' v` .�� Cit y of Tukwila i9C8 Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 floor. The clearance between the floor and the bottom of the installed hand -held extinguishers shall not be less than 4 inches (102 mm). (IFC 906.7 and IFC 906.9) Z 14: Fire extinguishers shall not be obstructed or obscured from view. In rooms or areas in which visual obstruction cannot W be completely avoided, means shall be provided to indicate the locations of the extinguishers. (IFC 906.6) 2 JU 15: Extinguishers shall be located in conspicuous locations where they will be readily accessible and immediately available N o for use. These locations shall be along normal paths of travel, unless the fire code official determines that the to W hazard posed indicates the need for placement away from normal paths of travel. (IFC 906.5) N U. wo 16: ** *MEANS OF EGRESS * ** - IFC Chapter 10 � 17: No point in a building may exceed the maximum exit access travel distance listed in Chapter 10, section 1015, Table u- 1015.1 of the International Fire Code and International Building Code. j Cl) a =w 18: Egress doors shall be readily openable from the egress side without the use of a key or special knowledge or effort. Z (IFC 1008.1.8.3 subsection 2.2) z O w 19: Dead bolts are not allowed on auxiliary exit doors unless the dead bolt is automatically retracted when the door handle is engaged from inside the tenant space. (IFC Chapter 10) v N 0- 20: Exit hardware and marking shall meet the requirements of the International Fire Code. (IFC Chapter 10) w w U U_ 21: ** *SPRINKLER SYSTEMS * ** - IFC Chapter 9 - NFPA 13 and 25 P 22: Maintain sprinkler coverage per N.F.P.A. 13. Addition /relocation of walls, closets or partitions may require relocating Z U CO and /or adding sprinkler heads. (IFC 901.4) 0 Z 23: All new srpinkler sysetms 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 recognized by the City of Tukwila, prior to submittal to the Tukwila Fire Prevention Bureau. No sprinkler work shall commence without approved drawings. (City Ordinance #2050) 24: All sprinkler system plans, calculations and the contractors Materials and Test Certificates submitted to the Tukwila Fire Prevention Bureau must be stamped with the appropriate level of competency seal. (WAC 212 -80) 25: Contact The Tukwila Fire Prevention Bureau to witness all required inspections and tests. (City Ordinances #2050 and #2051) 26: ** *BUILDING CONSTRUCTION * ** - IFC - IBC 27: When walls and ceilings are required to be of fire resistive or noncombustible construction, interior finish materials shall meet the requirements of International Building Code 803. 28: Accumulation of combustible waste material is prohibited during the demolition phase of this project. Remove and properly dispose of all waste material prior to the close of the working day and as often throughout the day as needed. * *continued on next page ** doc: Conditions D04 -337 Printed: 09 -29 -2004 e... �.,<:.:.�,.. �., ... ,..�.: .�.'.., .�� :.. }.! ... ..'�••' -'' :. e.,: ?kt,; a,a.i. .. a6' Lt.« �¢ s' N''+ a. Atl �tiS��f�hr� ,�..i4ii"e'�1ti�5's�Jli'.�� '�`� .�Fr�4 irMr �.. t' { �`�;. � i �+�,b,�y'� y � rii �.. City of Tukwila 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 a thority to violate or cancel the provision of any other work or local laws regulating construction or the perform a work. {' d 1 Signature: D i /kI rn4(60 -j 1 6 doc: Conditions D04 -337 Printed: 09 -29 -2004 z w UO N cl. LU J � N LL WO CO) LL D = C� W �. F- O: Z H- W W U � O ff . O E- WW LL 0 : W Z: U =; O F- Z aJ �WILA, S H N k ._aX 1808 CITY OF TUKWILA Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 Building Permit No. Mechanical Permit No. Public Works Permit No. Project No. (For off 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 ** SITE LOCATION King Co Assessor's Tax No.: Z34o 6 Ob 4-s cnw Site Address: 1 ? E- rJAZG ,4A L `YA S. Suite Number: Floor: h & W p Tenant Name: A:Drt, �t 7 - ,ZA o _TO P-7d &14;" C, iJ U New Tenant: ❑...... Yes ®,.. No Property Owners Name: G2oLl P rCAe-rd 601h FFQAII 4& reAnr)EL. ClZove C_ 0. Mailing Address t Z.SO 1 6. M &Z_4 „dn L ,1YA Ty k.v,L A meA City State Zip CONTACT PERSON Name: ALE--XAdy6g2 GLAV_k, Day Telephone: LZO(,) ( 8 $00 0 Mailing Address 1 9 °¢ 3 A Scl ► TL d. 5 op 55A=Qc I 9 g /C City 1 State Zip E -Mail Address ALlc,rk. _0rner54one_ar . LOnn Fax Number: �Za� I GZ/ - 77/ GENERAL CONTRACTOR INFORMATION - (Mechanical Contractor information on back page) Company Name: Mailing Address City state Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: Contractor Registration Number: Expiration Date: * *An original or notarized copy 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: e— 0Zd ax- 4 r� Mailing Address �0 t7S d 5 oo S6A, TLF NYA ')8101 City State Zip Contact Person: AL. e)e A, 9 - G-LAZ-K Day Telephone: LZL)(.) c,52- Sono E -Mail Address aLtark Fax Number (7_6f_) (,Z/ - 7:7 ENGINEER OF RECORD - All plans must be wet stamped by Engineer of Record Company Name: Mailing Address City state Zip Contact Person: Day Telephone: E -Mail Address: \applicalionsIpmnit application (7.2004) Paue l Fax Number: Z i� w �U UO ND W = NLL WO LLQ N =) = �W Z� F- O Z I_ U ON 0 1< WW H� L O -- Z W U= O Z i;..a,n:!.n77 ' 'fF�:. +::.'..'..ls .w.v. +:, .....,,.. ..x�:sx�.+. l ..�. o.,rw.'u JW i.' :.d.1il i".Ai::+G.tSY::u '...W .w.h' �.. . , '� �irbw}ffia+iiW�ii� ..• BUILDING PERMIT INFORMATION - 206431 -3670 Valuation of Project (contractor's bid price): $ . � y. _° a Existing Building Valuation: $ Scope of Work (please provide detailed information): APP rjL6 S 5,1kL✓rN4 o \-VOCK574 /o z> Ex► 6VJ4 rll_C S , OGM ADP *AW ZAe7 -1 rt0 �y,aCL +��G aoaK 7'0 �Xt srt �� loo n r 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 PROTECTION /HAZARDOUS MATERIALS: K . .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 11 paper indicating quantities and Material Safety Data Sheets. Wpplicationstpermit application (7.2004) Paee 2 Z Z W C UO (n o CO W J X H NU_ WO UQ N� = F.. W Z F- ZO W U� O N 0 1— WW LL O Z W U= O Z Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC 1 Floor 2" Floor 40141 S50 \V 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 PROTECTION /HAZARDOUS MATERIALS: K . .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 11 paper indicating quantities and Material Safety Data Sheets. Wpplicationstpermit application (7.2004) Paee 2 Z Z W C UO (n o CO W J X H NU_ WO UQ N� = F.. W Z F- ZO W U� O N 0 1— WW LL O Z W U= O Z MECHANICAL PERMIT INFORMATION — 206431 -3670 MECHANICAL CONTRACTOR INFORMATION Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: Contractor Registration Num\detail Expiration Date: * *An original or notarized rrent Washington State Contractor License must be presented at the time of permit issuance ** Valuation of Project (contracrice): $ Scope of Work (please proviinformation): Fuel Type Electric ...... ❑ Gas ..... ❑ Use: Residential: New ..... El Commercial: New ..... r_1 acement .....❑ kement .....❑ Indicate type of mechanical work being installed and the qtl ;ntity below: Unit Type: Qty Unit Type: ty Unit Type: Qty Boiler/Compressor: t Furnace<100K BTU Air Handling Unit >10,000 CFM Fire Damper 0 -3 HP /100,000 BTU Furnace >100K BTU Evaporator Cooler Diffuser 3 -15 HP /500,000 BTU Floor Furnace Ventilation Fan hermostat 15 -30 HP /1,000,000 BTU Suspended/Wall /Floor Mounted Heater Ventilation System od /Gas Stove 30 -50 HP /1,750,000 BTU Appliance Vent Hood Wate eater 50+ HP /1,750,000 BTU Heat/Refrig/Cooling System Incinerator - Domestic Emerge cy Generat Air Handling Unit <10,000 CFM Incinerator- Comm/Ind Other Mechanical 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 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. BUILDING OWIMR Olk?AUTH(1RIZEf6 AGENT: Signature: Print Name: Mailing Address; Date Application Accepted: Date Application E Staf nisi I — 6y / I e _A! 9 1 Date: ! b ` Day Telephone: ���G�O82 0 wD \applications'permit application (7 -2004) Paae 4 Z Z � W UO UJ H CO LL WO 9-1 LL to _CY F. W Z f- H- O ZH LLI W U� O� o1-- W 2 H� u. O 11! Z U_= f- H Z City State Zip � wWA w ..�:� City o f Tukwl l a 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 ! (206) 431 -3670 RECEIPT Parcel No.: 7340600480 Permit Number D04 -337 Address: 12400 EAST MARGINAL WY S TUKW Status: PENDING Suite No: Applied Date: 09/10/2004 Applicant: GROUP HEALTH ADMINISTRATION NORTH BUILDING Issue Date: Receipt No.: R04 -01209 Payment Amount: 174.55 Initials: SKS Payment Date: 09/10/200410:27 AM User ID: 1165 Balance: $0.00 Payee: CORNERSTONE ARCHITECTURAL GROUP TRANSACTION LIST: Type Method Description Amount Payment Check 16843 174.55 ACCOUNT YTEM LIST: Description Account Code Current Pmts ------------------------ - - - - -- ---------- - - - - -- ------ - - - - -- BUILDING - NONRES 000/322.100 103.06 PLAN CHECK - NONRES 000/345.830 66.99 STATE BUILDING SURCHARGE 000/386.904 4.50 Total: 174.55 i t)MO 9 7J-6 TOTAL V 4. err; doc: Receipt Printed: 09 -10 -2004 z W UO (1)C CO) F �LL W� LLj S2 CI HW z ZO W U� 0— CO. 0 F WW H U . Z W Cl) O Z INSPECTION RECORD Retain a copy with permit �� , INSPECTION NO. PE T 0. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Pct: +' n vt� Type of Insp ction: 4 Ad s: lle : In s uctions: ate Wanted: a.m. (P Oc/ # - - - T Requester: 4Qcw IAnU 11 11 1 - 4 � ' ( . �Ph ne N .r - 71 U I --- Approved per applicable codes. Corrections required prior to approval. COMMENTS: f , Inspecto Date: 1 /&7(2�1 $47.00 REINSPECTION F REQUIRED. Prior to inspection, fee must e I paid at 6300 Southcente r Ivd., Suite 100. Call to schedule reinspection. ! Receipt No.: Date: i , Z 1Z ' Z �QQ � JU UO Cl) =. N U. WO 9-1 U. = �W Z f- E O Z F- WW U� O -. o� W H H U- O .Z W U= O Z 1908 03 -31 -2005 City of Tukwila Steven M. Mullet, Mayor Department of Community Development Steve Lancaster, Director ALEXANDER CLARK 1904 THIRD AV, SUITE #500 SEATTLE, WA 98101 RE: Permit No. D04 -337 12400 EAST MARGINAL WY S 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 -time extension up to 180 days. Extension requests must be in 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 05/15/2005, 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, GPiJCCsv . Stefania Spencer, Permit Technician xc: Permit File No. D04 -337 Bob Benedicto, Building Official 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 Phone: 206 - 431 -3670 e Fax. 206 - 431 -3665 Z I2 �w JU 0 Co 0 W = co LL WO Co D = F- W Z H H- O Z F— w W U� O �. 0 F— WW H ti O .Z W U =. O Z 1 5 PERMIT COORD COPY s PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D04 -337 DATE: 09 -13 -04 PROJECT NAME: GROUP HEALTH ADMIN. BLDG NORTH SITE ADDRESS: 12400 EAST MARGINAL WAY SOUTH X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # after /before permit is issued DEPARTMENTS u4(74.10 51 1110(" q-W- M YI� q� Buil in ivision • Fire Prevention Q PI i g Division Public Work • Structural ❑ Permit Coordinator La m- A-q DETERMINATION OF COMPLETENESS (Tues., Thurs.) DUE DATE: 09 -14 -04 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: TOES /THURS Tstructural ING: Please Route Review Required REVIEWER'S INITIALS: APPROVALS OR CORRECTIONS 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 sllp.doc 2 -28 -02 PERMIT C O O R D COPY ❑ No further Review Required DATE: DUE DATE: 10 -12 -04 Not Approved (attach comments) ❑ z Z �w QQ JU UO N J � U- 111 U. Q = �w z H HO w ~ W U� o Ito_ F- wW �O •z w U= O z ILA, kS�' J S"i 1906 CITY OF TUKWIL4 Permit Center /Building Division: Community Development Department 206 - 431 -3670 Permit Center Public Works Department: 6300 Southcenter Blvd., Suite 100 206 - 433 -0179 Tukwila, WA 98188 Planning Division: 206 -4 -36 70 Z AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION z 1 �w PERMIT NO.: UO s STATE OF WASHINGTON) co W w= ss. COUNTY OF KING ) D U- O W }} ,states as follows: CO CY t [please print] W z 1. 1 have made application for a building permit from the City of Tukwila, Washington. ZO 2. 1 understand that state law requires that all building construction contractors be registered with the State of � W Washington. The exceptions to this requirement are stated under Section 18.27.090 of the Revised Code of =) o Washington, a copy of which is printed on the reverse side of this Affidavit. I have read or am familiar with RCW v 18.27.090. Q W 3. 1 understand that prior to issuance of a building permit for work which is to be done by any contractor, the City of v Tukwila must verify either that the contractor is registered by the State of Washington, or that one of the exemptions U. - 0 stated under RCW 18.27.090 applies. w Z 0 0 4. In order to provide verification to the City of Tukwila of my compliance with this requirement, I hereby attest that o after reading the exemptions from the registration requirement of RCW 18.27.090, 1 consider the work authorized Z under this building permit to be exempt under No. 1 , and will therefore not be performed by a registered contractor. understand that I may be waiving certain rights that I might othe71— ve unde to law in any decision to engage an unregistered contractor to perform construction work. ���� APPLICANT A GE ... P SCAN '•q� " : • ��,�s FAA. c o, NOTAg 9 r.•..r rr ' i N ' UBL%G \application s\8 -2004 affidavit in lieu of contractor registration Signed and sw�rn to before me this 44 day of _ SeP &t"he r , 20 e V aA' a. /)� NOTARY PUBLIC in and for thelState of Washington, Residing at K rio County. Name as commissioned Ah ce. A. Le c My commission expires: 6—/6-09 18.27.090 Exemptions. This chapter shall not apply to: 1. 2. An authorized representative of the United States Government, the State of Washington, or any incorporated city, town, county, township, irrigation district, reclamation district or other municipal or political corporation or subdivision of this state; 3. Officers of the court when they are acting within the scope of their office; 4. Public utilities operating under the regulations of the utilities and transportation commission in construction, maintenance, or development work incidental to their own business; 5. Any construction, repair or operation incidental to the discovering or producing of petroleum or gas, or the drilling, testing, abandoning, or other operation of any petroleum or gas well or any surface or underground mine or mineral deposit when performed by an owner or lessee; 6. The sale or installation of any finished products, materials, or articles of merchandise which are not actually fabricated into and do not become a permanent fixed part of the structure; 7. Any construction, alteration, improvement or repair of personal property, except this chapter .shall apply to all mobile, manufactured housing. A mobile /manufactured home may be installed, set up, or repaired by the registered or legal owner, by a contractor licensed under this chapter, or by a mobile /manufactured home retail dealer or manufacturer licensed under chapter 46.70 RCW; 8. Any construction, alteration, improvement, or repair carried on within the limits and boundaries of any site or reservation under the legal jurisdiction of the federal government; 9. Any person who only furnished materials, supplies, or equipment without fabricating them into, or consuming them in the performance of, the work of the contractor; 10. Any work or operation on one undertaking or ` project by one or more contractors, the aggregate contract price of which for labor and materials and all other items is less than $500.00, such work, or operations being considered as of a casual, minor, or inconsequential nature. The exemption l prescribed in this subsection does not apply in all instance wherein the work or construction is only a 1 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 r \applications \8 -2004 affidavit in lieu of contractor registration contracts of amounts less than $500.00 for the purpose of the evasion of this chapter or otherwise. The exemption prescribed in this subsection does not apply to a person who advertises or puts out any sign or card or other device which might indicate to the public that he is a contractor, or that he is qualified to engage in the business of contractor; 11. Any construction or operation incidental to the construction and repair of irrigation and drainage ditches of regularly constituted irrigation districts or reclamation districts; or to farming, dairying, agriculture, viticulture, horticulture, or stock or poultry raising; or to clearing or other work upon land in rural districts for fire prevention purposes; except then any of the above work is performed by a registered contractor; 12. An owner who contracts for a project with a registered owner; 13. Any person working on his own property, whether occupied by him or not, and any person working on his residence, whether owned by him or not but his exemption shall not apply to any person otherwise covered by this chapter who constructs an improvement on his own property with the intention and for the purpose of selling the improved property; (D 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 ;h, ighway. projects who have been prequalified, as required by chapter 13 of the Laws of 1961,` RCW °47.28.070 with the department of transportation' tai rpeiform'. highway construction, reconstruction, or- maintenance work. 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