HomeMy WebLinkAboutPermit D04-372 - BURNS RESIDENCE - RESIDENCE DEMOLITION4
•
BURNS RESIDENCE
5022 S 118 ST
D04 -372
City G. Tukwila Steven 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.: 3348400787 Permit Number: D04-372
Address: 5022 S 118 ST TUKW Issue Date: 03/09/2005
Suite No: Permit Expires On: 09/05/2005
Tenant:
Name: BURNS RESIDENCE
Address: 5022 S 118 ST, TUKWILA, WA
Owner:
Name: BURNS G H Phone:
Address: 5012 S 118TH, SEATTLE WA
Contact Person:
Name: ROBERT W. WADE Phone: 480 221 -3769
Address: 10024 S 46TH ST, PHOENIX, AZ
Contractor:
Name: COBBLESTONE COMPANY, THE Phone: 206 365 -6595
Address: 411 WEST GALER, STE B, SEATTLE, WA
Contractor License No: COBBLC *033BM Expiration Date: 11 /10/2005
i
DESCRIPTION OF WORK:
DEMOLITION OF EXISTING 580 SQUARE FOOT SINGLE FAMILY RESIDENCE.
PUBLIC WORKS ACTIVITIES INCLUDE SANITARY SIDE SEWER FOR SEPTIC SYSTEM ABANDONMENT, CAPPING THE
WATER SERVICE /WM REMOVAL, TEMP AND PERMANENT EROSION CONTROL..
Value of Construction: $3,000.00 Fees Collected: $446.55
Type of Fire Protection: N/A International Building Code Edition: 2003
Type of Construction: Occupancy per IBC: 0022
j Public Works Activities:
Channelization / Striping: N
Curb Cut / Access / Sidewalk / CSS: N
Fire Loop Hydrant: N Number: 0 Size (Inches): 0
Flood Control Zone: N
i 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:
doc: IBC- Permit D04 -372 Printed: 03 -09 -2005
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Water Meter;
City o� Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206- 431 -3670
Fax: 206 - 431 -3665
Web site: cOukwila.wa.us
N
* *continued on next page **
Steven M. Mullet, Mayor
Steve Lancaster, Director
doc :IBC - Permit D04 -372 Printed: 03 -09 -2005
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Cit y ox Tukwila
Departit:ent of Comutu►►ity Developme► ►t
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 - 431 -3665
Web site: cOukwila.wa.us
Steven M. Mtrllet, Mayor
Steve Lancaster, Director
Permit Number D04 -372
Issue Date: 03/09/2005
Permit Expires On: 09/05/2005
Permit Center Authorized Signature: .P�suai� Date:
.I hereby certify that I have read and examined this ermit 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 not presume to give authority to violate or cancel the provisions of any other state or local laws
regulating construction or the performance of work. I am authorized to sign and obtain this development permit.
Signature: /�L� �--- Date: 72 — C ? —
Print Name: nr c w q C. lam-fl—r-7
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 -372 Printed: 03 -09 -2005
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City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
PERMIT CONDITIONS
Parcel No.:
Address:
Suite No:
Tenant:
3348400787
5022 S 118 ST TUIKW
BURNS RESIDENCE
Permit Number:
Status:
Applied Date:
Issue Date:
D04 -372
ISSUED
10/06/2004
03/09/2005
1: ** *BUILDING DEPARTMENT CONDITIONS * **
2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the
Building Official.
3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to
start of any construction. These documents shall be maintained and made available until final inspection approval is
granted.
4: All construction shall be done in conformance with the approved plans and the requirements of the International
Building Code or International Residential Code, International Mechanical Code, Washington State Energy Code.
S: 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.
6: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * **
7: Contractor shall notify Public Works Utility Inspector at (206)433 -0179 of commencement and completion of work at least
24 hours in advance.
8: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation
off -site or into existing drainage facilities.
9: From October 1 through April 30, cover any slopes and stockpiles that are 3H:1V or steeper and have a vertical rise of
10 feet or more and will be unworked for greater than 12 hours. During this time period, cover or mulch other disturbed
areas, if they will be unworked more than 2 days. Covered material must be stockpiled on site at the beginning of this
period. Inspect and maintain this stabilization weekly and immediately before, during and following storms.
10: From May 1 through September 30, inspect and maintain temporary erosion prevention and sediment at least monthly. All
disturbed areas of the site shall be permanently stabilized prior to final construction approval.
11: The site shall have permanent erosion control measures in place as soon as possible after final grading has been
completed and prior to the Final Inspection.
12: Any septic tanks in the area shall be pumped empty and removed or filled with sand. A copy of the documentation from
the business that performed the pumping shall be provided to the City Utilities Inspector.
13: Since at the time of permit application the location of the septic system was unknown the contractor shall contact
Public Works project Inspector, Mr GREG VILLANUEVA at (206)431 -2442 or (206) 433 -0179 minimum 24 hours prior to house
demo to establish location of (1) one, possible 920 two sewer lines leaving the house.
doc: Conditions D04 -372 Printed: 03 -09 -2005
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City of Tukwila
too$
+! Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
-- -- ' --- ... -, -- _.. -..., ......
FINANCE DEPARTMENT AT (206)433 -1870 for FINAL water meter reading.
* *continued on next page **
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City of Tul�wila
809
j 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: ,/ %2���"�� Date:
Print Name: C L i CG r 4 C ! 4
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ILA w , CITY OF TUKWILA -1
Community Developmen. Department
Public Works Department
f Permit Center
1906 6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
Building Perna., No. �� 3 72
Mechanical Permit No.
Public Works Permit No.
Project No.
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 ax No.:
a Numb
Site Address: so o2 05-,- . I I F �7 i _� �w l i u>te — Floor: --
Tenant Name: H, - fS wr iA -S ! New Tenant: ❑ .... Yes ❑ ..No
Property Owners Name:_
Mailing Address: 10-0 a
ct-I 1A.1- e-
J0 q6 4-4- -
City
Z 35
State Zip
CONTACT PERSON
Name: a ev f Day Telephone: ?� - ;k `j
Mailing Address: k u ° Ll/L t �G
City State Zip
E -Mail Address: I� F ty�t �.- CDX Fax Number:
GENERAL CONTRACTOR INFORMATION - (Mechanical Contractor information on back page)
Company Name: W `e LS V1
Mailing Address: , () Z) �1 Z
Contact Person: v� 1 V\ f 64�t lit)
E -Mail Address:
, 1441 , .e. WA - %19
City State Zip
Day Telephone: )- d 6
Fax Number:
Contractor Registration Number: Expiration Date:
"V* *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 stamped.by Architect of Record
Company Name:_
Mailing Address:
Contact Person:
E -Mail Address:
City state Zip
Day Telephone:
Fax Number:
ENGINEER OF RECORD All plans:must be wet stamped by Engineer of Record
Company Name:
Mailing Address:
s Contact Person:
E -Mail Address:
\permits plus \ice changes \permit application (7.2004)
Page I
City State Zip
Day Telephone:
Fax Number:
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BUILDING PERMIT INFORMA _ [ON - 206 - 431 -3670
)( Valuation of Project (contractor's bid price): $ 219Da
Scope of Work (please provide detailed information):
�2�Wt O (� X 15 4 VUe5i 0 9 5 L vL-G
I E-11- ►,t� t l L , k o
Will there be new rack storage? ❑ .. Yes ❑ .. No
Existing Building Valuation: $
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 /fives ecks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): Floor area of pr: Floor area for accessory dwelling:
*Provide documentation that shows that the princin one of the dwellings as his or hK primary residence.
Number of Parking Stalls Provided: Standard: Compact: Handicap:
Will there be a change in use? E] ....Yes ❑ . explain:
El.. Sprinklers ❑..Automatise Alarm []..None El. 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 I1 paper indicating quantities and Material Safety Data Sheets.
\permits plus\icc changes \permit application (7.2004)
Page 2
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• Existing
Interior
Remodel
Addition to
Existing
Structure
New
Type of
Construction
per IBC
Type of
Occupancy per
IBC
V Floor
I
2 Floor
. 3r d 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 /fives ecks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): Floor area of pr: Floor area for accessory dwelling:
*Provide documentation that shows that the princin one of the dwellings as his or hK primary residence.
Number of Parking Stalls Provided: Standard: Compact: Handicap:
Will there be a change in use? E] ....Yes ❑ . explain:
El.. Sprinklers ❑..Automatise Alarm []..None El. 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 I1 paper indicating quantities and Material Safety Data Sheets.
\permits plus\icc changes \permit application (7.2004)
Page 2
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MECHANICAL PERMIT INFO.& dATION — 206 -431 -3670
MECHANICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
City
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 presen
Valuation of Project (contractor's bid price): $ 1
Scope of Work (please provide detailed information):
State Zip
at the time of permit issuance **
Use: Residential: New .... ❑
Commercial: New .... ❑
Fuel Type Electric ..... ❑ Gas .... ❑
Replacement..... ❑
Replacement..... ❑
Other:
Indicate type of mechanical work being installed and the quantity below:
Unit Type:
Qty
Unit Type:
Qty
I Un' T e:
Q
Boiler /Com pressor:
Q
Furnace <IOOK BTU
Air Handling Unit >I 0,000
F' a Damper
0 -3 HP /100,000 BTU
CFM
F 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
4
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 - Domesti
Emergency
Heat/Refrig/Cooling
Generator
System
Air Handling Unit
Incinerator - mmand
Other Mechanical
<10,000 CFM
I
I Equipment
.PERMIT APPLICATION N ES.- 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 OW7zw- RI AGE T: -4
Signature: T Date:
Print Name: 6 e—r/ W . & )&,�A e Day Telephone: 7 Fy " -�-' l — 3 7 (�) �
Mailing Address: ��6 PA U ° e l/t 1 � A"Y f� y
City State Zip
Date Application Accepted: Date Application Expires: I Staff Initials:
\permits plus \ice changes \permit application (7.2004)
Page 4
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..�Q City of Tukwila
i roe
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
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RECEIPT
Parcel No.: 3348400787
Address: 5022 S 118 ST TUKW
Suite No:
Applicant: BURNS RESIDENCE
Permit Number:
Status:
Applied Date:
Issue Date:
D04 -372
PENDING
10/06/2004
Receipt No.:
R04 -01621
Payment Amount:
272.00
Initials:
SKS
Payment Date:
12/02/2004 03:31 PM
User ID:
1165
Balance:
$0.00
Payee: GEORGE H. BURNS
TRANSACTION LIST:
Type Method Description Amount
Payment Check 1056 272.00
ACCOUNT ITEM LIST:
Description Account Code Current Pmts
------------------------ - - - - -- ---------- - - - - -- ------ - - - - --
PW BASE APPLICATION FEE 000/322.100 250.00
PW PERMIT /INSPECTION FEE 000/342.400 11.00
PW PLAN REVIEW 000/345.830 11.00
Total: 272.00
doc: Receipt Printed: 12 -02 -2004
wr,..MOwrea
1 11 IN
�1AQ City of Tukwila
rave
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
RECEIPT
Parcel No.:
Address:
Suite No:
Applicant:
3348400787
5022 S 118 ST TUKW
BURNS RESIDENCE - DEMO
Permit Number D04 -372
Status: PENDING
Applied Date: 10/06/2004
Issue Date:
Receipt No.: R04 -01369
s Initials: SKS
User ID: 1165
Payment Amount: 174.55
Payment Date: 10/06/2004 01:57 PM
Balance: $0.00
Payee: GEORGE H. BURNS
TRANSACTION LIST:
Type Method Description Amount
Payment Check 1090 174.55
ACCOUNT ITEM 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
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' INSPECTION RECORD
Retain a copy with permit 5'
INSPECTION NO. PE N
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Pr 'ect:
�
Type of Inspe tltma
tI y ►
Ad
Date Ca led:
Special Instructions:
1
Date Wanted:
caS
Reque e •
s � e V
PhP . ^�
Approved per applicable codes. Corrections required prior to approval.
Receipt No.: ` Date:
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$58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
INSPECTION RECORD '
Retain a copy with permit
INSPECTION NO. PE M
CITY OF TUKWILA BUILDING DIVISION Y
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
�1
Project;:
Type of Ins ction:
Address ��
Date Called:
Special Instructions:
Date Wanted: a.m.
�it � /d ��� �•
equester: �
�•7 �rr`-��
Phone N2 . _
�, ?� S - 65 95
�
000 fGU rCL+ 1A) � �L( �
per applicable codes. Corrections required prior to approval.
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J INSPECTION RECORD 0Y ?a
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Project:
U t� S r l ��rlc e
Type of Inspection:
W l�gmc
Address:
Date Called:
.?,f k 5
Special Instruction
' ��ID "'o
S
s /rJS�PC f/ �Yl
Date Wanted: 1Q j a.m.
".
Requester:
� V)
Phone No:
ti.
Corrections required prior to approval.
Fl Approved per applicable codes.
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$58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
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INSPECTION RECORD
Retain a copy with permit Do' 7a
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Project:
LA ins ~y .� S I < <P/t�
Type of 1. pectio
l Pein O
Address: t`
. via S 1l S
Date Called:
6 _5
Special Instructions:
o r
- 1!1
Date Wanted: a.
0 3 - L,
Requester: --}�
o �'te Ile
Phone No:.
,-�2o 6 - 3
Approved per applicable codes.. a Corrections required prior to approval.
COMMENTS:
� �s1 ttii
& e
Inspector: C� Date: ai
i $47.00 REINSPECTION FEE REQUIRED. Prior to Inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Cali to schedule reinspection.
Receipt No.: Date:
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G & N Septic Tank Service
37201 Military Road 1 9 7 9 8
Auburn, Washington 98001
(253) 838 -1028 or (253) 927 -2860
www.gnseptic.com
DATE 20
NAME
ADDRESS ;. : ", ! - ;• �; ?
CITY STATE
DESCRIPTION OF SERVICES, ETC.
AMOUNT
c.- I f it W 12
TOTAL
v C
SALES TAX
TOTAL AMT.
J
If this account is not paid as agreed, I agree to pay in addition to the
foregoing, a reasonable attorney's fee, or if this account is placed in the
hands of a collection agency, I acknowledge that you will be damaged
thereby to the extent of the collection charge against you and I therefor
agree to pay you, as liquidated damages, an amount equal to the amount
charged you on said collection by said collection agency, not exceeding
50% fifty percent of the amount unpaid thereon, and also a reasonable
attorney's fee.
Customer
Signature :` �' �- , �-i ✓ ' .�i - r-
Phone N umbe r
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NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEARfiHAN
THIS NOTICE IT IS DUE TO THE QUALITY OF THE DOCUMENT.-
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Return to:
City Clerk
City of Tukwila
6200 Southcenter Boulevard
Tukwila, WA 98188
Above this line reserved for Recorder's use
HOLD HARMLESS - SENSITIVE AREA
Grantor /Borrower: � ' vvA C
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Grantee /Beneficiary: CITY OF TUKWILA, a municipal corporation of King County,
Washington
Document Reference Number(s):
Section/Township /Range:
Assessor's Tax Parcel Number(s): z2 - d ?84y : - ? ?2404 0 — 0797
Property Legal Description (abbreviated):
COVENANT AND HOLD HARMLESS AGREEMENT — Sensitive Area
Page of _
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SENSITIVE AREA COVENANT AND HOLD HARMLESS AGREEMENT
This covenant and hold harmless agreement is entered into between
(Individual(s) (Corporation)
, ( "Grantor), and the City of Tukwila, a Washington municipal
corporation ( "Grantee ").
RECITALS
WHEREAS, Grantor owns and has applied for necessary permits to develop
certain real property (the "Property ") legally described in Exhibit A, which is attached and
incorporated by reference.
WHEREAS, a portion of the Property contains sensitive areas of potential geologic
instability (potential slide areas) as depicted in Exhibit B, which is attached and
incorporated by reference.
•. WHEREAS, as a condition of the issuance of subdivision plat approval, land use
permits, and /or construction permits for the Property, the Grantee required the Grantor to
execute and record this "Sensitive Area Covenant and Hold Harmless Agreement" to hold
the City of Tukwila harmless from all loss incurred as a result of any landslide or seismic
activity, or soil disturbance.
WHEREAS, Grantor assumed this obligation in order to obtain said subdivision
plat approval, land use permits, and /or cbnstructiori permits for the Property.
WHEREAS, the parties agree that this agreement constitutes an arms length,
bargained -for agreement,. which includes a waiver of liability that runs with the land for
risks created by the proposed use of property because of the shape, composition, location
or other characteristic unique to the Property sought to be developed.
NOW, THEREFORE, the parties agree as follows:
AGREEMENT
1. In consideration of Grantee issuing subdivision plat approval and /or other
development permits, which constitutes good and valuable consideration, the receipt of
which and the sufficiency of which the Grantor hereby acknowledges, the Grantor shall
defend, indemnify, and hold the Grantee, its officers, officials, employees, agents, and
assigns harmless from any and all claims, injuries, damages, losses, or suits, whether
brought by grantor or third parties, including all legal costs and reasonable attorney fees,
arising out of or in connection with any injuries or damages to persons or property caused
in whole or in part by any landslide or seismic activity or soil disturbance on the Property,
legally . described in Exhibit A, which is attached and incorporated by reference.
COVENANT AND HOLD HARMLESS AGREEMENT — Sensitive Area Page J of _
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2. Grantor on its own behalf and on behalf of its heirs, successors and assigns
hereby waives any right to assert any claim against the Grantee, its officers, officials,
employees, agents, and assigns for any loss, or damage to people or property either on or
off the site resulting from any landslide or seismic activity or soil disturbance on said
Property by reason of or arising out of the issuance of the permit(s) by the City for
development on said Property except only for such losses that may directly result from the
sole negligence of the City.
3. Grantor will inform its successors and assigns of said Property that the Property
is in an area of potential geologic instability (potential slide area), of the risks associated
with development thereon, of any conditions or prohibitions on development imposed by
the City of Tukwila, and of any features in this design which will require maintenance or
modification to address anticipated soils changes.
4. Grantor will maintain continuous insurance coverage as required by the permit
authorizing the development.
5. Grantee's inspection or acceptance of any of the Grantor's construction or other
work either during construction or when completed shall not be grounds to avoid any of
these covenants of indemnification.
6. This covenant and hold harmless agreement shall be a covenant running with
the land and the rights and obligations contained herein shall run with and burden the
Property, including each parcel comprising the Property and shall inure to the benefit of
and be binding upon the Grantor and Grantee, their successors and assigns. 1.
COVENANT AND HOLD HARMLESS AGREEMENT — Sensitive Area
i
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� � Notary Public in and for the State of Washington
F, ',residing, at r3=j L �� •�
Arty appointment expires ;,� - �� -65
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STATE OF WASHINGTON)
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County of King
I certify that I know or have satisfactory evidence that k j'&t - f - Cj and
_(3i/are the person(s) who appeared before me, and said individual(s)
acknowledged tha/she /they signed this instrument and acknowledged it to be
Qi /her /their free and voluntary act for the uses and purposes mentioned in this
instrument.
Dated /-� - Q
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DATED this day of , 20
GRANTEE: CITY OF TUKWILA
Mayor
ATTEST:
City Clerk
/
STATE OF WASHINGTON )
ss.
County of King )
On this day of , 20 , before me,
the undersigned, a Notary Public in and for the State of Washington, duly
commissioned and sworn, personally appeared
t
and
known to me to be the
Mayor and City Clerk, respectively, of CITY OF TUKWILA, the municipal
corporation that executed the foregoing instrument, and acknowledged it to be the
free and voluntary act of said municipal corporation, for the uses and purposes
mentioned in this instrument, and on oath stated that he /she was authorized to
execute said instrument.
WITNESS my hand and official seal hereto affixed the day and year above written.
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print name
NOTARY PUBLIC in and for the
State of Washington, residing at
COVENANT AND HOLD HARMLESS AGREEMENT — Sensitive Area Page ` of _
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EXHIBIT A
LEGAL DESCRIPTION OF PROPERTY
COVENANT AND HOLD HARMLESS AGREEMENT — Sensitive Area
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EXHIBIT B
ON OF SENSITIVE AREAS
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1908
City of Tukwila
Steven M. Mullet, Mayor
Department of Community Development Steve Lancaster, Director
08 -03- 2005
ROBERT W. WADE
10024 S 46TH ST
PHOENIX, AZ 85044
RE: Permit No. D04 -372
5022 S 118 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:
I
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.
i
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 09/07/2005, 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,
Brenda Holt,
Permit Coordinator
xc; Permit File No. D04 -372
j Bob Benedicto, Building Official
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 -431 -3665
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1908
November 4, 2004
City of Tukwila Steven M. Mullet, Mayor
Department of Community Development Steve Lancaster, Director
Mr. Robert W. Wade
10024 South 46' Street
Phoenix, Arizona 85044
RE: CORRECTION LETTER #1
Development Permit Application Number D04 -372
Burns Residence — 5022 South 118`" Street
Dear Robert:
This letter is to inform you of corrections that must be addressed before your development permit(s) 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 Public Works Department. At this time, the Building, Planning and Fire Departments
have no comments.
Public Works Department: Joanna Spencer, at (206) 431 -2440, if you have questions regarding the
attached memo.
Please address the attached comments in an itemized format with applicable revised plans, specifications, and /or
other documentation. The City requires that four (4) complete sets of revised plans, specifications and /or other.
documentation be resubmitted with the appropriate revision block.
In order to better expedite your resubmittal, a `Revision Submittal Sheet' must accompany every resubmittal. I have
enclosed one for your convenience. Corrections /revisions must be made its person and )pill not be accepted throuai
the mail or by a messeniver service.
If you have any questions, please contact me at (206) 433 -7165.
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Sincerely,
Stefania Spencer
•r
PUBLIC WORKS DEPARTMENT COMMENTS
DATE: October 20, 2004
PROJECT: Burns SFR Demo
PERMIT NO: D04 -372 nd D04 -373
PLAN REVIEWER: Contact Joanna Spencer at (206) 431 -2440 if you have any
questions regarding the following comments.
1) Please show north arrow and scale on your site plan. Label location of S 118 Street and
property addresses so the houses can be located in the field.
2) Both properties are on septic system. Please show location of existing septic tank for each
property. As part of the demo permit, each septic tank shall be abandoned. Refer to enclosed
Public Works Development Bulletin C6 for septic tank abandonment. Please note that a copy
of the documentation from the business that performed pumping of each tank shall be
provided to the Public Works Project Inspector, Mr. Greg Villanueva, at (206)431 -2442.
3) Show location of existing water meter and water service to each house. Water service shall
be capped at the main if you are planning to abandon water service to each lot. If these water
service lines will be used again in the near future, they shall be capped at the property line
and at the water meter respectively. If you need assistance in locating the existing water
meters, please call Mr. Bryan Still, Tukwila Water Superintendent, at (206)433 -1863.
4) City Finance Department records indicates that there are unpaid water bills for the subject
properties. There is $18.00 owing on 5022 S. 118 St. and $20.98 on 5026 S. 118 St.
Applicant shall contact Mr. Richard Takechi, Tukwila Finance Department, at (206)433 -1870
to pay these charges.
5) Applicant shall have Mr. G.H. Burns, property owner, execute a "Sensitive Area Covenant
and "Hold Harmless Agreement" for both properties. A portion of subject property
contains sensitive access and/or the property is adjacent to sensitive areas of potential
geologic instability. As a condition of the issuance of these permits, the property owner is
required to execute and record a "Sensitive Area Covenant" and "Hold Harmless Agreement"
to hold the City of Tukwila harmless from all loss incurred as a result of any landslide,
seismic activity, or soil disturbances.
(P:Laurie Admin /Joanna/Comments D04 -372 & D04 -373)
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PLAN REVI BIV/RD U T1 N G suP
ACTIVITY NUMBER D04 -372 DATE 12/10/04
PRO,E;T NAME Burns Demo
SITEADDRM 5022S118 1h St
Original Plan Submittal _ _Responseto Incomplete Letter#
Response to Correction Letter # I Revision # After Permit Is Issued
DEPARTM ENT&
Building Division ❑ Fire Prevention ❑ Planning Division ❑
Public Workk iG ,� o � Structural ❑ Permit Coordinator
DETMMINATION OFCOMPLETBVESS (rues., Thurs.) DUEDATE 12/14/04
Complete E� Incomplete ❑ Not Applicable ❑
Comments:
Permit Center Use Only
I N COMPLETE LETTER MAI LID: LETTER OF COMPLETEN E5S MAI LID:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials
TUBSi+THURSROUTI G.
Please Route Structural Review Required ❑ No further Review Required ❑
REVIMERS IN ITIALS DATE
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APPROVALS 0 R CO RRECTI 0 N & DUEDATE 01/11/05
Approved ❑ Approved with Conditions Not Approved (attach comments)❑
Notation:
REVIEWERS INITIALS DATE
Permit Center Use Only
CORRECTION ON LETTER MAI L®:
Departments issued corrections Bldg ❑ Fire ❑ Ping ❑ FW ❑ Staff Initials
Documentalrouting siip.doc
2-28-02
.:: ..`+, t. `. 1:,. ,+. 4. x. I. k.:.; i:.. Gwta.- oli':<,: W1.. Y, 1.'.,' w: s,.:. i+ rn. bt«..,. .,:Ni.xt.....n..rh�',':N.+:;:. �inn.a,.+;�:!� N:ry , + . wa«. i[ vN.'+ w. K:..., wF�». s.. i�.: u� ..;.�r..twuaee.v:r.4+�f: >:+ic' sAVi�+' 'k.:wIu7G3�.4L.ti:'if °, 0.4YIOti C>Ya
PERMIT COORD COPN
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: D04 -372 DATE: 10 -06 -04
PROJECT NAME: BURNS RESIDENCE - DEMO
SITE ADDRESS: 5022S.118 TH STREET
X Original Plan Submittal _Response to Incomplete Letter #
Response to Correction Letter # Revision # afteribefore permit is issued
DEPARTMENTS G AA ! /OA1 [:�M W`L, 10 ^7
Building Division Fire Prevention [� Planning Division
Public Works /� 1!A ' f Structural El Permit Coordinator
A � &
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DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 10 -07 -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:
TUES /THURS RROTING:
ute
Please Ro Structural Review Required
REVIEWER'S INITIALS:
u
APPROVALS OR CORRECTIONS
Approved ❑ Approved with Conditions ❑
Notation:
REVIEWER'S INITIALS:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED: 4 D 7
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW kf Staff Initials: cleS
PERMIT COORD COPY
Documents/rouft sllp.doc
2 -28.02
❑ No further Review Required
DATE:
DUE DATE: 11 - 04 - 04
Not Approved (attach comments) E
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File: D04 -0372
35mm Drawing
#1
I II So l L 1NE TABLE
LINE BEARING DISTANCE '
SO I 1 1 L I N 71 0 03'56 W 0.16
L 2 N 06 58' 35 "W 26. 89
L 3 N 06"58'35"W 47.47
L 4 N 71 ° 06' 31 "W 22. 23
LEGEND ----------- - - - - -- -- L 5 N 06 0 58 1 25 11 W 25.00 5P'
L 6 S 06° 58' 25 "E 31 . 32
= FND. MON. IN CASE, L 7 5 71 ° 02'54 "E 45.98 v
SET I/2" I.R. W /CAP ;21464
L 8 N 71 ° 02' 54 "W 22. 24
• =
L 9 N 71 0 02'54 "W 3).78 ? \1 58 � ��°) °5$ ''5 0 � r °5 g t4c
BASIS OF BEARINGS IS ASSUMED ' \," N 8. `"' 6 0 1 ° O
5(oOpfw v 2°- 5 85.51 5 Sla
ATION 0 INSTRUMENT USED: 6 SECOND SEMI -TOTAL STI,. =
UNADJUSTED TRAVERSE CLOSURE: 1:41.071 Z
W&Atw FND. 1. R. W /CAP =4596
ALL MONUMENTS TIED DEC. 1 991 � 4- .... ,
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0. 75' N. 8 I . 19' W. 6° sa ` -b5 "'° / 0 06 ° 58 2
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DATED 3/1'3/62. ° 5�� 25 E ���Ir�3 c d ®U prior a-pprova9 � LT R
`2 N � o $� 06 S o Revisio s�wili�require a new plan sub��
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P A R C,E L ° = ars and Wray include additional plan review
0 59 a L n F . I . R RECEIVED
I.R. W/ CAP .r fees.
I 6 ° � N � �
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\00 \ \ 6 ° * 4596 0. 35 N• / ND, I . R. W /CAP 8 17692
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8 0.
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I °' ��� N ° \ ° °'° „ - � ' a l . 01 w /Z ,. e DEC 10 2004 '
Co ° 5g 2 L FNO: I R R. W /CAP �/ �` II rUKWILA -
KS
+4596 I . 2 WLY• 4 REF. R.O. S. 77/ 1 64 F?E`' c1NEC� t C
I /' " CODE COMPLIA
OF LINE � - •
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FIND. LI . STAKE These plans "hav b review _ _ -f ^,;
tn
\00. UO 1.34' W 4 - D epartment for eonforr>r>la= vkftl eu�rent it �,• -
L E . ;r anco is s ubject to errors and
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I of con and
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cat adopted standards or or�nane� 'T'he aye rnsibility � —_
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bf a i adequacy
of the desa rests" totalt� with the Q l
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designer. additions, deletions
— / - - drawings after this date will �I � � •�:�'�� � � � ''j � � 1 ; �� �`�
and will require a resu d y L _ _.
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