HomeMy WebLinkAboutPermit D04-375 - PETERSON RESIDENCE - REROOFPETERSON
RESIDENCE
15785 62ND AVENUE
SOUTH
D04 -375
i
1
City V ., 'Tukwila Steven M. Mullet Mayor
! o Z Department of Cann :unity Development Steve Lancaster, Director
l0 6300 Southcenter Boulevard, Suite #100
N !2 Tukwila, Washington 98188
Phone: 206-431-3670
lio8 Fax: 206 - 431 -3665
r Web site: ci.tukwila.wa.us
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DEVELOPMENT PERMIT
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Parcel No.: 3597000144 Permit Number D04 -375
Address: 15185 62 AV S TUKW Issue Date: 10/06/2004
Suite No: Permit Expires On: 04/04/2005
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Tenant:
r Name: PETERSON RESIDENCE
Address: 15185 62 AV S, TUKWILA WA
Owner:
Name:
PETERSON LYNN ERIC
Phone:
Address:
15185 62ND AV S, TUKWILA WA 98188
Contact Person:
Name:
JOHN BERGIN
Phone: 206 824 -5852
Address:
20815 SECOND PL SW, SEATTLE WA
Contractor:
Name:
BERGIN ROOFING INC
Phone: 206 824 -5852
Address:
20815 SECOND PL SW, SEATTLE WA
Contractor
License No: BERGIRIO443A
Expiration Date: 04/01 /2006
DESCRIPTION OF WORK:
TEAR OFF SHAKE ROOF; INSTALL 1/2" CD X PLYWOOD OVER SPACE SHEETING; ASTM15 LB TAR PAPER; 30 YEAR
COMP SHINGLES. SUBJECT TO FIELD VERIFICATION
Value of Construction: $7,860.00 Fees Collected: $194.36
Type of Fire Protection: International Building Code Edition: 2003
Type of Construction: Occupancy per IBC: 0022
Public Works Activities:
Channelization / Striping: N
Curb Cut / Access / Sidewalk / CSS: N
Fire Loop Hydrant: N
Flood Control Zone: N
Hauling: N
Land Altering: N
Landscape Irrigation: N
Moving Oversize Load: N
Sanitary Side Sewer: N
Sewer Main Extension: N
Storm Drainage: N
Street Use: N
Water Main Extension: N
Water Meter: N
Number: 0 Size (Inches): 0
Start Time: End Time:
Volumes: Cut 0 c.y. Fill 0 c.y.
Start Time: End Time:
Private: Public:
Profit: N Non - Profit: N
Private: Public:
doc: IBC- Permit 004 -375 Printed: 10 -07 -2004
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City a Tukwila
Steven M. Mullet, Mayor
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206- 431 -3670
Fax: 206 - 431 -3665
Web site: ci.tukwila.wa.us
Permit Number:
Issue Date:
Permit Expires On:
Steve Lancaster-, Director
D04 -375
10/06/2004
04/04/2005
Permit Center Authorized Signature: �% Date:
I hereby certify that I have read and examined tf ris 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 constru 'nor he p ormance of work. I am authorized to sign and obtain this development perrt}it'
Signature: Date: /, � l
Print Name:
jd ),,/,Z - /0"
This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is
suspended or abandoned for a period of 180 days from the last inspection.
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M Ci oe of Tukwila
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Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
PERMIT CONDITIONS
Parcel No.: 3597000144
Address: 15185 62"S TUKW
Suite No:
Tenant: PETERSON RESIDENCE
Permit Number:
Status:
Applied Date:
Issue Date:
D04 -375
ISSUED
10/06/2004
10/06/2004
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 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.
5: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of,
any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits
presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila
shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the
Building Official from requiring the correction of errors in the construction documents and other data.
* *continued on next page **
doc: Conditions D04 -375 Printed: 10 -06 -2004
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�g 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 authority to violate or cancel the provision of any other work or local laws
regulating construction or the performance of work.
Signature:
Date:
/ o - � -'�'
a �
Print Name:
4
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doc: Conditions D04 -375 Printed: 10 -06 -2004
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IL CITY OF TUMILA
Community Development Department
g Public Works Department
Permit Center
Vn '� 6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
Building Permit No. _ �-- 57,5
Mechanical Permit No.
Public Works Permit No.
Project No.
For office use onl
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:
/ J
2
King Co Assessor's Tax No.:
W —
7 �
Site Address: / U
y
Suite Number:
Floor:
Tenant Name: Z V h h
P cr 0 A
New Tenant:
❑ .... Yes ❑ ..No
Property Owners Name: -V
12 h
Mailing Address:
-
City
State Zip
CONTACT PERSON -
-
Name: ,� �f� g
1 r
`
Da Tele hone:
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Mailing Address: Z ��
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E -Mail Address:
City State Zip
Fax Number:
GENERAL.CONTRACTOR INFORMATION'- ((Mechanical Contractor information on back page)
Company Name: BERGIN ROOFING 0
20815 2nd PL SW
Mailing Address
�^ City State Zip
_T04h Q , 206- 824 -5852
Contact Person: U PY lyt E3 Y itlHROIb 10 i A Day Telephone: l
E -Mail Address: Fax Number: b `J ? 7 6 1
Contractor Registration Number: Expiration Date: 7
—l— 6
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
ARCHITECT .OF RECORD := All. plans must be Wet stamped by Architect of Record
Company Name:
Mailing Address:
City State Zip
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
ENGINEER OF RECORD, All plans must be. Wet stamped by Engineer of Record'
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
City
Day Telephone:
Fax Number:
\permits plus\icc changes\permit application (7.2004)
' Page t
State Zip
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BUILDING PERMIT INFORK ' ION — 206 -431 -3670
Valuation of Project (contractor's bid price): $ v
Scope of Work (please provide detailed inform ation):��/" D
Existing Building Valuation: $ 2,S 0
1 tG r 0
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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 dwell' Floor area for accessory dwelling:
*Provide documentation that shows that the principal owne ves 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:
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FIRE PROTECTIONMAZARDOUS MATERIALS:
❑.. Sprinklers ❑ ..Automatic Fire Alarm one ❑ . Other (specify)
Will there be storage or use of flammable, combustible or zardous materials in the building? ❑ .. Yes ❑ .. No
If "yes", attach list of materials and storage locations a separate 8 -112 x I I paper indicating quantities and Material Safety Data Sheets.
\permits phu\iw changes\permit application (7.2004)
Page 2
Existing
Interior
Remodel
Addition to
Existing
Structure
New
Type of
Construction
per IBC
Type of
Occupancy per
IBC
V Floor
2 Floor
3` Floor
Floors thru
Basement
Accessory Structure*
Attached Garage
Detached Garage
Attached Carport
Detached Carport
Covered Deck
Uncovered Deck .
771
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 dwell' Floor area for accessory dwelling:
*Provide documentation that shows that the principal owne ves 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:
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FIRE PROTECTIONMAZARDOUS MATERIALS:
❑.. Sprinklers ❑ ..Automatic Fire Alarm one ❑ . Other (specify)
Will there be storage or use of flammable, combustible or zardous materials in the building? ❑ .. Yes ❑ .. No
If "yes", attach list of materials and storage locations a separate 8 -112 x I I paper indicating quantities and Material Safety Data Sheets.
\permits phu\iw changes\permit application (7.2004)
Page 2
l . MECHANICAL PERMIT INFORMATION 206- 431 -3670
l MECHANICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
City State Zip
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
Contractor Registration Number: Expiration Date:
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
Valuation of Project (contractor's bid price): $
Scope of Work (please provide detailed information):
I
I
i
Use: Residential: New .... Replacement ..... ❑
i Commercial: New .... ❑ Replacement..... ❑
I
FuelIMe Electric ..... ❑ Gas .... ❑ Other:
Indicate type of mechanical work being installed and the quantity below:
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Boiler /Com pressor:
Q
Furnace <100K BTU
Air Handling Unit >10,000
Fire Damper
0 -3 HP /100,000 BTU
CFM
Furnace>100K BTU
Evaporator Cooler
Diffuser
3 -15 HP /500,000 BTU
Floor Furnace
Ventilation Fan Connected
Thermostat
15 -30 HP /1,000,000 BTU
to Single Duct
Suspended /Wall/Floor
Ventilation System
Wood /Gas Stove
30 -50 HP /1,750,000 BTU
Mounted Heater
Appliance Vent
Hood and Duct
Water Heater
50+ HP /1,750,000 BTU
Repair or Addition to
Incinerator - Domestic
Emergency
Heat/Refrig/Cooling
Generator
System
Air Handling Unit
Incinerator – Comm/Ind
Other Mechanical
<10,000 CFM
Equipment
;PERMIT APPLICATION. NOTES Applicable to all permits 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 OWN HOR 20815 2nd PL SW IZED AGENT: BERGIN ROOFING
Signature: Date:
Print Name: °G� /�e� g l�, 206- 824 -5852 ay Telephone:
7i IAEIZL71Rtf)44�
Mailing Address:
City State Zip
Date Application Accepted: Date Application Expires: I Staff Initials:
\permits plus \icc cbanges\pcmit application (7.2004)
Page 4
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j 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
RECEIPT
r Parcel No.: 3597000144
Address: 15185 62 AV S TUKW
Suite No:
s Applicant: PETERSON RESIDENCE
Permit Number:
Status:
Applied Date:
Issue Date:
D04 -375
ISSUED
10/06/2004
10/06/2004
i
I
! Receipt No.: R04 -01374
i Initials: SKS
User ID: 1165
Payment Amount:
Payment Date:
Balance:
194.36
10/06/2004 03:47 PM
$0.00
I
Payee: BERGIN ROOFING INC
!! TRANSACTION LIST:
j: Type Method Description Amount
i---- - - - - -- -- - - - - -- --------------------- - - - - -- ------ - - - - --
Payment Check 2863 194.36
f ACCOUNT ITEM LIST:
Description Account Code Current Pmts
i
1 BUILDING - RES 000/322.100 189.86
STATE BUILDING SURCHARGE 000/386.904 4.50
Total: 194.36
doc: Receipt Printed: 10 -06 -2004
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INSPECTION RECORD �0`1,
3 Retain a copy with permit
INSPECTION NO. F2O 4 6)4 i 670
CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 i
Project:, ,
Type of InspeWion: .
Address:
Date Called:
Special Instructions:
4-).
f
Date Wanted: _ a.m.
�.m.
Requester:
Phone No:
1C7a6 .)
Approved per applicable codes. Corrections required prior to approval.
COMMENTS: �y
tiI /
Receipt No.: Date:
/ 13 -- v
E 7.00 REINSPECTIO FEE REC 1 IRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
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INSPECTION RECORD
.�7S
Retain a copy with permit
INSPECTION NO. P IT O.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Pro' ct:
Type of Inspe
- �' s
7/f n1 eS •
/Zvz7 P-4 /Lip'
Address:
Date Called:
7 -d
Special Instructions:
Date Wanted: a.m.
/d -- Z� p.m.
Requester:
Phone No:
e o e - SoS 2.
1
i
Approved per applicable codes. Corrections required prior to approval.
MENTS:
M nsct'r:Date: '
hA,^�*— 1�" /rU - 7 -- o
47.00 REINSPECTI N FEE REQ RED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.: Date:
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INSPECTION RECORD
Retain a copy with permit 4 06 ) 431-3670 3,'�
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISIO
6300 Southcenter Blvd., #100, Tukwila, WA 98188
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
Project: " /
Type of In §pe tion:
Address:
s
Date Called:
Special Instructions
Date Wanted: a. m.
7 -D
Requester:
: Td,�,� ,tee K(
Phone No:
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State of '
_ Washington
DEPARTMENT OF LABOR & INDUSTRIES
PO BOX 44450
OLYMPIA WA 98504 -4450
A BERGIN ROOFING INC
20815 2ND PL SW
s; SEATTLE WA 98166
FIRST CLASS MAIL
US POSTAGE.
PAID
OLYM WA
PERMIT NO 312
�a���.�a - � �a 11► 1►► 1+► i►+++ ti► Il+++ il►►► 1 + +t+ +1 ►t++t +1 ►i +1+► ► ►I1+1►1+ ►+ +411
r-- Detach And Display Ceilificate ----�
- DEPARTMENT OF LABOR AND INDUSTRIES
REGISTERED AS PROVIDED BY LAW AS
CONST CONT SPECIALTY !!
REGIST #' EXP..DATE
'CCCDCV 04/01/2006.
EFFECTIVE ;DATE 04/.01./1996
BERGIN ROOFING INC,
20815 2ND PL SW
SEATTLE WA 98166
r621- 052 -000 (8/971 s
Detach And Display Certificate
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