Loading...
HomeMy WebLinkAboutPermit D04-431 - BERNABEL RESIDENCE - RESIDENCE DEMOLITIONThis record contains information which is exempt from public disclosure pursuant to the Washington State Public Records Act, Chapter 42.56 RCW as identified on the Digital Records Exemption Log shown below. D04 -431 Bernabel Residence 5021 South 124th Street RECORDS DIGITAL D- ) EXEMPTION LOG THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION Page # tode Exemption = 8rlef Explanatory DeSclriptiop �t�tutel ule The Privacy Act of 1974 evinces Congress' intent that social security numbers are a private concern. As such, individuals' social security Personal Information — numbers are redacted to protect those Social Security Numbers individuals' privacy pursuant to 5 U.S.C. sec. 5 U.S.C. sec. DR1 Generally — 5 U.S.C. sec. 552(a), and are also exempt from disclosure 552(a); RCW 552(a); RCW under section 42.56.070(1) of the Washington 42.56.070(1) 42.56.070(1) State Public Records Act, which exempts under the PRA records or information exempt or prohibited from disclosure under any other statute. Redactions contain Credit card numbers, debit card numbers, electronic check numbers, credit Personal Information — expiration dates, or bank or other financial RCW 24,29 DR2 Financial Information — account numbers, which are exempt from 42.56.230(5) RCW 42.56.230(4 5) disclosure pursuant to RCW 42.56.230(5), except when disclosure is expressly required by or governed by other law. BERNABEL RESIDENCE 5021 S 124 STENSEN RD D04-431 Parcel No.: 0179002275 Address: 5021 S 124 ST TUKW Suite No: Tenant: Name: BERNABEL RESIDENCE Address: 5021 S 124 ST, TUKWILA WA Owner: Name: BERNABEL SIMON Phone: Address: 3002 S 208 ST, #K -2, SEA TAC, WA Contact Person: Name: SIMON BERNABEL Phone: 206 870 -7815 Address: 3002 S 208 ST, #K -2, SEA TAC, WA Contractor: Name: OWNER AFFIDAVIT IN FILE Phone: 206 870 -7815 Address: 3002 S 208 ST, #K -2, SEATAC, WA Contractor License No: Expiration Date: DESCRIPTION OF WORK: DEMOLITION OF EXISTING 840 SQ FT HOUSE. PUBLIC WORKS ACTIVITIES INCLUDE DISCONNECTING HOUSE SEPTIC SEWER SYSTEM AND CONNECTING THE EXISTING GARAGE TO THE EXISTING SEPTIC TANK. Value of Construction: $4,000.00 Type of Fire Protection: Type of Construction: Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N City o. Tukwila doc: IBC - Permit 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 Sanitary Side Sewer: N Sewer Main Extension: N Private: Storm Drainage: N Street Use: N Profit: N DEVELOPMENT PERMIT D04 -431 Permit Number: D04 -431 Issue Date: 04/06/2005 Permit Expires On: 10/03/2005 Fees Collected: $479.19 International Building Code Edition: 2003 Occupancy per IBC: 0022 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: Public: Non - Profit: N Steven M. Mullet, Mayor Steve Lancaster, Director Printed: 04 -06 -2005 z Z w 6 U 0 o Ill = H w 0 g a CO I I— w Z 1� 0 Z uj U� ON w - U 11 6 ..z UN 0~ z Water Main Extension: Water Meter: doc: IBC - Permit City o. 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 N Private: Public: N * *continued on next page ** D04 -431 Steven M Mullet, Mayor Steve Lancaster, Director Printed: 04 -06 -2005 i µ:+'*M.v, �4,N rPIWSW. 4F MNGYV.HTI ✓.na4.) Permit Center Authorized Signature: Signature: doc: IBC - Permit Cit y o: Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: ci.tulovila.wa.us 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 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. D04 -431 Steven M. Mullet, Mayor Steve Lancaster, Director Permit Number: D04 -431 Issue Date: 04/06/2005 Permit Expires On: 10/03/2005 Date: Date: 0 4 1/0t; !O•r" Print Name: Ole jCtvictvi vtc t3 r na be f 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. Printed: 04 -06 -2005 1 z re w 6 JU U y 0 -1_ H u. . w 0 u- aC • d III } ? t = - H- O Z r`- w • w U 0 0 O I— w w I- � O' ,z wow Z, O ~ Z City of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 Parcel No.: 0179002275 Address: 5021 S 124 ST TUKW Suite No: Tenant: BERNABEL RESIDENCE 1: ** *BUILDING DEPARTMENT CONDITIONS * ** PERMIT CONDITIONS Permit Number: D04 -431 Status: ISSUED Applied Date: 12/01/2004 Issue Date: 04/06/2005 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: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of this requirement. 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. 6: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * ** 7: The applicant must notify the City Utility Inspector at (206)433 -0179 upon commencement and completion of work at least 24 hours in advance. All inspection requests for utility work must also be made 24 hours in advance. 8: Contractor shall notify Public Works Utility Inspector at (206)433 -0179 of commencement and completion of work at least 24 hours in advance. 9: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation off -site or into existing drainage facilities. 10: 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. 11: APPLICANT SHALL FOLLOW ALL THE CONDITIONS OF NOV 9, 2004 KING COUNTY DEPARTMENT OF HEALTH APPROVAL LETTER ACTIVITY : 0N0067620, WHICH IS ATTACHED AS PART OF THIS PERMIT APPROVAL AND SUBMIT AN AS -BUILT PLAN TO THE CITY PUBLIC WORKS INSPECTOR PRIOR TO FINAL PERMIT SIGN -OFF. 12: ** *PLANNING DEPARTMENT CONDITIONS * ** 13: The applicant shall submit a Developer's Warranty Agreement for the demolition of the existing garage. The applicant shall provide the City with a cash, bond, or cash equivalent in the amount of $1,503.19 (150 percent of the estimate provided to the city). doc: Conditions D04 -431 Printed: 04 -06 -2005 z I1= '~ w o=ff 00 J = co 0 F- W O u.. I W Z = I- 1— O Z I— W O • N O 1— WW tL O co O~ z ,,. tF w. b. .: �; e4.:ci40,' {, tS:,144. doc: Conditions City of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 14: Within 30 -days of issuance of the demolition permit (D04 -431), the applicant shall submit a complete building permit application to convert the garage into a single - family dwelling unit. 15: The garage must be converted into a dwelling unit within one year from issuance of D04 -431. 16: The applicant can also choose to demolish the entire garage and this must be completed within one year of issuance of 004 -431. 17: If the applicant does not comply with conditions three or four, the City shall use the cash, bond, or cash equivalent provided to the City to demolish the garage on the property. * *continued on next page ** 004 -431 Printed: 04 -06 -2005 ( ice +.V.:W: iirv:tF:,Y9F1+:Y.:'cNisG,'Vw Signature: doc: Conditions 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 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 regulating construction or the performance of work. Print Name: � l ei a v► c� r tri� B er flat) e( D04 -431 of law and ordinances other work or local laws Date: D /0 Printed: 04 -06 -2005 SITE LOCATION CITY OF TUKWILA - Community Development n ,.artment Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 Name: S it N B C e ru iz S e t. 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 Address: 6021 s 124/ 7c*Lu t (-4 (A m • "ill ��' Tenant Name: 5111.0 &I 6E12Ai Property Owners Name: Si t" to M Q E2 ivA Q e C.. Mailing Address: 300 2 S• 20 ST APT K - Z Mailing Address: 3 208 sT ,AP K -2. Company Name: Y O W N'sk3 Mailing Address: 3O02-SS, 2O +ti sr Apt -2. Contact Person: SIMOM 13 6.12444 15 E -Mail Address: \permits plus \icc changes \permit application (7- 200.1) Page 1 Building Permi i0 ' !1 3 Mechanical Permit No. Public Works Permit No. Project No. (For ofce use only) King Co Assessor's Tax No.: 0 4 900 - ZZ Suite Number: Floor: New Tenant: ❑ .... Yes ❑ ..No C City w A- Stale Day Telephone: (2 co 8 3 0 --} g i S S &ATAC City Day Telephone: State State State `181 Zip 5g 15P Zip s�o Th C. City E -Mail Address: Fax Number: GENERAL: CONTRACTOR: INFORMATION :- (Mechanical Contractor information on back page) WA• State Zip �2 oc) 8 3o- 3Si,r 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: Mailing Address: Zip City Contact Person: Day Telephone: Fax Number: ENGINEER OF RECORD - All plans must be wet stamped by Engineer of Record Company Name: Mailing Address: Zip City Contact Person: Day Telephone: E -Mail Address: Fax Number: W cc 6 J 00 0 W g Q = d I— W Z = I— 0 W W • co O — O 1-- W W H � - LL. O .• Z w • N 0 Z •.. +�., w.,....:: J...'.>:.: iaN i+`.` f1�: fi.`, i.':::.. r;. l�b'•A:i.AY:.i:NYuY`J".1.w'�:�' �`L.f �A. BUILDING PERMIT INFORMATION - 206 - 431 -3670 aluation of Project (contractor's bid price): ,$" Lis 0©0 -. = Scope of Work (please provide detailed information):: s Number of Parking Stalls Provided: Standard: \permits plus\icc changes\permit application (7.2004) Page 2 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. Will there be a change in use? ❑ ....Yes ❑ ..No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ 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 -1/2 x 11 paper indicating quantities and Material Safety Data Sheets. Existing Building Valuation: $ a 's-7 «y kW' 40 Compact: Handicap: Existin Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC 1st Floor •y E�J 2n Floor .. - -- 3r Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck • BUILDING PERMIT INFORMATION - 206 - 431 -3670 aluation of Project (contractor's bid price): ,$" Lis 0©0 -. = Scope of Work (please provide detailed information):: s Number of Parking Stalls Provided: Standard: \permits plus\icc changes\permit application (7.2004) Page 2 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. Will there be a change in use? ❑ ....Yes ❑ ..No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ 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 -1/2 x 11 paper indicating quantities and Material Safety Data Sheets. Existing Building Valuation: $ a 's-7 «y kW' 40 Compact: Handicap: Unit Type: Qty Unit Type: Qty Unit Type: Qty Boiler /Compressor: Qty 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 Connected to Single Duct Thermostat 15 -30 HP /1,000,000 BTU Suspended/Wall/Floor Mounted Heater Ventilation System Wood /Gas Stove 30 -50 HP /1,750,000 BTU Appliance Vent Hood and Duct Water Heater 50+ HP /1,750,000 BTU Repair or Addition to Heat/Refrig/Cooling System Incinerator - Domestic Emergency Generator Air Handling Unit <10,000 CFM Incinerator — Comm/Ind Other Mechanical Equipment MECHANICAL PERMIT INFOT 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): Use: Residential: New ....❑ Replacement ❑ Commercial: New .... ❑ Replacement ❑ Fuel Type: 'ATION — 206 - 431 -3670 Electric ❑ Gas .... Other: Indicate type of mechanical work being installed and the quantity below: ; 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 CERTIF THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJ A R BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. UILDING O ' ' OR • UTHO c�JP% AGENT: Print Name: S 1 h O g Mailing Address: 300Q 5 2 O&4I \permits plus\icc changes \permit application (7.2004) _ Day Telephone: A s' r City Page 4 Date: J 'may ( 8?-o-1-6 Lt.) A • Slate 8191,' Zip Date Application Accepted: Date Application Expires: I Staff Initials: er retR�r r...:m,. gym.. , �y?^• . 'sH!rarK.t: rear Wrfi'ntrIs'oe,+r.ra.t•V evkelow.r,;aatezru.mrr,. ;rrvrwavv ^_•rramo,; mar. y .wr+r ,.».•...nv,,.rc�...,,..,.., ,..,.„., -, .�,..,..., Parcel No.: 0179002275 Address: 5021 S 124 ST TUKW Suite No: Applicant: BERNABEL RESIDENCE Receipt No.: R05 -00482 Payment Amount: 276.00 Initials: SKS Payment Date: 04/06/2005 02:10 PM User ID: 1165 Balance: $0.00 Payee: ALEJANDRINA BERNABEL M.O. #206950317 TRANSACTION LIST: Type Method Description Amount ACCOUNT ITEM LIST: Description doc: Receipt Payment Mon Ord 20695031 276.00 PW BASE APPLICATION FEE PW PERMIT /INSPECTION FEE PW PLAN REVIEW City of Tukwila 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 Account Code Current Pmts 000/322.100 000/342.400 000/345.830 RECEIPT Permit Number: D04 -431 Status: PENDING Applied Date: 12/01/2004 Issue Date: 250.00 13.00 13.00 Total: 276.00 r?G4 04/06 9716 TOTAL 276.00 Printed: 04 -06 -2005 Parcel No.: 0179002275 Address: 5021 S 124 ST TUKW Suite No: Applicant: BERNABEL RESIDENCE Receipt No.: R04 -01608 Initials: SKS User ID: 1165 City of Tukwila 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 Payee: SIMON BERNABEL TRANSACTION LIST: - 'Type Method Description ACCOUNT ITEM LIST: Description doc: Receipt Payment Cash BUILDING - NONRES PLAN CHECK - NONRES STATE BUILDING SURCHARGE RECEIPT Account Code Current Pmts 000/322.100 000/345.830 000/386.904 Z _ • II— it ix 2 Permit Number: D04 -431 -J 0 Status: PENDING N o Applied Date: 12/01/2004 co W Issue Date: J H u) w w Payment Amount: 203.19 g - Payment Date: 12/01/2004 12:02 PM H w Balance: $0.00 z i • i- 0 Z I- 2 ui 0 0 . .0 — CI I– W W 2 U Amount ~ H 9- O 203.19 U w 0 Z 120.42 78.27 4.50 Total: 203.19 .12 0 ; . ► r (. 2o: Printed: 12 -01 -2004 ik 0∎46, ..uJ1A Proje t: (/) u_� e l Type of Inspe tion; lac F1 J Address: b o a l $ / St Date Called: D d.VOS Special Instructions: �cl la- e Coo r� // 06 "l n 9 Date Wanted: / a, t�� //� p.m. Requester: + Vi1�'l'1 Phone No: ao6 -, 14f 4 INSPECTION RECORD Retain a copy with permit INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 206)431 -3670 Approved per applicable codes. J Corrections required prior to approval. COMMENTS: V o,4--- v A:i -- C' rryvkz L -i-� � > t - - n - 1 t\3,4 Inspect�f: AI AAA. r4 ”: .00 REINSPECTION EE REQUIRED. Vor to inspection, fee must be pad at 6300 Southcente Blvd., Suite 100. Call to sechedule reinspection. Date: 14) Z '~ W Q Q 2 J U O O U) k (0 ILI J � LL W I I oI W W 0 lll • = o ~ z Project P / e,. Type of Ins e0on: Coon 11e F7 Address: .6 ,2 ! S /ay s Date Calle : U 06/ ?5/0. Special Instructions: C OO L , 1C - Ie a)1 V )W ' -�- Date Wanted: ^ , a.m. o /05)o S Requester: 5i/Yl r>,1 P hone No: �Q J v 0 G -� yh- INSPECTION RECORD Retain a copy with permit INSPECTION NO. CITY OF TUKWILA BUILDING DIVISI 6300 Southcenter Blvd., #100, Tukwila, WA 98188 PERMIT NO. ON (206)431 -3670 Approved per applicable codes. Corrections required prior to approval. C • MMENTS: Inspector: Date: 7 /'; / $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. Receipt No.: 'Date: Pro ect: Typepection:- Address: Ad./ c5 / V Sf Date Called: OL /Pilo Special Instructions: � /� 14_ 1610�+J ✓ ■ Date Wanted: / a.m. ot d1f}� P.m. Reques at: , ri4 Don Phone No: / OCe)0 ( 4S ^ga ll INSPECTION NO. INSPECTION RECORD Retain a copy with permit / I 4) PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 r Approved per applicable codes. J Corrections required prior to approval. 17 $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. Receipt No.: Date: Z W 6 00 co CI CO J W a 1... W Z = Z1- W U N 0F_- WW tL O z .. W U= 0~ Z COMMENTS: Type of InspectionL 3k4. 4c Ad ress: Pc ) Id-V5t• /Qe 4 ,9 // C?D.�/ - �✓i / 2/ -/ ` - .. .. Special Instructions: a " 1 , 4 f I Date Wanted: CI, /3" )0- ' - / /N Ne" L i it/ A -- ,v- , e.e Phone v R 1.)2,/,6/ 6J ares I4/-4 ------ Pro' t I ()cc he I fs Sice Type of InspectionL 3k4. 4c Ad ress: Pc ) Id-V5t• Date Called: at,/ j' /05 _ Special Instructions: a " 1 , 4 f I Date Wanted: CI, /3" )0- ' a m Request r;, Phone v R Inspect $58.00 • EINSPECTION FEE • EQUIRED. Pri paid 6300 Southcenter Blvd., Suite 10 Date: INSPECTION NO. El Approved per applicable codes. No.: INSPECTION RECORD Retain a copy with permit CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Corrections required prior to approval. to inspe tion, fee must be Call to sechedule reinspection. Date: Z 1 Z � J U O 0 toa CO ul W I U W W O u_¢ N 3 = I_ W Z W O E W U � • N O H W W H � Z W U = O ▪ I— Z Projec z . Type of Inspection: Address: /2 e/ ET. Date Called: Special Instructions: Date Want / c a.m. 7 er ' �S" p.m. Requester: =- e.if7"1(h'✓ Phone No • •'(; X 7 t /.) INSPECTION RECORD Retain a copy with permit INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 El Approved per applicable codes. El Corrections required prior to approval. COMMENTS: / 6 d?,,/ � /c/170 Inspe r: $ 8.00 REINSPECTION F / paid at 6300 Southcenter eceipt No.: CAA./ Cc..< E REQUIRED. /Prior to inspection, fee must be lvd., Suite 1, 0. Call to sechedule reinspection. Date: _ f Li 1 - O,S Date: z Z W 6 00 U) 0 W = JI— • u_ W 2 gQ = • d z � 1-0 W ~ • W 0 O — 0 W W U. 0 . .. z W v= 0 z COMMENTS: /) Type of Inspection: r . I 7 �� JJ Address: � �:U21 / 2L( �' 7 /7/)3 5 S5 1cJc pyze , i Roo" Special Instructions: ‘, - A 0 /l z�. �..a4= r Date Wanted: i � iidLAJL hz frA. >tit -al 64.44- (LeJ i. Phone No: 9 1' -'. Project: /) Type of Inspection: r . I 7 �� JJ Address: � �:U21 / 2L( �' Date Called: I Vc.) Special Instructions: Date Wanted: i a.m. p.m. Requester: . Phone No: DLw-w 3 l INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (2 06)43 1 -3670 Approved per applicable codes. J Corrections required prior to approval. 'Inspector: 64-1 Date: .. 0 $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. W 00 co c J W 0 g a = • a Z Wo W 0 co O — O I— WW H rz LL Z LU U = O I— Z F.4%4I .+.' .t:K�.{�R�&7.Ri,:,?� ",14a'a�i'+ F'a'-:i:�. NJ.IE�I�•� >.a:.i'.. Receipt No.: Date: Project: ,,�r.- j R Type of Inspection: etk) Po Address: boat 5 1 ,9y 56 Date Called: 6. a / 7 / 9 / 1 ° Special Instructions: Date Wanted: C2 a:m. P.m. Requester: I M O Phone No: ,0(v 2W - 9 s D041- y31 INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (2 06)431 -3670 El Approved per applicable codes. Corrections required prior to approval. COMMENTS: •C sctze Al 's 4(14 ye]' 7y he S {ud-)a • El $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedute reinspection. Receipt No.: Date: Z W QQ • � J U ✓ O • U. W O 2 LL co _ � 11W ' Z O W W : c ON O I— W U1 0 u' .• Z W U� O Z COMMENTS: Type of Inspef�tion: nn V66 h4 COX. Date Called: 164//9/0.5 �' ✓/1G1�� ( Address : ' ooq/ ,5 /may.S Special Instructions: kt w I ' ) be " r n5 e C. 41 1 4-6 6 r n Date Wanted: fr OS �` a ^� Re S rmv, P-P 1/L4s/7 ell&iej ./6 /16(4 c sGt4.1Y S S i fLt 014. _ ' lie Prod Type of Inspef�tion: nn V66 h4 COX. Date Called: 164//9/0.5 �' ✓/1G1�� ( Address : ' ooq/ ,5 /may.S Special Instructions: kt w I ' ) be " r n5 e C. 41 1 4-6 6 r n Date Wanted: fr OS �` a ^� Re S rmv, Phone No: c w.�y.y,3AY;iui. U Approved per applicable codes. INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Corrections required prior to approval. Inspector: g.4 Date: / //i ' / CI $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. Receipt No.: Date: Z tU re 2 J U UO 0 LLI J = W u_ ¢ z = W W U0 o 1— W W H IL .. z W U = O 1- z .e.:.xaaers,..Yu.� a o'r�i" , •'-.,� }si s.. ::r::'i:::. r s .. _..._. . _ _..._. • • NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEARIHAN THIS NOTICE IT IS DUE TO THE QUALITY OF THE DOCUMENT. May 16, 2006 Simon Bernabel 5021 South 124th Street Tukwila, WA 98168 City of Tukwila Department of Community Development Steve Lancaster, Director RE: Release of Cash Assignment Dear Mr. Bernabel: Enclosed is a check in the amount of $1,503.19 for the demolition of the garage on the property located at 5021 South 124th Street, Tukwila, Washington. The project is complete and has been approved by the City of Tukwila. If you should have any questions, please contact our office at (206)431 -3672. Sincerely, Brenda Holt Permit Coordinator encl mit doe xc: Permit No. D04 -431 q: \documents \bond release \d05.0I 1 — release letter.doc bh Steven M. Mullet, Mayor 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 -431 -3665 1z mo w : u6= J U. U O N 0 . co w w • O :. 2 g a = w Z = F„ O Z I- U.1 uj O— '01-- W E- H ' - O .. Z U =` O Z May9, 2006 Memo To: Laurie Anderson From: Brenda Holt Oe Re: D04 -431 City of Tukwila Permit Center Please refund $1,503.19 to Simon Bemabel for the demolition of the existing garage at the property located at 5021 South 124 Street, Tukwila. Please make the check out to: Simon Bemabel 5021 South 124 Street Tukwila, WA 98168 Please send the check to my attention and I will forward it to him. Thank you. Xc: File No. D04 -431 Q:1Documents\Bond Release1D04.431- Refund Memo.doc z • ct 6 m N 0' W i I: w O. - d _ . z � 1— O Z I-- o U O— w IL (5 0 N . f=� O • Parcel No.: Address: Suite No: Applicant: Receipt No.: Initials: User ID: Payee: TRANSACTION LIST: Type Method ACCOUNT ITEM LIST: Description doc: Receipt Payment Payment City of Tukwila 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 0179002275 5021 S 124 ST TUKW BERNABEL RESIDENCE R05 -00565 BLH ADMIN SIMON BERNAL Check 891760701 Check 63302664qb BUILDING BOND /DEPOSIT Description RECEIPT Account Code 000/386.908 Permit Number: Status: Applied Date: Issue Date: Payment Amount: 1,503.19 Payment Date: 04/21/2005 12:03 PM Balance: $0.00 Amount 303.19 1,200.00 Current Pmts 1,503.19 Total: 1,503.19 D04 -431 ISSUED 12/01/2004 04/06/2005 238 7 04/21 9716 TOTAL 1503.19 Printed: 04 -21 -2005 z • z re W U 0 W J = 1- U) W O } J tL 4 CO = W Z �. F-0 Z U O F— WW � U. O .. W O N z Name of Development: Inspector City of Tukwila 6300 South'Center Blvd, Suite 100 Tukwila, WA 98188 206 - 431 -3670 DEVELOPER'S PROJECT WARRANTY REQUEST FORM Section 1 — to be completed by Developer /(.& f) Valet 614. Address: 5021 S I Z iI `)r 1,,,1�tu►lr� Release should be sent to: Name: �jya•� . UFiVV?�L(r��...1 Address: 4 021 P U HA si . City /State /Zip 11 ' 14 /A 1 06 Phone Number: 7o(- 01 - /0/6 Description of items to be completed (reference plans /documents where items are described): ii- Pr/1A,41l ( 6 f vim As the owner, or authorized agent of the owner, I hereby submit cash $ 105, 11 (150% of value to complete work above) an will have this Work carried out and call for a final inspection by this ' a these funds to carry out the work with their own contractor or in -h ' us authorize the City to go onto the property and carry out comple '•n o all work listed above prior to requesting inspection and relea Signed: Vw Section 2 — to be • mpleted by City staff se fund BE ACCEPTED Signed: I Department Head: Amount: $415 l . I Deposited this Date: 00 Cash /Check ❑ Cash Assignment ❑ Bond City Receipt No.: li - ODS(''S Received By: A40 Section 3 - to be completed by Developer All work identified in Section 1 of this form has now been completed and returned to department which authorized warranty. I hereby request inspection and release of my cash /cash equivalent/bond. Developer's Representative: Date: To be compl =ted by City staff kpollry and procedures\ed book dcvcloper's project warranty form Created: February 2003 Section 4 — to be completed by City staff Title: Date: t) THIS FUND IS AUTHORIZ Date: 4 Permit No.: 604 t•r cash equivalent in the amount of =ttach support documentation for value of work. I - -� , or risk having the City use manpower. If I fail to carry out the work, I hereby the above deficiencies. I. urther agree to complete � 4-21 -o. I hay- rev': id d the above work and found it acceptable and therefore authorize the rel a as Authorized By: of the above Amount Released: $ 1 6m. ( 1 [ ] Check - Check No. 32'il ❑ Cash Equivalent - Letter attached ❑ Bond - Letter attached Date Released: - 1 fr • D(p Released by: z ;= z re 111 6 O 0 • 0 w= F- U) w 2 g Q = • d I -w Z = 1-0 Z w uj 0 c-2 o f- w O w z co 0 1- z Parcel No.: Address: Suite No: Applicant: Receipt No.: Initials: User ID: Payee: SIMON BERNAL R05 -00565 BLH ADMIN TRANSACTION LIST: Type Method Payment Payment ACCOUNT ITEM LIST: Description doc: Receipt City of Tukwila 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 0179002275 5021 S 124 ST TURIN BERNABEL RESIDENCE Check 891760701 Check 63302664'tb BUILDING BOND /DEPOSIT Description RECEIPT Account Code 000/386.908 Permit Number: Status: Applied Date: Issue Date: Payment Amount: Payment Date: Balance: Amount 303.19 1,200.00 Current Pmts 1,503.19 Total: 1,503.19 D04 -431 ISSUED 12/01/2004 04/06/2005 1,503.19 04/21/2005 12:03 PM $0.00 Printed: 04 -21 -2005 redacted Date Estimate # 3/14/2005 7 7 seas drywall co po box 2564 auburn, WA 98071 -2564 Name / Address simon and alexia bernabel 5021 s 124th st tukwila wa 98178 Phone # 206 - 399 -1767 Fax # 253- 946 -0133 CORRECTION Estimate Ship To Description general demolition of garage except foundation dumpster load approx 40 yards backhoe loader and operator per hr As °Pr UKVINA PERMIT oeyrEg Total Project Total 252.64 612.57 136.92 $1,002.13 ;H W 00 CO W J CO W ga g2 = W I— _ ` Z F- O W I- U� O— CI F- W uj H � 11 0 Z ' W CO Z oanna Spencer - Bernabel @ 5021 S 1240—s x D04 -431 From: Joanna Spencer To: John.harvey @seattle.gov Date: 5/12/05 4:56PM Subject: Bernabel @ 5021 S 124th St Joanna Spencer Development Engineer Tukwila Public Works ph 206 - 431 -2440 fax 206 - 431 -3665 jspencer @ci.tukwila.wa.us Per applicants request this is to confirm that Public Works will allow for power to be fed overhead to the garage at the subject property. Pa ge It o 0 I-- w w H V. LI 0 W Z w N. H O z DATE: CONTACT: RE: ADDRESS: City of Tukwila Department of Community Development March 29, 2005 Simon Bernabel D04 -431 5021 S. 124`" Street PLANNING DIVISION COMMENTS The Planning Division of DCD has reviewed the above permit applications that were submitted on March 17, 2005. Planning has approved the application subject to the following conditions: 1. The applicant shall submit a developer's warranty agreement for the demolition of the existing garage. The applicant shall provide the City with a cash, bond, or cash equivalent in the amount of $1,503.19 (150 percent of the estimate provided to the City). 2. Within 30 -days of issuance of the demolition permit (D04 -431), the applicant shall submit a complete building permit application to convert the garage into a single- family dwelling unit. 3. The garage must be converted into a dwelling unit within one year from issuances of D04- 431. 4. The applicant can also choose to demolish the entire garage and this must be completed within one year of issuance of D04 -431. 5. If the applicant does not comply with conditions three or four the City shall use the cash, bond, or cash equivalent provided to the City to demolish the garage on the property. Steven M. Mullet, Mayor Steve Lancaster, Director 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 -431 -3665 a., �.��+Z. S.LL�. `uA:Y.«i�.a+�l ✓JyJ.tiA.:.l:v r...�6i1.y..v.'+4'Arr ._.✓L J:.a a.y�, .y 'rr.>-i:"«...� Date Estimate # 3/14/2005 7 ti , 7' seas drywall co r po box 2564 auburn, WA 98071 -2564 Name / Address simon and alexia bernabel 5021 s 124th st tukwila wa 98178 Phone # 206- 399 -1767 Fax # 253 -946 -0133 CORRECTION Estimate Ship To Description general demolition of garage except foundation dumpster load approx 40 yards backhoe loader and operator per hr cr ,,Iyec evED t'yR " �• ;,1191i Project Total 252.64 612.57 136.92 Total $1,002.13 Doti- -4-5i February 8, 2005 Mr. Simon Bernabel 3002 South 208 Street, Apt. K -2 SeaTac, Washington 98198 RE: CORRECTION LETTER #2 Development Permit Application Number D04 -431 Bernabel Residence — 5021 South 124 Street Dear Simon: 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 Planning Department. At this time, the Building, Public Works and Fire Departments have no comments. Planning Department: Brandon Miles, at (206) 431 -3684, 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 in person and will not be accepted through the mail or by a messenger service. If you have any questions, please contact me at (206) 433 -7165. Sincerely, Stefania Spencer Permit Technician encl xc: File No. D04 -431 City of Tukwila Steven M. Mullet, Mayor Department of Community Development Steve Lancaster, Director 41,y.,ih:ai:,F4.4' 5 omh. a•W A In . i' rsra :s•,o.'u`.;a.ire3LL;,9;:NwSiNO`• , 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206-431-3670 • Fax: 206 - 431 -3665 z cc 0 N O I _ H WO u_ cC d I-W Z = F- O Z U C) O- OH Ww Ht- - O OH z DATE: CONTACT: RE: ADDRESS: city of Tukwila Department of Community Development January 19, 2005 Simon Bernabel D04 -431 5021 S. 124 Street Please review the following comments listed below and submit your revisions accordingly. If you have any questions on the requested revisions, Brandon Miles is the planner assigned to the file and can be reached at (206) 431 -3684. 1. As was noted in the previous comments from Planning, the demolition of the house will leave a stand along accessory garage. There must be a primary building in order to retain the accessory garage. The applicant notes that he will convert the garage into a dwelling; however the applicant has not provided any plans for this conversion. The applicant must do one of the following if they want to tear down the existing house: A. B. PLANNING DIVISION COMMENTS Demolish the Garage If the applicant is going to convert the garage into the house the City must have a financial guarantee provided in the amount of 150 percent of the cost to demolish the garage. The financial guarantee can be a bond, cash, or cash equivalent. The financial guarantee and the cost estimate to demolish the garage must be provided to the City prior to issuance of the permit to demolish the house on the property. After the applicant has provided the financial guarantee he must submit the required permits to convert the garage into a dwelling within 30 -days of issuance of the permit to demolish the house. The garage must be converted into a dwelling within one year of issuance of the permit to demolish the house. Steven M. Mullet, Mayor Steve Lancaster, Director 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206- 431 -3670 • Fax: 206 - 431 -3665 z < z • ce w 6 U O 0 CO LLI W I N V_ W O 2 J u. = W z �. z w U 0 C1 W • W . ▪ O w Z U 2 OH z Public Health Seattle & King County HEALTHY PEOPLE. HEALTHY COMMUNITIES. Alonzo L. Plough, Ph.D., MPH, Director and Health Officer November 9, 2004 Simon Bernabel 3002 S 208 ST APT# K -2 Seatac, WA 98198 RE: Building Application Review Address: 5021 S 124 ST Parcel No: 0179002275 Owner: Bernabel Dear Mr. Bernabel: Public Health has received your Building Application to build a two- bedroom apartment in the existing garage while you repair your house. It has been reviewed in accordance with the King County Board of Health Code Title 13. Based on this review, it has been approved with the following comments and conditions: 1. Obtain a limited repair installation permit from Public Health to make the tight -line connection between the garage plumbing stub -out and the inlet line of the existing septic tank. A licensed septic system installer or resident homeowner must complete this connection. 2. The building sewer pipe must be a minimum 4 -inch inside diameter pipe. You may use pre- cast iron or PVC D -3034 as a minimum. The minimum grade for installation is 1/8" per foot. 3. Prior to backfilling the tightline connection, an inspection by Public Health will be required to verify that materials and construction are acceptable. 4. A revised As -built drawing at a scale of 1" = 20' or 1" = 30' by a certified septic system Ch•y installer or homeowner must be submitted with the limited repair installation permit. J 1 ruktN 5. Before you may occupy the main house, the property must be served by public sewer. p RM /r These conditions must be satisfied prior to final occupancy of the structure. If you have any � T FR questions, please contact me at (206) 296 -9743 between the hours of 7:00 AM and 9:00 AM or leave a message on my voice mail. My email address is jefferson.ketchel@metrokc.gov Jbff Ketchel, RS Health and Environmental Investigator II Community Environmental Health cc: King County Department of Development & Environmental Services Michael P. Cusick, City of Tukwila Eastgate Public Health Center 14350 SE Eastgate Way • Bellevue, WA 98007 T (206) 296-4932 F (206) 296 -4919 • www.metrokc.gov /health Pointed on Recycled Paper. Activity: ON0067620 RECEIVED JAN 2 4 2005 TUKWILA PUBLIC WORKS CORRECTION LTR# 0 City of Seattle O King County Gregory J. Nickels, Mayor Ron Sims, Executive P>V:lic Health Seattle & King Co11xtty Application for Health Departmet .pproval of Building Permit For houses or structures served by an on -site sewage (septic)system (OSS) Eastgate Public Health Center —14350 SE Eastgate Way, Bellevue WA 98007 (206) 296 -4932 Fax: (206) 296 -4919 Application Fee: $210.00 Please submit application and all support documents in triplicate The minimum support documents include: 1. detailed route map and directions to property 2. plot plan scaled at 1 " =20' or 1 " =30', 11" x 17" max. size, to include: • house footprint and any proposed changes to that footprint • , location of septic tank and pump tank, drainfield and all tight sewer lines • location of reserve drainfield area (repair area) • all water lines and well sites, show 100ft radius around all well sites • location of all out buildings • location of all driveways and parking areas • all property boundaries and easements • all streams and bodies of water 3. Floor plans of what is changing in the building 11" x 17" maximum size paper. Property Information Address of Property 50215 12 q Sr TA iu3 ► LA tu.ri - 98 / Parcel No (APN): City TA k w ILA }. Zip code G e 19- Applicant's Name • 5 MO nl pg eNA L ( Day Phone ( ) Applicant's Mailing Address 30023 2044.51 A Prr•a Sea c tA, .l1. c ialiCity • S ea +ct.0 Zip ci f 19 8 Owner's Name S 11101, a uentA 46 (. Age of House 57 '( &A €. Existing•Square footage of house Square footage to be added Description of proposed changes ggo Type of On -Site Sewage System Serving Property: : ►try u p Additions or repairs to sewage system (give dates and describe briefly) A 9 2 5 Day Phone (2t7 6 ) - Distance to nearest public sewer On - ME Pao pe e.T ' Number of existing bedrooms o 2, Number of bedrooms being added z W TO I-tAee Q -co:1S I Tlf6 GA1 6 C Describe or attach any drainfield easements, covenants or notices on title, which may impact the property Water Supply Information Public water system (water supply with 2 or Water System Name: . more connections) State I.D. Number: Private (well, spring, etc.) attach copies of well log, well covenants, chemical/bacteriological sample reports. For Health Department Use Only Approved Date By: ❑ Disapproved Date By: ❑ Hold Date By: Comments /Conditions: 'I if/ 00w n.. Initials Health Department Use Only Record I.D. Number ON 0 0 b 0 ) Health Dept. Use Only T - Guide Page/Loc. For DDES use Only Date Received Tracking No. Permit Tech HD Fee Collected: Yes No Date Date Received R*ECEI VE b SEP 2 4 2 004 "AISTGaTEitst19 r u Any person aggrieved by any decision or final order of the Health Officer may file a written application for appeal to the Health Officer within 60 calendar days of the decision. (Title 13, K.C.B.O.H. Chapter 13.12 - Sewage Review Committee REV 8/22/00, 9/15/00, 12/24/02, 9/7/04 >J F °` i' a` �rrr. �� .rn+..r•Fw+r.;q .. .e.v n ' . �„ «,.r. <�...- .. «- .r.... z z cc 6 QQ J0 00 0 co w J = u w w 0 2 L Q = a � z = ZO w U � O N O I— w - •• z W • = 17. • ~' z • September 21, 2004 Dear Sir or Madam: Sincerel Michael P. Cusick Project Manager MC:lw city of Tukwila Seattle King County Public Health Eastgate Environmental Health 14350 SE Eastgate Way Bellevue, WA 98007 Subject: The Simon Bernabel Residence 5021 S. 124 St. Tukwila, WA 98178 The existing septic tank will be cleaned, inspected, and approved by a licensed, on -site designer prior to the remodeled garage being connected to the septic tank. When the new public sewer is complete, the owner will be required to connect within 90 days. Please contact me at (206)431 -2441 if you have any questions. (P:Laurie Admin/Mike /Letter KC Public Health 092104) Steven M. Mullet, Mayor Department of Public Works James F. Morrow, P.E., Director The City of Tukwila is out to bid at this time to install'sanitary sewers in the Allentown area of Tukwila where the Bernabel home is located. It is our understanding that Mr. Bernabel plans to remodel the garage into a living space while the existing house is rebuilt to the same number of bedrooms and bathrooms prior to the damage caused by a truck hitting the house. When the house is complete, the bath and kitchen will be removed from the garage. 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 433 -0179 • Fax: 206 - 431 -3665 z • z Ce W QQ � J U O 0 N D CO LLI J H �!L W 0 ga • s u. a co a � _ z � I- 0 Z I- 111 ui O -. O F- W W Li-. 0 .. z W U = 0 z 4 h - 7 NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEAR IHAN THIS NOTICE IT IS DUE TO THE QUALITY OF THE DOCUMENT. NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEARYHAN THIS NOTICE IT IS DUE TO THE QUALITY OF THE DOCUMENT. • ACTIVITY NUMBER: D04 -431 DATE 3 -15 -05 PROJECT NAME BERN ABEL RESIDENCE SITE ADDREM 5021 S124 ST Original Ran Submittal Response to Incomplete Letter # Response to Correction Letter # 2 Revision # After Permit Issued D R'ARTM BV TS• I�I Building Division I I Public Works n D ETNA I NATI ON O F CO M PLFrEKf S (Tues., Thurs.) Incomplete I I Complete APPRO VACS O R C:O RRF('TI O N S Approved 1 I Notation' Documenldrouling dip.doc 2 -28 -02 PLAN l IZI&V9ROUTING SUP Fire Prevention Structural n NIA *ad 5 41 % Planning Division Permit Coordinator EL DUEDATE 3- 17-05 Not Applicable 1 Comments: Permit Center Use Only INCOMPLETE LETTER MAI LED • LETTER O F CO M PLETEV E5S MAILED • Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials TUMTHURSROUT G: I� Please Route Structural Review Required 1 I No further Review Required REVIEWER'S INITIALS REVIEWER'S INITIALS DUEDATE 4 -14 -05 DATE Approved with Conditions Not Approved (attach comments) 17 DATE Permit Center Use Only CORRECTION LETTER MAI LID • Departments issued corrections Bldg ❑ Fire ❑ Ping ❑ PVV ❑ Staff Initials ACTIVITY NUMBER: D04 -431 PROJECT NAME: BERNABEL RESIDENCE SITE ADDRESS: 5021 SOUTH 124 STREET DATE: 01 -18 -05 Original Plan Submittal Response to Incomplete Letter # X Response to Correction Letter # 1 Revision # permit is issued DEPARTMENTS: Complete PLAN REVIEW /ROUTING SLIP 0 PERMIT COORD COPY Building Division Public Works DETERMINATION OF COMPLETENESS: (Tues., Thurs.) )111 c, ► ti-oS Fire Prevention Structural Incomplete ❑ 6y1/1 d1 ( ❑ Manning Division ❑ Permit Coordinator pc, DUE DATE: 01 -20 -05 Not Applicable ❑ Comments: Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: z oc� UO co tu ul LL w ° 2 J LL d • I zw = ZO w U0 O - CI F- W • w u' O . W = ~ O �'._ Z ..t r...w . u. w. r. m wra....wrvry+�+.r...u+«.wv..r�w. a..aNi .w7I.rt'yor. Sa:ktiaYn4a^Yiii' ..+ i t�¢h�lv;.'a.Yr ^r'� TUES /THURS R TING: Please Route Structural Review Required ❑ No further Review Required ❑ REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: REVIEWER'S INITIALS: Documents /routing slIp.doc 2.28 -02 PERMIT COORD COPY DUE DATE: 02 -17 -05 t7r_ Approved ❑ Approved with Conditions ❑ Not App roved ( attach comments) Notation: DATE: Permit Center Use Only CORRECTION LETTER MAILED: ' Y Q Departments issued corrections: Bldg ❑ Fire ❑ Ping PW ❑ Staff Initials: SleS PERMIT COORD COL PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D04 -431 DATE: 12 -0 -04 PROJECT NAME: BERNABEL RESIDENCE - DEMO SITE ADDRESS: 5021 SOUTH 124 STREET X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision #_afterrbefore permit is issued DEPARTMENT Buildin II ivsi n ! I nlcL- l2 t -°Y Fire Prevention []� Public Works b e m 1 , 4 S •ructural ❑ DETERMINA ON OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 12 -02 -04 Complete Incomplete ❑ Comments: Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES /THURS R9UTING: Please Route Structural Review Required ❑ No further Review Required ❑ REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved ❑ Approved with Conditions ❑ Not Approved (attach comments) ) Notation: REVIEWER'S INITIALS: Permit Center Use Only CORRECTION LETTER MAILED: l' /be Departments issued corrections: Bldg ❑ Fire ❑ Ping J` PW Staff Initials: S Documents /routing slIp,doc 2-28-02 PERMIT COORD COPY ,mot \eIL a-1-01 Planning Division Permit Coordinator ac Not Applicable ❑ DUE DATE: 12 -30 -04 2/ DATE: z z 00 .0 0 111 Ill H Nw w u. � w z1.- Z o U O - o ff w w O .. - x 0 ~ z City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 - 431 -3665 Web site: http://www.ci.tukwila.wa.us ❑ Response to Incomplete Letter # ® Response to Correction Letter # 2 ❑ Revision # after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner Project Name: BERNABEL RESIDENCE Project Address: 5021 SOUTH 124 STREET Summary of Revision: Created: 8 -13 -2004 Revised: (Op I C Received at the City of Tukwila Permit Center by: Entered in Permits Plus on 3 q0 —/ \applications \forms - applications on Iine\revision submittal 1:13.1.N3 .1.1MrSteven M Mullet, Mayor Steve Lancaster, Director REVISION SUBMITTAL Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Date: Plan Check/Permit Number: D04 -431 Contact Person: Simon Bernabel Phone Number: /c. ('')p - 1 7 RE CEtVEO CITY OF TUKWILA MAK 1 5 2005 PERMIT (:I=NTER Sheet Number(s): "Cloud" or highlight all areas of revision including date of revision z Z . Ce "~ W —1 U 00 w W d— • U- w 0 g cn u_ = a w z = L`- I- 0 w U o O N O t— W W W Z O N 0 Z ::,i'. , :rr..�„ is:> .,.: �b.:..u�.A6::r.i.4>:; Sri .S'.P� : City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: http: / /www.ci.tukivila.wa.us Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Date: Summary of Revision: Plan Check/Permit Number: D04 -431 ❑ Response to Incomflete Letter # • Response to Correction Letter # 1 ❑ Revision # after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner BERNABEL RESIDENCE Steven M. Mullet, Mayor Steve Lancaster, Director ° /4-to Project Name: Project Address: 5021 South 124 Street Contact Person: Simon Bernabel Phone Number: (2.-6' / (87-0 7�7 I, g fr1/11/46 672dW‘'76 Ve 1-4 • /6//ide-it,v ? ?mac ��/ , . Sheet Number(s): "Cloud" or highlight all areas of revision including date of revision Received at the City of Tukwila Permit Center by: Entered in Permits Plus on \ applications \torms - applications on line\rcvision submittal Created: 8 -13 -2004 Revised: 4.14 ovReg, Z ' W cc 2 -J 00 to 0 CO al CO u_ uj = • a w zF- 1— 0 Z ~ w U� (-12 0I- wW Z 0 I z STATE OF WASHINGTON) COUNTY OF KING CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 Permit Center /Building Division: 206 - 431 -3670 Public Works Department: 206 - 433 -0179 Planning Division: 206 -431 -3670 AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION ss. /l Jeja n cIr i via Ze r na bs ( [please print] 1. I have made application for a building permit from the City of Tukwila, Washington. 2. I 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 of 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. I 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, I consider the work authorized under this building permit to be exempt under No. J 3 , 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. e A. 06- h z ",‘Ct. $ NO 9 : •••4 i P 0 2 � •' • •6.16 -0:• : g ib WAS "t .• \applications \8 -2004 affidavit in lieu of contractor registration • , states as follows: APPLICANT Signed and sworn to before me this 6th day of April PERMIT NO.: ai,a, a. NOTARY PUBLIC in and for State of Washington, Residing at 1619 Name as commissioned: A /ice A Deacy My commission expires: 6 -/6 -OX , 2005 , County. Z '~' w J U O 0 c o w J � � LL w 2 Q co = 1— w Z = • 1— 0 Z 1— Lu U 0 512 � f- w • ui u O ..z w 0 0 z .. w�a' a: e:::/ 1n. tth4iU�3 ..uV'�:1Y1�Y.4471!F�15{'� +. *EnYa* .rin:5i3is�.7, Y ` 'ai�� :a' NUS'�"hS��tt,.,citiftk;:'�v:.tiw�a 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 prescribed in this subsection does not apply in all 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 of the operation is made into \.applications \ti -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; 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; 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 or 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. frAff, File: D04-043J. 35mm Drawing #1 ftousE 0 ad fo de C E x I ST I sic TRt mommumummans mom 12 i::Y {; M . (PYA P"Jtii Ri:l4.tEF U AI 'e"F+Mu'sx1Ull mgt' , mu' fam7 _, • — _ O U 4 :` C) r� 0 0 et 50' •0 L.., A c :.m: _ �a ' Z : g m M s (-7 S t I 8 5 G "01, t*--7i rn 's rt(lc 0 -I -_;. _ :1- $'c pT t C T A " . 5141 0 c3A _o $ - o ENNa sN Vl.) A 'T e. fr{ 07 t T j L - pi -aris a e en reV1ew:ea by i e A ,tc _ rks Department for conformance with current y standards. Acceptance is subject to errors and ssions which do not authorize violations of pted standards or ordinances. The responsibility the adequacy of the design rests totally with the igner. Additions, deletions or r.visions 1 i�t �tt� t 9t �a11� Cry 1 + Aa m �p ' / nip _ 1�.►�!��!UhW IMER gi+mmum W Umftunsumm - " = � :'` ?a4 s dY�a€tM` MfiMWMWE' aMM iM'WMOM M EMM M3r�EEMM•EM EMEMMO6�661iWIaB: /�rffii�e�t�ri� 2g W �dLar�.r �_�;. t' Fi ?al acceptance i subject to fief� �._ inspection _ by Alf F� Public Works 'utilities inspector. t -. T -, D e B Filokt WSPeCTIO0 OLJt,W 1 ASS“ RAE THE 6404 I S COMI Ecr b 'v vie SEP77e ;- I - a rte► 4 _: 44F -- r UMW =- P�a(� _ id ZS gia e" y.4 " r :=127 e T ' rs ir: '1 arb .TSP'f � -4 ;13; ,� P G —1 File: D04 -0431 35mm Drawing #2 .r' f " • - t 1. • .._.o ......• . 7 /Al • _ • 1 4 A . n g% t o\ 1-L1 1 I . r ' . I I I t V I I I I I L I I1 �I LI I Ill l; I i I l I 5I ;,;`;,; i;;;( ,;; ,; Inch vas 4I I I • 3 a d .. • I I I I I I i I I I I I I I I LI.LI I I I I I I I I I I I I I I I I I II_I I I I I I I LLI I LL I LLLI z "'° Ili. l_ LIIIILLIIIIIII ��III�IIIJIIIl LLLi .II�IIILIUII�LIIIIIIIIIIIIII I III�II IIIIIIIIIIIIIIIIIIIIII • 0 1 .:APPROVED SEATTLE -KING (.�Olia li DEPT 0�'` I % ALTI. ']AT'