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HomeMy WebLinkAboutPermit D04-457 - KARCH PROPERTY - DEMOLITIONKARCH PROPERTY 12915 40 AV S EXPIRED D04 -457 1Z 6 JU O 0 U p, w W 0 2} g u. =a W Z= E--0: ZI- uj U� O Y2' t W W'• . u_ - f" - 0. W Z: = Z Parcel No.: 7345601005 Address: 12915 40 AV S TUKW Suite No: City G Tukwila Tenant: Name: KARCH PROPERTY Address: 12915 40 AV S, TUKWILA WA Owner: Name: PRODZINSKI H 3 Address: 1318 E BOSTON ST, SEATTLE WA Contact Person: Name: ROBERT KARCH Address: 12915 40 AV S, TUKWILA WA Contractor: Name: OWNER AFFIDAVIT - ROBERT KARCH Address: , Contractor License No: Value of Construction: $500.00 Type of Fire Protection: Type of Construction: Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Sanitary Side Sewer: N Sewer Main Extension: N Private: Storm Drainage: N Street Use: N Profit: N Water Main Extension: N Private: N Water Meter: 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 DEVELOPMENT PERMIT D04 -457 Steven M. Mullet, Mayor Steve Lancaster, Director Permit Number: D04 -457 Issue Date: 01/11/2005 Permit Expires On: 07/10/2005 Expiration Date: Phone: Phone: 206 - 841 -3029 Phone: DESCRIPTION OF WORK: I DEMOLITION OF A 2,100 SQ FT STRUCTURE. THERE ARE NO PW ACTIVITIES ASSOCIATED WITH THIS DEVELOPMENT. Fees Collected: $52,35 International Building Code Edition: 2003 Occupancy per IBC: 0026 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 Public: Printed: 01 -11 -2005 Permit Center Authorized Signature: City Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206- 431 -3665 Web site: ci.tukwila.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. Signature: Print Name: >3fK /CARGt r� doc: IBC - Permit D04 -457 Steven M. Mullet, Mayor Steve Lancaster, Director Permit Number: D04 -457 Issue Date: 01/11/2005 Permit Expires On: 07/10/2005 Date: / " / / —OS Date: / -ii -o 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: 01 -11 -2005 doc: Conditions City of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 1: ** *BUILDING DEPARTMENT CONDITIONS * ** 7: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * ** PERMIT CONDITIONS z Parcel No.: 7345601005 Permit Number: D04-457 ;1 w Address: 12915 40 AV S TUKW Status: ISSUED tu Suite No: Applied Date: 12/23/2004 6 v Tenant: KARCH PROPERTY Issue Date: 01/11/2005 U 0 J = F-- � LL W O 2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the 2 Building Official. d.< co 3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to = a start of any construction. These documents shall be maintained and made available until final inspection approval is F. W granted. z H z o 4: All construction shall be done in conformance with the approved plans and the requirements of the International LLI • W Building Code or International Residential Code, International Mechanical Code, Washington State Energy Code. v o O N 5: All construction noise to be in compliance with Chapter 8.22 of the City of Tukwila Municipal Code. A copy can be 0 obtained at City Hall in the office of the City Clerk. w W H • U 6: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, LL z any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits v di presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila H shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the O Building Official from requiring the correction of errors in the construction documents and other data. z 8: Any material spilled onto any street shall be cleaned up immediately. 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: 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. 11: 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. 12: 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. * *continued on next page ** D04 -457 Printed: 01 -11 -2005 I hereby certify that I have read these conditions and will comply with them 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 regulating construction or the performance of work. Signature: City of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 (Lett etn-c—t Print Name: R 08 04 -7 - u� as outlined. All provisions of law and ordinances cancel the provision of any other work or local laws Date: j -I,- os doc: Conditions D04 -457 Printed: 01 -11 -2005 406 //z/ Site Address: /Q Tenant Name: Property Owners Name: PO PEAT k4 Ac i t Mailing Address: Name: fro GEg.T E -Mail Address: Contact Person: CITY OF TUKWILA Community Developmen apartment Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 \permits plus\icc changes \permit application (7.2004) 2o.5 J: R-14 icARCM � f uf��.��'� , C -v M Page 1 Building Pern. No. &, i'7 Mechanical Permit No Public. Works Permit No. Project No. 1 7 % & (For office use. only) Applications and plans must be complete in order to be accepted for plan review. Applications will not be accepted through the mail or by fax. * *Please Print ** King Co Assessor's Tax No.: !J rig co Po City Suite Number: Floor: New Tenant: ❑..... Yes ❑ ..No V4 State Day Telephone: a e ?cry r '/-.2O a 5' Mailing Address: r/41^14 A ' T " E cit State Fax Number: GENERAL CONTRACTOR INFORMATION - (Mechanical Contractor information on back page) • 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 presented at the time of permit issuance ** State State State Vcio Zip Zip Zip ARCHITECT OF RECORD - All plans must be wet stamped by Architect of Record Company Name: Mailing Address: City Contact Person: Day Telephone: E -Mail Address: Fax Number: Zip ENGINEER OF RECORD = All plans must be wet stamped by Engineer of. Record Company Name: Mailing Address: City Day Telephone: E -Mail Address: Fax Number: Zip Valuation of Project (contractor's bid price): $ 6OC, o ° Existing Building Valuation: $ Scope of Work (please provide detailed information): ( berm ws E G S7 / ucTz4?E BUILDING PERMIT INFORMAT2QN - 206 - 431 -3670 Will there be new rack storage? ❑ ..Yes 1=1.. No If "yes ", see Handout No. for requirements. Provide All Building Areas in Square Footage Below PLANNING DIVISION: Single- family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq ft): Floor area of principal dwelling: Floor area for accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Will there be a change in use? ❑ ....Yes ❑ ..No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: 0.. 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. \permits pluskicc changes \permit application (7 -2004) Page 2 Compact: Handicap: Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC 1 Floor `f )/ D O s - 2nd Floor 3r Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck Valuation of Project (contractor's bid price): $ 6OC, o ° Existing Building Valuation: $ Scope of Work (please provide detailed information): ( berm ws E G S7 / ucTz4?E BUILDING PERMIT INFORMAT2QN - 206 - 431 -3670 Will there be new rack storage? ❑ ..Yes 1=1.. No If "yes ", see Handout No. for requirements. Provide All Building Areas in Square Footage Below PLANNING DIVISION: Single- family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq ft): Floor area of principal dwelling: Floor area for accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Will there be a change in use? ❑ ....Yes ❑ ..No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: 0.. 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. \permits pluskicc changes \permit application (7 -2004) Page 2 Compact: Handicap: PUBLIC WORKS PERMIT IW ThRMATION — 206 - 433 -0179 Scope of Work (please provide detailed information): Water District ❑ ...Tukwila ❑...Water District #125 ❑ ...Water Availability Provided Sewer District ❑ ...Tukwila ❑... ValVue ❑ .. Renton ❑ ...Seattle ❑ ...Sewer Use Certificate 0... Sewer Availability Provided ❑ .. Approved Septic Plans Provided ❑ ...Septic System - For onsite septic system, provide 2 copies of a current septic design approval by King County Health Department. Submitted with Application (mark boxes which apply): ❑ ...Civil Plans (Maximum Paper Size — 22" x 34 ") ❑...Technical Information Report (Storm Drainage) ❑ ...Bond 0 .. Insurance ❑ .. Easement(s) Proposed Activities (mark boxes that apply): ❑ ...Right -of -way Use - Nonprofit for less than 72 hours ❑ ...Right -of -way Use - No Disturbance ❑ ...Construction/Excavation/Fill - Right -of -way Non Right -of -way ❑ ...Total Cut ❑ ...Total Fill Please refer to Public Works Bulletin #1 for fees and estimate sheet. cubic yards cubic yards ❑...Sanitary Side Sewer ❑ ...Cap or Remove Utilities ❑ ...Frontage Improvements ❑ ...Traffic Control ❑ ...Backflow Prevention - Fire Protection Irrigation Domestic Water ❑ ...Permanent Water Meter Size... ❑ ...Temporary Water Meter Size .. ❑ ...Water Only Meter Size ❑ ...Sewer Main Extension Public _ 0 ...Water Main Extension Public %permits plusticc changes %permit application (7 -2004) „ „ „ Call before you Dig: 1- 800 - 424 -5555 ❑ .. Abandon Septic Tank 0 .. Curb Cut ❑ .. Pavement Cut ❑ .. Looped Fire Line „ „ „ WO# WO# WO# Private Private 0 .. Highline ❑ .. Work in Flood Zone ❑ .. Storm Drainage Page 3 0 ...Renton ❑ .. Geotechnical Report ❑...Traffic Impact Analysis ❑ .. Maintenance Agreement(s) ❑...Hold Harmless ❑ .. Right -of -way Use - Profit for less than 72 hours ❑ .. Right -of -way Use — Potential Disturbance ❑ .. Grease Interceptor ❑ .. Channelization ❑ .. Trench Excavation ❑ .. Utility Undergrounding ❑...Deduct Water Meter Size /Q Ler7er_ &CrIt -11 eJ I-1AU '3t;G.) C/:1wD /.,)Na kemoVLp FINANCE INFORMATION Fire Line Size at Property Line Number of Public Fire Hydrant(s) 0 ... Water ❑ ...Sewer ❑ ...Sewage Treatment Monthly Service Billing to: Name: Day Telephone: Mailing Address: Water Meter Refund/Billing: Name: Day Telephone: City State Zip Mailing Address: Zip City State Z tH W O 0 co o (A LIJ U) u_ W O 2 u.Q = Z = F- 1- ZF- W W gy = p U 0— a '- W u H � t ll O H Z 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>I00K 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 INFOR _4TION — 206 - 431 -3670 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: Electric ❑ Gas ....0 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 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. 2. BUILDING OWNER OR AUTHORIZED AGENT: 64-6 LCD , 7 ?o B � K.F Gv C.Q l�1ZC -�- Signature: Print Name: Mailing Add Date Application Accepted: 7 - 2 . — off \ permits pluAicc changeslpermit application (7.2004) Date Application Expires: Page 4 Date: Day Telephone: P06 ) .8 y/ -- 3v to j' 7a c,�,rr GSA 50yn i City State Zip .. .. ,�,t r�aG ;+a:.1tk .st�ruAS� l:b:S..iYu»rilii tii. 3+;: :ai.•"!e'::riiaY.Ya.wt�:fi}ihl" :n:9 r)s i2 • City of Tukwila 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 Parcel No.: 7345601005 Address: 12915 40 AV S TUKW Suite No: Applicant: KARCH PROPERTY Receipt No.: R05 -00034 Payment Amount: 32.35 Initials: BLH Payment Date: 01/11/2005 12:11 PM User ID: ADMIN Balance: $0.00 Payee: ROBERT KARCH TRANSACTION LIST: Type Method Description Amount doc: Receipt Payment Cash ACCOUNT ITEM LIST: Description BUILDING - NONRES STATE BUILDING SURCHARGE RECEIPT 32.35 Account Code Current Pmts 000/322.100 27.85 000/386.904 4.50 Permit Number: D04 -457 Status: APPROVED Applied Date: 12/23/2004 Issue Date: Total: 32.35 25:13 971 Printed: 01 -11 -2005 Receipt No.: R04 -01715 Initials: BLH User ID: ADMIN Payee: ROBERT KARCH ACCOUNT ITEM LIST: Description doc: Receipt City of Tukwila 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 Parcel No.: 7345601005 Address: 12915 40 AV S TUKW Suite No: Applicant: KARCH PROPERTY TRANSACTION LIST: Type Method Description Amount Payment Cash BUILDING - NONRES PLAN CHECK - NONRES RECEIPT Account Code Current Pmts 000/322.100 1.15 000/345.830 18.85 Permit Number: D04 -457 Status: PENDING Applied Date: 12/23/2004 Issue Date: Payment Amount: 20.00 Payment Date: 12/23/2004 12:39 PM Balance: $32.35 20.00 Total: 20.00 a77 12/27 .^}7 0 TOTAL ?0.00 .00 Printed: 12 -23 -2004 COM ` S: 4 . - - Address: 1 C i t 5 rn�r w E. , Date Called: to �! , Special Instructions: Pale. .?o lll i-t4 ah ad-- Date Wanted: _ 63 a.m . Requester — 7 — o i 9 Phone No: aO(a- 91-//- 9vlvl igi , e---i. ii r"...e.77-7Mi. ...e , , /� .. .. .. t 4 ,,,,f //S ,. Gf - 47 .. l 17- 4.-4 I . p -1.1-7-7 , S.0,,/ -1 7 I A , - / r-----" t Project: Ica rc !A. d e V1 C Type of Inspection: Ft,wa, Address: 1 C i t 5 rn�r w E. , Date Called: to �! , Special Instructions: Pale. .?o lll i-t4 ah ad-- Date Wanted: _ 63 a.m . Requester — 7 — o i 9 Phone No: aO(a- 91-//- 9vlvl INSPECTION NO. INSPECTION RECORD Retain a copy with permit CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 Ej Approved per applicable codes. D04- 4-5 (206)431 -3670 Corrections required prior to approval. El $58.00 REINSPECTIO FEE REQUIRED.3Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection. bate: Inspector: Receipt No.: Date: t Pin review approval is subject to errors and omissions. P4tproval of construction documents does not audio** eft VidEti011 of a9y code or ordinance. RICI( — - of approved Date: /- 11 - s ----- 1 City orThbvila BUILDING DIVISION M I 1, 1 EIBIZZIM No changes slava be ma* to the mops ©g wc.aet without prior approval of a-111B Building Division. NOTE: Revisions and may include 5 04CILYA Izqls yo 4111111111111111- /1/ pc./\/cb // PR RilailvAL AvE S. ,4 igm'AvF SP. IEWED FOR CODE COMPLIANCE ''DEC 3 0 2004 104 City Of Tukwila 113017-PiNci DIMCION / NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEAR THIS NOTICE IT IS DUE TO THE QUALITY OF THE DOCUMENT. /fa UT1LifIE5 SEPVICE6 ELecrocit 8EEN REVINJ5L-V SHUT OFF AND SEALED 2VE rb 1 low WS 'DEMOLITION WOO, PON ir NO, Vi2 RECEIVED CITY OF TUKWILA DEC 2 3 2004 PERMIT CENTER October 2005 ROBERT KARCH 6905 S TYLER ST TACOMA, WA 98409 RE: Permit No. D04 -457 12915 40 AV S TUKW Dear Permit Holder: Department of Community Development Steve Lancaster, Director Ciz of Tukwila Steven M. Mullet, Mayor In reviewing our current records the above noted permit has not received a final inspection by the City of Tukwila Building Division. Per the International Building Code and/or the International Mechanical Code, every permit issued by the Building Division under the provisions of this code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 180 days from the date of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days. Based on the above, you are hereby advised to: Call the City of Tukwila Permit Center at 206 -431 -3670 to arrange for the next or final inspection. This inspection is intended to determine if substantial work has been accomplished since issuance of the permit or last inspection; or if the project should be considered abandoned. If such determination is made, the Building Code does allow the Building Official to approve a one -time extension up to 180 days. Extension requests must be in writinx and provide satisfactory reasons why circumstances beyond the applicant's control have prevented action from being taken. In the event you do not call for the above inspection and receive an extension prior to 11/30/2005, 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, t . rife arshall Permit Technician xc: Permit File No. D04 -457 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206-431-3665 l: r': �SJifS.�'S,t•.vk13Y:��a'LktiT 10 -03 -2005 ROBERT KARCH 1291540AVS TUKWILA WA 98188 RE: Permit No. D04 -457 12915 40 AV S TUKW Dear Permit Holder: In reviewing our current records the above noted permit has not received a final inspection by the City of Tukwila Building Division. Per the International Building Code and/or the International Mechanical Code, every permit issued by the Building Division under the provisions of this code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 180 days from the date of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days. Based on the above, you are hereby advised to: Call the City of Tukwila Permit Center at 206 - 431 -3670 to arrange for the next or final inspection. This inspection is intended to determine if substantial work has been accomplished since issuance of the permit or last inspection; or if the project should be considered abandoned. If such determination is made, the Building Code does allow the Building Official to approve a one - time extension up to 180 days. Extension requests must be in writing and provide satisfactory reasons why circumstances beyond the applicants control have prevented action from being taken. In the event you do not call for the above inspection and receive an extension prior to 11/30/2005, 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, Jennifer Marshall, Permit Technician xc: Permit File No. D04 -457 City of 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 PERMIT COORD COPY PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D04 -457 DATE: 12 -23 -04 PROJECT NAME: KARCH PROPERTY - DEMOLITION SITE ADDRESS: 12915 40 AVENUE SOUTH X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision #_afteribefore permit is issued DEPARTMENTS: � I2 2-f_ Buildi g Division El IMF 1 - 17 L f Fire Prevention P� OA_ 1Z —7J6 Planning Division Permit Coordinator jilt ALUM I2 -24 DETERMINAT ON OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 12 -28 -04 Public Work Structural ❑ 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 �TING: Please Route Structural Review Required ❑ No further Review Required ❑ REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 01 -25 -05 Approved ❑ Approved with Conditions Not Approved (attach comments) ❑ Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents /routing slip.doc 2-28-02 PERMIT COORD COPY " �'AGkJ'�.:.'LW;1 .u�Ft�ut.JYhdt�+x}tk�:v.L ��....tF.s..�};444i�hiv'•.�1r_, STATE OF WASHINGTON) COUNTY OF KING CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION s s. �g �lZT `4 c.44. states as follows: [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. 13 , 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. ( Gv. APPLI T <0E A. = S saioN F4 h, I 0 N AOTAo k 9N; • (r) p U B Lk° ' • 911 1 1 ,.• 16-O.•' Q? 1 4 Op S ' \applications \8.2004 affidavit in lieu of contractor registration PERMIT NO.: k.e&Ccr NOTARY PUBLIC in and forate of Washington, Permit Center /Building Division: 206- 431 -3670 Public Works Department: 206 - 433 -0179 Planning Division: 206 - 431 -3670 P. Signed and sworn to before me this /� day of JQYl u , 20 ' 5 . Residing at k n /` , County. Name as commissioned: Alec e A. Deac y My commission expires: 6- /6 -08 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\B-2004 affidavit in lieu of contractor registration contracts of amounts less than $500.00 for the purpose of the evasion of this chapter or otherwise. The exemption prescribed in this subsection does not apply to a person who advertises or puts out any sign or card or other device which might indicate to the public that he is a contractor, or that he is qualified to engage in the business of contractor; 11. Any construction or operation incidental to the construction and repair of irrigation and drainage ditches of regularly constituted irrigation districts or reclamation districts; or to farming, dairying, agriculture, viticulture, horticulture, or stock or poultry raising; or to clearing or other work upon land in rural districts for fire prevention purposes; except then any of the above work is performed by a registered contractor; 12. An owner who contracts for a project with a registered owner; 13. Any person working on his own property, whether occupied by him or not, and any person working on his residence, whether owned by him or not but his exemption shall not apply to any person otherwise covered by this chapter who constructs an improvement on his own property with the intention and for the purpose of selling the improved property; 14. Owners of commercial properties who use their own employees to do maintenance, repair, and alteration work in or upon their own properties; 15. A licensed architect or civil or professional engineer acting solely in his professional capacity, an electrician licensed under the laws of the state of Washington, or a plumber licensed under the laws of the state of Washington while operating within the boundaries of such political subdivision. The exemption provided in this subsection is applicable only when the licensee is operating within the scope of his license; 16. Any person who engages in the activities herein regulated as an employee of a registered contractor with wages as his sole compensation; 17. Contractors on 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.