HomeMy WebLinkAboutPermit 0125 - Nelsen Residence - Foundation and BasementJOB AODR (SS
16235 West Valley Road
DAT
(a
1. 1117----
LEGAL
1 DESCR.
LOT N0.
BLK
TRACT
( SEE ATTACH SHEET)
OWNER MAIL ADDRESS ZIP PHONE
z Walter M. Nelsen 16235 West Valley Rd. Renton, 98055 Al. 5 -6806
CONTRACTOR MAIL ADDRESS PHONE LICENSE NO.
3 Owner
ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO.
4
ENGINEER MAIL ADDRESS PHONE LICENSE NO.
5
LENDER l.IAIL ADDRESS BRANCH
G
USE OF BUILDING
Dwelling
8 Class of work: • NEW O ADDITION • ALTERATION REPAIR • MOVE • REMOVE
9 Describe work: Replace Foundation and put in basement
10 Change of use from
Change of use to
11 Valuation of work: $ 1 000•00
PLAN CHECK FEE
PERMIT FEE 10.00
SPECIAL CONDITIONS:
Typo of
Const. V — N Group
Occupancy
I
Division 1
Size of Bldg. Repair
(Total) Sq. Ft.
No. of
Stories 1
Max.
r
Repair
Occ. Load ' p
Fire
Zone II
Use
Zone M -1
Fire Sprinklers
Required ■Yes ®No
APPLICATION ACCEPTED BY:
• '
PLANS CH •CK ^. CV
t
rte..
A"RO ED FOR ISSUA CE
PT
t
,: _' 1 4-
No, of
Dwelling Units
OFFSTREET PARKING SPACES:
Covered Uncovered
N O T I v
SEPARATE PE'MITS ARE REQUIRED FOR ELECTRICAL, PLUMB-
ING, HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK I$ COM•
MENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
.C7f•! - /''...
IN C �/ r f� �
Special Approvals
Required
Not Required
_
Approved
ZONING
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
FOUNDATION
FRAMING
FINAL
O F OWNER or OW N R
s 1'M' U RE O L BUIL I
SIGNATURE OR AUTHORIZED AGENT (DATE)
BUILDING PERMIT
Applicant to complete numbered spaces only.
CITE OF TU KWI LA BUILDING Pi, .MIT
14475 • 59th Ave. So. / Tukwila, Washington 98067
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION
OCCUPANCY PERMIT REQUIRED
BUILDING
PERMIT NO.
N 125
M.O. CASH
RATE Or
..LEVY
TRAY rAOE
' ,
LAND
DOLLARS ONLY
DUILDINOS
DOLLARS ONLY
TOTAL
.DOLLARS ONLY
GENERAL TAX ,
DOLLARS O CENT
:,
.
•
In
C'
• .
D.
J
UJ
i ,
o 4 Lu
1 a W
t ,
C4 p
PLEASE PRINT IN CHANGE OF
N OT CE: TAXPAYER OR ADDRESS BELOW r ; *• ' J r + ,
ES 7A711 A711` B t`.X S f J
ADDRESS KING COUNTY—STATE OF W
CITY STATE OF ALL STATE, COUNTY, MUNICIPAL, SCHO(
i } TIArni • �S k •:tl�' 1 -- PAYMENTS ON WRONG PROPI
,NAME AND ADDRESS DES
•
.
•
w
NAMr
":Ql t-nr M '41lilo
1023) W. Val 1. y Rd.
Ra nton, VVaa11i.
LOT BLOCK
v
..+ L'e1•) •
"7
ti
LEVY ACCOUNT NUMUCR
CODE UCC. I TWF'. 11(1 TAX LOT
() i�1iy z�,�.; .r,
Por of. Gov Lot 2 Iy 1 4 of Co My or
in bar on. Vi r•,!m Co ? ;;: at pt 1; ::1)7' 11/1.
S or U bdvy or roc th Wly 4 i ?/A t;a L ;:l'
.EECOND HALF PAYABLE ON OR E.EFC E OCT.,
JOS ADDRESS
GATE
t /67/ 7 z
t I
.•,
/6.i...5 3 �. ) �� o .o re) ' ,G ) i a)19tc
LEGAL
1 DESCH.
I LOT M0.
I
TR �aa ATTACHED SHEET)
OWNER ,,/ MAIL ADDRESS I ZIP ►HOME
2 lX/ ilk i i / I / y eLS ...-- /e, .s W , !' 4 4 (E ∎1 2O , Tg s /92. ‘8
CONTRACTOR MAIL ADDRESS .- PHONE LICENSE NO.
. 2S «l .f 1 ;'
ARCy+44CT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO.
4
ENGINEER MAIL ADDRESS PHONE LICLNSL,NO.
5
LENDER MAIL ADDRESS SRANCH
6 -
USE OF SUILDINO
8 Class of work: ❑ NEW • ADDITION • ALTERATION BIEPAIR 0 MOVE • REMOVE
9 Describe work: 1c. 's t� KXJA.JOA U /[J ' - r / .) S — , 0 924.--) 7
10 Change of use from
Change of use to
11 Valuation of work: $
L OGO I 00 JIAN FEE CHECK
PERMIT FEE 'tt
('
SPECIAL CONDITIONS:
Type of I
conic --
Occupancy
Group
Division 1.
(Total) Sq. Ft. 0 N l'
Stories
Occ. Load V4 / \ \ t
Fire Sprinklers 1
Required D/.a NO
Fire
Zone
Use
Zone ✓
APPLICATION ACCEPTED BY:
PLANS CHECKED BY:
APPROVED FOR ISSUANCE 9Y:
No. of
Dwelling Units
OFFSTREET PARK NO
Covered
SPACES:
Uncovered
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-
ING, HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK I$ COM•
MENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
/;, 4.--e---/ � i s
Special Approvals
Required
Not Required
Approved
ZONING
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
—�
FOUNDATION
FRAMING
FINAL
SIGNATURE OP OWNER (1► NEN U DE
SIGNATURE ON AUTHORIZED AGENT IDATEI
CITU)F TUKWILA BUILDING P/ ".MIT
..MIT
BUI PERMIT 144/5 59th Ave. So. / Tukwila, Washington 99167
Applicant to complete numbered spaces only.
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION cK. M.O. CASH PERMIT VALIDATION
OCCUPANCY PERMIT REQUIRED
o "
it
M .O.
CASH