HomeMy WebLinkAboutPermit D03-027 - JOHNSON RESIDENCE - FIRE DAMAGE REPAIRJOHNSON
RESIDENCE
4725 S. 104T" PL
EXPIRED
2 -26 -04
D03 -027
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City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
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Parcel No.: 5476800283 Permit Number: D03-027 ;1 _..
Address: 4725 S 104 PL TUKW Issue Date: 01/22/2003 ce w
Suite No: Permit Expires On: 07/21/2003 6 v
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Owner:
Name: JOHNSON TERRANCE A Phone: u.
Address: P 0 BOX 451, SEATTLE WA co CJ
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Contact Person: z _
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Name: TERRANCE JOHNSON Phone: 206 - 391 -2763 z O
Address: 4725 S 104 PL, TUKWILA WA al Lu
Contractor: v 0
Name: DAKE CUSTOM CONSTRUCTION LLC Phone: o
Address: 22012 234 AV SE, MAPLE VALLEY, WA w w
Contractor License No: DAKECCL021P2 Expiration Date:10 /21/2004 H H
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DESCRIPTION OF WORK: w z
REPAIR FIRE DAMAGE RESIDENCE. SEE DETAILED SCOPE OF WORK OUTLINED IN STATE FARM INSURANCE COMPANY U
DOCUMENT. ~ O /—
Tenant:
Name: JOHNSON RESIDENCE
Address: 4725 S 104 PL, TUKWILA WA
Value of Construction: $ $111,985.00 Fees Collected: $1,065.45
Type of Fire Protection: Uniform Building Code Edition: 1997
Type of Construction: V -N Occupancy per UBC: 0007
Public Works Activities:
Channelization / Striping: N
Curb Cut / Access / Sidewalk / CSS: N
Fire Loop Hydrant: N Number: 0 Size (Inches): 0
Flood Control Zone: N
Hauling: N Start Time: End Time:
Land Altering: N Volumes: Cut 0 c.y. Fill 0 c.y.
Landscape Irrigation: N
Moving Oversize Load: N Start Time: End Time:
Sanitary Side Sewer: N
Sewer Main Extension: N Private: N
Storm Drainage: N
Street Use: N Profit: ??
Water Main Extension:
Water Meter:
doc: Devperm
N
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DEVELOPMENT PERMIT
Private: N
D03 -027
Public: N
Non - Profit: ??
Public: N
Printed: 04 -21 -2003
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City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Permit Center Authorized Signature: _._--- - -�' 44--,L&2- ✓ c `�- Date: ya
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.
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Signature: �V � {� Date: L- /C. t/c
Print Name: ‘./..// —J C..,
This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is
suspended or abandoned for a period of 180 days from the last inspection.
doc: Devperm
D03 -027
Printed: 04 -21 -2003
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City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
PERMIT CONDITIONS
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Parcel No.: 5476800283 Permit Number: D03 -027 i w
Address: 4725 S 104 PL TUKW Status: ISSUED ce
Suite No: Applied Date: 01/22/2003 6 v
Tenant: JOHNSON RESIDENCE Issue Date: 01/22/2003 v O
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3: Plumbing permits shall be obtained through the Seattle -King County Department of Public Health. Plumbing will be CO d
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4: Electrical permits shall be obtained through the Washington State Division of Labor and Industries and all electrical z O
work will be inspected by that agency (206- 835 - 1111). I uj
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6: All permits, inspection records, and approved plans shall be available at the job site prior to the start of any w • w
construction. These documents are to be maintained and available until final inspection approval is granted. i- -
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7: All construction to be done in conformance with approved plans and requirements of the Uniform Building Code (1997 tii z
Edition) as amended, Uniform Mechanical Code (1997 Edition), and Washington State Energy Code (1997 Edition). a
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8: Validity of Permit. The issuance of a permit or approval of plans, specifications, and computations shall not be z
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 ordinance of the jurisdiction. No permit presuming to give authority to violate or cancel the provisions of this
code shall be valid.
1: ** *BUILDING DEPARTMENT CONDITIONS * **
2: No changes will be made to the plans unless approved by the Engineer and the Tukwila Building Division.
inspected by that agency, including all gas piping (296- 4722).
5: All mechanical work shall be under separate permit issued by the City of Tukwila.
9: There shall be no occupancy of the building(s) until the final inspection has been completed by the Tukwila Building
Inspector.
I hereby certify that I have read these conditions and will comply with them as outlined. All provisions of law and ordinances
governing this work will be complied with, whether specified herein or not.
The granting of this permit does not presume to give authority to violate or cancel the provision of any other work or local laws
regulating construction or the performance of work.
Signature:
Print Name: 1"1/
doe: Conditions
D03 -027
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Date: L(
Printed: 04 -21 -2003
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City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 5476800283
Address: 4725 S 104 PL TUKW
Suite No:
Tenant:
Name: JOHNSON RESIDENCE
Address: 4725 S 104 PL, TUKWILA WA
Owner:
Name: JOHNSON TERRANCE A
Address: P 0 BOX 451, SEATTLE WA
Contact Person:
Name: TERRANCE JOHNSON
Address: 4725 S 104 PL, TUKWILA WA
Contractor:
Name: OWNER AFFIDAVIT ON FILE
Address:
Contractor License No:
DESCRIPTION OF WORK:
REPAIR FIRE DAMAGE RESIDENCE. SEE DETAILED SCOPE OF WORK OUTLINED IN STATE FARM INSURANCE COMPANY
DOCUMENT.
Value of Construction:
Type of Fire Protection:
Type of Construction:
Public Works Activities:
Landscape Irrigation: N
Moving Oversize Load: N
Sanitary Side Sewer: N
Sewer Main Extension: N
Storm Drainage: N
Street Use: N
Water Main Extension: N
Water Meter:
Channelization / Striping:
doc: Devperm
$111,985.00
V -N
DEVELOPMENT PERMIT
D03 -027
Permit Number: D03 -027
Issue Date: 01/22/2003
Permit Expires On: 07/21/2003
Expiration Date:
Phone:
Phone: 206 - 391 -2763
Phone:
Fees Collected: $1,065.45
Uniform Building Code Edition: 1997
Occupancy per UBC: 0007
Curb Cut/Access /Sidewalk/CSS: N
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.
Start Time:
Private: N
Private: N
** Continued Next Page **
End Time:
Public: N
Public: N
Printed: 01 -22 -2003
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Permit Center Authorized Signature: 44th_
Date: / —Z2 - 03
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 ofrwor'r I am authorized to sign and obtain this development permit.
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Signature: V/`/A/ta,/ ai /VI / Date:
�
Print Name: C (i0i I�/� r1 /UV'� � l1
doc: Devperm
D03 -027
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 -22 -2003
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 5476800283
Address: 4725 S 104 PL TUKW
Suite No:
Tenant: JOHNSON RESIDENCE
1: ** *BUILDING DEPARTMENT CONDITIONS * **
2: No changes will be made to the plans unless approved by the Engineer and the Tukwila Building Division.
3: Plumbing permits shall be obtained through the Seattle -King County Department of Public Health. Plumbing will be
inspected by that agency, including all gas piping (296- 4722).
4: Electrical permits shall be obtained through the Washington State Division of Labor and Industries and all electrical
work will be inspected by that agency (206 -835 - 1111).
5: All mechanical work shall be under separate permit issued by the City of Tukwila.
6: All permits, inspection records, and approved plans shall be available at the job site prior to the start of any
construction. These documents are to be maintained and available until final inspection approval is granted.
7: All construction to be done in conformance with approved plans and requirements of the Uniform Building Code (1997
Edition) as amended, Uniform Mechanical Code (1997 Edition), and Washington State Energy Code (1997 Edition).
8: Validity of Permit. The issuance of a permit or approval of plans, specifications, and computations 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 ordinance of the jurisdiction. No permit presuming to give authority to violate or cancel the provisions of this
code shall be valid.
9: There shall be no occupancy of the building(s) until the final inspection has been completed by the Tukwila Building
Inspector.
I hereby certify that I have read these conditions and will comply with them as outlined. All provisions of law and ordinances
governing this work will be complied with, whether specified herein or not.
The granting of this permit does not presume to giv, authority to violate or cancel the provision of any other work or local laws
regulating construction or the performance wor
Signature:'
Print Name:
doc: Conditions
PERMIT CONDITIONS
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D03 -027
Permit Number: D03 -027
Status: ISSUED
Applied Date: 01/22/2003
Issue Date: 01/22/2003
Date:
Printed: 01 -22 -2003
Tenant Name:
Property Owners N
Mailing Address:
GENERAL:CO
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
\applications \pennit application (1-2003)
1/2003
CITY OF TUKWILA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
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.:
Site Address: 1 S 6VU ` h 1 0'4 - 0644 (c1 Suite Number: Floor:
New Tenant: 0 .... Yes ..No
) sit Office,
Name: C, t
l
Mailing Address:
IIJJ City State Zip
6 E -Mail Address: e i')(t,� � U �S o yV �� C'G('tt 1 I1JIFa me/Fax Number:
RACTOR`INFORMATIO
57 SCE ca fi Le 11/� 9 (rI «- c'
tt State Zip
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: OE RECORD All plans must be wet stamped by Architect,of Record
'ENGINEER.OF RECORD All plans must be wet stamped by Engineer of Record
Page 1
:Building Penriit No.> 1 . y?)"L-
M echamcal Permit No
.Public. W(irks- Permit No.
(F or : office use only) `-
Day Telephone:
City
Day Telephone:
Fax Number:
City
Day Telephone:
Fax Number:
City
Day Telephone:
Fax Number:
State
State
State
Zip
Zip
Zip
;BUILDING -PERMIT:INFORMt-
Valuation of Project (contractor's bid price): $
Scope of Work (please provide detailed information):
tapplicationstpermit application (1.2003)
1/2003
6= 431 -3670 .`
Will there be new rack storage? 0... Yes ❑ .. No If "yes ", see Handout No.
Page 2
Existing Building Valuation: $
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: Compact: Handicap:
Will there be a change in use? ❑...Yes ❑ .. No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
❑ .. Sprinklers ❑...Automatic Fire Alarm 0...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.
UTILITY DISTRICTS:
Note: If the utility district is not City of Tukwila, you must provide written verification and approval from that utility district at the time of permit
application.
Water
❑ .. City of Tukwila Water District ❑.. Water District /1125 ❑... Highline Water District 0... City of Renton Water District
Sewer
❑ .. City of Tukwila Sewer District ❑.. Val Vue Sewer District ❑...City of Renton Sewer District ❑...City of Seattle Sewer District
❑ .. Septic System (If property is served by a septic system, 2 copies of approved septic design from King County Health Department must be
submitted at the time of permit application)
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Ali. K"v`tuT+r(fief".w1 .flF?.SJ:YtPtiw«i'?lY,�`.
Existing
Interior
. Remodel
Addition to
Existing
Structure
New
Type of
Construction .
per UBC
Type of
Occupancy per
UBC
1" Floor .: .
2n0 Floor
3 Floor
Floors thru
Basement
Accessory Structure*
Attached Garage
Detached Garage
Attached Carport
Detached Carport .
Covered Deck
Uncovered Deck
;BUILDING -PERMIT:INFORMt-
Valuation of Project (contractor's bid price): $
Scope of Work (please provide detailed information):
tapplicationstpermit application (1.2003)
1/2003
6= 431 -3670 .`
Will there be new rack storage? 0... Yes ❑ .. No If "yes ", see Handout No.
Page 2
Existing Building Valuation: $
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: Compact: Handicap:
Will there be a change in use? ❑...Yes ❑ .. No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
❑ .. Sprinklers ❑...Automatic Fire Alarm 0...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.
UTILITY DISTRICTS:
Note: If the utility district is not City of Tukwila, you must provide written verification and approval from that utility district at the time of permit
application.
Water
❑ .. City of Tukwila Water District ❑.. Water District /1125 ❑... Highline Water District 0... City of Renton Water District
Sewer
❑ .. City of Tukwila Sewer District ❑.. Val Vue Sewer District ❑...City of Renton Sewer District ❑...City of Seattle Sewer District
❑ .. Septic System (If property is served by a septic system, 2 copies of approved septic design from King County Health Department must be
submitted at the time of permit application)
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:PUBLIC NORM .PERMIT JN ... :MATION 206433 -0179
Scope of Work (please provide detailed information):
Street Use:
0.. Street Use
Land Altering and /or Hauling:
0.. Land Altering: ❑...Cut
Storm Drainage:
❑ .. Storm Drainage ❑...Flood Control Zone
Water ... 0
Water Meter Refund/Billing:
Name:
Mailing Address:
■applications\pennit application (1 -2003)
1/2003
❑... Channelization /Striping
CaII before you Dig: 1- 800 - 424 -5555
cubic yards ❑...Fill
❑...Curb cut/Access /Sidewalk
City
Sewer ... ❑ Sewage Treatment
Page 3
City
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
cubic yards ❑ .. Hauling
Sewer Information:
❑ .. City of Tukwila Sewer District ❑ .. Val Vue Sewer District ❑...City of Renton Sewer District ❑ .. City of Seattle Sewer District
❑ .. Sanitary Side Sewer 0.. Sewer Main Extension ❑ .. Private ❑ .. Public
Water Information:
0.. City of Tukwila Water District 0.. Water District #125 ❑... Highline Water District ❑...Cit of Renton Water District
❑ .. Water Main Extension ❑ .. Private ❑ ...Public
❑ .. Water Meter /Exempt: Size(s): ❑ .. Deduct 0... Water Only
❑ .. Water Meter Permanent #: Size(s):
❑ .. Water Meter Temporary #: Size(s): ❑ .. Est. Quantity: gallons
❑ .. Fire Loop/Hydrant (main to vault) #: Size(s): ❑ .. Landscaping Irrigation
❑ .. Miscellaneous:
Monthly Service Billing to:
Name: Day Telephone:
Mailing Address:
State
Fire Line .... ❑
Zip
Day Telephone:
Slate Zip
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Boiler /Compressor:
Qty
Furnace <100K BTU
Air Handling Unit
>= 10,000 CFM
Other Mechanical
Equipment
0 -3 HP /100,000 BTU
Furnace >I00K BTU
Evaporator Cooler
3 -15 HP /500,000 BTU
Floor Furnace
Ventilation Fan
15 -30 HP /1,000,000 BTU
Suspended/Wall /Floor
Mounted Heater
Ventilation System
30 -50 HP /1,750,000 BTU
Appliance Vent
Flood
50+ HP /1,750,000 BTU
Heat/Refrig/Cooling
System
Incinerator - Domestic
Air Handling Unit
<= 10,000 CFM
Incinerator — Comm /Ind
MECHANICAL;PERMIT INFORMATION ,- 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 ....0 Replacement ....0
Commercial: New ....0 Replacement .... fl
Fuel Type: Electric 0
BUILDIN I NER OR AUTHORIZED AGEN
•
Signature: Ik 1 i i CO
Print Name: Ci a J;
1, (
Mailing Address: SOT i/ ` A.
Date Application Accepted:
/— 22
\appticalionstpermit application (t.2003)
11200)
Gas ....J 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 TI-IAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF 1 STA ;mss F WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
Date Application Expires:
Page 4
Day Telephone:
fly
Date:
State Zip
Staff Initials:
Payee:
TRANSACTION LIST:
ACCOUNT ITEM LIST:
Description
doc: Receipt
TERRANCE JOHNSON
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
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RECEIPT W
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Parcel No.: 5476800283 Permit Number: D03 -027 U O p
Address: 4725 S 104 PL TUKW Status: PENDING w W
Suite No: Applied Date: 01/22/2003 W
A pplicant: JOHNSON RESIDENCE Issue Date: N u-
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2
Receipt No.: R03 -00072 Payment Amount: 1,065.45 a.. j
Initials: BLH Payment Date: 01/22/2003 11:18 AM H w
User ID: ADMIN Balance: $0.00 z i =.. '
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Type Method Description Amount H U
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Payment Check 2598 1,065.45 z
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BUILDING - RES 000/322.100
STATE BUILDING SURCHARGE 000/386.904
Account Code Current Pmts
1,060.95
4.50
Total: 1,065.45
614 ?1/2% x716 TOTAL 1065.45
Printed: 01 -22 -2003
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Project l •
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Type of Inspection:
. t .,, .,..r --••
Address:
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Date C. es:
if
Special Instructions:
Date Want d:
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......,s,_,,.3
P.m.
Requeste :
,49A)
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Phope o: „ ...
V/ — W7/
N NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 9818,8
• 'f•
INSPECTION RECORD
Retain a copy with permit
PERMIT
(206)431-3670
Approved per applicable codes, Corrections required prior to approval.
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IMMENTS:
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.fr-747 r r/ erc )7 Z /
$47. EINSPECTIO FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
7
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Pr - i •ct: n ��a T.filf
Type of Ins ec P y 1/
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S ecia� Instructions: �/�
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Date Wanted:
5 3
am.
Reque r:
(Approved per applicable codes.
El $47.00 REINSPECTION F REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
INSPECTION RECORD
Retain a copy with permit
t O -b 7
INSPECT! � N NO. PERMIT N�
CITY OF TUKWILA BUILDING DIVISION j•• I
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (20.)431 -3670
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❑ Corrections required prior to approval.
Receipt No.:
Date:
COMMENTS:
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Type of Inspection: //
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INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
El Approved per applicable codes. ^ Corrections required prior to approval.
Inspector
�✓ 1 A iii
El $47.00 REINSPECTION EE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
a • to
INSPECTION RECORD
Retain a copy with permit
.n.IVl - r`v.
Date /
PER
6) 31 -3670
Prod ct:
.) J j f siie/ec
Type of In ec '
t � // � n nst ( Id -r-
Address:
1 1 '7 , 5 /o / Pe--
Date Called:
'� ,5 3
Special Instructions:
Date Wa d: 2
Criii..
Reques .;
i.5! isn
Phone lgiow ' ".. jiii4
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
Do5` 'Dori
K Approved per applicable codes. El Corrections required prior to approval.
COMMENTS:
e/14-1 e-
F
p4 e.„, C., 17 i
te S' 6
❑ $47.0 REINSPECTIp FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
PERMI
(206)431 -3670
Pr ect:
)7 bi main i 6s;( n r t
Type of Inspection:
lam.- X
1 47A5 Co 1 (e1
Date Calle
371(
Special Instructions:
fLett ihk?
Date Wanted:
5/
a.m.
p.m.
Request r
Phope
o Le )
31 i f Li 1v Li
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION •
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
El Approved per applicable codes.
INSPECTION RECORD
Retain a copy with permit
h
PERMIT
•
COMMENTS:
re7 _,1
Corrections required prior to approval.
$47 OQ INSPECTION FEL REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
January 21, 2003
To: City of Tukwila
Building Department
6300 Southcenter Boulevard
Tukwila, Washington 98188 -2544
w
From: Terrance & Jonelle Johnson 0!
Post Office Box 451
Seattle, Washington 98111 -0451 c o
J
Re: Fire Damage Building Permit Narrative co u_
w
On December 23 2002 a fire occurred at our personal residence located at 4725 South
104 Place, Tukwila, Washington 98178. The fire started in the kitchen wall. u_
co d
There was no structural damage other than a need to replace a few of the burned kitchen 1- i
wall studs. The heat, smoke and soot basically destroyed all our personal contents. z �-
►-
z r
On January 5, 2003 Tukwila Building Inspectors Dave Larson and Bill Rambo walked 2 uj
through and observed the damage. Mr. Larson advised that plans etc. would not be v a
needed to obtain a building permit since we would be repairing and replacing the o D-
electrical and plumbing as needed, removing the old drywall and insulation and replacing w w
with new drywall and insulation, and replacing the burned kitchen wall studs as needed.
O
Our intent is to return the condition of our home to where it was prior to the fire. iii N
o
Attached please find the Scope of Work Summary as prepared by State Farm Insurance. z ~
According to Mr. Larson the cost of the permit will be based on this document.
We are currently living in a hotel so the best mailing address is the post office box listed
above.
Our contact phone numbers are cell phone (206)391 -2763, home (answering service)
(206)723 -4125 and work (206)352 -3654.
Thank you for your expeditious review of this matter.
EiV
C1"��OP
PERMS' CENT ES
tY IT�bi`AV4 *Pt'Lratr.>„5�au. r.
Estimate:
Insured:
Home:
Line Item Total
Sales Tax
Replacement Cost Value
Less Depreciation
Actual Cash Value (ACV)
Overhead
Profit
Tax on O &P
47-M106-546R
Johnson, Terrance & Jonelle
4725 S 104th P1
Tukwila, WA 98178 -2087
@ 8.800% x
Actual Cash Value (Including Overhead and Profit)
Less Deductible
,,tate Farm Insurance Companies
15320 NE 40th Street
P.O. Box 3219
Redmond WA 98073 -3219
01/13/2003
@ 10.0% x
@ 10.0% x
Summary for Fire
85,773.14
85,773.17
85,773.17
Claim Number:
Policy Number:
Type of Loss:
Deductible:
Price List:
Date of Loss:
Date Inspected:
Meeds, Al
(206) 431 -1859
ALL AMOUNTS PAYABLE ARE SUBJECT TO THE TERMS, CONDITIONS AND
LIMITS OF YOUR POLICY.
POLICYHOLDER: DO NOT USE THIS DRAFT AS A BASIS FOR A CONTRACT WITH A REPAIR FIRM.
47-M106-546
47 -BA- 9319 -9
Fire
$ 0.00
WASE4F2D 1
Restoration /Service /Remodel
with Service Charges Factored
In
12/23/2002
12/27/2002
CONTRACTORS: DO NOT USE THIS DRAFT AS A BASIS FOR A CONTRACT WITH A PROPERTY OWNER.
'4 �t.LI�1 L
co -: ( of Tt IvC1?Vtl .
Ali 2 '1 2°3
PERO' CSI ISS
85,773.17
7,548.04
93,321.21
(0.00)
93,321.21
8,577.32
8,577.32
1,509.61
111,985.46
(0.00)
Net Actual Cash Value Payment $111,985.46
THIS IS A ROUGH DRAFT ONLY! THE PURPOSE OF THIS DRAFT IS TO REVIEW THE SCOPE. THE FINAL DRAFT
MAY BE SUBSTANTIALLY DIFFERENT THAN THIS DRAFT. THERE MAY BE ITEMS ADDED AND /OR DELETED.
J3w� 2.7
State Farm Insurance Companies
Jphnson, Terrance & Jonelle 01/13/2003
Room: Entry /Foyer
Missing Wall:
Missing Wall:
Subroom 1: Offset
Missing Wall:
Missing Wall:
Missing Wall:
Subroom 2: Stairway Closet
DESCRIPTION
482.67 SF Walls
138.67 SF Floor
56.00 SF Long Wall
Blown -in insulation - 12" depth -
R38
1/2" drywall - hung, taped, floated,
ready for paint
Seal then paint the walls and ceiling
(2 coats)
Sand, stain, and finish wood floor
Baseboard - 2 1/4"
Paint baseboard - two coats
Exterior door - fiberglass / wood
w /detail - Premium grade
Exterior door sidelight (window) -
12"- 14" width
Door lockset - exterior - High grade
Deadbolt - High grade
Stain and finish door slab only -
exterior (per side)
* Stain & finish door trim & jamb
(per side)
47-M106-546R
1 - 4'0" X 8'0"
1 - 3'5" X 8'0"
l - TO" X 8'0"
1 - 3'6" X 8'0"
1 - 3'3" X 8'0"
47- M106 -546R
Interior
1st Floor
QUANTITY UNIT COST
117.48 SF
633.48 SF
633.48 SF
138.67 SF
38.67 LF
38.67 LF
1.00 EA
0.51
1.26
0.73
769.51
2.00 EA 226.91
1.00 EA 65.25
1.00 EA 44.88
2.00 EA 41.51
2.00 EA 20.63
Opens into E
Opens into E
Opens into 0
Opens into E
Opens into E
150.81 SF Ceiling
15.41 SY Flooring
56.00 SF Short Wall
1.28
Formula Sloped Ceiling 9'0" x 7'0" x 13'6"
Goes to Floor
Goes to Floor
LxWxH 7'0" x 7'0" x 8'0"
Goes to Floor /Ceiling
Goes to Floor /Ceiling
Goes to Floor /Ceiling
Formula Sloped Ceiling 8'0" x 3'4" x 8'0"
633.48 SF Walls & Ceiling
54.50 LF Floor Perimeter
67.48 LF Ceil. Perimeter
RCV DEPREC. ACV
810.85
323.07
48.72
28.23
769.51
Insulation
810.85
323.07
Flooring
48.72
28.23
769.51
453.82 453.82
65.25
44.88
83.02
65.25
44.88
83.02
41.26 41.26
Page: 2
�u4�t�il�F w�tNlltdYlil1� ltS}11C+G�
Jphnson, Terrance & Jonelle
* Stain & finish exterior door
sidelight (window) (per side)
* Interior door - solid core lauan /
mahogany or birch flush
Door lockset - interior
Paint door slab only - 2 coats (per
side)
* Paint door trim & jamb - 2 coats
(per side)
* Mirror - 1/4" plate glass - on door
Skylight - double dome fixed, 6.6 - 9
sf
Closet rod
Door chime - Premium grade
Hanging light fixture - High grade
Room Totals: Entry/Foyer
Room: Den
Subroom 1: Offset
Missing Wall:
Missing Wall:
Subroom 2: Window Bay
Missing Wall: 1 - 13'9" X 11'3"
753.33 SF Walls
308.94 SF Floor
484.76 SF Long Wall
DESCRIPTION
Batt insulation - 6" - R19 383.29 SF
1/2" drywall - hung, taped, floated, 1,062.28 SF
ready for paint
Seal then paint the walls and ceiling 1,062.28 SF
(2 coats)
47-M106-546R
1 - 16'2" X 8'0"
1 - 4'0" X 8'0"
State Farm Insurance Companies
4.00 EA 30.83
1.00 EA 191.83
1.00 EA 30.38
2.00 EA 15.70
2.00 EA 15.93
17.78 SF 7.89
1.00 EA 310.88
3.33 LF 2.90
1.00 EA 155.34
1.00 EA 67.67
Opens into 0
Opens into E
Opens into 0
308.94 SF Ceiling
34.33 SY Flooring
290.37 SF Short Wall
QUANTITY UNIT COST
1.28
0.51
123.32
191.83
30.38
31.40
31.86
140.27
310.88
9.67
155.34
67.67
3,761.23
1,359.72
541.76
Goes to Floor /Ceiling
1,062.28 SF Walls & Ceiling
65.33 LF Floor Perimeter
65.33 LF Ceil. Perimeter
RCV DEPREC.
01/13/2003
123.32
191.83
30.38
31.40
31.86
140.27
310.88
9.67
155.34
67.67
0.00 3,761.23
LxWxH 16'2" x 9'4" x 12'5"
LxWxH 16'2" x 8'4" x 8'0"
Goes to Floor /Ceiling
Goes to Floor /Ceiling
Formula Bay Window 13'9" x 9'7" x 11'3"
ACV
Insulation
1,359.72
541.76
Page: 3
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
Seal underlayment for odor control 308.94 SF 0.31 95.77 95.77
Carpet pad 308.94 SF Flooring
* Carpet - (material and labor) 1.00 EA Flooring
Baseboard - 2 1/4" 65.33 LF 1.26 82.32 82.32
Paint baseboard - two coats 65.33 LF 0.73 47.69 47.69
* Aluminum window - awning, 7 -12 2.00 EA 296.56 593.12 593.12
sf
Aluminum window, picture /fixed 5.00 EA 231.51 1,157.55 1,157.55
12 -23 sf (2 pane)
Aluminum window, picture /fixed 5.00 EA 122.06 610.30 610.30
3 -11 sf (2 pane)
* Wood window wrap 158.00 LF 2.66 420.28 420.28
* Seal & paint window wrap 158.00 LF 1.31 206.98 206.98
Casing - 2 1/4" 158.00 LF 1.22 192.76 192.76
Paint casing - two coats 158.00 LF 0.73 115.34 115.34
* Clean fireplace face & hearth 30.00 SF 0.89 26.70 26.70
Wall heater 2.00 EA 151.35 302.70 302.70
Thermostat - electric heat 1.00 EA 42.85 42.85 42.85
Light fixture 1.00 EA 38.29 38.29 38.29
Room Totals: Den 5,834.13 0.00 5,834.13
47-M106-546R
Page: 4
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
Room: Hallway
Missing Wall: 1 - 3'3"
Missing Wall: 1 - 6'0"
119.33 SF Walls
27.08 SF Floor
66.67 SF Long Wall
DESCRIPTION
Blown -in insulation - 12" depth -
R38
1/2" drywall - hung, taped, floated,
ready for paint
Seal then paint the walls and ceiling
(2 coats)
Sand, stain, and finish wood floor
Baseboard - 2 1/4"
Paint baseboard - two coats
Smoke detector - High grade
Light fixture
Room Totals: Hallway
47-M106-546R
X 8'0"
X 6'8"
QUANTITY UNIT COST
27.08 SF
146.42 SF 1.28
146.42 SF 0.51
27.08 SF
8.92 LF 1.26
8.92 LF 0.73
1.00 EA 38.21
1.00 EA 38.29
Opens into E
Opens into E
27.08 SF Ceiling
3.01 SY Flooring
26.00 SF Short Wall
RCV
187.41
74.67
11.24
6.51
38.21
38.29
356.33
LxWxH 8'4" x 3'3" x 8'0"
Goes to Floor /Ceiling
Goes to Floor
146.42 SF Walls & Ceiling
13.92 LF Floor Perimeter
19.92 LF Ceil. Perimeter
DEPREC.
0.00
ACV
Insulation
187.41
74.67
Flooring
11.24
6.51
38.21
38.29
356.33
Page: 5
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
Room: Laundry Room
Missing Wall: 1 - 6'0" X 6'8"
141.33 SF Walls
25.00 SF Floor
66.67 SF Long Wall
DESCRIPTION
Blown -in insulation - 12" depth -
R38
1/2" drywall - hung, taped, floated,
ready for paint
Seal then paint the walls and ceiling
(2 coats)
Sand, stain, and finish wood floor
Baseboard - 2 1/4"
Paint baseboard - two coats
Bypass (sliding) door set - Colonist
Paint bypass door set - slab only - 2
coats (per side)
Shelving - wire (vinyl coated)
Washing machine outlet box with
valves
Clothes dryer vent - installed
Light fixture
Room Totals: Laundry Room
Room: Bathroom
DESCRIPTION
47-M106-546R
210.67 SF Walls
41.33 SF Floor
64.00 SF Long Wall
Opens into E
25.00 SF Ceiling
2.78 SY Flooring
24.00 SF Short Wall
QUANTITY UNIT COST
25.00 SF
166.33 SF 1.28
166.33 SF 0.51
25.00 SF
16.67 LF 1.26
16.67 LF 0.73
1.00 EA 141.57
2.00 EA 24.52
8.00 LF 6.67
1.00 EA 117.63
1.00 EA 41.82
1.00 EA 38.29
41.33 SF Ceiling
4.59 SY Flooring
41.33 SF Short Wall
QUANTITY UNIT COST
RCV
212.91
84.83
21.00
12.17
141.57
49.04
53.36
117.63
41.82
38.29
772.62
LxWxH 8'4" x 3'0" x 8'0"
Goes to Floor
166.33 SF Walls & Ceiling
16.67 LF Floor Perimeter
22.67 LF Ceil. Perimeter
DEPREC.
0.
252.00 SF Walls & Ceiling
26.33 LF Floor Perimeter
26.33 LF Ceil. Perimeter
ACV
Insulation
212.91
84.83
Flooring
21.00
12.17
141.57
49.04
53.36
117.63
41.82
38.29
772.62
LxWxH 8'0" x 5'2" x 8'0"
RCV DEPREC. ACV
Page: 6
4$t
' . 't�ussti«r;u u.Sii ,
Johnson, Terrance & Jonelle
Blown -in insulation - 12" depth - 41.33 SF
R38
Batt insulation - 6" - R19 41.33 SF
side)
per side)
47-M106-546R
State Farm Insurance Companies
01/13/2003
Insulation
Insulation
1/2" drywall - hung, taped, floated, 252.00 SF 1.28 322.56 322.56 Z
ready for paint
= 1-=
Seal then paint the walls and ceiling 252.00 SF 0.51 128.52 128.52 ~ W
(2 coats) Q
U
Sand, stain, and finish wood floor 41.33 SF Flooring O �
U
Baseboard - 2 1/4" 12.50 LF 1.26 15.75 15.75 co H
Paint baseboard - two coats 12.50 LF 0.73 9.13 9.13 W 0
Interior door - Colonist - pre -hung 1.00 EA 117.85 117.85 117.85 g 5
unit
j.
_ d
Door lockset - interior 1.00 EA 30.38 30.38 30.38 =
i ul
- _
Z !-
Paint door slab only - 2 coats (per 2.00 EA 15.70 31.40 31.40 1- O
Z 1-
iii 0
* Paint door trim & jamb - 2 coats 2.00 EA 15.93 31.86 31.86 U 0
O N
O H
Mirror - 1/4" plate glass 8.00 SF 7.89 63.12 63.12 w W
• U
Vanity 2.50 LF 101.67 254.18 254.18 LL 0
Countertop - Tile 5.00 SF 17.84 89.20 89.20 ti.i 0
U =
Sink - single - Premium grade 1.00 EA 351.12 351.12 351.12 0 1-
Z
Sink faucet - Bathroom - Premium 1.00 EA 191.74 191.74 191.74
grade
Toilet - High grade 1.00 EA 354.06 354.06 354.06
Toilet seat 1.00 EA 26.12 26.12 26.12
Bathtub - High grade 1.00 EA 453.38 453.38 453.38
Tile tub surround - 60 to 75 SF 1.00 EA 941.66 941.66 941.66
Tub /shower faucet - High grade 1.00 EA 206.26 206.26 206.26
Shower curtain rod 1.00 EA 20.67 20.67 20.67
Bath accessory - High grade 3.00 EA 26.50 79.50 79.50
Bathroom fan, light, and heater 1.00 EA 132.15 132.15 132.15
Light bar - 4 lights - High grade 1.00 EA 101.86 101.86 101.86
Page: 7
Johnson, Terrance & Jonelle
Room Totals: Bathroom
Room: Office
Missing Wall:
Subroom 1: Closet
Missing Wall:
406.67
125.75
158.00
DESCRIPTION
Batt insulation - 6" - R19
1/2" drywall - hung, taped, floated,
ready for paint
Seal then paint the walls and ceiling
(2 coats)
Seal underlayment for odor control
Carpet pad
* Carpet - (material and labor)
Baseboard - 2 1/4"
Paint baseboard - two coats
Interior door - Colonist - pre -hung
unit
Door lockset - interior
Paint door slab only - 2 coats (per
side)
* Paint door trim & jamb - 2 coats
(per side)
Bifold door set - Colonist - Double
Paint bifold door set - slab only - 2
coats (per side)
6 -0 6 -8 bronze sliding patio door
insulated (2 panes)
47-M106-546R
l - 6'0" X 6'8"
l - 4'0" X 6'8"
SF Walls
SF Floor
SF Long Wall
State Farm Insurance Companies
Opens into 0
125.75 SF Ceiling
13.97 SY Flooring
92.00 SF Short Wall
QUANTITY UNIT COST
186.00 SF
532.42 SF 1.28
532.42 SF 0.51
125.75 SF 0.31
125.75 SF
1.00 EA
45.83 LF 1.26
45.83 LF 0.73
1.00 EA 117.85
1.00 EA 30.38
2.00 EA 15.70
2.00 EA 15.93
1.00 EA 143.48
2.00 EA 25.34
1.00 EA 803.59
Opens into E
3,952.47
RCV
681.49
271.53
38.98
57.75
33.46
117.85
30.38
31.40
31.86
143.48
50.68
803.59
01/13/2003
0.00 3,952.47
LxWxH 11'9" x 9'0" x 8'0"
Goes to Floor
LxWxH 8'0" x 2'6" x 8'0"
Goes to Floor
532.42 SF Walls & Ceiling
48.50 LF Floor Perimeter
62.50 LF Ceil. Perimeter
DEPREC.
ACV
Insulation
681.49
271.53
38.98
Flooring
Flooring
57.75
33.46
117.85
30.38
31.40
31.86
143.48
50.68
803.59
Page: 8
Johnson, Terrance & Jonelle
* Wood window wrap
* Seal & paint window wrap
Casing - 2 1/4"
Paint casing - two coats
Wall heater
Thermostat - electric heat
Light fixture
Room Totals: Office
Room: Living Room
Missing Wall:
Subroom 1: Offset
Missing Wall:
Missing Wall:
Subroom 2: Window Bay
Missing Wall: 1 - 13'9" X 11'3"
838.08 SF Walls
410.08 SF Floor
501.77 SF Long Wall
DESCRIPTION
Batt insulation - 6" - R19
1/2" drywall - hung, taped, floated, 1,248.17 SF
ready for paint
Seal then paint the walls and ceiling 1,248.17 SF
(2 coats)
Sand, stain, and finish wood floor 410.08 SF
Baseboard - 2 1/4"
Paint baseboard - two coats
* Aluminum window - awning, 7 -12
sf
47-M106-546R
1 - 3'5" X 8'0"
1 - 17'0" X 8'0"
1 - 9'0" X 8'0"
State Farm Insurance Companies
19.33 LF 2.66
19.33 LF 1.31
19.33 LF 1.22
19.33 LF 0.73
1.00 EA 151.35
1.00 EA 42.85
1.00 EA 38.29
Opens into 0
410.08 SF Ceiling
45.56 SY Flooring
356.06 SF Short Wall
QUANTITY UNIT COST
459.33 SF
1.28
0.51
62.08 LF 1.26
62.08 LF 0.73
2.00 EA 296.56
Opens into E
Opens into 0
Opens into E
51.43
25.33
23.59
14.11
151.35
42.85
38.29
2,639.40
1,597.65
636.57
78.22
45.32
593.12
01/13/2003
51.43
25.33
23.59
14.11
151.35
42.85
38.29
0.00 2,639.40
LxWxH 17'0" x 15'0" x 12'5"
Goes to Floor
LxWxH 17'0" x 7'9" x 8'0"
Goes to Floor /Ceiling
Goes to Floor /Ceiling
Formula Bay Window 13'9" x 9'7" x 11'3"
Goes to Floor /Ceiling
1,248.17 SF Walls & Ceiling
68.75 LF Floor Perimeter
72.17 LF Ceil. Perimeter
RCV DEPREC. ACV
Insulation
1,597.65
636.57
Flooring
78.22
45.32
593.12
Page: 9
•
.4 .�.Y.�+t
Johnson, Terrance & Jonelle
Aluminum window, picture /fixed
12 -23 sf (2 pane)
Aluminum window, picture /fixed
3 -11 sf (2 pane)
* Wood window wrap
* Seal & paint window wrap
Casing - 2 1/4"
Paint casing - two coats
Detach & Reset Wood stove -
Medium size
Single wall flue - black, 8"
Wall heater
Thermostat - electric heat
Chandelier - Average grade
Light fixture
Room Totals: Living Room
Room: Kitchen
Missing Wall:
Subroom 1: Bay
Missing Wall:
350.67
176.08
272.00
DESCRIPTION
Blown -in insulation - 12" depth -
R38
Batt insulation - 6" - R19
1/2" drywall - hung, taped, floated,
ready for paint
47-M106-546R
1 - 9'0" X 8'0"
1 - 17'0" X 8'0"
SF Walls
SF Floor
SF Long Wall
State Farm Insurance Companies
5.00 EA 231.51
5.00 EA 122.06
158.00 LF 2.66
158.00 LF 1.31
158.00 LF 1.22
158.00 LF 0.73
1.00 EA 115.25
16.00 LF 19.09
2.00 EA 151.35
1.00 EA 42.85
1.00 EA 189.90
1.00 EA 38.29
Opens into 0
176.08 SF Ceiling
19.56 SY Flooring
169.33 SF Short Wall
QUANTITY UNIT COST
176.08 SF
272.00 SF
526.75 SF
1.28
Opens into E
1,157.55
610.30
420.28
206.98
192.76
115.34
115.25
305.44
302.70
42.85
189.90
38.29
6,648.52
0.00 6,648.52
LxWxH 17'0" x 7'8" x 8'0"
Goes to Floor /Ceiling
Formula Bay Window 17'0" x 13'6" x 8'0"
674.24
Goes to Floor /Ceiling
526.75 SF Walls & Ceiling
43.83 LF Floor Perimeter
43.83 LF Ceil. Perimeter
RCV DEPREC.
01/13/2003
1,1 57.55
610.30
420.28
206.98
192.76
115.34
115.25
305.44
302.70
42.85
189.90
38.29
ACV
Insulation
Insulation
674.24
Page: 10
Johnson, Terrance & Jonelle
Seal then paint the walls and ceiling
(2 coats)
Seal underlayment for odor control
Oak flooring - #1 common - no
finish
Sand, stain, and finish wood floor
Baseboard - 2 1/4"
Paint baseboard - two coats
Cabinetry - upper (wall) units
Cabinetry - lower (base) units
Countertop - Flat laid plastic
laminate
Countertop - Flat laid plastic
laminate - Oversized
* Sink - kitchen - High grade
Sink faucet - Kitchen - High grade
Range - 30" drop in
Garbage disposer
Recessed light fixture
Room Totals: Kitchen
Room: Garage
Missing Wall:
594.69
422.31
186.69
DESCRIPTION
CIean the walls and ceiling
Seal then paint the walls and ceiling 1,017.01 SF
(2 coats)
47 -M 106 -546R
2- 8'0"X7'0"
SF Walls
SF Floor
SF Long Wall
State Farm Insurance Companies
526.75 SF 0.51
176.08 SF 0.31
176.08 SF
176.08 SF
16.17 LF 1.26
16.17 LF 0.73
8.00 LF 73.70
25.67 LF 107.34
19.67 LF 22.19
14.00 LF 27.61
1.00 EA 368.84
1.00 EA 162.24
1.00 EA 721.90
1.00 EA 141.56
3.00 EA 77.51
QUANTITY UNIT COST
1,017.01 SF
Opens into E
422.31 SF Ceiling
46.92 SY Flooring
166.66 SF Short Wall
0.24
268.64
54.59
20.37
11.80
589.60
2,755.06
436.40
386.54
368.84
162.24
721.90
141.56
232.53
6,824.31
RCV
244.08
0.51 518.67
0.00
LxWxH 21'9" x 19'5" x 8'7"
Goes to Floor
1,017.01 SF Walls & Ceiling
66.33 LF Floor Perimeter
82.33 LF Ceil. Perimeter
DEPREC.
01/13/2003
268.64
54.59
Flooring
Flooring
20.37
11.80
589.60
2,755.06
436.40
386.54
368.84
162.24
721.90
141.56
232.53
6,824.31
ACV
244.08
518.67
Page: 11
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
CONTINUED - Garage
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV
Clean concrete on the floor
Clean overhead door & hardware
Exterior door - solid core lauan /
mahogany or birch flush
Door lockset - exterior
Paint door slab only - 2 coats (per
side)
* Paint door trim & jamb - 2 coats
(per side)
Room Totals: Garage
Room: Study
Subroom 1: Closet
Missing Wall:
406.33
127.75
64.00
DESCRIPTION
Clean the walls and ceiling
1 - 6'0" X 6'8"
SF Walls
SF Floor
SF Long Wall
Seal then paint the walls and ceiling
(2 coats)
Clean and deodorize carpet
Clean door (per side)
Room Totals: Study
47-M106-546R
422.31 SF
2.00 EA
1.00 EA
0.19
26.30
191.83
1.00 EA 38.48
2.00 EA 15.70
2.00 EA 15.93
534.37 SF
534.37 SF
127.75 SF
2.00 EA
Opens into 0
128.03 SF Ceiling
14.19 SY Flooring
40.00 SF Short Wall
QUANTITY UNIT COST
0.24
0.51
0.31
4.50
80.24
52.60
191.83
38.48
31.40
31.86
1,189.16
RCV
128.25
272.53
39.60
9.00
449.38
0.00
Goes to Floor
534.37 SF Walls & Ceiling
54.00 LF Floor Perimeter
66.09 LF Ceii. Perimeter
DEPREC.
80.24
52.60
191.83
38.48
31.40
31.86
1,189.16
Formula Sloped Ceiling 13'6" x 6'6" x 7'6"
LxWxH 8'0" x 5'0" x 8'0"
ACV
128.25
272.53
39.60
9.00
0.00 449.38
Page: 12
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
Room: Storage Area/Room
DESCRIPTION
Clean the walls and ceiling
Seal then paint the walls and ceiling
(2 coats)
Clean concrete on the floor
Clean door (per side)
Room Totals: Storage Area/Room
Area Totals: 1st Floor
4,623.86 SF Walls
1,931.26 SF Floor
1,920.55 SF Long Wall
Area Items Total: 1st Floor
Room: Stairway
Missing Wall: 1 - 3'6" X 7'11"
Subroom 1: Upper Stairway
Missing Wall: 1 - 3'6" X 7'11"
Missing Wall: 1 - 8'4" X 6'0"
325.81 SF Walls
91.58 SF Floor
DESCRIPTION
47 -M 106 -546R
320.08 SF Walls
128.25 SF Floor
448.75 SF
448.75 SF
128.25 SF
2.00 EA
128.66 SF Ceiling
14.25 SY Flooring
QUANTITY UNIT COST
0.24
0.51
0.19
4.50
1,944.09 SF Ceiling
214.58 SY Flooring
1,261.76 SF Short Wall
2nd Floor
Opens into E
Opens into 0
58.33 SF Ceiling
10.18 SY Flooring
QUANTITY UNIT COST
Opens into E
Formula Sloped Ceiling 13'6" x 9'6" x 7'6"
32,797.48
448.75 SF Walls & Ceiling
46.00 LF Floor Perimeter
46.09 LF Ceil. Perimeter
RCV DEPREC. ACV
107.70 107.70
228.86 228.86
24.37 24.37
9.00 9.00
369.93
0.00 369.93
6,567.96 SF Walls & Ceiling
504.17 LF Floor Perimeter
574.74 LF Ceil. Perimeter
0.00 32,797.48
Formula Stairway 8'4" x 3'6" x 4'6"
Goes to Floor
Formula Stairway 8'4" x 3'6" x 4'6"
Goes to Floor
Goes to Ceiling
384.14 SF Walls & Ceiling
44.88 LF Floor Perimeter
30.67 LF Ceil. Perimeter
RCV DEPREC. ACV
Page: 13
r x.+.:. . x u v ti i -zS axSZ�s ' Y i LwAliktCw.fw.ivrihtita.A,4, K.
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
Blown -in insulation - 12" depth - 58.33 SF Insulation
R38
Batt insulation - 6" - R19 86.92 SF Insulation
1/2" drywall - hung, taped, floated, 384.14 SF 1.28 491.70 491.70 Z
ready for paint
;1-- = Z
w
Seal then paint the walls and ceiling 384.14 SF 0.51 195.91 195.91
tr 2
(2 coats)
00
Seal underlayment for odor control 91.58 SF 0.31 28.39 28.39 (.0 CI
jI
Carpet pad 91.58 SF Flooring co I.-
O
* Carpet - (material and labor) 1.00 EA Flooring 2 g
Step charge for carpet installation 14.00 EA Flooring u.. Q
* Wall cap 9.50 LF 3.14 29.83 29.83 I H W
Z
* Seal & paint wall cap 9.50 LF 0.73 6.94 6.94
F- 0 O
Z I
Handrail - 2" copper 16.17 LF 14.45 * 233.61 233.61 2 ? .
M
Ceiling fan & light - High grade 1.00 EA 276.99 276.99 276.99 0
O E-
W
Room Totals: Stairway 1,263.37 0.00 1,263.37 H 2
tL O
.Z
W
- • I
1- 1-
Room: Hallway LxWxH 12'8" x 3'3" x 7'11" Z
Missing Wall: 1 - 3'6" X 7'11" Opens into E Goes to Floor /Ceiling
Subroom 1: Offset LxWxH 4'8" x 3'7" x 7'11"
Missing Wall: 1 - 4'8" X 7'11" Opens into 0 Goes to Floor /Ceiling
Subroom 2: Linen Closet LxWxH 2'3" x 2'0" x 7'11"
Blown -in insulation - 12" depth - 62.39 SF
R38
47-M106-546R
348.33 SF Walls
62.39 SF Floor
155.03 SF Long Wall
62.39 SF Ceiling
6.93 SY Flooring
69.93 SF Short Wall
410.72 SF Walls & Ceiling
44.00 LF Floor Perimeter
44.00 LF Ceil. Perimeter
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV
Insulation
1/2" drywall - hung, taped, floated, 410.72 SF 1.28 525.72 525.72
ready for paint
Page: 14
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
Seal then paint the walls and ceiling 410.72 SF 0.51 209.47 209.47
(2 coats)
Seal underlayment for odor control 62.39 SF 0.31 19.34 19.34
Carpet pad 62.39 SF Flooring
* Carpet - (material and labor) 1.00 EA Flooring
Baseboard - 2 1/4" 27.83 LF 1.26 35.07 35.07
Paint baseboard - two coats 27.83 LF 0.73 20.32 20.32
Bifold door set - Colonist - Single 1.00 EA 85.69 85.69 85.69
Paint single bifold door - slab only - 2.00 EA 15.40 30.80 30.80
2 coats (per side)
Shelving - 12" - in place 8.00 LF 5.40 43.20 43.20
Attic entrance cover and trim 1.00 EA 42.31 42.31 42.31
Door chime - Standard grade 1.00 EA 75.55 75.55 75.55
Smoke detector - High grade 1.00 EA 38.21 38.21 38.21
Light fixture 1.00 EA 38.29 38.29 38.29
Room Totals: Hallway 1,163.97 0.00 1,163.97
Room: Storage Area/Room LxWxH 17'0" x 3'8" x 3'6"
144.67 SF Walls
62.33 SF Floor
59.50 SF Long Wall
Clean the walls and ceiling
Seal then paint the walls and ceiling
(2 coats)
Clean floor
Seal underlayment for odor control
Interior door - Colonist - pre -hung
unit
47-M106-546R
62.33 SF Ceiling
6.93 SY Flooring
12.83 SF Short Wall
207.00 SF Walls & Ceiling
41.33 LF Floor Perimeter
41.33 LF Ceil. Perimeter
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV
207.00 SF 0.24 49.68 49.68
207.00 SF 0.51 105.57 105.57
62.33 SF 0.26 16.21 16.21
62.33 SF 0.31 19.32 19.32
1.00 EA 117.85 117.85 117.85
Page: 15
ls,,,41:;.40.1a+
4
Johnson, Terrance & Jonelle
DESCRIPTION
Door lockset - interior
Paint door slab only - 2 coats (per
side)
* Paint door trim & jamb - 2 coats
(per side)
Light fixture - Standard grade
Room Totals: Storage Area/Room
Room: Bedroom
Subroom 1: Offset
Missing Wall:
Subroom 2: Closet
Missing Wall:
516.39
186.36
201.22
DESCRIPTION
Blown-in insulation - 12" depth -
R38
Batt insulation - 6" - R19
1/2" drywall - hung, taped, floated,
ready for paint
Seal then paint the walls and ceiling
(2 coats)
Seal underlayment for odor control
Carpet pad
47 -M 106 -546R
1 - 3'3" X 7'11"
1 - 6'0" X 6'8"
SF Walls
SF Floor
SF Long Wall
State Farm Insurance Companies
CONTINUED - Storage Area /Room
QUANTITY UNIT COST
1.00 EA 30.38
2.00 EA 15.70
2.00 EA 15.93
2.00 EA 23.48
QUANTITY UNIT COST
186.36 SF
343.30 SF
702.75 SF
702.75 SF
186.36 SF
186.36 SF
1.28
0.51
0.31
Opens into 0
Opens into 0
186.36 SF Ceiling
20.71 SY Flooring
122.71 SF Short Wall
RCV
30.38
31.40
31.86
46.96
449.23
RCV
899.52
358.40
57.77
DEPREC.
0.00
Goes to Floor
702.75 SF Walls & Ceiling
63.33 LF Floor Perimeter
75.33 LF Ceil. Perimeter
DEPREC.
01/13/2003
ACV
30.38
31.40
31.86
46.96
449.23
LxWxH 14'8" x 11'2" x 7'11"
LxWxH 3'3" x 2'4" x 7'11"
Goes to Floor /Ceiling
LxWxH 7'6" x 2'0" x 7'11"
ACV
Insulation
Insulation
899.52
358.40
57.77
Flooring
Page: 16
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State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
* Carpet - (material and labor) 1.00 EA Flooring
Baseboard - 2 1/4" 60.67 LF 1.26 76.44 76.44
Paint baseboard - two coats 60.67 LF 0.73 44.29 44.29 Z
Interior door - Colonist - pre -hung 1.00 EA 1 17.85 117.85 11 7.85 1 W
unit re
Door lockset - interior 1.00 EA 30.38 30.38 30.38 U O .
N c
Paint door slab only - 2 coats (per 2.00 EA 15.70 31.40 31.40 N W
side) _I H
u) W
* Paint door trim & jamb - 2 coats 2.00 EA 15.93 31.86 31.86 uj 0
(per side)
Bifold door set - Colonist - Double 1.00 EA 143.48 143.48 143.48 a
c d
Paint bifold door set - slab only - 2 2.00 EA 25.34 50.68 50.68 H =
coats (per side) Z F-
1- 0
Aluminum window, horiz. slider 1.00 EA 256.83 256.83 256.83 W I-"
12 -23 sf (2 pane) g j .
* Wood window wrap 16.00 LF 2.66 42.56 42.56 p D .
0 I--
* Seal & paint window wrap 16.00 LF 1.31 20.96 20.96 W W
H V
Casing - 2 1/4" 16.00 LF 1.22 19.52 19.52 u.. ~ O '
- z
Paint casing - two coats 16.00 LF 0.73 11.68 11.68 U
P. N.
_
Closet rod 15.00 LF 2.90 43.50 43.50 Z F-
Z
Wall heater 1.00 EA 151.35 151.35 151.35
Thermostat - electric heat 1.00 EA 42.85 42.85 42.85
Smoke detector - High grade 1.00 EA 38.21 38.21 38.21
Light fixture 1.00 EA 38.29 38.29 38.29
Room Totals: Bedroom 2,507.82 0.00 2,507.82
Room: Bathroom
47-M106-546R
211.11 SF Walls
42.19 SF Floor
64.65 SF Long Wall
42.19 SF Ceiling
4.69 SY Flooring
40.90 SF Short Wall
LxWxH 8'2" x 5'2" x 7'11"
253.31 SF Walls & Ceiling
26.67 LF Floor Perimeter
26.67 LF Ceil. Perimeter
Page: 17
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV
Blown -in insulation - 12" depth - 42.19 SF Insulation
R38
Batt insulation - 6" - RI9 40.90 SF Insulation
1/2" drywall - hung, taped, floated, 253.31 SF 1.28 324.23 324.23
ready for paint
Seal then paint the walls and ceiling 253.31 SF 0.51 129.19 129.19
(2 coats)
* Seal subfloor for odor control 42.19 SF 0.31 13.08 13.08
Underlayment - 1/2" particle board 42.19 SF 1.62 68.35 68.35
* Vinyl floor covering (sheet 1.00 EA Flooring
goods)
Baseboard - 2 1/4" 12.67 LF 1.26 15.96 15.96
Paint baseboard - two coats 12.67 LF 0.73 9.25 9.25
Interior door - Colonist - pre -hung 1.00 EA 117.85 117.85 117.85
unit
Door lockset - interior 1.00 EA 30.38 30.38 30.38
Paint door slab only - 2 coats (per 2.00 EA 15.70 31.40 31.40
side)
* Paint door trim & jamb - 2 coats 2.00 EA 15.93 31.86 31.86
(per side)
Mirror - 1/4" plate glass 9.33 SF 7.89 73.64 73.64
Vanity 2.50 LF 101.67 254.18 254.18
Countertop - Flat laid plastic 2.50 LF 22.19 55.48 55.48
laminate
Sink - single - Premium grade 1.00 EA 351.12 351.12 351.12
Sink faucet - Bathroom - Premium 1.00 EA 191.74 191.74 191.74
grade
Toilet - High grade 1.00 EA 354.06 354.06 354.06
Toilet seat 1.00 EA 26.12 26.12 26.12
Bathtub - High grade 1.00 EA 453.38 453.38 453.38
Tile tub surround - 60 to 75 SF 1.00 EA 941.66 941.66 941.66
Tub /shower faucet - High grade 1.00 EA 206.26 206,26 206.26
47-M106-546R
Page: 18
•
:0+4.41. . jI:. ^R= }.LHw.:4:iea:c r'.Y4.wJp1�1 iW:5as4i�L:JJVw.14�.i:uwR:if:
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
Shower curtain rod 1.00 EA 20.67 20.67 20.67
Bath accessory - High grade 3.00 EA 26.50 79.50 79.50
Bath fan - with light 1.00 EA 100.70 * 100.70 100.70
Light bar - 4 lights - High grade 1.00 EA 101.86 101.86 101.86 Z
4- Z
W
Room Totals: Bathroom 3,981.92 0.00 3,981.92 Q
J U
0
u) o
co w
WI
1._
Room: Master Bedroom LxWxH 14'9" x 9'8" x 7'11" Q U.
W
Subroom 1: Offset LxWxH 11'6" x 3'6" x 7'11" Q
LL Q
Missing Wall: 1 - 11'6" X 7'11" Opens into 0 Goes to Floor /Ceiling = CC
Subroom 2: Closet LxWxH 7'4" x 2'3" x 7'11" F- _
Zi.
Missing Wall: 1 - 6'0" X 6'8" Opens into 0 Goes to Floor W O
513.75 SF Walls 199.33 SF Ceiling 713.08 SF Walls & Ceiling j
199.33 SF Floor 22.15 SY Flooring 63.00 LF Floor Perimeter U 0
265.87 SF Long Wall 122.05 SF Short Wall 75.00 LF Ceil. Perimeter 0 H
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV W
H�
u" O
Blown -in insulation - 12" depth - 199.33 SF Insulation LLi Z
R38 0
O ~
Batt insulation - 6" - R19 238.82 SF Insulation Z
1/2" drywall - hung, taped, floated, 713.08 SF 1.28 912.75 912.75
ready for paint
Seal then paint the walls and ceiling 713.08 SF 0.51 363.67 363.67
(2 coats)
Seal underlayment for odor control 199.33 SF 0.31 61.79 61.79
Carpet pad 199.33 SF Flooring
* Carpet - (material and labor) 1.00 EA Flooring
Baseboard - 2 1/4" 58.08 LF 1.26 73.18 73.18
Paint baseboard - two coats 58.08 LF 0.73 42.40 42.40
Interior door - Colonist - pre -hung 1.00 EA 117.85 117.85 117.85
unit
Door lockset - interior 1.00 EA 30.38 30.38
47-M106-546R
30.38
Page: 19
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
Paint door slab only - 2 coats (per 2.00 EA 15.70 31.40 31.40
side)
* Paint door trim & jamb - 2 coats 2.00 EA 15.93 31.86 31.86
(per side)
Z
Bifold door set - Colonist - Double 4.00 EA 143.48 143.48 143.48 �' -
~ W
re
Paint bifold door set - slab only - 2 2.00 EA 25.34 50.68 50.68 6
coats (per side) J U
U O
Aluminum window, horiz. slider 1.00 EA 323.69 323.69 323.69 u) 0
24 -32 sf (2 pane) W = Lu
J H '
C0 LL .
* Wood window wrap 20.00 LF 2.66 53.20 53.20 W 0
* Seal & paint window wrap 20.00 LF 1.31 26.20 26.20 g J
u_Q
Casing - 2 1/4" 20.00 LF 1.22 24.40 24.40 0
I
1--
Paint casing - two coats 20.00 LF 0.73 14.60 14.60 Z =
Closet rod 14.67 LF 2.90 42.53 42.53 Z
Shelving - 12" - in place 7.33 LF 5.40 39.60 39.60 D p
Wall heater 1.00 EA 151.35 151.35 151.35 p I-
W -
Thermostat - electric heat 1.00 EA 42.85 42.85 42.85 H U
u'O
Smoke detector - High grade 1.00 EA 38.21 38.21 38.21 Z
W
Light fixture 2.00 EA 38.29 76.58 76.58 H H
O
Room Totals: Master Bedroom 2,692.65 0.00 2,692.65
Room: Master Bath
Subroom 1: Offset
Missing Wall:
Subroom 2: Closet
47-M106-546R
440.69 SF Walls
117.39 SF Floor
155.03 SF Long Wall
1 - 5'5" X 7'11"
LxWxH 11'6" x 8'4" x 7'11"
LxWxH 5'5" x 2'8" x 7'11"
Opens into 0 Goes to Floor /Ceiling
LxWxH 2'8" x 2'8" x 7'11"
117.39 SF Ceiling
13.04 SY Flooring
108.19 SF Short Wall
558.08 SF Walls & Ceiling
55.67 LF Floor Perimeter
55.67 LF Ceil. Perimeter
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV
Page: 20
[ u, • niAler41' 44141 ',.' ei.:. , :i.c.4"
Z
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
Blown -in insulation - 12" depth - 117.39 SF Insulation
R38
Batt insulation - 6" - R19 155.03 SF Insulation
1/2" drywall - hung, taped, floated, 558.08 SF 1.28 714.35 714.35
ready for paint
Seal then paint the walls and ceiling 558.08 SF 0.51 284.62 284.62
(2 coats)
* Seal subfloor for odor control 117.39 SF 0.31 36.39 36.39
Underlayment - 1/2" particle board 117.39 SF 1.62 190.17 190.17
* Vinyl floor covering (sheet 1.00 EA Flooring
goods)
Baseboard - 2 1/4" 36.08 LF 1.26 45.47 45.47
Paint baseboard - two coats 36.08 LF 0.73 26.34 26.34
Pocket door unit - Colonist 1.00 EA 193.10 193.10 193.10
Paint door slab only - 2 coats (per 2.00 EA 15.70 31.40 31.40
side)
* Paint door trim & jamb - 2 coats 2.00 EA 15.93 31.86
(per side)
Bifold door set - Colonist - Single 1.00 EA 85.69 85.69
Paint single bifold door - slab only - 2.00 EA 15.40 30.80
2 coats (per side)
Skylight - double dome fixed, 6.6 - 9 1.00 EA 310.88 310.88
sf
Mirror - 1/4" plate glass 36.94 SF 7.89 291.49
Vanity 10.25 LF 101.67 1,042.12
Countertop - Flat laid plastic 10.25 LF 22.19 227.45
laminate
Sink - single - Premium grade 2.00 EA 351.12 702.24
Sink faucet - Bathroom - Premium 2.00 EA 191.74 383.48
grade
Toilet - High grade 1.00 EA 354.06 354.06
Toilet seat 1.00 EA 26.12 26.12
Bathtub - High grade 1.00 EA 453.38 453.38
Tile tub surround - up to 60 SF 1.00 EA 786.99 786.99
47-M106-546R
31.86
85.69
30.80
310.88
291.49
1,042.12
227.45
702.24
383.48
354.06
26.12
453.38
786.99
Page: 21
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
Tub /shower faucet - High grade 1.00 EA 206.26 206.26 206.26
Shower curtain rod 1.00 EA 20.67 20.67 20.67
Bath accessory - High grade 3.00 EA 26.50 79.50 79.50
Shelving - 12" - in place 10.67 LF 5.40 57.60 57.60
Bath fan - with light 1.00 EA 100.70 * 100.70 100.70
Light bar - 6 lights - High grade 1.00 EA 117.03 117.03 117.03
Light bar - 8 lights - High grade 1.00 EA 133.48 133.48 133.48
Room Totals: Master Bath
Area Totals: 2nd Floor
2,500.75 SF Walls
761.58 SF Floor
901.31 SF Long Wall
Room: Floor Coverings
47-M106-546R
728.33 SF Ceiling
84.62 SY Flooring
476.62 SF Short Wall
General
6,963.64
0.00 6,963.64
3,229.08 SF Walls & Ceiling
338.88 LF Floor Perimeter
348.67 LF Ceil. Perimeter
Area Items Total: 2nd Floor 19,022.60 0.00 19,022.60
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV
Carpet pad 974.36 SF 0.57 555.39 555.39
Carpet - (material and labor) 1,120.00 SF 2.22 2,486.40 2,486.40
Step charge for carpet installation 14.00 EA 6.57 91.98 91.98
Vinyl floor covering (sheet goods) 207.00 SF 3.19 660.33 660.33
Oak flooring - #1 common - no 176.08 SF 8.11 1,428.01 1,428.01
finish
Page: 22
•
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
CONTINUED - Floor Coverings
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV
Sand, stain, and finish wood floor 818.25 SF 3.72 3,043.89 3,043.89
Room Totals: Floor Coverings 8,266.00 0.00 8,266.00
Room: Window Coverings
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV
Window coverings 1.00 EA Pending
Room Totals: Window Coverings 0.00 0.00 0.00
Area Totals: General
Area Items Total: General
Area Totals: Interior
7,124.61 SF Walls
2,692.84 SF Floor
2,821.85 SF Long Wall
47-M106-546R
2,672.43 SF Ceiling
299.20 SY Flooring
1,738.37 SF Short Wall
8,266.00
0.00 8,266.00
9,797.04 SF Walls & Ceiling
843.05 LF Floor Perimeter
923.40 LF Ceil. Perimeter
Area Items Total: Interior 60,086.08 0.00 60,086.08
Page: 23
Johnson, Terrance & Jonelle
Room: W Exposure
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV
Trim board - 1" x 6" - installed 126.00 LF 3.90 491.40 491.40
(cedar)
Seal & paint trim 126.00 LF 0.73 91.98 91.98
Room Totals: W Exposure 583.38 0.00 583.38
Room: N Exposure
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV
Trim board - 1" x 6" - installed 36.00 LF 3.90 140.40 140.40
(cedar)
Seal & paint trim 36.00 LF 0.73 26.28 26.28
Room Totals: N Exposure 166.68 0.00 166.68
47-M106-546R
State Farm Insurance Companies
Exterior
01/13/2003
Page: 24
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State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
Room: E Exposure
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV , H Z
' w
CC W D
Siding - beveled - cedar (clapboard) 187.00 SF 4.27 798.49 798.49 U O
0
Exterior - seal or prime then paint 187.00 SF 0.73 136.51 136.51 CO w
with one finish coat III Z
H
U) LL.
Trim board - 1" x 6" - installed 63.33 LF 3.90 247.00 247.00 w 0
2
Seal & paint trim 63.33 LF 0.73 46.23 46.23 <
Fascia - 1" x 8" #3 cedar 22.00 LF 3.82 84.04 84.04 = a
H w
Z .
* Prime & paint exterior fascia - 22.00 LF 0.87 19.14 19.14 Z
F— O
Z I—
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D
Room Totals: E Exposure 1,331.41 0.00 1,331.41 0 to
O I—
w w
u- O
Room: S Exposure 1 j Z .
U I .
O I
(cedar)
wood, 8" wide
DESCRIPTION
No damage noted.
Room Totals: S Exposure 0.00 0.00 0.00
47-M106-546R
QUANTITY UNIT COST
RCV DEPREC. ACV
Page: 25
z
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
Room: Roof
Z
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Z 1—
~ W
Laminated - 30 yr: - comp. shingle 2.00 SQ 138.00 276.00 276.00 J 0
rfg - incl. felt U 0
J �
Room Totals: Roof 276.00 0.00 276.00 u.
Area Totals: Exterior W O
2
�Q
co D
I
Area Items Total: Exterior 2,357.47 0.00 2,357.47 I— _ ,
Z 1—
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Z 1—
W
• W
U� .
General N
O —
O 1—
W W
H H
u. O
z
Room: Framing
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV
Stud wall - 2 "x6 "x 8'- 16" oc
Rafters - 2x6 - 24" OC (3 -5/12
Gable, per SF of floor)
Sheathing - plywood - 1/2" CDX
Room Totals: Framing
47-M106-546R
17.00 LF 21.91 *
120.00 SF 1.83 *
320.00 SF 0.84
372.47
219.60
268.80
372.47
219.60
268.80
860.87 0.00 860.87
Page: 26
Z
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
Room: Electrical
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV
Rewire - average residence - copper 2,217.00 SF 2.03 4,500.51 4,500.51
wiring
Wiring trim -out 2,217.00 SF 0.75 * 1,662.75 1,662.75
Room Totals: Electrical 6,163.26 0.00 6,163.26
Room: Plumbing
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV
Rough plumbing repairs 1.00 EA Pending
Room Totals: Plumbing 0.00 0.00 0.00
Room: Insulation
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV
Blown -in insulation - 12" depth -
R38
Batt insulation - 6" - R19
Room Totals: Insulation
47-M106-546R
1,053.00 SF 0.81 852.93 852.93
2,207.00 SF 0.64 1,412.48 1,412.48
2,265.41 0.00 2,265.41
Page: 27
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
Room: Temporary Repairs
Z
~ W
CY sq
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV J U
0
u) 0
co w
Temporary power - hookup 1.00 EA 131.97 131.97 131.97 — H
N IL.
Temporary power usage (per month) 3.00 EA 88.01 264.03 264.03 w 0
Temporary toilet (per month) 3.00 EA 97.10 291.30 291.30 g 5
LL. Q
Material handling 40.00 HR 30.27 * 1,210.80 1,210.80 = d
This is the allowance, in excess of standard, for getting the materials from the street to the house. W
H
Z I—
Z0
Room Totals: Temporary Repairs 1,898.10 0.00 1,898.10 LU
UO
O
0 1—
w W .
Room: Demolition I � ?
LLO
.Z
W
U=
O~
Z
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV
General Demolition - per hour 164.00 HR 30.27 4,964.28 4,964.28
Dumpster load - Approx. 30 yards, 5 3.00 EA 589.00 1,767.00 1,767.00
tons of debris
Room Totals: Demolition
47-M106-546R
6,731.28 0.00 6,731.28
Page: 28
State Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
Room: General Requirements
Z
DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 1 Z
Ce W
* Smoke seal open framing 7,590.00 SF 0.43 3,263.70 3,263.70 6 U
0
General clean - up 24.00 HR 28.00 672.00 672.00 u) 0
W = .
* Taxes, insurance, permits & fees 1.00 EA 1,475.00 * 1,475.00 1,475.00 0 H ,
� LL
WO
Room Totals: General 5,410.70 0.00 5,410.70 g J
Requirements u_
Area Totals: General = d
I— 11
Z1.-
1— O
Z I-
ILI n
Area Items Total: General 23,329.62 0.00 23,329.62 U 0
Line Item Totals: 47- M106 -546R 85,773.17 0.00 85,773.17 O N
o I—
W W
2
Grand Total Areas: LL 1-
7,124.61 SF Walls 2,672.43 SF Ceiling 9,797.04 SF Walls & Ceiling W Z
2,692.84 SF Floor 299.20 SY Flooring 843.05 LF Floor Perimeter U �.
2,821.85 SF Long Wall 1,738.37 SF Short Wall 923.40 LF Ceil. Perimeter F. H
Z
47-M106-546R
Page: 29
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-,fate Farm Insurance Companies
Johnson, Terrance & Jonelle 01/13/2003
O &P Items
APPLIANCES 863.46 0.77%
CABINETRY 6,001.01 5.36%
CLEANING 1,459.43 1.30%
GENERAL DEMOLITION 6,731.28 6.01%
DOORS 3,250.58 2.90%
DRYWALL 9,715.10 8.68%
ELECTRICAL 8,154.24 7.28%
FLOOR COVERING - CARPET 3,133.77 2.80%
FLOOR COVERING - VINYL 918.85 0.82%
FLOOR COVERING - WOOD 4,471.90 3.99%
PERMITS AND FEES 1,475.00 1.32%
FINISH CARPENTRY / TRIMWORK 3,262.67 2.91%
FINISH HARDWARE 895.39 0.80%
FIREPLACES 420.69 0.38%
FRAMING & ROUGH CARPENTRY 860.87 0.77%
HEAT, VENT & AIR CONDITIONING 41.82 0.04%
INSULATION 2,265.41 2.02%
LIGHT FIXTURES 1,612.89 1.44%
MIRRORS & SHOWER DOORS 568.52 0.51%
PLUMBING 5,939.61 5.30%
PAINTING 11,186.73 9.99%
ROOFING 276.00 0.25%
SIDING 798.49 0.71%
SOFFIT, FASCIA, & GUTTER 84.04 0.08%
SPECIALTY ITEMS 1,210.80 1.08%
TILE 2,759.51 2.46%
TEMPORARY REPAIRS 687.30 0.61%
WINDOWS - ALUMINUM 4,116.22 3.68%
WINDOWS - SLIDING PATIO DOORS 803.59 0.72%
WINDOWS - SKYLIGHTS 621.76 0.56%
WINDOWS - VINYL 1,186.24 1.06%
Subtotal
Overhead @ 10.00%
Profit @ 10.00%
O &P Items Subtotal
Sales Tax @ 8.800%
Grand Total
47-M106-546R
Trade Summary
Total Dollars
85,773.17 76.59%
8,577.32 7.66%
8,577.32 7.66%
102,927.81
9,057.64
111,985.45
91.91%
8.09%
Page: 30
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January 2, 2004
Terrance Johnson
4725 South 104th Place
Tukwila, WA 98168
RE: Permit Application No. D03 -027
4725 South 104th Place
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 Uniform Building Code and /or Uniform Mechanical Code, every permit issued by the
Building Official 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 or request and receive an extension prior to February 24,
2004, 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,
Xc: Permit File No. D03 -027
Bob Benedicto, Building Official
City of Tukwila
Steven M Mullet, Mayor
Department of Community Development Steve Lancaster, Director
Stefania Spencer
Permit Technician
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
•••••,,•;•:":
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'CLINSTCONT ENERAL- :
REGIST....#, ,,-;EXP,•:DATE
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EitttTIVE DATE-- . . , ,.
DAKE CUSTOWCONSTRUCTIOWLLO—
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•:'.122012 234TH'AVEHSE.--•:'
':- MAPLE VALLEY 98038
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4. • .
, _.gnature ----
.' Issued by'DEPARTMENT OF LABOR AND INDUSTRIES
STATE OF WASHINGTON
COUNTY OF KING
AFFCONT 1/13/00
CITY OF T :WILA
Permit Center
6300 Southcenter Boulevard, Suite 100, Tukwila, WA 98188
Telephone: (206) 431 -3670
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
ss.
t t fro vot. A , states as follows:
P ERMIT CF.N F.Ft
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 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 RCVS/ 18.27.090, I
consider the work authorized under this building permit to be exempt under No. / 17< , and
will therefore not be performed by a registered contractor.
I understand that I may be waiving certain rights that I might otherwise have er state law in any decision to
engage an unregistered contractor to perform construction work.
APPLICANT
_= GE A. 4 \
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\5S10NF'••:'�' It
;' : o � NOTARy ; e
i : 0 r..«� co • j
i •• • • . ae.c -c.z a. x
.,%, op NOTARY PUBLIC in and fbr the State of Washington,
Signed and sworn to before me this
22vcl day of fan ua ry
residing at kfriq
7U I , ONI 1 A
c; l•r � or
3 22
H -4
,20 03 •
County.
Name as commissioned: Alice A. Deasy
My commission expires: 6 -16-64
18.27.090 Exemptions. This chapter shall not apply to:
1. 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;
2. Officers of a court when they are acting within the
scope of their office;
3. Public utilities operating under the regulations of the
utilities and transportation commission in
construction, maintenance, or development work
incidental to their own business;
4. 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;
5. 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 a structure;
6. 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;
7. 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;
8. 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;
9. Any work or operation on one undertaking or project
by one or more contracts, the aggregate contract
price of which for labor and materials and all other
items is less than $500, such work, or operations
being considered as of a casual, minor, or
inconsequential nature. The exemption prescribed in
this subsection does not apply in any 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
AFFCONT 1/13/00
of the operation is made into contracts of amounts
less than $500 for the purpose of 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;
10. 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 when
any of the above work is performed by a registered
contractor;
11. An owner who contracts for a project with a
registered contractor;
erson working on his own property, whether
pied by him or not, and any person working on
is residence, whether owned by him or not but this
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;
13. Owners of commercial properties who use their own
employees to do maintenance, repair, and alteration
work in or upon their own properties;
14. 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;
15. Any person who engages in the activities herein
regulated as an employee'of a registered contractor
with wages as his sole compensation;
16. 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.