HomeMy WebLinkAboutPermit D03-039 - LEABO RESIDENCE - GARAGE DEMOLITIONLEABO DEMOLITION
4320 S 150 ST
EXPIRED
D03 -039
Value of Construction:
Type of Fire Protection:
Type of Construction:
Public Works Activities:
doc: Devperm
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 0042000085
Address: 4320 S 150 ST TUKW
Suite No:
Tenant:
Name: LEABO RESIDENCE
Address: 4320 S 150 ST, TUKWILA WA
Owner:
Name: GREENRIDGE HOMES
Address: 6855 176 NE, #235, REDMOND WA
Contact Person:
Name: DON LEABO
Address: 6855 176 NE, #235, REDMOND WA
Contractor:
Name: GREENRIDGE HOMES LLC
Address: 6855 176TH AVE NE #235, REDMOND WA 98052
Contractor License No: GREENHLOO2PK
DESCRIPTION OF WORK:
DEMOLISH 340 SQ FT DETACHED GARAGE.
$900.00
DEVELOPMENT PERMIT
D03 -039
Permit Number: D03 -039
Issue Date: 02/20/2003
Permit Expires On: 08/19/2003
Phone: 800 - 892 -8462
Phone: 800 - 892 -8462
Phone: 800 - 892 -8462
Expiration Date: 10/15/2004
Fees Collected: $51.50
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.
Landscape Irrigation: N
Moving Oversize Load: N Start Time: End Time:
Sanitary Side Sewer: N
Sewer Main Extension: N Private: n Public: n
Storm Drainage: N
Street Use: N
Water Main Extension: N Private: n Public: n
Water Meter:
Channelization / Striping:
** Continued Next Page **
Printed: 02 -20 -2003
Permit Center Authorized Signature:
doc: Devperm
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
D03 -039
Date:
0 (€90/03
/I
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 t 'ermit does not pre me to give authority to violate or cancel the provisions of any other state or local laws
regulating cons on or the .erfor• ce of work. I am authorized to sign and obtain this developmgnt permit.
Signature: Date: Z
Print Name:��
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: 02 -20 -2003
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Signature:
Print Name:
doc: Conditions
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 0042000085
Address: 4320 S 150 ST TUKW
Suite No:
Tenant: LEABO 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: 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.
4: 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).
5: 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.
6: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * **
7: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation
off -site or into existing drainage facilities.
8: 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.
9: 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.
10: The site shall have permanent erosion control measures in place as soon as possible after final grading has been
completed and prior to the Final Inspection.
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 constructi.j or the performanc>.f work.
c 4a Ai 4 4.5AgE)
PERMIT CONDITIONS
D03 -039
Permit Number: D03 -039
Status: ISSUED
Applied Date: 02/03/2003
Issue Date: 02/20/2003
Date: 2-- ?- d
Printed: 02 -20 -2003
Site Address:
Tenant Name:
Property Owners Name: 0 N
Mailing Address: f 65– (7 7 N6 /Z 3 J
Name: A N Day Telephone: y eP 5
Mailing Address: 'PJV X76 A-ie J2 J� /kdN49, w1-- 7d 52--
City '' `` State Zip
E -Mail Address: do IA (e4�. –
/ �l �./d- /• c — 7� SS ZD 3Z_
lOt� �' � r Fax Number: or —
[GENERAL CONT
Company Name: 6 c e5
(7& ,JE X2.3
Mailing Address:
Contact Person: D
E -Mail Address: Jdk t% v 4 / », l . co ti
Contractor Registration Number: 44 1 - K� HZ. Do ZPK
Expiration Date: / '(-C "d t
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
ARCHITECT OF RECORD - All plans must be wet stamped by Architect of Record
Name:
Mailing Address:
Contact Person:
E -Mail Address:
ENGINEER OF RECORD = All plans must be wet stamped by Engineer of Record
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
\applicationsspermit 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 **
: CTOR INFORMATION
Page l
Building Permit 3-
Mechanical Permit No
Public Works Permit No
(For office use 'only) ' '... .
King Co Assessor's Tax No.:
Suite Number:
New Tenant:
City
Fax Number:
Floor:
E1 .... Yes E ..No
t k ° ` ■J# Cce
S to Zip
c,t,,4 ft
City / State Zip
Day Telephone: l'et 2 -
� 24' S' 'p- 20 3 2 —
City
Day Telephone:
Fax Number:
State
State
Zip
Zip
City
Day Telephone:
Fax Number:
s.c.k�rbaa�n.n:pd2.ch.; !:'. iatir�: 'u& `�F ;a.F,.w:ika2idG+is
BUILDING PERMIT. INFORMATION - 206 -431 -3670
.. 22 . ,. .. �
Valuation of Project (contractor's bid price): $ 900. 00 Existing Building Valuation: $ — C9---
Scope of ork (please provide detailed information):
t 64/-o 1:47 cf- ( r ?‘/ z
Will there be new rack storage? ❑... Yes a:'.No If "yes ", see Handout No.
\application \petntit application (1.2003)
1/2003
Page 2
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 ❑...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 0.. Water District i#125 ❑... Highline Water District ❑...City of Renton Water District
Sewer
❑ .. City of Tukwila Sewer District 0.. Val Vue Sewer District ❑...City of Renton Sewer District ❑...City of Seattle Sewer District
0.. 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)
.1W.:i::'�.- .�i.r?w::..d,LhL:t r 4t 4 -. Ha �• r tl i� kt!
2222. _ � .�..�.r,.iv:a .:.,;, . a:{v'sy'^.j,'� s.�- y.�.— ..�5.... 3s�.'�•. •�y.'�r
�.r ?at�'ier
Existing
Interior
Remodel
Addition to
Existing
Structure
New
Type of
Construction
per UBC
Type of
. Occupancy per
UBC
1' Floor
gnu Floor
,
3 Floor
,
Floors thru
Basement
Accessory Structure*
Attached .Garage.
•
Detached Garage
f ZO r
dew
.
.
.
Attached Carport
Detached Carport
Covered Deck
Uncovered Deck
•
BUILDING PERMIT. INFORMATION - 206 -431 -3670
.. 22 . ,. .. �
Valuation of Project (contractor's bid price): $ 900. 00 Existing Building Valuation: $ — C9---
Scope of ork (please provide detailed information):
t 64/-o 1:47 cf- ( r ?‘/ z
Will there be new rack storage? ❑... Yes a:'.No If "yes ", see Handout No.
\application \petntit application (1.2003)
1/2003
Page 2
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 ❑...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 0.. Water District i#125 ❑... Highline Water District ❑...City of Renton Water District
Sewer
❑ .. City of Tukwila Sewer District 0.. Val Vue Sewer District ❑...City of Renton Sewer District ❑...City of Seattle Sewer District
0.. 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)
.1W.:i::'�.- .�i.r?w::..d,LhL:t r 4t 4 -. Ha �• r tl i� kt!
2222. _ � .�..�.r,.iv:a .:.,;, . a:{v'sy'^.j,'� s.�- y.�.— ..�5.... 3s�.'�•. •�y.'�r
�.r ?at�'ier
PUBLIC WORKS PERM IT INF:v.RMATION‘ =206- 433 -0179
Scope of Work (please provide detailed information):
Street Use:
❑ .. Street Use
Land Altering and /or Hauling:
❑ .. Land Altering: ❑...Cut
❑... Channelization /Striping
Storm Drainage:
❑ .. Storm Drainage ❑...Flood Control Zone
Monthly Service Billing to:
Name:
Mailing Address:
\ipplicationApcnnit application (1-
1/2003
Water... ❑
Water Meter Refund /Billing:
Name:
Mailing Address:
Call before you Dig: 1- 800 - 424 -5555
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
cubic yards ❑... Fill
❑...Curb cut/Access /Sidewalk
City
Sewer ... ❑ Sewage Treatment
Page 3
City
cubic yards ❑ .. Hauling
Sewer Information:
❑ .. City of Tukwila Sewer District 0.. Val Vue Sewer District ❑...City of Renton Sewer District ❑ ..City of Seattle Sewer District
❑ .. Sanitary Side Sewer ❑.. Sewer Main Extension [] .. Private 0.. Public
Water Information:
❑ .. City of Tukwila Water District ❑ .. Water District #125 0... Highline Water District 0... City of Renton Water District
❑ .. Water Main Extension ❑ .. Private ❑ ... Public
❑ .. Water Meter/Exempt: Size(s): ❑ .. Deduct ❑ ...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:
Day Telephone:
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 >100K 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
Hood
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:
Print Name:
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 .... El
Commercial: New ....0 Replacement .... E]
Fuel Type: Electric Ej 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 CERTIF j HAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PE BY THE LAWS 0 HE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING O R 'j R AUT ENT:
Signature:
Day Telephone: ,S
Mailing Address: 6 f.r (760 N 4 i 2 -3 r , — W/9 5".
Cit� State Zip
Date Application Ac epted:
Cc) D3 03
\applications \permit application (1.2003)
)/:003
Date Application xpires:
0r 03 6
Page 4
Date: �.3/ 3
Staff Initials:
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RECEIPT ,...._
re L u
6 =
-J 0
Parcel No.: 0042000085 Permit Number: D03-039 o 0
w 0
i Address: 4320 S 150 ST TUKW Status: APPROVED u) UJ
UJ 1
Suite No: Applied Date: 02/03/2003 -.I I-
A p p I i c a n t: LEABO RESIDENCE Issue Date:
La 0
g 5
Receipt No.: R03-00203 Payment Amount: 51.50
2 2 el
Initials: LAW Payment Date: 02/20/2003 10:45 AM Ii_ W
User ID: 1630 Balance: $0.00 i
Z 1--
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Z I-
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2 D
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0
0 -
0 I-
' TRANSACTION LIST: W u l
Type Method Description Amount 1:0
9 - - 0
Payment Check 7644 51 .50 Z
1 Lii (i)
0 z .- :
P -'-
0 1—
z
Payee:
doc: Receipt
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188/ (206) 431-3670
DON LEABO
ACCOUNT ITEM LIST:
Description
BUILDING - NONRES
STATE BUILDING SURCHARGE
Account Code Current Pmts
000/322.100
000/386.904
4 7 . 00
4 . 50
Total: 51.50
32/21 '2716 TOTAL 51 50
Printed: 02-20-2003
- ' -
Project:
Type opplIpection: .
Address:
5L-1 1 -1- - SDI i 5 5+
Date Called:
e 1 ig. (O
Special Instructions:
•
Date Wanted: a.m.
(47 a? (
Requegt •
el ( ((
Ph (g : 3 5.5. Z
'16
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 981 88
(206)431-3670
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
' 6Citi`k4
Inspector q
Date: 9-
$47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
4
234'
2 32'
230'.
•
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•
•
•
• 111
go
AN
wm
rtrn=2;0.1
inv(12 cpvc N
Inv(12"cpvc(
CS F1L
PROTECTS
(SEE DET.
12"decid.
_ .
219.6
OM
FILE Cn2Y
undetOand-that the Plan CI ck eppro ids a e
subjectlo errors and omisilis and approval
plans do s not authorize the iolation o any
adopted ; ode or ordinance. eceipt of con-
tractors c'py of a *proved pl ns acknowle
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--------
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111104
6' chain
link fenc
14"decld.
— 1
,1 garage I
'61) BE REMOVED)
L _
230--
0
Li
192.78'
curb cut
EXISTING CONTOUR
(TYP.)
wrn
PROPOSED CONTOUR
(TYP)
E
shed (SHED TO BE
I REMOVED
30.11\
_
v;11j
r
Existing
House #4320
L _J
nmarke
? ult 20.0'
N88'09
010
.■•■•••••""
20.0'
i"
curb cut
RECEIVED \
CITY OF TUKWI
1)
FEB - ) 00
PERMIT NT
21"dect
.., 2 : 2"deaje
decid.
I
110
: 1
;
O 1
0 ir 0
soclig
2OdecI
ex. conc. walk
4"decld.
FILTER FABRIC SILT FENCE
PLACE AS SHOWN
(SEE DET. SHT. 4)
decid.tree
e 0
6' chain
link fenc
Ai
IRIC SILT FENCE
SHOW
SHT. 4)
MITS
..D
s\--D \ FABLI FENCE
7
PLACE \ (SEE DET. SHT.
238'
-.• • • • ■• •
Zt
216.5 ,
:&N->S) 210.7
co
m r' r:VOSIC) 3
06,0 ,
kr..11. BE MADE TO
-" .
.. suiLcro
WILL riaZIVRE A NEW P% SUBMITTAL
d
. of yard
ion
Dmh \
rim=2234
Inv(S)=219,4
House
#4310
' 4 9.o1'
1 8 \\\ -1-
. \
\ EXIST. L1RIVEWAY
\ REMf4IN
. N \... r
Inv 12 CPV
\ north end
...• 5.18
South 150th Street
CLEARING TS
(TYPICAL)
S88'05 192.85'
Guy Of TOMO
APPROVED
FEB 1 PO3
w
QUARRY SPALL CONSRUCTION ACCESS
PAD: 50' LONG x 15' WIDE
(SEE DET. SHT.
•
g
curb
July 3, 2003
Don Leabo
6855 176TH NE, #235
Redmond, WA 98052
RE: Permit Application No. D03 -039
4320 S 150th St
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:
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 August 19,
2003, 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,
Stefania Spencer
Permit Technician
Xc: Permit File No. D03 -039
Bob Benedicto, Building Official
City of Tukwila
• Call the City Of Tukwila Permit Center at (206) 431 -3670 to arrange for the next or final
inspection.
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
4!
ACTIVITY NUMBER: D03 -039 DATE: 02 -03 -03
PROJECT NAME: Don Leabo Residence — Garage demolition
SITE ADDRESS: 4320 S 150 St
_Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # Revision # After Permit Is Issued
DEPARTMENTS:
Building Division Ii
Public Works
(3S ,1 (' 2 -03
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete FO
I
TUES/THURS ROUTING:
Please Route F Structural Review Required
APPROVALS OR CORRECTIONS:
Approved ❑
Notation:
Documents/routing slip.doc
2.28.02
PLAN REVIEW /ROUTING SLIP
M5 1 7 2.
Fire Prevention
Structural
Incomplete ❑
REVIEWER'S INITIALS:
CP
Planning Division
No further Review Required
DUE DATE: 03-04 -03
Permit Coordinator
DUE DATE: 02 -04 -03
Not Applicable ❑
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
REVIEWER'S INITIALS: DATE:
Approved with Conditions t Not Approved (attach comments) C
D ATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
l 4:af9c:.r'.�;
:•w .1C;1'*}r�'�;; :`u`t'lb;i+t.. �in..,:? 4,,
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL.
REGIST. # EXP. DATE:'
CCO1 GREENHLOO2PK 10/15/2004
EFFECTIVE DATE 10/12/2000
GREENRIDGE HOMES LLC
6855 176TH AVE NE #235
REDMOND WA 98052
Signature
Issued by DEPARTMENT OF LABOR AND INDUSTRIES
�� .. _t�Ua.r .;;,:j:i .: 4�7; �.: �i: Xx.,;:. �: ��:: eui�. �i�i 'Cn:•.'��:�iu'.:. �`ioA.:':i,a,i:;ttyw::.�r