HomeMy WebLinkAboutPermit D03-155 - DONALDSON RESIDENCE - FIRE DAMAGE REPAIRDONALDSON
RESIDENCE
13533 37 AV S
D03 -155
Water Meter:
doc: Devperm
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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.: 8864000075 Permit Number: D03 -155 jE z
Address: 13533 37 AV S TUKW Issue Date: 05/21/2003 W 2
Suite No: Permit Expires On: 12/16/2003 6 U
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Tenant: J H
Name: DONALDSON RESIDENCE
Address: 13533 37 AV S, TUKWILA WA w O
2
Owner: 5
Name: DONALDSON KENNETH EDWARD +KA Phone: N a
Address: 13533 37TH AVE S, TUKWILA WA =
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Contact Person: ?
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Name: ROD ]ESMER Phone: 206 264 -0404 Z O
Address: P.O. BOX 53123, BELLEVUE, WA I
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Contractor: O co
Name: OWNER AFFIDAVIT - KENNETH DONALDSON Phone: o i—
Address: 13533 37 AV S, TUKWILA WA = w
Contractor License No: Expiration Date:05 /07/2004 I—
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DESCRIPTION OF WORK:
REPAIR FIRE DAMAGE. NO STRUCTURAL DAMAGE, REMOVE SHEETROCK, INSULATION, NEW WINDOWS (SAME FOR SAME). U
O ff '"
Value of Construction: $ $45,000.00 Fees Collected: $597.75
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: N
Water Main Extension: N Private: N
N
DEVELOPMENT PERMIT
D03 -155
Public: N
Non - Profit: N
Public: N
Printed: 07-28-2003
doc: Devperm
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Permit Center Authorized Signature:
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 constru on or the erformance of work. I am authorized to sign and obtain this development permit.
Signature: Date: 7 Z g ' 03
Print Name: PD. J S iv) . R
Date: 3
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.
D03 -155
Printed: 07 -28 -2003
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
z
Parcel No.: 8864000075 Permit Number: D03-155 i z
Address: 13533 37 AV S TUKW Issue Date: 05/21/2003
c4 2
Suite No: Permit Expires On: 12/16/2003 6 v
0
cn a
Tenant: CO I
N ame: DONALDSON RESIDENCE
Address: 13533 37 AV S, TUKWILA WA w p
Owner:
Name: DONALDSON KENNETH EDWARD +KA Phone:
Address: 13533 37TH AVE S, TUKWILA WA co a
F ..w
Contact Person: ?
'—
Name: VICTOR GUESS Phone: 206 - 312 -8631 z O
Address: 714 S HOMER ST, SEATTLE WA LU LIJ
U
Ca
Contractor: co
Name: OWNER AFFIDAVIT - KENNETH DONALDSON Phone: a '-
Address: 13533 37 AV S, TUKWILA WA = w
Contractor License No: Expiration Date :05 /07/2004 t— H
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REPAIR FIRE DAMAGE. NO STRUCTURAL DAMAGE, REMOVE SHEET INSULATION, NEW WINDOWS (SAME FOR SAME). v
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DESCRIPTION OF WORK:
Value of Construction: $ $45,000.00 Fees Collected: $597.75
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
' R.E 1> ( - t.
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: N
Water Main Extension: N Private: N
N
Water Meter:
doc: Devperm
DEVELOPMENT PERMIT
D03.155
Public: N
Non - Profit: N
Public: N
Printed: 07 -07 -2003
z
doc: Devperm
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Permit Center Authorized Signature:
I hereby certify that I have read and examined his permit and know the same to be true and correct. All provisions of law and
ordinances governing this work will be complied with, whether specified herein or not.
The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws
regulating construction or the performance of work. I am authorized to sign and obtain this development permit.
Signature:7 1Q r .,r-i Date: ` - c7
Print Name: key rpv (c/
Date:
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.
003 -155
Printed: 07 -07 -2003
Parcel No.: 8864000075
Address: 13533 37 AV S TUKW
Suite No:
Tenant:
Name: DONALDSON RESIDENCE
Address: 13533 37 AV S, TUKWILA WA
Owner:
Name: DONALDSON KENNETH EDWARD +KA
Address: 13533 37TH AVE S, TUKWILA WA
Contact Person:
Name: VICTOR GUESS
Address: 714 S HOMER ST, SEATTLE WA
Contractor:
Name: PHILO COMPANY INC
Address: 714 S HOMER ST, SEATTLE WA
Contractor License No: PHILOCI080MO
DESCRIPTION OF WORK:
REPAIR FIRE DAMAGE. NO STRUCTURAL DAMAGE, REMOVE SHEETROCK, INSULATION, NEW WINDOWS (SAME FOR
SAME).
Value of Construction:
Type of Fire Protection:
Type of Construction:
Water Meter:
doc: Devperm
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
$ $45,000.00
V -N
Public Works Activities:
Channelization / Striping: N
Curb Cut / Access / Sidewalk / CSS: N
Sanitary Side Sewer: N
Sewer Main Extension: N Private: N
Storm Drainage: N
Street Use: N Profit: N
Water Main Extension: N Private: N
N
DEVELOPMENT PERMIT
D03 -155
Permit Number: D03 -155
Issue Date: 05/21/2003
Permit Expires On: 11/17/2003
Phone:
Phone: 206 -312 -8631
Phone: 206 - 467 -8414
Expiration Date:05 /07/2004
Fees Collected: $597.75
Uniform Building Code Edition: 1997
Occupancy per UBC: 0007
Fire Loop Hydrant: N Number: 0 Size (Inches): 0
Flood Control Zone: N
Hauling: N Start Time: End Time:
Land Altering: N Volumes: Cut 0 c.y. Fill 0 c.y.
Landscape Irrigation: N
Moving Oversize Load: N Start Time: End Time:
Public: N
Non - Profit: N
Public: N
Printed: 05-21-2003
Permit Center Authorized Signature: f
The granting of this permit.do
regulating construction or t
Signature:
Print Name:
doc: Devperm
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
s s
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.
of presume to give authority to violate or cancel the provisions of any other state or local laws
ormance of work. I am authorized to sign and obtain this development permit.
Date: Sb-D / 3
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.
003 -155
Date:
Printed: 05 -21 -2003
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 8864000075
Address: 13533 37 AV S TUKW
Suite No:
Tenant: DONALDSON RESIDENCE
PERMIT CONDITIONS
Permit Number:
Status:
Applied Date:
Issue Date:
D03 -155
ISSUED
05/21/2003
05/21/2003
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.
I hereby certify that I have read these conditions and will comply with them as outlined. All provisions of law and
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
regulating construction or the performance of work.
Signature: tY-01
Print Name: k. e r)'1 r4_ at:4 d
doc: Conditions
Date: - 7 — 7 ` c)
003 -155
ordinances
or local laws
Printed: 07 -07 -2003
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 8864000075
Address: 13533 37 AV S TUKW
Suite No:
Tenant: DONALDSON 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.
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 • • - : • of presume to give authority to violate or cancel the provision of any other work or local laws
regulating construction or mance of work.
Signature:
Print Name:
doc: Conditions
c_Acr 44
PERMIT CONDITIONS
D03 -155
Permit Number: D03 -155
Status: ISSUED
Applied Date: 05/21/2003
Issue Date: 05/21/2003
Date: s/2. 0(
Printed: 05 -21 -2003
SITE;, LOCATION,
Site Address: 135 3 3
Tenant Name: kQ
Property Owners Name:
Mailing Address:
Name:
Mailing Address:
E -Mail Address:
Contact Person:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Contact Person:
E -Mail Address:
\applications \permit application (3.2003)
3/2003
CITY OF TUKWILA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
CONTACT PERSON
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.:
�7 A S - rtji.k;rt€. c if/ (4
bonaldson
5R M L
5
.5. h4 tr
GENERAL CONTRACTOR. INFORMATION
54- ce, att. c i if
Page 1
Suite Number:__
New Tenant:
City
ARCHITECT OF RECORD = All plans must be wet stamped by Architect of Record
ENGINEER OF RECORD All plans must be wet stamped by Engineer of Record
Floor:
.... Yes El ..No
State
Day Telephone: JO to 3 21 y& 3
City State
Fax Number: r; 70 & 9& y 93/
1
Company Name: P) • Win. T L .
Mailing Address: 7 i y .5 . 1 ..4 r S4- . <-514 h#6 Ai II- oi 810 &'
City
U ii State
L' -
t O r Day Telephone: c)-O L 3 - i SG 31
Fax Number: ,?D [7 L/ (, 7 9 4 3 /
State
Zip
Zip
Zip
Contractor Registration Number: p14-LL 0 C b' 9 m 0 Expiration Date: 5) -00'1
* *An original or notarized copy of current Washington State Cot tractor License must be presented at the Time of permit issuance **
Zip
City
Day Telephone:
Fax Number:
Company Name:
Mailing Address:
City State
Day Telephone:
Fax Number:
Zip
BUILDING PERMIT. INFORMATION.- 206- 431 -3670
Valuation'of Project (contractor's price): $ `'t 5 • D 0 Existing Building Valuation: $ / 5 / o'er • ° c'
Scope of Work (please provide detailed information): F r'e ReS•lorcttiovt — See lit)rI •c Op
Will there be new rack storage? ❑ ..Yes [].. No If "yes ", see Handout No. for requirements.
Number of Parking Stalls Provided: Standard:
tapplicationslpennit application (3.2003)
3/2003
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 documen ±:anon that shows that the principal owner lives in one of the dwellings as his or her primary residence.
Page 2
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 -112 x 11 paper indicating quantities and Material Safety Data Sheets.
Existing
Interior
Remodel
Addition to
Existing
Structure
New
Type of
Construction
per UBC
Type of
Occupancy per
. UBC
1 Floor
2 "° Floor
- 3 zt Floor
Floors thru
Basement
Accessory Structure*
Attached Garage .
Detached Garage
Attached Carport
Detached Carport .: .
Covered Deck
Uncovered Deck
BUILDING PERMIT. INFORMATION.- 206- 431 -3670
Valuation'of Project (contractor's price): $ `'t 5 • D 0 Existing Building Valuation: $ / 5 / o'er • ° c'
Scope of Work (please provide detailed information): F r'e ReS•lorcttiovt — See lit)rI •c Op
Will there be new rack storage? ❑ ..Yes [].. No If "yes ", see Handout No. for requirements.
Number of Parking Stalls Provided: Standard:
tapplicationslpennit application (3.2003)
3/2003
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 documen ±:anon that shows that the principal owner lives in one of the dwellings as his or her primary residence.
Page 2
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 -112 x 11 paper indicating quantities and Material Safety Data Sheets.
PUBLIC WORKS PERMIT INFO''''[ATION - 206 - 433 -0179
Scope of Work (please provide detailed information):
Water District
❑ ...Tukwila 0... Water District #125
❑ ... Water Availability Provided
Sewer District
❑ ...Tukwila ❑... ValVue ❑ .. Renton 0 ...Seattle
❑ ...Sewer Use Certificate 0... Sewer Availability Provided ❑ .. Approved Septic Plans Provided
❑ ...Septic System - For onsite septic system, provide 2 copies of a current septic design approval by King County Health Department.
Submitted with Application (mark boxes which apply):
❑ ...Civil Plans (Maximum Paper Size — 22" x 34 ")
❑ ...Technical Information Report (Storm Drainage)
❑ ...Bond ❑ .. Insurance ❑ .. Easement(s)
Proposed Activities (mark boxes that apply):
❑ ...Right -of -way Use - Nonprofit for less than 72 hours
❑ ...Right -of -way Use - No Disturbance
❑ ...Construction/Excavation/Fill - Right -of -way
Non Right -of -way
❑ ...Total Cut
❑ ...Total Fill
❑ ...Sanitary Side Sewer
❑ ...Cap or Remove Utilities
❑ ...Frontage Improvements
❑ ...Traffic Control
❑ ...Backflow Prevention - Fire Protection
Irrigation
Domestic Water
FINANCE INFORMATION
Water Meter Refund /Billing:
Name:
Mailing Address:
\applications \permit application (3.2003)
3/2003
Call before you Dig: 1 -800- 424 -5555
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
cubic yards
cubic yards
❑ .. Abandon Septic Tank
❑ .. Curb Cut
❑ .. Pavement Cut
❑ .. Looped Fire Line
ff
11
❑ .. Highline ❑ ...Renton
❑ .. Geotechnical Report ❑...Traffic Impact Analysis
❑ .. Maintenance Agreement(s) 0... Hold Harmless
❑ .. Right -of -way Use Profit for less than 72 hours
❑ .. Right -of -way Use — Potential Disturbance
❑ .. Work in Flood Zone
❑ .. Storm Drainage
Page 3
City
❑ .. Grease Interceptor
❑ .. Channelization
❑ .. Trench Excavation
❑ .. Utility Undergrounding
❑ ...Permanent Water Meter Size... WO#
❑ ...Temporary Water Meter Size.. WO#
❑ ...Water Only Meter Size 11 WO# ❑ ...Deduct Water Meter Size "
❑ ...Sewer Main Extension Public Private
❑ ...Water Main Extension Public Private
Fire Line Size at Property Line Number of Public Fire Hydrant(s)
❑ ... Water ❑ ...Sewer ❑ ...Sewage Treatment
Monthly Service Billing to:
Name: Day Telephone:
Mailing Address:
City State Zip
Day Telephone:
State Zip
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Boiler /Compressor:
Qty
Furnace <100K BTU
I
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 INt oRMATION —p6-431-3670
MECHANICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
City Stale 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:
Commercial:
Fuel Type: Electric
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 Codc (current edition). No application shall be extended more than once.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY Y IE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER OR. ' U it f ED AGENT:
Signature:
Print Name: L try r Glitt S .S
Mailing Address:
Date Application Accepted:
Date Application Expires:
1/- z& -3
S nitial
\applicationslpermit application (3.2003)
3/2003
New .... ❑ Replacement .... d
New .... ❑ Replacement .... ❑
❑ Gas ....Er Other:
Date: .Slag f 0
Day Telephone: _O to 30.1 8&0 3
714 S. /4-orr' -e t- w k I O
Page 4
City
State
Zip
Parcel No.:
Address:
Suite No:
Applicant:
Receipt No.:
Initials:
User ID:
ACCOUNT ITEM LIST:
Description
doc: Receipt
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
8864000075
13533 37 AV S TUKW
DONALDSON RESIDENCE
R03 -00622
BLH
ADMIN
Payee: PHILO COMPANY INC
TRANSACTION LIST:
Type Method Description
Payment Check 1022
BUILDING - RES
STATE BUILDING SURCHARGE
RECEIPT
Account Code
000/322.100
000/386.904
Permit Number:
Status:
Applied Date:
Issue Date:
Payment Amount: 597.75
Payment Date: 05/21/2003 10:07 AM
Balance: $0.00
Amount
597.75
Current Pmts
593.25
4.50
Total: 597.75
003 -155
APPROVED
05/21/2003
8882 05/21 9716 TO'T'AL 597.75
Printed: 05 -21 -2003
COMMENT` t-- e�J 9 <N.'S (* E-vv'e o -t ∎ x•...) 5 — C gW\f t €
- �
�P_,r dv1 l 1- 0 pi e
�(... ,
Date Called:
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Special Instructions:
' /� i Y 3 O
Date W nteck
Requester: , d-\
•
P G eNo.
.
' ,4
■
Pl'oj ct:
1 1r) 0 (1./edgerk? A0.4 ,
Type of Inspection:
HI tae)L-
Address: _7 /� I `
I -* 57 3-, C
Date Called:
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Special Instructions:
' /� i Y 3 O
Date W nteck
Requester: , d-\
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P G eNo.
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
Approved per applicable codes.
INSPECTION RECORD
Retain a copy with permit
X
PER IT
!•,
31 -3670
❑ Corrections required prior to approval.
�---. Date:
&. ) . 1 mac. ..) C- It -
U $4 REINSPECTION FEE REQUIRED. Prio to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.: Date:
Prrect:
Type of I spe tion:
•
Ac ress:
1 37 AV c 4
Date Called:
1
i
/(P
Special Instructi6ns:
Date Wanted:
_ 1
-)
�()' (p• .
Requester: c
//().'
P"e5c -- 3
32
___(.45)067
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
1251 ,6pproved per applicable codes. El Corrections required prior to approval.
COMMENTS:
.a- -.n.4.._)
Date:
(206)431 -3670
7.00 REINSP CTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
COMMENTS:
0?) .-Sc5o*L c d 0 r i- SI ci -01 0 47
,
m.r 2ILCI11
A dr - s•
37 Al),Se
Date Called: *3
Date Wanted: ,
/ s-
i
a.m.
) J.T G rckl-e r ,, -P t S - \ a
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INSPECTION RECORD
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INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
El Approved per applicable codes.
Inspector: Q
2 Corrections required prior to approval.
Date: i ? _ f
$47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
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INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
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( 06)431 -3670
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INSPECTION RECORD
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INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (2
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
11 $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
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CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
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(206)431 -3670
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INSPECTION NO. PERMIT • .
CITY OF TUKWILA BUILDING DIVISION 'Ail .1
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206) , 31 -3670
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INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
El Approved per applicable codes.
El $47.00 REINSPECTIO FEE REQUIRED. Prior to inspection, fee must be
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6300 Southcenter Blvd., #100, Tukwila, WA 98188 (20
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INSPECTION RECORD
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6300 Southcenter Blvd., #100, Tukwila, WA 98188
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AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
STATE OF WASHINGTON
COUNTY OF KING
AFFCONT 1/13/00
.id
CITY OF TUKWILA
Permit Center
6300 Southcenter Boulevard, Suite 100, Tukwila, WA 98188
Telephone: (206) 431 -3670
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 18.27.000:
3. I understand that prior to issuance of a building permit for work which is to be done by any
contractor, the City of Tukwila must verify either that the contractor is registered by the State of
Washington, or that one of the exemptions stated under RCW 18.27.090 applies.
4: In order to provide verification to the City of Tukwila of my compliance with this requirement, I hereby
attest that after reading the exemptions from the registration requirement of RCW 18.27.090, I
consider the work authorized under this building permit to be exempt under No. /Z• , and
will therefore not be performed by a registered contractor.
I understand that I may be waiving certain rights that I might otherwise have under state law in any decision to
engage an unregistered contractor to perform construction work.
ss.
, states as follows:
0 ,-„Joexzerz---
APPLICANT
Signed and sworn to before me this
71 day of 3-14 /y
H -4
, 20 V3
621,,ae,
NOTARY PUBLIC in an he State of Washington,
residing at Al n5
Name as commissioned: Alice A. De0.C
My commission expires: 6 ~ / 6 - 0
County.
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;
12. Any person working on his own property, whether
occupied by him or not, and any person working on
his residence, whether owned by him or not but 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.
LICENSE DETAIL INFORMATION Form Page 1 of 2
Current Filter: None
STATE OF WASHINGTON
DEPARTMENT OF LABOR AND INDUSTRIES
Specialty Compliance Services Division
P. O. Box 44000 Olympia, WA 98504 -4000
THE RESULT OF YOUR INQUIRY FOR LICENSE NUMBER SELECTED IS:
LICENSE DETAIL INFORMATION
Registration# or License PHILOCI080MO
Name PHILO COMPANY INC
Address 714 S HOMER ST
Address
City SEATTLE
State WA
Zip 98108
Phone Number 2064678414
Effective Date 7/20/1992
Expiration Date 5/7/2004
Registration Status ACTIVE
Type CONSTRUCTION CONTRACTOR
Entity CORPORATION
Specialty Code GENERAL
Other Specialties
UBI Number 601352731
*VIEW CROSS REFERENCE FILE FOR THIS LICENSE* * *
*VIEW PRINCIPAL OWNER(S) FOR THIS LICENSE* * *
*VIEW CONTRACTOR BOND /SAVINGS INFORMATION * * *
*CHECK INQUIRY FOR SUMMONS AND COMPLAINTS* * *
* VIEW CONTRACTOR INSURANCE INFORMATION * * *
New inquiry by CITY , NAME , PRINCIPAL OWNER NAME , LICENSE , UBI
NUMBER , check the
L&I Contruotor Industrial Ilnsurunmc Premium Status . or return to the L &I Construction
Compliance_Hontc Page
https : / /wws2.wa.gov /lni/bbip /TF2Form .asp ?License= PHILOCI080MO
05/21/2003