HomeMy WebLinkAboutPermit D03-157 - BRANTON RESIDENCE - BATHROOMBRANTON
RESIDENCE
16303 45T" PLACE
SOUTH
D03 -157
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Parcel No.: 9314900110 Permit Number: D03 -157
Address: 16303 45 PL S TUKW Issue Date: 06126/2003 2
Suite No: Permit Expires On: 12/23/2003 0
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Owner: g a
Name: BRANTON KEN G Phone: W a
Address: 16303 45TH PL S, SEATTLE WA = w
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Contact Person:
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Name: KENNETH G. BRANTON Phone: 206 244 -3108 z O 1--
Address: 16303 45 PL S, TUKWILA, WA 1.1.1 uj
Contractor: 0 N
Name: OWNER AFFIDAVIT IN FILE Phone: ct (-
Address: , W Ui
Contractor License No: Expiration Date: H
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W Z
U
A
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Tenant:
Name: BRANTON RESIDENCE
Address: 16303 45 PL S, TUKWILA WA
DESCRIPTION OF WORK:
15 SQ FT TUB /SHOWER ADDITION TO EXISTING BATHROOM
Value of Construction: $ $1,386.00 Fees Collected: $88.57
Type of Fire Protection: N/A Uniform Building Code Edition: 1997
Type of Construction: VN Occupancy per UBC: 7
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 Public: N
Storm Drainage: N
Street Use: N Profit: N Non - Profit: N
Water Main Extension: N Private: N Public: N
N
Water Meter:
doc: Devperm
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Public Works Activities:
DEVELOPMENT PERMIT
** Continued Next Page'`*
D03 -157
Printed: 06 -26 -2003
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 construction or the performance of work. I am authorized to sign and obtain this development permit.
Signature:
doc: Devperm
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Print Name: 4n e0( (i%✓ p//
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 -157
Date: O(1�(cA -3
Printed: 06 -26 -2003
Parcel No.: 9314900110
Address: 16303 45 PL S TUKW
Suite No:
Tenant: BRANTON 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: 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.
5: Any exposed insulations backing material shall have a Flame Spread Rating of 25 or less, and material shall bear
identification showing the fire performance rating thereof.
6: 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).
7: 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 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:
doc: Conditions
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
ge/59/7
PERMIT CONDITIONS
D03 -157
Permit Number: D03 -157
Status: ISSUED
Applied Date: 05/27/2003
Issue Date: 06/26/2003
Printed: 06 -26 -2003
King Co Assessor's Tax No.:
Suite Number:
Tenant Name: .u _ n,_ ._,, n New Tenant: ❑ .... Yes E] ..No
Property Owners Name: tke riii. th G. Branton
Site Address: 1 X15 P1. So
Mailing Address:
CONTACTPERS
Name: T:ennet - h G. Rrnnton
Mailing Address: 16303 45 P1. So.
E - Mail Address: kndbranton(:bctzero. et
(GENERA CONTR GTOR' INFORMA;TIO
Company Name:
Mailing Address:
City State Zip
Day Telephone:
Fax Number:
Contact Person:
E -Mail Address:
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: OF.:RECORD , must be wet stamped by Archite Record.
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
L ENGINEER OF RECORD - All plans be wet byEngineer•of Record
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
.applications'pennit application (I.2003 )
1/2007
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 **
Page 1
Tukwila
City
�(A
Floor:
Stat Zip
Day Telephone: '206 - 244 - 3108
City
Fax Number: •
41y 98188 -•7710
Slate
98188 - 2710
Zip
City State Zip
Day Telephone:
Fax Number:
City State Zip
Day Telephone:
Fax Number:
x p.�: ^kis.:, tin: i��.::: ::; �a.:.::+' S•..+: sKd :>rylr�#:'tt+3��7,1 =J4- �,ai�:.�
Scope of Work"(please'provide detailed information):
Street Use:
❑ .. Street Use
Land Altering and /or Hauling:
❑ .. Land Altering: ❑...Cut
Storm Drainage:
❑ .. Storm Drainage ❑...Flood Control Zone
❑... Channelization /Striping ❑...Curb cut/Access/Sidewalk /
Sewer Information:
❑ .. City of Tukwila Sewer District ❑.. Val Vue Sewer District
❑ .. Sanitary Side Sewer ❑ .. Sewer Main Extension
Water Information:
0 .. City of Tukwila Water District ❑ .. Water District #125
❑ .. Water Main Extension 0.. Private ❑...Public
❑ .. Water Meter/Exempt: Size(s):
0.. Water Meter Permanent #:
❑ .. Water Meter Temporary #:
❑ .. Fire Loop /Hydrant (main to vault) #:
.. Miscellaneous:
Monthly Service Billing to:
Name:
Mailing Address:
kapplicationApermil eppliution (1 -2003)
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 0... Fill
er ... ❑
Page 3
❑...City of enton Sewer District
❑ .. Priva ❑ .. Public
❑... �(igh Water District
/ ❑ .. Deduct 0... Water Only
Size(s):
Size(s):
S e(s):
cubic yards
Day Telephone:
City State
Sewage Treatment ❑ Fire Line .... ❑
Day Telephone:
City
❑ .. Hauling
State
❑ .. City of Seattle Sewer District
❑...City of Renton Water District
❑ .. Est. Quantity: gallons
❑ .. Landscaping Irrigation
Zip
Zip
:BUILDING: PERMIT (RAIN '�
N ':2Q1 =431►; 670
r•i‘ . f . r ^ ��t •
)(Valuation of Project con aster' �t Existing Building d i
�(V j ( - e- �d-price): S G 5 GC Exis to Valuation: $ /ft 66.c
Scope of Work (please provide detailed information): A‘,.//1 tab/ Shc,.:'e'r l C Ai //, pc' t c bc. r/'Ge"
Will there be new rack storage? ❑...Yes [►.. No If "yes ", see Handout No. for requirements.
-Tr-Floor
2 a Floor
3`° Floor
Floors thru
Basement
Accessory Structure
• Attached Garage
Detached Garage •
Attached Carport
Detached. Carport
Covered Deck
Uncovered Deck
PLANNING DIVISION:
Single family building footprint (area of the foundation of a11 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? 0...Yes 0.. 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
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
0 .. City of Tukwila Water District 0.. Water District i125 Highline Water District ❑...City of Renton Water District
Sewer
0.. 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)
lappliationAperrnit application (1.2103)
(/2003
Existing
/6 f2
.35 - 7
Provide All Building Areas in Square Footage Below
Interior
Remodel
Page 2
Addition to
Existing
Structure
New
Type of
Construction
per UBC . .
Type of
Occupancy per
UBC
l.. :r..d,.2 ia-. v,.;::.iwii :;r,✓'.,: r`.� :� :G{w•i r » :.t✓F .. :. r. ?y, to
tt
Unit T yp e:: '
Q ty °
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/I,750,000 BTU
Heat/Refrig/Cooling
System
Incinerator - Domestic
Air Handling Unit
<= 10,000 CFM
Incinerator — Comm/Ind
MECHANICALr :PERK I7r�:
MECHANICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
FO :
KSii t ti
ION' 206 - 431 :367
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): S
Scope of Work (please provide detailed information):
Use: Residential: New .... ❑ Replacement .... ❑
Commercial: New .... ❑ Replacement .... ❑
Fuel Type: Electric ❑ Gas ....❑ Other:
Indicate type of mechanical work being installed and the quantity below:
PERM
IT:APPLICA�TION;�tOTE$ -; Applicable. to• all ; perinits; : iq't6i�applicatiot :
Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject
to possible revision by the Permit Center to comply with current fee schedules.
Expiration of Plan Review — Applications for which no permit is issued within 180 days following the date of application shall expire by limitation.
The Building Official may extend the time for action by the applicant for a period not exceeding 180 days upon written request by the applicant as
defined in Section 107.4 of the Uniform Building Code (current edition). No application shall be extended more than once.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER OR AUTHORIZED AGENT: /t) Signature: •, p,�lZZ�t ' Date: G r7/5 3
Print Name: i/ 6 3R,,44/TU /lf Day Telephone: 204 A4 -3/
Mailing Address: / �S // Se i 2
City State Zip
Date Application Accepted:
�- 7 �3
4tpplicationt*rmii application (1.2003)
1/2003
Date Application Expires:
Page 4
City State Zip
Day Telephone:
Fax Number:
Staff Initials:
ACCOUNT ITEM LIST:
Description
doc: Receipt
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 9314900110
Address: 16303 45 PL S TUKW
Suite No:
Applicant: BRANTON RESIDENCE
Payee: KENNETH BRANTON
Payment Cash
BUILDING - RES
STATE BUILDING SURCHARGE
RECEIPT
TRANSACTION LIST:
Type Method Description Amount
Account Code Current Pmts
000/322.100 50.95
000/386.904 4.50
Permit Number: D03 -157
Status: APPROVED
Applied Date: 05/27/2003
Issue Date:
Receipt No.: R03 -00782 Payment Amount: 55.45
Initials: SKS Payment Date: 06/26/2003 11:33 AM
User ID: 1165 Balance: $0.00
55.45
Total: 55.45
9941 06/26 971.6 TOTAL 55.45
Printed: 06 -26 -2003
Payee: KENNETH G. BRANTON
doc: Receipt
Payment Cash
ACCOUNT ITEM LIST:
Description
PLAN CHECK - RES
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
RECEIPT
Parcel No.: 9314900110 Permit Number: D03 -157
Address: 16303 45 PL S TUKW Status: PENDING
Suite No: Applied Date: 05/27/2003
Applicant: BRANTON KEN G Issue Date:
Receipt No.: R03 -00638 Payment Amount: 33.12
Initials: SKS Payment Date: 05/27/2003 09:37 AM
User ID: 1165 Balance: $55.45
TRANSACTION LIST:
Type Method Description Amount
33.12
Account Code Current Pmts
000/345.830 33.12
Total: 33.12
9013 05/28 9716 TOTAL 33-12
Printed: 05 -27 -2003
Project
ti e,fri
ei:e i 7 az-)
of Inspection
. _
Address:
,..."4_
Date Called:
27= o 3
Special Instructions:
Date Wanted:
7 r
Requester
Phone No
2(Z —211 -- 3/0E
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PER
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (2 6)431-3670
gk pproved per applicable codes. Corrections required prior to approval.
COMMENTS:
ipt No.:
Date:
In p tor: Dat
r,,....0.".. i
3 0 — 0 3
.00 REINSPECTION hEE REQUIRED. Prior to inspection, fee must be
d at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
. t .,`;" A • "
Project. -- 0
111D_____A r d .n ______p
Address:
__101115-- ?\
S
Type of Inspection:
wok t\ \f)
v
Date Called:
- 3 - 0 1 8 - 03
----...
Special Instructions:
Date Wanted:
7-)g-Q3
a.m.
.m.
Requester:
------e V\
Phone No:
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431-3670
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
k.d1/4)c.d \)0Gr 0 p roved
Receipt No.:
t (k)r - \i\ovi cr.
Date:
D $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Project: ` �
J�'f�AV�
Q Yk
Type of InARection:
-..-
r
vv 1- ear -✓' L )ri I / boar('
Address:
. X 303 � s
l s-
Date Called:
�7 — � - a 3
Special Instructions:
Date Wanted:
.
(
\
a.m.
p.m.
Requester: �`
i P ✓I
Phone No:
am(- 2- , -v- -\ - 3 I 0
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
Receipt No.:
qVC
v S -
Pl ✓•
0 $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
c
Projects
C I'Gt�
� Pri .
Type of Inspection:
. >\--" -e v 1A f )∎Pc , - A - L
Address: _
1 L
V\ 5
Date Called:
- 7-11-03
Special Instructions:
Date Wanted:
a.m.
p.m.
Requester:
�
Phone No:
206 7 L 1 - 1 — 31 OS
COMMENTS:
Receipt No.:
t
Date:
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. ° ° PERMIT N
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
A pproved per applicable codes. Corrections required prior to approval.
Inspector: '' _Dater -7`
El $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
".7
4
‘r
Project ,-
G VN`� v�
DI �
1° S
Type of Inspection:
L ' N-ek-e r % SkA4Y-4 Al
Address:
1 3 a
Date Called: I
3
Special Instructions:
D
to Wanted: a.m.
` ) - 1M - 03
Requester: i
IA
Phone No:
,-o ( 1 - .)-- L I - 31 c) 6
y
INSPECTION NO.
INSPECTION RECORD
Retain a ropy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
El Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
/00f ► �� d 10 4 ` Sig- P 1 ti�
( II (X otrotiv\A �a�-�1
`` 1X‘ Q o c\ 1 �C t � l I �
Inspector:
Ei $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:
D03- ;57
PER
NO
(2 • : )431 -3670
G
Date: `
S
Proj
RA Vt�Wn -1 4) S .
Type of Inspection:
Wc.1 t\ - I1\S j\cA IC/v.
All dr s:
O.. L i
. \
S
Date Called:
- 7-10-o - 5
Date Wanted:
- 1-11-0 . 3
a m
p.m.
Special Instructions:
Requester:
Le vk
Phone No:
(o- c. LI `. I OB
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERM!
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (2 a 6)' 31 -3670
A pproved per applicable codes. 0 Corrections required prior to approval.
COMMENTS:
Inspector:
Receipt No.:
Date:
El 6e
$47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must
paid at 6300 Southcenter Blvd., Suite 100, Call to schedule reinspection.
Date:
Proje t:
Type of Inspection:[ e'cz ---
cl
Addre s:
Date a ed:
Special instructions: ,L�
/� Le.i 4 / /«1,
`
•
Date Wanted:
6) 3
a.tn
Cp m
R equester
Phone No:
--2i/6 A Zy yZ -/oi3
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. P RMIT NO,
CITY OF TUKWILA BUILDING DIVISION +�� r►
6300 Southcenter Blvd., #100, Tukwila, WA 98188 r, (20)4 1 -3670
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
J
Date:
� �. iL
nspecto
ri $47.00 REINSPECTIO r EE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
Project*
Type of Inspection:
Address ix
Date Called:
Special Instructions:
Date Wanted:
a. m.`
Requester .
Phone No:
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
Approved per applicable codes.
COMMENTS:
Receipt No.:
PER
Cb.5 LIS'
(206)431 -3670
El Corrections required prior to approval.
Inspector:
Date:
Qom/ Date:
WHIN . g
$47.00 R INSPECTIO (EE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcen r Blvd., Suite 100. Call to schedule reinspection.
• K Bras
SEPARATE PERMIT
REQUIRED FOR:
[� MECHANICAL
ELECTRICAL
El PLUMBING
(� GAS PIPING
CITY OF TUKWI
BUILDING DIVISI
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r iLE COPY
stand that the Plan Check approvals are
to errors and omissions and approval of
was not authorize the violation of any
d ;ode or ordinance. Receipt of con-
's copy of approved plans acknowledged.
e
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CITY Of TUKWItA
APPROVED
J U t ?_ 6 (7 2oo3
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RECEIVED
Orrtr' cP TUKWILA
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NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEAR THAN
THIS NOTICE IT IS DUE TO THE QUALITY OF THE DOCUMENT.
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NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEAR - THAN
THIS NOTICE IT IS DUE TO THE QUALITY OF THE DOCUMENT.
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PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: 003 -157
PROJECT NAME: BRANTON RESIDENCE
SITE ADDRESS: 16303 45 PL S
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter #
DATE: 05 -27 -03
Revision # After Permit Is Issued
DEPARTMENTS:
Bui ding Division rj
Publi kg ti-o3
(45
Fire Prevention 0
(K t/ 2 q - C 6
Planning Division �]
Structural ❑ Permit Coordinator
DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 05 -29 -03
Complete d Incomplete ❑ Not Applicable ❑
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS RROTING:
Please Route Structural Review Required ❑ No further Review Required ❑
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS: DUE DATE: 06 -26 -03
Approved ❑ Approved with Conditions ii Not Approved (attach comments) ❑
Notation:
REVIEWER'S INITIALS: DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
Documents /routing slIp,doc
2.28.02
PERMIT COORD COPY
CITY OF JKWILA
Permit Center
6300 Southcenter Boulevard, Suite 100, Tukwila, WA 98188
Telephone: (206) 431 -3670
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
STATE OF WASHINGTON
COUNTY OF KING
AFFCONT 1/13/00
ss.
�'11 C• 5 eAvr,wil , states as follows:
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 RCW 18.27.090, I
consider the work authorized under this building permit to be exempt under No. /a , 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.
APPLICANT
Signed and sworn to before me this
2 b+A day of jiA
NOTARY PUBLIC in and f4 the State of Washington,
residing at _.kLy) 1G
Name as commissioned:
My commission expires:
H -4
, 20 0 .
County.
Alice, A. Deac y
f �,!�'.l.t;::r
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.