HomeMy WebLinkAboutPermit D03-235 - WHITE RESIDENCE - FENCEWHITE RESIDENCE
14475 58T" AVENUE
SOUTH
D03 -235
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City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 3365900647
Address: 14475 58 AV S TUKW
Suite No:
Tenant:
Name: WHITE RESIDENCE
Address: 14475 58 AV S, TUKWILA WA
Owner:
Name: SCHROETER RICHARD L Phone:
Address: PO BOX 813, SEAHURST WA
Contact Person:
Name: RON WHITE Phone: 206 - 794 -6933
Address: 14475 58 AV S, TUKWILA WA
Contractor:
Name: OWNER AFFIDAVIT IN FILE Phone: 206 794 -6933
Address: 14475 58 AV S, TUKWILA WA
Contractor License No: Expiration Date:
DESCRIPTION OF WORK:
CONSTRUCT A 7 -FOOT FENCE WITH ADDITIONAL 1 -FOOT OF LATTICE FENCE THAT FOLLOWS A LEVEL HORIZONTAL
LINE WILL HAVE POSTS CEMENTED AND WILL USE CEDAR, OUTDOOR REATED AND PRESSURE TREATED WOOD. SEE
PHOTOS AND LETTER SUBMITTED WITH APPLICATION.
Value of Construction: $ $1,200.00 Fees Collected: $78.50
Type of Fire Protection: Uniform Building Code Edition: 1997
Type of Construction: Occupancy per UBC: 0007
Channelization / Striping: N
Curb Cut / Access / Sidewalk / CSS: N
Fire Loop Hydrant:
Flood Control Zone:
Hauling:
Land Altering:
Landscape Irrigation:
Moving Oversize Load:
Sanitary Side Sewer:
Sewer Main Extension:
Storm Drainage:
Street Use:
Water Main Extension:
doc: Devperm
Public Works Activities:
N
DEVELOPMENT PERMIT
Private:
Profit:
Private:
D03 -235
Permit Number: DO3 -235
Issue Date: 08/11/2003
Permit Expires On: 02/07/2004
Number: 0 Size (Inches): 0
Start Time: End Time:
Volumes: Cut 0 c.y. Fill 0 c.y.
Start Time: End Time:
Public:
Non - Profit:
Public:
Printed: 08 -11 -2003
...v
.L.. .�. '.. ,�r:�r�„ :t.;e, •�.•' �+:3:'s ✓ Il. � 7�« �r {x�¢ .4vw '.il:.�
Water Meter: N
doc: Devperm
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
** Continued Next Page **
D03 -235
Printed: 08 -11 -2003
Signature:
Print Name:
doc: Devperm
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Permit Center Authorized Signature:
AM&
D03 -235
Date:
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 ' f.this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws
regulating con • u'on or t manc of work. I am authorized to sign and obtain this development ermit.
` Date: g[1( � Q D
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: 08 -11 -2003
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 3365900647
Address: 14475 58 AV S TUKW
Suite No:
Tenant: WHITE 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: Notify the City of Tukwila Building Division prior to placing any concrete. This procedure is in addition to any
requirements for special inspection.
6: 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 . is permit does not presume to give authority to violate or cancel the provision of any other work or local laws
regulating con- r ction or the performance of work.
Signature:
Print Name:
doc: Conditions
PERMIT CONDITIONS
D03 -235
Permit Number: D03 -235
Status: ISSUED
Applied Date: 08/04/ 2003
Issue Date: 08/11/2003
Date: 0 3 7
.
Printed: 08 -11 -2003
7! r¢ t, .'w+i:V+.l$ {r.{ {,i�:.%.iS.'� ?'S
?:SITE I OCATI.
Site Address: 14 15"
Tenant Name:
Property Owners Name:
Mailing Address:
.;CONTACTPERS
Name:
Mailing Address: a%&
E -Mail Address: (Z' W v,.1 2
',GENERALCONTRACTORINFORMATION
Company Name:
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
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 **
O‘n I.. 11114)
City
CS, Own
Page 1
King Co Assessor's Tax No.: , Xo ?2O
Suite Number:
New Tenant:
Day Telephone:
City
Fax Number:
State
Floor:
❑ .... Yes ❑ ..No
1 eq— qff/ /AP
State Zip
Zip
Mailing Address:
State Zip
City
Day Telephone:
Fax Number:
t •
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 **
State
Zip
City
Day Telephone:
Fax Number:
Company Name:
Mailing Address:
State
Zip
City
Day Telephone:
Fax Number:
,ARCHITECT:OF::RECORD: All plans must be,wet stamped by Achitecofltecord,
A
WOMMA w ~ uw w'+'dzdJ�Gdat elL' ,
1$ UIL111Plhr ' YL+'JliMi?1'1Plk'tlxm".1.1 ,N•' ` �GU,d F�1- �dIUI
::�.•fyj"•,`:T .A - ;1.�.:..,�.!'t. .�'. �j T �}:�3.l F i'::..Tw'�•: �i •..i J. 'Ii
....xtr �.�t•r 1 t ���_:;:. ,�,,; r i :•?5` �"����a�k r�,+ti�F�.TMt "r..��t�. �t,;,. ;• :t
i'3-'. -- -. -_ t `. , � °: o+f'.: lam, .. ,^ oM.i�i`,•.b; *'� ..
n . r ry, /
Valuation of Project (contractor's bid price): I, d ,0n Existing Valuation: $
Scople of Work (please provide detailed information):(, Sk \JJ O
- b t i l,C T-tv1P, —tW 4 t\ 0,0S 4z124.9 Q
\\ V.a, 0 .
tAkpoo Lobo' . pwm- U Su 101M`I \— (,c�) AfpGit6thm.
' Om 1(a . W p 11) 1 : tYILL Oil I I st jiu
Will there be new rack storage? .. Yes
rovide •Al1•Building'Areas in Square Footage Below .:..
l' Floor •..
2 "
3`d Floor •
Floors
ru •
Basement:::
Accessory. S tructures , .
Attached Garage-
Detached.Garage ,
Attached: Carport
Detached: Carport.;.
Covered Deck
Uncovered. Deck
Addition :to
Existing ..;'
Structure
Type of
Construction
per.UBC
• Type .of. , .
:.
Occupancy per
UBC
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? 0 ....Yes ❑ ..No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
❑ .. Sprinklers ..Automatic Fire Alarm p ..None J . 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.
'applicationslpermit application (3.2003)
3/2003
. No If "yes ", see Handout No. for requirements.
Pagc 2
C
Scope of Work (please provide detailed int..mation):
Water District
❑ ...Tukwila 0... Water District #125
❑...Water Availability Provided
Sewer District
❑ ...Tukwila
❑ ...Sewer Use Certificate
Please refer to. Public Works Bulletin #1 for fees: and estimate sheet.
❑... ValVue ❑ .. Renton ❑ ...Seattle
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 cubic yards
❑ ...Total Fill cubic yards
❑...Sanitary Side Sewer
❑ ...Cap or Remove Utilities
❑...Frontage Improvements
❑ ...Traffic Control
❑ ...Backflow Prevention - Fire Protection
Irrigation
Domestic Water
❑ ...Permanent Water Meter Size...
❑...Temporary Water Meter Size..
❑ ... Water Only Meter Size
❑ ...Sewer Main Extension Public _
❑ ...Water Main Extension Public
FINANCE INFORMATION
Fire Line Size at Property Line
❑ ...Water ❑ ... Sewer
Monthly Service Billing to:
Name:
'applications permit application (3 -2003)
3/2003
„
„
Call before you Dig: 1- 800 - 424 -5555
❑ .. Abandon Septic Tank
❑ .. Curb Cut
❑ .. Pavement Cut
❑ .. Looped Fire Line
WO#
WO#
WO#
Private
Private
0 .. Highline
❑ .. Geotechnical Report ❑...Traffic Impact Analysis
❑ .. Maintenance Agreement(s) ❑...Hold Harmless
❑ .. Right -of -way Use - Profit for less than 72 hours
❑ .. Right -of -way Use — Potential Disturbance
❑ .. Work in Flood Zone
❑ .. Storm Drainage
Number of Public Fire Hydrant(s)
❑ ...Sewage Treatment
❑ ...Deduct Water Meter Size
Day Telephone:
Mailing Address:
City State Zip
Water Meter Refund/Billing:
Name:
Mailing Address:
Page 3
n 3 fit3hi. ��S�c' 6: Gw�J` M Tivi:1.Vhu'dS:KE°aliVIISy'YkR'+A.'K. VARAA, 1itSi+ r' rOwammonA "
Day Telephone:
City
❑ ...Renton
❑ .. Grease Interceptor
❑ .. Channelization
❑ .. Trench Excavation
❑ .. Utility Undergrounding
State
Zip
IzJ.vkb:.iw»;
Unit T e:'
Type:
Qty
Type � ,
.Qty:
Unit T e:
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
ZE ClIANICA L:TERMIT. 206-431367
^ �''�` g kl' 'q 5 :' t te r . ' :
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 ....❑ Replacement .... ❑
Commercial: New ....❑ Replacement ....
Fuel Type: Electric ❑ Gas ....❑ Other:
Indicate type of mechanical work being installed and the quantity below:
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
Signature:
'appliationslpermit application (3.2003)
3/2003
Print Name: D n LM,l
ZED(IGENT:
1 T .- 71 - n Mailing Address: I �441'6 'J
�IVt'/ •
Page 4
Date: )1A , �/'
,f 0
Day Telephone: 990 i tf • /{/mil
- Pv_t(d.► I cl, q( g
Ci ty State Zip
Date Application Accepted:
Date Application Expires:
z
S t nitials:
i
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Parcel No.: 3365900647 Permit Number: D03 -235 6 v
Address: 14475 58 AV S TUKW Status: APPROVED v p
Suite No: Applied Date: 08/04/2003 co w
Applicant: WHITE RESIDENCE Issue Date: -J H
w
Receipt No.: R03 -00983 Payment Amount: 49.35
co
Initials: SKS Payment Date: 08/11/2003 02:54 PM H w
User ID: 1165 Balance: $0.00 z H
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Type Method Description Amount H H
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Payment Check 3669 49.35 LLiZ
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0
Payee:
TRANSACTION LIST:
ACCOUNT ITEM LIST:
Description
doc: Receipt
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
T. L. WHITE
BUILDING - NONRES
STATE BUILDING SURCHARGE
RECEIPT
Account Code Current Pmts
000/322.100 44.85
000/386.904 4.50
Total: 49.35
1442 42 0Q.' 1 2 9716 Ito TOTAL 49.35
Printed: 08 -11 -2003
z
Payee: T.L. WHITE
ACCOUNT ITEM LIST:
Description
doc: Receipt
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 3365900647 Permit Number: D03 -235
Address: 14475 58 AV S TUKW Status: PENDING
Suite No: Applied Date: 08/04/2003
Applicant: WHITE RESIDENCE Issue Date:
Receipt No.: R03 -00950 Payment Amount: 29.15
Initials: BLH Payment Date: 08/04/2003 12:11 PM
User ID: ADMIN Balance: $49.35
TRANSACTION LIST:
Type Method Description Amount
Payment Check 3666
PLAN CHECK - NONRES
RECEIPT
29.15
Account Code Current Pmts
000/345.830 29.15
Total: 29.15
8/05 1716 TUN_ 1.. 2`9' 1
Printed: 08 -04 -2003
ar.:cu,.tii3.li.Lr;li. tad.::;.: �i ::iu+.::aiU✓w.Ud:i7t.:+........
1P.1!f:14t" #[r; "vi �^'i�kfiSiR�:aS+.'KiiN./.r
Pro ect: /
Type of Ins �ee.ss tion:
Address:
/14/73 i er A/ S
Date Called;
,)'-..2/-D .3
_
Special Instructions:
Date Wanted:
a' D3
f
a.m.
p.m.
Requester: 1/'
Phone fy 7? /-
693_3
7
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.
biO3 -23.x"
Corrections required prior to approval.
COMMENTS:,
To I- --_t._ U / (.
Date:
o- 2 —c
.00 REINSPECTION 1EE REQUIRED./Prior to inspection, fee must be
aid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
rS
\\
•
.4
1.4
O
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•
sts
" 01 .•■•■■■•■••■•••..Maimiwaa.....
FILE COPY
J ord6rstand that the Plan Check aprovals are
subject to errors and omissions and Dproval of
plans does not authorize the violation of any
adopted code or ordinance. Receipt f con-
t actor's copy of approved plans acknowledged.
By
Dat
Permit No
PERMIT CENTER
CATY OF TUICWII.A _
PPROVED
AtiC 7 2t13)3. _
-
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03
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'I
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LOT ARFAS
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Casement Neu - 2,133 uy.1l
Told Lot Meal - 6,636 tqM.
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Rea. No. 9705270!0 shall have 1.41511 and
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shown far fire access, but will net be
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28
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cone In woe - 4/23/07 `' RPCIIA;'t Or ICAO COUNTY;
hl. 53)1• Are. Se. ft 1 rs,^.Fer THE NOR711.61.01• FRET OF 11
So. 1471n EL 1 25 •IttECIF,• (ALSO KNOW AS PA1C
I LINE ,WJUSTMQO'•AG.,L91 -0O24, RC'
RECORDING NO. 970527011101:
RECORDING NO. 9106t70531 440't.1E
EASEMENT RECORDING NU
NECESSAR** SLOPES FOR CUTS','NQ•F
5706040, ..
93' talc.
a.s192.00' a plot
1 0
Pa'ce.'A.•fukw2u Bu L97 -0024
Roc..` 765210919)
'I (Not it slant plat)
0
N 119•40'21r E
11 calm. 192.00' pill '
S 6946'59• W
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(E14:im9)
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This sketcl7 ,. `0t tel: ;J.; t•'. r• 11 ,1 E'
the appro>;.ti1i ;)t.(: (7!t 'dl.;' � :, ,.•.rtl ti'
premises rill; :J ••. • •
Washin9tor r'+.; I:. • +trues
connection with tn', .. t1" •
- 139
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.SURVEY FOR
20' I
1
POA T10N OF • • :
of __P•' 1./4, �•_
1 ACV 1 rpAI. OFSCRIP nofr
LOT 1
THAT 1 04110N of L0T5 25 ANC 26.!
CAROM TRACTS, ACCORDING TO The
VaLNE 11 Or PLATE. PACE 24, RccC
W4SI4NOT0.1, DESCRIFKO AS FOLLOWS
BEGINNING A' IN! SOUIHLAS' CUNNL
:MTli 69'16 /E_sr, sumo SAID 1
TTICNCC NOt111 0074'32 BEST 51,00
•6'59' EAT 7n.RA FEET; IN: N:11
FEET TO PIE SOUTH LL OF T HE NOI
Nonni THENCE Ni 69'46'20' EAST, ;
166,55 TO 3iE EAST LINE Of SAD LC
32• CAS -, ALCNC •)4E EAST UN: CF
INNW
POINT Or BEGC, `•UB.F_CT 10 Sit
RECI)RCING NO. 9106170531i SUDJE :1
EASEMENT RECOfh7,NG NO. 67011040: .
e ESSJRY SLOPES FOR 01115 A.11
6706040; SUBJECT 10 AN EA.'141 NT
uTi7T1ES '011 fit ear,' 1
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U0•' EAST 61.01 FEET TRCM,
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rCC 1116166 NCRT1: 67y)D'4Y
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GARDEN TRAC ACCORDINGV TO THE'
VOLUME Ii OF PLA'S, PAGE 24, REV
WASHINGTON, DESCRIBED AS FOLLOWS
SECWNING AT THE soi:THCASr antic
SOUTH 69'46'59• NEST, ALONG SA,] :
ME TRUE PONT OF BEGINNING; THEN
6946'39' WCS1 64.45 FEET TO NE r
LOTS 25 AN0 26; THENCE NORTH 0C'
SAID NEST LINE, 132.00 TO O E NOW
25: THENCE ALONG SAID NORM U1;E,
65.36 TO THE NEST UNE OF THE CA_
T)hCRCO(; T1ICNCC S01;111 t)U'J4 C
StAlr) 69'46'59• iPSI 20.95 F;Fr; 1
EAST b1.00 •t1:i 0 INC IN1I1 PUNT
T00:1HER 4431 AN :4SEuEVT FOR IN
DESCRIBES A5 rOLLOY S:
lie PORTION CY SAID L010 25 AND
SE71/0. AT A POMP ON T•E EAST
111)7)4'32 EAST 61.01 FEET FROM PIE
THEREOF; MENU cuts to; SCAT IF
FEET; THENCE NOITH 67170 WEST
9'46
6'50' WCST 35.44 "CET; T11CNC: I
20.00 MET: 711CNC: N0 60
VCINI UI BLUINNWG: AAJ, SUBJECT T:
RECORDNG NJ. 51%170531.
SCHROETER
.x 1 � 96• ��`2,
rlry Ti/kWq a
41/ ,
p D 4 2003
PROFESSIOP.
PC. las II% S.eNx•t VO4w•
DAN. BY Wt OAT
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7 a , .L.d S/24/00
.!K Pod* aw•; s,'. nr. - +o4,9++iy2r.a4661 /4:141 /311.14411•314itC67kjear .1
PERMIT COORD Gov t'
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: D03 -235 DATE: 08 -04 -03
PROJECT NAME: WHITE RESIDENCE - FENCE
SITE ADDRESS: 14475 58 AV S
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter #
Revision # After permit Is Issued
DEPARTMENTS:
C $ /r 4 /4
Building Division Fire Prevention ❑
PubtVt'Ylo ks °g- Structural ❑
L 0 -6
Planning Division 0
Permit Coordinator
DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 08 -05 -03
Complete 21 Incomplete ❑
Comments:
Not Applicable ❑
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS RO
Please Route , lel Structural Review Required ❑ No further Review Required ❑
REVIEWER'S INITIALS: DATE:
REVIEWER'S INITIALS:
DUE DATE: 09 -02 -03
APPROVALS OR CORRECTIONS:
Approved ❑ Approved with Conditions ° � Not Approved (attach comments) ❑
Notation:
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
} d...Lv .w .... ... .
r
+.wrMnmai«w+u9++� +ava -+r
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
STATE OF WASHINGTON
COUNTY OF KING
AFFCONT 1/13/00
CITY OF T CWILA
Permit Center
6300 Southcenter Boulevard, Suite 100, Tukwila, WA 98188
Telephone: (206) 431 -3670
ss.
, 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 RC� 8.27.090, I
consider the work authorized under this building permit to be exempt under No. , 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.
Q• I I I
:0 • NOTAR y
i . o _" u).
PUBLIC
/ / I N9 •
• • s 16 - 0�`
‘■ ` '
Sign
AP °L ANT
ttA.
My commission expires:
and sworn to before me this
/ /th day of Au yu S , 20 D3 .
Ow.* d. NOTARY PUBLIC in a C r the State of Washington,
residing at Kin County.
Name as commissioned: Alice A. Dea y/
6-- 16--0
H -4
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 opera,, on 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.
!Fi .flLrt}?'M5