HomeMy WebLinkAboutPermit 5990 - BCTI - WallsAPPHOVED FOR BUILDING
ISSUANCE BY: %7 ' 4 , ,,--_, OFFICIAL
i � %
DATE:
3 -91- /D
I hereby certify t at I have read and ined 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 or work. I am authorized to sign for and obtain this building permit.
SIGNATURE: 1 4t. _
DATE: 2 •- ,,'
V COMPANY: 1 .../Z:4-t r C "y 7` C). ,
PRINT NAME: L
PROPERTY OWNER William Kobayashi
PHONE 363 -7665
ADDRESS 2707 N.E. 125th, Seattle, WA
ZIP 98125
CONTRACTOR - -
PHONE
531 -901
ADDRESS 121 East 121st Street, Tacoma, WA
ZIP
WA. ST. CONTRACTOR'S LICENSE #AEBERCC170BM
EXP. DATE 1 -01 -91
ARCHITECT N/A
PHONE
ADDRESS
ZIP
TYPE OF CONSTRUCTION: UBC EDITION (year) 88
SETBACKS: N - S - E -
W-
FIRE PROTECTION:
OSprinklers ® Detectors 0 NIA
UTILITY PERMITS REQUIRED ? 0 Yes ®N o
(through
Public Worksl
ZONING: BAR /LAND USE CONDITIONSOYes Q No
CONDITIONS (other than those noted on or attached to permit/plans):
CITY OF TUKWILA
Department of Community Development - Building Division
6200 Southcenter Boulevard, Tukwila WA 98188
(206) 433 -1849
BUILDING
PERMIT NO.
DATE ISSUED:
99n
DESCRIBE WORK TO BE DONE:
15445 53 Av S
Move two walls.
BUILDII'3 PERMIT
(POST WITH INSPEC iION CARD AND PLANS
IN A CONSPICUOUS LOCATION)
DESCRIPTION
AMOUNT
BUILDING PERMIT FEE
PLAN CHECK FEE
BUILDING SURCHARGE
ENERGY SURCHARGE
OTHER:
TOTAL -
35.00
23.00
6104
6104
4.50
62.50
RCPT #
6104
DATE
2 -26 -90
2 -26 -90
2 -26 -90
PLAN CHECK #90 -082
UI 0
V U
FEES
le , -
PROJFCT INFORMATIOP
•` .T&'
•
1,500.00
PROJECT NAME/TENANT ASSESSOR ACCOUNT N
BCTI 115720-00135-Q
TYPE OF U New Building Addition Tenant Improvement (commercial) U Demolition (building) lJ Grading/Fill
WORK: 0 Rack Storage 0 Reroof 0 Remodel (residential) 0 Other:
CODE COMPLIANCE
USE -4
FLOOR 4
TOTAL
- SQUARE
FEET
/ /
OCC. SQUARE OCC.
LOAD FEET LOAD
SQUARE
FEET
SQUARE
FEET
/
OCC.
LOAD
OCC.
LOAD
SQUARE OCC. TOTAL
FEET LOAD SQUARE FEET
TOTAL
OCC. LOAD
This permit shall become nu nd void if the work is not commenced within 1 days from the date of
issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection.
CERTIFICATE OF
OCCUPANCY NO.
DATE ISSUED:
PROPERTY OWNER Wi lliam Kobayashi
PHONE 363 -7665
ADDRESS 2707 N.E. 125th, Seattle, WA
ZIP 98125
CONTRACTOR A. E. Berger Conctriirtinn
PHONE 531
-9001
ZIP
ADDRESS 121 East 121st Street, Tacoma, WA
WA. ST. CONTRACTOR'S LICENSE #AEBERCC170BM
EXP. DATE 1 -01 -91
ARCHITECT N/A
PHONE
ADDRESS
ZIP
D SCRIPTION
AMO T
RCPT #
DATE
BUILDING PERMIT FEE
35.00
61 n4
2 -26 -90
PLAN CHECK FEE
23.00
6104
2 -26 -90
BUILDING SURCHARGE
4.50
6104
2- 26 -9Q_
ENERGY SURCHARGE
OCC.
LOAD
SQUARE
FEET
OCC.
LOAD
OTHER:
TOTAL
OCC. LOAD
TOTAL -
62.50
USE
/
W -
CODE COMPLIANCE
UTILITY PERMITS REQUIRED? O Y es ® o
,'
,`.
FtcsoR
SQUARE
FEET
OCC.
LOAD
SQUARE
FEET
OCC.
LOAD
SQUARE
FEET
OCC.
LOAD
SQUARE
FE
OCC.
LOAD
SQUARE
FEET
OCC.
LOAD
TOTAL
SQUARE FEET
TOTAL
OCC. LOAD
,
TOTAL
TYPE OF CONSTRUCTION: UBC EDITION (year) 88
SETBACKS: N _ S - E -
W -
FIRE PROTECTION: [� Sprinklers (X) Detectors N/A
UTILITY PERMITS REQUIRED? O Y es ® o
(through
Public Works)
ZONING: BAR /LAND USE CONDITIONS0Yes 117 No
:;ONDITIONS (other than those noted on or attached to permit/plans):
APPHOVED FOR BUILDING _
iSSUANCE BY: a> 4 z. % OFFICIAL
DATE: `�
;. 7 .d U -- cto
I hereby certify t at 1 have read d nd ined permit to true and correct. All r
e y e y a e e � e this pe mtt and know the same be co 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 or work. I am authorized to sign for and obtain this building permit.
0
SIGNATURE: `_, ,
PRINT NAME: G- ,( a e ).. g e j--
DATE:
COMPANY:
V --
dj,�.�rf f Gees Z 6,,
VITY OF TUKWILA
Department of Community Development - Building Division
6200 Southcenter Boulevard, Tukwila WA 98188
(206) 433-1849
PROJECT •IN FORMATION
BUILDING
PERMIT NO.
DATE ISSUED:
DESCRIBE WORK TO BE DONE:
990
PROJECT NAME/TENANT BCTI
TYPE OF 0 New Building Addition
WORK: 0 Rack Storage O Reroof
Move two walls.
PLAN CHECK #90 -082
VALUE Of-
ASSESSOR ACCOUNT # 115720 -0135-
U Tenant Improvement (commercial) (• Demolition (building) Grading/Fill
0 Remodel (residential) 0 Other
BUILDII3 PERK SIT /
(POST WITH INSPECTION CARD AND PLANS
IN A CONSPICUOUS LOCATION)
FEES
N - C 1,500.00
This permit shall become null nd void if the work is not commenced within 1871 days from the date of
issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection.
CERTIFICATE
O NO CCUPANCY NO.
DATE ISSUED:
CITY OF TUKWILA
Building Division
6200 Southcenter Boulevard
Tukwila,,Mashinaton 98188
(206) 433 -1849
Date 5 " s '- 9C)
Type of Inspec ion /C�,� Date Wand 5 a.m.
Site Address 4 3'��` j -- 3 r , Project 5(n�� (�
Requestor c� hC�. r 0 Phone # Ai 3/ - Co
Special Instructions
Inspection Results /Comments
•
Inspector ( -9 5 ,uz .
INSPECTION RECORD
PERMIT # 9 0
Date 5/9 /ii3
CITY OF TUKWILA
Building Division
Tukwila,,tWashington Boulevard
98188
(206) 433 -1849
Type of Inspection c
Site Address SOu5 — E 5 - / e, J
Requestor 1.10. r
PERMIT # 5 9 9 r)
Date
Special Instructions
Inspection Results /Comments: 3Ck -I.L41 et ,A.
......,. �......., »....wM.w.m -r... w..n w..a nr wc.rcwra.u�x rtua.rn•.,+.,.:, wry.. ma:.« ww •. , . , :r.. , .. a.vn. cr � ��,c:� u!r:n:5•: ;�kC.9.i`v
INSPECT N RECORD
5 - tf
Inspector - Date 5• /
Date Wanted 5 - 7 - 9d a.m p.m.
Project I` L-T — E,.
Phone # q?)
CITY OF TUKWILA
Building Division
Tukwila,�
(206) 433 -1849
;pection Results /Comments: 114 AwA re g.
INSPECTION RECORD
PERMIT #
Date 4
Type of Inspection 612, I 1 Date Wanted 4/(025d a.m. p,m
Site Address "� -` Project --
s, t l fir' � s --S �. �- -P �� �, � �C-/ -�.
Requester r Phone #
Special Instructions
Inspector 6.Sz -2-.. Date 1400
' � �# YNh. �' CuiS 7cTd�' TA+'"' irM;: �l niaFx�: wKa3Awtxsr..t5itti�rt�ew,i:*.kx . t�. u +awere�r+m,.,vavc+s�1�a�Jxu+z� xe�rjawn,. Hr.Nerexx � .rt E�,,;a r ,�.r t�. «.�},a�:
_ * CITY OF TUKWILA 1 SPECTION
Building Division
6200 Southcenter Boulevard
Takwila, Washington 98188
.(206) 433 -1849
Inspection Results /Comments:
Type of Inspection 4'ec/ YP
Site Address /5
Requester
Special Instructions
Inspector
PERMIT # 77 D
Date ` `- ti ()
Date Wanted — -- 2()
Project t TZ
Phone # /. - (Q 1 )/ 1 " -,
Date
fr}rr`Cfb's;o'C!B .
CITY OF TUKWILA
Building Division
6200 Southcenter Blvd.
Tukwila, WA 98188
433-1845
Permit No.,. 9 0 Date l -/-,e; w'70 Job Address. / 5 '"" g co
CORRECTION NOTICE
The following items are found to be in violation of Ordinance
and shall be corrected.
Signed
BulidIn fficial/Inspector
CITY OF TUKiLA
Central Permit System
FINAL APPROVAL FORM
Project Name a'c7/
Address s - ./','' . S .3 s -''. . t' . S_
Type of Permit(s) i i
Vontrol No.
Permit No. .f4-,,
TO: El Building
❑ Planning
❑ Public Works
Fire Dept.
❑ Police
El Parks/Recreation
This project is nearing completion. Please investigate your area of responsibility and indicate
below either your final approval or necessary corrections.
If no response is received within one week, it will be assumed that the project is of no concern
to your department and a certificate of occupancy may be issued.
This project is NOT approved by this department; the following corrections are necessary:
()
()
()
( )
()
()
(
()
()
O
()
()
Authorized Signature
Date
J
This project isapproved by this department:
Authorized Signature
Date
CPS Form 3
RECEIVED
CITY OF TUKWIUA
FEB 2 B 1990
PERMIT CENTER
EXI11 rc"
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plans does not
copy of approved ( puns �.
By...
Date y — r 3
Permit No
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CePIC.0
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CITY DF TUKVJILA'
AP DROVED
"r' ' 199:0
V \
BUILDING DIVISION
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APPRO
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RECENED
CITY OP TUKWILA
Plan Check t)9O -482: BCT I
15445 53 Av S
THE FOLLOWING COMMENTS APPLY TOARp PART OF THE APPROVED PLANS UNDER
TUKWILA BUILDING PERMIT NUMBER= __ .
1. No changes will be made to the plans unless approved by the
Architect and the Tukwila Building Division,
2. Electrical permit shall be obtained through the Washington State
Division of Labor and Industries and all electrical work will be
inspected by that agency (872 - 6363).
3. All permits, inspection records, and approved plans shall be
posted at the job site prior to the start of any construction.
4. Any exposed insulations backing material to have Flame Spread
Rating 'of 25 or less, and material shall bear identification
showing the fire performance rating thereof.
A11 construction to be done in conformance with approved plans and
requirements of the Uniform Building Code (1988 Edition), Uniform
Mechanical Code (1988 Edition), Washignton State Energy Code. (1989
Edition), and Washington State Regulations for Barrier" Free
Facility (1989 Edition).
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 this code or of any other ordinance of the
jurisdiction. No permit presuming to give authority or violate or
cancel the provisions of this code shall be valid, .
"X"
REQUIRED INSPECTIONS
PHONE
APPROVED
INITIALS
CORRECTION NOTICE ISSUED
1 Footings
433 -1849
.
2 Foundation
433 -1849
3 Slab and/or Slab Insulation
433 -1849
4 Shear Wall Nailing
433 -1849
5 Roof Sheathing Nailing
433 -1849
6 Masonry Chimney
433 -1849
X
7 Framing
433 -1849
8 Insulation
433 -1849
9 Suspended Ceiling
433 -1849
X
10 Wall Board Fastening
433 -1849
11
12
13
14 FIRE FINAL Insp:
575 -4404
15 PLANNING FINAL
433 -1849
16 PUBLIC WORKS FINAL
433 -0179
X
17 BUILDING FINAL
433 -1849
CITY OF TUKWILA
BuILD:1G PERMIT
INSPECTION RECORD
Post with Building Permit in conspicuous place)
Department of Community Development - Building Division
6200 Southcenter Boulevard, Tukwila WA 98188
(206) 433 -1849
SITE ADDRESS:
15445 53 Av S
SUITE NO.:
BUILDING
PERMIT NO. ✓ 190
DATE ISSUED:
1 -1 - 3 90
PROJECT:
BCT I
CALL FOR INSPECTIONS AT LEAST 24 HOURS IN ADVANCE
(INSPECTOR COMMENT SECTION ONR R
INSPECTION PROCEDURES AND REQUIREMENTS
All approved plans and permits shall be maintained available on the site in the same location.
'1. FOOTING - When survey stakes and forms are set and rebar is tied in place.
2. FOUNDATION - When forms and rebar are in place.
3. SLAB - If structural slab or If underslab insulation is required.
4. SHEARWALL NAILING - Prior to cover.
;5. ROOF SHEATHING NAILING - Prior to cover.
'6. MASONRY CHIMNEY - Approximately midpoint.
'7. FRAMING - After rough -in inspections such as mechanical, plumbing, gas piping, electrical and fire stopping is in place.
8. INSULATION - After framing approval, but before installation of wallboard. Baffles must be installed to keep attic
ventilation points clear.
9. SUSPENDED CEILING - Fasten diffusers, lights and seismic bracing.
10. WALL BOARD FASTENING - Prior to taping (see UBC Chap. 47 and Table 47G).
111.
X12.
13.
14. FINAL FIRE INSPECTION - Contact Fire Department for their requirements.
15. FINAL PLANNING INSPECTION - Contact Planning Department for their requirements.
116. FINAL PUBLIC WORKS INSPECTION - Contact Public Works Department for their requirements.
,17. FINAL BUILDING INSPECTION - When all work, corrections, reports and other inspections are complete.
'OTHER AGENCIES:
Plumbing (including gas piping) — King County Health Department — 296 -4732
Electrical — Washington State Department of Labor and Industries — 872 -6363
A preconstruction meeting with the Building Inspector may be scheduled prior to starting the job by
contacting the Department of Community Development, Building Division at 433 -1849. Although not
required, a meeting of this type can often eliminate problems, delays and misunderstandings as the
project progresses.
01,28/60
"X"
REQUIRED INSPECTIONS
1 Footings
2 Foundation
3 Slab and/or Slab Insulation
4 Shear Wall Nailing
5 Roof Sheathing Nailing
Masonry Chimney
P41
7 Framing
8 Insulation
I
9 Suspended Ceiling
/� `
1 Wall Board Fastening
'
11
12
13
414
FIRE FINAL Insp:
15 PLANNING FINAL
16 PUBLIC WORKS FINAL
i17 BUILDING FINAL
PLAN CHECK
NUMBER
PROJECT:
THE FOLLOWING COMMENTS APPLY TO AND BECOME PART OF THE APPROVED PLANS UNDER
TUKWILA BUILDING PERMIT NUMBER
,,r) No changes will be made to the plans unless approved by the
"'vJ�CCJ// Architect and the Tukwila building Division.
O 2 Plumbing permit shall be obtained through the Ming County Health
Department and plumbing will be Inspected by that agency,
including all gas piping (296 - 4732).
111 Electrical permit shall be obtained through the Washington State
�+[J Division of Labor and Industries and all electrical or will be
inspected by that agency (872 - 63631.
O All mechanical work shall be under separate permit through the
City of Tukwila.
Qr All permits, inspection records, and approved plans shall be
posted at the job site prior to the start of any construction.
O When special inspection is required either the owner, architect or
engineer shall notify the Tukwila Building Division of appointment
of the inspection agencies prior to the first building inspection.
Copies of all special inspection reports shall be submitted to the
Building Division in a timely Banner. Reports shall contain
address, project name and permit number of the project being
inspected.
O All structural concrete to be special inspected (Sec. 306, UDC).
All structural welding, to be done by W.A.8.0. certified welder and
special inspected (Sac. 306, UBC).
O All high-strength bolting to be special inspected (Sec. 306, UBC).
10 Any new ceiling grid and light fixture installation is required to
meet lateral bracing requirements for Seismic lone 3.
O Partition walls attached to ceiling grid must be laterally braced
if over eight (8) feet in length.
12 Readily accessible access to roof mounted equipment is required.
l3 Engineereed truss drawings and calculations shall be on site and
available to the building inspector for inspection purposes.
Documents shall bear the seal and signature of a Washington State
Professional Engineer.
Any exposed insulations backing material to have Flame Spread
Rating of 25 or less, and material shall bear identification
showing the fire performance rating thereof.
O Subgrade preparation including drainage, excavation, compaction,
and fill requirements shall conform strictly with recommendations
given in the soils report prior to final inspection (see attached
procedure.).
O A statement from the roofing contractor verifying fire retardancy
of rook will be required prior to final inspection (see attached
procedure).
All construction to be done in conformance with approved plans and
requirements of the Uniform Building Code (1988 Edition), Uniform
Mechanical Code (1988 Edition), Washignton State Energy Code (1989
Edition), and Washington Stae Regulations for Barrier Free
Facility (1989 Edition).
l8 All food preparation establishments oust have King County Health
Department sign -off prior to opening or doing any food processing.
Arrange.ents for final Health Department inspection should be aide
by calling King County Health Department, 296 -4787, at least three
working days prior to desire inspection date. On work requiring
Health Department approval, it is the contractor's responsibility
to have a set of plans approved by that agency an the job site.
•
19 Fire retardant treated wood shall have a flame spread of not over
25. All materials shall bear identification showing the fire
performance rating thereof. Such identification shall be issued
by an approved agency having a service for inspection at the
factory.
20 Notify the City of Tukwila Building Division prior to placing any
concrete. This procedure is in addition to any requirements for
spacial inspection.
21 All spray applied fireproofing as required by U.B.C. Standard No.
43 -8, shall be special inspected.
22 All wood to regain in placed concrete shall be treated mood.
23 All structural masonry shall be special inspected per U.B.C.
Section 306 fa) 7.
'Validity of Perelt. 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 this code or of any other ordinance of the
jurisdiction. No permit presuming to give authority or violate or
cancel the provisions of this cods shall be valid.
Dear Sir:
City cc Tukwila
FIRE DEPARTMENT
444 Andover Park East
Tukwila, Washington 98188 -7661
(206) 575 -4404
Fire Department Review
Control Number 90 -082
(513)
Gary L. VanDusen, Mayor
March 21, 1990
Re: B.C.T.I. - 15445 -53rd Avenue South, Tukwila, Wa.
The attached set of building plans have been reviewed by
The Fire Prevention Bureau and are acceptable with the
following concerns:
1. Maintain fire extinguisher coverage throughout.
2. Exit hardware and marking must meet the requirements
of Uniform Fire Code Sections 12.104 & 10.402(a).
Exit doors shall be openable from the inside without
the use of a key or any special knowledge or effort.
(UFC 12.104b)
3. Maintain square foot coverage of detectors per
manufacturer's specifications in all areas including:
closets, elevator shafts, top of stairwells, etc. (NFPA
72A, 1-2.2 & NFPA 72E) (UFC 10.301)
All modifications to fire alarm systems shall have the
written approval of the Tukwila Fire Department. No
work shall commence without approved drawings. (City
Ordinance #1327) (UFC 10.301)
4. All required occupancy separations, area separation
walls, and draft -stop partitions shall be maintained and
shall be properly repaired, restored or replaced when
damaged, altered, breached, penetrated, removed or
improperly installed. (UFC 10.401)
Plan Review
PROJECT 3C TT_
ADDRESS 1 5 14 4 5 5 3 kv
DATE 3 I L q0
OCCUPANCY GROUP 3-2 0 -P-Pi �.
TYPE OF CONSTRUCTION N / [-
LOCATION ON PROPERTY N ! c
BUILDING HT. / N0. STORIES
FLOOR AREA
OCCUPANT LOAD
EXITING REQUIREMENTS N C- rec d C`�lc1
DETAILED REQUIREMENTS
OCCUPANCY
TYPE OF CONSTRUCTION N ` c
PART V, CHAPTER 23, U.B.C. , N LC_
W.S.E.0 .. A .
CHAPTER 51 -10, W.A.C.
CITY OF TUKWILA
DEPARTMENT OF COMMUNITY DEVELOPMENT prepared by: ,
PLANNING DIVISION
- ?P i A ink()
PLAN CHECK
NUMBER
cU - UB2
C
NOTES:
PERMIT NO.
CONTACTED
L.-� -E 'IYl-P � �
0. \Q
DATE READY
DATE NOTIFIED
PERMIT EXPIRES
2nd NOTIFICATION
BY:
(init.)
AMOUNT OWING
,'
3RD NOTIFICATION
BY:
(init.)
PLAN CHECK
NUMBER
Div- ova
INSTRUCTIONS TO STAFF
• Contacts with applicants or requests for information should be summarized in writing by staff so that
any time the status of the project may be ascertained.
• Plan corrections shall be completed and approved prior to sending on to the next department.
• Any conditions or requirements for the permit shall be noted on the plans or summarized concisely
in the form of a formal letter or memo, which will be attached to the permit.
• Please fill out your section of the tracking chart completely. Where information requested is not
applicable, so note by using "N /A ".
BUILDING SQUARE FOOTAGE/OCCUPANCY INFORMATION
(to be fIlled out by Plan Checker)
SQUARE
FEET
OCC,
LOAD
SQUARE
FEET
OCC.
LOAD
SQUARE
FEET
OCC.
LOAD
SQUARE
FEET
OCC.
LOAD
SQUARE
FEET
OCC.
LOAD
TOTAL
SQUARE FEET
TOTAL OCCU-
PANCY LOAD
DEPARTMENTAL REVIEW
"X" In box Indicates which departments need to review the project.
21 BUILDING -
initial review
FIRE
0 PLANNING
O PUBLIC
• WORKS
O OTHER
BUILDING PERMIT APPLICATION TRACKING
PROJECT NAME
SITE ADDRESS SUITE NO.
Q - &b
6 y
NI BUILDING -
final review / / )
REVIEW COMPLETED
3 / '4 /cro
(ROUTED)
bl/'6/6
INIT: `)t
INIT:
INIT:
INIT:
r
INIT:
CONSULTANT: Date Sent -
FIRE PROTECTION: [ 1 Sprinklers '.) Detectors [ 1 N/A
FIRE DEPT. LETTER DATED: 5 -24 - 4'p INSPECTOR:
BONING: i BAR/LAND USE CONDITIONS? [ lYes [�
REFERENCE FILE NOS.:
UIRE
MINIMUM SETBACKS: N- S-
UTILITY PERMITS REOUIRRD L] Yes
PUBLIC WORKS LETTER DATED:
TYPE OF CONSTRUCTION:
roved
UBC EDITION (year):
w-
SITE ADDRESS SUITE #
3 ` ■ `
/ ' . J ��_� �.._,J .J � r ter' ' >r'
VALUE OF CONSTRUCTION - $
C7 00 . 00
PROJECT NAME/TENANT
ASSESSOR
ACCOUNT #
TYPE OF U New Building U Addition 16 Tenant Improvement (commercial) U Demolition (building)
WORK: 0 Rack Storage 0 Reroof O Remodel (residential) 0 Other
DESCRIBE WORK TO BE DONE:
;',' - 1 c' l le ,i' -C'(
BUILDING USE (office, warehouse, etc.)
(' ) z_
NATURE OF BUSINESS:
WILL THERE BE A CHANGE IN USE? No Yes IF YES, EXPLAIN:
SQUARE FOOTAGE - Building: Tenant Space: ,5 ' Area of Construction: c i: ;
WILL THERE BE STORAGE OR USE OF FLAMMABLE, COMBUSTIBLE OR HAZARDOUS MATERIALS IN THE
BUILDING? 0 No 0 Yes IF YES, EXPLAIN:
PROPERTY OWNER ,
∎ • 0._•5 W 1 \ 1 G. V
PHONE /
j 3 , - 1 . L--
(!
ADDRESS • `. - ///,..-- ZI 7 - ,
CONTRACTOR f j
!f /�r r' <' /'_ , lei J � ,
PHONE r
�� 3I C e
ADDRESS /,, / , . 1 / > r j -/, ,> i.
Z IP . / / 1
WA. ST. CONTRACTOR'S LICENSE # — /- i'M
EXP. DATE 0/ o
ARCHITECT 1. i
PHONE
ADDRESS
ZIP
I Y.ERTII~Y TI'fA ': `:# IAVE R D EXAM.INE4'THIS APPUCATION AN NQYII TN :SAME. ° TQ.:BE .... ' • `RUE A C ORRECT, >i N !!I AM; A " TI JORI EI 'FO APPLY FOI:THIS t llulil t .. : : >: <: > :.::: ........
BUILDING OWNER
OR
AUTHORIZED
AGENT��::
SIGNATURE �:
O G / - - I' .� -6 -
DATE
el,
PRINT NAME ..
`"
PHONE �•- �,
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ADDRESS /) / -f /) / s' ,rt ,5 / l rte >rL ,t..
CITY /ZIP <..' < / S
PHONE
CONTACT PERSON
CITY OF TUKWILA
Department of Community Development - Building Division
6200 Southcenter Boulevard, Tukwila WA 98188
(206) 433 -1849
!1 PPL IC/1 TION lull 1 L3L
EIl 1E OUT COIIIPLE TELY
APPLICATION SUBMITTAL In order to ensure that your application is accepted for plan review, please make sure to fill
out the application completely and follow the plan submittal checklist on the reverse side of this form. Handouts
are available at the Building counter which provide more detailed information on application and plan submittal
requirements. Application and plans must be complete in order to be accepted for plan review.
VALUATION OF CONSTRUCTION Valuation for new construction and additions are calculated by the Department of
nommunity Developr prior to application submittal. Contact the Permit Coord!na!or at 133 - 1951 prior to
submitting application. In all cases, a valuation amount should be entered by the applicant. This figure will be
reviewed and is subject to possible revision by the Building Division to comply with current fee schedules.
BUILDING OWNER / AUTHORIZED AGENT If the applicant is other than the owner, registered architect/engineer, or
contractor licensed by the State of Washington, a notarized letter from the property owner authorizing the agent
to submit this permit application and obtain the permit will be required as part of this submittal.
EXPIRATION OF PLAN REVIEW Applications for which no permit is Issued within 180 days following the date of
application shall expire by limitations. 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 304(d) of the Uniform
Budding Code (current edition). No application shall be extended more than once.
11 you have any questions about our process or plan submittal requirements, please
contact the Department of Community Development Building Division at 433 -1849.
DATE APPLICATION ACCEPTED
BUILDUI'(.) PERMIT
APPLICATION
FEES (for staff use only)
DESCRIPTION :.
BUILDING PERMIT: FEE
PLAN CHECK FEE
BUILDING SURCHARGE
ENERGY SURCHARGE
OTHER:
TOTAL -
AMOUNT RCPT # DATE
.0O b S'U
OD G a y a; G -Su
( .50 ((Qrl
DATE APPLICATION EXPIRES
Q(0-90
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