HomeMy WebLinkAboutPermit M04-054 - LE RESIDENCELE RESIDENCE
4009 SOUTH 748r"
STREET
M04 -054
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Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Value of Construction:
Type of Fire Protection:
Signature:
Print Name:
doe: Mech
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 0041000164
Address: 4009 S 148 ST TUKW
Suite No:
LE RESIDENCE
4009 S 148 ST, TUKWILA WA
TIEN LE
9420 8 AV SW, SEATTLE WA
TIEN LE
9420 8 AV SW, SEATTLE WA
Contractor:
Name: OWNER AFFIDAVIT - TIEN LE
Address: 9420 8 AV SW, SEATTLE WA
Contractor License No:
$250.00
N/A
MECHANICAL PERMIT
M04 -054
Permit Number:
Issue Date:
Permit Expires On:
Expiration Date:
Phone: 206 778 -2655
Phone: 206 778 -2655
Phone: 206 778 -2655
DESCRIPTION OF WORK:
EXISTING OIL FURNACE (FOR ADJOINING HOME) CHANGE THE 6" PIPE TONEW 6" PIPE AND
INSTALL METALBESTOS CHIMNEY SYSTEM (SEPARATE SHED FOR FURNACE) - NOTES BY KEN
NELSEN 4 -6 -04
M04 -054
04/06/2004
10/03/2004
Fees Collected: $44.45
Uniform Mechnical Code Edition: 1997
Permit Center Authorized Signature:."-- ......) .4' ""_- Date: '�z -or
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 mechanical permit.
Date: 4 l - 6 0 4
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: 04 -06 -2004
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Parcel No.: 0041000164
Address: 4009 S 148 ST TURIN
Suite No:
Tenant: LE 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: Manufacturers installation instructions required on site for the building inspectors review.
6: Fuel burning appliances may not be installed in sleeping rooms, U.M.C. 304.5.
7: Appliances which generate flame, spark or glowing ignition, shall be elevated 18 inches above the floor (U.M.C.
303.1.3.).
8: Water heater shall be anchored to resist earthquake (U.P.C. 510.5).
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
PERMIT CONDITIONS
Permit Number: M04 -054
Status: ISSUED
Applied Date: 04/06/2004
Issue Date: 04/06/2004
Date: 0) 6/c) tr.
M04 -054 Printed: 04 -06 -2004
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Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
\applications \permit application (3.2003)
3/2003
CITY OF TUKWIL.
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 **
Site Address: If o `t+ S /It ?3 /'<
Tenant Name: Sp ....(G. - Tt n1 a- '( (La 7assos,vaa)
Property Owners Name: .. (� .
Mailing Address: /If
•'CONTACT.PERSO
Name:
Mailing Address: a 0
E -Mail Address:
GENERAL:: CONTRACTORINFORMATION
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 All ,plans must; wet stamped by Architect'of Recor
•
`ENGINEER; OF, .RECORD All;plans;must be wet stamped, by Engineer ofRecord >
Page 1
Building Permit -No
Mechanical Permit No.
Public .Works Permit :No.
Project No
For office use only)
King Co Assessor's Tax No.: Oo N f co o / 6
Suite Number:
City
Day Telephone:
City
Fax Number:
New Tenant: ❑ .... Yes EI:..No
LtJ
State
State Zip
City
Day Telephone:
Fax Number:
State
City
Day Telephone:
Fax Number:
State
City
Day Telephone:
Fax Number:
State
Floor:
y I'
Cl f C)C
Zip
Zip
Zip
Zip
ILDING'PERMIT INFO ON 206 431 -3670
Valuation of Project (contractor's bid price): $
Existing Building Valuation: $
Scope of Work (please provide detailed information):
Will there be new rack storage? ❑ ..Yes ❑ .. No If "yes ", see Handout No. for requirements.
Provide All Building Areas in Square. Footage Below
1
• 2a Floor:
3 Floor,:
Floors
thrti : .
Basement
Accessory Structure* .: :.
Attached.Garage
• Detached Garage;
Attached Carport
Detached Carport: :;;
'Covered Deck '.
Uncovered: Deck •
Interior
Remodel
Addition to
Existing
Structure
New
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 0 ..No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
❑.. Sprinklers ❑..Automatic Fire Alarm ❑..None EJ . Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? El ..Yes ❑ ..No
If "yes", attach list of materials and storage locations on a separate 8 -1/2 x 1I paper indicating quantities and Material Safety Data Sheets.
.applications \permit application (3.2003)
3/2003
Page 2
Scope of Work (please provide detailed information):
Water District
❑ ...Tukwila p ... Water District #125
❑...Water Availability Provided
Sewer District N ; .L.
❑::.Tukwila ❑... ValVue ❑ .. Renton ❑ ...Seattle
❑ ...Sever Use Certificate 0... Sewer Availability Provided ❑ .. Approved Septic Plans Provided
, �O, is System - F 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 ")
1112 . :.Teci3nical Information Report (Storm Drainage) ❑ .. Geotechnical Report ❑...Traffic Impact Analysis
❑...Bond ❑ .. Insurance ❑ .. Easement(s) ❑ .. Maintenance Agreement(s) ❑...Hold Harmless
Proposed Activities (mark boxes that apply):
❑ ...Right -of -way Use - Nonprofit for less than 72 hours ❑ .. Right -of -way Use - Profit for less than 72 hours
❑ ...Right -of -way Use - No Disturbance ❑ .. Right -of -way Use — Potential Disturbance
❑ ...Construction /Excavation/Fill - Right -of -way
Non Right -of -way
e
❑...Total Cut
❑ ...Total Fill
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
cubic yards
cubic yards
❑ ...Sanitary Side Sewer
❑...Cap or Remove Utilities
❑...Frontage Improvements
❑ ...Traffic Control
❑ ...Backflow Prevention - Fire Protection
Irrigation
Domestic Water
\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
❑ ...Permanent Water Meter Size... WO#
❑ ...Temporary Water Meter Size.. WO#
❑...Water Only Meter Size WO#
❑ ...Sewer Main Extension Public _ Private
❑ ...Water Main Extension Public _ Private
❑ .. Highline
❑ .. Work in Flood Zone
❑ .. Storm Drainage
❑ ...Renton
❑ .. Grease Interceptor
❑ ., Channelization
❑ .. Trench Excavation
❑ .. Utility Undergrounding
❑...Deduct Water Meter Size
FINANCE INFORMATION
Fire Line Size at Property Line
❑...Water ❑...Sewer
Monthly Service Billing to:
Name:
Mailing Address:
Number of Public Fire Hydrant(s)
❑ ...Sewage Treatment
Water Meter Refund/Billing:
Name:
Mailing Address:
Day Telephone:
City
State
Zip
Day Telephone:
City
State
Zip
Page 3
1
Unit Type:
Qty ..
Unit Type:.
Qty
Unit Type :.
Qty .
Boiler/Compressor:
Qty
Furnace <100K BTU
Air Handling Unit
>= 10,000 CFM
Other Mechanical
Equipment
0 -3 HP /100,000 BTU
Furnace>100K BTU
Evaporator Cooler
3 -15 IIP /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: INFORitvIATION —206-431-3670
MECHANICAL CONTRACTOR INFORMATION
Company Name: 'i7 -i L
Mailing Address: o
Contact Person: ,.1
E -Mail Address:
Contractor Registration Number: Q ..- i 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): Ejc s k" J v '
r 1- DD 6 lr Pipes- Iv C r r
Use:
Residential:
Commercial:
J (
New .... D Replacement ....O.
New .... Replacement .... El
Fuel Type: Electric 0 Gas ....El Other: 011
Indicate type of mechanical work being installed and the quantity below:
o
City State Zip
Day Telephone: ,9r . -, 2 4 — C
Fax Number:
Ate' dryn
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:
Signature:
Name: : J
Mailing Address: 9 rs 7 - n � ,'�t� s • .1
\applications \permit application (3 -2003)
3/2003
Page 4
City
Date: G/ G/ v L
Day Telephone: ,Poi . 7 -) 9 - -0
State
Zip
Date Application Accepted:
Date Application Expires:
4 o y `o - 'off
Staff Initials:
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 0041000164
Address: 4009 S 148 ST TUKW
Suite No:
Applicant: LE RESIDENCE
Receipt No.: R04 -00405
Initials: SKS
User ID: 1165
Payee: TIEN Q. LE
TRANSACTION LIST:
Type Method Description
doc: Receipt
Payment Check 2180
ACCOUNT ITEM LIST:
Description
MECHANICAL - RES
RECEIPT
Permit Number: M04 -054
Status: PENDING
Applied Date: 04/06/2004
Issue Date:
Payment Amount: 44.45
Payment Date:
Balance:
Amount
44.45
Account Code Current Pmts
000/322.100 44.45
Total: 44.45
04/06/2004 03:18 PM
$0.00
96 04 r 0a6 9716 TOTAL 44.45
Printed: 04 -06 -2004
Prot
(),ew
Type of In sron:
Ad tcrlibc‘ e (
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D ate Called:
Q ( 0
Special Instructions:
ate Wanted: (e i
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P.m.
Requester: 1
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INSPECTION RECORD
Retain a copy with permit
INSPECTIOrfNO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 981 88
COMMENTS:
Approved per applicable codes. Corrections required prior to approval.
PER
(206)431-3670
El $47.00 REINSPE N FEE REQUIRED. Prior to inspection, fee mijt be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
'Receipt No.:
'Date:
Project:
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Type of Ins ion: � �
YP P, l�.�f"
Add �: n °( .S - I R `'``''
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Date Called:
7 a II
Special Instructions:
F
Date Wanted:
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Requester:
Lex
Phone,: OLe —77?
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INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
COMMENTS:
/b-/ Leo
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Approved per applicable codes.
$47.00 REINSPECTIO EE REQUIRED. Prior to inspection, fee mu %t be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
'Date:
INSPECTION RECORD ' ' '
Retain a copy with permit
d '
PERMIT -
Corrections required prior to approval.
COMMENTS: it -r_ i
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Type of ection:
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Ad r ss:
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Date Cal ed:
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Specs I nstructi ns: -
Date Wanted: -^� '/
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Requester:: - f
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INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
❑ Approved per applicable codes.
nspect
' 1
• INSPECTION RECORD
Retain a copy with permit
C.�
(206)431 -3670
Corrections required prior to approval.
Date
ri $47.00 REINSPECTIdN FEE REQUIRED. Prior to inspection, fee rt�ist be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
'Receipt No.:
'Date:
COMMENTS: ) c)
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Tif I/ if: c t t,
/Ote...arf
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Date Called:
1/44.71- c
Date Wanted:
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Requester: .....
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Phone No:
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Project:
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Date Called:
Special Instructions:
Date Wanted:
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`( //6/04 P.m.
Requester: .....
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Phone No:
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INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 981 88
0 Approved per applicable codes.
Inspector;
I Date: L /4
PERM 9 /
06 431-3670
Corrections required prior to approval.
i .
I $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:
'ILE COPY
I understand that the Plan Check approvals are
subject to errors and omissions and approval of
plans does not authorize o iance� Receipt of ny
tractor s copy d
adopted code of a pproved plans acknowledge
By
Date
Permit No.
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hECEIVED
CITY OF TUKWI A
APR - 6 2004
PERMIT CENTER
SU ' 3 JECT To
F/ELD /NSPECTio
N
MO 010
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
STATE OF WASHINGTON
COUNTY OF KING
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. , and
will therefore not be performed by a registered contractor.
I understand that I may by waiving certain rights that I might otherwise have under state law in any decision to
engage an unregistered contractor to perform construction work.
AFFCONT 1/13/00
CITY OF T'ICWILA
Permit Center
6300 Southcenter Boulevard, Suite 100, Tukwila, WA 98188
Telephone: (206) 431 -3670
ss.
, states as follows:
APPLICANT
Signed and sworn to before me this
64 day of April
(21,:ce_ a. y
NOTARY PUBLIC in and Mir the State of Washington,
residing at ki✓7J
Name as commissioned:
My commission expires:
County.
Alice A. Deac y
6 -/6 -
H -4
, 20 04 .
18.27.090 Exemptions. This chapter sh ^II 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 wlio 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.