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City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 5379800483
Address: 16224 47 AV S TUKW
Suite No:
Tenant:
Name: DREBAUM RESIDENCE
Address: 16224 47 AV S, TUKWILA WA
Owner:
Name: DREBAUM MARK LEONARD
Address: 16224 47TH AVENUE S, TUKWILA WA
Contact Person:
Name: MARK DREBAUM
Address: 16224 47 AV S, TUKWILA WA
Contractor:
Name: OWNER AFFIDAVIT IN FILE
Address: 16224 47 AV S, TUKWILA WA
Contractor License No:
DESCRIPTION OF WORK:
INSTALLED NEW GAS FURNACE AND ASSOCIATED DUCTWORK TO REPLACE EXISTING ELEC
FURNACE.
Value of Construction: $1,000.00 Fees Collected: $70.25
Type of Fire Protection: NA Uniform Mechnical Code Edition: 1997
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 perfgm,a1ixe of work. I am authorized to sign and obtain this mechanical pe it.
Signature:
doc: Mech
MECHANICAL PERMIT
M03 -129
Permit Number: M03 -129 z
Issue Date: 09/11/2003 et L I
Permit Expires On: 03/09/2004 6 =
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Phone: 206 242 -9905 z O
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Phone: 206 242 -9905 o f-
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Expiration Date: H H
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Date: ll��
Print Name: Al 1C /.)2 �QsI.
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: 09 -11 -2003
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City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 5379800483
Address: 16224 47 AV S TUKW
Suite No:
Tenant: DREBAUM RESIDENCE
PERMIT CONDITIONS
Permit Number: M03-129
Status: ISSUED
Applied Date: 08/14/2003
Issue Date: 09/11/2003
1: ** *BUILDING DEPARTMENT CONDITIONS * **
2: No changes will be made to the plans unless approved by the Engineer and the Tukwila Building Division.
3: Plumbing permits shall be obtained through the Seattle -King County Department of Public Health. Plumbing will be
inspected by that agency, including all gas piping (296- 4722).
4: Electrical permits shall be obtained through the Washington State Division of Labor and Industries and all electrical
work will be inspected by that agency (206- 835 - 1111).
5: All 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.
6: 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.
7: All construction to be done in conformance with approved plans and requirements of the Uniform Building Code (1997
Edition) as amended, Uniform Mechanical Code (1997 Edition), and Washington State Energy Code (1997 Edition).
8: Validity of Permit. The issuance of a permit or approval of plans, specifications, and computations shall not be
construed to be a permit for, or an approval of, any violation of any of the provisions of the building code or of any
other ordinance of the jurisdiction. No permit presuming to give authority to violate or cancel the provisions of this
code shall be valid.
9: Manufacturers installation instructions required on site for the building inspectors review.
10: Fuel burning appliances may not be installed in sleeping rooms, U.M.C. 304.5.
11: Appliances which generate flame, spark or glowing ignition, shall be elevated 18 inches above the floor (U.M.C.
303.1.3.).
12: 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.
doc: Conditions
M03 -129
Printed: 09 -11 -2003
doc: Conditions
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Signature: . 77 -' _ Date:
Print Name: G4IIC �J(Uz�i- s�►�
M03 -129
Printed: 09 -11 -2003
Site Address: Au S
Tenant Name:
Property Owners Nanie:
Mailing Address: (6 t4 1
GENERAL CONTRACTOR INFORMATION
Contact Person:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
lapplication\permit application (3.2003)
3/2003
CITY OF TUKWILA -
Community Development D .1rtment
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
Public . Works Permit No
Project No
(For ofce use only) . .
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
King Co Assessor's Tax No.:
Suite Number:
New Tenant:
vI
City
ARCHITECT OF RECORD - All plans must be wet stamped by Architect of Record
Floor:
[].... ElrNo
Stale
X31en?
Zip
CONTACT PERSON
Name: Y " isaue_ Da12 - 3 `,'' 6 7 , E 5 "7-)4 Day Telephon t� _ Z - � / j OS
Mailing Address: (oa')i2• y —1 -- - AT - "7-)4 c, `-�
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City State Zip
E -Mail Address: VV\4Zi( utsV► b.A-j t 21J. COAFax Number:
Company Name: f
Mailing Address:
State
Zip
City
Day Telephone:
Fax Number:
Contractor Registration Number: (7 Expiration Date:
**An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
Zip
State
City
Day Telephone:
Fax Number:
ENGINEER OF RECORD - All plans must be wet stamped by Engineer of Record
Zip
Slate
Cily
Day Telephone:
Fax Number:
I i .ButpiN . PERMIT INFORMATION 7 . 2067431 -3670
Valuation of Project (contractor's bid prit $
Scope of Work (please provide detailed information):
Will there be new rack storage? [] ..Yes ❑.. No
Provide MI Building Areas in Square Footage Below
PLANNING DIVISION:
Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): Floor area of principal dwelling: Floor area for accessory dwelling:
*Provide 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:
Will there be a change in use? D ....Yes [] ..No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
❑ ..Sprinklers []..Automatic Fire Alarm
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑..Yes ❑..No
1f "yes", attach list of materials and storage locations on a separate 8-1/2 x // paper indicating quantities and Material Safety Data Sheets.
■applicationttpermit application (3•2003)
3!!003
If "yes ", see Handout No. for requirements.
❑..None ❑ . Other (specify)
Page 2
Existing L ,ling Valuation: $
Handicap:
Existing
Interior
Remodel
Addition to
Existing
Structure
New
Type of
Construction
per UBC
Type of
Occupancy per
UBC
In Floor
2 " Floor
3' Floor
Floors thru
Basement
Accessory Structure*
Attached Garage
Detached Garage
Attached Carport
Detached Carport
Covered Deck
Uncovered Deck
I i .ButpiN . PERMIT INFORMATION 7 . 2067431 -3670
Valuation of Project (contractor's bid prit $
Scope of Work (please provide detailed information):
Will there be new rack storage? [] ..Yes ❑.. No
Provide MI Building Areas in Square Footage Below
PLANNING DIVISION:
Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): Floor area of principal dwelling: Floor area for accessory dwelling:
*Provide 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:
Will there be a change in use? D ....Yes [] ..No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
❑ ..Sprinklers []..Automatic Fire Alarm
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑..Yes ❑..No
1f "yes", attach list of materials and storage locations on a separate 8-1/2 x // paper indicating quantities and Material Safety Data Sheets.
■applicationttpermit application (3•2003)
3!!003
If "yes ", see Handout No. for requirements.
❑..None ❑ . Other (specify)
Page 2
Existing L ,ling Valuation: $
Handicap:
1 ,ruppc WORKS PERMIT INFORMATION 206 -433 -0179
Scope of Work (please provide detailed info....ation):
❑...Total Cut
❑...Total Fill
FINANCE INFORMATION
Fire Line Size at Property Line
❑...Water ❑...Sewer
Monthly Service Billing to:
Name:
Mailing Address:
Water Meter Refund/Billing:
Name:
Mailing Address:
'applicauonslperrnit application (3.3007)
3!2003
Please refer. to Public Works Bulletin #1 for fees and estimate sheet.
Water District
❑ ...Tukwila 0... Water District # 125
❑ ... Water Availability Provided
Sewer District
❑ ...T ukwila 0... ValVue ❑ .. Renton ❑ ...S eatt le
❑ ...Sewer Use Certificate ❑ ... 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 0 .. 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
cubic yards
cubic yards
❑ ...Sanitary Side Sewer
❑ ...Cap or Remove Utilities
❑ ... Frontage Improvements
❑ ...Traffic Control
❑...Backnow 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
11
ff
❑ .. Abandon Septic Tank
❑ .. Curb Cut
❑ .. Pavement Cut
❑ .. Looped Fire Line
Call before you Dig: 1- 800 - 424 -5555
WON
W O#
WO#
Private
Private
❑ .. Highline
❑ .. Geotechnical Report ❑...Traffic Impact Analysis
❑ .. Maintenance Agreement(s) ❑...Hold Harmless
❑ .. Right -of -way Use - Profit for Tess than 72 hours
❑ .. Right -of -way Use — Potential Disturbance
❑ .. Work in Flood Zone
❑ .. Storm Drainage
Number of Public Fire Hydrant(s)
❑ ...Sewage Treatment
Page 3
❑ ...Renton
❑ .. Grease Interceptor
❑ .. Channelization
❑ .. Trench Excavation
❑ .. Utility Undergrounding
❑...Deduct Water Meter Size "
Day Telephone:
City State Zip
Day Telephone:
City
State
Zip
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Boiler /Compressor:
Qty
Furnace <100K BTU
1 -
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+ IIP /1,750.000 BTU
Heat/Refrig /Cooling
System
Incinerator - Domestic
•
Air Handling Unit
<= 10,000 CFM
Incinerator — Comm /Ind
MECHANICAL PERMIT INFO' CATION — 206- 431 -3670
MECHANICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Contractor Registration Number: 094'04 /7/r'�Ahf/ /T Expiration Date:
**An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance**
Project (contractor's bid price): $ /
Scope of Work (please provide detailed information):
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512/4L " , QJ/O c) i &1 ? -iT CArAC tr`l I 2-4::)% p�� /o CA - ' Use: Residential: New ....D Replacement ..- f O
Commercial: New .... Replacement ....El
Indicate type of mechanical work being installed and the quantity below:
BUILDING OWNS OR AUTF
a ll
Signature: •
Print Name:
\applicationslpermit application (3.2003)
3/2003
,Jegt4 -0,,44
Page 4
City State Zip
Day Telephone:
Fax Number:
Z3. �U
Fuel Type: Electric 0 Gas ..„1SL Other: t t a. `
PERMIT APPLICATION NOTES - Applicable to all permits in this application
Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject
to possible revision by the Perrnit 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.
1 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 T IS PERMIT.
Date:
Day Telephone:
Mailing Address: i t224 7 7114°- f¢ -,Iii 7 iTJ /C 1.44e0 14L
City
State
Zip
Date Application Accepted:
Date Application Expires:
Staff Initial
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City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
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RECEIPT =
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Parcel No.: 5379800483 Permit Number: M03 -129 v
Address: 16224 47 AV 5 TUKW Status: APPROVED 0 O
Suite No: Applied Date: 08/14/2003 co w
Applicant: DREBAUM RESIDENCE Issue Date: H
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Receipt No.: R03 -01109 Payment Amount: 70.25 g 5
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Initials: SKS Payment Date: 09/11/2003 10:39 AM z w
User ID: 1165 Balance: $0.00 Z i
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Payee: BISMARK MORTGAGE COMPANY m o
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TRANSACTION LIST:
Type Method Description Amount F'
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Payment Check 50588 70.25 11Z
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ACCOUNT ITEM LIST:
Description
doc: Receipt
MECHANICAL - RES
PLAN CHECK - RES
Account Code Current Pmts
000/322.100 56.20
000/345.830 14.05
Total: 70.25
2520 09/11 9716 TOTAL 117.25
Printed: 09 -11 -2003
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Type of I , ection:
Address
Date Called: i 0 8 7
eci4
S l Instructions
Date Wanted: [ � r..10 - p.m.
Requester: ��//
01.1(/1.*
Phone No:
20(.x 2y 2-g9os
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
(206)431 -3610
Approved per applicable codes:
COMMENTS:
547.00 REINSPECTION FE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. CaII to schedule reinspection.
(Receipt No.:
'Date:
orrections required prior to approval.
N\ Y I2 J
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Mir
OMMENTS:
Inspector:
()4fillj
Date:
INSPECTION RECORD
Retain a copy with permit
INSPEC ON NO.
CITY OF TUKWILA BUILDING DIVISION
6300' Southcenter Blvd., #100, Tukwila, WA 98188
(206)431 -3670
P,roiect:'
Al • J . .t . •
Address:
Special Instructions:
Type of Inspection:
Date Called:
! Date Wanted: 1 a
j 1L73
Requester:„
(0
Ca .)
p.m.
Phone No
Approved pet:applicable codes.
Corrections required prior to approval.
—AO idikfa
$47.00 REINSPECTION I REQUIRED. Prior to inspection, fee must be
. paid at t300 Southcenter Blvd., Suite 100. CaII to schedule reinspection.
Receipt No.:
Date:
INSPECTION RECORD Man
Retain a copy with permit
INSPECTION NO. PERMIT NO. �
CITY OF TUKWILA BUILDING DIVISION
- 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Type of I pection:
Date C Ilec:
Date
Or
30
W anted:
1 1Z12'
Froj
Addr
Special Instruc i • ns:
Requester:
2 './,i4,
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Approved per applicable codes. gtorrections required prior to approval.
COMMENTS:
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Inspecto
!Date: /0 CJ)
547.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
' , paid at $300 Southcenter Blvd., Suite 100. CaII to schedule reinspection.
Receipt No.:
Date:
P ject:
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Type of spection: e
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Address:
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Date Called: v
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Special Instru tions:
Date Wanted: a.m
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Requester:
Phpne fV
2.6l .- `105
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
El Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
Se G
/'
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El $4 REINSPE - I %N FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
Pct: 0 2 id-
'( ill 5
p Date
Typ Inspection:
7.4t) ---
ess:
Called:
9 /I#
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Special Instructions:
•
Date Wanted:
.,.....aL...n .
P.m•
Requm:
Phpne No: '\
1 (906 ) P 12
7,5
INSPECTI.N NO.
El Approved per applicable codes.
INSPECTION RECORD
Retain .a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 981 88
IT NO.
Corrections required prior to approval.
COMMENTS:
Cx
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P41 4A0 7,12."
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Date:
El $47 EleSPECTIO REQUIRED. Prior to inspection, fee must be
I—I paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
(206)431-3670
File: M03 -0129
35mm Drawing
#1
February 2, 2004
Mark Drebaum
16224 47th Avenue South
Tukwila, WA 98168
RE: Permit Application No. M03 -129
16224 47th Avenue South
Dear Permit Holder:
In reviewing our current records the above noted permit has not received a final inspection by the City of Tukwila
Building Division. Per the Uniform Building Code and /or Uniform Mechanical Code, every permit issued by the
Building Official under the provisions of this code shall expire by limitation and become null and void if the
building or work authorized by such permit is not commenced within 180 days from the date of such permit, or if
the building or work authorized by such permit is suspended or abandoned at any time after the work is
commenced for a period of 180 days.
Based on the above, you are hereby advised to:
• Call the City Of Tukwila Permit Center at (206) 431 -3670 to arrange for the next or final
inspection.
This inspection is intended to determine if substantial work has been accomplished since issuance of the permit
or last inspection; or if the project should be considered abandoned.
If such determination is made, the Building Code does allow the Building Official to approve a one -time
extension up to 180 days. Extension requests must be in writing and provide satisfactory reasons why
circumstances beyond the applicants control have prevented action from being taken.
In the event you do not call for the above inspection or request and receive an extension prior to April 14, 2004,
your permit will become null and void and any further work on the project will require a new permit and
associated fees.
Thank you for your cooperation in this matter.
Sincerely,
uw ....-
Stefania'Spencer
Permit Technician
City of Tukwila
Steven M. Mullet, Mayor
Department of Community Development Steve Lancaster, Director
Xc: Permit File No. M03 -129
Bob Benedicto, Building Official
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
5- 19- O4;1O:39AM;HONEYWELL
Mark L. Drebaum
16224 47 Avenue South
Tukwila, WA 98188
206.321.6770
May 19, 2004
City of Tukwila/Permit Center
Attn: Stephania
6300 Southcenter Blvd. #100
Tukwila, WA 98188
RE: PERMIT #M03129
This is a request for a Permit Extension.
Please extend my permit for building site: 16224 47 Avenue S - Tukwila, WA 98188
If you have any questions, 1 can be reach at 206.321.6770
Thank you,
c0
Mark L. Drebaum
Fax to: 206.431.3665
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Mark L. Drebaum
16224 47 Avenue South
Tukwila, WA 98188
206.321.6770
May 19, 2004
City of Tukwila/Permit Center
Attn: Stephania
6300 Southcenter Blvd. #100
Tukwila, WA 98188
RE: PERMIT #M03129
This is a request for a Permit Extension.
Please extend my permit for building site: 16224 47 Avenue S - Tukwila, WA 98188
If you have any questions, I can be reach at 206.321.6770
Thank you,
Mark L. Drebaum
Fax to: 206.431.3665
MAY 9 20
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PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: M03 -129
PROJECT NAME: DREBAUM RESIDENCE
SITE ADDRESS: 16224 47 AV S
DATE: 08 -18 -03
X Original Plan Submittal Response to Incomplete Letter #
_ Response to Correction Letter # Revision # After permit Is Issued
DEPARTMENTS:
Buildg t ivis (�]
Public Works ❑
M51
Fire Prevention
Complete Incomplete ❑
Planning Division
Structural ❑ Permit Coordinator
DETERMINA ON OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 08 -19 -03
Not Applicable ❑
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS r4.A.ILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS ROUTING:
Please Route , Structural Review Required ❑ No further Review Required ❑
REVIEWER'S INITIALS: DATE:
REVIEWER'S INITIALS:
DUE DATE: 09 -16 -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
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STATE OF WASHINGTON )
COUNTY OF KING
AFFCONT 1/13/00
CITY OF TL . WILA'
Permit Center
6300 Southcenter Boulevard, Suite 100, Tukwila, WA 98188
Telephone: (206) 431 -3670
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
ss.
ark Leo 6A. L Y , , 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. ? •(=7 ?, 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
day of
H -4
4,
t?✓ 2 003
NOTARY PU :LIC in and for the State of ashington,
residing at � County.
Name as commissione•: Ke // �. , va/
My commission expires: c Q`/
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.
File: M03 -0129
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NO CHANGES SHALL BE MADE TO
E SCOPE OF WORK WITHOUT PRPOR
APPROVAL OF 'I'll.) 9'6!_.:''1, BUILDING CC IVIBI I ,
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I understand that the Plan Check approvals are
subject to errors and omissions and approval of
plans does not authorize the violation of any
adopted code or ordinance. Receipt of con -
tractor'g copy of appFoved,.pfans acknowledged.
By
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