HomeMy WebLinkAboutPermit M02-157 - DEMPERE RESIDENCEM02 -157
Dempere
Residence
132174OAvS
Parcel No.:
Address:
Suite No:
Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
Address:
DESCRIPTION OF WORK:
FURNACE FOR MOVED HOUSE - BOILER
Signature:
Print Name:
doc: Mech
7340600901
1321740 AV S TUKW
JACKIE DEMPERE
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
DEMPERE JACKIE L
128TH, TUKWILA WA 98168
DEMPERE JACKIE L
128TH, TUKWILA WA 98168
Contractor:
Name: OWNER AFFIDAVIT IN FILE
Address:
Contractor License No:
Rcxt� lernee
MECHANICAL PERMIT
MO2 -157
Permit Number:
Issue Date:
Permit Expires On:
Expiration Date:
Phone:
Phone: 206 433 -8539
Phone:
MO2 -157
Value of Construction: $0.00 Fees Collected: $44.45
Type of Fire Protection: N/A Uniform Mechnical Code Edition: 1997
Permit Center Authorized Signature: sf�ctsi GC`t Date: 7r _9 / -O Z
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:
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: 07 -31 -2002
Proje ame/Ten nt:
EfriPE2 nictc(t6'
AGENT:
Value of Mechanical Equipment:
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Site Address I
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Street Address:
City State/Zip:
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Contractor:
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Phone: ( )
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City State/Zip:
Fax #: ( )
Contact Person:
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Street Address:
City State /Zip:
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CITY OF T''KWILA
Permit Center
6300 Southcenter Boulevard, Suite 100
Tukwila, WA 98188
(206) 431 -3670
R slim USE ONI Y
Project Number:
Permit Number:
N10 i5 (Al
Mechanical Permit Application
Application and plans must be complete in order to be accepted for plan review.
Applications will not be accepted through the mail or facsimile.
MECHANICAL PERMIT REVIEW AND APPROVAL REQUESTED: (TO BE FILLED OUT BY APPLICANT)
Description of work to be done (please be specific):
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Current copy of Washington State Department of Labor and Industries Valid Contractor's License. If not available at the time of
application, a copy of this license will be required before the permit is issued OR submit Form H -4, "Affidavit in Lieu of Contractor
Registration ".
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.
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 THIS PERMIT.
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 114.4 of the Uniform Mechanical Code (current edition). No application shall be
extended more than once.
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Date application accepted:
7 -3 / -oz
Date application expires:
/-- 3/-0.3
Application taken by: (initials)
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Submittal Requirements
Floor plan and system layout
Roof plan required to identify individual equipment and the location of each installation (Uniform
Mechanical Code 504 (e))
Details and elevations (for roof mounted equipment) and proposed screening
Heat Loss Calculations or Washington State Energy Code Form #H -7
.
H.V.A.C. over 2,000 CFM (approximately 5 ton and larger) must be provided with smoke detection shut-
off and will be routed to the Fire Prevention division for additional comments (Uniform Mechanical
Code 1009).
Specifications must be provided to show that replacement equipment complies with the efficiency ratings
and other applicable requirements of the Washington State Nonresidential Energy Code.
Structural engineer's analysis is required for new and the replacement of existing roof equipment
weighing 400 pounds and greater (Uniform Building Code 1632.1). Structural documentation shall be
stamped by a Washington State licensed Structural Engineer.
New Single Family Residence
Mechanical Permits
COMMERCIAL: Two complete sets of drawings and attachments required with application submittal
NOTE: Water heaters and vents are included in the Uniform Mechanical Code — please include any water
heaters or vents being installed or replaced.
RESIDENTIAL: Two complete sets of attachments required with application submittal
Submittal Requirements
Heat loss calculations or Form H -6.
Equipment specifications.
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Change -out or replacement of existing mechanical equipment
Narrative of work to be done, including modification to duct work.
Installation of Gas Fireplace
Narrative with specification of equipment and chimney type.
If using existing chimney, provide a letter by a certified chimney sweep stating that the chimney is in safe
condition.
NOTE: Water heaters and vents are included in the Uniform Mechanical Code — please include any water
heaters or vents being installed or replaced.
SignaturC
Print Name:
doc: Conditions
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 7340600901
Address: 13217 40 AV S TUKW
Suite No:
Tenant: DEMPERE JACKIE L
PERMIT CONDITIONS
Permit Number:
Status:
Applied Date:
Issue Date:
MO2 -157
PENDING
07/31/2002
1: ** *BUILDING DEPARTMENT * **
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
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
amended, Uniform Mechanical Code
(1997 Edition), and Washington State Energy Code (1997 Edition).
5: Validity of Permit. The issuance of a permit or approval of plans, specifications, and computations shall not
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
give authority to violate
or cancel the provisions of this code shall be valid.
6: Manufacturers installation instructions required on site for the building inspectors review.
7: Fuel burning appliances may not be installed in sleeping rooms, U.M.C. 304.5.
8: Appliances which generate flame, spark or glowing ignition, shall be elevated 18 inches above the floor (U.
9: Water heater shall be anchored to resist earthquake (U.P.C. 510.5).
construction. These
Code (1997 Edition) as
be construed to be a
permit presuming to
M.C. 303.1.3.).
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.
SaC.K.,t DEMre.R.E.:
MO2 -157
Date:
Printed: 07 -31 -2002
TRANSACTION LIST:
ACCOUNT ITEM LIST:
doc: Receipt
City of Tukwila
Current Pmts
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
4
Parcel No.: 7340600901 Permit Number: MO2 -157
Address: 13217 40 AV S TUKW Status: PENDING
Suite No: Applied Date: 07/31/2002
Applicant: DEMPERE JACKIE L Issue Date:
Receipt No.: R020001079 Payment Amount: 44.45
Initials: SKS Payment Date: 07/31/2002 04:50 PM
User ID: 1165 Balance: $0.00
Payee: JACKIE DEMPERE
Amount
Payment Check 6318
MECHANICAL - RES
Type
RECEIPT
Method Description
44.45
Description Account Code
000/322.100 44.45
Total: 44.45
Printed: 07 -31 -2002
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Special:Instructions:-
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Date Wanted: 2/--0
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INSPECTION REC ZD
Retain a copy with permit
INSPECTION NO:
ITY OF'.TUKWILA BUILDING DIVISION
„_6300;Southcenter.Blvd., #100, Tukwila, WA 98188
COMMENTS:
Approved per applicable codes.
PERMIT NO.
(206)431 3670
El Corrections required prior to approval.
EINSPECTION '(EE REQUIRED. Prior to inspection, fee must be
:; paid at 6300;.Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.
! Date:
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Pro {ect:
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Type of-I spection:
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Addtess: r q °11/1 Ave
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Date Called: �� QZ (�
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Special Instructions:
Date Wanted:
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2 p.m -
Requester: C 141.0
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Pho e�Nso: /
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INSPECTION RECAD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
)7'/& - / 57
Approved per applicable codes.
Fit Corrections required prior to approval.
COMMENTS:
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Inspect
Date: /0....
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El S47.00 REINSPECTION FEE, REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
'Date:
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Mini 1 livrrn II ,IV t1 iriu,rl
Document 1025V
Installation
and Operating
Instructions f or
Mini. -Their
(Mo del JV
Residen
Gas - Fired
Hydro
Boilers
5is lS optional in Canada.
s tored in the packet provided on the boiler.
FOR YOUR SAFETY:
Do not store or use gasoline or other flammable vapors and liquids in the vicinity of this or any other appliance.
WARNING:
Improper installation, adjustment, alteration, service or maintenance can cause injury or property damage. Refer to this
manual. For assistance or additional information consult a qualified installer, service agency or the gas supplier.
FOR YOUR SAFETY - WHAT TO DO IF YOU SMELL GAS:
• Do not try to light any appliance.
• Do not touch any electrical switch; do not use any phone in your building.
• Immediately call your gas supplier from a neighbor's phone. Follow the gas supplier's instructions.
• If you can not reach your gas supplier, call the fire department.
WTELEDYNE LAARS
STATE OF WASHINGTON
COUNTY OF KING
AFFCONT 1/13/00
CITY OF T"'CWILA
Permit Centel
6300 Southcenter Boulevard, Suite 100, Tukwila, WA 98188
Telephone: (206) 431 -3670
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
Sptc ,te Jtir1 PE12E , 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. 1 2. , 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.
\s
i
APPLICANT
GE A. O O h
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f 510N ' t C� -
4 NOTAF : � �
: o i
i AUBUC
1 u>' • •• e .16_0 b . •
ss.
ned and sworn to before me this
residing at
day of
County.
Name as commissioned: A I C e. A. Deal
My commission expires: 6 - / b -
H -4
NOTARY PUBLIC in and far the State of Washington,
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;
y 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.
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