HomeMy WebLinkAboutPermit 0505 - Siegel ResidenceJOB AOOR EGO .�
DATE
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LOT NO.
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OW ER MAIL ADDRESS ZIP PHONE
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CONTRACTOR MAIL ADDRESS PHONE LICENSE NO.
3 \Y/7NkC
ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO.
4
ENGINEER MAIL ADDRESS PHONE LICENSE NO.
5
LENDER MAIL ADDRESS BRANCH
6
USC OF BUILDING
7
8 Class of work: • NEW Lr1ADDITION • ALTERATION ❑ REPAIR ■ MOVE • REMOVE
9 Describe work: 7 k ,r rA 4 l /iax ' - Aq Ci el .�G44. "...._ L /��Zds"
10 Change of use from
Change of use to
11 Valuation of work: $ v4) -
PLAN CHECK FEE
..-- e l
d
PERMIT FE %
SPECIAL CONDITIONS:
Typo of
Const.
Occupancy
Group
Division
Size of Bldg.
(Total) Sq. Ft.
No. of
Stories
Max.
Occ. Load
Fire
Zone
Use
Zone
Fire Sprinklers
Required • Yes • No
APPLICATION ACCEPTED BY:
PLANS CHECKED BY: {
\\
APPS D FOR SSUANCE BY
^
No. of
Dwelling Units
OFFSTREET PARKING SPACES:
Covered Uncovered
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-
ING, HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK I$ COM-
MENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STAT OR LOCAL t,.AW REGULATING
CONSTR TION OR THE PERF ANCE OF C NSTRUCTION.
--
Special Approvals
Required
Not Required
Approved
ZONING
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
FOUNDATION
FRAMING
SIGNATURE OF OWNER IF OW BUILDER)
FINAL
SIGNATURE OR AUTHORIZED AGENT (DATE)
BUILDING PERMIT
App licant to complete numbered spaces only.
CIT( JF TUKWILA BUILDING PL MIT
14475 • 59th Ave. So. / Tukwila, Washington 98067
N :")05
BUILDING -
PERMIT NO.
WHEN PROPERLY VALIDATED ON THIS SPACE) THIS IS YOUR PER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION
OCCUPANCY PERMIT REQUIRED
M.O. CASH
JO0 AzO'I E55
DATE y
LEO�L
1 D
LOT NO.
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ELK
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4-V�i4� .r /rs L.Nr4 V � V v'�"�'/s
O NNE , MAIL ADDRESS ZIP %Fp' ' ^ PHONE 1— 4.f - 4��
2
CON:RAC TOf! MAIL A0311E99 PHONE LICENSE NO.
3 • _
ARCH:'CCT OR OESIGN1n MAIL ADDRESS PHONE LICENSE NO.
ENGINEGR MAIL ADDRESS PHONE LICENSE I10.
5
LENDER MAIL ADDRESS DRANCH
6 •
use Or 0UI1..0:'1G
7
3 Class of work: 0 NEW. L! ADDITION • ALTERATION 0 REPAIR 0 MOVE • REMOVE
9 Describe work: �"� / ®•
10 Change Of use from
Change of use to
......._,... ........._.....,,.o.*
w........w.
11 Valuation of work: $ •
PLAN CHECK FEE
PERMIT FEE
SPECIAL CONDITIONS:
'type of
Const.
Occupancy .
Group
Division
Size of Bldg.
(Total) Sq. Ft.
No, of ,
Stories
Max.
Occ. Load
Fire
Zone
Use
Z one
Fire Sprinklers
Required Dyes riNo
APPLICATION ACCEPreo a Y:
PLANS CHECKED OY:
APPROVED FOR ISSUANCE DY;
No. of
Dwelling Units
OFFSTREET PARKING
Covered
SPACES:
Uncovered
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-
1NC, HEATING, VENTILATING OR AIR CONDITIONING. •
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME To GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
Special Approvals
Required
Not Required
Approved
ZONING
'
HEALTH DEPT,
FIRE DEPT,
.
SOIL REPORT
OTHER (Specify)
FOUNDATION
FRAMING
FINAL.
SiGtA7URE OF 0Y9 :,Ei1 Ilr UY/NE I nulLOEn)
•
_____
S::N ATUi'F. On AUTIHORIZRO AGENT (DA TEI
BUILDIr; J PERMIT
•
APPLICATION
CF — OF TUKWILA BUILDING DEPART!; :NT
6230 Southcenter Blvd.
Tukwila, Washington 98067
Phone: 242 -2177