The URL can be used to link to this page

Home My WebLink AboutPermit PG07-209 - STEPPING STONE VENTURES #58This record contains information which is exempt from public disclosure pursuant to the Washington State Public Records Act, Chapter 42.56 RCW as identified on the Digital Records Exemption Log shown below. PG07 -209 Southgate Mobile Home Park #58 1400542 nd Avenue South RECORDS DIGITAL D- ) EXEMPTION LOG THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION Page # tode Exemption = 8rlef Explanatory DeSclriptiop �t�tutel ule The Privacy Act of 1974 evinces Congress' intent that social security numbers are a private concern. As such, individuals' social security Personal Information — numbers are redacted to protect those Social Security Numbers individuals' privacy pursuant to 5 U.S.C. sec. 5 U.S.C. sec. DR1 Generally — 5 U.S.C. sec. 552(a), and are also exempt from disclosure 552(a); RCW 552(a); RCW under section 42.56.070(1) of the Washington 42.56.070(1) 42.56.070(1) State Public Records Act, which exempts under the PRA records or information exempt or prohibited from disclosure under any other statute. Redactions contain Credit card numbers, debit card numbers, electronic check numbers, credit Personal Information — expiration dates, or bank or other financial RCW 21 DR2 Financial Information — account numbers, which are exempt from 42.56.230(5) RCW 42.56.230(4 5) disclosure pursuant to RCW 42.56.230(5), except when disclosure is expressly required by or governed by other law. SOUTHGATE MOBILE HOME PARK #58 14005 42 AV S PGO 7-209 Parcel No.: 1523049008 Address: 14005 42 AV S TUKW Suite No: Tenant: Name: Address: Owner: Name: Address: Contact Person: Name: ERIN O'LEARY Address: 20303 10 AV W , LYNNWOOD WA REVISION #1: ADD WATER HEATER Value of Plumbing /Gas Piping: Fees Collected: doc: UPC -10/06 City J Tukwila Plumbing Bathtub or combination bath/shower 0 Bidet 0 Clothes washer, domestic Dental unit, cuspidor Dishwasher, domestic, with independent drain Drinking fountain or water cooler (per head) Food -waste grinder, commercial Floor drain Shower, single head trap Lavatory Wash fountain Receptor, indirect waste Sinks Urinals Water Closet Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 - 431 -3665 Web site: http: / /www.ci.tukwila.wa.us STEPPING STONE VENTURES #58 14005 42 AV S , TUKWILA WA STEPPING STONE VENTURES L L 20303 10TH AVE W , LYNNWOOD WA Contractor: Name: OWNER AFFIDAVIT - ERIN O'LEARY Address: 2030310 AV W , LYNNWOOD WA Contractor License No: $200.00 $207.00 PLUMBING /GAS PIPING PERMIT Expiration Date: DESCRIPTION OF WORK: HOOKING MOBILE HOME UP TO PROPANE TANK AND EXISTING WATER AND SEWER ON PROPERTY Uniform Plumbing Code Edition: 2006 International Fuel Gas Code Edition: 2006 FIXTURE TYPE AND QUANTITY Plumbing (cont.) Building sewer and each trailer park sewer 1 Rain water system - per drain (inside bldg) 0 0 Water heater and/or vent 1 0 Industrial waste treatment interceptor, including 0 its trap and vent, except for kitchen type 0 grease interceptors 0 0 Repair or alteration of water piping and/or water 0 treatment equipment 1 0 Repair or alteration of drainage or vent piping 0 0 Medical gas piping system serving (1 -5) 0 inlets /outlets for a specific gas 0 0 Medical gas piping (6 +) inlets /outlets 0 O Gas Pipinq O Gas piping outlets (0 -5) 1 O Gas piping outlets (6 +) 0 * *continued on next page ** Permit Number: Issue Date: Permit Expires On: Phone: Phone: 206- 484 -3848 Phone: 206 - 484 -3848 PG07 -209 08/09/2007 03/04/2008 PG07 -209 Printed: 09-20 -2007 Permit Center Authorized Signature: Signature: Print Name: TIN City oHTukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us I hereby certify that I have read and xanned this permit and know the same to be true and correct. All provisions of law and ordinances governing this work will be compile 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 performan e work. I am authorized to sign and obtain this plumbing /gas piping permit. Date: R (c )-() / J 7 Permit Number: PG07 -209 Issue Date: 08/09/2007 Permit Expires On: 03/04/2008 QQ Date: ff1(2,9 This permit shall become null and void if the work • 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. doc: UPC-10 /06 PG07 -209 Printed: 09 -20 -2007 Parcel No.: 1523049008 Address: Suite No: Contact Person: Name: ERIN O'LEARY Address: 20303 10 AV W , LYNNWOOD WA doc: UPC - 10/06 14005 42 AV S TUKW Value of Plumbing /Gas Piping: Fees Collected: Cityf Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us Tenant: Name: SOUTHGATE MOBILE HOME PARK #58 Address: 14005 42 AV S , TUKWILA WA Owner: Name: STEPPING STONE VENTURES L L Address: 20303 10TH AVE W , LYNNWOOD WA Contractor: Name: OWNER AFFIDAVIT - ERIN O'LEARY Address: 2030310 AV W , LYNNWOOD WA Contractor License No: DESCRIPTION OF WORK: HOOKING MOBILE HOME UP TO PROPANE TANK AND EXISTING WATER AND SEWER ON PROPERTY $200.00 $197.00 Plumbing Bathtub or combination bath/shower 0 Bidet 0 Clothes washer, domestic Dental unit, cuspidor Dishwasher, domestic, with independent drain Drinking fountain or water cooler (per head) Food -waste grinder, commercial Floor drain Shower, single head trap Lavatory Wash fountain Receptor, indirect waste Sinks Urinals Water Closet PLUMBING /GAS PIPING PERMIT FIXTURE TYPE AND OUANTITY * *continued on next page ** Permit Number: Issue Date: Permit Expires On: Expiration Date: Phone: Phone: 206- 484 -3848 Phone: 206 - 484 -3848 PGO7 -209 08/09/2007 02/05/2008 Uniform Plumbing Code Edition: 2006 International Fuel Gas Code Edition: 2006 Plumbing (cont.) Building sewer and each trailer park sewer 1 Rain water system - per drain (inside bldg) 0 0 Water heater and/or vent 0 0 Industrial waste treatment interceptor, including 0 its trap and vent, except for kitchen type 0 grease interceptors 0 0 Repair or alteration of water piping and/or water 0 treatment equipment 1 0 Repair or alteration of drainage or vent piping 0 0 Medical gas piping system serving (1 -5) 0 inlets /outlets for a specific gas 0 0 Medical gas piping (6 +) inlets /outlets 0 0 Gas Piping 0 Gas piping outlets (0 -8) 1 0 Gas piping outlets (6 +) 0 PG07 -209 Printed: 08-09 -2007 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 p ce of wo k I am authorized to sign and obtain this plumbing /gas piping permit. (, Signature: Date: 9 - " Print Name: doc: UPC -10/06 City dr Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us Permit Number: PG07 -209 Issue Date: 08/09/2007 Permit Expires On: 02/05/2008 LU4fiLR Date: O -q - Q 7 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. PG07 -209 Printed: 08 -09 -2007 Parcel No.: 1523049008 Address: Suite No: Tenant: 1: ** *PLUMBING AND GAS PIPING * ** doc: Cond - 10/06 14005 42 AV S TUKW City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us SOUTHGATE MOBILE HOME PARK #58 PERMIT CONDITIONS * *continued on next page ** Permit Number: Status: Applied Date: Issue Date: 2: No changes shall be made to applicable plans and specifications unless prior approval is obtained from the Tukwila Building Division. 3: All permits, inspection records and applicable plans shall be maintained at the job and available to the plumbing inspector. 4: All plumbing and gas piping systems shall be installed in compliance with the Uniform Plumbing Code and the Fuel Gas Code. 5: No portion of any plumbing system or gas piping shall be concealed until inspected and approved. PG07 -209 ISSUED 08/09/2007 08/09/2007 6: All plumbing and gas piping systems shall be tested and approved as required by the Plumbing Code and Fuel Gas Code. Tests shall be conducted in the presence of the Plumbing Inspector. It shall be the duty of the holder of the permit to make sure that the work will stand the test prescribed before giving notification that the work is ready for inspection. 7: No water, soil, or waste pipe shall be installed or permitted outside of a building or in an exterior wall unless, adequate provision is made to protect such pipe from freezing. All hot and cold water pipes installed outside the conditioned space shall be insulated to minimum R-3. 8: Plastic and copper piping running through framing members to within one (1) inch of the exposed framing shall be protected by steel nail plates not less than 18 guage. 9: Piping through concrete or masonry walls shall not be subject to any load from building construction. No plumbing piping shall be directly embedded in concrete or masonry. 10: All pipes penetrating floor /ceiling assemblies and fire- resistance rated walls or partitions shall be protected in accordance with the requirements of the building code. 11: Piping in the ground shall be laid on a firm bed for its entire length. Trenches shall be backfilled in thin layers to twelve inches above the top of the piping with clean earth, which shall not contain stones, boulders, cinderfill, frozen earth, or construction debris. 12: The issuance of a permit or approval of plans and specifications shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the Plumbing Code or Fuel Gas Code or any other ordinance of the jurisdiction. PG07 -209 Printed: 08 -09 -2007 City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us 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: Cond -10/06 e4,Ai 11, Date: PG07 -209 Printed: 08 -09 -2007 Site Address: Mailing Address: Name: Contact Person: E -Mail Address: E -Mail Address: CITY OF TUKWIL Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us PLUMBING / GAS PIPING PERMIT APPLICATION 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 LOCATION L Tenant Name:U- Property Owners Name: S 00 O 4- Q:\Applications\Forms- Applications On Line\3 -2006 - Plumbing -Gas Piping Permit Applieation.doe Revised: 4-2006 bh Plumbing/Gas Permit No. Project N Mailing Address: E -Mail Address: L ''' GAS. PIPING CONTRACTORINFORMATIO King Co Assessor's Tax No.: 1 5 O) 3ce-/ q Suite Number: New Tenant: A... Yes U�h'�i / LC} City o. Fax Number: or offic use only) State CONTACT PERSON -Who '(lo we contact when •your permit is ready to be issue Day Telephone: c 300 e9 et/ 3 g ti �'S�tet ip Zip Company Name: Mailing Address: City Day Telephone: Fax Number: Contractor Registration Number: Expiration Date: State ARCHITECT OF RECORD - All plans must be wet stamped by Architect co Company Name: Mailing Address: Zip Contact Person: E -Mail Address: City Day Telephone: Fax Number: State ENGINEER OF RECORD - All plans must be wet stamped by Engineer o Company Name: Mailing Address: Zip Contact Person: City Day Telephone: Fax Number: State Floor: ..No Zip Zip Page 1 of 2 Fixture TYPe: Fixture. Type: Y " Fixture- pm City. ; Fixture Type: Qty Bathtub or combination bath/shower j Drinking fountain or water cooler (per head) Wash fountain Gas piping outlets Bidet Food -waste grinder, commercial Receptor, indirect waste Clothes washer, domestic 1 Floor drain Sinks Dental unit, cuspidor Shower, single head trap Urinals / Dishwasher, domestic, with independent drain Lavatory Water Closet Building sewer or trailer park sewer Rain water system — per drain (inside building) Water heater and/or vent I Additional medical gas inlets/outlets — six or more Industrial waste pretreatment interceptor, including its trap and vent, except for kitchen type grease interceptors Repair or alteration of water piping and/or water treating equipment Repair or alteration of drainage or vent piping Medical gas piping system serving one to five inlets/outlets for specific gas tv Valuation of Project (contractor's bid price): $ P K) 0 (please provide • i / 1 �.�i • • CI Sc. of Work (ple detaile information): Building Use (per Intl Building Code): Occupancy (per Intl Building Code): Utility Purveyor: Water: f C)S Sewer: Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below: Signature: Mailing Address! 7� Mi1ti Print Name: I Date Application Accepted: Q:\Applications\Forms- Applications On LineG -2006 - Plumbing -Gas Piping Perini Application.doc Revised: 4 -2006 bb ty \41 Vt7 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 grant one extension of time for an additional period not to exceed 180 days. The extension shall be requested in writing and justifiable cause demonstrated. Section 103.4.3 International Plumbing Code (current edition). 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 0 -. •• OR AUTHO • v ED AG NT: Day Telephon Date: _ 1-0 arou State Zip Date Application Expires: Staff Initials: Page 2 of 2 Doc: RECSETS -06 RECEIPT NO: R07 -02049 Initials: JEM User ID: 1165 City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us Payee: STEPPING STONE VENUTES, LLC SET ID: 0920C SET NAME: STEPPING STONE VENTURES SET TRANSACTIONS: Set Member ACCOUNT ITEM LIST: Description GAS - RES PLUMBING - RES Amount PG07 -209 10.00 PG07 -250 119.00 TOTAL: 129.00 TRANSACTION LIST: Type Method Description SET RECEIPT Payment Date: 09/20/2007 Total Payment: 129.00 Amount Payment Check 6593 129.00 TOTAL: 129.00 Account Code Current Pmts 000/322.100 88.00 000/322.100 41.00 TOTAL: 129.00 T.:1 ` :r_ Receipt No.: R07 -01644 Payee: STEPPING STONES ACCOUNT ITEM LIST: Description GAS - RES PLUMBING - RES City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 -431 -3665 Web site: http: //www.ci.tukwila.wa.us RECEIPT Parcel No.: 1523049008 Permit Number: PG07 -209 Address: 14005 42 AV S TUKW Status: PENDING Suite No: Applied Date: 08/09/2007 Applicant: SOUTHGATE MOBILE HOME PARK #58 Issue Date: Initials: WER Payment Date: 08/09/2007 12:08 PM User ID: 1655 Balance: $0.00 TRANSACTION LIST: Type Method Description Amount Payment Check 6551 197.00 Account Code Current Pmts 000/322.100 88.00 000/322.100 109.00 Total: $197.00 Payment Amount: $ 197.00 doc: Receiot -06 Printed: 08 -09 -2007 Project: _7 o4/ r° Type of Inspection: ,.-- .q/ x4.0.5- Ctr Address: / 5 924u Date Called: Special Instructions: Date Wanted: a.m. Re ues e : Ph N .2 one �- y/1 ff 4/0 INSPECTION NO. INSPECTION RECORD Retain a copy with permit CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 7 - 2a PERMIT NO. � (206)431 -36710 V Approved per applicable codes. ❑ Corrections required prior to approval. COMMENTS: P /?/«1b,,1 F' v4 (_) gas - r,A7A/ Pe-/m g fi - rrf f1 Date: 2 -7 /Ue $ .00 ' EINSPECTION FE REQUIRED. rior to inspection, fee must be p = 'd - 6300 Southcenter Blvd.. Suite 10 . Call the schedule reinspection. 'Receipt No.: 'Date: • Projes TEM ( 6 S j Type of ns ection: CU 4 I Adt dress: N o0S 14 Z S Date Called: Special Instructions: I S -1 -C kJ ( C y'%' Date W nted: Requester: Phone No: 1..4J1vIMCN 1 3: U l•\()4 l.JAtei/ 4.'RNJIC-- S ?.vC S %-T l0 it kip — \lF ni-t I S -1 -C kJ ( C y'%' I Insp to : JDat 07 `O 3 INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 Approved per applicable codes. El Corrections required prior to approval. 58 0 REINSPECTION FEE1 EQU ED. Prior to inspection, fee must be ai at 6300 Southcenter Blvd.. S ite 100. Call the schedule reinspection. (Receipt No.: 'Date: INSPECTION RECORD Retain a copy with permit P6.0-7 - zo? (206)431- 6 Prokct: /l 6 Type of Inspection: I _ 1 IV Address: / ./ Date Called: Special Instructions: Date Wanted 69 3 0 — 7 tzle P.m. Requester: Phone ---- YE;V— ..36'e/67 INSPECTION NO. INSPECTION RECORD Retain a copy with permit /-17-265 PERT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 2 - 'proved per applicable codes. El Corrections required prior to approval. COMMENTS: 5 8.00 REINSPECTIO EE REQU ED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection. 'Receipt No.: 'Date: Pro 'ect : l L Type of / Inspection: _ - _ ( Address: /4 4 --/Z /IL) S Date Called: x2�r /� 6 0 S Special Instructions: Date Wanted: e_97-- _" P.m. Requester: Phon V9 INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 INSPECTION RECORD Retain a copy with permit PERMIT NO. (206)431 -36 [74.pproved per applicable codes. Q Corrections required prior to approval. COMMENTS: A $ b0 REINSPECTION F E REQUIRED. dor to inspection. fee must be pad at 6300 Southcenter Blvd., Suite 100. Call the schedule reinspection. !Receipt No.: 'Date: 02 -12 -2008 ERIN O'LEARY 20303 10 AV W LYNNWOOD WA 98036 RE: Permit No. PG07 -209 14005 42 AV S TUKW 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 International Codes, Uniform Plumbing/Fuel Gas Code and/or the National Electrical Code, every permit issued by the Building Division under the provisions of the 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 issuance, 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 Inspection Request Line at 206 -431 -2451 to schedule 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 International Codes, Uniform Plumbing/Fuel Gas Code and/or the National Electrical Code does allow the Building Official to approve one extension of time for an additional period not exceeding 180 days. Extension requests must be in writine 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 and receive an extension prior to 03/04/2008 , your permit will become null and void and any further work on the project will require a new permit application and associated fees. Thank you for your cooperation in this matter. Sincerely, fer Marshall Permit Technician t19, xc: Permit File No. PG07 -209 City of Tukwila Jim Haggerton, Mayor Department of Community Development Jack Pace, Director 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 October 17, 2007 City of Tukwila Steven M. Mullet, Mayor Department of Community Development Steve Lancaster, Director Eric O'Leary Stepping Stone Ventures LLC 20303 — 10 Avenue W Lynnwood, WA 98036 RE: Partial Permit Fee Refund Dear Ms. O'Leary: Enclosed is a check in the amount of $74.00 for the partial permit fee paid at the time of permit issuance for the project located at 14005 — 42 Avenue S, Unit #46 (Permit No. EL07 -523) and for Unit #58 (Permit No. PG07 -209), Tukwila, Washington. Per your written request to cancel this permit, a refund is being sent to you. If you have any questions, please feel free to contact our office at 206 - 431 -3670. Sincerely, encl 110 Brenda Holt, Permit Coordinator xc: Permit No. EL07 -523 Permit no. PG07 -209✓ H:\Documents\Letters\PG07- 209 -PG07- 250 -ELO7 -523 - refund Ietter.doc bh 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 Memo 27, 2007 Re: PG07 -209 Xc: File No. PG07 -209 H:tDocumentslLetters\PG07 -209 - refund memo.doc bh To: Laurie Anderson From: Brenda Holt Erin O'Leary Stepping Stone Ventures LLC 20303 — 10 Avenue W Lynnwood, WA 98036 City of Tukwila Permit Center Please refund $10.00 for the permit fee paid for the installation of a water heater. The scope of work under the jurisdiction of Labor and Industries. Please make the check out to the following and I will forward it to them: kuui aX wove 40 Cam +L �,'� (tc or V r 4-1-eneys0 a� a v, - 8ott, Y PCB o - taO E L o"] -5a3 -b Cosy\ LJd u -1-L '` NS w ±-Or et- Vi'f\nj - P6)0/ - Q-0 6 1 LAJ4 f tivck6_s4 voDuaLo I'- 4 r+ ma x. S -k -P-or m 315 �, AE SEP 2 ua 1 2001 -INTER oy - o ) _Si n v■-\', -A- ; s ` cry v; 4-4) LEI � hod u4- dt-T ,lk V€1/4-1 LEL 3 ° -0 fei/Pid Ik -z50 ; eig zaxo — /65 &rvoAECE E107-5 p-- �n�' �l j7 -zoq O ea°3 i.0 o9/207 CITY OF TUKWILA, WA 98188 -2544 iNVO CE NUMBER 101507302 10/10/2007 P O. NUMBER . 'r- -- DESCRIPTION 80% PERMIT REF. ELO7 -523 (94" 6 Rvi-tk i P P(0,1 lc CC 10- cc; 74.00 THE FACE OF THIS DOCUMENT HAS A COLORED BACKGROUND -NOT - A'WHITE BACKGROUND PAYABLE THROUGH U.S. BANK 151 Andover Pale Eas Tukwila. WA 95155 010576 10/15/2007 1250 74.00 PAY Seventy Four Dollars and No Cents TO THE ORDER Tukwila WA 98188 -2544 CITY OF TUKWILA 6200 Southcenter Boulevard THE BACK OF THIS DOCUMENT +HAS AN ARTIFICIAL WATERMARK -HOLD AT AN ANGLE TO VIEW STEPPING STONE VENTURES LLC C /O ERIN O'LEARY 20303 10TH AVE W LYNNWOOD, WA 98036 ACCOUNTS PAYABLE CHECK PLEASE DETACH BEFORE DEPOSITING NO. City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us Revision submittals must be submitted In person at the Permit Center. Revisions will not be accepted through the mail, fad etc. Date: - off: C - 0 Plan Check/Permit Number: ❑ Response to Incomplete Letter # ❑ Response to Correction Letter # Revision # I after Permit is Issued Revision requested by a City Building Inspector or Plans Examiner Project Name: SDv ,` �'� Project Address: 1 oo A c h 11 2_ S *- 5 Created: 8 -13 -2004 Revised: Contact Person: IV o L--eA 0. ■ Phone Number: GC.r iPk IN et QY. i RECE►vED C1 Y QFruKti ltA SEP 20 1001 rIE "mo coa Summary of Revision: p—e c- p kn-t- 60.cf-ev -1 Sheet Number(s): "Cloud" or highlight all areas of revision including date of revision Received at the City of Tukwila Permit Center by: l it Entered in Permits Plus on lapplicationslforms- applications on Iine\revision submittal STATE OF WASHINGTON) COUNTY OF KING CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 Permit Center /Building Division: 206 - 431 -3670 Public Works Department: 206433 -0179 Planning Division: 206 - 431 -3670 AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION as. N � .L-Qoor\. , states as follows: [please pr 1E. A. WF ;WO pli - _ A � 4138„ 8 0 2 S y 0.2a AO 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 of 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 req ment 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 be waiving certain rights that I might otherwise have under state law in any decision to engage an unregistered contractor to perform construction work. \applications\8 -2004 affidavit in lieu of contractor registration Signed and sworn to before me this day of T A Y PUBLIC in and and for the State of Washington, Residing at K n , County. ke,u_ A My commission expires: Name as commissioned: PERMIT NO.: Fka7 - 3 SI 20 c 7.