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HomeMy WebLinkAboutPermit PG09-031 - WOODSIDE APARTMENTS - BUILDING 1TO6OOd IS ZSIT S TgLE 1 SJLINf1'T3�TH SJLTV UISUOOM Parcel No.: 0043000115 Address: Suite No: 3721 S 152 ST TUKW Owner: Name: KIM CHUE Address: 13327 279TH ST SE , KENT WA Contact Person: Name: CHUL KIM Address: PO BOX 69517 , SEATTLE WA Contractor: Name: OWNER AFFIDAVIT - CHUL KIM Address: Contractor License No: DESCRIPTION OF WORK: PROVIDE HOT /COLD WATER TO WASHER/DRYER Citylif 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: WOODSIDE APTS BLDG 1 - UNITS 1 & 2 Address: 3721 S 152 ST , TUKWILA WA PLUMBING /GAS PIPING PERMIT Permit Number: Issue Date: Permit Expires On: Expiration Date: Phone: Phone: 206 835 -6300 Phone: Value of Plumbing /Gas Piping: $0.00 Uniform Plumbing Code Edition: Fees Collected: $173.50 Plumbing Bathtub or combination bath/shower Bidet 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 doc: UPC -10/06 FIXTURE TYPE AND QUANTITY * *continued on next page ** PG09 -031 03/31/2009 09/27/2009 2006 International Fuel Gas Code Edition: 2006 Plumbing (cont.) 0 Building sewer and each trailer park sewer 0 0 Rain water system - per drain (inside bldg) 0 2 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 0 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 1 0 Medical gas piping (6 +) inlets /outlets 1 0 Gas Piping 0 Gas piping outlets (0 -5) 0 0 Gas piping outlets (6 +) 0 PG09 -031 Printed: 03 -31 -2009 Permit Center Authorized Signature: I hereby certify that I have read and e governing this work will be complied ith Signature: Print Name: doc: UPC -10/06 City ol 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: PG09 -031 Issue Date: 03/31/2009 Permit Expires On: 09/27/2009 Date: 0-217,1 i ed this permit and know the same to be true and correct. All provisions of law and ordinances whether specified herein or not. The granting of this permit do not presume to give authority to violate or cancel the provisions of any other state or local laws regulating construction or the performan of work. I am authorized to sign and obtain this plumbing /gas piping permit. - 1 ( 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. PG09 -031 Printed: 03 -31 -2009 Parcel No.: 0043000115 Address: 3721 S 152 ST TUKW Suite No: Tenant: WOODSIDE APTS BLDG 1 - UNITS 1 & 2 1: ** *PLUMBING AND GAS PIPING * ** • 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 PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: 5: No portion of any plumbing system or gas piping shall be concealed until inspected and approved. doc: Cond =10/06 * *continued on next page ** PG09 -031 ISSUED 03/24/2009 03/31/2009 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. 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 m 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. PG09 -031 Printed: 03 -31 -2009 • 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 s I hereby certify that I have read these conditions and will comply with them as outlined. All provisions of law and 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 construction or the performance of work. Signature: Print Name: doc: Cond -10/06 PG09 -031 Date: ordinances governing or local laws regulating Printed: 03 -31 -2009 SITE LOCATION Site Address: Tenant Name: Property Owners Name: C t.-. i ! L.-) v1.-- Mailing Address: r / 7 Name: Company Name: Mailing Address: Contact Person: E -Mail Address: Contractor Registration Number: Company Name: Mailing Address: Contact Person: E -Mail Address: Company Name: Mailing Address: CITY OF TUKWILA Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 hap://www.ci.tukwila.wa.us 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 ** v , 14 . 1r Contact Person: E -Mail Address: H Upplicuions\Forms- Applications On tane\2009 Applications \1 -2009 - Permit Application. dac Revised 1.2009 bh Building Permit No. Mechanical Permit No Plumbing /Gas Pexmit Ia o. Public Works Permit 9 Project No. King Co Assessor's Tax Noo2e7 3' i' - / / S 0 / Suite Number: I Mailing Address: () l -0 /� v X. 6 ci / x7 , - � ' ti , (--`,= `:d 'f k ln E -Mail Address: 0 Ji ?Ni k— (0 t) y tto a (9 GENERAL CONTRACTOR INFORMATION — (Con?tractor Information :for Mechanieai (pg for Plumbing and Gas Piping (pg City Day Telephone: City Fax Number: ARCHITECT OF RECORD — All plans must be wet stamped by. Architect of Record . (F"or. ofce New Tenant: ❑ Yes ❑..No e on(y) State State State State Floor: Zip CONTACT PERSON who do.we contact when,your permit is ready -to e issued - 14 G-- 74 s; State Zip Zip City Day Telephone: Fax Number: Expiration Date: Zip City Day Telephone: Fax Number: ENGINEER OF RECORD All.pla(ns must be wet °stainped b_y Engineer of Zip City Day Telephone: Fax Number: Page 1 of 6 Fixture Type: Qty Fixture Type: Qty Fixture Type: Qty Fixture Type: Qty Bathtub or combination bath/shower Bidet Clothes washer, domestic L 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 Building sewer and each trailer park sewer Rain water system — per drain (inside building) Water heater and/or vent Industrial waste treatment interceptor, including trap and vent, except for kitchen type grease interceptors Each grease trap (connected to not more than 4 fixtures - <750 gallon capacity) Grease interceptor for commercial kitchen ( >750 gallon capacity) Repair or alteration of water piping and /or water treatment equipment Repair or alteration of drainage or vent piping Medical gas piping system serving 1 -5 inlets /outlets for a specific gas Each additional medical gas inlets/outlets greater than 5 Backflow protective device other than atmospheric -type vacuum breakers 2 inch (51 mm) diameter or smaller Backflow protective device other than atmospheric -type vacuum breakers over 2 inch (51 mm) diameter Each lawn sprinkler system on any one meter including backflow protection devices Atmospheric -type vacuum breakers not included in lawn sprinkler backflow protections (1 -5) Atmospheric -type vacuum breakers not included in lawn sprinkler backflow protections over 5 Gas piping outlets PLUMBING AND GAS PIPING PERMIT INFORMATION - 206 - 431 -3670 PLUMBING AND -cP*e- PIPING CONTRACTOR INFORMATION Company Name: Mailing Address: Contact Person: Zvi a 1 h.-- E -Mail Address: )CI Contractor Registration Number: Scope of Work (please provide detailed information): pro v t b 'f'/r %7 7- Valuation of Project (contractor's bid price): $ iN Li, t,G - f Building Use (per Int'l Building Code): Occupancy (per Int'l Building Code): Utility Purveyor: Water: 1)I 5 . 4-t`-i c . 't 1 Z 5 Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below: H:\Applications\Forms- Applications On-Line \2009 Applications \I -2009 Permit Application doc Revised. 1.2009 i7 c.t� City State Zip Day Telephone: 2 '' --t C - 6 3 c' J Fax Number: )' 2 f / Expiration Date: Sewer: VET /I 4-1 t/ Vhi- Page 5 of 6 RECEIPT NO: R09 -01898 Initials: JEM Payee: CHUL KIM SET TRANSACTIONS: Set Member Amount M09 -027 M09 -032 PG09 -031 TOTAL: ACCOUNT ITEM LIST: Description GP of Tukwila, TRANSACTION LIST: Type Method Description 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 SET RECEIPT Payment Date: 11/25/2009 User ID: 1165 Total Payment: 180.00 SET ID: 1125 SET NAME: CHUL KIM 60.00 60.00 60.00 60.00 Amount Payment Credit C MC - - - 180.00 TOTAL: 180.00 Account Code Current Pmts MECHANICAL - NONRES 000.322.102.00.0 PLUMBING - NONRES 000.322.103.00.0 120.00 60.00 TOTAL: 180.00 PAYMENT ECEIVED RECEIPT NO: R09 -00504 Initials: JEM User ID: 1165 Payee: WAMU SET ID: 0331 SET NAME: WOODSIDE APTS SET TRANSACTIONS: Set Member M09 -032 PG09 -031 TOTAL: ACCOUNT ITEM LIST: Description MECHANICAL - NONRES PLUMBING - NONRES CiP 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 Amount 90.00 136.00 90.00 TRANSACTION LIST: Type Method Description Payment Check 86003993 SET RECEIPT Payment Date: 03/31/2009 Total Payment: 226.00 Amount 226.00 TOTAL: 226.00 Account Code Current Pmts 000.322.102.00.0 90.00 000.322.103.00.0 136.00 TOTAL: 226.00 RECEIPT NO: R09 -00462 Initials: JEM User ID: 1165 Payee: CHUL KIM SET ID: 0324 SET TRANSACTIONS: Set Member M09 -032 • I?'t309 -031 TOTAL: Payment Cash ACCOUNT ITEM LIST: Description PLAN CHECK - NONRES PLUMBING - NONRES CiP of Tukwila. Amount 22.50 37.50 22.50 TRANSACTION LIST: Type Method Description 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 SET RECEIPT Payment Date: 03/24/2009 Total Payment: 60.00 SET NAME: WOODSIDE APTS BLDG 1 Amount 60.00 TOTAL: 60.00 Account Code Current Pmts 000/345.830 52.00 000.322.103.00.0 8.00 TOTAL: 60.00 Pro t: 0,0 ns , LI a Type I PtiA Mb Address: 3921 S. rsz sr_ Date Called: Special Instructions: 0 3 ri 1'1 - ° ( 4' Bo: a . (`-'� UA C t AZ Date Wanted: a rte, Requester: Phone No: 7 , 6 6 - ''3 -C'"- 1 0 31 / INSPE ON NO. INSPECTION RECORD Retain a copy with permit CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 ,se• ... 4.1 - -- laa , _a PGo'1 -oar PERMIT NO. (206)431 -$6 Approved per applicable codes. El Corrections required prior to approval. COMMENTS: ct)r0, 4 CO Q 1g 4P A N A O. y 0 REINSPECTION FEl3 • EQUIRED. '' rior to inspection, fee must be p =i at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. (Receipt No.: Date: COMMENTS: Type of Ins ection: A14 Address: _, 32 S /� f. 3'i _ i s ( J 0 C ( e -A 1 - -, AA( to. i , IJf tS (.. DI /.) - R - : (T , I 3 r !m`( ( L1 J i Skat, . — GiO[ re.6t ILA i S a . C ^ ) 6 u tv r- 2 - TI. u e , s 5 0 . 5 , -.- Pc 1 /•- N 6c ' l<1 & 6.. ), .) p D5 A -c . J A _IA. A k - k A u e /\'\.. L ( e r.c ,A-," r '')b(Jk it, 4'AA ) /(,4t f /le1- Alcr 4-JA: ( A C (r () 't : T i ' r .iv, ( I re- iN CT:6,1 ° 1 a iki OT 0 CL,t) pl , .. . Project_ ( 4P1 Type of Ins ection: A14 Address: _, 32 S /� f. 3'i _ Date Called: Special Instructions: Ukr( r L 4 i d - # 2 7 Date Wanted: /D – 23- a . C Requester: Phone No: a o & - (935-63 INSPECTION RECORD Retain a copy with permit PERMIT NO. INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Approved per applicable codes. Corrections required prior to approval. ❑ $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. 1 Receipt No.: 'Date: Projec , )) 9 { `)e Type of I 1 A.16 J /4: ` Address: l'* Date Called: Special Instructions: Date Wanted: f�' � - T ~� — a.m p.m. Requester: Phone No: 4*1 INSPECTION NO. INSPECTION RECORD Retain a copy with permit PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -36 Approved per applicable codes. Corrections required prior to approval. COMMENTS: f -1)f /e r` - :3AJ Inspec a_ •V\ Date: . 1 t ri $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: 'Date: Project: [e/0.461 .Si Type of pection: v ' Address: "Z 17l/ l 52 Date`Calle Spel'4'al nstructions: Date Wanted: 6 a : m m. Requester: Phone No: INSPECTION RECORD Retain a copy with permit INS ' ON NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 E1 Approved per applicable codes. COMMENTS: a o / 03 PERMIT NO. d (206)431 -3( 0 $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: Date: Corrections required prior to approval. o ),77; tAeseAse frA7 7 j ` . f J. • 4 ✓S.J I _ / 5 - II � , %JiJ _�J. 1 1 . _./.Ji J io. 1 `, ._ice:. y .i .4. .1 `Ov-7 ;6. Project: 4S, ' (7. Type of I r�s / IA ' 1 _ J '/ 'l/ Address: 3 72- 1 s . 5 - 5-r Date Ca Special Instructions: Ui‘i ‘ 4, 2___. ©^ IL/ 7 ss -¢ 4 S Date Wanted: 5 - Ca)) - D p.m. Requester: Phone No: c,26 6 -83 - Lauzi INSPECTION RECORD I P646--03 Ret ain a copy with permit � INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 1 -. 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Approved per applicable codes. Corrections required prior to approval. COMMENTS: Ivy — l„.7 u c,J /Z ( -e 1lc 1/45S" (( /I e Insper: 1 4aA Date: -,.., s El $60.0 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: Date: COMMENTS: Type of Inspection: Address: re 3 ? t 5- I C2. -- Date Called: j ) 01 ( i ih , I ) , • /*I vn , I�fc - a m . p.m. Requester: Phone No: (1 7- , ( -IA-) 4^+ A r 7‘ 7 - 1 ( - '• 1$ n ..c.f i) , l .)) / r! ' �j v.i.erfk o f - S i Ar( A6 J S. r- - 1 t, 71,\ pr- r ,, i 1 1 .-„, w I n Project: Type of Inspection: Address: re 3 ? t 5- I C2. -- Date Called: Special Instructions: Vu : k ,L k. ` 0 • � r 5 ( 1 NT * czt 0 'II: / er 6f.- Date Wanted: S 1 • J y a m . p.m. Requester: Phone No: (1 7- , F6 d1 -u3f INSPECTION RECORD Retain a copy with permit INSPECT! a N NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION P--- 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Approved per applicable codes. Corrections required prior to approval. Inspector: Date: 5 - (--6? ri $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: 'Date: 0 C - 14 8 1 / 9elah review itiaubject to eiloOs and . /". Approval construction documents dies notatithorize the Iiiolation of any adopted Code or ordiniinCe. Receipt of approved Fiel y and conditions is acknowledged BUILDING FOUR See Ar 04. • 1 4 i ; Date • I F AtOf BUIL PARKING SPACES 21 • 27 • 14 62 11 GARAGED 2 MC ACCESSELE 3 COLAP.CI Aa ST NOME STALLS . 20 - 2_ L1 21 8 WOODSIDE APARTMENT REMODEL NE IP 3721 9 152nd Street 1 Tukwila. lirashington I /tans BuiLoiNo ONE REVISIONS No changes shall be madeko Of work without prior approval of - - T NOTE: Revisions will requ nAw ninn AtIhMiIIP I and may include additional plan revir 7' 014e_ :M4 14301111363• 46.111T13 clwata MOGI ..__ft411 Of 1143260.0706 22 KC C vAJAI NM 2? REVIEWED OR CODE CtOMPLIANC APPROVED .MAR 3=0_249 2' 114" City qt Tukwila BUILDING DIVISION cnAF —1M R 2 4 1009 PERMIT' CENTER R CHANDLER SOGGE ARCHITECT 2A Ito.* ovItar 1012 Skyridge SL SE Olympia WA 913503 Al. 1 fax 980 491-8904 phone 491-1881 e L 3 " 8'-6" (3017 4 :6 , 1 1 P( e."?) (A:as-ki p -car A iA S f1/401r/vao- UI CC z o40® cn LL - o cm w2® o U� a vp 0 ��+ c p y(*I • prn.„,„! ) *' ) !v—v!} -t �' � , --Hw6n ► 7►Q — D1 c cb1c) - „9",9 41414 d WC WG� VP F f� 1 ` 2 W 4c1.42 r- kr-o ~ SewJ -rte L cipt4— CNA w Vapo.¢.4-i-,` Igv 'for- wa CODE COMPLIANCE CE APPROVED MAR 3 0 2009 City of Tukwila BUILDING DIVicinKI i ■ ,411A ..' mc`Zus" "°m^° ,^'.° .n" .o,..".w" | i DIE ,z=sNCORPORATION m"^• '~ is ^^. [ f ! I // / • December 4, 2009 City of Tukwila 6300 Southcenter Boulevard Tukwila, Washington 98188 -8548 Mr. Bob Benedicto Building Official Dear Mr. Benedicto, Thank you for your courtesy to me this morning, and for your willingness to work with us as we seek to improve our property and satisfactorily comply with the City of Tukwila's code requirements. Please be advised that I have designated Brian Derdowski to act as my representative in working with the City on all permit related issues, subject to my approval and until further notice. I will continue to sign all legal documents and be responsible for all applicable fees. I'm sure that you will enjoy working with Mr. Derdowski as much as I have over the last couple of weeks. Sincerely, ✓' /l,, [ c-, Chul Kim , (1);\°-' `k � �2 / 1, 19 RIECEWWEP DEC 04 2009 PERMIT CENTEU DEPARTMENTS: 3 27 BuLng1son iv r Pu61ic Wo Complete n Comments: APPROVALS OR CORRECTIONS: Documents/routing slip.doc 2 -28 -02 M PERINIT COORD COPY PLAN REVIEW/ROUTING SLIP ACTIVITY NUMBER: PG09 -031 DATE: 03 -24 -09 PROJECT NAME: WOODSIDE APTS BLDG 1, UNITS 1 & 2 SITE ADDRESS: 3721 S 152 ST X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # After Permit Issued Fire Prevention Structural DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Permit Center Use Only INCOMPLETE LETTER MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: LETTER OF COMPLETENESS MAILED: TUES /THURS ROUTING: Please Route 1 1 Structural Review Required REVIEWER'S INITIALS: Approved ❑ Approved with Conditions Notation: REVIEWER'S INITIALS: Incomplete U DATE: DATE: Planning Division Permit Coordinator DUE DATE: 03-26-09 Not Applicable No further Review Required Not Approved (attach comments) n n DUE DATE: 04-23-09 Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: CITY OF TUKWILA Department of Community Development 630o Southcenter Boulevard, Tukwila, WA 98188 Telephone: (206) 431 -3670 FAX (206) 431-3665 E -mail: tukplanPci.tukwila.wa.us AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION STATE OF WASHINGTON) ) ss. COUNTY OF KING ) 4 ,1 M . Ka., kt.--, [please print name] • , states as follows: 1. I have made application for a 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 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 permit to be exempt under number _, and will therefore not be performed by a registered contractor. 5. I understand that the licensing provision of RCW 19.28.161 through 19.28.271 shall not apply to persons making electrical installations on their own property or to regularly employed employees working on the premises of their employer. The proposed electrical work is not for the construction of a new building for rent, sale or lease. 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. Owner /Own is Agent* Signed and sworn to before me this Residing at Name as commissioned: My commission expires: Permit Center /Building Division 206 431 -3670 Public Works Department 206 433 - 0 1 79 Planning Division 206 431 -3670 PERMIT NO: Am- 02A -j WIL day of ! (CCI'�L , 20o P . 1 P071 vi 1 ,t- G-ft a C L� NO ' Y ' UBLIC in and for the State of Washington , County )W1 C;� -/ a 18.27.090 Exemptions. The registration provisions of this chapter do 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 of any finished products, materials, or articles of merchandise that are not fabricated into and do not become a part of a structure under the common law of fixtures; 6. Any construction, alteration, improvement, or repair of personal property performed by the registered or legal owner, or by a mobile /manufactured home retail dealer or manufacturer licensed under chapter 46.70 RCW who shall warranty service and repairs under chapter 46.7o 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 five hundred dollars, 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 of the operation is made into contracts of amounts less than five hundred dollars 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 or she is a contractor, or that he or she 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, except that this exemption shall not deprive the owner of the protections of this chapter against registered and unregistered contractors. The exemption prescribed in this subsection does not apply to a person who performs the activities of a contractor for the purpose of leasing or selling improved property he or she has owned for less than twelve months; 12. Any person working on his or her own property, whether occupied by him or her or not, and any person working on his or her personal residence, whether owned by him or her or not but this exemption shall not apply to any person who performs the activities of a contractor on his or her own property for the purpose of selling, demolishing, or leasing the property; 13. An owner* who performs maintenance, repair, and alteration work in or upon his or her own properties, or who uses his or her own employees to do such work; 14. A licensed architect or civil or professional engineer acting solely in his or her professional capacity, an electrician certified under the laws of the state of Washington, or a plumber certified under the laws of the state of Washington or licensed by a political subdivision 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 person certified is operating within the scope of his or her certification; 15. Any person who engages in the activities herein regulated as an employee of a registered contractor with wages as his or her sole compensation or as an employee with wages as his or her sole compensation; 16. Contractors on highway projects who have been prequalified as required by RCW 47.28.070, with the department of transportation to perform highway construction, reconstruction, or maintenance work; 17. A mobile /manufactured home dealer or manufacturer who subcontracts the installation, set -up, or repair work to actively registered contractors. This exemption only applies to the installation, set -up, or repair of the mobile /manufactured homes that were manufactured or sold by the mobile /manufactured home dealer or manufacturer; 18. An entity who holds a valid electrical contractor's license under chapter 19.28 RCW that employs a certified journeyman electrician, a certified residential specialty electrician, or an electrical trainee meeting the requirements of chapter 19.28 RCW to perform plumbing work that is incidentally, directly, and immediately appropriate to the like -in -kind replacement of a household appliance or other small household utilization equipment that requires limited electric power and limited waste and/or water connections. An electrical trainee must be supervised by a certified electrician while performing plumbing work. • Per Washington State Department of Labor and Industries, lessee has been interpreted to be equivalent to owner for the purpose of these exemptions.