HomeMy WebLinkAboutPermit PG09-049 - LEE RESIDENCELEE RESIDENCE
12621 42 AV S
PGO9-049
Parcel No.:
Address:
Suite No:
Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
Contractor License No:
DESCRIPTION OF WORK:
ADD CLOTHES WASHER TO MAIN FLOOR, REPLACE WATER HEATER, REPLACE ALL OTHER
PLUMBING FIXTURES WITH INTERIOR REMODEL.
Value of Plumbing /Gas Piping:
Fees Collected:
Plumbing
Bathtub or combination bath/shower 0
Bidet 0
Clothes washer, domestic 1
Dental unit, cuspidor 0
Dishwasher, domestic, with independent drain 0
Drinking fountain or water cooler (per head) 0
Food -waste grinder, commercial 0
Floor drain 0
Shower, single head trap 0
Lavatory 0
Wash fountain
Receptor, indirect waste 0
Sinks 0
Urinals 0
Water Closet 0
doc: UPC -7/07
7340600681
12621 42 AV S TUKW
CityIkf 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
LEE RESIDENCE
12621 42 AVE S , TUKWILA WA
OWNER AFFIDAVIT - PHOEBE LEE
$3,000.00
$105.00
PHOEBE LEE
11510 17 AVE NE , SEATTLE WA
PLUMBING /GAS PIPING PERMIT
HEMENWAY DANIEL TRUST
C/O HEMENWAY JOHN D TTEE , 4816 RODMAN ST NW
FIXTURE TYPE AND OUANTITY
0
* *continued on next page **
Permit Number:
Issue Date:
Permit Expires On:
Expiration Date:
Phone:
Phone: 206 - 268 -0541
Phone:
PG09 -049
06/24/2009
12/21/2009
Uniform Plumbing Code Edition: 2006
International Fuel Gas Code Edition: 2006
Plumbing (cont.)
Building sewer and each trailer park sewer 0
Rain water system - per drain (inside bldg) 0
Water heater and /or vent 1
Industrial waste treatment interceptor, including
its trap and vent, except for kitchen type
grease interceptors 0
Repair or alteration of water piping and /or water
treatment equipment 0
Repair or alteration of drainage or vent piping 0
Medical gas piping system serving (1 -5)
inlets /outlets for a specific gas 1
Medical gas piping (6 +) inlets /outlets 1
Gas Piping
Gas piping outlets (0 -5) 0
Gas piping outlets (6 +) 0
PG09 -049 Printed: 06 -24 -2009
Permit Center Authorized Signature:
I hereby certify that I have read and e
governing this work will be complied
Signature:
Print Name:
doc: UPC =7/07
City otTukwila
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
mi
th,
Permit Number: PG09 -049
Issue Date: 06/24/2009
Permit Expires On: 12/21/2009
Date: (11.11-414.,1)
ed this permit and know the same to be true and correct. All provisions of law and ordinances
hether specified herein or not.
The granting of this permit d es not presume to give authority to violate or cancel the provisions of any other state or local laws regulating
construction or the perfo a ice of work. A I am authorized to sign and obtain this plumbing /gas piping permit.
Date: (I (i 24,24t' 1
This permit shall become n land 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 -049 Printed: 06 -24 -2009
Parcel No.:
Address:
Suite No:
Tenant:
7340600681
12621 42 AV S TUKW
LEE RESIDENCE
1: ** *PLUMBING AND GAS PIPING * **
doc: Cond -10/06
•
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.
* *continued on next page **
PG09 -049
ISSUED
06/01/2009
06/24/2009
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 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.
PG09 -049 Printed: 06 -24 -2009
Signature:
Print Name:
•
City of Tukwila
I hereby certify that I have read these conditions and will comply with them as outlined. All provisions
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
construction or the performance of work.
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
doc: Cond -10/06 PG09 -049
Date:
a
of law and ordinances governing
other work or local laws regulating
Printed: 06 -24 -2009
Site Address:
Tenant Name:
Mailing Address: i a ';' I v
Name:
Company Name:
Revised: 1 -2009
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CITY OF TUKWILA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://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 **
SITE LOCATION
w►, eke'
Property Owners Name: 4..y., , Lee ; 1 e' C''
Xing Co Assessor's Tax No.: 3 j+ V O'
Number: Floor: Z
New Tenant: ❑ Yes Er.No
jLek.
Mailing Address: 1 ) S - I i `t� Ave h/
E -Mail Address: fivzhelle Lee si b @
Company Name: "TecJm °E.rtAtt LL �..
Contact Person: R 0 la,. Ft f' nip cA , . i . 4% •
E -Mail Address: 14e;irvq.Sel.@ 701 A
Contact Person: Zo IC,.v, A l i e in•. • 5 c�. , V• 8 •
E -Mail Address: rive ;n.. i c e k e --:'YN
H: Applications\Forms- Applications On Line\2009 Applications <1 -2009 - Permit Application.doc
S
tAf rywot
City
Day Telephone:
City
Y•
State
State
Fax Number:
Mailing Address:
City
Day Telephone:
Fax Number:
State
Contact Person:
E -Mail Address:
Contractor Registration Number: Expiration Date:
Mailing Address: b g 3 0 /v 13044 We ■y,, St,,;te C , .- rinG i 31, )(Nnio -e w1\ 011r
City State
Zip
•t - -Q. y-
Zip
Zip
Zip
Day Telephone: ( ' 1 , . ) ( ) )
FaxNumber: ( ) L 1+4 0
Company Name: - red h trtinM t LL
Mailing Address: 67 3 O HV not/ail We. y , Str.%4t CJ Pim 18 ! Kl'gr� J6e , , t. by r i TO z t
City State Zip
Day Telephone: C 3 -o U) l 17 t
Fax Number: (10 () ��2 4 t- O 3'
Page 1 of 6
Fixture Type:
Qty "
Fixture Type: Qty
.
" "F ixtur':e :Type ::.
Qty:.
- Fixture Type:.
]
Bathtub or combination
bath/shower
Bidet
Clothes washer, domestic
I
Dental unit, cuspidor
Dishwasher, domestic,
with independent drain
Drinking fountain or
water cooler (per head)
Lavatory
Food -waste grinder,
commercial
Wash fountain
Floor Drain
Receptor, indirect waste
Shower, single head trap
Sinks
- —
Urinals
Water Closet
Industrial waste treatment
interceptor, including trap
and vent, except for kitchen
type grease interceptors
Repair or alteration of
drainage or vent piping
Backflow protective device
other than atmospheric -type
vacuum breakers over 2
inch (51 mm) diameter
'
1
Building sewer and each
trailer park sewer
Each grease trap
(connected to not more
than 4 fixtures - <750
gallon capacity)
Medical gas piping
,ystem serving 1 -5
:nlets /outlets for a
specific gas
Each lawn sprinkler
system on any one meter
including backflow
protection devices
_
_
Rain water system — per
drain (inside building)
Water heater and/or vent
Repair or alteration of
water piping and/or water
treatment equipment
Grease interceptor for
commercial kitchen ( >750
gallon capacity)
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
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 PERMI
PLUMBING AND GAS PIPING CONTRACTOR INFORMATION
Company Name: O er arm V d A
Mailing Address:
City State Zip
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
Contractor Registration Number: Expiration Date:
Valuation of Project (contractor's bid price): $
Scope of Work (please provide detailed information):
Building Use (per Int'l Building Code):
Occupancy (per Int'l Building Code):
Utility Purveyor: Water: Sewer:
Indicate type of plumbing fixtures and /or gas piping outlets being installed and the quantity below:
H:\ApplicationsWorms- Applications On- Line\2009 Applications \1-2009 Permit Application.doc
Revised: 1 -2009
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Page 5 of 6
PERMIT APPLICATI
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.
Building and Mechanical Permit
The Building Official may grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be
requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition).
Plumbing Permit
The Building Official may grant one extension of time for an additional period not exceeding 180 days. The extension shall be requested
in writing and justifiable cause demonstrated. Section 103.4.3 Uniform 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 OWNER OR AUTIGEN
Signature: ( `J`
Print Name:
Mailing Address:
Date Application Accepted:
H: \Applications\Forns- Applications On Line\2009 Applications \1 -2009 - Permit Application.doc
Revised: 1 -2009
bh
IienUl t9'all per is applica
3� L
Awic
City
1( 4-S Day Telephone:
,, c: , Li 'i Z t
Date: k / v `1
C mob) J'I -
State
Staff Initials:
Zip
Date Application Expires:
Page 6 of 6
i
Copy Reprinted on 06 -24 -2009 at 09:07:50 06/24/2009
RECEIPT NO: R09 -00959
Initials: WER
User ID: 1655 Total Payment: 1,342.91
Payee: PHOEBE T LEE
SET ID: 0624 SET NAME: LEE RESIDENCE
SET TRANSACTIONS:
Set Member Amount
D09 -090
M09 -060
PG09 -049
TOTAL:
1,092.70
166.21
84.00
1,092.70
TRANSACTION LIST:
Type Method Description Amount
Payment Credit C VISA
ACCOUNT ITEM LIST:
Description
BUILDING - NONRES
MECHANICAL - RES
PLUMBING - RES
STATE BUILDING SURCHARGE
Ci, of Tukwila.
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206-431-3665
Web site: httt): //www. ci. tukwila. wa. us
SET RECEIPT
0
Payment Date: 06/24/2009
1,342.91
TOTAL: 1,342.91
Account Code Current Pmts
000/322.100 1,088.20
000.322.102.00.0 166.21
000.322.103.00.0 84.00
640.237.114 4.50
TOTAL: 1,342.91
PAYMENT
RECEIVED
Parcel No.: 7340600681
Address: 12621 42 AV S TUKW
Suite No:
Applicant: LEE RESIDENCE
Receipt No.: R09 -00805
S
City of Tukwila
Initials: WER Payment Date: 06/01/2009 10:46 AM
User ID: 1655 Balance: $84.00
Payee: PHOEBE LEE
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
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd VISA -
Authorization No. 03671C
ACCOUNT ITEM LIST:
Description
PLAN CHECK - RES
RECEIPT
21.00
Account Code Current Pmts
000/345.830 21.00
Total: $21.00
Permit Number: PG09 -049
Status: PENDING
Applied Date: 06/01/2009
Issue Date:
Payment Amount: $21.00
E T
Eel Y
a�E
doc: Receiot -06 Printed: 06 -01 -2009
Project: �
Type of Inspection:
Address:
r 7- ' 2 r
N
42. A;.i. -_...�
Date Called f7 I , - 4
1
Special Instructions:
/
Date Wanted:
Co - it0 _/J
rr a.
p .m.
Requester:
Phone No:
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION 1(2
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3 7
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
PGO -041
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
0 r ci 1,4*
r M■ M klVr
Inspector:
Date:
ti - (J
❑ $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
'Date:
COMMENTS:
.41 4: 4 1 Al AO j( .....-
" r''' AZAWAIMIIMINIZT", Al
IIIIV ( WV I.
Date Called:
Special Instructions:
/
Date Wanted:
Requester:
/
F
54 /
Pro ct:
Type of,�nspection:
�/ `,
Address s: t 42 1-4
Date Called:
Special Instructions:
/
Date Wanted:
Requester:
Phongo� /_
54 /
INSPECTION RECORD
Retain a copy with perm1l~
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
INSPECTION NO.
Approved per applicable codes.
.1
kol -0-41
PERMIT NO.
(206)431 -3
rrecUon$ -T gwr rlor to approval.
Inspec =t':
EIN
pa ; at 6'00
V
eceipt No.:
0.
NF
Blv ite
thce
Date:
' aT
QU D. Prior to inspection, fee must be
00. Call to schedule reinspection.
'Date:
•
COMMENTS:
Type of Inspection:
/L L 6
/{ .�?lAY A au 19r. ^i-- t
1A / ! 1 .i 1' A it
� � ' U J �l P •) ''
6 .-$i ! •• t
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kiur , / e /"3, i
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5L, Jr - A r1 C (a/ � 4tl
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Pro ct:
/ Cf j eA i
Type of Inspection:
/L L 6
( X8•.4
Address:
/2 G 2 ( 92 fesr
D t o Called:
1
a
�� w
Special Instructions:
Date Wanted:
a.m.
Requester:
Phone No
4 2.5 - jo 6 —5 144
EI Approved per applicable codes.
INSPECT! . N N0.
INSPECTION RECORD
Retain a copy with permit
('God —o4
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 - (206)431 -3670
orrections required prior to approval.
i' Date:
0 $60.00 REINSPECTION FEE R D. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Inspector:
Receipt No.:
Date:
PHOEBE LEE
11510 17 AVE NE
SEATTLE WA 98125
RE: Permit No. PG09 -049
12621 42 AV S TUKW
Dear Permit Holder:
Based on the above, you are hereby advised to:
-or-
The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is
determined that your extension request is granted, you will be notified by mail.
Thank you for your cooperation in this matter.
Sincerely,
Bill Rambo
Permit Technician
File: Permit File No. PG09 -049
Jim Haggerton, Mayor
epartment of Community Development Jack Pace, Director
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 Building Code, International Mechanical Code, Uniform
Plumbing Code and /or the National Electric Code, every permit issued by the Building Division under the
provisions of these codes shall expire by limitation and become null and void if the building or work authorized
by such permit has not begun within 180 days from the issuance date of such permit, or if the building or work
authorized by such permit is suspended or abandoned at any time after the work has begun for a period of 180
days. Your permit will expire on 07/23/2010.
1) Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 to schedule for the next or final
inspection. Each inspection creates a new 180 day period.
2) Submit a written request for permit extension to the Permit Center at least seven (7) days before it is
due to expire. Address your extension request to the Building Official and state your reason(s) for
the need to extend your permit.
In the event you do not call for an inspection and /or receive an extension prior to 07/23/2010, your permit will
become null and void and any further work on the project will require a new permit and associated fees.
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
January 29, 2010
Phoebe Lee
11510 17 Ave NE
Seattle, WA 98125
Dear Ms. Lee,
Department of Community Development
RE: Request for Permit Extensions
Mechanical Permit Number M09 -060
Plumbing /Gas Piping Permit Number PG09 -049
This letter is in response to your written request for an extension to Permit Numbers M09 -060
and PG09 -049. The Building Official has reviewed your letter and considered your request to
extend the above referenced permit. The City of Tukwila Building Department will be extending
the permits an additional 180 days from the date of expiration, through July 23, 2010.
If you should have any questions, please contact our office at (206) 431 -3670.
Sincerely,
ifer Mar all
it Technician
File:
M09 -060 & PG09 -049
W:\Pennit Center\Extension Letters\Permits\2009\PG09 -049 Permit Extension.doc
Jim Haggerton, Mayor
Jack Pace, Director
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
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PHOEBE LEE
11510 17 AVE NE
SEATTLE WA 98125
RE: Permit No. PG09 -049
12621 42 AV S TUKW
Dear Permit Holder:
Sincerely,
-or-
City of T u s ida
Department of Community Development
Based on the above, you are hereby advised to:
Jim Haggerton, Mayor
Jack Pace, Director
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 Building Code, International Mechanical Code, Uniform
Plumbing Code and /or the National Electric Code, every permit issued by the Building Division under the
provisions of these codes shall expire by limitation and become null and void if the building or work authorized
by such permit has not begun within 180 days from the issuance date of such permit, or if the building or work
authorized by such permit is suspended or abandoned at any time after the work has begun for a period of 180
days. Your permit will expire on 01/25/2010.
1) Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 to schedule for the next or final
inspection. Each inspection creates a new 180 day period.
2) Submit a written request for permit extension to the Permit Center at least seven (7) days before it is
due to expire. Address your extension request to the Building Official and state your reason(s) for
the need to extend your permit.
The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is
determined that your extension request is granted, you will be notified by mail.
In the event you do not call for an inspection and /or receive an extension prior to 01/25/2010, 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.
Bill Rambo
Permit Technician
File: Permit File No. PG09 -049
6300 Southcenter Boulevard, Suite #100 0 Tukwila, Washington 98188 0 Phone: 206 - 431 -3670 0 Fax: 206 - 431 -3665
DEPARTMENTS:
A ding Divi
� O PC611'61-' Public orks
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
Comments:
TUES/THURS RpUTING:
Please Route J Structural Review Required
REVIEWER'S INITIALS:
APPROVALS OR CORRECTIONS:
Approved Approved with Conditions
Notation:
REVIEWER'S INITIALS:
Documents /routing slip.doc
2 -28 -02
P MIT
PLAN REVIE
Fire Prevention
Structural
Incomplete
�o
/ROUTING SLIP
ACTIVITY NUMBER: PG09 -049
PROJECT NAME: LEE RESIDENCE
SITE ADDRESS: 12621 42 AVE S
X Original Plan Submittal
Response to Correction Letter #
DATE: 06 -01 -09
Response to Incomplete Letter #
Revision # After Permit Issued
DUE DATE: 06 -02 -09
DATE:
DATE:
Planning Division
Permit Coordinator
Not Applicable
No further Review Required
Not Approved (attach comments)
DUE DATE: 06 -30 -09
U
Permit Center Use Only
INCOMPLETE LETTER MAILED:
Departments determined incomplete: Bldg ❑
LETTER OF COMPLETENESS MAILED:
Fire ❑ Ping ❑ PW ❑ Staff Initials:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire El Ping ❑ PW ❑ Staff Initials:
CITY OF TUKWILA
Department of Community Development
6300 Southcenter Boulevard, Tukwila, WA 98188
Telephone: (206) 431 -367o FAX (206) 431 -3665
E -mail: tukplanPci.tukwila.wa.us
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
STATE OF WASHINGTON)
) ss.
COUNTY OF KING )
ho,ek
[please print name]
[please print name]
, states as follows:
Permit Center /Building Division
206 431 -3670
Public Works Department
206 433 - 0 1 79
Planning Division
206 431 -3670
PERMIT NO: DO 1 U , . o ° i l& 0
?mil
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 t3 , 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 ork.
Owner / wner s
Signedand sworn to before me this
( day of
NOTARY PUBLIC in and for the State of Washington
Residing at , County
Name as commissioned:
My commission expires:
,20 01
-A A -S o - - [ o c_
�O't1' cD__D3I
18.27.090 Exemptions. The registration provisions of this
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 46.7o 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
chapter do not apply to:
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.