HomeMy WebLinkAboutPermit 5533 - Keenan Supply - Storage Racks. A:
CITY OF TUKWILA lir
Building Division
6200 Southcenter Boulevard
Tukwila, Washington 98188
(206) 433-10g- ts4.9 BUILDING PERMIT
Work to be done T.I. (kacks)
Site Address 402 BAKER BLVD
Building Use WAREHOUSE
Property Owner RICHARD DAVIDSON
Address 631 SOUTH 291ST STREET
Contractor KEENAN SUPPIY
Address 402 BAKFR MILD
FOR BUILDING PERMIT ONLY Approved for
PERMIT #
Control #
_28-401
(513)
Suite # Tenant KEENAN SUPPLY
Assessors Account # 022310-0031
Phone # F3q-46qS
Zip 9R0n1
FRIFRAI WAY, WA
Phone # 433-1003
Zip (181R8
t.-70 Date:/—_-5W2'
Taig11
Issuance By:
Sq. Ft.
Office
Veremhi Tls ie
Retail
Other
Occ.
Load
1st Fl.
2nd Fl.
"3rd Fl.
_
\ -4416
Total
Fire Protection: Sprinklers Detectors
Zoning Type of Construction
Special Conditions
Fees
sq. ft. @ 1st Fl. $
sq. ft. @ 2nd Fl.
sq. ft. @ other $
sq. ft. @ other $
Total Valuation of Construction $
Bldg. Permit Fee
Plan Check Fee
Demolition
Surcharges
Other
Other
TOTAL
Re::: :75 $
Receipt #
Receipt #
Receipt #
Receipt #
500 00
78.72
3.50
$ 82.22
FOR SIGN PERMIT ONLY
0 Permanent ['Temporary
0 Single Face 0 Double Face Wall Mounted El Free Standing J Other
Building face Setbacks: Front Side Side Rear
Square Footage of each sign face Total square footage of sign
Special Conditions
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS 'ASP(NDED OR
AllANDONEU FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
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 UR ANGEL THE PROW SIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
Signed ,1, Dee 1--;24)-70E_
LICENSED CONTRACTORS DECLARATION
I hereby affirm that I am licensed under provisions of the Business and Professions Code, and my license is In full force and effect.
Contractor (signature)
Date
OWNER-BUILDER DECLARATION
( ) I, as owner of the property, or my employees, with wages as their sole compensation, will do the work, and the structure is not
offered for sale.
( ) I, as owner of the property, am exclusively contracting with licensed contractor's to construct the project,
Owner (signature) Date
Infended or
CITY OF TUKWILA
Building Division
Tu0l0d no thashingtBoulevard BUIL 'SING PERMIT APPLI P TION Control # (1° /
(206) -433 -1849
Site Address '/42 Le Eva ' �kwicy f ■-i
Project Name /Tenant AlE hw S
Suite# h44 Floor#
Valuation of Construction /QE 'Son.do Assessors Account# 0„a3/0- 0U3 /-
Property Owner iftyARb L'AW . cAl Phone 404- 839- y69S'
Address 63/ . irW aq/S 3 ,EET, CizE,egc W9Y, 14,4 Zip 98m3
Applicant 14E469N uPPtY Phone 4/33 - /OCZ3
Address you &ire,'' &vcr --77.7twun I yiq Zip 98/88
Architect /Engi neer ,4ssocigrEtt. C,o vsiaTANrs ..Taut Phone care- VS.2-35S?
'/I
Address i9ascg a'81444E Se ,✓lodE ibuley y4 Zip
Contractor /SEEnr.9N.�1IPPzy biPloyees License## Phone ,/.�3 -/0o3
Address y02 &- a✓a) "7aKwi<A yVA Zip /8/68
Class of Work: 0 New [] Addition TR Tenant Improvement 0 Remodel (residential) [] Reroof
0 Demolition ❑ Interior Demolition 0� Other
Describe work to be done .��ECN,et ,4 �sr�esJ..v YI/AR6Noast / sLEr File-es i �cr/ 044
� Sib /�..F /1497E4,4G Jrvt#96E
Type of Const. (UBC) Occ. Group (UBC)
Square footage of entire building /t 4yOS fi- Square footage of tenant space /S1c S&Fr
Building Use 4%LfsQLE, .L lsrueuricli/ Will there be a change of use? 0 Yes 2r No
If yes, describe change of use, including square footages of changed areas
Will there be storage or use of flammable, combustible or hazardous materials on the premise or
area of construction? [] Yes 14 No If yes, explain
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND
CORRECT AND THAT I HAVE THE PROPERTY OWNER'S AUTHORIZATION TO DO THIS WORK.
Applicant /Authorized Agent (signature) 7i2eZ ��- /- r�,aory `"& v �•r Date /Z -Z7 8$
(print name) 4E /ENSoA/
Contact Person (please print),* ke. Lj ,/so& C2v 40(gcE A1.9.eks Phone 4/.?3-/003
1
FEES: Building Permit Fee
Plan Check Fee
Bldg Code Sur Charge
Energy Sur Charge*
Other
*New construction only
'1 1:
OFFICE USE ONLY
(000/322.100) $
(000/345.830)
(000/386.904)
(000/386.907)
( )
TOTAL
ScG ,G16-PW Pc C-cLIC5,
3M7 Receipt# Date Paid
Receipt# Date Paid
31.50 Receipt# Date Paid
Receipt# Date Paid
Receipt# Date Paid
7 .2 1 (OWES: $ R, of
aWUMRG ruuuMUL /DUILULIYl7 uJG 119rut riMl lun square Fogt ae or tntirq oun Iaina:
FLOOR
USE /Occ Type
SQ.FT.
UGC
,LOAD
-
USE /Occ Type
SO.FT.
OCC
LOAD USE /Occ Tvac
SO.FT.
OCC
OA[]
TOTAL
SO.FT.
TOTAL
OCC.
1'3,�y
Approved (Initials) Per letter dated i 3 - £sue
Fire Protection: ri n ers 0 Detectors
s/
PLNG
Approved (Initials) p BAR ❑ LAND USE /SEPA CONDITIONS
Zoning Setbacks: N S E W
Parking stalls required for: Site Tenant Space
Parking stalls provided: Site Tenant Space
ADDITIONAL PARKING STALLS REQUIRED:
OWD
Approved (Initials) Per letter /plans dated
TOTAL
I KHI.KIIVU
COM E
BLDG
i t.)-a -gg
I -3181 R.
pprove or ssuance ype of oust.
To Mahan: ( Date Approved: j- r --1
FIRE
.
-3.gq R
1'3,�y
Approved (Initials) Per letter dated i 3 - £sue
Fire Protection: ri n ers 0 Detectors
s/
PLNG
Approved (Initials) p BAR ❑ LAND USE /SEPA CONDITIONS
Zoning Setbacks: N S E W
Parking stalls required for: Site Tenant Space
Parking stalls provided: Site Tenant Space
ADDITIONAL PARKING STALLS REQUIRED:
OWD
Approved (Initials) Per letter /plans dated
igadViiijighLt
CITY OF TUKWILA
INSPECTION RECORD
Dept. of Community Development - Building Dh4slon
Phone: (206) 431 -3670
6300 Southcenter Boulevard - #100
Tukwila Washington 98188
PROJECT: k e,,,,-,,,,,,, S'. l
PERMIT NO. (5....S-la
/-,',--1
SITE ADDRESS: a7_ /3 4 a /.C3 /,4
DATE CALLED:
r
TYPE OF INSPECTION:
DATE WANTED: .3 -- r I - `'t l
REQUESTER:
a.m.
64.
SPECIAL INSTRUCTIONS: e-Ac kS -- .-" Wo u c- !P AG- Ct, i-g--
PHONE NO.:
INSPECTION RESULTS /COMMENTS:
/ -c 4_S �G- C ,,) C ,160 1,3'N)
,v t= Ems—►✓
`C iiti l LY)1 NC)
-Ii
0 l LC
A',AO
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KJ ni- -- _
VACl
IT E .O 4 h1 ( �v �Y_- W 64 (-;
,`S —< ii 1.3 -CAS ll,f,-vC At. t 'f iti, � /-4 w vtiY)_
lSYa' -.i, Cr" •■ d u c�JJ o f C 4-,J c /. L- -`O ?
DATE: -5 - / i
-- 9 r
-
INSPECTOR: _ S- L- '1-'S`r
CRY OF TUKWILA
Dept. of Community Development - Building Division
Phone: (206) 431-3670
INSPECTION RECORD
6300 Southcenter Boulevard — #100
Tukwila Washington 98188
PROJECT: A-'.,o %ls, 2
PERMIT NO. �5 3 T\
SITE ADDRESS: Li '2 / - TR (._._.,�'
DATE CALLED:
TYPE OF INSPECTION: `").rz
,
DATE WANTED:
p,m•
SPECIAL INSTRUCTIONS:
REQUESTER:
PHONE NO.:
INSPECTION RESULTS /COMMENTS: 7—�.'s^
�, U s ,)- 7-•c�S , 1:`
4.7 S
„S _AF -z.r� !! // //1�-_�' l
i •-7 U4 ! , �-- f/G• C- 4
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v 4 .! L j v
✓
% ... .rT...r .% r
MJ7 i�✓tY.✓ '•
2 -"r�
_
INSPECTOR: /!i���-P --
DATE: 7_ ,--/
--
CITY OF "KWILA
Builds 'apartment
6300 So tncentsr Boulevard
Tukwila, WA 98188
(206) 431 -3670 t�
Type of Inspection. /1e0$1/.4
Site Address GAG 2_ /?6,
Requestor
Special Instructions
INSPECTN RECORD
PERMIT #
Date
Date Wanted /2-2-6-9e a.m.
Project Z ' t e��te.., ce....e j j'
Phone #
Inspection Results /Comments:
Inspector
Date
CITY OF TyWILA
Building ( ?rtment
6300'Sou ' rater Boulevard
Tukwila, WA 98188
(206) 431 -3670
Type of Inspection G1.�
Site Address 49 , , ' /ce-ck.
Requestor
INSPECTN RECORD
INSPECT
IN
# c'"'S 3_
Date
Special Instructions
Date Wanted G.--13 --
Project .e,.400-7 G.,
Phone #
.m.
Inspection Results /Comments:
7j71,7.1 �1 r<< C
/S
Date 6 -
CITY OF TUKWILA
Building Division
6200 Southcenter Boulevard
Tukwila, Washington 98188
(206) 433 - 141 BUILDING PERMIT
Work to be done
Site Address
Building Use
Property Owner
Address
Contractor
Address 402 BAKER RIVO
T.I. c s
402 BAKER BLVD
WAREHOUSE
RICHARD DAVIDSON
631 SOUTH 241ST STREET
KEENAN SUPPLY
PERMIT #5 3 3
Control #
uite enant KEENAN SUPPLY
Assessors Account # 022310 -0031
FEDFRAI WAY, WA
111161_11
FOR BUILDING PERMIT ONLY
Approved for Issuance By: dl
88 -401
(513)
Phone # 839 -4695
Zip 98003
Phone 0 433 -1003
Zip 98188
Date:
Sq. Ft.
St .
Office
Storage/
Warehouse
Retail
Other
Occ.
Load
2nd Fl.
3rd Fl.
iPi
Total
Fire Protection: J Sprinklers ❑ Detectors
Zoning ('_' YY1 Type of Construction
Special Conditions
Fees
sq. ft. @
sq. ft. @
sq. ft. @
sq. ft. @
1st Fl. S
2nd Fl. $
other $
other $
Total Valuation of Construction $
500 00
Bldg. Permit Fee Receipt #74/73 $ 78.72
Plan Check Fee Receipt #
Demolition Receipt 0 $
Surcharges Receipt # ;x1 ?3 $
Other Receipt 0 $
Other Receipt 0 $
TOTAL
3.50
3 82.22
FOR SIGN PERMIT ONLY
['Permanent ❑ Temporary
['Single Face ❑ Double Face [I Wall Mounted [I Free Standing ['Other
Building face Setbacks: Front Side Side Rear
Square Footage of each sign face Total square footage of sign
Special Conditions
THIS PERMIT BECOMES NULL ANU VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS ',,S'ENOEO OR
ABANDONED FUR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS ANU JROINANCES
GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AeTHORITY TO
VIOLATE OR ANCEL THE PROV SIONS OF AN OTHER STATE ON LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
S igned_
Date 1— 20 -P9'
- -- - -.
LICENSED CONTRACTORS DECLARATION
I hereby affirm that I am licensed under provisions of the Business and Professions Code, and my license is in full force and effect.
Date
Contractor (signature)
OWNER- BUILDER DECLARATION
( ) I, as owner of the property, or my employees, with wages as their sole compensation, will do the work, and the structure is no +noel or
offered for sale.
( ) I, as owner of the property, am exclusively contracting with licensed contractor's to construct the project.
Owner (signature) Date
City of Tukwila
6200 Southcenter Boulevard
Tukwila. Washington 98188
(206) 433 -1 800
Gary L. VanDusen, Mayor
Keenan Supply
402 Baker Blvd.
Tukwila, WA 98188
Attn: Bruce Marks
Keenan Supply Rack Storage Permit
Dear Mr. Marks:
Per our conversation this morning, the permit number issued on your
rack storage permit is incorrect. The permit number should be 5533
not. 0107 -M. Please change your records accordingly.
If you should have any questions, please feel free to contact me at
Sincerely,
.1,,
Becky L. Davis
Permit Coordinator
i:'
THE FOLLOWING. COMMENTS APPLY TO AND BECOME PART OF THE APPROVED PLANS UNDER:
TUKWILA BUILDING- PERMIT NUMBER 10/07-441.
1' NO. CHANGES: WILL BE.MADE TO•PLANS UNLESS•APPROVED BY ARCHITECT AND TUKWILA:.
BUILDING'DEPARTMENT.
2 ALL PERMITS TO BE POSTED AT•JOB SITE PRIOR TO START OF ANY CONSTRUCTION..:
:ALL.'CONSTRUCTION TO BE DONE.IN CONFORMANCE WITH APPROVED PLANS AND
REQUIREMENTS. OF THE UNIFORM BUILDING :CODE (1985 EDIT.ION), UNIFORM
MECHANICAL CODE'(1985 EDITION), WASHINGTON. STATE ENERGY. CODE (1986
EDITION), AND WASHINGTON STATE REGULATIONS FOR BARRIOR FREE FACILITY
• (1986 EDITION).•
City of Tukwila
FIRE DEPARTMENT
444 Andover Park East
Tukwila, Washington 98188 -7661
(206) 575 -4404
Gary L. VanDusen, Mayor
January 3, 1989
Fire Department Review
Control Number 88 -401
(513)
Re: Keenan Supply - 402 Baker Blvd., Tukwila, Wa.
Dear Sir:
The attached set of building plans have been reviewed by
The Fire Prevention Bureau and are acceptable with the
following concerns:
1. The total number of fire extinguishers required for
your establishment is calculated at one extinguisher for
each 1,500 sq. ft. of area. The extinguisher should be of
the "all purpose" (2A, 20 B:C) dry chemical type. The
travel distance to any extinguisher must be 75' or less.
(NFPA 10,3 -1.1) (UFC 10.301)
This level of coverage is required in the high rack
storage area only.
Extinguishers shall be installed on the hangers or in
the brackets supplied, mounted in cabinents, or set on
shelves (NFPA 10, 1 -6.6), and shall be installed so
that the top of the extinguisher is not more than 5
ft. above the floor. (NFPA 10, 1 -6.6) (UFC 10.301)
Extinguishers shall be located so as to be in plain
view (if at all possible), or if not in plain view,
they shall be identified with a sign stating, "Fire
Extinguisher," with an arrow pointing to the unit.
(NFPA 10, 1 -6.3) (UFC 10.301)
2. No point in a sprinklered building may be more than
200 feet from an exit, measured along the path of travel.
(UBC 3302) (UFC 12.101)
3. Maintain sprinkler protection for all enclosed areas.
(NFPA 13, 4- 1.1.1) (UFC 10.302)
City Tukwila
FIRE DEPARTMENT
444 Andover Park East
Tukwila, Washington 98188 -7661
(206) 575 -4404
Gary L. VanDusen, Mayor
Page number 2
All sprinkler drawings shall be prepared by companies
licensed to perform this type of work. Drawings shall
first be approved by the Washington Surveying & Rating
Bureau, Factory Mutual Engineering or Industrial Risk
Insurers, then by the Tukwila Fire Department. No
sprinkler work shall commence without approved
drawings. (City Ordinance #1141 & NFPA 13, 1 -9.1)
(UFC 10.307)
4. Storage over 12 feet high in racks requires a special
permit from the fire department (UFC 4.101, article 81).
Please submit the following information to the fire
department to obtain this permit:
(A) A floor plan showing the location and height of
rack storage. This plan should be dimensioned or
drawn to scale.
(B) A document indicating the N.F.P.A. class of
storage.
(C) A document indicating that the sprinkler
protection provided complies with N.F.P.A. Article
C -231.
If the building is to be used for the storage of
high -piled combustible material (as defined in UFC,
Sec. 9.110); automatic fire- extinguishing systems,
smoke - removal systems, fire protection and fire
separations are required per Uni -form Fire Code -
Article 81.
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CITY OF TUKWILA
APPROVED
ANA 1989
;FILE COPY
I understand ,that the Plan Choc. ovals re
G
subject to errors and yid approval of
plans does not valorize ;9hc vielation.ot any
adopted code or or'.:! {";anco. kcceipl of contractor's
copy of appravecj p .74:13 ccIt.r euged.
Date '
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DEC 19 '88
RE HEAD
•• PNOA.
• 41! wedge
8 : 3 2 F M;11,,GR I KNELL F . P F.F. SEATTLE
wedge anchors
• Available in carbon steel or 303 stainless.
anchors feature one piece stainless steel expanders
to assure full expansion while resisting corrosion.
• Non- bottom bearing. Does not require precise
hole depth.
• Anchor size equals hole size. Can be installed
through object to be fastened.
• Can be installed in thin sections of concrete.
• Supplied complete with nuts and washers.
1, Drill hole to
any depth ex-
ceeding the
embedment.
Partial Cleaning
of the hole can
greatly reduce
required
drilling depth.
6%::...4-11
r+■W.
NibizivoR
9--se
2. Insert as-
sembled anchor
and expand
by tightening
nut. Normally
requires 3-5
turns.
Sots working loads foe iiergl• instatiatwns ynpor Odic boding should not *stood 25% of the utlWnate Mad
up.cny. For infermotion on other condition., coM•el your n.ee•.t busily representative,
For teenptele installation Inforrnetion bee instruction, packed in •wry box of enahe9.
Maintain an acturele hot• ■tre for proper installation one Oarlermance.
.-..
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7011, r« nrstenr
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Carbon
Steel
Catalog
Number
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Catalog
Member
Galvanized
Steel
Catalog
Number
Anchor
Size Size A
Oriel
Sin
..•
A
Overall
l e h
Max.
Thickness
of Material
to be
Fastened
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C
Thread
Length
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Min.
Embed.
meet in
Concrete
I'Nlfoft
US.
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155.
W5•1416
WS -1422
WS-1432
WW -1416
WW-142,2
WW -1432
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21/ar'
31/a"
1/4"
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144"
3'4"
3 /n"
1/4"
1%"
2400
2325
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• WS -3521
• WS -3830
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• WW -3822
• W•3126
• WW -3130
• W•3$36
• WW -3850
•
3/4"
216"
23/4"
3"
33/4"
5"
1/4"
3/4"
1"
11/4"
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1114"
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1114"
134"
41
5000
• WS -1228
• W$ -1236
• WS -1242
• WS -1254
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• WW-1226
• WW -1236
• W•1242
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•
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• WS -125.6
1/2"
21/4"
31/4."
43/4",
51/2"
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114"
1W
1W
3"
4W
111s -
11/4"
111."
11/4"
1114"
2114"
5900
8400
• WS•5834
• WS -535o
• W5•586o
• WS -5870
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. WW -5834
• W -5850
• WW•5880
• WW -5870
• WW-51184
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6"
7'
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2"
3"
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WIN
CITY OF TUKWILA
Building Division
6200 Southcenter Boulevard
Tukwila, Washington 98188
(206) 433 - Ig¢9 BUILDING PERMIT
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Jork to be done T.I. (Racks
>ite Address 402 BAKER BLVD —uiteI
Wilding Use WAREHOUSE
'roperty Owner RICHARD DAVIDSON
Address 631 SOUTH 291ST STRFFT FFf]FRAI WAY, WA
:ontractor _ KEENAN SUPPLY .
Address 402 BAKFR. RI V❑ TILKWII A9 Wit
'OR BUILDING PERMIT ONLY Approved for Issuance By: ,( %,((,b „-, `
PERMIT #_ ,553
Control I
8R -4.01
(513)
Tenant KFFNAN SUPPLY _ _
Assessors Account N 02231Q 0031
Phone I $39 -4695
Zip 9R0Q3
Phone I 433 -1003
,, I Zip 98188
Dated_ 5-
Sq. Ft.
11t -FT.
Office
w; enou :e
Retail
Other
Occ.
Load
2nd Fl.,
3rd Fl.
■
Y:
Total
Fire Protection: 0 Sprinklers [] Detectors
Zoning Type of Construction
Special Conditions
Fees
sq. ft. @
sq. ft. @
sq. ft. @
sq. ft. @
1st Fl. $
2nd Fl. S
other S
other S
Total Valuation of Construction S
SOn_On
Bldg. Permit Fee Receipt #7Q1,3 $ 78.72
Plan Check Fee Receipt # S
Demolition Receipt N S
Surcharges Receipt #_7475 S
Other Receipt N S
Other Receipt I $
3.50
TOTAL
$ 82.22
OR SIGN PERMIT ONLY
0 Permanent 0 Temporary
J Single Face [] Double Face [] Wall Mounted [] Free Standing [] Other
Building face Setbacks: Front Side Side Rear
Square Footage of each sign face Total square footage of sign
Special Conditions
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS ' >uSPENOED OR
ABANDONtU FUR A PLRIOD OF 180 DAYS Al ANY TIME AFTER WORK IS COMMENCED.
1 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 GE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO
VIOLATE OR ANGEL THE PROV SIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE ��THHEpE PERFORMANCE OF CONSTRUCTION.
Signed_ r =, Date /--R0--
CONTRACTORS DECLARATION
I hereby affirm that 1 on licensed under provisions of the Business and Professions Code, and my license
Contractor (signature) _ Date
OWNER - BUILDER DECLARATION
or my employees, with wages as their sole compensation, will do the work, and the structure is not 'n',nded or
on exclusively contracting with licensed contractor's to construct the project.
Date
( ) 1. as owner of the property.
offered for sale.
( ) 1, as owner of the Property.
Owner (signature)
is in full force and effect.