HomeMy WebLinkAboutPermit 5873 - Gorjance Residence - ReroofBUILDING PERMIT
(POST WITH INSF`k.,.. ;TION CARD AND PLANS
IN A CONSPICUOUS LOCATION)
CITY OF TUKWILA
Department of Community Development - Building Division
6200 Southcenter Boulevard, Tukwila WA 98188
(206) 433 -1849
BUILDING
PERMIT NO.
5"13
DATE ISSUED:
PLAN CH
FEES
'bESCRIPTION
AMOUNT
RCPT N
DATE
BUILDING PERMIT FEE
_,_,_63 _ nn
4524
12 -28 -89
PLAN CHECK FEE
BUILDING SURCHARGE
4.50
4524
12 -28 -89
ENERGY SURCHARGE
FZQpy
trOC
SQUARE
FEET
OTHER:
SQUARE
FEET
OCC.
LOW
SQUARE
FEET
TOTAL -
67.50
OCC.
LOAD
SQUARE
FEET
16604 53_Av S - 4,161 85
ASSESSOR ACCOUNT ate
PROJECT NAMEfTENANT
Wi 11 i ?i .1— Gnr j e x$5880— 40 -01
TYPE OF U New Building U Addition U Tenant Improvement (commercial) U Demolition (building) U Grading/Fill
WORK: 0 Rack Storage ® Retool 0 Remodel (residential) 0 Other
DESCRIBE WORK TO BE DONE:
Remove and replace house and carport roofing.
PROPERTY OWNER
.11 • ./ -
PHONE
I/— •
ADDRESS 16604 53rd Avenue South. Tukwila. WA
ZIP %8188
CONTRACTOR South End Roofing, Inc.
PHONE 575 -3183
ADDRESS 35823 First Avenue South, Federal Way, WA
ZIP98003
WA. ST. CONTRACTOR'S LICENSE # SOUTHER141PM
EXP. DATE 6790
PHONE
ARCHITECT N/A
ADDRESS
ZIP
TYPE OF CONSTRUCTION: UBC EDITION (year)88
SETBACKS: N - s-
E -
CODE COMPL.1Ar1CL
FIRE PROTECTION:OSprinklers 0 Detectors N/A
UTILITY PERMITS REQUIRED?
Yes ®N o
USE .•4
I
/
l
/
/
FZQpy
trOC
SQUARE
FEET
C.
LOAD
SQUARE
FEET
OCC.
LOW
SQUARE
FEET
OCC.
LOAD
SQUARE
FEET
OCC.
LOAD
SQUARE
FEET
OCC.
LOAD
TOTAL
SQUARE FEET k
TOTAL
OCC. LOAD
,
TOTAL
TYPE OF CONSTRUCTION: UBC EDITION (year)88
SETBACKS: N - s-
E -
W —
FIRE PROTECTION:OSprinklers 0 Detectors N/A
UTILITY PERMITS REQUIRED?
Yes ®N o
(publ� works)
ZONING: , -1 BAR /LAND USE CONDITIONS0Yes i7 No
CONDITIONS (other than those noted on or attached to permit/plans):
APPROVED FOR `, `/ i BUILDING
ISSUANCE BY: ��2 "/ ��� OFFICIAL
DATE: ("),(A
/d -2X — 6
I hereby certify at I have red and exa n-' this peri%it and know the same to be true and correct. All provisions
of law and ordinances governing this w. 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 performance or work. I am authorized to sign for and this building permit.
SIGNATURE: C� C �/Wt,c '''''- ,v,4 �
gobtain
1 L /�$1 1
DATE:
PRINT NAME: WILLIAM J. G O R J AN C E
COMPANY: "`
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 01180 days from the last inspection.
CERTIFICATE OF
OCCUPANCY NO.
DATE ISSUED:
US eJsv
0
CITY OF TUKWILA
UILDING PEMT
(POST WITH INSF►cCTION CARD AND PLANS
IN A CONSPICUOUS LOCATION)
Department of Community Development • Building Division
6200 Southcenter Boulevard, Tukwila WA 98188
(206) 433 -1849
BUILDING
PERMIT NO.
DATE ISSUED:
PLAN CH
FEES
DESCRIPTION
AMOUNT
A
t.1
T72-
DATE
7.•.•c
BUILDING PERMIT FEE
63.011.
PLAN CHECK FEE
-3183
BUILDING SURCHARGE
4. 1
4
'
12-72.83- •
ENERGY SURCHARGE
OTHER:
�IP -
OCC.
LOAD
SQUARE
FEET
OCC.
• • e
TOTAL -
I 67.50
SI •DRESS SUITE # VALUE OF NSTRUCTION - $
166�_ � _4,161 85
PROJECT NAME/TENANT ASSESSOR ACCOUNT #
Wi 11 tail 1 885880- .QQ4D- I
TYPE OF Li New Building U Addition LJ Tenant Improvement (commercial) LJ Demolition (building) (_J Grading/Fill
WORK: ❑ Rack Storage X Reroof ❑ Remodel (residential) ❑ Other:
DESCRIBE WORK TO BE DONE:
Remove and replace house and carport roofing,
PROPERTY OWNER
W 11 iam tl ,.finciance_.._
PHONE
244-
• s
ZIP981RR
ADDRESS
16604 53rd Avenue South, Tstkwil ra., WA
South End R ig, Inc.
PHONE 575
CONTRACTOR
-3183
ADDRESS
35823 First Avenue South, Federal Way, WA
IZIP98003
EXP. DATE
6/�9
'PHONE
WA. ST. CONTRACTOR'S LICENSE # SOIIiFIER141PM
ARCHITECT
N/A
ADDRESS
�IP -
USE .
/
4,.;, ,
/
E
cob ES'
P I1A
/
P L•.I A N C E
/
't.
/
,1:,,.
yji'rP
,
^'∎ V i
FL.X•IN
SQUARE
FEET
OCC.
LOAD
SQUARE
FEEL
OCC.
LQP
SQUARE
__
OCC.
I Q D
SQUARE
Fft.L
OCC.
LOAD
SQUARE
FEET
OCC.
• • e
TOTAL
. UARE FE
TOTAL
_ G LQAD .1
TOTAL
TYPE OF CONSTRUCTION: UBC EDITION (year)88
SETBACKS: N - $ - E -
UTILITY PERMITS REQUIRED?
❑ Yes (X) N o
W _
(through
public wc.r+•sL.
FIRE PROTECTION:
❑Sprinklers O Detectors N/A
ZONING: R -1 BAR /LAND USE CONDITIONSEYes L JNo
CONDITIONS (other than thoso noted on or attached to pormit/plans):
ANF'HOVED FOR /
�
BY / /t'� 4'•
1 ISSUANCE
.. :
I hereby certify that 1 have read and oxa in
�j BUILDING DATE: (
�.� OFFICIAL 1�� -� c7
m this perthit and know the same to be true and correct. All provisions
of law and ordinances governing this wt ric will be complied with, whether specitied 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 performance or work. I am authorized to sign for and obtain this building permit.
:-A?/2
SIGNATURE: C, nrrt2 I DATE:
J
PAINT NAME: ��1L �' I� J. 0�ZJ�1''� I COMPANY:
DATE ISSUED:
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.
CERTIFICATE OF
OCCUPANCY NO.
CITY OF TUKWILA
Building Division
6200 Southcenter Boulevard
Tukwila Washington 98188
(206) 433 -1849
:� „r @LMN'. +bv;.rr,. .,.. -.m• ,• rrw: rreor.. ..Y�nr.ra.f:x-.u1R::r.:y.,;!xn. Mit7:yNVa-- uP..W. .Ylx ��e., r, u: u' t; xC.:.tx:NeiY.':0:'i{.L',._!:��: �!L`:E'i!1 :, �,;a':'r: i.' +•.'s' r! /: rtNEr'n.Y >ri:�'t+!:'.:'
Type of Inspection /J
Site Address /6 ( 0 4/ )
Requestor 11.,/,4�,
Special Instructions
INSPECTION RECORD
PERMIT # .5 ef 73
Date /— "2.— 5' v
Date Wanted
Project (A)�
Phone # .��y�� 9 I
Inspection Results /Comma ts: ✓ Q/. f—Q Fr"'";,76r
Date /- 3 --- 91'�i
BUILDUG PERMIT
INSPECTION RECOR[
(Post with Building Permit In conspicuous place)
CITY OF TUKWILA
Department of Community Development - Building Division'
6200 Southcenter Boulevard, Tukwila WA 98188
(206) 433 -1849
BUILDING
PERMIT NO.
DATE ISSUED:
5Sa3
SITE ADDRESS:
SUITE NO.:
PROJECT:
16604 53 Av S William J. Gorjance
CALL FOR INSPECTIONS AT LEAST 24 HOURS IN ADVANCE
"X"
REQUIRED INSPECTIONS
PHONE '
DATE
APPROVED
INSPECT.
INITIALS
DATE(S)
CORRECTION NOTICE ISSUED
1 Footings
433 -1849
2 Foundation
433 -1849
3 Slab and/or Slab Insulation
433 -1849
4 Shear WalI Nailing
433 -1849
5 Roof Sheathing Nailing
433 -1849
6 Masonry Chimney
433 -1849
7 Framing
433 -1849
8 Insulation
433 -1849
9 Suspended Ceiling
433 -1849
10 Wall Board Fastening
433 -1849
11
12
13
14 FIRE FINAL Insp:
575 -4404
15 PLANNING FINAL
433 -1849
16 PUBLIC WORKS FINAL
433 -0179
X
17 BUILDING FINAL
433 -1849
INSPECTION PROCEDURES AND REQUIREMENTS
All approved plans and permits shall be maintained available on the site in the same location.
1. FOOTING - When survey stakes and forms are set and rebar is tied in place.
2. FOUNDATION - When forms and rebar are in place.
3. SLAB - If structural slab or if underslab insulation is required.
4. SHEARWALL NAILING - Prior to cover.
5. ROOF SHEATHING NAILING - Prior to cover.
6. MASONRY CHIMNEY - Approximately midpoint.
7. FRAMING - After rough -in inspections such as mechanical, plumbing, gas piping, electrical and fire stopping is in place.
8. INSULATION - After framing approval, but before installation of wallboard. Baffles must be installed to keep attic
ventilation points clear.
9. SUSPENDED CEILING - Fasten diffusers, lights and seismic bracing.
10. WALL BOARD FASTENING - Prior to taping (see UBC Chap. 47 and Table 47G).
11.
12.
13.
14. FINAL FIRE INSPECTION - Contact Fire Department for their requirements.
15. FINAL PLANNING INSPECTION - Contact Planning Department for their requirements.
16. FINAL PUBLIC WORKS INSPECTION - Contact Public Works Department for their requirements.
17. FINAL BUILDING INSPECTION - When all work, corrections, reports and other inspections are complete.
OTHER AGENCIES:
Plumbing (including gas piping) — King County Health Department — 296 -4732
Electrical — Washington State Department of Labor and Industries — 872 -6363
A preconstruction meeting with the Building Inspector may be scheduled prior to starting the job by
contacting the Department of Community Development, Building Division at 433 -1849. Although not
required, a meeting of this type can often eliminate problems, delays and misunderstandings as the
project progresses. a/zere+
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n
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RESIDENCE
MOAT
y.fto �'t., o ff'
BLACKTOP
DRivEWAY
'DECK, MOAT 8'
)0)0)/
20
DECK
a8
iCARPOF:T
i// //' // /i/1,/ I I
A/
a4' 14
/ / /// AREA 5EING
RER0oFED
811
53RD AVE. so.
PLOT PLAN
SCALE: 3/32' z 1' -Q"
w.j.,G0RJANU RESU ENCE
LOT# I BLOCK *a VA
I-10LLM�S EY VIEW
16,404- 53RD AVE. SO.
� iirovosal
Arm:tant of Proposal - The above prices, WWII-
cations and conditions are
satisfactory and are hereby accepted. You are authorized to do the work
as specified. Payment will be made as outlined above. 1 understand that
am responsible for all the survey lines of my property, all underground
obstructions, Including telephone, water, and electrical power tines.
Oahe of Acceptance: (its 1 (, I ?
WHITE — CUSTOMER'S COPY
Signature
Signature
PINK — FILE COPY
CANARY — PLEASE RETURN THIS SIGNED COPY
L
K.\ SOUTH END ROOFING, INC. WA Cont. License #SOUTHER 141 PM
35823 1st Ave. So. SEA. (206) 575 -3183
Federal Way, WA 98003 TAC. (206) 952 -3355
PROPOSAL SUBMITTED TO
Bill Gorjancc e
PHONE
244 -2938
DATE
October 12, 1989
STREET
16604 - 53rd Avenue, South
JOB NAME
CITY, STATE AND ZIP CODE
••
JOB LOCATION
DATE OF PLANS
PRO It
JOB PHONE
' We hereby submit specifications and estimates for:
Roof Condition - Roof is in
a very dry and brittle stage, oils cooked out by ultra- violet
leaving cracks to penetrate down through the plys of felts
membrane.
reroof with Elastomeric SBS & Polyester System
to deck. Clean up and haul away' debris.
decking. Replace or renail N needed. Extra charge based
installed.
and roof deck scuppers. Install new metal edge cap
base sheet over existing roof deck using Superkote 100.
has been completed, spray Gilsonite Superkote 100 at four
modified ply sheet into coating and top -spray with Gilsonite
per 100 sq. ft.
into Superkote 100 as to completely saturate polyester.
Superkote 100 at five gallons per 100 sq, ft. over polyester.
at 50 lbs, per 100 sq. ft. into Superkote 100 as to form a
over entire roof as to protect system from ultra - violet rays.
TEN -YEAR WRITTEN GUARANTEE
allow 4 to 6 week for scheduling Note: Recommend you hay-
job. someone reflashingchimne
metal flashing very bad.
rays causingtasphalt to shrink
that make up the water - proofing
Recommendation - Tear off and
1. Tear off old roof membrane
2. Check for dry rot or loose
on $25.00 per sheet of plywood
3. Install new lead pipe flashing
color - galvanized.
4. Seal 28 lb. SBS rubber modified
, 5. After all prepar ation work
gallons per 100 sq. ft.
6. Embed 28 pound SBS rubber
Superkote 100 at seven gallons
7. Embed Phillips E3M polyester
8. Final spray with Gilsonite
9. Blow white ceramic granules
complete seamless blanket
CASH PRICE $3.85Q.00
i 311.85 Please
TAX
, of
TOTAL $4:161.85
lie Prnpp,v hereby to furnish materiel and labor — complete in accordance with above specifications, for the sum of:
Four Thousand One Hundred Sixtv -One and 85/100 ** dollars($ 4.161.8 )
Payment to be made as follows: .
Upon completion of work and submittal of bill.
ml material according r is ng.terstan to r M es practice.. Any It wore to be anon from In a workmanlike
manner eeeording to standard iraetkee, Any alteration or deviation Irom above epaeifiea•
pons Involving .sire costs wIP Be sweated only upon written orders, and wit become en
*Mrs chwie over and above the estimate. AB agreements contineeM upon strikes, accidents
or delays beyond our contra. Owner to carry ere, torpedo end other necessary insurance.
O workers ere fully covered by Workmen's Compensation Insurance.
Ow
—'��
Au1halZed � .L,
Signature 1 ✓f- -vti �
Note: This proposal may
withdrawn by us if not accepted within
be - 30 -
days
Arm:tant of Proposal - The above prices, WWII-
cations and conditions are
satisfactory and are hereby accepted. You are authorized to do the work
as specified. Payment will be made as outlined above. 1 understand that
am responsible for all the survey lines of my property, all underground
obstructions, Including telephone, water, and electrical power tines.
Oahe of Acceptance: (its 1 (, I ?
WHITE — CUSTOMER'S COPY
Signature
Signature
PINK — FILE COPY
CANARY — PLEASE RETURN THIS SIGNED COPY
A
1-
-.-- 12'
r
S31
r 1#/$44 R40, 4044►9///4/7,4+j %9.0,44,./ ,4, /,,/,/ / /- i > /l/A, / /isoy/
/
RESIDENCE
l
,) i�)1 /l /dil/ ///j/l111).W :' / /0/1 /1J
;DECK, MOAT
���'!1)� X11//
MOAT
BLACKTOP
DRIVEWA�t
20 l
qjj
'9
DECK
/
i
. i
/I)))/
/ /4.7
CARPORT )5,1"
l41 " /h /////'//1/1/ ii/,//
24•
/ / /// AREA 5EING
RER00FEID
20
8I'
53RD AVE. SO,
PLOT PLAN
CAL 3/32" _ 11 °0'1
1
A
28
W.J..GOI:zJANCZ RESIAENCE
LoT # 1 BLOCK #a - VALLEY VIEW
MQMeS
14404. 53RD AVE. SO.
tiropoon1
1•
PaeNo.
Pages
SOUTH END ROOFING, INC.
35823 1st Ave. So.
Federal Way, WA 98003
WA Cunt. License A SOUTHER 141 PM
SEA. (206) 575-3183
'I AC. (206) 952 -3355
--�
Arri tir at proposal - The above Prices speclll•
cations and conditions are
satisfactory and are hereby accepted. You are authorized to do the work
at specified. Payment will be made as outlined above. 1 understand that 1
am responsible for all the survey Ilnos of my property, all underground
obstructions, Including telephone, water, and electrical power
G lines.
Date of Acceptances `. I , 1 ( s ,.
WHITE — CUSTOMER'S COPY
CANARY — PLEASE RETURN THIS SIGNED COPY
PINK — FILE COPY
PROPOSAL SUBMITTED TO P
PHONE D
DATE
STREET J
CITY, STATE AND ZIP CODE J
JOB LOCATION
DATE Of PLANS P
PRO$ J
JOB PHONE
We hereby submit specifications and estimates for:
Roof Condition - Roof is in a
a very dry and brittle stage, oils cooked out by ultra- violet
rays causing,asphalt to shrink l
1. Tear off old roof membrane t
311.85 M
of j
lb Propos! hereby to furnish material and labor — complete in accordance with above specifications, for the sum of:
Four Thousand One Hundred Sixty -One and 85 /100 ** dollars ($ 4.161.85 ). `
Payment to be made as follows: r
Upon completion of work and submittal of bill.
l material is guarenteed to W as specified. Al wort to W completed in • workmanlike
manner according to standard practices. Any aherelfon or deviation from .Hove specifics.
AWhaired � �
M1L_�-CTL /t
Note: This proposal may b
be - 30 -
Arri tir at proposal - The above Prices speclll•
cations and conditions are
satisfactory and are hereby accepted. You are authorized to do the work
at specified. Payment will be made as outlined above. 1 understand that 1
am responsible for all the survey Ilnos of my property, all underground
obstructions, Including telephone, water, and electrical power
G lines.
Date of Acceptances `. I , 1 ( s ,.
WHITE — CUSTOMER'S COPY
CANARY — PLEASE RETURN THIS SIGNED COPY
PINK — FILE COPY
I
BUILDING PERMIT APPLICATION TRACKING
PLAN CHECK
NUMBER
PROJECT NAME
aryl
SITE ADDRESS SUITE NO.
1 1p(p O y u f\
INSTRUCTIONS TO STAFF
• Contacts with applicants or requests for information should be summarized in writing by staff so that
any time the status of the project may be ascertained.
• Plan corrections shall be completed and approved prior to sending on to the next department.
• Any conditions or requirements for the permit shall be noted on the plans or summarized concisely
in the form of a formal letter or memo, which will be attached to the permit.
• Please fill out your section of the tracking chart completely. Where information requested is not
applicable, so note by using "N /A ".
BUILDING SQUARE FOOTAGE/OCCUPANCY INFORMATION
(to be filled out by Plan Checker)
SQUARE
FEET
OCC.
LOAD
SQUARE
FEET
OCC.
LOAD
SQUARE
FEET
OCC.
LOAD
SQUARE
FEET
OCC.
LOAD
SQUARE
FEET
OCC.
LOAD
TOTAL
SQUARE FEET
TOTAL OCCU-
PANCY LOAD
DEPARTMENTAL REVIEW
"X" In box Indicates which departments need to review the project.
Ai
REt IR.EMENTS / >COMMEN' S
54 BUILDING -
initial review
(ROUTED)
CONSULTANT: Date Sent -
Date Approved -
O FIRE
INIT:
FIRE PROTECTION: (J Sprinklers (1 Detectors (}Q N/A
FIRE DEPT. LETTER DATED: INSPECTOR:
O PLANNING
INIT:
ZONING: [BAR/LAND USE CONDITIONS? r] Yes (l No
REFERENCE FILE NOS.: �`
MINIMUM SETBACKS: N- S- E- W-
O PUBLIC
WORKS
O OTHER
UTILITY PERMITS REQUIRED?
INIT:
PUBLIC WORKS LETTER DATED:
Yes MNo
INIT:
CiO BUILDING -
final review
1Q-E.-61 INIT:
TYPE OF CONSTRUCTION:
UBC EDITION (year):
Lc Sc
REVIEW COMPLETED
PERMIT NO.
CONTACTED
(J l t o.m
DATE READY
DATE NOTIFIED
la- Qs _- 6 1
BY:
snit.)
Q
,J,_.6 J
PERMIT EXPIRES
2nd NOTIFICATION
BY:
(Init.)
AMOUNT OWING
4
3RD NOTIFICATION
BY:
(init.)
CITY OF TUKWILA
Department of Community Development - Building Division
6200 Southcenter Boulevard, Tukwila WA 98188
(206) 433 -1849
BUILDIF3 PERMIT
APPLICATION
FEES (for staff use only)
DESCRIPTION: ;
AMOUNT RCPT #: DATE
APPLICATION n1US T QE
FILLED OUT COMPLETELY
B
PLAN CHECK FEE
BUILDING SURCHARGE
ENERGY SURCHARGE.
OTHER:
UILDING`PERMIT.FEE
Co3;oo .1a a�--
TOTAL
l07 5o
U
SITE ADDRESS SUITE #
) “czr 3D Avg. 5 (3.. —.
VALUE OF CONSTRUCTION • $
4,)c�) --
PROJECT NAME/TENANT
\N\t.L)AM J, G(RJANCE
ASSESSOR ACCOUNT #
_ ASS o-o04n-o'
TYPE OF LFNew Building U Addition U Tenant Improvement (commercial) U Demolition (building)
WORK: O Rack Storage 2 Reroof 0 Remodel (residential) 0 Other
DESCRIBE WORK TO BE DONE:
'R 1-i'l eJvL ANJ \LPLACL )- \O\)3L AN CAR17v7 -r r Qos \N 9
BUILDING USE (office, warehouse, etc.)
PCI \I -iiE RF5DENcE
NATURE OF BUSINESS: pz 1 VA i e i? E ,5 1 D E. JI C, C
WILL THERE BE A CHANGE IN USE? N No ti Yes IF YES, EXPLAIN:
SQUARE FOOTAGE - Building: Tenant Space: Area of Construction:
WILL THERE BE STORAGE OR USE OF FLAMMABLE, COMBUSTIBLE OR HAZARDOUS MATERIALS IN THE
BUILDING? 3 No 0 Yes IF YES, EXPLAIN:
PROPERTY OWNER ILL)AM
GoRJANCE
PHONE 2,4C”
-_2(33
ADDRESS 1 (- ,-,dpi- . 3r<i) AVE, JO, 0-C VvIL A
ZIP ,g\s.e
CONTRACTOR 5QwTr\ LN fZ40ZIN ( INC.
PHONE 375 3\ 3
ADDRESS '35223 1 5--c" AV). rah, FL- :\D RIB L wA'r
ZIPC 2s0U.3
WA. ST. CONTRACTOR'S LICENSE # SOUTHER 0.) a 1+1
EXP. DATE ,..m.1 L ) 99 C)
ARCHITECT _
PHONE
ADDRESS
ZIP
:HERE. Y: CERTIFY • THAT <I ;:h AVE `REA /k 11 `: EXAMINED :.,. 1. ' • S'APPU AT.I I4 AND
• TRUE<AND CORRECT ..AND 1 1M ::A T ORIZEp: >:: AP LY:FOR THIS EAMI i'; ..........
:KNOW::THI; :SAME T :
:.: ... >:.:.: ;:«
BUILDING OWNER
OR
AUTHORIZED
AGENT
SIGNATUR 'T�
f �. R
DATE 1 L Lrzr B.)
PRINT NAME N f 1 L L 1 /a i`� 3 C1 J A N C L
PHONE 2A- - 2,932,
ADDRESS) ("604- 53r \) AvE, jp,
CITY /ZIP i U'1(alLA gg)22
CONTACT PERSON A C/V Ls
PHONE
APPLICATION SUBMITTAL In order to ensure that your application is accepted for plan review, please make sure to till
out the application completely and follow the plan submittal checklist on the reverse side of this form. Handouts
are available at the Building counter which provide more detailed information on application and plan submittal
requirements. Application and plans must be complete in order to be accepted for plan review.
VALUATION OF CONSTRUCTION Valuation for new construction and additions are calculated by the Department of
Community Development prior to application submittal. Contact the Permit Coordinator at 433 -1851 prior to
submitting application. In all cases, a valuation amount should be entered by the applicant. This figure will be
reviewed and is subject to possible revision by the Building Division to comply with current fee schedules.
BUILDING OWNER / AUTHORIZED AGENT If the applicant is other than the owner, registered architect/engineer, or
contractor licensed by the State of Washington, a notarized letter from the property owner authorizing the agent
to submit this permit application and obtain the permit will be required as part of this submittal.
EXPIRATION OF PLAN REVIEW Applications for which no permit Is issued within 180 days following the date of
application shall expire by limitations. The building official may extend the time for action by the applicant for a
period not exceeding 180 days upon written request by the applicant as defined in Section 304(d) of the Uniform
Building Code (current edition). No application shall be extended more than once.
If you have any questions about our process or plan submittal requirements, please
contact the Department of Community Development Building Division at 433 -1849.
DATE APPLICATION ACCEPTED
DATE APPLICATION EXPIRES
COMMERCIAL
S‘ 3MITTAL CHECK-IST
.,•.•
NEW DO,MAENCIAL.
.....,. ,......„„
C:49491010 10141019i) 0914111104991100011.(40.4144...f9r...Pa..•H:Jiiiii....
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sirssor.At?count
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Two sets (2) of the following:
.... . .• • ..„ „.
Specification:a •
• : • •.:. . .
5:tructu ral calculations stamped by a Waahlrigton. State Il�nsed
engineer „ . •
„...: ...„ •
Soils report stamped by a Washingtori State Hcensed • . . , • • • .. • :.• .• .... • . .
Topographical calCulations stamped by a Wth
a Ina
•••• . . . ... ...
o10,
J ::! Orclia:49°11 gni :i.444ti.deb344.71:04O10 11:a.Washington .
ral
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•,•COMMENCIALTENANT.IMPROVEMENIE::•: ••••••'• ••
. • •
•. ••,•.. • •.. •. ••• ... • •::.:.: ,"..• . • .••: ..•.
application (one for each structure or
. . . .
E.Aisessor Ao flt NUMbers,•:•.:••••;•:•••:•::::••••.2,•••••,>•:::',:-::•1:'::::::::.i::.,'•:::::::::.,•:•:'•:',,;,•::::•i':::::::':::•:•••••:•::••••••••••••''''.•••••.::::••::,:.
.„ .
TWo...(2)sata:•ofObi.strtiotforl plans,
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: •••••• •:•:.: ,:•• "
.Teriant
of adjacent (common .wall): tenant.::',•:: •
• Overall 'diniensiOni of building .Or square footage
Floor plan 01 • •••••.: -..: • ....
proposed tenanfripace..,::,„: . .
. . . . ::::•
••••••,......•!::11jnant space :plan . with u SeOf each .
„ .......... .„ • existing wall and wafls to be demollshed
. . : . • • •
COMpleted PerinitapplicadOn••.(onafoi,„antira:
. .
. .
NOTE S.e uttftypemsli appficialion:•:Eind .<:1100140t:for::.
submittal
•••••••
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Suctural tiOna:Starnped:bY.A:Waabington:Stata11co
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Completed 0+41!d .0ermitappiica tiop: (one for 1:0
•••••• • . . • . • . . •••••••••••••••-',.--
Nairathre.deScribingealtiang:rdof :niaterial being removed, and
materlal
.... • • ..... • • • • .• • • ••• • • • • .....
final 10pe
61917-
offofthe .*:0■:
RACK::EYONADE • • • • • • • • • .
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Completed 0.4411019t(PerM!t application
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.T40091 space ..., floor Pipp:::sl?.■.y...l.n...is rock siria. ,...............:.:.i..;:.,.,:
. '..)d'.:.:'.t$. •s•....0...1.7.....:::::.:::(•::, :::-.••••:::::,.......:... is ttir... won.. taie..,iicI.
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and ..' s's .... • ' lotions stamped ...
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....... . engineer (rook .
••EttrUctural'Calcuatarage 8 and
RESIDENTIAL
...............:„.:,..„.,,....:,,,,::„,.:,..:...,.... .........::::„
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NEW:SING4E-FAIAllik.)'.DIVE4141443.S/ADDIT:IONS ....,::;:.:::::::::::::',::,:.:,..ii:;::::::::::, •
•, [300'0'4)18.10d balding penbit'appilcailonli(OnelOreaCkinraOpre):::::::::::...,
, •. ..::::::.:::::::::::::,•::::;:::.:...:::::::.-..::::.:.,: .'. ' - .-. •••• — . • • ' . '
.... 0 Lhial desorption • :,1.- : • ::1•:••:-::.:,:•:'• • • •'''"'''' ''''''':::.''1":'..........:..::''''''."..:'''''''''''''''' ' •
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P.!anri•••,WhiCti. ncIude
Site Plan (.howing building :ginCi dish)
and d.ofaachtnen
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13E81Plit1TIA4,:11ENDDEI:..8::::::.:.:,•:::,:••,•:::,..,:,„....
C•oraPlatad building PermIt.apPlic44i0Fi.•(One:fe,!'.eaCh...;Structu!!)......
Aiiiiiis...,.0.....,r,:.:,..,....06;,.....,:...:.:::.:....:::::.0t....::::4::: 0,.......::::: c...:,.....:,.............::.....:::.:::,::::,':::......:.:.....•!:.:,..:,......,,,,,.::!....:.•::::,....:,....::::";:::::i..::::::::::::::::.::i.:::::.::::::::....,:::::::::::•:::::::....:,:::...,:,..:: . ..i...,:...::,..::........„.
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Two (2) sets O *of 101ni:0MiiiOgii. ■•■!11ati Iri 000e.;:.'::::.:::::::.......,:::::•...
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;:,;:;•....,:-:::*:;.:::',:*••••;*:FOOOdaticifi plan
Floor oiRn,....• •:.:::::,........:•::::•,.........,:„,::::,::::::::„....:;:,:„ „:„.: •::::::::::::::::„...,...„,:::::::::::::::„...:::::::::,:.„......,....:,.....,...:::::.,::...,:::::-..,.„.::•:::..
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:f1110.0**..!00114*1..
. .
. done
,ndp1ans must be aubmitted
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