HomeMy WebLinkAboutPermit 0235 - Fox ResidenceA. 4`
BUILDING PERMIT
CITE, OF TUKWILA BUILDING P,._ :MIT
14475 - 59th Ave. So. / Tukwila, Washington 98067
Applicant to complete numbered spaces only.
BUrLDING •
PERMIT NO.
NI' 235
JOB ADDR E55
15455 - 53rd Ave. So.
GATE
5/30/73
LEGAL
1DESCR.
LOT NO.
1
Easterly '
BLK
4
TRACT
( ❑SEE ATTACHED SHEET)
Brookvale Garden Tracts
OWNER MAIL ADDRESS ZIP PHONE
2 Charles Fox 15455 - 53rd Ave. So. Seattle 98188
CONTRACTOR MAIL ADDRESS PHONE LICENSE NO.
3 Servicmaster 600 Elliott Ave. West At. 4 -6121 223 -02- 11421
ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO.
4 C -578 -83142
ENGtf /EF.R MAIL ADDRESS PHONE LICENSE NO.
5
LENDER MAIL ADDRESS BRANCH
6
USE OF BUILDING
7
8 Class of work: • NEW • ADDITION • ALTERATION ifl REPAIR • MOVE • REMOVE
9 Describe work: Repair of ceiling joists and sub floor liner due to basement fire.
10 Change of use from
Change of use to
11 Valuation of work: $ 175.00
PLAN CHECK FEE
Typo of
Const. V -N
Occupancy
Group
PERMIT FEE
1
a 5.00
Division 1
SPECIAL CONDITIONS:
Size of Bldg. Same
(Total) Sq. Ft.
No. of
Stories 2
Max.
Occ. LoacSame
Fire
Zone ZIT
Use V
Zone RMH
Fire Sprinklers
Required •Yes ZJNO
APPLICATION ACCEPTED BY:
PLANS CHECKED BY:
APP • OVED FOR ISSU •
/4�
it. Ilk .
NCE BY
L
No. of
Dwelling Units
OFFSTREET PARKING
covered
SPACES:
Uncovered
NOTIC
SEPARATE PERMITS ARE REQUIRED F• - CTRICAL, PLUMB•
ING, HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK 1$ COM-
MENCED.
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 BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
Special Approvals
Required
Not Required
Approved
ZONING
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
FOUNDATION
FRAMING
SIGNATURE OF OWNER (Ir OWNER BUILDER)
,l9.- ---24...,4--a
FINAL
SIGMA OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. M.O. CASH
OCCUPANCY PERMIT REQUIRED
BUILDING PERMIT
CIT OF TUKWILA BUILDING PERMIT
14475 • 59th Ave. So. / Tukwila, Washington 98067
Applicant to complete numbered spaces only,
Joe ADOR ESS
514-SS -- 53 9..d Ave. • So•
DATE
5) soi13
LEGAL
1 DESER.
LOT NO,
y�
\��TE �`
SLR
TRACT
Clime ATTACHED SHEET)
�2oc�kvAl� GAQdc�J
OWNER MAIL ADDRESS ZIP PHONE
2 Crho,ale.S roX %Sy55•• 5'�vu3 PVC- so'
CONTRACTOR MAIL ADDRESS PHONE LICENSE N0.
3 SERV∎c',N.wS +Eg C 1t1-1-611 Ave. k.,i1'S-1 F1} 4-(018.\ a33-Oa- 11.4 a.1
ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE N0.
4 C S1$ - IS 304a.
ENGINEER MAIL ADDRESS PHONE LICENSE N0.
5
LENDER MAIL ADDRESS BRANCH
6
USE OF BUILDING
7
8 Class of work: • NEW ❑ ADDITION ❑ ALTERATIONHEPAIR • MOVE ❑ REMOVE
9 Describe work: - • ev -����/ "2 ����'
`
fj r.,1 r0 _.I "..,rcG7r
10 Change of use from
Change of use to
11 Valuation Of work: $
PLAN CHECK FEE
PERMIT FEE 15
SPECIAL CONDITIONS:
Type of V.
Const.
Division
Occupancy
Group
(Total) Sq. F o
Stories
Max. 'r�!"
Occ. Load iaw�'M
Fire
Zone
Use
Zone
Fire Sprinklers
Required •Yes aie
APPLICATION ACCEPTED BY:
PLANS CHECKED BY:
APPROVED FOR ISSUANCE BY:
No. of
Dwelling Units
OFFSTREET PARKING
Covered
SPACES:
Uncovered
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-
ING, HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK I$ COM-
MENCED.
I HEREBY CERTIFY THAT 1 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 OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
Special Approvals
Required
Not Required
Approved
ZONING
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
FOUNDATION
FRAMING
SIGNATURE OF OWNER III OWNER GUILDER)
FINAL
SIGNATURE OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION ac. M.O. CASH PERMIT VALIDATION CK.
OCCUPANCY PERMIT REQUIRED
M.O. CASH
REPAIR ESTIMATE ,
POLICY NUMBER ,t
INSURED C' hail %,S rix ,r
LOCATION '4 j.d 1LiI J'( SO
REPAIR SPECIFICATIONS • `
(location In building, work to be done, materials ,
required, quality, measurements and dimensions)
.QUANTITl
AND
UNIT
UNIT
COST
TOTAL
SUBTOTAL.
The undersigned contractor agrees to.complete ondl
the above repairs for the total price of $
Toff,
(
,.
guarantee
THIS IS NOT AN ORDER TO REPAIR ..
Adjuster
REPAIR ESTIMATE
INSURED
DATE
POLICY NUMBER
LOCATION
REPAIR SPECIFICATIONS
(Location In building, work to be done, materials
required, quality, measurements and dimensions),
QUANTITY
AND., < •
UNI
UNIT
COST
TOTAL,
01(tVol Poor-.
r.
1) %f it l •:9 t t,+, /t/Will to (i0 ra:..
E1 t-. 7- ,f!'fj._... ---- s t� -
N 0 7 ?2 1 a'4 /t.e(6' ( f'�2
f� ,mss •
?it*
the undersigned contractor agrees to complete and
guarontee Iha above repairs (or the,total price oftb
THIS IS NOT AN ORDER TO REPAIR
SOB TOTAL
on S ., ;
Contractor ;
Dale �;
Adjuster ( T}Q T A l