HomeMy WebLinkAboutPermit D04-144 - HIGHLINE PHYSICAL THERAPY CLINIC - REROOFHIGHLINE PHYSICAL
THERAPY CLINIC
13050 MILITARY RD S
D04 -144
•
•
City of Tukwila
Department of Community Development/6300 Southcenter BL, Suite 100 / Tukwila, WA 98188/ (206) 431 -3670
Parcel No.: 1623049175
Address: 13050 MILITARY RD S TUKW
Suite No:
DEVELOPMENT PERMIT
Permit Number:
Issue Date:
Permit Expires On:
D04 -144
05/06/2004
11/02/2004
Tenant:
Name: HIGHLINE PHYSICAL THERAPY CLINIC
Address: 13050 MILITARY RD S, TUKWILA WA
Owner:
Name: MILITARY ROAD PROPS LLC
Address: 16259 SYLVESTER RD SW, BURIEN WA
Contact Person:
Name: JOHN BERGIN
Address: 20815 SECOND PL SW, SEATTLE WA
Contractor:
Name: BERGIN ROOFING INC
Address: 20815 SECOND PL SW, SEATTLE WA
Contractor License No: BERGIRI044JA
Phone:
Phone: 206 824 -5852
Phone: 206 824 -5852
Expiration Date:04 /01/2006
DE
SCRIPTION OF WORK:
TEAR OFF AND RE ROOF OF COMPOSITION SHINGLES ON APPROX.
60 FT X 90 FT ROOF.
Value of Construction: $ $9,800.00
Type of Fire Protection: SPRINKLERS
Type of Construction: VN
Fees Collected: $303.56
Uniform Building Code Edition: 1997
Occupancy per UBC: 0015
blic Works Activities:
Channelization / Striping: N
Curb Cut / Access / Sidewalk / CSS: N
Fire Loop Hydrant:
Flood Control Zone:
Hauling:
Land Altering:
Landscape Irrigation:
Moving Oversize Load:
Sanitary Side Sewer:
Sewer Main Extension:
Storm Drainage:
Street Use:
Water Main Extension:
Water Meter:
N
N
N
N
N
N
N
N
N
N
N
N
Number: 0
Start Time:
Volumes: Cut
Start Time:
Private:
Profit: N
Private:
Size (Inches): 0
End Time:
0 c.y. Fill 0 c.y.
End Time:
** Continued Next Page **
Public:
Non - Profit: N
Public:
Pu
doc: Devperm
D04 -144
Printed: 05 -06 -2004
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Permit Center Authorized Signature:
I hereby certify that I have read and examined is permit and know the same to be true and correct. All provisions of law and
ordinances governing this work will be complied with, whether specified herein or not.
Date:
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 constru ion r th performance of work. I am authorized to sign and obtain this development permit.
Signature: - /`--- Date: (`" # Y
i v
Print Name: ICS) h ge 1//)
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.
doc: Devperm
D04 -144
Printed: 05 -06 -2004
r
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 1 (206) 431 -3670
PERMIT CONDITIONS
Parcel No.: 1623049175 Permit Number: D04-144
Address: 13050 MILITARY RD S TUKW Status: ISSUED
Suite No: Applied Date: 04/28/2004
Tenant: HIGHLINE PHYSICAL THERAPY CLINIC Issue Date: 05/06/2004
1: ** *BUILDING DEPARTMENT CONDITIONS * **
2: No changes will be made to the plans unless approved by the Engineer and the Tukwila Building Division.
3: All permits, inspection records, and approved plans shall be available at the job site prior to the start of any
construction. These documents are to be maintained and available until final inspection approval is granted.
4: A statement from the roofing contractor verifying fire retardant class of roof will be required prior to final
inspection (see attached procedure).
5: All construction to be done in conformance with approved plans and requirements of the Uniform Building Code (1997
Edition) as amended, Uniform Mechanical Code (1997 Edition), and Washington State Energy Code (1997 Edition).
6: Validity of Permit. The issuance of a permit or approval of plans, specifications, and computations shall not be
construed to be a permit for, or an approval of, any violation of any of the provisions of the building code or of any
other ordinance of the jurisdiction. No permit presuming to give authority to violate or cancel the provisions of this
code shall be valid.
I hereby certify that I have read these conditions and will comply with them as outlined. All provisions of law and ordinances
governing 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 or local laws
regulating construction or the performance of work.
Signature: Date: D
Print Name: 14111,, Peij )
doc: Conditions
D04 -144 Printed: 05 -06 -2004
'.5'ir:`a:�''{'� «'�` �u:ti`�o
APR 28 '04 10 :44AM TUKWILA DCD /PW
CITY OF TUKW -Th
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
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**
,,11 /H,2iVj ,/King Co Assessor's Tax No.: / 6,0230Y-7/7y-
Site Address: of d , Suite Number:
Tenant Name: �5 � �Sir c 7 w New Tenant: ❑ .... Yes X,?.No
Floor:
Property Owners Name: Cf
Mailing Address: / f fJ. Ai/ li e Y
Name:
Mailing Address:
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E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
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Ciry
Day Telephone:
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Zip
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city / state zip
Fax Number: 21'b 17 fp)
Seattle, WA 98166
Ciry
206- _ Day Telephone:
CORE. # BERGIRI044JA
Smte
Zip, '
Fax Number: Z d
Contractor Registration Number: Expiration Date: Y
* *Au original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Ciry
Day Telephone:
Fax Number:
State
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Mailing Address:
Contact Person:
E -Mail Address:
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Fax Number.
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10 :45AM TUKWILA DCD /PW
Valuation of Project (contractor's bid price): $
P.3 /5
Existing Building Valuation; $
Scope of Work (please provide detailed intbrmation):
Will there be new rack storage? ..Yes I`-ti'. No If "yes ", see Handout No. for requirements.
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PLANNING DIVISION:
Single -family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Arca (sq ft): Floor area of principal dwelling: Floor area for accessory dwelling:
`Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard: Compact: Handicap:
Will there be a change in use? ❑ ..,.Yes ❑ ..No if "yes ", explain:
FIRE PROTECTION /HAZARDOUS MATERIALS:
Sprinklers ❑.,Automatic Fire Alarm (]..None 0.Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? El -Yes ❑..No
1f 'yes ", attach hot of muterlalx and storage locations On a separate 8 -1/2 x 11 paper Indicating quantities and Material Safety Data Sheets.
■koollatlonmVermit ooptiatioa (7.2003)
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Page 2
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APR 28 '04 10 :46AM TUKWILA DCD /PW.
P. 5/6
M CHANICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address: i; l 5 2nd PI. 5 W
Contact Person:
E-Mail Address:
Contractor Registration Numbe
* *An original or notarized co
Cary
Day Telepho
Fax Number:
piration Date:
st be presented a
issuance**
Valuation of Project (contractor's bid
Scope of Work (please provide detailed
v 1
Use: Residential: New ....❑ Replacement ....❑
Commercial: New ,,,, fl Replacement ....
Fuel Type: Electric ❑ Gas ,,,.❑ Other:
Indicate type of mechanical work being installed and the quantity below:
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�' gaiCcR /,�io>�ARf�i;Sir�t,.,,.,.,, .,
•.;Q fir„
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Furnace <100K k TU
Air Handling Unit
>=1o,000 CFM
Other Mechanical
Equipment
0-3 HP /100,000 BTU
Fumacc>100K BTU
Evaporator Cooler
3 -15 HP /500,000 BTU
--Floor Furnace
Veutilation Fan
15 -30 HP /1,000,000 BTU
Suspended/Wall /Floor
Mounted Heater
Ventilation System
30.50 HP /1,750,000 BTU
Appliance Vent
Hood
50+ HP /1,750,000 BTU
Hcat/Rcfrig/Cooling
System
Incinerator - Domestic
Air Handling Unit
<10,000 CFM
Incinerator — Comm/Ind
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4•. 1p,r. .
^
lYa r,, r `\ r "t ,� 4 inln9 1
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 liunitation.
-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 107.4 of the Uniform Building Code (current edition). No application shall be extended more than once.
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF um STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER R A FIZZED AGENT:
Signature:
Print Name:
MI.., ., .6 erg i.
Mailing Address: 7-00P/s— z /10L ✓1i)
Date: 9— 2 e _ IY
Day Telephone: 2dI 0 2- Vi-V i 2.
/r/rrn ' pun- /< 11%, 99//
�6
Date Application Accepted: ' Date Application Expires:
- ,� ?'a Y 1 /1' 'a "
Staff Initials:
J
Vpplialionslpeenic application (3-2003)
312003
Page4
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
z
RECEIPT 1 Z
re W
Parcel No.: 1623049175 Permit Number: D04-144 6 5
Address: 13050 MILITARY RD S TUKW Status: APPROVED U p
Suite No: Applied Date: 04/28/2004 w =
Applicant: HIGHLINE PHYSICAL THERAPY CLINIC Issue Date: —1 I—
WO
Receipt No.: R04 -00552 Payment Amount: 185.75 ti.
co
Initials: SKS Payment Date: 05/06/2004 04:27 PM H W
User ID: 1165 Balance: $0.00 z H
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Z I-
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TRANSACTION LIST: W W
Type Method Description Amount ~ H
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Payment Check 2650 185.75 uiZ
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Payee: BERGIN ROOFING INC
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
BUILDING - NONRES 000/322.100
STATE BUILDING SURCHARGE 000/386.904
181.25
4.50
Total: 185.75
fihOr 05/10 9716 TOTAL 185.75
doc: Receipt
Printed: 05 -06 -2004
z
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.:
Address:
Suite No:
Applicant:
RECEIPT
1623049175
13050 MILITARY RD S TUKW
HIGHLINE PHYSICAL THERAPY CLINIC
Permit Number:
Status:
Applied Date:
Issue Date:
D04 -144
PENDING
04/28/2004
Receipt No.:
Initials:
User ID:
R04 -00504
SKS
1165
Payment Amount: 117.81
Payment Date: 04/28/2004 03:52 PM
Balance: $185.75
Payee:
BERGIN ROOFING INC
TRANSACTION LIST:
Type Method
Description
Amount
Payment Check
2636
ACCOUNT ITEM LIST:
Description Account Code
117.81
Current Pmts
PLAN CHECK - NONRES 000/345.830
117.81
Total: 117.81
03&; 04/29 9 716 TOTAL 117.01
doc: Receipt
Printed: 04 -28 -2004
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
PER
06)431 -3670
P o ect:
ftv ca.P
Type of Inspection:
9
("A /IQ
A dr J .
`� r
ate C�Yed:
, , 1(I 0 `/
S ecia(instructions:
'
j Le2&
4-Q7\ ` �- �
1 �'
,�
Dace- Wanted: - a:m: y
/ster:
Reque
1 r .4 ��`
Phone No: �
b j c ti— Asa
Approved per applicable codes.
Xl...,,,
\ Corrections required prior to approval.
COMMENTS:
JOO
iv / '..-V7
..
J
71..
Inspect
r:
INSPECTIO E REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. CaII to schedule reinspection.
Receipt No.:
Date:
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 981 88
INSPECTION RECORD
Retain a copy with permit
DO-10
(206)431-3670
Projecty /, ...:,)/
/)41,,-, /•(..,,,.- / /(-. 7
Type of Inspection:
, 2
7.-?''..e..
•
Address':
/30-CO /-4L
f
/0/.5.
Date Called:
:;‘)-- 4;••
" e 4/
Special Instructions:
ad,e_ e
./
,
.
Date Wanted:
a3 int,
C .m.
Requester:
Phone(No:
e.:■2
El
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
Inspector
Date:
Ej $47.00 REINSPECT' N FEE REQUIRED. Prior to inspection, fee mtfst be
. paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
. •
Receipt No.:
Date:
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I understand B. 1- 'I.
su ject to errors and o
plans does not authorize
adopted code or ordinan
tractor's copy of approve
By
Date
Permit No.
Che
sions and approval of
t e violation of any
e. Receipt of con -
plans acknowledged.
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CHAMES SHAUL BE Vt; ?6':
.�.Ap ei nra' v r C4�'./l�p�n L' ^,r i. \ \;�,i�', Ii �� �l"'��„ �.1.�,` _ a
"i.,�''��:'?.1 OF II IiJJ r ��i^i IL '{�.!n4+ir�
ED/839ONS WILL Kann A «M R.Lm
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"TY OF TUKWII A
APR 2 8 2004
PERMIT CENTER
i
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PRESTIQUE's
HIGH DEFINITION.
Prestique Plus nth Drfinil'on
It and Prestique Gallery Collection'"
Product size
Exposure
Piecas/Bundle
Bundies/Squere
Squeres/Paltat
13 %"x 391r
.SSL'
16
4/98.5 sq.ft.
11
Prestique 1 High /Wfunr
Raised Profile
50- yeerEniitedwarrer*y period:
non-prorated coverage for
shingles and apptiretion labor for
the 'algal 5 year& plus an option
for transferability": prorated
coverage for'eppticatIon labor and
shinetes for belmce of limited
worm */ period: 5-year limited
wind warranty'.
Product sizo
Exposure
Pioces/Bundle
Bundles/Square
Squares/Pallet
Product size
Exposure
PIeces/eundlo
Bundles/Square
Squares/Pallet
13W'x 391''
is
4/98.5 rq.ft.
14
Prestique High Definition
44 year limited warranty period:
non - proceed coverage for
shingles and application lobar for
the 'nine, 5 years, plus an °pylon
for transferability"; prorated
coverage for application labor and
shingles for balance of limited
warranty period: 6 -Yee► limited
wind warranty.
Product size 13Wx 38%
Exposure . 5W
Pieces/Bundle 22
Bundiea/3gu.re 3/100 sq.ft.
'Squares/Pallet 10
30'Yesi limited warranty period:
nor•promted ooverage.fbr
shingles and application labor for
Ilse jN1fa15 yerramiwr en option
for h ileramblar: Waited
coverage focappealloaiabor and
shingles forbalince of limbed
vN rren*Period: Shearlimited
wiryw�raia�►� :.
CITY OF TUKWILq
APPROVED
HAY -5 2004
As 'OIL-I)
RAISED PROF D x.751''
13Wx 38%'
22
3/100 sq.ft.
16
3e -year Unified warranty period:
non•prorvted coverage for
shingles end application labor for
the initial 5 years, plus an option
for transferability: prorated
coverage for application arbor and
shingles for boI Ica of amited
warranty period; 5-yew 5mited
wind warranty'.
NIP AND RIDGE SHINGLES
ZIP Ridge
Size: 138 "x 95ir"
Exposure: 5 %"
Piocos/Bundle: 72
Coverage: 3 bundles -
100 linear feet
RidgeCrest'" w /PLX
Non - Vented
Size: 13'4 x 9'X"
Exposure: 9•/."
Pieees/Bvx: 32
Coverage: 4 boxes -
100 linear feet
RidgeCrest'" w /FLX"'
Vented
Size: 1354 "x 11'/"
Exposure: 9'/."
Pieces/Box: 26
Coverage: 5 boxes. 100 ('veer feet
Elk Starter Strip
52 Bundles/Pallet
18 Pallets/Truck
936 Bundlcs/Truck
18 Pieces/Bundle
1 Bundle - 120.33 linear feet
Available Colors: Antique 'late, Weatheredwood, Shakewood, Sablewood. Hickory, Barkwood, Forest Green, Aspen Whhe""
Gallery Collection: Balsam Forest', Weathered Sage ", Sienna Sunset",
All Prestique and Raised Profile roofing products contain ELK WindGuarde sealant WindGuard activates with the suns heat, bonding shingles
into a wind and weather r resistant cover that resists blow -offs and leaks.
AN Prestique and Raised Profile shingles meat UL• Wind Resistant (UL 997) and Class "A" Fire Ratings (UL 790).
AN Prestique and Raised Profge shingles comply with the requirements of ASTM D 3462 as well as the Wisconsin
Uniform Dwelling Code. In K 10 regulatory areas:, all Prestique and Raised Profile shingles meet the acceptance criteria
of AC 127. The IMO Evaluation Service approval number for all Prestique and Raised Profile products in these locations
is ER 5414. Ail Prestique and Raised Profile shingles meet the Canadian Standards Association (CSA) CODE A123.5.
'Sae actual warranty for coofitlona and ilmltedons.
"'Check for product ovanab Iltp.
- . ft t
BERGIN ROOFING INC.
20815 2nd Pl. SW
Seattle, WA 98166
206- 824 -5852
Cont. 0 SSROIRT J
RECEIVED
CITY OF TI IKWII A
APR 2 8 2004
PERMIT CENTER
,
10 -01 -2004
JOHN BERGIN
20815 SECOND PL SW
SEATTLE WA 98166
City of Tukwila
Steven M. Mullet, Mayor
Department of Community Development Steve Lancaster, Director
RE: Permit No. D04 -144
13050 MILITARY RD S TUKW
Dear Permit Holder:
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 and /or the International Mechanical Code, every permit issued by the Building Division under the
provisions of this code shall expire by limitation and become null and void if the building or work authorized by such permit is not
commenced within 180 days from the date of such permit, or if the building or work authorized by•such permit is suspended or
abandoned at any time after the work is commenced for a period of 180 days.
Based on the above, you are hereby advised to:
Call the City of Tukwila Permit Center at 206 - 431 -3670 to arrange for, the next or final inspection.
This inspection is intended to determine if substantial work has been accomplished since issuance of the permit or last inspection; or if
the project should be considered abandoned.
If such determination is made, the Building Code does allow the Building Official to approve a one -time extension up to 180 days.
Extension requests must be in writinj' and provide satisfactory reasons why circumstances beyond the applicants control have
prevented action from being taken.
In the event you do not call for the above inspection and receive an extension prior to 11/03/2004, 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.
Sincerely,
Stefania Spencer,
Permit Technician
xc: Permit File No. D04 -144
Bob Benedicto, Building Official
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 -431 -3665
April 29, 2004
City of Tukwila
Steven M. Mullet, Mayor
Department of Community Development Steve Lancaster, Director
Mr. John Bergin
20815 Second Place S.W.
Seattle, Washington 98166
RE: Letter of Incomplete Application # 1
Development Permit Application D0 -144
Highline Physical Therapy Clinic — 13050 Military Road South
Dear John:
This letter is to inform you that your revision received at the City of Tukwila Permit Center on April 28, 2004, is
determined to be incomplete. Before your application can continue the plan review process the following items need
to be addressed:
Building Department: Bill Rambo, at 206 431 -3679, if you have questions concerning the following:
1. Please provide Washington State Non - residential Energy Code information as required on the
attached submittal checklist M -6.
Please address the above comments in an itemized format with applicable revised plans, specifications, and/or other
documentation. The City requires that four (4) complete sets of revised plans, specifications and/or other
documentation be resubmitted with the appropriate revision block.
In order to better expedite your resubmittal a `Revision Submittal Sheet' must accompany every resubmittal. I have
enclosed one for your convenience. Revisions must be made in person and will not be accepted through the mail
or by a messenger service.
If you have any questions, please contact me at the Permit Center at (206) 433 -7165.
Sincerely,
Stefania pencer
Permit Technician
Enclosures
File: Permit File No. D04 -144
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 -431 -3665
sy44.•4107.kt 'A44
u1w
�'PcRfu11T COORD COPc
PLAN REVIBIV/ROUTING SUP
ACTIVITY NUMBER D04 -144 DATE 5-5 -04
PRO.,ECT NAME HIGH LINEPHYSI CAL THRAPY CIJNIC
SITE ADDRESS 13050 MILITARY RD S
Original Plan Submittal _Response to Incomplete Letter # 1
Response to Correction Letter # Revision # After Permit Issued
Aw6 61e
Building Division F I Fire prevention I Planning Division ❑
Public Works ❑ Structural I I Permit Coordinator
DE?H3MINATION OF CC MP ECENEE (Tues., Thurs.)
Complete
Incomplete ❑
DUEDATE 5-6-04
Not Applicable ❑
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED • LETTER O F CO M PLETE1 ESS MAI L® •
Departments determined incomplete: Bldg El Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUESITHURSROUTING:
Please Route
Structural Review Required
No further Review Required ❑
REVIEWER'S INITIALS DATE
APPROVACSOR CORRECTIONHS
DUE DATE 6-3 -04
Approved fl Approved with Conditions Not Approved (attach comments)
Notation:
REVIEWHR'SINITIALS
DATE
Permit Center Use Only
CORRECTION LETTER MAI I W •
Departments issued corrections: Bldg ❑ Are ❑ Ping ❑ PW ❑ Staff Initials:
Documentslrouting slip.doc
2 -28 -02
PERMIT COORD CAR
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: D04 -144 DATE: 04 -28 -04
PROJECT NAME: HIGHLINE PHYSICAL THERAPY CLINIC
SITE ADDRESS: 13050 MILITARY ROAD SOUTH
X Original Plan Submittal
Response to Incomplete Letter #
Response to Correction Letter # Revision # afteribefore permit is issued
DEPARTM NTS:
4 -1901
Building Di sion
Public Works ❑
5((o na, 6\-4,04f-
Fire Prevention Q Planning Division
Structural ❑ Permit Coordinator
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete El
Incomplete
DUE DATE: 04 -29 -04
Not Applicable ❑
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: 11;02-PeY LETTER OF COMPLETENESS MAILED: SAC
Departments determined incomplete: Bldg,' Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS ROUTING:
Please Route ❑ Structural Review Required ❑ No further Review Required ❑
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS:
DUE DATE: 05 -27 -04
Approved ❑ Approved with Conditions ❑ Not Approved (attach comments) ❑
Notation:
REVIEWER'S INITIALS:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
PERMIT COORD COPY
Documents /routing slip,doc
2 -28 -02
eaS
City of Tukwila
Department of Community Development - Permit Center
6300 Southcenter Blvd, Suite 100
Tukwila, WA 98188
(206)431 -3670
Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted
through the mail, fax, etc.
Date: CJ -5 D4, Plan Check/Permit Number: 1704— 144-il
(] Response to Incomplete Letter # f
[] Response to Correction Letter #
0 Revision # after Permit is Issued
0 Revision requested by a City Building Inspector or Plans Examiner
Project Name:
Project Address:
Contact Person:
Summary of Revision:
17.X I �I 4
k t ►r /71' 6t,1 1A,Le.)
07o lo WI; 1-44,9 RA .
Phone Number:
rM-b vvvt a,Fi r�
Sheet Number(s):
"Cloud" or highlight all areas of revision including date of revision
Received at the City of Tukwila Permit Center by:
tEntered in Permits Plus on
......n..t 4' .:...w.w.:.w. ». 4:w+..- .,�444,44 16,44.11 441,44,1144,,44,474>.4...,..
. ...••�n NMM/Mnn'i.N Va
08/06/03
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State of
Washington
DEPARTMENT.OF LABOR & INDUSTRIES
PO BOX 44450
OLYMPIA WA 98504 -4450
BERGIN ROOFING INC
20815 2ND PL SW
SEATTLE WA 98166
FIRST CLASS MAIL
US POSTAGE
PAID
OLYMPIA WA
PERMIT NO 312
S 8 %. S 4 0.2.2. 3 4 1 111 {�1111111��1��111�1111�11�11 '1111 {!11't'11111�11{�11111��
Detach And Display Certificate
M25.052 -000 (8 /97) .
DEPARTMENT OF LABOR AND INDUSTRIES
REGISTERED AS PROVIDED BY LAW AS
CONST CONT SPECIALTY
REGIST. # .EXP.,:DATE
CCCDCV BERGIRI044JA 04/01/2006
EFFECTIVE DATE 04/01/1996
BERGIN ROOFING INC
20815 2ND PL SW
SEATTLE WA 98166
Detach And Display Certificate
RECEIVED
CITY OF TUKWILA
APR 2 8 2004
PERMIT CENTER