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Permit D10-219 - BRATCHER RESIDENCE - DECK
BRATCHER DECK 13030 56 AV S D10 -219 City oliTukwila 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 Parcel No.: 2172000280 Address: 13030 56 AV S TIIKW Suite No: Project Name: BRATCHER DECK DEVELOPMENT PERMIT Permit Number: D10 -219 Issue Date: 03/09/2011 Permit Expires On: 09/05/2011 Owner: Name: BRATCHER CHARLES +JACKSON,MA Address: 13003 56TH AVE S , TUKWILA WA 98178 Contact Person: Name: JEFF GREEN Address: 11925 288 ST E , GRAHAM WA 98338 Contractor: Name: OWNER AFFIDAVIT - CHARLES BRATCHER Address: Contractor License No: Phone: 253 651 -6518 Phone: Expiration Date: DESCRIPTION OF WORK: ADD A 192 SF DECK TO EXISTING GARAGE. SINCE PROPERTY IS ON SEPTIC REFER TO KC HEALTH DEPT DECK APPROVAL DATED 02/03/2011. Value of Construction: $7,912.32 Fees Collected: $642.09 Type of Fire Protection: NONE International Building Code Edition: 2009 Type of Construction: VB Occupancy per IBC: 26 Electrical Service Provided by: * *continued on next page ** doc: IBC -7/10 D10 -219 Printed: 03 -09 -2011 Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Fire Loop Hydrant: N Number: 0 Flood Control Zone: Hauling: N Start Time: End Time: Land Altering: Volumes: Cut 0 c.y. Fill 0 c.y. Landscape Irrigation: Moving Oversize Load: Start Time: End Time: Size (Inches): 0 Sanitary Side Sewer: Sewer Main Extension: Private: Public: Storm Drainage: Street Use: Profit: N Non - Profit: N Water Main Extension: Private: Public: Water Meter: N Permit Center Authorized Signature: Date: I hereby certify that I have read and examined this 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. 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 th rformance of work. I am authorized to sign and obtain this development permit and agree to the conditions attached to this permit / Signature: �� /ill _� , Date3 —q l Print Name: s �/tSC�A 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. PERMIT CONDITIONS: 1: ** *BUILDING DEPARTMENT CONDITIONS * ** 2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the Building Official. 3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to start of any construction. These documents shall be maintained and made available until final inspection approval is granted. 4: All construction shall be done in conformance with the approved plans and the requirements of the International Building Code or International Residential Code, International Mechanical Code, Washington State Energy Code. 5: Notify the City of Tukwila Building Division prior to placing any concrete. This procedure is in addition to any requirements for special inspection. 6: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of doc: IBC -7/10 D10 -219 Printed: 03 -09 -2011 this requirement. • 7: All plumbing and gas piping work shall beinspected and approved under a separate permit issued by the City of Tukwila Building Department (206- 431 - 3670). 8: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building Department (206- 431 - 3670). 9: VALIDITY OF PERMIT: The issuance or granting of a permit 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 ordinances of the City of Tukwila. Permits presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the Building Official from requiring the correction of errors in the construction documents and other data. doc: IBC -7/10 D10 -219 Printed: 03 -09 -2011 CITY OF TUK Community Develc ent Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us Building Peri/ No. b p— Mechanical Permit No. Plumbing/Gas Permit No. Public Works Permit No. Project No. Pao — 12�1 (For office use only) 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 Site Address: /.'0 6' Tenant Name: �� Property Owners Name: /9 - :--S' s King Co Assessor's Tax No.: 1--11900 —MV isZ,9- Suite Number: Floor: Mailing Address: % 307 Sa, 7/11 New Tenant: ❑ Yes D.. No City / Statel t6 /fr,-6/7' CONTACT PERSON - who do we contact when your permit is ready to be issued Name: Mailing Address: c• Th' Day Telephone: -25-3 A-341,41.4.7' AlY City State Zip E -Mail Address: �� ii% %a,�, /� � jL ; ( fFax Number: i( //4 GENERAL CONTRACTOR INFORMATION - (Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5)) Company Name: C�.ej 44;7.<5" 2/ ti Mailing Address: ///2 8j' i"/ e4�fAit �/� ,�, 3 / �� City State Zip Contact Person:—L4-1,c" (5--,07,4.,,) Day Telephone: ? 3 61.5"-r /F' E -Mail Address: (?37. /i ' r5 //(-6,q/6 , C C27Fax Number: ��i} Contractor Registration Number: c c V 7� / Expiration Date: -,,t,/,2., ARCHITECT OF RECORD - All plans must be stamped by Architect of Record Company Name: �`� Mailing Address: City Day Telephone: Fax Number: Contact Person: E -Mail Address: State Zip ENGINEER OF RECORD - All plans must be stamped by Engineer of Record Company Name: %1J0- Mailing Address: City Contact Person: Day Telephone: E -Mail Address: Fax Number: State Zip H:\Applications\Forms- Applications On Line\2010 Applications \7 -2010 - Permit Application.doc Revised: 7 -2010 bh Page I of 6 I BUILDING PERMIT INFORMATION — 206 - 431 -3670 Valuation of Project (contractor's bid pri $ 1 � " L l2- . 1 Existing ding Valuation: $ Scope of Work (please provide detailed information): ,41>27 ,4 g:,74/ "X T ' ti ,1-3,45- Will there be new rack storage? ❑ ....Yes If yes, a separate permit and plan submittal will be required. Provide All Building Areas in Square Footage Below 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 Area (sq ft): Floor area of principal dwelling: Floor area of 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 Ef--"1—■lo If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ Sprinklers ❑ Automatic Fire Alarm �one ❑ Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes ❑ No If 'yes', attach list of materials and storage locations on a separate 8 -1/2" x 11" paper including quantities and Material Safety Data Sheets. SEPTIC SYSTEM " On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. H:\Applications\Forms- Applications On Line\2010 Applications \7 -2010 - Permit Application.doc Revised: 7 -2010 bh Page 2 of 6 Existing Interior Remodel Addition" to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC l' Floor 75(7 2 "d Floor 750 3`d Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck /22— V e) IA 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 Area (sq ft): Floor area of principal dwelling: Floor area of 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 Ef--"1—■lo If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ Sprinklers ❑ Automatic Fire Alarm �one ❑ Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes ❑ No If 'yes', attach list of materials and storage locations on a separate 8 -1/2" x 11" paper including quantities and Material Safety Data Sheets. SEPTIC SYSTEM " On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. H:\Applications\Forms- Applications On Line\2010 Applications \7 -2010 - Permit Application.doc Revised: 7 -2010 bh Page 2 of 6 LPUI3LIC WORKS PERMIT INFOATION — 206 - 433 -0179 Scope of Work (please provide detailed information): / Call before you Dig: 1 -800- 424 -5555 Please refer to Public Works Bulletin #1 for fees and estimate sheet. Water istrict Water ❑ ...Water District #125 ❑ -. Water Availability Provided Sewer District [(]i'1'ukwila ❑ -. Sewer Use Certificate ❑ ... Highline ❑ ...Valley View ❑...Renton 0 ...Sewer Availability Provided 0... Renton - P ❑... Seattle Septic System: D--15n-site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. Submitted with Application (mark boxes which apply): Civil Plans (Maximum Paper Size — 22" x 34 ") ❑ .. Technical Information Report (Storm Drainage) ❑ .. Bond 0... Insurance 0... Easement(s) Proposed Activities (mark boxes that apply): ❑ .. Ri f -way Use - Nonprofit for less than 72 hours ight -of -way Use - No Disturbance ❑ .. Construction/Excavation /Fill - Right -of -way ❑ Non Right -of -way ❑ otal Cut ❑ .. Total Fill cubic yards cubic yards ❑ ... Geotechnical Report 0... Maintenance Agreement(s) ❑ .. Traffic Impact Analysis ❑ .. Hold Harmless — (SAO) ❑ .. Hold Harmless — (ROW) 0... Right-of-way Use - Profit for less than 72 hours 0... Right-of-way Use — Potential Disturbance 4—A A 4-5 ❑... Work in Flood Zone 0... Storm Drainage ❑ .. Sanitary Side Sewer 0... Abandon Septic Tank ❑ .. Cap or Remove Utilities 0... Curb Cut ❑ -- Frontage Improvements ❑... Pavement Cut ❑ -- Traffic Control ❑... Looped Fire Line ❑ .. Backflow Prevention - Fire Protection Irrigation Domestic Water ❑ -. Permanent Water Meter Size.. ❑ -. Temporary Water Meter Size . ❑ .. Water Only Meter Size ❑ .. Sewer Main Extension Public ❑ .. Water Main Extension Public WO # WO # WO # Private ❑ Private ❑ O ... Grease Interceptor ❑ ..- Channelization ❑...Trench Excavation O ... Utility Undergrounding ❑ .. Deduct Water Meter Size FINANCE INFORMATION Fire Line Size at Property Line ❑ .. Water Number of Public Fire Hydrant(s) ❑ .. Sewer ❑ .. Sewage Treatment Monthly Service Billing to: Name: Mailing Address: Day Telephone: Water Meter Refund/Billing, Name: Mailing Address: City State Zip Day Telephone: City State Zip H:\Applications\Forms- Applications On Line\2010 Applications \7 -2010 - Permit Application.doc Revised: 7 -2010 bh Page 3 of 6 l MECHANICAL PERMIT INFORMATION — 206 - 431 -3670 MECHANICAL CONTCTOR INF MATION Company Name: 47/4 Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: Contractor Registration Number: Expiration Date: Valuation of Mechanical work (c• tractor's bid price): $ Scope of Work (please provide det..'led information): Use: Residential: New .... ❑ Re , acement .... ❑ Commercial: New.... ❑ Repla ment.... ❑ Fuel Type: Electric ❑ Gas....❑ Othe Indicate type of mechanical work being installed and the quant ,; :elow: Unit Type: Qty Unit Type: ,fly Unit Type: Qty Boiler /Compressor: Qty Furnace <100K BTU Air Handling Unit >10,000 ; CFM ire Damper 0 -3 HP /100,000 BTU Furnace>100K BTU Evaporator Cooler , Di ser 3 -15 HP /500,000 BTU Floor Furnace Ventilation Fan C.. ected to Single Duct Ther , tat 15 -30 HP /1,000,000 BTU Suspended/WallFloor Mounted Heater Ventilation S . em Wood/G. -'. tove 30 -50 HP /1,750,000 BTU Appliance Vent Hood an . 0 uct Emergency Generator 50+ HP /1,750,000 BTU Repair or Addition to Heat/Refrig/Cooling System Inci ator - Domestic Other Mechanica • Equipment Air Handling Unit <10,000 CFM ncinerator — Comm/Ind H:1Applications\Forms- Applications On Line\2010 Applications\7.2010 - Permit Application doc Revised: 7 -2010 bh Page 4 of 6 PERMIT APPLICATION NOTES — cable to all permits in this application 41) 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 Signatur IZED AGENT: Print Nam - : --_ :At t<2 Date: d2.—/Z--/ Day Telephone:_ // Mailing Address: i T� k7. 4,1., / City/ State IDate Application Accepted: Date Application Expires: Zip H:\ApplicationsWorms- Applications On Line\2010 Applications \7 -2010 - Permit Application doe Revised: 7 -2010 bh Staff Initials: (,ti. Page 6 of 6 PLUMBING AND GAS PIPING PENFORMATION — 206 - 431 -3670 PLUMBING AND GAS PI I G CONTRACTOR INFORMATION Company Name: 4, Mailing Address: City State Zip Day Telephone: Fax Number: Contact Person: E -Mail Address: Contractor Registration Number: Expiration Date: Valuation of Plumbing work (contractor's bid price): $ Valuation of Gas Piping work , .ntractor's bid price): $ Scope of Work (please provide det.'.ed information): Building Use (per Int'l Building Code): Occupancy (per Int'l Building Code): Utility Purveyor: Water: Indicate type of plumbing fixtures and/or gas piping outlets bein Sewer-,.''' stalled a; f the quantity below: Fixture Type: Qty Fixture Type: Qty '. to c,- Type: Qty Fixture Type: Qty Bathtub or combination bath/shower Bidet Clo',,js washer, domestic r Dental unit, cuspidor Dishwasher, domestic, with independent drain Drinking fountain or water cooler (per head) , ;, ood -w.. e grinder, commerci Floor Drain single head trap Lavatory ✓ Wash fount.':, Receptor, indirect waste Sinks Urinals /.' Water Closet ` Building sewer and each trailer park sewer Rain water system — per drain (inside building) Water heater and /or ver / ' f Industrial waste trea ent interceptor, including \,.p and vent, except for kite,; n type grease interceptors ' Each grease trap (connected to not more than 4 fixtures - <750 gallon capacity) Grease interceptor for commercial kitchen ( >750 gallon capacity) Repair or alt- :tion of water pipi • . r and/or water treatme� e'equipment Repair or alteration of `'. drainage or vent piping Medical gas piping system serving 1 -5 inlets /outlets for a specific gas Each additional medical gas inlets /outlets greater than 5 d' ,,,' Bac ow protective d :•I ice other than /mospheric-type vacuum breakers 2 inch (51 mm) diameter or smaller Backflow protective device other than atmospheric -type vacuum breakers over 2 inch (51 mm) diameter , Each lawn sprinkler system on any one meter „, eluding backflow p ection devices 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 H:1Applications\Forms- Applications On Line \2010 Applications17 -2010 - Permit Application.doc Revised: 7 -2010 bh Page 5 of 6 • • �J��I�A wqs 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 Parcel No.: 2172000280 Address: 13030 56 AV S TUKW Suite No: Applicant: BRATCHER DECK RECEIPT Permit Number: D10 -219 Status: APPROVED Applied Date: 08/19/2010 Issue Date: Receipt No.: R11 -00458 Initials: User ID: WER 1655 Payment Amount: $485.70 Payment Date: 03/09/2011 03:06 PM Balance: $0.00 Payee: CHARLES BRATCHER TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 50442H ACCOUNT ITEM LIST: Description 485.70 Account Code Current Pmts BUILDING - RES STATE BUILDING SURCHARGE 000.322.100 481.20 640.237.114 4.50 Total: $485.70 doc: Receiot -06 Printed: 03 -09 -2011 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 Parcel No.: 2172000280 Address: 13030 56 AV S TUKW Suite No: Applicant: BRATCHER DECK RECEIPT Permit Number: D10-219 Status: PENDING Applied Date: 08/19/2010 Issue Date: Receipt No.: R10 -01625 Initials: User ID: Payee: JEM 1165 Payment Amount: $156.39 Payment Date: 08/19/2010 12:44 PM Balance: $485.70 GREEN WORKS LLC TRANSACTION LIST: Type Method Descriptio Amount Payment Check 2066 156.39 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts PLAN CHECK - RES 000.345.830 156.39 Total: $156.39 PAYMENT RECFIVED doc: Receipt -06 Printed: 08 -19 -2010 INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 INSPECTION RECORD Retain a copy with permit PERMIT NO. (206)431 -3670 Pro ect: r-a 1- c L' -D.E. c. Type of Inspection: L___ lnr f I) - A v e ..,P ---to lam, 14 Address: Date Ca lms_ 1' ,t 4■ ;4 /4S /it b71Aef i` tJ L.A-t,J of L.! v :Al Special Instructions: k ecf raw, / 6-c LN- 2 OP) rrrl abo f---- Date Wanted: T- 4077 if a.m. p.m. Requester: el-Kr /PS Phone No: 67 02 9 g I x719 Approved per applicable codes. El Corrections required prior to approval. COMMENTS: Q.% At; r C49 ii- 117(e j et f I) - A v e ..,P ---to lam, 14 r /U4) -- 51 kArr 61' used /4S /it b71Aef i` tJ L.A-t,J of L.! v :Al A/1, AI ✓)eA4f1 AI e_ ?! v0 _ A A Inspector: Date: /, ! ` „ r 0 $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: r.71T; c. INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT N0. CITY OF TUKWILA BUILDING DIVISION t' (206) 431 -3670 01 I5 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 431 -2451 Project: t ATC4N- _ 1 e 14_ Types Inspection: RF of tl -' STa-P rte Address: 13530 5-6 AV S Date Called: ' ,i 1 u ✓,e T_.._J\i ((:: i 0, l_ i Special Instructions: f`: � /� !„/ r 30'0 Date Wanted: a.m. cam~ Requester: Phone No: as 3 -(A51 - (05 I P) Approved per applicable codes. D Corrections required prior to approval. COMMENTS: o f el I T~ k ""AQP i t 6- ' ,i 1 u ✓,e T_.._J\i ((:: i 0, l_ i io 4 u1xer W 3 s08- (8 . ? prz p' ` i i' n —11"e u c/li re ;\/‘---D rp_s.1)._ee�.ce . '-(71,,e C, &qi vi 6Ll [Ol■ 1C Prtij 4 Be Lo AA. e L — u A.f,eA , . r Inspector: Date:3 q ri REINSPECTION FEE REQUIRED. rior to next inspection. fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. 1 D 3 Al blic Health - Seattle & King County Application for Health Department Approval of Building eE COMP For houses or structures served by an on -site sewage ti"'c y em (OSS) Office Address - 900 Oakesdale Avenue Southwest, WA- 9805.2-52,1. _ (206) 296 -4932 Fax: (206) 296 -4919 Application Fee: $473.00 + Water Supply Note: Indicate if access to property is a problem due to locked fencing, guard dogs, etc. Application and all support documents must be submitted in TRIPLICATE —3 complete sets In addition, your application sets must include: [`A detailgrkroute map and directions to property; [Z-f of or plans showing what is changing in the building or on the pr The maximum size paper accepted is 11" x 17" �An attached completed CHECKLIST FOR HEALTH DEPARTMI REVIEW OF APPLICATION FOR BUILDING PERMIT Property Information Health D ent Use Health Dep ent Use Only Retard LTb lertCb% Health Dept. Use Only T - Guide Page/Loc. REVIEWED FOR— CODE COM ertY FEB 18 2011 NT City of Tukwila BUILDING DIVIFInN Addres_s_.fProperty / jajn , rim. %"/Z S Parcel No (APN): J� / City /U.'ct/ r r-f Zip code �S7/7 Applicant's Name ;,per j _4. �s / / � Day Phone �( '3) S/ 6:-,5/09" Applicant's Mailin_ ..� Zip 6 - c7/� ess Day Phone ) Distance to nearest public sewer S� Number of existing bedrooms c4 Number of bedrooms being added 0 71,2 Owner's Name Age of House /yam 3 5-6741i Existing Square footage of house Square footage to be added Description of proposed changes Type of On -Site Sewage System Serving Property: Additions or repairs to sewage system (give dates and describe Is prop(rty in an incorporated city? es ❑ No ri G riefly) �2 ECE VED FEB 112011 Descr. a or attach any drainfield easements, covenants or notices on title, which may impa A/ 6�, ,t Water Supply Information ❑Group B Water Supply Name of WaterSystem (2 or more connections) State ID # ❑ Group A Less Than 1000 ❑ Group A More Than 1000 ❑Private (well, spring, etc.) attach copies of well log, well covenants, chemical/bacteriological sample reports. For Health Department Use Only ,i Approved 7/373w ❑ Disapproved ❑ Hold Comments /Conditions: Date By: Date By, Date B x2........_ eleased Initials Date RE i,le rvEd ; S BLACK RI\!',R ENVIRONNIENTAL HEALTH Any person aggrieved by any decision or final order of the Health Officer may file a written application for appeal to the Health Officer within 60 calendar days of the decision. (K.C.B.O.H. Title 13, Chapter 13.12 — Sewage Review Committee) FORM_9_D_Rev 11/19/09 — Previous Versions are Obsolete 0 42°1q CHECKLIST FOR HEALTH DEPARTMENT REVIEW OF APPLICATION FOR BUILDING PERMIT ( (For buildings not served by public sewer) The following checklist is a guide to assist the applicant in submitting a complete application. A properly prepared application must include this checklist below along with any additional details and specifications required by applicable provisions of the King County Board of Health — Title 13. Note: For non - applicable items put NA in the "NO" column. SITE ADDRESS: / 349.5Q ;X .5 PARCEL NUMBER (APN)aiz - r Yes No 1AP,PLI TION.FORM :'` . GA ;w Application indicates that public sewer service is not available within 200 feet of the subject property. The Application for Health Department Approval of Building Permit form is complete; Data on all copies must k legible. r/ Application is submitted in triplicate, and accompanied by the appropriate fee. Detailed reference maps for locating the property are provided (vicinity, location and routing to site). There is access for field inspection by health department. / The application indicates if the owner needs to be present due to access issues (e.g. guard dog, locked gate, etc.). ` G Application sets are properly collated 1/ rmoT PLANS -, „ ' ' '.: ,. ..,. y,: 4 .. . ; `r . , _ ::i Yes No PARCEL PLOT PLAN A 1 " =20' scale or 1 "= 30' scale is used. The parcel plot plan is provided on paper that is 11" x 17" or smaller. Entries on the plot plan are legible `..-- A North arrow is indicated on the plan Z------- Property and easement lines are shown, (specific lengths are indicated) 7....-- . Direction(s) of surface drainage is /are shown The plans show existing structures present on the site, including all out buildings Plan shows the location of existing wastewater tank(s) — (e.g. septic tanks, pre - treatment tanks, dosing/pump tanks, containment vessels) 1' Plan shows (if present) the location of existing sand filter(s) Location of the primary sewage disposal area (e.g. drainfield, mound, up -flow sand filter) is shown Location of the designated reserve sewage disposal area is shown L� Location of other septic components are shown (e.g. tightlines, d -box, pressure lines) Z-.= Existing Horizontal Separations (e.g. the proposed addition setback to sewage system components) 1` The above scaled plot plan depicts the accurate location(s) of the following: driveways and parking areas j/ wells, other water sources — show a 100' radius for each well location I/ abandoned wells water supply lines drainage features (e.g. footing drains, curtain drains, drainage ditches) L.----- cuts, banks, areas of filled terrain `/- retaining walls 6/ surface water, streams, bodies of water seasonal water DIE -LLTIVAEP. iRT1 NTASrB( IC: R ORD,.;'; s . , Yes No A copy of an approved as-built diagram is provided/attached t/'-' A same scale (i.e. matching the as-built diagram scale) transparent overlay is provided showing the proposed construction/addition �`'� OTHER R> L,ATtWDOCILJMENTS y,.. K ..,.... ' _..... • r , , , Yes No If applicable /existing, other recorded documents relating to the sewage system and water supply are referenced. ✓-- BA Checklist Print Date 3/05/07 rmoT PLANS -, „ ' ' '.: ,. ..,. y,: 4 .. . ; `r . , _ ::i Yes No PARCEL PLOT PLAN A 1 " =20' scale or 1 "= 30' scale is used. The parcel plot plan is provided on paper that is 11" x 17" or smaller. Entries on the plot plan are legible `..-- A North arrow is indicated on the plan Z------- Property and easement lines are shown, (specific lengths are indicated) 7....-- . Direction(s) of surface drainage is /are shown The plans show existing structures present on the site, including all out buildings Plan shows the location of existing wastewater tank(s) — (e.g. septic tanks, pre - treatment tanks, dosing/pump tanks, containment vessels) 1' Plan shows (if present) the location of existing sand filter(s) Location of the primary sewage disposal area (e.g. drainfield, mound, up -flow sand filter) is shown Location of the designated reserve sewage disposal area is shown L� Location of other septic components are shown (e.g. tightlines, d -box, pressure lines) Z-.= Existing Horizontal Separations (e.g. the proposed addition setback to sewage system components) 1` The above scaled plot plan depicts the accurate location(s) of the following: driveways and parking areas j/ wells, other water sources — show a 100' radius for each well location I/ abandoned wells water supply lines drainage features (e.g. footing drains, curtain drains, drainage ditches) L.----- cuts, banks, areas of filled terrain `/- retaining walls 6/ surface water, streams, bodies of water seasonal water DIE -LLTIVAEP. iRT1 NTASrB( IC: R ORD,.;'; s . , Yes No A copy of an approved as-built diagram is provided/attached t/'-' A same scale (i.e. matching the as-built diagram scale) transparent overlay is provided showing the proposed construction/addition �`'� OTHER R> L,ATtWDOCILJMENTS y,.. K ..,.... ' _..... • r , , , Yes No If applicable /existing, other recorded documents relating to the sewage system and water supply are referenced. ✓-- BA Checklist Print Date 3/05/07 DIE -LLTIVAEP. iRT1 NTASrB( IC: R ORD,.;'; s . , Yes No A copy of an approved as-built diagram is provided/attached t/'-' A same scale (i.e. matching the as-built diagram scale) transparent overlay is provided showing the proposed construction/addition �`'� OTHER R> L,ATtWDOCILJMENTS y,.. K ..,.... ' _..... • r , , , Yes No If applicable /existing, other recorded documents relating to the sewage system and water supply are referenced. ✓-- BA Checklist Print Date 3/05/07 OTHER R> L,ATtWDOCILJMENTS y,.. K ..,.... ' _..... • r , , , Yes No If applicable /existing, other recorded documents relating to the sewage system and water supply are referenced. ✓-- BA Checklist Print Date 3/05/07 BA Checklist Print Date 3/05/07 • /94 _ • / . . .7s 14) 4-6 Ti 4v E 774. L. f 2-5ei/z.7_ • 0 ;74 RECEIVED UV OF TUKWILA AUG 1 9 2010 PERMIT CENTER • City of Tukwila Jim Haggerton, Mayor Department of Community Development Jack Pace, Director February 18, 2011 Jeff Green 11925 288 ST E Graham, WA 98338 RE: Request for Application Extension Application Number D10 -219 Bratcher Deck —13030 56 Av S Dear Mr. Green, This letter is in response to your written request for extension to Permit Application Number D.10 -219. The Building Official has reviewed your letter and considered your request. It has been determined that the City of Tukwila will extend the permit application expiration dates an additional 90 days, through May 16, 2011. If you should have any questions, please contact our office at (206) 431 -3670. Sincerely, ifer Marshall it Technician File: Permit No. D10-219 W:\Permit Center\Extension Letters\Applications\2010\D10 -219 Application Extension.doc 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 (-// T O J 7eJ /c 6c/�G�� /-f‘ 0. �. .4-o 61/4c,nc, ail cakiow 0'10 dins . --- .4f4g oz/t601 RECEIVED WOF TUKWILA FEB 112011 PERMIT CENTER I 01 ittlit 01 -03 -2011 • o� Cw ( TI • 1 '9 Jim Haggerton, Mayor Department of Comm nity Development Jack Pace, Director JEFF GREEN 11925 288 ST E GRAHAM WA 98338 RE: Permit Application No. D10 -219 13030 56 AV S TUKW Dear Permit Applicant: In reviewing our current application files, it appears that your permit applied for on 08/19/2010, has not been issued by the City of Tukwila Permit Center. Per the International Building Code, International Mechanical Code, Uniform Plumbing Code and /or National Electrical Code every permit application not issued within 180 days from the date of application shall expire and become null and void. Your permit application will expire on 02/15/2011. If you still plan to pursue your project, a written request for extension of your application must be submitted 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 application. If it is determined that an extension is granted, your application will be extended for an addtional 90 days from the expiration date and you will be notified by mail. In the event that we do not receive your written request for extension or request was denied, your permit application will expire, become null and void and your project will require a new permit application, plans and specifications, and associated fees. Thank you for your cooperation in this matter. Sincerely, Bill Rambo Permit Technician File: Permit File No. D10 -219 6300 Southcenter Boulevard, Suite #100 © Tukwila, Washington 98188 o Phone: 206 - 431 -3670 as Fax: 206 - 431 -3665 • . a L' City o u .,'. Jim Haggerton, Mayor Department of Community Development Jack Pace, Director August 24, 2010 Jeff Green 11925 288 St E S Graham, WA 98338 RE: Incomplete Letter #1 Development Permit Application D10 -219 Bratcher Deck —13030 56 Av S Dear Mr. Green, This letter is to inform you that your permit application received at the City of Tukwila Permit Center on August 19, 2010 is determined to be incomplete. Before your application can continue the plan review process the attached/following items from the following department(s) need(s) to be addressed: Public Works Department: Joanna Spencer at 206 431 -2440 if you have any questions Concerning the attached comments. Please address the comment above in an itemized format with applicable revised plans, specifications, and /or other documentation. The City requires that four (4) 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) 431 -3670. Sincerely, J\ 1 1Q Bill Rambo Permit Technician Enclosures File: DI0 -219 W: \Permit Center \Incomplete Letters \2010\D10-219 Incomplete Ltr #1.DOC 6300 Southcenter Boulevard, Suite #100 o Tukwila, Washington 98188 ® Phone: 206 - 431 -3670 o Fax: 206 - 431 -3665 • • PUBLIC WORKS DEPARTMENT COMMENTS DATE: August 24, 2010 PROJECT: Bratcher Deck 13030 56th Ave S PERMIT NO: D10 -219 PLAN REVIEWER: Contact Joanna Spencer (206) 431 -2440 if you have any questions regarding the following comments. 1) Since the property is on a septic system, approval from King County Environmental Health Department is required for your deck addition to the existing garage. You have submitted only the septic As -Built plan when your house was constructed. Please submit your plans for review to King County Wastewater Program, Black River Environmental Health office at 900 Oakesdale Avenue SW, Suite 100, Renton, WA 98057, phone 206 296 -4932 to start the process. Submit copy of the above King County approval. 2) Please revise direction of the North arrow on your site plan. H: Joanna/D10 -219 inc • PERK OM PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D10 -219 DATE: 02 -11 -11 PROJECT NAME: BRATCHER DECK SITE ADDRESS: 13030 56 AV S Original Plan Submittal X Response to Incomplete Letter # 1 Response to Correction Letter # Revision # After Permit Issued DEPARTMENTS: on kJ (<0i.�, t:I Idling )Ivi I Public Works / ire Prevdntion ® Planning Division Structural DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Incomplete Permit Coordinator DUE DATE: 02 -15-11 Not Applicable n Comments: Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES/THURS ROUTING: Please Route Structural Review Required n No further Review Required ❑ REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved Notation: n Approved with Conditions DUE DATE: 03-15-11 Not Approved (attach comments) n REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents/routing slip.doc 2 -28 -02 • PE IrcooRD COP PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D10 -219 PROJECT NAME: BRATCHER DECK DATE: 08/19/10 SITE ADDRESS: 13030 56 AV S X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # after Permit Issued DEPARTMENTS: Building Division, Pu is Works Fire Prevention Structural Sri /A- Planning Division UPermit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Comments: Incomplete DUE DATE: 08/24/10 Not Applicable Permit Center Use Only Q, INCOMPLETE LETTER MAILED: �/ O LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES /THURS ROUTING: Building Please Route REVIEWER'S INITIALS: Structural Review Required u No further Review Required ❑ DATE: APPROVALS OR CORRECTIONS: Approved Notation: REVIEWER'S INITIALS: Approved with Conditions DUE DATE: 09/21/10 Not Approved (attach comments) DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents/routing slip.doc 2 -28 -02 • City of Tukwila REVISION SUBMITTAL Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 306- 431 -3670 Web site: http: / /www.ci.tukwila.wa.us Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Datei.j_: / - / / Plan Check/Permit Number: 0/(2 --_2/ Response to Incomplete Letter # / 7 Response to Correction Letter # ❑ Revision # after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner Project Name: Project Address: i3030 `jam T'S`B Contact Person: .- !/ Phone Number.25 ' L 5 -0_55/4L Summary of Revision: art OF TUKW LA FEB 112911 PERMIT CENTER Sheet Number(s): "Cloud" or highlight all areas of revision including date o revision Received at the City of Tukwila Permit Center by: `Entered in Permits Plus on - (, ( --1 ( H:\Applications \Forms - Applications On Line\2010 Applications \7-2010 - Revision Submittal.doc Created: 8 -13 -2004 Revised: 7 -2010 CITY OF TUKINILA Department of Community Development 6300 Southcenter Boulevard, Tukwila, WA 98188 Telephone: (206) 431 -3670 FAX (206) 931 -3665 E -mail: tukplanaci.tukwila.wa.us Permit Center /Building Division 206 431 -3670 Public Works Department 206 433-0179 Planning Division 206 431 -3670 AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION STATE OF WASHINGTON) ) ss. COUNTY OF KING (- L QrJ [please prim name] , states as follows: PERMIT NO: 1J I 0 - 9 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 /3 , 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 construcon work. w 5. , te 11111� W ASMISG,„ Owner /Owner's Agent* Signed and sworn to �bbeef�ore me this day of // atk ,201 I N(1AR PUBLIC in and for the State of Washington Residing at Name as commissioned: My commission expires: County 18.27.oQo Exemptions, The regilition provisions of this chapter do not apply. 1. An authorized representative of the United States by a registered contractor; 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 46.70 RCW who shall warranty service and repairs under chapter 46.70 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; g. 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 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 e 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; 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; 1.5. 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 toperform 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. 1- _gam '-v2 ` SEFAR :A T E PERMIT REQUIRED FOR: ti Mechanical Electrical IV Plumbing ti Gas Piping City of Tukwila BUILDING DIVISION REVISIONS No changes shall be made to the scope of work without prior approval of Tukwila Building Division. NOM PoktItions will require anew plan acid plan :view fees, ‘,3 c'J\) uk 0, 1 REVIEWED FOR CODE COMPLIANCE City of BUILDING 1 `y \our ''\i()\Z N la IVIgInNI '1 FILE COPY alt No.. t 10 -?-1,1 Plan review approval is suit to more and omissions. Approval of construction documents does not authorize the violation of ; adopted code or ordinance. Receipt of : and conditions is acknowledged: Dom. City Of BUILDING DIVISION RECEIVED CITY OF TUKW ILA AUG 19 2010 PERMIT CENTER rid 11 i+ asp 13 6,F'r'v RoJ7-c.- .i c / ,o . ,7. 6 x 7o ,���T 3 2''7 o� la i41 � Gam S.. " ©C. E sc 6�� r i/ � •9 L �.021/4./ Pc T 7-e, Cv r�A2. iCs -it, cc i /.79 CG s- /,.2 - w'ca ,• -74 6 " eJ / /%i9J2 279A) A1�.s" 7- <E•�a -77O01) 1/ '177V TO 86,/c7.c, t- , 2A' 7TIcfl TC'? 2if? CODE FOR E COMPLIANCE FEB 18'Lid City of Tukwila BUILDING fIUicink Cfsij 6.07-7-1 l /v,‘,<.ec,.e._..1, 9-8*i 8' co--6 7 /10sc /557 . c— ✓�-7�= %� 24 C ‘o--/ RECEIVED CITY OF TUKWILA AUG 19 2010 PERMIT CENTER ��d�9Tif� vs� SS i( 1 i i 0 , 0 i 0 ij I, ij 0 7:4": . • %��f%%��� a" poSi� .� -X� 7�c�ti tO GCZ�rvC /Z .SFGU.�� lam% o2x. �-.ro �7-� �� o, C: Lc a !a 10 /z-79 CC S' -// `' -74 ..49.c%7 CC- S��'" 1 / / ;S - �L Et/f -�77 1.) RECEIVED VOW A CITY OF AUG 19 2010 PERMIT CENTER ef y r1‘77.9 / cr,/CD 8 5- i/o.c, s2,lr ff T�cfl rc� 2,'-i 4 R.6,� Rim REVIEWEFOR CODE COMPLIANCE iniconvFn FEB 18 Lui1 City of Tukwila BUILDING nivisION jf /!; 7"--fr# Z e."/"/"C 8 .4. l2'3 ( .7'),?4'G- ' �s6 rAJ / &730 02J9.4.,_1., .' (..ZS3> 6-0/ - Gsic5"---- 4 r� 2"?y /O 8J. CXJ /o �c9 ,g4-79 /fie d C- S' pOS7- -TO 0.6417 Cef,r-•1 i4r7r.9c� `� /mac --- r-C7eVe., CORnEVIEWED FOR A CODE COMPLIANCE FEB 18 "zuil City of Tukwila BUILDING niviqinw► RECEIVED CITY OF TUKWILA AUG 192010 PERMIT CENTER