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Home My WebLink AboutPermit D10-259 - LAPINE RESIDENCE - REROOFPINE REROOF 14443 58 AV S D10 -2594 City oPTukwila • 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.: 3365900620 Address: 14443 58 AV S TUKW Suite No: Project Name: PINE REROOF DEVELOPMENT PERMIT Permit Number: D10-259 Issue Date: 09/15/2010 Permit Expires On: 03/14/2011 Owner: Name: LAPINE GARY +DIANA Address: 14443 58TH AVE S , TUKWILA WA 98168 Contact Person: Name: KRISTINA DAVIS Address: 26301 79 AV S , KENT WA 98032 SUB3ECT TO FIELD INSPECT MM Phone: 253- 887 -0194 Contractor: Name: CHETS ROOFING & CONST INC Phone: 253 - 887 -0194 Address: 26301 79TH AVE S , KENT WA 98032 Contractor License No: CHETSRC924BB Expiration Date: 01/04/2012 DESCRIPTION OF WORK: 1) REMOVE EXISTING ROOFING, 2 LAYER TEAR OFF, COMPOSITION WITH HOT TAR BUILT IN GUTTERS 2) REMOVING EXISTING 3/8 PLYWOOD ROOF SHEATHING AND REPLACING WITH 1/2" CDX PLYWOOD. 24" BETWEEN TRUSSES. TRUSSES ARE IN GREAT CONDITION. 3) CUTTING DOWN GUTTER FASCIA TO ALLOW FOR INSTALLATION OF 5" K -LINE CONTINUOUS ALUMINUM GUTTERS 4) INSTALL 30 YR ARCHITECTURAL GAF /ELK TIMBERLINE COMPOSITION, WITH CONTINUOUS RIDGE VENT 5) INSTALLING ICE WATER SHEILD ROOF EDGE AND VALLEYS. 25 ROOF SQUARES Value of Construction: $6,106.16 Fees Collected: $226.00 Type of Fire Protection: International Building Code Edition: 2009 Type of Construction: VB Occupancy per IBC: 0022 * *continued on next page ** doc: IBC -10/06 D10 -259 Printed: 09 -15 -2010 City oNukwila • 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 Permit Number: D10 -259 Issue Date: 09/15/2010 Permit Expires On: 03/14/2011 Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Fire Loop Hydrant: N Number: 0 Size (Inches): 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: 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 t •ermit 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 the performance of I am authorized to sign and obtain this development permit. Signature: Date: / (7 Print Name: kyl 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: IBC -10/06 D10 -259 Printed: 09 -15 -2010 • 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.: 3365900620 Address: 14443 58 AV S TUKW Suite No: Tenant: PINE REROOF • PERMIT CONDITIONS SUBJECT TO FIELD INSPECTION Permit Number: D10-259 Status: ISSUED Applied Date: 09/15/2010 Issue Date: 09/15/2010 1: ** *BUILDING DEPARTMENT CONDITIONS * ** 2: 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. 3: 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 this requirement. 4: All construction noise to be in compliance with Chapter 8.22 of the City of Tukwila Municipal Code. A copy can be obtained at City Hall in the office of the City Clerk. 5: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the City of Tukwila Building Department (206- 431 - 3670). 6: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building Department (206- 431 - 3670). 7: 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. * *continued on next page ** doc: Cond -10/06 D10 -259 Printed: 09 -15 -2010 • 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 • I hereby certify that I have read these conditions and will comply with them as outlined. All provisions of law and 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 construction or the performance of work. Print Name: Date: / / - to ordinances governing or local laws regulating doc: Cond -10/06 D10 -259 Printed: 09 -15 -2010 CITY OF TUKAPA Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us Building Perr>•No. VD 1 " (95 9 Mechanical Permit No. Plumbing/Gas Permit No. Public Works Permit No. Project No. (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 / ^ ,, King Co Assessor's Tax No.: 3 �3' � 5 -! Y t 1 t) a o Site Address: / y'7 y 3 , ,4U€ -S Suite Number: Tenant Name: Property Owners Name: G r71 LGi Pt /L'? Mailing Address: � hi 1 3 Sq t'' ,4v° lc, New Tenant: Floor: ❑ Yes ❑ .. No W !1- City State Zip CONTACT PERSON — who do we contact when your permit is ready to be issued Name: ��57�1 nct beiui'S Day Telephone: G ZS 3 Mailing Address: E -Mail Address: City State Zip Fax Number: GENERAL CONTRACTOR INFORMATION — (Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5)) Company Name: CAr4 C ROO Pt h Tht', Mailing Address: 2630 f 7G11� AVt" Contact Person: 4S ) n o. 6 a vl .S Mrl� E -Mail Address: Contractor Registration Number: CH F 7-s-12 City Day Telephone: Fax Number: Zs ZS 5 hd- 9S-037 Sate Zip ft8�� 619(/ ,S(1 LIS I Cd Expiration Date: ARCHITECT OF RECORD — All plans must be stamped by Architect of Record Company Name: Mailing Address: Contact Person: E -Mail Address: City Day Telephone: Fax Number: State Zip ENGINEER OF RECORD — All plans must be stamped by Engineer of Record Company Name: Mailing Address: Contact Person: E -Mail Address: H:\Applications \Forms - Applications On Line\2010 Applications \7 -2010 - Permit Application.doc Revised: 7 -2010 bh City Day Telephone: Fax Number: State Zip Page 1of6 BUILDING PERMIT INFORMATI. 206 - 431 -3670 • Valuation of Project (contractor's bid price): $ (✓ < % �'O Existing Building Valuation: $ c 0(1 06 Scope of Work (please provide detailed information): 7rct r cr Pxt }7 t 19 Cj--- p r7 aS tree 5 but 14- 11-i cS ken-) O(C= t" x 3 n 1 food s ee%l' arc/ � (G cm /�Z- 11 ,/(00, (h,$)�,. l� ti ►„ c S' �c 1 t h C4n-n 1. alc-frninruni adikkorS 7 ns /mil /I Iii 4 mAlPy---- c51ti.m.-e 4 / CP vz,v6 vo l i. j "-As Will there be new rack storage? ❑ ....Yes 0:7y17if oS t fzesV ke_9—J ? 'No 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 ❑ No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ Sprinklers ❑ Automatic Fire Alarm ❑ None ❑ 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: WpplicationslForms- Applications On Line'2010 Applications17 -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 1st Floor 2nd Floor 3rd Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck 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 ❑ No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ Sprinklers ❑ Automatic Fire Alarm ❑ None ❑ 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: WpplicationslForms- Applications On Line'2010 Applications17 -2010 - Permit Application.doc Revised: 7 -2010 bh Page 2 of 6 IDate Application Accepted: • • PERMIT APPLICATION NOTES — Applicable to all permits in this application 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 OWNER OR AUTHORI 1 AGENT: Signature: Print Name: Date: CJ l S t� Day Telephone: Mailing Address: City State Zip Date Application Expires: Staff Initials: H:\Applications \Forms - Applications On Line\2010 Applications \7 -2010 - Permit Application.doc Revised: 7 -2010 bh Page 6 of 6 1 1 PLUMBING AND GAS PIPING PERMIT INFORMATION — 206 - 431 -3670 PLUMBING AND GAS PIPING CONTRACTOR INFORMATION Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: Contractor Registration Number: Expiration Date: Valuation of Plumbing work (contractor's bid price): $ Valuation of Gas Piping work (contractor's bid price): $ Scope of Work (please provide detailed information): Building Use (per Int'l Building Code): Occupancy (per Int'l Building Code): Utility Purveyor: Water: Sewer: Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below: Fixture Type: Qty Fixture Type: Qty Fixture Type: Qty Fixture Type: Qty Bathtub or combination bath/shower Bidet Clothes washer, domestic Dental unit, cuspidor Dishwasher, domestic, with independent drain Drinking fountain or water cooler (per head) Food -waste grinder, commercial Floor Drain Shower, single head trap Lavatory Wash fountain 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 vent Industrial waste treatment interceptor, including trap and vent, except for kitchen 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 alteration of water piping and/or water treatment 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 Backflow protective device other than atmospheric -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 including backflow protection 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:\Applications\Porms- Application, On Line\2010 Applications \7.2010 - Permit Application.doc Revised: 7-2010 bh Page 5 of 6 • City of Tukwila 1 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.: 3365900620 Address: 14443 58 AV S TUKW Suite No: Applicant: PINE REROOF RECEIPT Permit Number: D10-259 Status: PENDING Applied Date: 09/15/2010 Issue Date: Receipt No.: R10 -01833 Initials: TLS User ID: 1670 Payment Amount: $226.00 Payment Date: 09/15/2010 10:46 AM Balance: $0.00 Payee: CHET'S ROOFING AND CONSTRUCTION INC TRANSACTION LIST: Type Method Descriptio Amount Payment Check 34854 226.00 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts BUILDING - RES STATE BUILDING SURCHARGE 000.322.100 221.50 640.237.114 4.50 Total: $226.00 doc: Receipt -06 Printed: 09 -15 -2010 L.- 4° IN PECTION NO. ,• PERMIT N24es CITY OF TUKWILA BUILDING DIVISION .- 6300 Southcenter Blvd., #100, Tukwila. WA.98188 (206) 431-3670. •'' Permit Inspection Request Lille (206) 431-2451 INSPECTION RECORD Retain a copy withpermit 40( 04.51 •1 Projcq, -,, .-..... M AL 1 K-C 416° r Type • t , 46 0 Address: Se- (14 ii4-70 -11 Date Called: Specia , Instructions: • • Date Wanted: a.m. —V) ..,-(40 p.m. Requester: Phone No: 5 --50-(r) -0(54 Approved Per applicable codes. EJCorrections required prior to approval. COMMENTS: tf11-4 77-7-0 X' D REINSPE ION REQUIRED. Prior t. next inspection. fee must be 1---1 paid at 630 Southeenter Blvd.. Suite 100. Call to schedule reinspection. "- 1•1;:11 • • • a • • • • •11.412: '"Cr• • • • 0-••••Ifrit - "%l% - "•*.1 INSPECTION RECORD Retain a copy with permit INSPECTION O. PERMIT NO CITY OF TUKWILA BUILDING DIVISION /- 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 431 -2451 Oro -25` (206) 431 -3670 Projeclat • l'AJ E. I91::: j)-Cri-tA UMW - 1/J!‘ AoAAR A.Pt--kA Address: � 4 3 Date Called: f- P Alp.QJ' - -. Special Instructions: 0.13 S 3 9" 0( sli • Date Wanted: 1 �r �.m. p Requester: Phone No: tJApproved per applicable codes. Corrections required prior to approval. 7. COMMENTS: v j)-Cri-tA UMW k . 1/J!‘ AoAAR A.Pt--kA t e. f A FJ is (C:i.. pi , \ \ , I P p c fr J f- P Alp.QJ' ?, nom' P Q �. " _ch. .t_.,1'4-1` '- • ■ - -- l C i As k .'=e-i :/''N Sp.c,c...e— . _14 11 IInspec or pate: at �. REINSPECTION FEE REQUIRED. Prior to.next inspection, fee must be : •- paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. 0 . — r..w+rmen0. •••s.r •+• -- ••.e• r INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 t (206) 431 -3670 !:. Permit Inspection Request Line (206) 4 245 t. k • • F. rr • Oio 294 Project: TytSe of Inspect'on: Address: 1444 rh 5rA„ ..r Date Called: f Special Instructions: Date Wanted: 9 / / a.m. Requester: . Phone No: Approved per applicable codes. . 0 Corrections required prior to approval. 7.- COMMENTS: �� % % -e (A 2 A—S Datel f Cie �c Ilnspn REINSPECTION FEE REQUIRED. rior• to next ?inspection, fee must be ec or: paid at 6300•Southcenter Blvd:, Suite 100. CaU'to schedule'reinspection: • ' • s ia•a'.er,e�aa..en- I+a.. r..., 4�a�n r . � • r •.rszerime, - •.ti-�- OTTO ROSENAU & ASSOCIATES, INC. Geotechnical Engineering, Construction Inspection & Materials Testing R.CE1VT) Job Number: 11 -0031 CONCRETE REPORT Report Number: RC130318 Permit Number: D10 -295 MAY 31 20111 cOMMUN,T( �j Gr,4 -1JT Project: IFLY - Indoor Skydiving - The Annex @ South Center Client: IFLY Seattle Indoor Skydivin� r Address: 301 Tukwila Parkway, Tukwila Address: 349 Tukwila Parkway, Tukwila Inspector(s): Paul Kanikkeberg Date: 4/20/2011 Description /Location: Elevator pit at grid lines AA- A/2.7 -3. The inspected work was found to be done as per approved plans and details. Resteel Verified: Yes 4/20/2011 Paul Kanikkeberg (Grade 60) Mfg: Cascade Placement Data Design p Actual ❑ Batch Weights /Cubic Yard Supplier: CalPortland (Glacier) Cement (lbs/type): 423# Type: 1/II Mix Number: 3000 Fine Agg. (lbs): 1410# Slump Spec: 4" +/- 1" Coarse Agg. (lbs/size): 1940# 3/4" Slag (Ibs): W/C Ratio Spec: 0.65 Coarse Agg. (lbs/size): Air Spec: N/A Coarse Agg. (Ibs /size): Total Yards: 4 Fly Ash (lbs): Placed Via: Wheelbarrow Water (lbs or gal): 275# Consolidated: Yes Admixtures (specify): Required Strength: 3000 psi at 28 days. Sampling and Testing Data Time Cubic Water Slump Air % Conc.Temp Ambient Truck Ticket ASTM C 172, C 31 Made Yards Added C 143 C 231 C 1064 Temp No. No. Cast Samples: 1 -4 2:30 pm 4.00 0 gal. 4 1/2" N/A 60 °F 53 °F 7631 390500 Weather: Cloudy Slump Range: 4 1/2" Air% Range: N/A Date Samples Picked Up: 4/21/2011 Initial Curing Method: ASTM c31, Exclude C31- 12.1.5 Initial Curing Temp: ASTM C31, Exclude C31- 10.1.2 Comments REINFORCING / PLACEMENT: Conforms COMPRESSIVE TEST RESULTS Specimen Test Field Age Size Area Weight Max Load Number Date Cure (Days) (in.) (Sq.ln.) (Lbs.) (Lbs.) 1 4/27/11 7 4 x 8 12.63 8.89 46,710 Does Not Conform ❑ Strength Fracture Type (psi) 3700 (other than cone) 2 5/18/11 5/18/11 5/18/11 = Discarded 28 4 x 8 12.57 8.81 65,960 5250 28 4 x 8 12.57 8.8 62,570 4980 28 4 x 8 12.57 8.78 64,650 5140 Tested in general accordance to: ASTMC39 ASTMC617 ❑ ASTMC1231 Copies to: ❑ Client ❑ Engineer n Building Dept ❑ Owner ❑ Contractor MI Batch Plant Architect ❑ Others Technical Responsibility: W si oject Manager This report applies only to the items tested or reported and is the exclusive property of Otto Rosenau & Associates, Inc. Reproduction of this report except in full, without written permission from our firm is strictly prohibited. 6747 M.L. King Way S., Seattle, Washington 98118 — Phone (206) 725 -4600 or 1- 888- OTTO -4 -US — Fax (206) 723 -2221 Form No.: ADMIN -62 -04 (Rev 09/06) Page 1 of 1 OTTO ROSENAU & ASSOCIATES, INC. - Geotechnical Engineering, Construction Inspection & Materials Testing Job Number: 11 -0031 CONCRETE REPORT Report Number: RC129912 Permit Number: D10 -295 Project: IFLY - Indoor Skydiving - The Annex @ South Center Address: 301 Tukwila Parkway, Tukwila Inspector(s): Ross Bogle Client: IFLY Seattle Indoor Skydiving Address: 349 Tukwila Parkway, Tukwila Date: 4/21/2011 R"�+ pe ei pm. Description /Location: Wall (elevator pit) at grid lines AA to B on 3. Reinforcing steel was inspected and found to be placed per approved plans. Resteel Verified: Yes 4/21/2011 Ross Bogle (Grade 60) Mfg: Nucor Placement Data Design Actual ❑ Batch Weights /Cubic Yard Supplier: CalPortland (Glacier) Cement (Ibs /type): 470# Type: I Mix Number: 3100 Fine Agg. (Ibs): 1440# Slump Spec: 4 " -5" Coarse Agg. (Ibs /size): 1900# 3/4" Slag (Ibs): W/C Ratio Spec: 0.55 Coarse Agg. (Ibs /size): Air Spec: N/A Coarse Agg. (Ibs /size): Total Yards: 3 Fly Ash (Ibs): Placed Via: Chute Water (Ibs or gal): 260# Consolidated: Yes Admixtures (specify): 25 oz. NON - CHLORIDE ACCELERATOR Required Strength: 4000 psi at 28 days. Sampling and Testing Data Time Cubic Water Slump Air % Conc.Temp Ambient Truck Ticket ASTM C 172, C 31 Made Yards Added C 143 C 231 C 1064 Temp No. No. Cast Samples: 1-4 12:15 pm 3.00 8 gal. 5" N/A 63 °F 50 °F 5350 390916 Weather: Partly Cloudy Date Samples Picked Up: Slump Range: 4 " -5" Air % Range: N/A 4/22/2011 Initial Curing Method: Asrm C31, Exclude C31- 12.1.5 Initial Curing Temp: ASTM C31, Exclude C31- 10.1.2 Comments REINFORCING / PLACEMENT: Conforms 0 Does Not Conform ❑ COMPRESSIVE TEST RESULTS Specimen Test Field Age Size Area Weight Max Load Strength Fracture Type Number Date Cure (Days) (in.) (Sq.ln.) (Lbs.) (Lbs.) ) (psi) (other than cone) 1 4/28/11 7 4 x 8 12.62 8.83 49,890 3950 5 2 5/19/11 28 4 x 8 12.57 8.84 70,710 5630 2 3 5/19/11 28 4 x 8 12.57 8.79 71,020 5650 2 4 5/19/11 28 4 x 8 12.57 8.76 71,420 5680 2 • = Discarded Tested in general accordance to: ASTMC39 I ASTMC617 ❑ ASTMC1231 Copies to: ❑ Client ❑ Owner ❑ Engineer ❑ Contractor Architect ❑ Others Building Dept Batch Plant Technical Responsibility: alter Hansen, Project Manager This report applies only to the items tested or reported and is the exclusive property of Otto Rosenau & Associates, Inc. Reproduction of this report except in full, without written permission from our firm is strictly prohibited. 6747 M.L. King Way S., Seattle, Washington 98118 — Phone (206) 725 -4600 or 1- 888 - OTTO -4 -US — Fax (206) 723 -2221 Form No.: ADMIN -62 -04 (Rev 09/06) Page 1 of 1 OTTO ROSENAU & ASSOCIATES, INC. Geotechnical Engineering, Construction Inspection & Materials Testing Report Number: 135492 Project: Address: • CONSTRUCTION INSPECTION REPORT IFLY — Indoor Skydiving — The Annex @ South Center 301 Tukwila Parkway, Tukwila IFLY Seattle Indoor Skydiving Permit Number: Job Number: Client Address: rS^jrPgfr''.d MAY ? 1 20111 COMMUN;Tlr DEVELOPMENT 11 -0031 349 Tukwila Parkway, Tukwila WA 98188 Inspections Performed Proprietary Anchors: Steel Decking Other (specify): • Anchor Bolt Installation Structural Steel Fabrication • Epoxy Grouting (Rebar / Bolts) Structural Steel Erection X Inspector and Date Remarks Dusty Johnston 5/3/2011 Visual inspection was made of the welds of the ledger angles on (2) sections of the plenum deck welding. Performed by WABO certified welders (cards on file with contractor) using AWS D1.1 procedures and found to be according to plans. Conforms Copies to: X Client X Engineer Owner Contractor X Architect X Building Dept. Others Technical Responsibility: `er'Iter C. '' en, Project Manager This report applies only to the items tested or reported and is the exclusive property of Otto Rosenau & Associates, Inc. Reproduction of this report, except in full, without written permission from our firm is strictly prohibited. Page 1 of 1 6747 M.L. King Way S., Seattle, Washington 98118 — Phone (206) 725 -4600 or 1- 888 - OTTO -4 -US — Fax (206) 723 -2221 Form No.: ADMIN -63 -02 (Rev 11/08) OTTO ROSENAU & ASSOCIATES, INC. Geotechnical Engineering, Construction Inspection & Materials Testing 20111 MASONRY REPORT l'rEl = "rtT Job Number: 11 -0031 Report Number: 110916 Permit Number: 010 -295 Project: IFLY - Indoor Skydiving - The Annex Client: IFLY Seattle Indoor Skydiving Address: 301 Tukwila Parkway, Tukwila Inspector & Date: Dusty Johnston 5/3/2011 Masonry Sub or Contractor: DESCRIPTION / LOCATION IBC Level of Inspection: (Projects located outside Seattle) Level 1 Level 2 • Ref. 17- 04.5.1/17- 04.5.3 IBC 2006 SBC Level of Inspection: (Projects located in Seattle) Level 1 (Periodic) ❑ Level 2 (Continuous) • Ref. 17- 04.5.1/17- 04.5.3 SBC 2006 2nd lift line AA from 0.5 to 5.8. Approximate square footage completed on this date: Are anchors in place? (if required) : Was reinforcing steel verified? Yes Is reinforcing steel secured in place ?: Grade of reinforcing steel: 60 Manufacturer: Cascade Is high lift grouting approved ?: GROUT INFORMATION (ASTM C 1019) (excluding paragraph 12.16) Mix no. /type: 0365030 Grout supplier: Miles Grout preparer: Batch Plant Grout temperature: 61° Grout slump: 8" Total yardage: 6 Method of consolidation: Vibrator Grout ingredients & weights: 611# I -11, 1960# sand, 890# 3/8 ", 392# water MORTAR INFORMATION (ASTM .0 7801 Mix no. /type: Mortar supplier: Mortar preparer: Mortar temperature: Mortar ingredients: MATERIAL INFORMATION ,(ASTM C 67/ ASTM ,C 140) Block /unit supplier: Mutual Material Block/unit type: STD SAMPLE INFORMATION Were any samples made? No If Yes - see attached report OTHER. INFORMATION, . Weather & ambient temperature: Overcast Protection methods: Visqueen Is this a re- inspection? No If yes - original inspection date: COMMENTS Other ASTM Methods Used: Conforms X Does Not Conform Copies to: X Client X Engineer Owner Contractor X Architect X Building Dept. Others Technical Responsibility: Project Manager C,I en Pro1 g er This report applies only to the items tested or reported and is the exclusive property of Otto Rosenau & Associates, Inc. Reproduction of this report, except in full, without written permission from our firm is strictly prohibited. Page 1 of 1 6747 M.L. King Way S., Seattle, Washington 98118 - Phone (206) 725 -4600 or 1- 888 - OTTO -4 -US - Fax (206) 723 -2221 Form No.: ADMIN -72 -06 (Rev 02/11) OTTO ROSENAU & ASSOCIATES, INC. Geotechnical Engineering, Construction Inspection & Materials Testing i PAY MASONRY REPORT 2011 1 Ti t'u�E4T Job Number: 11 -0031 Report Number: 63860 Permit Number: D10-295 Project: IFLY — Indoor Skydiving — The Annex Client: IFLY Seattle Indoor Skydiving Address: 301 Tukwila Parkway, Tukwila Inspector & Date: Dusty Johnston 5/4/2011 Masonry Sub or Contractor: DESCRIPTION /:LOCATION IBC Level of Inspection: (Projects located outside Seattle) Level 1 CO Level 2 ❑ Ref. 17-04.5.1/17-04.5.3 IBC 2006 SBC Level of Inspection: (Projects located in Seattle) Level 1 (Periodic) ❑ Level 2 (Continuous) ❑ Ref. 17- 04.5.1/17- 04.5.3 SBC 2006 3rd lift wall line AA. Approximate square footage completed on this date: Are anchors in place? (if required) : Was reinforcing steel verified? Yes Is reinforcing steel secured in place ?: Grade of reinforcing steel: 60 Manufacturer: Cascade Is high lift grouting approved ?: ROUTTINFORMATION, ASTM 1019) t•xaiiiarne #r+ a ph )� i Mix no. /type: 0365030 Grout supplier: Miles Grout preparer: Batch Plant Grout temperature: Grout slump: 8" Total yardage: Method of consolidation: Vibrator Grout ingredients & weights: 611# I -11, 1960# sand, 890# 3/8 ", 392# water 3 MORTAR.INFORMATION (ASTM. tC 700 Mix no.Itype: Mortar supplier: Mortar preparer: Mortar temperature: Mortar ingredients: IATERIAL INFO iiATIOl!+1. ASTM Block/unit supplier: Block/unit type: SAMPLE INFORMATION , ;; , . Were any samples made? No OTT E If Yes — see attached report Weather & ambient temperature: Overcast Protection methods: Visqueen Is this a re- inspection? No If yes — original inspection date: COMMENTS k, Ambient Temperature 60 °, Truck #134, Ticket #141458 :Conform Does sNot,Confolrm Copies to: X Client X Engineer Owner Contractor X Architect X Building Dept. Others Technical Responsibility: alt ansen, Project Manager This report applies only to the items tested or reported and is the exclusive property of Otto Rosenau & Associates, Inc. Reproduction of this report, except in full, without written permission from our firm is strictly prohibited. Page 1 of 1 6747 M.L. King Way S., Seattle, Washington 98118 — Phone (206) 725 -4600 or 1- 888 - OTTO -4 -US - Fax (206) 723 -2221 Fonn No.: ADMIN -72 -06 (Rev 02/11) OTTO ROSENAU & ASSOCIATES, INC. Geotechnical Engineering, Construction Inspection & Materials Testing MASONRY REPORT MAY s 20111 COMMUIV-F, Job Number: 11 -0031 Report Number: 110931 Permit Number: D10 -295 Lk VeCP`� "d17 Project: IFLY — Indoor Skydiving — The Annex Client: IFLY Seattle Indoor Skydiving Address: 301 Tukwila Parkway, Tukwila Inspector & Date: Dusty Johnston 5/10/2011 Masonry Sub or Contractor: ° ". DESCRIPTION / LOCATION IBC-Level of Inspection: (Projects located outside Seattle) Ref. Level 1 ►ZI Level 2 • SBC Level of Inspection: (Projects located in Seattle) Level 1 (Periodic) • Level 2 (Continuous) • 17- 04.5.1/17- 04.5.3 IBC 2006 Ref. 17- 04.5.1/17- 04.5.3 SBC 2006 4th lift wall line AA. Approximate square footage completed on this date: Are anchors in place? (if required) : Was reinforcing steel verified? Is reinforcing steel secured in place ?: Grade of reinforcing steel: Manufacturer: Is high lift grouting approved ?: GROUT INFORMATION (ASTM C :1019) (excluding paragraph 12.1.6) Mix no. /type: 0365030 Grout supplier: Miles Grout preparer: Batch Plant Grout temperature: 61° Grout slump: 9" Total yardage: 6 Method of consolidation: Vibrator Grout ingredients & weights: 611# I -II, 1980# sand, 890# 3/8 ", 392# water MORTAR INFORMATION (ASTM C 780 w Mix no.ltype: Mortar supplier: Mortar preparer: Mortar temperature: Mortar ingredients: MATERIAL INFORMATION, (ASTM C 67IASTM;=C;140) < :' Block/unit supplier: Mutual Material Bellevue Block/unit type: STD SAMPLE INFORMATION.." . ti Were any samples made? No If Yes — see attached report OTHER INFORMATION Weather & ambient temperature: Overcast Protection methods: Visqueen Is this a re- inspection? No If yes — original inspection date: COMMENTS Other ASTM Methods Used: 1 Conforms A Does Not Conform Copies to: X Client X Engineer Owner Contractor X Architect X Building Dept. Others Technical Responsibility: en, Project Manager This report applies only to the items tested or reported and is the exclusive property of Otto Rosenau & Associates, Inc. Reproduction of this report, except in full, without written permission from our firm is strictly prohibited. Page 1 of 1 6747 M.L. King Way S., Seattle, Washington 98118 — Phone (206) 725 -4600 or 1- 888 - OTTO -4 -US — Fax (206) 723 -2221 Form No.: ADMIN -72 -06 (Rev 02/11) OTTO ROSENAU & ASSOCIATES, INC. Geotechnical Engineering, Construction Inspection & Materials Testing MASONRY REPORT rim 0 1 2011i COMM! ;'•,ry DEVELOP( Job Number: 11 -0031 Report Number: 63862 Permit Number: D10 -295 Project: IFLY - Indoor Skydiving - The Annex Client: IFLY Seattle Indoor Skydiving Address: 301 Tukwila Parkway, Tukwila Inspector & Date: Dusty Johnston 5/13/2011 Masonry Sub or Contractor: DESCRIPTION / LOCATION IBC Level of Inspection: (Projects located outside Seattle) Ref. Level 1 ►�.. Level 2 • SBC Level of Inspection: (Projects located in Seattle) Level 1 (Periodic) • Level 2 (Continuous) ■ 17- 04.5.1/17- 04.5.3 IBC 2006 Ref. 17- 04.5.1/17- 04.5.3 SBC 2006 6th lift wall line AA. Approximate square footage completed on this date: Are anchors in place? (if required) : Was reinforcing steel verified? Yes Is reinforcing steel secured in place ?: Grade of reinforcing steel: 60 Manufacturer: Cascade Is high lift grouting approved ?: GROUT INFORMATION (ASTM C 1019) (excluding parag ...ph 12.t.6) Mix no. /type: 0370030 Grout supplier: Miles Grout preparer: Batch Plant Grout temperature: 60° Grout slump: 9" Total yardage: 6 Method of consolidation: Vibrator Grout ingredients & weights: 658# I -11, 2000# sand, 870# 3/8 ", 375# water MORTAR INFORMATION (ASTM C 780 Mix no. /type: Mortar supplier: Mortar preparer: Mortar temperature: Mortar ingredients: MATERIAL INFORMATION (ASTM C 67/ ASTM C: 140) ,. Block/unit supplier: Block/unit type: SAMPLE INFORMATION Were any samples made? No If Yes - see attached report OTHER INFORMATION Weather & ambient temperature: Overcast Protection methods: Visqueen Is this a re- inspection? No If yes - original inspection date: COMMENTS Ambient Temperature 55 °, Truck #094, Ticket #250689 Other ASTM Methods Used: °1 Conforms 1 X 1 Does Not Conform Copies to: X Client X Engineer Owner Contractor X Architect X Building Dept. Others Technical Responsibility: alter ' ansen, Project Manager This report applies only to the items tested or reported and is the exclusive property of Otto Rosenau & Associates, Inc. Reproduction of this report, except in full, without written permission from our firm is strictly prohibited. Page 1 of 1 6747 M.L. King Way S., Seattle, Washington 98118 - Phone (206) 725 -4600 or 1- 888 - OTTO -4 -US - Fax (206) 723 -2221 Form No.: ADMIN -72 -06 (Rev 02/11) vv urx vruci 9/13/2010 Job #: 5184600 Branch: Seattle Price List: Seattle Sale Date: 8/15/2010 Homeowner Mr. Gary LaPine Install 14443 58th Ave S Address: WORK ORDER Work Order 1 #: City, St, Zip: Seattle, WA 98168 Home Phone: (206) 244-7216 Work Phone: Cell Phone: (206) 617 -1303 Cross Street 144th St "" Lead Paint Info ""' Special Considerations: Installer Notes: No Test/ No LSWP •1V 1 Vl 1 t+b- to -03( 12:13 PM Installer. CHETS ROOFING & Crew. CHESTER CHMIELINSKI FI: Maxwell Lieurance Measure FI: Maxwell Lieurance FI Phone: (253) 299 -3400 Description (Receipts must be attached) Cash Ticket Items Amount Total: Manufacturer Notes: Shingles And Ridge To Be Birchwood : Rvo38 Gray : Spray Primer To Be Gray : 5/12 Pitch : Good Access : Drip & Gutter Metal To Be White Hardie Paint Colors: Siding - Soffit - Trim - Square Order Description Timberline 30 High Definition Additional Layer Removal - Composition/Gravel Rolled Ridge Vent Chimney /Skylight Flashing - F &I Miscellaneous Labor Indicate with an X if additional labor is required If additional labor is required, call FI immediately UI Size Window/Door - Installed Extended Give Reason for Reduction Feet Qty Qty Rate Amount 0-0 0-0 0-0 0-0 0-0 16.3 16.3 56 1 8.5 Total: v n etc n j 2 I a. r k1 D ) Gvyn,oS / /r dry rho c � rvv� °J `� 4'1/ !tiv / ,L 1r 7 bu /J /,1 ?4Ye' (lomov l n 9 etleS/1719. r p ij Lake.' / Snea t Ply and 606 -ses TrUs.1 are /n CptepC GcG�� % /i Oo � p � Z / /..-tA &f#r) a /Paw /- /nJh /f4Lry G� Mfr h G�.�n �v�'%r -�c.sC� iv '7 - , �t//nr rrc,m 114145 ,� /�� cdrl �-iry ��s s 11 arc 1, tee Let/ GA-/ E //G % r hix>e Lpr7-IpArt`icUrq et, 1)14,1 ConhhUUS nar 1n°i-?1 . J 4 / Ls-1,,,w 6 r ea/9,e Ua /Arl, Ar i-ox 2( v Sc ' uce v' 41- 27- yfi'�j httn: / /mail.aol.com/32644 -111 /ao1 -1 /en- us/mail /get- attachment .asnx?uid = 1.26886575 &fol... 9/13/2010 Contractors or Tradespeople P1iir Friendly Page • Page l of l General /Specialty Contractor A business registered as a construction contractor with LaI to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name Phone Address Suite /Apt. City State Zip County Business Type Parent Company CHETS ROOFING Et CONST INC UBI No. 602786907 Status Active 26301 79Th Ave S License No. CHETSRC924BB 2538870194 Kent WA 98032 King Corporation License Type Construction Contractor Effective Date 1/2/2008 Expiration Date 1/4/2012 Suspend Date Specialty 1 General Specialty 2 Unused Other Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status CHETSRC011MA CHET'S ROOFING & CONSTRUCTION Construction Contractor General Unused 7/1/1999 7/1/2000 Archived DYNAMDR975MB DYNAMIC DESIGN ROOF CONST INC Construction Contractor General Unused 7/2/2003 7/2/2005 Expired CHETSRC000BE CHET'S ROOFING a CONSTRUCTION Construction Contractor General Unused 1/5/2000 7/9/2009 Relicensed Business Owner Information Name Role Effective Date Expiration Date CHMLELINSKI, CHESTER T President 01/02/2008 Amount CHMIELINSKI, HELEN H Secretary 01/02/2008 GLO191312 Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 1 AMERICAN STATES INS CO 6542953 01/01/2008 Until Cancelled $12,000.00 01/02/2008 Assignment of Savings Information No records found for the previous 6 year period Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date 4 CRUM Et FORSTER SPECIALTY INS GLO191312 07/01/2010 07/01/2011 $1,000,000.00 06/28/2010 3 UNITED SPECIALTY INS AGL0920704 07/01/2009 07/01/2010 $1,000,000.00 07/06/2009 2 UNITED SPECIALTY INS CO AGL0810441 07/01/2008 07/01/2009 $1,000,000.00 07/01/2008 1 FIRST MERCURY INS CO FMFL002902 07/01/2007 07/01/2008 $1,000,000.00 01/02/2008 Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period Warrant Information No unsatisfied warrants on file within prior 6 year period https: // fortress .wa.gov /lni /bbip /Print.aspx 09/15/2010