HomeMy WebLinkAboutPermit D11-316 - SOUND TRANSIT - PLATFORM REPAIRSOUND TRANSIT
PLATFORM REPAIR
7301 S LONGACRES WY
Di 1-316
City "ukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206431 -3670
Inspection Request Line: 206- 431 -2451
Web site: http: / /www.TukwilaWA.gov
DEVELOPMENT PERMIT
Parcel No.: 0005800020
Address: 7301 S LONGACRES WY TURIN
Suite No:
Project Name: SOUND TRANSIT PLATFORM REPAIR
Permit Number: D11 -316
Issue Date: 09/23/2011
Permit Expires On: 03/21/2012
Owner:
Name: CPSRTA (SOUND TRANSIT)
Address: 401 S JACKSON ST , SEATTLE WA 98104
Contact Person:
Name: KYM WILLIAMS
Address: 401 S JACKSON ST , SEATTLE WA 98104
Contractor:
Name: WALSH CONSTRUCTION CO/WASH
Address: 2905 SW FIRST AVE , PORTLAND OR 97201
Contractor License No: WALSHCC990D 1
Phone: 206 - 398 -5156
Phone: 503 222 -4375
Expiration Date: 03/19/2013
DESCRIPTION OF WORK:
REPLACE AND RESTORE IN KIND DAMAGED NORTHBOUND PLATFORM.
Value of Construction: $75,830.00
Type of Fire Protection:
Type of Construction:
Electrical Service Provided by: PUGET SOUND ENERGY
Fees Collected: $2,026.08
International Building Code Edition: 2009
Occupancy per IBC:
* *continued on next page **
doc: IBC -7/10
D11 -316 Printed: 09 -27 -2011
Public Works Activities:
Channelization / Striping: N
Curb Cut / Access / Sidewallc / 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: 1017- 7//
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 the performance of work. I am authorized to sign and obtain this development permit and agree to the conditions attached
to this permit.
Signatur
Print Name:
�? 4_2c(6/,:,1
Date: 4,
This permit shall be • me 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: 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.
6: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of,
doc: IBC -7/10
D11-316 Printed: 09 -27 -2011
any violation of any of the provisions of the 1-Ming code or of any other ordinances of the f Tukwila. Permits
presuming to give authority to violate or car he provisions of the code or other ordinanc 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
D11-316 Printed: 09 -27 -2011
City oilk ukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Inspection Request Line: 206 - 431 -2451
Web site: http: / /www.TukwilaWA.gov
DEVELOPMENT PERMIT
Parcel No.: 0005800020
Address: 7301 S LONGACRES WY TUKW
Suite No:
Project Name: SOUND TRANSIT PLATFORM REPAIR
Permit Number: D11 -316
Issue Date: 09/23/2011
Permit Expires On: 03/21/2012
Owner:
Name: CPSRTA (SOUND TRANSIT)
Address: 401 S JACKSON ST , SEATTLE WA 98104
Contact Person:
Name: KYM WILLIAMS
Address: 401 S JACKSON ST , SEATTLE WA 98104
Phone: 206 - 398 -5156
Contractor:
Name: OWNER AFFIDAVIT - KYM WILLIAMS (SOUND TRANSIT) Phone:
Address:
Contractor License No: Expiration Date:
DESCRIPTION OF WORK:
REPLACE AND RESTORE IN KIND DAMAGED NORTHBOUND PLATFORM.
Value of Construction: $75,830.00
Type of Fire Protection:
Type of Construction:
Electrical Service Provided by: PUGET SOUND ENERGY
Fees Collected: $2,026.08
International Building Code Edition: 2009
Occupancy per IBC:
* *continued on next page **
doc: IBC -7/10
D11 -316 Printed: 09 -23 -2011
Public 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:
Permit Center Authorized Signature:
I hereby certify that I have read and
governing this work will be complied
N
N
N
•
Number: 0 Size (Inches): 0
Start Time:
Volumes: Cut 0 c.y.
End Time:
Fill 0 c.y.
Start Time: End Time:
Private:
Profit: N
Private:
Public:
Non - Profit: N
Public:
ed this permit and know the same to be true and correct. All provisions of law and ordinances
whether specified herein or not.
The granting of this permit does not pr
construction or the performance of work.
to this permit.
e to give authority to violate or cancel the provisions of any other state or local laws regulating
am authorized to sign and obtain this development permit and agree to the conditions attached
Signature. — -�
Print Name:
/77
Date: / /T-. —� //
This permit shall be •me 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: 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.
6: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of,
doc: IBC -7/10
D11 -316 Printed: 09 -23 -2011
any violation of any of the provisions of the }ing code or of any other ordinances of the Clif Tukwila. Permits
presuming to give authority to violate or c he provisions of the code or other ordinanc 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
D11 -316 Printed: 09 -23 -2011
CITY OF TUKWILA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
htto://www.TukwilaWA.00v
Building Permit No. b 1-3t
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
3 4( S L0,^1 eu r s
King Co Assessor's Tax No.: 000. 13O '" 0O.1)
Suite Number: Floor:
New Tenant:
Site Address: Tukwila Sounder Station
Tenant Name:
Sound Transit
Property Owners Name: Sound Transit
Mailing Address: 401 S Jackson St
Seattle
City
State
Yes m ..No
98104
Zip
CONTACT PERSON — who do we contact when your permit is ready to be issued
Name: Kym Williams
Mailing Address: 401 S Jackson St
E -Mail Address: kym.williams @soundtransit.org
Day Telephone:
Seattle
(206) 398 -5156
WA 98104
City State
Fax Number: (206) 398 -5228
Zip
GENERAL CONTRACTOR INFORMATION —
(Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5))
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Contractor Registration Number:
City
Day Telephone:
Fax Number:
Expiration Date:
State
Zip
ARCHITECT OF RECORD — All plans must be stamped by Architect of Record
Company Name:
Mailing Address:
city
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
State
Zip
ENGINEER OF RECORD — All plans must be stamped by Engineer of Record
Company Name: Sound Transit
Mailing Address: 401 S Jackson St
Contact Person: Tanveer Sahoo
E -Mail Address: tanveer.sahoo @soundtransit.org
H: \Applications\Fonns- Applications On Line \2010 Applications \7.2010 - Permit Application.doc
Revised 7 -2010
bh
Seattle
City
Day Telephone:
Fax Number:
State
(206) 689 -4946
98104
Zip
Page 1 of 6
� l� og
BUILDING PERMIT INFORMATION — 206 -431 -3670
Valuation of Project (contractor's bid price): $ F30 Existing Building Valuation: $
Scope of Work (please provide detailed information): Replace and restore in kind damaged northbound platform
Will there be new rack storage? ❑ Yes
m.. 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 m No If `yes ", explain:
FIRE PROTECTION /HAZARDOUS MATERIALS:
❑ Sprinklers ❑ Automatic Fire Alarm m 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: \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
Ist Floor
rd 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 m No If `yes ", explain:
FIRE PROTECTION /HAZARDOUS MATERIALS:
❑ Sprinklers ❑ Automatic Fire Alarm m 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: \Applications\Forms•Applications On Line \2010 Applications \7.2010 • Permit Application.doc
Revised: 7 -2010
bh
Page 2 of 6
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 0 AUTHO FZ AGENT:
Signal r�! ��
Print Name: KY
illiams
Mailing Address: 401 S Jackson St
Date: 9/21/11
Day Telephone: 206 398 -5156
Seattle WA 98104
City State
Zip
Date Application Accepted: q
Date Application Expires:
Staff Initials:
H:\Applrcations \Forms - Applications On Line \2010 Applications \7 -2010 - Permit Application.doc
Revised: 7 -2010
bh
Page 6 of 6
0
City of Tukwila
0
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206-431-3665
Web site: http: / /www.TukwilaWA.gov
RECEIPT
Parcel No.: 0005800020 Permit Number: D11-316
Address: 7301 S LONGACRES WY TUKW Status: PENDING
Suite No: Applied Date: 09/21/2011
Applicant: SOUND TRANSIT PLATFORM REPAIR Issue Date:
Receipt No.: R11 -02068
Payment Amount: $2,026.08
Initials: WER Payment Date: 09/21/2011 11:43 AM
User ID: 1655 Balance: $0.00
Payee: MARINA VALLEJO
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd VISA
Authorization No. 077745
ACCOUNT ITEM LIST:
Description
2,026.08
Account Code Current Pmts
BUILDING - NONRES
PLAN CHECK - NONRES
STATE BUILDING SURCHARGE
000.322.100
000.345.830
640.237.114
Total: $2,026.08
1,225.20
796.38
4.50
doc: Receiot -06 Printed: 09 -21 -2011
#7_
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
INSPEC TION NO.
Proj:JA.6 d A 1J.S
Type ofspection: _ A ' 1 6
�4
Address:
r)30( i onAAY r 'S
Date Called:
Special Instructions:
7-
Date Wanted:.
/0- / -7 - I(
a.m.
p.m
Requester:
Phone No:
?.p (p -SS i A- ('1:2
Approved per applicable codes. El Corrections required prior to approval.
COMMENTS:
0 er g'
646 +61:•6
Inspect r:
Date
❑ REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
•
h.
r.
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
�
Proj t: 0340 t � , r
Type pf-InsA ction
H. , 4 G
Address:
.13 6( WnG!tACS
Date Called:
.
Special Instructions:
Date Wanted/ .D
4
_ , `
a.m.
cirDn
Requester:
Phone No:
1.�+ �
��� � I`' Clj
1
Approved per applicable codes.
Corrections Corrections required prior to approval.
COMMENTS:
(Date. �4 — (1
REINSPECTION FEE REQUIR'I . Prio•to next inspection. fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
SOUNDTRANSIT
September 20, 201QU-
-�'`' FILE COPY
Perm!' ! o.
TO: Dave Larson — City of Tukwila
Bob Benedicto — City of Tukwila
FROM: Tanveer Sahoo, P.E. — Sound Transit
SUBJECT Tukwila Sounder Station
MEMO
nREVIEINED FOR
CODE COMPLIANCE
APPROVED
SEP222011
City of BUILD NGTDIVISI
Tukwila Sounder station's northbound platform sustained damage on Thursday early morning due to
a passing freight train. Fortunately, there were no injuries or passengers at the station at the time.
The northbound platform is closed after visual inspection by Sound Transit's engineering staff.
Sound Transit structural engineers inspected the platform Thursday moming following the incident.
The damage is primarily contained to the west edge of the platform, with the majority of damage
sustained by the cantilever ends of the platform joists and decking. The fascia board on the west
face of the platform was almost entirely destroyed as well.
Platform foundations and main support beams do not appear to be displaced or damaged.
Replacement or repair of foundation or main beam elements will not be necessary.
Per your verbal authorization, Sound Transit removed the approximate (westem) 6 feet of platform
deck for the entire length of the platform to determine the extent of the required repairs. Sound
Transit's structural engineers did another site visit on September 16, 2011 and identified existing
wood joists in following three categories. Refer attached Sketches (SK1, SK2 & SK3) for wood joist's
repair /replacement details:
1. Wood joists with full damage - replace with similar wood members full width of platform
2. Wood joists with no damage — Retain the existing wood joists
3. Wood joists with partial damage — partial plate (sister) with existing joist to make new
cantilever member.
Construction is expected to begin shortly after receipt of the repair permit. Until the northbound
platform is back in service, both northbound and southbound passengers will use the southbound,
(west) platform.
Attachments: Sketches SK -1, SK -2 and SK -3
bt3i Lo
RECEIVED
SEP 21 2011
PERMIT CENTER
SOUNDTRANSIT
401 S. Jackson Street
Seattle, WA 98104-2826
Phone; .(206),398 -5000 • Fax: (206) 689-3360
1-
Project:
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Job #:
Subject:
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Date:
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Page #:
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REVIE ED FOR
APP OVED tNy X
SEP422011 rST
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2011
PERMITtENTir
SOUNDTRANSIT
401 S. Jackson Street
Seattle, WA 98104-2826
Phone: (206) 398 -5000 • Fax: (206) 689 -3360
Project:
/LIkW/I. T.!)^'
Job #:
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Subject
By:
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Date:
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Page #:
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PERMIT ENTER
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.__SEP 21 2011
IF'ERMITCENTER
p 4%
Jennifer Marshall
From: Williams, Kym <kym.williams @soundtransit.org>
Sent: Tuesday, September 27, 2011 11:56 AM
To: Jennifer Marshall
Subject: Revision D11 -316
Hi Jennifer —
I need to revise the permit I picked up from you Friday to reflect the contractor ST brought on board to do the
work. The contractor is Walsh Construction. Their license number is WALSHCC990D1. Would it be possible to pick up
the revised permit this afternoon?
•
PE V
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: D11 -316 DATE: 09 -21 -11
PROJECT NAME: SOUND TRANSIT PLATFORM REPAIR
SITE ADDRESS: 7301 S LONGACRES WY
X Original Plan Submittal
Response to Correction Letter #
Response to Incomplete Letter #
Revision # After Permit Issued
D PARTMENTS: II
u Iding" Division
Structural
Permit Coordinator
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
Incomplete
DUE DATE: 09-22 -11
Not Applicable
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
LETTER OF COMPLETENESS MAILED:
TUES/THURS ROUTING:
Please Route ❑ Structural Review Required ❑ No further Review Required rtc
�
REVIEWER'S INITIALS: DATE: ���"`
APPROVALS OR CORRECTIONS:
Approved
Notation:
Approved with Conditions
DUE DATE: 10-20-11
Not Approved (attach comments) ❑
REVIEWER'S INITIALS: DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
Documents/routing stip.doc
2 -28 -02
pTG Pw f-62b DL
Contractors or Tradespeople Pijier Friendly Page
*I
General /Specialty Contractor
A business registered as a construction contractor with L &I 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 WALSH CONSTRUCTION CO /WASH UBI No. 602050186
Phone 5032224375 Status Active
Address 2905 Sw First Ave License No. WALSHCC990D1
Suite /Apt. License Type Construction Contractor
City Portland Effective Date 3/21/2001
State OR Expiration Date 3/19/2013
Zip 972014705 Suspend Date
County Out Of State Specialty 1 General
Business Type Corporation Specialty 2 Unused
Parent Company
sociated Licenses
License
Name
Type
Specialty
1
Specialty
2
Effective
Date
Expiration
Date
Status
RDFBUBC937LK
RDF BUILDERS CO
Construction
Contractor
General
Unused
6/12/2007
6/12/2013
Active
WALSHC'253BP
WALSH
CONSTRUCTION CO
Construction
Contractor
General
Unused
1/17/1975
3/23/2013
Active
WALSHBL972ND
WALSH BUILDERS
LLC
Construction
Contractor
General
Unused
8/4/2003
8/4/2009
Re-
Re-
Licensed
Business Owner Information
Name
Role
Effective Date
Expiration Date
JGB SERVICE CORP
Agent
01/01/1980
Bond Amount
WALSH, ROBERT SIDDOWAY
Chief Executive Officer
01/01/1980
400SR2642
MATHEWS, THOMAS JESS
President
03/14/2011
WIED, JOHN MACMURTRIE
Secretary
03/14/2011
ST PAUL FIRE a
MARINE INS CO
REID, WILLIAM TODD
Vice President
03/14/2011
FORSTER, ROBERT D
Secretary
01/01/1980
03/14/2011
RICE, M BURKE
Treasurer
01/01/1980
03/14/2011
Bond Information
Page 1 of 2
Bond
Bond Company Name
Bond Account Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Bond Amount
Received Date
3
TRAVELERS CAS &
SURETY CO
400SR2642
03/01/2008
Until Cancelled
$12,000.0002/19
/2008
2
ST PAUL FIRE a
MARINE INS CO
400SR2642
03/01/2002
03/01/2008
$12,000.0002/19
/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
8
ZURICH
AMERICAN INS
CO
GLA3999943
03/01/2009
03/01/2012
$1,000,000.0002
/24/2011
7
NATIONAL
UNION FIRE INS
OF PA
GL1617535
03/01/2008
03/01/2009
$1,000,000.0002
/28/2008
6
NATIONAL
UNION FIRE INS
GL1798569
03/01/2008
03/01/2009
$1,000,000.00
02/11/2008
https://fortress.wa.gov/lni/bbip/Print.aspx
09/27/2011
0
CITY OF TUKWILA
Department of Community Development
6300 Southcenter Boulevard, Tukwila, WA 98188
Telephone: (206) 431 -3670 FAX (206) 431 -3665
E -mail: tukplanOci.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 )
[please print name]
, states as follows:
PERMIT Nth 1211-27tU
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 requirem t of RCW 18.27.090,
I consider the work authorized under this permit to be exempt under number , 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 construction work.
Signed and sworn to before me this
day of Se n/I Ger , 201 .
ARY PUBLIC in and for the State of Washington
Residing at
(V7 , County
Name as commissioned: ' _tine fie✓%
My commission expires: 05--01-q-/(/
18,27.090 Exemptions. The regtion provisions of this chapter do not apply.
1. An authorized representative of the United States
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;
z. 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;
9. 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
by a registered contractor;
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
twelve 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;
13. 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;
15. 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 trical.contractor s
license under chapter 19.28 RCW'thateipploys a certified
journeyman electrician,, a!CeFtifiedresideatial;specialty
electrician, or an elect:414l t*inee'meetingithe=.
requirements of chapter• & 8 RCW to perform plumbing
work that is incidentally, directly, and immediately
appropriate to the like -in -kind replacement of a`•household
appliance or other small household utilisation equipment
that requires limited ele'c ie;power and 'limited waste
r..i,r
and /or water connections:An'electrigal 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.