HomeMy WebLinkAboutPermit D11-391 - INDIAN CHURCH OF GOD - REROOFINDIAN
CHURCH OF GOD
14275 INTERURBAN AV S
D11 -391
City olif 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.: 3365901440
Address: 14275 INTERURBAN AV S TUKW
Suite No:
Project Name: INDIAN CHURCH OF GOD
Permit Number: D11 -391
Issue Date: 12/12/2011
Permit Expires On: 06/09/2012
Owner:
Name: MATHEW WILSON +JESSIE K
Address: 4830 S 152ND ST , TUKVVILA WA 98188
Contact Person:
Name: VINCE CHRISTIANSON
Address: 823 SW 152 ST , BURIEN WA 98166
Contractor:
Name: SOUND ROOF SERVICES INC
Address: 18908 HWY 99 SUITE B , LYNNWOOD WA 98036
Contractor License No: SOUNDRS932J3
Phone: 206 715 -3003
Phone: 425 - 672 -4730
Expiration Date: 04/23/2013
DESCRIPTION OF WORK:
REPAIR PERMIT: REROOF COMPOSITION ROOF WITH SAME AND INSTALL NEW GUTTER
Value of Construction: $8,500.00 Fees Collected: $264.20
Type of Fire Protection: International Building Code Edition: 2009
Type of Construction: VB Occupancy per IBC: A3
Electrical Service Provided by: PUGET SOUND ENERGY
* *continued on next page **
doc: IBC -7/10
D11 -391 Printed: 12 -12 -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 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 do s not presume to give authority to violate or cancel the provisions of any other state or local laws regulating
construction or t e perf an e of work. I am authorized to sign and obtain this development permit and agree to the conditions attached
to this permit.
Signature: Date: I Z
Print Name:
U1 bkiiA I 44t\SSOcNi
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:
doc: IBC -7/10
D11 -391 Printed: 12 -12 -2011
CITY OF TUK
Community Develop Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
CONSTRUCTION PERMIT APPLICATION
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 Address: 6 115 -�—~i-- Uf11S 1 7,442-
Tenant Name:
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Tukwila Business License No.: C0521) p j
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King Co Assessor's Tax No.:
Suite Number: Floor:
New Tenant: ❑ Yes ❑.. No
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Page 1 of 4
rrirW"DIN = 06T01f367 j
Valuation of Project (contractor's bid pr. $ (354)(3
Describe the scope of work (please provide detailed information):
Existing ilding Valuation: $
S-r 1( (4‘.4_ r(E 4—
Will there be new rack storage? ❑ ....Yes
❑ ..No If yes, a separate permit and plan submittal will be required.
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PLANNING DIVISION:
Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot 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:
Will there be a change in use?
❑ Yes
Compact: Handicap:
❑ 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 ' tkpplications'Forms- Applications On Line12011 Applications\Permit Application Revised - 8- 9.11.docx
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Page 2 of 4
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.
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).
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY T E LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER 0
Signature:
Print Name:
VtiA/ tAs•
Mailing Address:
ED AGENT:
J
&t4 PI
Date: Ill
Day Telephone:
City
H:WpplicationsTorms- Applications On Line \2011 Applications\Permit Application Revised - 8- 9- 11.docx
Revised: August 2011
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State Zip
Page 4 of 4
•
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.TukwilaWA.gov
RECEIPT
Parcel No.: 3365901440 Permit Number: D11 -391
Address: 14275 INTERURBAN AV S TURIN Status: APPROVED
Suite No: Applied Date: 12/12/2011
Applicant: INDIAN CHURCH OF GOD Issue Date:
Receipt No.: R11 -02702
Initials:
User ID:
Payee:
JEM
1165
Payment Amount: $264.20
Payment Date: 12/12/2011 12:13 PM
Balance: $0.00
VINCE J CHRISTIANSON
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd VISA
Authorization No. 01523D
ACCOUNT ITEM LIST:
Description
264.20
Account Code Current Pmts
BUILDING - NONRES
STATE BUILDING SURCHARGE
000.322.100 259.70
640.237.114 4.50
Total: $264.20
doc: Receiot -06 Printed: 12 -12 -2011
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INSPECTION RECORD 171/-37/ Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 1•L, (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
1t+►h Chi4
P.A.
ess:
Inspection:
d e/
' d4 d
�
bate Called:
Special Instructions:
•
Date Wanted:
� ---14 /� A
Requester:
Phone No:
Ilkppreved per applicable codes.
ElCorrections required prior to approval. 1
COMMENTS:
(9k 7 P;)70./
REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
. paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
4
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
PERMIT N .
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 I�^(206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
Project: ,, ,,, / ^�'
�,� C.,1lsi,aCrf -t'T
Type of I ection:
Ar�29 4
Address: �����w �
Date Called:
����JJ
Special Instruct oni" s:
Date Wanted
Requester:
Phone No:
Approved per applicable codes. O Corrections required prior to approval.
COMMENTS:
La/
..erz.eff
/00/'„ rA(74'
Goof
ri REINSPECTION FEE I QUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Contractors or Tradespeople P;ter Friendly Page
•
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 SOUND ROOF SERVICES INC UBI No. 602709020
Phone 2066724730 Status Active
Address 18908 Hwy 99 Ste B License No. SOUNDRS932J3
Suite /Apt. License Type Construction Contractor
City Lynnwood Effective Date 4/23/2007
State WA Expiration Date 4/23/2013
Zip 98036 Suspend Date
County Snohomish Specialty 1 Roofing
Business Type Corporation Specialty 2 Unused
Parent Company
Business Owner Information
Name
Role
Effective Date
Expiration Date
STOREY, BRIAN D
President
04/23/2007
Amount
WILLIAMS, MICHAEL JAMES
Vice President
04/23/2007
FMWA002231
Bond Information
Page 1 of 1
Bond
Bond Company Name
Bond Account Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Bond Amount
Received Date
1
DEVELOPERS SURETY
& INDEM CO
746471C
04/17/2007
Until Cancelled
$12,000.00
04/23/2007
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
5
First Mercury
Ins Co
FMWA002231
04/17/2011
04/17/2012
$1,000,000.0004
/14/2011
4
FIRST MERCURY
INS CO
FMWA001302
04/17/2010
04/17/2011
$1,000,000.0004
/15/2010
3
FIRST MERCURY
INS CO
FMWA0001212
04/17/2009
04/17 /2010
$1,000,000.00
04/15/2009
2
MERCURY
NS
FMWA000121
FMWA000121
04/17/2008
04/17 /2009
$1,000,000.00
04 /10/2008
1
FIRST MERCURY
INS CO
FMFL002696
04/17/2007
04/17/2008
$1,000,000.00
04 /23/2007
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
12/12/2011