HomeMy WebLinkAboutPermit M11-004 - LARSON RESIDENCECARSON RESIDENCE
14224 55 AV S
M11-004
City ofkukwila
•
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.ci.tukwila.wa.us
MECHANICAL PERMIT
Parcel No.: 3365900119
Address: 14244 55 AV S TUKW
Project Name: LARSON RESIDENCE
Permit Number: M11 -004
Issue Date: 01/10/2011
Permit Expires On: 07/09/2011
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Email:
Contractor:
Name:
Address:
Contractor License No:
LARSON DAVID V
14244 55TH S , TUKWILA WA 98168
DAVID LARSON
14244 55 AV S , TUKWILA WA 98168
DLARSON @CI. TUKWILA. WA. US
Phone: 206 799 -7892
OWNER AFFIDAVIT - DAVID V LARSON Phone:
Expiration Date:
DESCRIPTION OF WORK:
FURNACE CHANGE OUT
Value of Mechanical: $2,000.00
Type of Fire Protection: SMOKE DETECTORS
Permit Center Authorized Signature:
Fees Collected: $167.70
International Mechanical Code Edition: 2009
Date: Oil 101 ( I
I hereby certify that I have read and xaed this permit and know the same to be true and correct. All provisions of law and ordinances
governing this work will be complie wit 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 mechanical permit and agree to the conditions on the
back of this permit.
Signature:
Print Name:
Date: "—Val/
/
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: IMC -4/10
M11-004 Printed: 01 -10 -2011
• •
PERMIT CONDITIONS
Permit No. M11 -004
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: Manufacturers installation instructions shall be available on the job site at the time of inspection.
5: Except for direct -vent appliances that obtain all combustion air directly from the outdoors; fuel -fired appliances
shall not be located in, or obtain combustion air from, any of the following rooms or spaces: Sleeping rooms,
bathrooms, toilet rooms, storage closets, surgical rooms.
6: Equipment and appliances having an ignition source and located in hazardous locations and public garages, PRIVATE
GARAGES, repair garages, automotive motor -fuel dispensing facilities and parking garages shall be elevated such that
the source of ignition is not less than 18 inches above the floor surface on which the equipment or appliance rests.
7: Water heaters shall be anchored or strapped to resist horizontal displacement due to earthquake motion. Strapping shall
be at points within the upper one -third and lower one -third of the water heater's vertical dimension. A minimum
distance of 4- inches shall be maintained above the controls with the strapping.
8: 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).
9: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building
Department (206- 431 - 3670).
10: 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: IMC -4/10
M11-004 Printed: 01 -10 -2011
CITY OF TUKW
Community Develo41111nt Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
htto://Www.ci.tukwila.wa.us
Mechanical I it No. M `\
Project No.
(For office use only)
MECHANICAL 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 LOCATION
7!� King Co Assessor's Tax No.: 33,6 5 9'o - O/l /
21
Site Address: / 299 - >, rA ,dc?_ S Suite Number: Floor:
Tenant Name: att., e_ ! . , C124 New Tenant: ❑ Yes K. No
Property Owners Name:
Mailing Address:
State Zip
CONTACT PERSON — who do we contact when your permit is ready to be issued
Name:
Day Telephone: 27,6— "7 .709
Mailing Address:
E -Mail Address:
City
Fax Number:
State
Zip
MECHANICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
Contractor Registration 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:
Fax Number:
E -Mail Address:
State
Zip
ENGINEER OF RECORD — All plans must be stamped by engineer of record
Company Name:
Mailing Address:
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
State
Zip
H:\Applications\Forms- Applications On Line \2010 Applications \7 -2010 - Mechanical Permit Application.doc
Revised: 7 -2010
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Page 1 of 2
Valuation of project (contractor's bid pr ce : $
Scope of work (please provide detailed information):
Use: Residential: New ❑ Replacement ❑
Commercial: New ❑ Replacement ❑
Fuel Type: Electric ❑ Gas
Other:
Indicate type of mechanical work being installed and the quant'ty below:
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Bioler /Compressor
Qty
furnace <100k btu
i
air handling unit
>10,000 cfm
fire damper
0 -3 hp /100,000 btu
furnace >100k btu
evaporator cooler
diffuser
3 -15 hp /500,000 btu
floor furnace
ventilation fan connected
to single duct
thermostat
15 -30 hp /1,000,000
btu
suspended/wall/floor
mounted heater
ventilation system
wood/gas stove
30 -50 hp /1,750,000
btu
appliance vent
hood and duct
emergency
generator
50+ hp /1,750,000 btu
repair or addition to
heat/refrig/cooling system
Incinerator – domestic
other mechanical
equipment
air handling unit <10,000
cfm
incinerator – comm/ind
PERMIT APPLICATION NOTES -
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 extension of time for additional periods not to exceed 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 THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWN
Signature:
R AUTHORI D AGE
.
Print Name: /`/ C�
Mailing Address:
Date: /—/0–//
[/ –/
Day Telephone:
Date Application Accepted:
City
State
Zip
Date Application Expires:
H: Applications \Forms - Applications On Line\2010 Applications \7 -2010 - Mechanical Permit Application,doc
Revised: 7 -2010
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Staff Initials:
Page 2 of 2
1
•
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: htqx//www.ci.tukwila.wa.us
Parcel No.: 3365900119
Address: 14244 55 AV S TUKW
Suite No:
Applicant: LARSON RESIDENCE
RECEIPT
Permit Number: M11 -004
Status: APPROVED
Applied Date: 01/10/2011
Issue Date:
Receipt No.: RI 1 -00035
Payment Amount: $167.70
Initials: JEM Payment Date: 01/10/2011 09:07 AM
User ID: 1165 Balance: $0.00
Payee: DAVID V LARSON
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd VISA
Authorization No. 00565C
ACCOUNT ITEM LIST:
Description
167.70
Account Code Current Pmts
MECHANICAL - RES
000.322.102.00.00 167.70
Total: $167.70
doc: Receiot -06 Printed: 01 -10 -2011
•
INSPECTION RECORD A�
Retain a copy with permit / "i li"
'
GTIONO. PERMIT NO.
"N
CITY OF TUKWILA BUILDING DIVISION le-
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Project: %j-''�
. Lot, Gce illie-501
Type of Inspection:
ri., R r. et, ,-.1-,,
Address: j
Date Calle :
Special Instructions:
Date Wanted:
�
/m
p.m.
Requester:
Phone No:
Opproved per applicable codes. Corrections required prior to approval.
COMMENTS:
491 t
F
$60.00 RENQSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
06 -01 -2011
City of Tukwila
Jim Haggerton, Mayor
Department of Community Development Jack Pace, Director
DAVID LARSON
14244 55 AV S
TUKWILA WA 98168
RE: Permit No. M11 -004
14244 55 AV S TUKW
Dear Permit Holder:
In reviewing our current records, the above noted permit has not received a final inspection by the City of
Tukwila Building Division. Per the International Building Code, International Mechanical Code, Uniform
Plumbing Code and/or the National Electric Code, every permit issued by the Building Division under the
provisions of these codes shall expire by limitation and become null and void if the building or work authorized
by such permit has not begun within 180 days from the issuance date of such permit, or if the building or work
authorized by such permit is suspended or abandoned at any time after the work has begun for a period of 180
days. Your permit will expire on 07/09/2011.
Based on the above, you are hereby advised to:
1) Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 to schedule for the next or final
inspection. Each inspection creates a new 180 day period, , provided the inspection shows progress.
-or-
2) Submit a written request for permit extension 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.
The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is
determined that your extension request is granted, you will be notified by mail.
In the event you do not call for an inspection and /or receive an extension prior to 07/09/2011, your permit will
become null and void and any further work on the project will require a new permit and associated fees.
Thank you for your cooperation in this matter.
Sincerely,
c
Bill Rambo
Permit Technician
File: Permit File No. M11 -004
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
•
CITY OF TUKWILA
Department of Community Development
6300 Southcenter Boulevard, Tukwila, WA 98188
Telephone: (206) 431-367o FAX (206) 431 -3665
E -mail: tukplanoci.tukwila.wa.us
1
Permit Center /Building Division
206 431 -3670
Public Works Department
206 433 -0179
Planning Division
206 431 -3670
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
PERMIT NO: M I 0 Oel
STATE OF WASHINGTON)
) ss.
COUNTY OF KING )
Da Vi r/( v, 2,:e7IS'Q/.2states as follows:
[please print name]
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 J 2, 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.
4111
Owner Owner's Agent*
Signed and sworn to before me this
l 0 day of \� v I l t vL , 20 I I .
NOT ' Y PUBLIC in and for the State of Washington
Residing at XlJl
County
Name as commissioned: ,(,(,{!) ' A'1,0tir k
My commission expires: 05--A4 y
18.27.090 Exemptions, The region provisions of this chapter do not apply to
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;
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;
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;
it 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 w}wti h l a valid _elect ica1 contractor's
license under chap er i9.28 RCWgthht employs a certified
journeyman el`ectr 4n, a certified residential specialty
electrician, orlan electrical trainee`riieetiilg the
requirements of'g'apter 19.28 RCW to perform plumbing
work that is incidntally, directly, a31t�'immediately
appropriate to the, hke-in- kind,re ilaceinent of a household
appliance or other r'ssiil householktitilization 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.