HomeMy WebLinkAboutPermit M11-129 - KELLER ADDITIONKFI.I.F,R ADDITION
13338 34 AV S
Mi 1 -129
City GlOrukwila
•
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
MECHANICAL PERMIT
Parcel No.: 7358600115
Address: 13338 34 AV S TUKW
Project Name: KELLER ADDITION
Permit Number:
Issue Date:
Permit Expires On:
M11 -129
09/22/2011
03/20/2012
Owner:
Name: KELLER DANIEL J JR
Address: 13338 34TH AVE S , TUKWTLA WA 98168
Contact Person:
Name:
Address:
Email:
DANIEL J KELLER
13338 34 AV S , TUKWILA WA 98168
CLOCKREPAIRMAN AOL.COM
Contractor:
Name: OWNER AFFIDAVIT - DANIEL J KELLER
Address:
Contractor License No:
Phone: 206 327 -7000
Phone:
Expiration Date:
DESCRIPTION OF WORK:
INSTALL WOOD STOVE IN NEW ADDITION (WAS INSTALLED IN HOME SINCE 2000)
Value of Mechanical: $1,200.00
Type of Fire Protection: SMOKE DETECTORS
Electrical Service Provided by:
Permit Center Authorized Signature:1
I hereby certify that I have read an
governing this work will be complie
Fees Collected: $209.63
International Mechanical Code Edition: 2009
Date:
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 p
construction or the performance of work
back of this permit.
Signature: lJ0
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 mechanical permit and agree to the conditions on the
Print Name:
Date:
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 -129 Printed: 09 -22 -2011
•
PERMIT CONDITIONS
Permit No. M11-129
1: ** *BUILDING DEPARTMENT CONDITIONS * **
2: No changes shall be made to the approved plans unless approved by the design professional m 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: Manufacturers installation instructions shall be available on the job site at the time of inspection.
6: 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 -129 Printed: 09 -22 -2011
CITY OF TUKVl4
Community Deve /o ent Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http: / /www.TukwilaWA. clov
/
Mechanical liit No. I vl
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
Site Address:
333 3 (/Mti 4 e
57
King Co Assessor's Tax No.: ! 14R D-- O `t s-
Suite Number: Floor: %
Tenant Name: ?,,, ; r l J /i'- /lam r New Tenant: ❑ Yes O. No
Property Owners Name:
Mailing Address:
Sct
City
State
Zip
CONTACT PERSON — who do we contact when your permit is ready to be issued
Name: 2)G etl ( J Ice
Mailing Address: % 33 3 g 3 y/4 - ;
E -Mail Address: C /o c k reps i r t/-70 C- "Pi
Day Telephone: .706 — 3 27 -706 0
City
State Zip
Fax Number:
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: J e IF
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: ca- I
Mailing Address:
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
State
Zip
H:\Applications\Porms- Applications On Line\2010 Applications \7 -2010 - Mechanical Permit Application.doc
Revised: May 2011
bh
Page 1 of 2
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Valuation of project (contractor's bid price): $ /2. (f 1, -/ Q g
Scope of work (please provide detai led information): ( (/ G oe g- c-/ % e ) C ([1-, O N /
l-JR S �w 5't !(mac , V /-�o Ai es; SdNc
•2 060
Use: Residential: New ❑ Replacement
Commercial: New ❑ Replacement ❑
Fuel Type: Electric ❑
Gas ❑
Other: LA) 00 0
Indicate type of mechanical work being installed and the quantity below:
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Bioler /Compressor
0 -3 hp /100,000 btu
Qty
furnace <100k btu
air handling unit
>10,000 cfm
fire damper
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 o()�VNE�THORI�� T:
Signature: ����``//jj q /
Print Name: DG rsl se 1 J r`'Q / �(.Q ✓ J r . Day Telephone: 2 o6 " 3 2 7 - 7 d D C)
Mailing Address: (3j5 7 3'/M gcp.e .5d, 7,kJ(4 • tJa . City te
Date: 7- /3- /
Zip
IDate Application Accepted:
1
P of 2
oitkv2,1
Date Application Expires: o J `t 2I I z.
Staff Initials:
H.1ApplicationslForms- Applications On Line \2010 Applications \7 -2010 - Mechanical Permit Application.doc
Revised: May 2011
bh
• i
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
Parcel No.: 7358600115
Address: 13338 34 AV S TUKW
Suite No:
Applicant: KELLER RESIDENCE
RECEIPT
Permit Number: M11 -129
Status: PENDING
Applied Date: 09/13/2011
Issue Date:
Receipt No.: R11 -02009
Payment Amount: $209.63
Initials: JEM Payment Date: 09/13/2011 04:17 PM
User ID: 1165 Balance: $0.00
Payee: DANIEL j KELLER, JR
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 15850 209.63
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
MECHANICAL - RES
PLAN CHECK - RES
000.322.102.00.00 167.70
000.345.830 41.93
Total: $209.63
doc: Receiot -06 Printed: 09 -13 -2011
3
INSPECTION' RECORD /� /Z
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 lit (206) 431 -3670 .
Permit Inspection Request Line (206) 431 -2451
Project: /
en
Type of Inspon:� l )7G
Alle41.,
Addre 3,3 36 `39
ate Called:
Special Instructions:
Date Wanted:
.... ply_ / ?
a
Requester:
Phone No:
pproved per applicable codes. El Corrections required prior to approval.
COMMENTS:
).7
pt-Artz., U 11
REINSPECTION FEE REV RED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Date:
2_..
INSPECTION RECORD
Retain Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 31 -3670
Permit Inspection Request Line (206) 431 -2451
Proj c • ,
�eR A88tr 7 acv
Type of Inspecti n•
OW `k rep ACC
Add ess: eti•
1 ` 1� �/ 34 Atfc,
bate Called:
6 k Woo A s _.
Special Instructions:
0"; g3ell-f -c (2$
Date Wanted:. a.m.
3 -/(P -(Z._
Requester: I
ro:A �
Phone
0(0 - 327 -'7oco
❑ Approved per applicable codes.
COMMENTS:
Corrections required prior to approval.
s Pro'
� s--
eboi,61 549.)e__
n REINSPEECCTION FEE REQITIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
SPE TIO
IN (/ N NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 A (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
INSPECTION RECORD
Retain a copy with permit
• • r „
PERMIT NO.
Project:
�_'�"
Type of Inspection •
Address:
Date Called:
Special Instructions:
3 P/c/( )
Date Wan ed:
17
a.m.
Requester:
Phone No:
54 Approved per applicable codes.
COMMENTS:
OCorrections required prior to approval.
.4
Inspecto
ri REINSPECTION FEE R
paid at 6300 Southcent
Date. ?...291../4/
UIRED. Prior to next inspection. fee must be
Blvd., Suite 100. Call to schedule reinspection.
bing
ukwffa
DIVISION
1Q'
�o, �, tat rVO rr,
E COPY
A/ 11-12)1
kko Pitt No.
Plan review approval subject to emus and off.
Approval of documents does not authorize
th,: violation of any : ; opted code or ordnance. Receipt
W ° of approved Reki and oondlions is
at
By *0 . „
-�Z -,f
REVIEvvED FOR
CODE COMPLIANCE
APPROVED
SEP 2 1 2011
TA-
City of T
BUILDING
CCo Zo=o„
Of Tukwila
BUI ING DIVISION
1/(n,f4,0
L-0
[C syzxvciue
/0 roved
Q2401 kebuc Lt
tocle 14a h
-o
3050 VS
3oSo Vs
•
45 -l0"
REVISIONS
No changes shall be made to the scope
of work without prior approval of
Tukwila Building Division. w
NOTE: Revisions will require a new plan submittal
and may include additional plan review fees.
CRY OF TUKNALA
MAY 27 2011
PERMIT CENTER
SCALE :
DATE:
/-)t))- cnorf •
/3,33.A1 34 40c
DRAWING NUMBER
SEPARATE PERMIT
REQUIRED FOR:
❑ Mechanical
Electrical
Plumbing
Gas Piping
City of Tukwila
BUILDING DIN/ S1 A
RECEIVE
C1TY OF TUKWWLA
SEP 1 2011
PERMIT CENTER
M -12-1
BUILT
CHIMNEY
/-A i i� 9 c, r" CIA MAR S 41C)S
A
3k--.:411 iti rs De.:: h k 1,1,11 per c.--14r,
5Psci
himney Cap
(See the section "Chimney
Termination Requirements"
for more details)
Chimney Sections
•
is
Cao,011. / / sk l44,4
mQriu/4 Yd l% c4h4,
opt° mu,?-
A.Atei/e7,5 p'-do
raVent.
Roof Support
Designed to support DuraTech chimney. Allows chimney to
pass through the roof and extend down from ceiling. Ideal
for cathedral ceilings and free standing fireplaces.
Adjustable to different roof pitches. Supports max total
chimney length of 445' & 20' chimney below roof support.
LiAt
l-A
Pad a lot 1t fie)
J s y rGa�
DVL Telescoping
Length
Allows one -piece installation
from stove to ceiling support
box or finishing collar. Easy
to Install. No cutting required.
or 48° -
88 °.
Attoi-k.
RE EIV
CITY OF TUKVVILA
SEP 13 2011
EP ERMIT CENTER
Stove Clearances
(See the section "Stove
Placement Requirements"
for more details)
CYO
N CTOR
Minimum 15'
Maximum 33
M l'e\
STOVE INSTALLATION (CONT.) PAGE 9
CHIMNEY TERMINATION REQUIREMENTS ==-
• Must have an approved cap (to prevent water from entering)
• Must not be located where it will become plugged by snow or other material
• Must terminate at least 3' above the roof and at least 2' above any portion of the roof within 10'
Slanted Roofs
Chimney must
extend 3'
above the roof
Fiat Roofs
Chimney must extend 2'
above any portion of the roof
within 10' of the chimney
Chimney must
extend 3'
above the roof
Chimney must extend 2'
above any portion of the roof
within 10' of the chimney
0 Vier- ; LVi11 rk +c•D jJ ji
c1 / ?(c�tike. 1 a Cft to 1P0'
- A II pipe 6-1,„witi; 7 ed
'J
014.35 orci plus' 4Ple4rnl
E X 1eridr Qrede.. (J i• -.
City I ,p IN
G DIVISION
Tukwila
LISTING INFORMATION
Warnock Hersey
wL..7. 1. 10
Report 476 -1054 (Aug 94)
DO NOT REMOVE THIS LABEL
CONTACT LOCAL BUILDING OR FIRE OFFICIALS ABOUT
INSTALLATION AND RESTRICTIONS IN YOUR AREA.
LISTED SOLID FUEL BURNING APPLIANCE SUITABLE FOR USE IN
RESIDENTIAL, ALCOVE AND MOBILE HOME INSTALLATIONS.
MODEL:
PATRIOT
TESTED TO UL 1482 AND RELEVANT
PORTIONS OF UL 127.
SERIAL
NUMBER
PREVENT HOUSE FIRES - Install and use only in accordance with the manufacturer's installation and operating instructions. Contact
your local building or fire officials about restrictions and installation inspection in your area. Refer to local building codes and
manufacturer's instructions for precautions required tor passing a chimney through a combustible wall or ceiling. Do not run a
chimney connector through a combustible wall or ceiling. Do not connect this unit to a chimney Ilue serving another appliance.
Clearances may be reduced by methods specified in NFPA 211 • listed wall shields, pipe shields. or other means approved by local
building or lire officials. For use with solid wood fuel only (cord wood). Operate with teed door closed - open to feed tire only. Do not
use a grate to elevate fire - build lire directly on hearth.
FREESTANDING INSTALLATION
STANDARD RESIDENTIAL FREESTANDING INSTALLATIONS REQUIRE: 6 diameter. minimum 24 MSG black or 25 7ASG blued steel
connector, with listed (type NT) factory -built chimney. suitable for use with solid fuels or masonry chimney.
ALCOVE INSTALLATIONS REOUIRE: One of the Listed doublewall connectors listed below. Maximum alcove depth 48, minimum
alcove height 84 ".
MOBILE HOME INSTALLATIONS REQUIRE: One of the Listed doublewall connectors listed below. Mobile home installations also
require outside an - use the Lop, optional outside air boot.
DOUBLEWALL CONNECTORS
• DURAVEN1 model DVL with DURA -PLUS chimney
• AMERI -TEC model DCC with model H5 chimney
• SECURITY model OP with SECURITY model ASHT or S2100 chimney
• GSI0 model Super Chimney Twenty -One connected directly to appliance
• SELKIRK METALBESTOS model DS connector with model SSII chimney
CLEARANCE
RECU:REMENTS:
STANDARD RESIDENTIAL
INSTALLATION (SINGLEWALL
CONNECTOR)
MOBILE HOME AND ALCOVE
INSTALLATIONS
(DOUBLE WALL CONNECTOR)
A. SIDEWALL TO UNIT
13'
18'
B. BACKWALL TO UNIT
13'
10.S-
C. CORNERWALL•TO UNIT
10'
10'
0. SIDEWALLTDCOt:ECTCR
27'
26.5 -
E. BACKWALL TO CONNECTOR
19'
11'
F. CORNERWALL TO CONNECTOR
17.75-
17.25
timiLlUIt CLEARANCES TO CU..RUSTI0L ES•
OACKWALL
is
7LOGP P0O'ECT0R
16 1.1111.
OPTIONAL EQUIPMENT: Rear Blower
Electrical rating: 115V, 60 Hz., 1.8 Amps
Replace glass only with LOPI supplied NEOCERAM
ceramic glass (5mm).
Llanulacturcd By v v
s4•Travis Industries,Inc.
10850 117th PI. N.E. Kirkland. WA 98033
U.S. ENVIRONMENTAL PROTECTION AGENCY
Certified to comply with July 1990 particulate emission standards.
DATE OF MANUFACTURE
1998 1999 2000 Jan. Feb. Mar. Apr. May
■ III ®® ®e ■■
June July Aug.
• • •
Sep. Oct. Nov. Dec.
• • • •
REVIE )p� Co Ap �R
APp�0��� SCE
SEP 2Z 2011
SOLO Hof Tukwila
STOVE INSTALLATION
STOVE PLACEMENT REQUIREMENTS
HINT: REDUCING CLEARANCES - Clearances may be reduced i methods specified in
NFPA 211, listed wall shields, pipe shields, or other means approve4by local
building or fire officials. L..::
• Stove must be placed so that no combustibles are within, or can swing within (e.g. drams,
doors), 36" of the front of the stove
• If the stove is placed in a location where the ceiling height is less than 7', it must follow the
requirements in the section "Alcove Installation Requirements"
• Must maintain the following clearances to combustibles (drywall, furniture, etc.):
Minimum Clearance
(See the illustration below)
Singlewall
Connector
Reduced
Clearance E
A Sidewall to stove
18"
18 "i COD
B Backwall to stove
18"
10 /2"
C Cornerwall to stove
10"
10"
D Connector to sidewall
27"
26 1/2" 5
E Connector to backwall
19"
111
F Connector to cornerwall
17 3/4"
17 /4"
VIEWED FOR
E COMPLIANCE
PPROVED
EP 2 1 2011
STRAIGHT
INSTALLATION
CORNER
INSTALLATION
Ci1v of TukRI
BUILDING DIVISIO
NOTE: Measure rear clearances from the edge of the stove top, not the rear heat shield.
Reduced clearance installations require one of the chimneys .& connectors below:
• DURAVENT model DVL with DURA -PLUS chimney • AMERI -TEC model DCC with model HS chimney
• SECURITY model DP with SECURITY model ASHT or S2100 chimney • GSW model Super Chimney Twenty One connected directly to appliance
• SELKIRK METALBESTOS model DS connector with model SSII chimney • I.C.C. Excel BIGHT Chimney with Ultrablack HP Double -Wall connector
• Standard Masonry Chimney with any one of the above listed connectors
FLOOR PROTECTION REQUIREMENTS
• Must be non - combustible and at (east
.018" thick (26 gauge)
• Must extend 6" to the side (measure
from the side of the stove, not the stove
top)
• Must extend 6" to the rear (measure
from the stove top, not the heat shield)
• Must extend 16" from the front
(measure from the faceplate)
• Minimum 36 5/8" deep by 33 3/8" wide
1
6" Minimum
(from side of stove,
not stove top)
Floor Protection
(Minimum .018" thick)
YY:r .6„t nnlmin' - f
(from stove',1top) X
,
4
. .
.34
• }
tiiea
u to •
`� x z r 16' Mlnlmum
-e lane
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a(a. x A l „ ^n�'} r 5 YA. A
1
ML, A) -(2) 114;.vi !nu tri e(64a wCE'
ry ( riq fer ; or •v 5-14 A Povti
REVIEWED FOR
ODE COMPLIANCE
APPROVED
SEP 21 2011
City of Tukwila
BUILDING DIVISION
Nc W4 01 she /IA; •v y 'ey0t' c9
As Reducvci( (i,eet- e
064,1, p p
used
z.
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C ievt-t A v•dc- e C
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I gab
d. ear e10c e
08 -01 -2012
City of Tukwila
Department of Community Development
DANIEL J KELLER
13338 34 AV S
TUKWILA WA 98168
RE: Permit No. M11 -129
KELLER ADDITION
13338 34 AV S TUKW
Dear Permit Holder:
Jim Haggerton, Mayor
Jack Pace, Director
In reviewing our current records, the above noted permit has not received a fmal 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 09/15/2012.
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 fmal 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 09/15/2012, 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,
File: Permit File No. M11 -129
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone 206 -431 -3670 • Fax 206 -431 -3665
City of Tukwila
Jim Haggerton, Mayor
Department of Community Development Jack Pace, Director
DANIEL J KELLER
13338 34 AV S
TUKWILA WA 98168
RE: Permit No. M11 -129
KELLER ADDITION
13338 34 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 03/20/2012.
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 03/20/2012, 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,
er Marshall
t Technician
File: Permit File No. M11 -129
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
HERMIT COORD COPAN
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: M11 -129
PROJECT NAME: KELLER ADDITION
DATE: 09/13/11
SITE ADDRESS: 13338 34 AV S
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # Revision # after Permit Issued
DEPARTMENTS: ct434
Building Division
Public Works
AIM )1 ik lie
Fire Prevention
Structural
Planning Division
Permit Coordinator
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete V
Incomplete
DUE DATE: 09/15/11
Not Applicable
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES/THURS ROUTING:
Please Route
Structural Review Required n No further Review Required
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS:
Approved
Notation:
REVIEWER'S INITIALS:
Approved with Conditions
DUE DATE: 10/13/11
Not Approved (attach comments) ri
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
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Documents /routing slip.doc
2 -28 -02
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City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Web site: http: / /www.TukwilaWA.gov
STATE OF WASHINGTON )
COUNTY OF KING )
ss.
K I C€1
[please print]
7AFFIDAVIT IN LIEU OF
CONTRACTOR
REGISTRATION
PERMIT NO.:
, states as follows:
1. I have made application for a building 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 building 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 re 'station requirement of RCW 18.27.090, I consider the work authorized under this building permit
to be exempt under No. , and will therefore not be performed by a registered contractor.
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.
APPLICANT
Signed and sworn to before me this l,,n
CA day of ep/?/ WtJ�V , 20 11 .
NOTARY PUBLIC in and for the State of Washington,
Residing at
Name as commissioned:
, County.
)14,,cA/vi (-"Obk-
My commission expires: 6 OJ (� J c)-0//
H:IApplicationslFotms- Applications On Line12009-08 Affidavit in Lieu of Contractor Registration.doc
Revised: May 2011
18.27.090 Exemptions. This chapter shall not apply to:
1.
2. 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;
3. Officers of the court when they are acting within the
scope of their office;
4. Public utilities operating under the regulations of the
utilities and transportation commission in construction,
maintenance, or development work incidental to their
own business;
5. 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;
6. The sale or installation of any finished products,
materials, or articles of merchandise which are not
actually fabricated into and do not become a permanent
fixed part of the structure;
7. Any construction, alteration, improvement or repair of
personal property, except this chapter shall apply to all
mobile, manufactured housing. A
mobile /manufactured home may be installed, set up, or
repaired by the registered or legal owner, by a
contractor licensed under this chapter, or by a
mobile /manufactured home retail dealer or
manufacturer licensed under chapter 46.70 RCW;
8. 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;
9. 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;
10. Any work or operation on one undertaking or project
by one or more contractors, the aggregate contract price
of which for labor and materials and all other items is
less than $500.00, such work, or operations being
considered as of a casual, minor, or inconsequential
nature. The exemption prescribed in this subsection
does not apply in all 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
H:Wpplications \Forms - Applications On Line12009-08 Affidavit in Lieu of Contractor Registration.doc
Revised: May 2011
operation is made into contracts of amounts less than
$500.00 for the purpose of the 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 is a contractor, or that he
is qualified to engage in the business of contractor;
11. 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 then any
of the above work is performed by a registered
contractor;
12. An owner who contracts for a project with a registered
owner;
13. Any person working on his own property, whether
occupied by him or not, and any person working on his
residence, whether owned by him or not but his
exemption shall not apply to any person otherwise
covered by this chapter who constructs an improvement
on his own property with the intention and for the
purpose of selling the improved property;
14. Owners of commercial properties who use their own
employees to do maintenance, repair, and alteration
work in or upon their own properties;
15. A licensed architect or civil or professional engineer
acting solely in his professional capacity, an electrician
licensed under the laws of the state of Washington, or a
plumber licensed under the laws 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 licensee is
operating within the scope-601s license;
16. Any person who ep Oges .ice tbe, activities herein
regulated as an' erpplriyee -of a •riegirtered contractor
with wages as fiiisple compensation;;
17. Contractors ori:Ighway: projects who have been
prequalified as recjuired jby chapteir..13: of the Laws of
1961, RCW 47 :28:0715 " Viritht Vie department of
transportation to perform highway construction,
reconstruction, or maintenance work.