HomeMy WebLinkAboutPermit PG10-108 - MUBARAK RESIDENCEMUBAREK RESIDENCE
13619 52 AV S
PG1O-108
City Tukwila
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
Parcel No.: 0003000087
Address: 13619 52 AV S TUKW
Project Name: MUBAREK RESIDENCE
PLUMBING /GAS PIPING PERMIT
Permit Number: PG10 -108
Issue Date: 08/27/2010
Permit Expires On: 02/23/2011
Owner:
Name: MUBAREK JAMAL A
Address: 13613 52ND AVE S , TUKWILA WA 98168
Contact Person:
Name: JAMAL MUBARAK
Address: 13619 52 AV S , TUKWILA WA 98168
Email: JAMAL9 @HOTMAIL.COM
Phone: 206 250 -8378
Contractor:
Name: OWNER AFFIDAVIT - JAMAL MUBARAK Phone:
Address:
Contractor License No: Expiration Date:
DESCRIPTION OF WORK:
INSTALL (4) GAS PIPING OUTLETS - WATER HEATER, (2) FIRE PLACES, AND STOVE -TOP
OVEN.
Value of Plumbing /Gas Piping:
Fees Collected:
Permit Center Authorized Signature:
$300.00
$120.75
Uniform Plumbing Code Edition: 2009
International Fuel Gas Code Edition: 2009
.ft,
Date: ,-fl --to
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 gran
constructs
g of this p
or the perf
mit do of presume to give authority to violate or cancel the provisions of any other state or local laws regulating
f work. I am authorized to sign and obtain this plumbing /gas piping permit.
m•• e
Signature: Date:
Print Name:
This permit
or aband
all become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is suspended
ed for a period of 180 days from the last inspection.
doc: UPC -4/10
PG10 -108 Printed: 08 -27 -2010
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Fax: 206 - 431 -3665
Web site: http: / /www.ci.tukwila.wa.us
Parcel No.: 0003000087
Address:
Suite No:
Tenant:
1361952AVSTUKW
MUBAREK RESIDENCE
PERMIT CONDITIONS
Permit Number:
Status:
Applied Date:
Issue Date:
PG10 -108
ISSUED
08/16/2010
08/27/2010
1: ** *PLUMBING AND GAS PIPING * **
2: No changes shall be made to applicable plans and specifications unless prior approval is obtained from the Tukwila
Building Division.
3: All permits, inspection records and applicable plans shall be maintained at the job and available to the plumbing
inspector.
4: All plumbing and gas piping systems shall be installed in compliance with the Uniform Plumbing Code and the Fuel Gas
Code.
5: No portion of any plumbing system or gas piping shall be concealed until inspected and approved.
6: All plumbing and gas piping systems shall be tested and approved as required by the Plumbing Code and Fuel Gas Code.
Tests shall be conducted in the presence of the Plumbing Inspector. It shall be the duty of the holder of the permit to
make sure that the work will stand the test prescribed before giving notification that the work is ready for inspection.
7: No water, soil, or waste pipe shall be installed or permitted outside of a building or in an exterior wall unless,
adequate provision is made to protect such pipe from freezing. All hot and cold water pipes installed outside the
conditioned space shall be insulated to minimum R -3.
8: Plastic and copper piping running through framing members to within one (1) inch of the exposed framing shall be
protected by steel nail plates not less than 18 guage.
9: Piping through concrete or masonry walls shall not be subject to any load from building construction. No plumbing
piping shall be directly embedded in concrete or masonry.
10: All pipes penetrating floor /ceiling assemblies and fire - resistance rated walls or partitions shall be protected in
accordance with the requirements of the building code.
11: Piping in the ground shall be laid on a firm bed for its entire length. Trenches shall be backfilled in thin layers to
twelve inches above the top of the piping with clean earth, which shall not contain stones, boulders, cinderfill,
frozen earth, or construction debris.
12: The issuance of a permit or approval of plans and specifications shall not be construed to be a permit for, or an
approval of, any violation of any of the provisions of the Plumbing Code or Fuel Gas Code or any other ordinance of the
jurisdiction.
* *continued on next page **
doc: Cond -10/06
PG10 -108 Printed: 08 -27 -2010
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Fax: 206 - 431 -3665
Web site: http://www.ci.tulcwila.wa.us
I hereby certify that I have read these conditions and will comply with them as outlined. 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 provision of any other work or local laws regulating
construction or the performance of work.
Signature:
Print Name:
Date: g ' 27.
doc: Cond -10/06
PG10 -108 Printed: 08 -27 -2010
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
httpl/www.ci.tukwila.wa.us
Plumbing /Gas Permit No.
Project No.
(For office use only)
PLUMBING / GAS PIPING 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:
Tenant Name: I
Property Owners Name: d ANAL MO IZA
Mailing Address:
f 32Iq 5av)d Avg
King Co Assessor's Tax No.: 0002700 1
Suite Number:
Floor:
New Tenant: ❑ Yes ❑..No
rq 52"d A-0i: S
R-516/J I (,PV
City
t SP1
State Zip
CONTACT PERSON — Who do we contact when your
permit '! is ready to be issued
Name:
JAM Art- Mug k A-IL
l i q 52 4 Pok)�
JM 4L L wIG;(.cNAA
Mailing Address:
E -Mail Address:
Day Telephone:
City
Fax Number:
aoc:, 266 931
KGB
State Zip
PLUMBING / GAS PIPING CONTRACTOR INFORMATION
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:
Contact Person:
E -Mail Address:
City
Day Telephone:
Fax Number:
State
Zip
ENGINEER OF RECORD — All plans must be stamped by Engineer of Record
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
City
State
Zip
Day Telephone:
Fax Number:
H:Wpplications\Forms- Applications On Line\2010 Applications \7 -2010 - Plumbing -Gas Piping Permit Application.doc
Revised: 7 -2010
bh
Page 1 of 2
Valuation of Project (contractor's bid pT�e): $ 3bt) ` �O
Scope of Work (please provide detailed information):
x-;,42 VOCQJ
•
NN► Dues , 0k c (c z / t.cc4ev r 6 clo ve -1-0P
Building Use (per lnt'I Building Code):
Occupancy (per Int'I Building Code):
Utility Purveyor: Water:
Sewer:
Indicate type of plumbing fixtures and /or gas piping outlets being installed and the quantity below:
Fixture Type:
Qty
Fixture Type:
Qty
Fixture Type:
Qty
Fixture Type:
Qty
Bathtub or combination
bath/shower
Bidet
Clothes washer, domestic
Dental unit, cuspidor
Dishwasher, domestic,
with independent drain
Drinking fountain or
water cooler (per head)
Food -waste grinder,
commercial
Floor Drain
Shower, single head trap
Lavatory
Wash fountain
Receptor, indirect waste
Sinks
Urinals
Water Closet
Building sewer and each
trailer park sewer
Rain water system — per
drain (inside building)
Water heater and/or vent
Industrial waste treatment
interceptor, including trap
and vent, except for kitchen
type grease interceptors
Each grease trap
(connected to not more
than 4 fixtures - <750
gallon capacity)
Grease interceptor for
commercial kitchen ( >750
gallon capacity)
Repair or alteration of
water piping and/or water
treatment equipment
Repair or alteration of
drainage or vent piping
Medical gas piping
system serving 1 -5
inlets /outlets for a
specific gas
Each additional medical
gas inlets /outlets greater
than 5
Backflow protective
device other than
atmospheric -type vacuum
breakers 2 inch (51 mm)
diameter or smaller
Backflow protective device
other than atmospheric -type
vacuum breakers over 2
inch (51 mm) diameter
Each lawn sprinkler
system on any one meter
including backflow
protection devices
Atmospheric -type vacuum
breakers not included in
lawn sprinkler backflow
protections (1 -5)
Atmospheric -type
vacuum breakers not
included in lawn
sprinkler backflow
protections over 5
Gas piping outlets
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 an additional period not to exceed 180 days. The extension shall be requested in writing
and justifiable cause demonstrated. Section 103.4.3 International 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 O ' R S ' AUTH 7" IZED AGENT:
Signature:
Print Name:
Mailing Address:
r)2G(c 52tA4 s
Date Application Accepted: OS
Date: O$ 11p • •"a
Day Telephone: 9f6G 250 8378
State Zip
-77,k lc
City
il/p
Date Application Expires:
H:\Applications\Forms- Applications On Line\2010 Applications \7 -2010 - Plumbing -Gas Piping Permit Application.doc
Revised: 7 -2010
bh
Staff Initials:
(.1,_
Page 2 of 2
• lb
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Fax: 206 - 431 -3665
Web site: http://www.ci.tulcwila.wa.us
Parcel No.: 0003000087
Address: 13619 52 AV S TUKW
Suite No:
Applicant: MUBAREK RESIDENCE
RECEIPT
Permit Number: PG10 -108
Status: APPROVED
Applied Date: 08/16/2010
Issue Date:
Receipt No.: R10 -01702
Initials:
User ID:
Payee:
WER
1659
Payment Amount: $96.60
Payment Date: 08/27/2010 01:59 PM
Balance: $0.00
JAMAL MUBARAK
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 1637 96.60
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
GAS - RES
000.322.103.00.00 96.60
Total: $96.60
PAYMENT
aEr.FivFlD
doc: Receiot -06 Printed: 08 -27 -2010
t
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Fax: 206 - 431 -3665
Web site: http: / /www.ci.tukwila.wa.us
Parcel No.: 0003000087
Address: 13619 52 AV S TUKW
Suite No:
Applicant: MUBAREK RESIDENCE
RECEIPT
Permit Number: PG10 -108
Status: PENDING
Applied Date: 08/16/2010
Issue Date:
Receipt No.: R10 -01591
Initials:
User ID:
Payee:
JEM
1165
Payment Amount: $24.15
Payment Date: 08/16/2010 01:32 PM
Balance: $96.60
JAMAL A MUBARAK
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 1636 24.15
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
PLAN CHECK - RES
000.345.830 24.15
Total: $24.15
PAYMENT
RECEIVED
doc: Receiot -06 Printed: 08 -16 -2010
F-6 fro --- (0(-
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 Ix (206) 431 -367
Permit Inspection Request Line (206) 431 -2451
Project:
(AA,JJ3A TA V-
i2
Type of Inspectio
;, K i
6 A- r P -',
Address:
Date Called:
Special Instructions:
f
fQ
Date Wanted:
4—
- Vim.
// 1 .1"?...- p.m.
Reque f e
Phone No:
Approved per applicable codes. El Corrections required prior to approval.
COMMENTS:
n REINSPECTION FEE REdyJIREDlPrior to next inspection, fee must be
paid at 6300 Southcenter Md./ Suite 100. Call to schedule reinspection.
INSPECTION NO.
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
Project:
MU6arek J':�k"U,-
Type of 1 spectio
F Ai* to -x 4PP'&
Address:
136 (1 52- 4u _-
Date Called:
-.g. t b AI eL ,14-5 ej Ij d(
n (NO 1t.A ,9 r
Special Instructions:
Date Wanted:
3 -f4
e
1 / 7
gym ,
p.m.
Requester:
I AJ i t S ; e\.s A-11 -e A A l
EJ J Pe / A'I--P A- eve w P P/ tit; r-
Phone No:
DApproved per applicable codes. corrections required prior to approval.
COMMENTS:
(() u) f r -A- - C ■ A-- T- 6'
i /1 (? Ar & L --
1
-.g. t b AI eL ,14-5 ej Ij d(
n (NO 1t.A ,9 r
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✓o e „D a r l T1 eC c__( v (e'
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I AJ i t S ; e\.s A-11 -e A A l
EJ J Pe / A'I--P A- eve w P P/ tit; r-
r
-PAC 1-1 be Keil
Inspector('
Date:
n REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
s71
INSPECTION RECORD
Retain a copy with permit PG 1C2 -1° g
INSPECTION NO. PERMIT N0. it/
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
Pr). cut: r ic n G c.,
Typ of Inspect' n: / AZ
Address: c _ ^�
13 &3t J Z
Date Called:
Special Instructions:
F.aI --
DS5 ( . //')/�
c, p , s7,ocL Tp avtkP
Date Wanted:. a.m.
(Q - rE - (J
Requester:
-� -2_ o_�s3'18
ElApproved per applicable codes. Corrections required prior to approval.
COMMENT SF G at .y ( it I'�'YeT. r_or :I -.4I 4
it r ,`/ f _A -la A, 4A.A4A V\ k ( l r ` 'e'er+" " -F
Pv4 : ,,1-e -rk . , ,. 1\J 0) o A P U J is 4
P
( 1.:). tze _ sc_.Qr ei J 1 e ... fc J
1 0 or— 7.".cn- 2 ,(7,,)/\ 3
t_ ,Per-u- __. -L.
Inspe4tor:
akti;JI k
REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter- Blvd., Suite 100. Call to schedule reinspection.
Dater
INSPECTI N NO.
CITY OF TUKWILA BUILDING DIVISION
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
6300 Southcenter Blvd., #100, Tukwila. WA 98188
Permit Inspection Request Line (206) 431 -2451
(206) 431 -3670
Pro' t:
Mt/ Ii e k 266.3
Type f Inspect'on:
R o 4 ---4.) 'lkf
Address:
1.3(to 1dr 52
n ,
S.
Date Called:1
Lo
Special Instructions: ions:
Date Wanted:
r a.rr
C7 — 2-5—i0 p.m.
Requester:
eX- 6/- c' 6 �.
Ph
_ 7.®(
-25d -S37
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
`-if
Lo
l0 c1e
_`
;h4 Nom —`'"
� c1 0J ;' - 1 01
eX- 6/- c' 6 �.
r i- (.,0 per /41ti -
A-AeeX. .
P
a
9 \1
Inspector:
r:
Date:
(O -2 - -ems
n REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
•
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REVISIONS
No changes shall be made to the scope
. . of Work without prior approval of
Tukwila Building Division.
NOTE: Revisions will require a new plan submittal
i ..r.•1 may licit/de additional plan review fees.
SEPARATE PERMIT
REQUIRED FOR:
&Mechanical
Crtlectric:al
arPtumbing
0 Gas Piping
City of Tukwila
BUILDING DIVISION
2640 FX/AWN
FSE COPY
permft No. T6p (0- 09,
Plan review approval is subject to errors and omIssbns.
Aproval of construction documents does not authorize
1 1,,,, violation of any adopted code or ordinance. Receipt
c uppro ,-f -is, - •••y and conditions is acknowledged:
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City Of Tukwila
BUILDING DIVISION
RECEIVED
CITY OF TUKWILA
AUG 1 6 2010
PERMIT CENTER
0
REVIEWED FOR
CODE COMPLIANCE
APPOPVED
AUG 214 2010
BUrDINti r ia
DUkWilViglON
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PstIAL AC
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• •
April 4, 2012
To City of Tukwila
Building Dept.
RE: PG 10 -108
Dear Sir /Madam
This is to inform you of that due to unavoidable circumstances I will not be installing the Gas Range
and the 2 Fireplace inserts as indicated on the permit.
Please exclude this from the final inspection .1 will however request for a new permit in the future if I
decide to install the other appliances.
Sincerely. Jamal i -' barak
111141
SECEIVED
CITY OF TUKWRA
APR .0.4 2012i
PERMIT CENTER
•
City of Tukwila
•
Jim Haggerton, Mayor
Department of Community Development Jack Pace, Director
JAMAL MUBARAK
13619 52 AV S
TUKWILA WA 98168
RE: Permit No. PG10 -108
MUBAREK RESIDENCE
13619 52 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 04/16/2012.
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 04/16/2012, 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,
Bill Rambo
Permit Technician
File: Permit File No. PG10 -108
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
09 -01 -2011
•
City of Tukwila
•
Jim Haggerton, Mayor
Department of Community Development Jack Pace, Director
JAMAL MUBARAK
13619 52 AV S
TUKWILA WA 98168
RE: Permit No. PG10 -108
13619 52 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 10/20/2011.
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 10/20/2011, 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,
Bill Rambo
Permit Technician
File: Permit File No. PG10 -108
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
March 28, 2011
Jamal Mubarak
13110 88 Place NE
Kirkland, WA 98034
RE: Request for Extension
Plumbing/Gas Piping Permit PG10 -108
Mubarak Residence —13619 52 Av S
Dear Mr. Mubarak,
This letter is in response to your written request for an extension to Permit Number PG10 -108.
The Building Official has reviewed your letter and considered your request to extend the above
referenced permit. The City of Tukwila Building Division will be extending your permit an
additional 180 days from the date of expiration, through October 20, 2011, as requested.
If you should have any questions, please contact our office at (206) 431 -3670.
Sincerely,
Ati\lkU
Jenn fM shall
Pe t ec ician
File: Permit No. PG10 -108
T:\Links\Docs\PG10- 108\PG10 -108 Permit Extension.doc
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
•
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CITY OF TUKWILA
MAR 21 20111.
PERMIT CENTER
03 -02 -2011
City of Tukwila
Jim Haggerton, Mayor
Department of Community Development Jack Pace, Director
JAMAL MUBARAK
13619 52 AV S
TUKWILA WA 98168
RE: Permit No. PG10 -108
13619 52 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 04/23/2011.
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 04/23/2011, 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.
Bill Rambo
Permit Technician
File: Permit File No. PG10 -108
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
• PERMIT UM cov' ;.
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: PG10 -108 DATE: 08/16/10
PROJECT NAME: MUBARAK RESIDENCE
SITE ADDRESS: 13619 52 AV S
X Original Plan Submittal
Response to Correction Letter #
Response to Incomplete Letter #
Revision # after Permit Issued
D PARTMENTS:
i ding ivision
Public Works
Fire Prevention
Structural
Planning Division
Permit Coordinator
n
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
Comments:
Incomplete I-I
DUE DATE: 08/17/10
Not Applicable
Permit Center Use Only
INCOMPLETE LETTER MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
LETTER OF COMPLETENESS MAILED:
TUES /THURS ROUTING:
Building
Please Route
REVIEWER'S INITIALS:
Structural Review Required
No further Review Required
DATE:
APPROVALS OR CORRECTIONS:
DUE DATE: 09/14/10
Approved ❑ Approved with Conditions Nr Not Approved (attach comments) n
Notation:
REVIEWER'S INITIALS:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections:
Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
Documents/routing slip.doc
2 -28 -02
City* Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Web site: http: //www.ci.tukwila.wa.us
REVISION
SUBMITTAL J
Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through
the mai, fax eta
Date: A.( ( r
Plan Check/Permit Number:
(1 0 -
❑ Response to Incomplete Letter #
❑ Response to Correction Letter #
Revision # 1 after Permit is Issued
❑ Revision requested by a City Building Inspector or Plans Examiner
Project Name:
Project Address:
Contact Person:
Summary of Revision:
Arstagf .17)
To 01 CJ (J a"_ (9'
Ph
ber: c7
HSCSIVEa
OIYOF TUKWILA
APR .0.4 20121
PERMIT CEWTEB
Sheet Number(s):
"Cloud" or highlight all areas of revision including date of revis n
< -_2rje
Received at the City of Tukwila Permit Center by:
4 `k
Entered in Permits Plus on - ,1
H:Uppliestio, Pomi-Appiications On L ne%2010 AppIIcstionone7 -2010 - Revision Submitul.doc
Created: S-13-2004
Revised: 7-20W
CITY OF TUKWILA
Department of Community Development
6300 Southcenter Boulevard, Tukwila, WA 98188
Telephone: (206) 431 -3670 FAX (206) 431 -3665
E -mail: tukplanPci.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
PERMIT NO: 'PG 10-169
STATE OF WASHINGTON)
) ss.
COUNTY OF KING )
() M && , states as follows:
[please print name]
1. 1 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 (Z, 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 tha ' : ; othe e have under state law in any decision
to engage an unregistered contractor to perform co
A q • IBL\
ent
igned and sworn to before me this
772 day of
, 20 / d .
wi.6
Y PUBLIC in and for the State of Washington
Residing at �l 4 , County
Name as commissioned: /,LI4 C ?U''// C
My commission expires: V S/-019 - /'/
18.27.040 Exemptions. The regillion provisions of this
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
chapter do not apply*
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 electrical contractor's
license under chapter 19.28 RCW that employs a certified
journeyman electrician;a certified residential specialty
electrician, or an electrical'trainee Meeting the
requirements of chapter:19.28 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 utilization equipment
that requires limited electric power and.limited waste
and /or water connections. A eelectrical 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.