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HomeMy WebLinkAboutPermit MI02-156 - COUNTRY VITTLES - DEMOLITIONMI02 -156 Country Vittle s 14212 Tukwila Interna'lBl City of'1'ukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 Parcel No,: 1523049242 Address: Suite No: MISCELLANEOUS PERMIT 14212 TUKWILA INTERNATIONAL BL TUKW Permit Number: Issue Date: Permit Expires On: M102 -156 10/04/2002 04/02/2003 Tenant: Name: COUNTRY VITTLES Address: 14212 TUKWILA INTERNATIONAL BL, TUKWILA, WA Owners Name: TEMPLE ROBERT +GINNY Address: 14212 PACIFIC HWY S, TUKWILA WA Contact Person: Name: BOB TEMPLE Address: 14212 TUKWILA INTERNATIONAL BL, TUKWILA, WA Contractors Name: R L CLEARING & EXCAVATION INC Address: PO BOX 4203, FEDERAL WAY Contractor License No: RLCLEEI097N2 Phone: Phone: 206 248-2180 Phone: (253)661-6967 Expiration Date: 04/15/2004 DESCRIPTION OF WORK: ASBESTOS ABATEMENT AND DEMOLITION OF COUNTRY VITTLES INCLUDING REMOVAL OF DEBRIS AND CONCRETE SLAB AND FOOTINGS AND EROSION PREVENTION AND SEDIMENT CONTROL Value of Construction: Type of Fire Protection: Type of Construction: $25,000.00 Fees Collected: Uniform Building Code Edition: Occupancy per UBC: $76.50 1997 0020 Public Works Activities: Curb Cut/Access/Sldewalk/CSS: N Fire Loop Hydrant: N Flood Control Zone: N Hauling: N Land Altering: N Landscape irrigation: N Moving Oversize Load: N Sanitary Side Sewer: N Sewer Main Extension: N Storm Drainage: Y Street Use: N Water Main Extension: N Water Meter: Channelization / Striping: Number: 0 Size (Inches): 0 Start Time: End Time: Volumes: Cut 0 c.y. Fill 0 c.y. Start Time: End Time: Private: Public: Private: Public: * Continued Next Page ** don: Miscperm M102-156 Printed: 10.04.2002 I§ It It City of Tukwila Department of Community Development / 8300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (208) 431 -3870 Permit Center Authorized Signature: Date: /e`t/e,'c"� I hereby certify that I have read and examined this permit and know the same to be true and correct. All provisions of law and ordinances governing this work will be complied with, whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws regulating construction or the performance of work. I am authorized to sign and obtain this mechanical permit, Signature: Print Name: l< Date: `''= 20fi 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: Miscperm M102.156 Printed: 10. 04.2002 City of'1'ukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431-3670 PERMIT CONDITIONS Parcel No.: 1523049242 Address: 14212 TUKWILA INTERNATIONAL 8L TUKW Suite No: Tenant: COUNTRY VITTLES Permit Number: M102 -156 Status: ISSUED Applied Date: 09/20/2002 Issue Date: 10/04/2002 1: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * ** 2: Contractor shall notify Public Works Utility Inspector at (206)433.0179 of commencement and completion of work at least 24 hours in advance. 3: Erosion As the first order of business, the Permittee shall Install erosion prevention and sediment control measures before any site disturbance occurs. Before the temporary measures are removed, install and establish the upstream permanent ESC measures. The Permittee shall at all times protect sensitive areas, their buffers, and adjacent private properties and public rights -of -way or easements from damage during grading operations, The Permittee shall restore, to the standards in effect at the time of the issuance of the permit, sensitive areas, their buffers, and public and private properties and improvements damaged by the Permlttee's operations. At all times, any disturbed areas left unworked for more than 30 days shall be seeded. May 1 through September 30, temporary cover measures shall bo Installed on ALL areas left undisturbed for more than seven days. October 1 through April 30: 1. Temporary cover measures shall be installed on ALL disturbed areas left unworked for more than TWO DAYS. 3, Retain onsite a quantity of cover measures materials sufficient to cover all disturbed areas. 4. By October 8, temporarily seed and mulch all areas that will be unworked during the wet season. 1 Mulch all seeded areas. 6. Stabilize all construction traffic areas, unless already graveled. Failure to maintain ESC measures In accordance with the approved maintenance schedule may result in the work being performed at the direction of the Director, 4: "* *BUILDING DEPARTMENT CONDITIONS * ** 5: No changes will be made to the plans unless approved by the Engineer and the Tukwila Building Division. 6: All permits, inspection records, and approved plans shall be available at the job site prior to the start of any construction. These documents are to be maintained and available until final inspection approval is granted. 7: All construction to be done in conformance with approved plans and requirements of the Uniform Building Code (1997 Edition) as amended, Uniform Mechanical Code (1997 Edition), and Washington State Energy Code (1997 Edition). 8: Validity of Permit. The issuance of a permit or approval of plans, specifications, and computations 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 ordinance of the jurisdiction, No permit presuming to give authority to violate or cancel the provisions of this code shall be valid. 9: ** *FIRE DEPARTMENT CONDITIONS * ** 10: The attached set of plans have been reviewed by The Fire Prevention Bureau and are acceptable with the following concerns: 11: Accumulation of combustible waste material is prohibited during the demolition phase of this project. Remove and properly doc: Conditions M102-156 Printed: 10.04.2002 City of 'Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 dispose of all waste material prior to the close of the working day and as often throughout the day as needed. 12: Please contact the Tukwila Fire Department Training Division at 206. 5754404, in regards to the possible use of the structure for training purposes prior to demolition. 13: These plans were reviewed by Inspector 510. If you have any questions, please call Tukwila Fire Prevention Bureau at (206)575- 4407. 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 :uV l [ Print Name: r Date: & Y c doc: Conditions M102.156 Printed: 10.04.2002 ig C'I T Y OF '.IKWI LA Permit Center 6300 Southeenter Boulevard, Suite 100 Tukwila, WA 98188 (206; 431 -3670 -1` t `• R stArr USE ONLY Project Number: Permit Number: '`° Miscellaneous Permit Applications: Application and plans must be complete in order to be accepted for plan review. Applications will not be accepted through the mail or facsimile. Project Name/Tenant: met -N`f- 4.7 %� K} wt 1 � Value of Construction: 0.7,7,- eoc- Tax Parcel Number: / ,-- 3 0 ,--/ --- -i..?- y z -- V ti- 4'--S �S Site Address : • /'•z / Z- Alt. r �rc /fi.. elk S0 , City State /Zip: - T;,,k ' t u' 'ii111 Property ne Phone: (k 6 ) Street Address: 3 1 j 5 / City State/Zip: u etz.eiv iV yo c Fax #: ( ) C `' r•a�o.. et C�a1h G -t A to City State/Zip: Phone: 01;W pt"J'r Fax If: ( --bet 1/7 ) o 1.157+ . set Adclres . l . 3 �� -h t' rIctot, !%AD Architect: Phone: ( .iy ) Street Address: City State/Zip: Fax #: ( Engineer: • Phone: ( ) Street Address: , ,. , City State/Zip: Fax #: ( Contact Person: C. ----- Phone: ( ) Street Address: / / /,'�{ 7 / w lit ..o. ___-- "City,State/Zip: / c,G M.. t to v C. Fax #: ( ) MISCELLANEOUS PERMIT REVIEW AND APPROVAL REQUESTED: (O RE FILLED OUT BY APPLICANT) nest ptlon of work to be done (please be specific): f P1 40,405ktir 4l A,4.C- sv,errj. h'h�i be ar M t u�CA�.h +( V1411 eA A� 1 `4'ZI Z 'PAt.4"j;c.. 4%41 50, 7 iectu les verm6,141 d el PPI A4nd r.d"cvtiv . drab Cepokirts, Will there be storage of flammable/combustible hazardous material in the building? El yes >44 no Attacir Ilit oft trials and stout a loentlen o► rate If 1/2 -X �1 ri� ��9 rf er Irtr/1c Aurin-arieer & Mnteri�al Sci!et tin *eels_ El Above Ground Tanks LJ Antennas /Satellite Dishes U Bulkhead /Docks tICornntmcial Ream( ,Demolillon ❑ Fence ❑ manufactured Housin •Replacemtnt only ❑ Parkin Lots O Retainit20 Wails d lentporary l acllitie, LI Tter Cuttin APPLICANT RE • UEST FOR MISCELLANEOUS PUBLIC WORKS PERMITS Channellzatlon /Striping O Flood Conttul Zone Landscape Irrigation ❑ Stortn Drainage ❑ Water Meter /Exempt # Size(s): ❑ Water Motor /Permanent # ❑ Water Meter Tonip #,__�, ❑ Miscellaneous Curb cut/Access/Sidewalk • Fire Loop /Hydrant (main to vault) #: Site(s): ❑ Land Altering: 0 Gut cubic yards 0 Fill cubic yards 0 sq, ft,grddlitg/Clearing Cl Sanitary Side Sewer It: _ Cl Sower Main Extension —6 Prlvdte 0 Publle ❑ Street Use ❑ Water Main Extension 0 Private 0 Public 0 Deduct 0 Water Only Slze(s): Est. quantity: gal t.._I M;; Oversized Load/Hauling Schedule: MONTHLY SERVICE BILLINGS TO: Name: Phone: Address: City /Sta dip: *NOM ��� 0 Water p 0 Sewer ■ - � 0 Metro 0 Standby WATER METER DEPOSIT/REFUND BILLING: Name: Address: Phone: City /State /Zip: 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 shali expire by limitation. The building official may extend the time for action by the applicant for a period not exceeding 180 days upon written request by the applicant as defined in Section 107.4 of the Uniform Building Code (current edition). No application shall be extended more than once. Date application ac •epted: 9/9/99 ruiscpr+r.dac .01•11•..•••• Date application expires: ;,2O-O3 Application to 'en by: (initials) AIL ALL MISCELLANEOUS PE . ,JT APPLICATIONS MUST BESUOMIT ALL DRAWINGS SHALL BE AT A LEGIBLE SCALE AND NEATLY DRAWN > BUILDING SITE PLANS AND UTILITY PLANS ARE TO 13E COMBINED WITH THE FOLIO INGi > ARCHITECTURAL DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED ARCHITECT > STRUCTURAL_ CALCULATIONS AND DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED STRUCTURAL ENGINEER CIVIUSITE PLAN DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED CIVIL ENGINEER (P.E.) fi SUBMIT APPI I(ATION AND RF(1UIRFD ( HECKIISTS FOR PERMIT REVIEW Above Ground Tanks /Water Tanks - Supported directly upon grade exceeding 5,000 gallons and a ratio of height to diameter or width which exceeds 2:1 Submit checklist No: M -9 , 0 Antennas /Satellite Dishes Submit checklist No: M -1 Bulkhead /Dock n Submit checklist No M -10 a Commercial Reroof Submit checklist No: tvi -F, 0 — Demolition Submit checklist No: M -3 in Fences - Over 6 feet in hteight Submit checklist No: M -9 d Land Altering/Grading/Preloads Submit checklist No M -2 Miscellaneous Public Works Permits Submit checklist No: H -9 d Manufactured Housing (RED INSIGNIA ONLY) Submit checklist No: M -5 C Moving Oversized Load /Hauling . , Submit checklist No: M -5 - Parking Lots • ` Submit checklist No: M -4 to Retaining Walls - Over 4 feet In height Submit checklist No: M -1 0 Temporary Facilities Submit checklist No: M -7 Tree Cutting_ Submit checklist No: M-2 Current copy of Washington State Department of Labor and industries Valid Contractor's License. If not available at the time of application, a copy of this license will be required before the permit is ;!sued, unless the homeowner will be the builder OR submit form 1-1-4, "Affidavit In Lieu •,f Contractor Registration ". Building Owner /Authorized Aunt If the applicant is other tltab the owner, registered architect/engineer, or contractor licensed by the State of Washington, n notarized letter from the property owner authorizing the agent to submit this emit application and obtain the permit will bo re Wind as part of this submittal I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW TIIF SAME TO DE TRUE UNDER PENALTY OF PERJURY DY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR TIIIS PERMIT. BUILDING OW ER OR AUTHORIZED AGENT; Signature: C. pate: Print Wimp: Ph2221 ,City /State/ /.ip: C� Fax it, ( ) Address: CITY OF T - 'KWILA Permit Center 6300 Southcenter Boulevard, Suite 100 Tukwila, WA 98188 (206) 431 -3670 Submittal Checklist Miscellaneous Permits DEMOLITION ✓ .r__. -. '— Site Plan Requirements ✓ Distance between structures and property lines IIII Working Drawings S S it { Existing landscaping Ming _ _fr Abandonment of Se • tic Tank for residential re • uires t e followin conditions be met: Building location and total square footage MI T_ A,. f- f, th, Fill w th Sand High water mark of river if within 200 feet of shoreline identify water 1118ter $ILA MI .,,... ♦ r, Ny( Fire Protection S stem Demo (issued throu s h Fire De • artment) Foot print and location of structures to be removed j , ; A fit., !_•,,t — Temporary /permanent erosion control plan Two (2) foot contours on site • I. Points of access for demolition activities • r Li 1' , .; a fr+f ° - ' • • S Limits of area to be disturbed by demolition activities (¢ 1..4, 'viz i t/ ft / t t 4r,t.4. ,`. ,ft- -, Locate existing sanitary aide sewers and points to be •Iu• ed /ca• •ed at •ro•e line C_A -IC"> 4 it,, 1.,•' Locate existing water meters, Identify existing meters to be removed by City Public Works staff. Identify existing water services to be cs • • od b demolition contractor. i, I./ , ,, ii" 4- ri ci' 1.t l l Identify existing side drain: modify and /or capped A Location of slopes 20% or greater, wetlands, watercourses and their buffers ti' if ,____ Ask /itiynal Regyire',rerits Asbestos Abatement: Obtain approval from Puget Sound Air Pollution Control Agency prior to proceeding with demolition if structure to be demolished Is over 4000 8.. ft„ SEPA checklist Is re • uired Construction debris to be token to debris facility (K1ng County informational handout available at Permit Center Foundation must be com • letel removed Abandonment of Se • tic Tank for residential re • uires t e followin conditions be met: Pum • tank em • t Fill w th Sand sntie /d a estro c ma LeD tter or recei t to ■eri above conditions have been Met by urn viceervi Ice w„ ___,;_ ,____-„ Identi current sewer/water billin • account number Haulin re uirements must be met if over 50 cubic ards of material is to be taken to or from sites, :!, Fire Protection S stem Demo (issued throu s h Fire De • artment) An inspection prior to demolition will be made and again at mid•demolition and after work is completed. 2/2:101 appskm3.doc i f (f6/S9 t9t-99 'O/7 Uabd YJdesd '1(mr:4y etp Aq;dtaoai saw sXt'p 2u aonl -at upptnt noL as pate= aq ram anurad uopttottmci pano1dde max 'uo rutto#uc pamtbar atp tptns sn paptnord anrq nazi .:ate Sap 2upt1om -tint atp uo uqt nourap 4aq Arm nox -irr 9 iasttf }t tn.m.2uoi Mod 101 1911, �► ?�� 'pans; aq ;o ;tad ao uopuottdda rnoA tptM staonstadt'd parrnbaz atp ;d ire apntotrt as td .S it g a n to so;saasr Are §notuai P � 1 '!/ o; io30r . uoa so35agsa ua Aq paaj aiosd smoggy ur truoprad o; uos;t'a dy tta ptmo; seM,sojsagsa ou ptr¢ pa#aadstn wog sett am;ottras alp Scrims RanztiS 4do, j 'V tTVSd aicjuAvd:?fioPtje SZrs (?) ,; uopttOW Q a uno red o; uopvorjddy pa;atdtao, v C� tpauramoo si stroMradvd sr re; sr paau I op;vttm • v a � may nox 'uo AT ooze soz d gnomes a ;smut ;lStrlpjrnq p trr so;sd sv 'rags 3I 'jBnourer so; ropvS ;uoo;uatue;vge sossaqsv pappsao, t ulpirnq al; tq comgsa spin; aopadstrl too; 3! oqM '21upsa3, puts Suprnsuoa jtuuauzuorjAUu so mow 'uopoadsuj Sulpjina "rvoj pruy sago ;e ;ogr'renourn sossegry laptrtt fraud i. aurm otp ul sko ;sedsul pejj vnb so; 'tool luasald ups swam Auv trsrivt Sutpjtnq u t ouoop;ouuvo nox uouuouaop 2ulrnp uopoadsul so; orgy/re/iv aq ;snuz ADArns ;o Ado* y *swam so; arryoruu molt 'Atan=tts o; ;opadsuu pa;lpeaov (yd) busily uopoa;osd jusUausuoagnUu uv oxrq smut nox 1045 op I prnogs 'so ;sags8 Try Jo TUAOU aI puv'Loudy jor;uoa uopnuod rly ptmos ;rind eye tpin;pxuad uojpcjourap B ;o Soup ay; saltttbas tee! doped 'so ;sagstt a ;ujnsal;ou op ssIzeuassvdep SuTPllna ' ;udui4tsdap 2uriptirccl DR; 114114 DUD 70114 APvoirtv I tvadvSJ tl;jM;Fulrad uopuotuap a so; t+m I ;sntu htult 'uoj ;jlourep o; sotld eas;-so ;sagse sj Su}p jptq ay; ;mil Apse, o; st ;}trued atp Jo esodrnd atu, .Asradv,td a ;eipc1 uci sarr.pngs pauopt^oqu xo'ssu;put ivjazmmaaon'c,; pamgi ;ou;nq luypnpui 'arn40nxis MIT tjsjjouzap 10 umq o; Surjos st otim ;-sumo l adoxd Auy t;juuad uoRjtouzap ;a3 am ;mu: otjM uo RxIottt j unto zed o; uoRrarJddy to J sau nappi j 008B-Cfi£ (90Z,) 8£OZ-tOt86,VM ♦ai as • 00s a}mS' }aax1S =QTufl Ott ua � JOJ UOD UORnUad V pun °, ;a8ncI MICRO COM SYSTEMS LTD. ATTENTION El The next image may be a duplicate of the previous image. c4 Please disregard previous image. ❑ Please disregard previous 2 images. ❑ Please disregard previous 3 images. ❑ Other: Puget Sound Air Pollution Control Agency 110 Union Street, Suite 500 ♦ Seattle ♦WA +98101 -2038 (206) 343 -8800 Guidelines for Application to Perform a Demolition Who must file for a demolition permit? Any property owner who is going to burn or demolish anx structure, including, but not limited to, cottutersri,albuildings, or abandoned structures em private property. The purpose of the permit is to certify that the building is asbestos -free prior to demolition. Why must !file for a demolition per=mit with PSAPCA? t already filed one with the building departments Building departments do not regulate asbestos. Federal law requires the filing of a demolition per utit with the Puget Sound Air Pollution Control Agency, and removal of all asbestos. What should I do first? You must hire an Environmental Protection Agency (EPA) accredited inspector to survey your structure for asbestos. A copy of this survey Must be available for inspection during demolition You cannot demolish a building with any asbestos still present: Look for qualified inspectors In the yellow pegt's under Asbestos Removal, Laboratories Analytical,. Building Inspection, Asbestos or Environmental Consulting and Testing, What if the inspector finds ASbertoa in the building? If there is asl stos in the building, it must be removed prior to demolition. You must hire a 'certified asbestos abatement contractor for =oval. at do l need `aa1 sr u paperwork is concerned? A coMiatifted Application to Perform a Demolition SZti clue Pa PSAI A. L able to Y �. Copy of. #,Aurvey stating the structure has been inspected and no :as b p...s vas found an Ap ation to terfor*n an Asbestos Project filed by an asbestos con remove any asbestos in the building, s ems' Please' include all of the required paperwork with your application or a permit e issued, �. How long will it take ?`r fl(' jea " You may begin demoliii�rt on the 11th =working day after you have provided us with the required information. Your approved Demolition Permit will be mailed 010 to you within 1O-working days after receipt by the Agency. PSAPCC, Fonn No 66 -181, ($/94i : j City of Tukwila 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431.3670 RECEIPT Parcel No,: 1523049242 Address: 14212 TUKWILA INTERNATIONAL 01 TUKW Suite No: Applicant: COUNTRY VITTLES Permit Number: MI02 -156 Status: APPROVED Applied Date: 09/20/2002 Issue Date: Receipt No,: R020001441 Initials: SKS User ID: 1165 Payment Amount: 25.00 Payment Date: 10/04/2002 10:33 AM Balance: 50.00 Payee: COUNTRY VITTLES, INC TRANSACTION LIST: Amount Type Method Description Payment Check 8336 ACCOUNT ITEM LIST: Description Current Pmts 35.00 Account Codo INSP FEE - STORM DRAIN 412/342.400 PLAN CHECK - UTILITY 000/345.830 15.00 10.00 Total: 25.00 doc: Receipt Printed: 10-04-2002 City of 'Tukwila 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 RECEIPT Parcel No.: 1523049242 Address: 14212 TUKWILA INTERNATIONAL 01 TUKW Suite No: Applicant: COUNTRY VITTLES Permit Number: M102 -156 Status: PENDING Applied Date: 09/20/2002 Issue Date: Receipt No.: R020001382 Initials: User ID: 1165 SKS Payee: BOB. W. TEMPLE TRANSACTION LIST: Amount Payment Amount: 51.50 Payment Date: 09/20/2002 10:12 AM Balance: $0.00 Type Method Description Payment Check 3954 ACCOUNT ITEM LIST: Description Current Pmts 51.50 Account Code BUILDING - NONRES 000/322.100 STATE BUILDING SURCHARGE 000/386.904 47.00 4.50 Total: 51.50 doe: Receipt Printed: 09.20.2002 ig INSPECTION RECORD Retain a copy with permit INSPECTION NO CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd, #100, Tukwila, WA 90188 PERMIT NO (306)431.3670 Pr' t: Type o, 1pspecti : A' 'q s • i / Date ca i Specie Instructions: Date want ; : Requester riot, 1 #iie( Phor1 : Approved per applicable codes. Corroctlons required prior to approval. COMMENTSt El $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reins ' ection, ECTION.NO. INSPECTION RECD Retain a copy with permit ITYOF TUKWILA BUILDING DIVISION PERMIT NO. 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431.3670 Approved par applicable codes. Corractlons required prior to approval. iiiii3AtralMffiti.w. 111•11111111 ,QO REINSPECTION F E REQUIRED. Prior to inspection, fee must be aid att3QQ Southcente Blvd., Suite 100. Call to schedule reinspection. ecelpt Nb. :.:• Date: Type o Inspectiony //er/ Date tilled t) 2— r sg 7 —T, B pet a nstruct ons: = " . P.m. e q u s r: 'i /c,1-1 le ono $3 3 ... j`7 f Approved par applicable codes. Corractlons required prior to approval. iiiii3AtralMffiti.w. 111•11111111 ,QO REINSPECTION F E REQUIRED. Prior to inspection, fee must be aid att3QQ Southcente Blvd., Suite 100. Call to schedule reinspection. ecelpt Nb. :.:• Date: INSPECTION REcCD Retain a copy with permit MIO? 1567 5 CTIO NO PERMIT NO, CITY OF TUKWILA BUILDING DIVISION 2� 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431.3670 ro)e t: I/ 4 1 • 1 f ,/ pe o 1 nspectIQn: I r -.V �dr :ss: 1 • p • • Date Ca e•: , . 0A. /� nstruct ons: paca� l tNlr y po5s ' ate "ante : / n _ • Al.'. :squoster: ttit • ono ,o . 5 3' ID to f' 10 (I If 7 Approved par applicable codes. El Correction required prior- to Approval. COMMENTS: Inspect7r r� 47.00 REINSPECTION EE REQUIRED. r+' paid at b300 Southcent r Blvd., Suite 1 Receipt No.: P or to Inspection, fee must be . CaII to schedule reinspection. Date: ti !iI p ig •74:7,0i7,74;,4 44. -.."7", •"*"" • • ,••'•17--r7s,t.;,•••,I,••r•,4:,, •'; , City of Tukwila Steven M. Mullet, Mayor Fire Department Project Name Address TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Thomas I! Keefe, Fire Chle Permit No. AO cn /S Retain current inspection schedule Needs shift inspection Suite # Approved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre-Fire: Permits: //lie Authorized 'Signature =111.11111■111■11■1■1111•M=VE FINALAPP.FRM Rev. 2/19/98 1 efl Date T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: 206,575.4404 • Fax: 206475,4439 FILE COra ( I understand that the Plan Check approvals aro subject to errors and OlitiSCI0113 and approval of plans does not authorize the violation of any adopted code or ordinan ^e. Receipt of con- tractor's copy of approved plans acknovilodclod. .. __- ......:....... By Date Permit No. wF NO GHAT' ra. THE 'SCOPE APPROVAL yF pf- 8JiJ.+,;) s.. PYr.3.,. c A t1e.N vs,Atl '•' �Y• tItelcievisloNs • 4- SUBJECT PROPERTY PHOTOGRAPHS I COUNTRY YIMfs I:�.r.•II , �,......I,'. •,t fir, +f 1,1 ;l rc• +rrr i, Sff doigtict, Acic 11 an$, 'c r ",,~ a � �,�; �,t ► 4ii►t tttl� ,t�w;�tutt�c: 01 Exterior view &' 'abedcqu re a4r4ith1e11�• %gig0S ■ilawitign al I Final acceptance is subjcs;t to fluid luzi ctiva by the Public Works utilities inspector, Date: $y. C T .. 1 2002 AS NOTED 02 Exterior view of north and east elevations PGP VALUATION INC AroZ-• /54 UQ z 9 Country Vittles: " Regarding demolition " Existing Landscaping = blacktop Identify water meter size = one inch residential line Legal description = enclosed Point of access for demolition = south and west sides Limits of area to be disturbed = Country Vittles property. Locating side sewers and points to be capped = Discussion with Steve Flecther (Val Vue Sewer) He marked the lines and I will apply for a capping permit, and call him to have the line capped before demolition begins. Locate existing water meters = there is only one water meter and it is located at the southwest corner of the property. I have notified Water District # 125 by letter that we will need the water meter shut off and capped before demolition begins. I will call them at the appropriate time. CITY Of TUKWtA *PROM OCT - 1 2002 AS WO 664 65' l of 355 CATS CAI.ItNgAK • WORKMAN $'UBLlS11IN(. ts. 66—'1— eri-\ f 2 cog-°jai va41 0.1-'"'l, aieti EwipeA I 981 ouNf2as a if ,*(07 --(7-114f(C CITY �� WiUI 06 —7 tlg -�2f5 otIlieitto sipeo loop "MirCsNri:a OCT - 1 2002 AS hith kO 1 ig ig C4TY OF T f WL OCT - 1 2002 AS MAD CITyOF rUkW/LA SEp 2 0 2002 • 1'�17I,11rC�1�r�fi 1 • • • • II • • ose 18 et e 4 Og •. • EXHIBIT That portion of Lot 9, Block 3, James Clark's Garden Addition to the City of Seattle, according to the plat thereof recorded in Volume 13 of Plats, page 12, records of King County, Washington, and of the southeast quarter of the southwest quarter of Section 15, Township 23 North, Range 4 East, W.M., in King County, Washington, described as follows: Beginning at the northwest corner of the south 812.6 feet of the east 425.5 feet of said southeast quarter; thence south 1 °27'30" want 200 feet to the true point of beginning of thin description; thence southwesterly to a point on the easterly line of Pacific Highway South (State Road No. 1), distant southerly 250.50 feet (as measured along said easterly line) from the intersection of said easterly lint with the north line of the south 812.6 feet of said southeast quarter; thence southerly along said easterly highway line to the south line of said Lot 9; thence easterly along said south line to the southeast corner thereof; thence southerly to A point on the'northerly lino of a tract conveyed to Ziba Huntington by deed recorded under Auditor's Pile No 412377; thence easterly along said nortK line to a point which bears south 1'27'30" west from the true point of beginning; i °s,:'t� thsncd north 1'27'30" east 198.01 feat to the true point of beginning. ►4p 4 TOGETHER WITH a non - exclusive easement for ingress and ogress ,over a 44 d �O strip of land 20 feet in width the southerly line of which is .described '�,fF a? as follows: Beginning at a point on the north lino of the north 398.1 feet of the east 525.5 feet of the south 812.6 feat of the southeast quarter of the southwest quarter of Section 15, Township 23 North, Range 4 East, W.M., in King County, Washington, 100 feat distant east of the northwest , corner of said subdivision; thence south 1'27'30" west 200 feet to the true point of beginning of the southerly line of the easement herein described; thence southwesterly to a point on the easterly margin of Pacific Highway South (State Road No. 1) which point is 250.50 feet southerly as measured along said highway from,a point in the east margin of said highway distant 23.40 feet, more or less, west of the west line of the subdivision herein described and on the north line thereof as the same is produced westerly. , • cm of woo oc• -- 1 2002 hS NOILU 1§ fv` • c TUY,WO o L ; - 2a2 P6 NOVO rte' • ACCT NO SERVICE ADDRESS PERIOD COVERED 165100 14212 PACIFIC HWY 9 CHARGES Previous Balance Payments First 760 cubic ft. Excess 750 cubic ft. 156.80 •156.80 29.40 127.40 /\ MOO N I EMI 156,80 Aug BILLING DATE DUE DATE 09/02/02 ANNOUNCEMENTS 09/30/02 We now offer an automatic payment plan through deductions from your checking or savings account = please call our office at (206) 242 =3236 for more Information. N/,. WES TFIEL D WORKS WONDERS Look for the Westfield Works Wonders announcement in Ibis month's bill - This is a great opportunity to say "Thank You" to your employees and valued customers. All donations are tax deductible. toes, r mamma ow � o eso pa s v MAKE CHECKS PAYABLE TO: VAL VUE SEWER DISTRICT • PLEASE WRITE ACCOUNT NUMBER ON CHECK VAL VUE SEWER DISTRICT • 14816 MILITARY ROAD SOUTH ► PO BOX 69550 • SEATTLE, WA 88168.8550 165100 (206) 242.3236 • FAX (206) 242.1527 • SEE REVERSE SIDE ' M PERTY TAX' RP10 03214 9 60 -06 06/02 /2002GAGE CORP CORRECTED STATEMENT RING ALL PARTS WHEN PAVING IN PERSON 9 s L2 TT JR S ROBERT AU URN WA KCEP (i) Stet. 576.97 Local School Support 803.68 County 279.75 City UnIncorporatad/Road Pmt Mm Sewer Saar Water Ubrery Other Emergency Med Svc • Other Chetpes ...,,.:, 2002 KING COUNTY, WA, REAL ESTATE TAX RM 600. 500 r -TH AVE, SEATTLE WA 98104 -2387 f?.VI5fb 7 PORTION 191246 *ONAO uRWEEDG 98001 SWM r • ,r APPRAISAL SUMMA Y Name: Property Type: Location: Map No.: Improvement Description — Use: maw - Design: Quality /Condition: Construction: Year Built: Occupancy: Size: Site Description — Size: ofamoio Zoning: S01 -542 333.52 36.59 289.50 109.00 48.25 8.50 first halt mutt be paid of postmarked by April 30, or FULL AMOUNT BECOMES bEUNQUENT end accrues Worst end penalty es prescribed by few. If first hell paid by Apra 30 second hell must be paid by October 31 or It becomes deW►quem and twos knout end pemaHy, FULL AMOUNT MAY OE PAID APRIL 30th 102.00 Lind Value Improvements Less: Exempt Value TAXABLE VALUE Levy Rate General tax *Other Cherges TOTAL CURRENT BILLING Omitted taxes TOTAL CURRENT HILLINO INCLUDING OMI1S....,, VOTER APPROVED SOIL CON 471( 146,( 193,( 12.84: 2,478. 8 :417 ;.:77f 5•( yf_AA IINTEAESY PRINCIPAL PENALTY DELINQUENT TOTAL Country Villles Restaurant Free - standing sit -down restaurant building 14212 Pacific Highway South (also known International Blvd.) Tukwila, Washington Thomas Bros. page 655 E3 TUKWILA CATY AP OYED Restaurant One -story OCT - 1 2002 Average /Below Average AS HU t t=U Wood Frame 1962 100% (single tenant) 2,748 SF (gross and rentable area) as Tukwila 26,072 SF NCC, Neighborhood Commercial Center, primarily commercial uses allowed (Le., retail and office) PGP VALUATION INC 1 Oct 23 02 09:17a RL CL.ERR 1 NG 253x661 -1574 p.1 FACSIMILIE COVER SHEET R.L. CLEARING & EXCAVATING, INC. 1741 SO. 358TH ST P.O. BOX 4203 FEDERAL WAY, WA 98063 253 $614.17 FAX: 283 881d1574 DATE: 140+1on. ATTENTION: ftia,Atteoi) FAX NUMBER: r 4.PI Ih 5` TOTAL PAGES: COMMENTS: RECEIVED OCT. 4 2002 MMNE tOPM1NT FROM: Oct 23 02 09:18a RL CLEARING 10/23/2002 09:50 253-5? "14)1881 $881 253-661-1574 .&65, SERVIC p.3 PAGE 01/01 10/23/02 Tom Hudson Puget Soured Clem Air Amt 110 Mom Street Stark, WA 98101 AT1'N: Tom Hudson CITY C Tt1KW1LA OCT 2 3 2002 pt,1.'101l CENT RE: Asbestos Removal , A$uaay Case M 210202517, 14212 Pasta Hwy So., Tukwla, WA 981U 1 am writing you this letter u a statement of oompletion, that the asbestos removal work done at the above mentioned address was completed on 10.14.02. In accordance with 40 CPR subpart E, aU asbestos material, as identified in the survey, has been removed and properly disposed o1 This project is now complete. All closeout paperwork wiI be forwarded to R.L, Clearing & Excavating AS soon eti possible. taideL05.Clat Cld. etGordon Williams President Co: LL. Clearing * Excavating 16214 57tbi Ave East, Suite A 1 Phone: 253$464011 Puyallup, WA 98375 Fax: 253.536.8418 1' M 0 20, I56 PERMIT COORD COP`( PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: M102 -156 DATE: O9- 23 -02, PROJECT NAME: COUNTRY VITTLES.- DEMOLITION SITE ADDRESS: 14212 PAC HY S X Original Plan Submittal Response to Incomplete Letter #,_,_, .Response to Correction Letter # Revision # After Permit Is Issued DEPARTMENTS: Avg. q-244 Buildin 'vision Pub I .Works IJ VIP I-oL Fire Peention Structural ❑ UN. a.. 144-40, Planning Division Permit Coordinator ►: PETER_MINATION_OLCOMPLETENESS: (Tues., Thurs.) Complete (r Comments: Incomplete ❑ DUE DATE: Oh -24.02 Not Applicable ❑ Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED :. Departments determined Incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:, TUES/THURS ROUTING: Please Route Er Structural Review Required ❑ No further Review Required ❑ REVIEWER'S INITIALS: DATE: AP.PRO.Y .QI .R IONS: DUE DATE: 10.22 -02„ Approved ❑ Approved with Conditions (El Not Approved (attach comments) ❑ Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections; Bldg ❑ Fire ❑ Ping 0 PW ❑ Staff Initials; DocumenWtoutin$ slip.doc 2.28.02 PERMIT COORD COPY PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: MI02 -156 DATE: 09 -23 -02 PROJECT NAME: COUNTRY VITTLES - DEMOLITION SITE ADDRESS: 14212 PAC . WY S X Original Plan Submittal Response to Incomplete Letter #_„_ Response to Correction Letter Revision # After Permit Is Issued DEPARTMENTS: Building Division 2* Fire Prevention ❑ Public Works ❑ Structural Planning Division ❑ Permit Coordinator ❑ R 1NATION OF COMPLET` ESS: (Tues., Thurs.) Complete .l Incomplete ❑ Comments: DUE DATE: 09.24.02 Not Applicable ❑ Permit Center Use Only INCOMPLETE LETTER MAILED: Departments determined Incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: LETTER OF COMPLETENESS MAILED: TUES/TWURS ROUTING: Please Route ❑ Structural Review Required ❑ No further Review Required NIP REVIEWER'S INITIALS; .._�_..�`1 DATE: APPROVALS OR CORRECTIONS; DUE DATE: 10.22.0 Approved ❑ Approved with Conditions • Not Approved (attach comments) ❑ Notation: t - REVIEWER'S INITIALS: Permit Center Use Only CORRECTION LETTER MAILED:.._. Departments issued corrections: Pocumentshouting slip.doc 248-02 DATE: R ((Q� Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials; PERMIT NO.: /1%Z -40z" /•$-a" .) BUILDING PERMITS INSPECTIONS O 2 0 56 7 O 50 O 60 0 70 71 72 90 95 100 200 250 300 350 400 450 500 323 550 600 610 700 750 800 801 802 803 815 900 000 001 110 115 120 140 400 700 900 3100 4000 4001 4001 4003 4004 4005 4006 Progress Inspection Status Pre - construction Investigation OK to Occupy Remove Stop Work Order Follow -up Pre -Move Inspection WSEC Residential WA Ventilation /Indoor ACC NLEA Inspection/Modular Struct Mobile Home Tie Down insp Marriage Lines Rested) Footing Drains Foundation Footings Foundation Walls Foundation insulation Concrete Slab /Slab Insulation Crawl Space Shear Wall Nailing Plywood Wall Sheathing Roof Sheathing Nailing Plywood Deck Nailing Exterior Wall Sheathing Masonry Chimney Chimney Installation/All Types Framing Roof/Ceiling Insulation Floor insulation Wall Insulation Exterior Roof Insulation Glazing Inspection Lighting and Controls Suspended Ceiling Interior Wallboard Fastening Exterior Wallboard Fastening Pre -Move Inspection Motor Inspection Pro -Demo Pro- reroof Final-Fire Final•Building Final•Roroof She Visit Special•Concrete Special -Bolts in Concrete Special-lvlom/Resist Conc Frame Spccial•Reinf Steel Prestress Special-Welding Special -High- Strength Boling Special - Structural Masonry Special•Relnf Gypsum Concrete Special-Insulating Cone Fill Special-Spray Fireproofing Special-Piling, Piers, Caissons Special•Shotcrete Special - Grading, Excav /Fill Special - Retaining Wall Special - Panels Special -Smoke Control System 8 • tai • :__I__I-H 1 =1 -1 -1 • • • • • • • • • • • ■ ■ 4007 400078 4009 4010 4011 0 4012 0 4013 0 4014 0 4015 TENANT NAME: 6'4' 4, CONDITIONS 4 10001 No changes will be made to the plans unless approved by the Engineer and the Tukwila Building Division O 10002 Plumbing permits shall be obtained through King Co O 10003 Electrical permits obtained through L & 1 j10004 All mechanical work shall be under separate permit 10005 ...,,All permits, insp records & approved plans available O 10006 All structural concrete shall be special inspected O 10007 ,.,,,,, All structural welding shall be done by WABO certified inspector O 10008 All high - strength bolting shall be special inspected O 10009 Bolts installed in concrete shall be special inspected O 10010 When special inspection is required—notify Tukwila Building Division O 10011 ,: The special inspector shall submit a final signed report O 10012 ,,,,,,, My new ceiling grid and light fixture installation O 10013 Partition walls attached to ceiling grid O 10014 ,,,,.,,, Readily accessible access to roof mounted equipment 81001Engineered truss drawings & gales shall be on site 5 10016 Any exposed insulation backing material shall have 0 10017 Subgradc preparation including drainage, excavation 0 10018 ,,,,,,,A statement film the rooting contractor verifying fire retardant class of roof 10019 All construction to be done In conformance w /npprovcd plans 0 e B 0020 Structural observation shall be provided for this protect 0021 All food preparation establishments must have King Co 0022 Piro retardant treated wood shall have flame spread or 0023 ,,,, „,Notify Building Division prior to pining any concrete 0024 ,,,,,,,, All spray applied fireproofing shall be special inspected 0025 All wood to NMI!) in placed concrete shall be treated 0026 All structural masonry shall be special inspected 0027 „ „,,,, Validity or Penult 0028 flack storage requires separate permit 0030 No occupancy of building until final insp by Bldg Div 0031 Comply with requirements of TMC 16,04 0032 Remove all weeds, concrete, stone foundations, flat concrete 0034 Removal orscptle tanks require approval and compliance with King Co I lcalth Dept. 0035 Contact PW Div to obtain insp for water /sewer connect 0036 Manufsgurcrs installation instructions required on situ 0038 ,,,,,,,, A C o1'O will be required for this permit 0039 Final approval for all Ti w /in the limits of the SC Mall 0040 All construction noise to be in compliance with 8,2 TMC 0041 Ventilation is required for all new rooms & spaces 0042 Fuel burning appliances 0043 Appliances, which generate 0044 Water heater shall be anchored 0045 Reroof "Anchoring -- Ail new construct and substantial improvement shall be anchored to prevent flotation” Plan Reviewer: Date: 0 Date: Permit Tech: It PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: MI02 -156 DATE: 0923 -02 PROJECT NAME: COUNTRY VITTLES - DEMOLITION SITE ADDRESS: 14212 PAC HY S X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # After Permit Is Issued DEPARTMENTS: Building Division ❑ Fire Prevention Public Works ❑ Structural 30( Planning Division Permit Coordinator ❑ DETERMIN:_ .ON OF COMPLETENESS: (Tues., Thurs.) Complete ❑ Comments: Incomplete 0 DUE DATE: a-24 -02 Not Applicable ❑ Permit Center Use Only INCOMPLETE LETTER MAILED: Departments determined Incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:, LETTER OF COMPLETENESS MAILED! TUESITHURS ROUTING: Please Route ❑ Structural Review Required ❑ No further Review Required ❑ REVIEWER'S INITIALS: DATE: APf sQVALLQR CODE T� IONS: DUE DATE: i Q Q2 Approved ❑ Approved with Condition Not Approved (attach comments) ❑ Notation: REVIEWER'S INITIALS:. DATE: 1 � OZ., Permit Center Use Only CORRECTION LETTER MAILED: .. Departments issued corrections: Bldg ❑ Fire ❑ Ping Cl PW ❑ Staff Initials: Documents/routing slip.doc 2.213.02 PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: MI02 -156 DATE: 09 -23 -02 PROJECT NAME: COUNTRY. VITTLES - DEMOLITION SITE ADDRESS: 14212 PAC. HY S %Original Plan Submittal Response to Incomplete Letter #,_,_ Response to Correction Letter # Revision # �.. After Permit Is Issued DEPARTMENTS: Building Division ❑ Fire Prevention ❑ Planning Division 31( Public Works ❑ Structural ❑ Permit Coordinator ❑ DETERMINATION OF COMPLWN(SSS : (Tues., Thurs.) Complete fik Comments: Incomplete ❑ DUE DATE: 0 -24-02 Not Applicable ❑ Permit Center Use Only INCOMPLETE LETTER MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW 0 Staff Initials: LETTER OF COMPLETENESS MAILED: TUES/THURS ROUTING: Please Route ❑ Structural Review Required ❑ No further Review Required Lk REVIEWER'S INITIALS: ..y _�_..�� DATE: 12-4. 2L ,OV R ORRECTIONS: DUE DATE: 10 -22 -02 Approved ❑ Approved with Conditions ❑ Not Approved (attach comments) ❑ Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: bldg CI Fire 0 Ping 0 PW ❑ Staff Initials: Oocwnentshouting slip.doc Z•tg -OZ 1g PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: MI02 -156 DATE: 09 -23 -02 PROJECT NAME: .....COUNTRY V-IT.TLESa DEMOLI'IC!N . SITE ADDRESS: 14212 PAC HY S _ X_Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # After Permit Is Issued DEPARTMENTS: Building Division ❑ l=ire Prevention Public Works Structural ❑ Planning Division ❑ © Permit Coordinator ❑ D ERMINMION.OFCt'JJMPLETENESS: (Tues., Thurs,) Complete ❑ Comments: Incomplete 0 DUE DATE:.X9 124 -Q Not Applicable ❑ Permit Center Use Only INCOMPLETE LETTER MAILED: Departments determined Incomplete: Bids ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: LETTER OF COMPLETENESS MAILED: TUESITHURS ROUTING: Please Route "f Structural Review Required ❑ No further Review Required ❑ REVIEWER'S INITIALS :__ DATE: ,_—_�0.1„,g,„,_ tirnaYMELQUORLEMMI Approved ❑ Approved with Conditions 0' DUE DATE:,._ IN/4g Not Approved (attach comments) 0 Notation: REVIEWER'S INITIALS: DATE: 01 ► a 5. a -- Permit Center Use Only CORRECTION LETTER MAILED:..._._ Departments issued corrections: Bldg ❑ Eire ❑ Ping PW ❑ Staff Initials Oocyments touting slip.doc 2 -24-02 18 "§ ea t 7 0j, 1 0 / eviAftety 4 .1\ All.01•1111111.1111111011•1111111.1MANNII HIM 102.4MNI titArto I, DEPARTMENT OP LABOR AND INDUSTRIES -REGISTiABD AS PROVIDED BY LAW AS CONST,CONT. GENERAL • t ..,0:111iNnOTW C:1:;VAEXPWPATE CCO1 RLCLEEI097N2 04/15/2004 EFFECTIVE DATE 08/22/1991 R L CLEARING & EXCAVATING INC PO BOX 4203 FEDERAL WAY WA 98063 - .• AA102.•-15(0