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Permit MI2000-190 - FRIDLEY RESIDENCE - DEMOLITION
LAURA FRIDLEY DEMO 12202 42 AV S • City of Tukwila NE- P krith r / /o,' (206) 431-3670 Community Development / Public Works • 6300 Southcenter Boulevard, Suite 100 • Tukwila, Washington 98188 MISCELLANEOUS PERMIT WARNING: IF CONSTRUCTION BEGINS BEFORE APPEAL PERIOD EXPIRES. APPLICANT IS PROCEEDING AT THEIR OWN RISK. Parcel No: 017900 -0005 Address: 12202 42 AV S Suite No: Location: Category: DEMO Type: MISCPERM Zoning: LDR Const Type: Gas /Elec.: Units: 001 Setbacks: North: Water: TUKWILA Wetlands: Contractor License No: OCCUPANT OWNER CONTACT CONTRACTOR Permit No: Status: Issued: Expires: MI2000 -190 ISSUED 09/01/2000 03/04/2001 Occupancy: DWELLING UBC: 1997 Fire Protection: .0 South: .0 East: .0 West: .0 Sewer: SEPTIC Slopes: N Streams: OUALIST005JJ FINDLEY DEMOLITION 12202 42 AV S, TUKWILA, WA 98168 JACOBSON JAMES 12202 42 AV S, TUKWILA WA 98168 JASON BLAND 1916 SW HOLDEN, SEATTLE, WA 98106 QUALITY STONE & TILE 1916 SW HOLDEN, SEATTLE, WA 98106 ***************************************************** * * * * * * * * * * * * * * * * * * * * * * *k * * * * * ** Permit Description: DEMOLITION AND REMOVAL OF BURNT OUT HOUSE. BACK FILL THE CRAWL SPACE HOLE, AND INSTALL IN- GROUND STORM DRAINS. ***************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Construction Valuation: $ 14,000.00 PUBLIC WORKS PERMITS: *(Water Meter Permits Listed Separate) Eng. Appr: Curb Cut /Access /Sidewalk /CSS: N Fire Loop Hydrant: N No: Size(ln): .00 Flood Control Zone: N Hauling: N Start Time: End Time: Land Altering: N Cut: Fill: Landscape Irrigation: N . Moving Oversized Load: N Start Time: End Time: Sanitary Side Sewer: Y No: Sewer Main Extension: N Private: Public: Storm Drainage: Y Street Use: N Water Main Extension: N Private: Public: r***** * * * * * * * * * * * * * * * * * * * * * ** * * ** * * ** ***************** * **** * ** * * ** * * * * * * ** * * * * * * * * ** TOTAL DEVELOPMENT PERMIT FEES: $ 96.5 *************************** ** * * * * * * * * * * * * * * * * ** * * * ** * * * * * * * ** *** * ** * * * * * * *** * ** Phone: Phone: 206 - 387 -8462 Phone: 206 - 387 -8462 Permit Center Authorized Signatur I hereby certify that I have rea -:)4- nd examined t ate: o?" ©/ —rte is permiyand know the same to be true and correct. All prob"isions 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 state or local laws regulating construction or the performance of work. I am authorized to sign for and obtain this development permit. Signature Print Name:_:=2cu,scli.a Date: j..... __.. 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. V US 2 Z� 1 City of Tukwila (206) 431 -3670 Community Development / Public Works • 6300 Southcenter Boulevard, Suite 100 • Tukwila, Washington 98188 MISCELLANEOUS PERMIT Ze-�o 9/1/� WARNING: IF CONSTRUCTION BEGINS BEFORE APPEAL PERIOD EXPIRES, APPLICANT IS PROCEEDING AT THEIR OWN RISK. Parcel No: 017900 -0005 Address: 12202 42 AV S Suite No: Location: Category: DEMO Type: MISCPERM Zoning: LDR Const Type: Gas /Elec.: Units: 001 Setbacks: North: Water: TUKWILA Wetlands: Permit No: Status: Issued: Expires: MI2000 -190 ISSUED 09/01/2000 02/28/2001 Occupancy: DWELLING UBC: 1997 Fire Protection: .0 South: .0 East: .0 West: .0 Sewer: SEPTIC Slopes: N Streams: Contractor License No: QUALIST00 5JJ OCCUPANT OWNER CONTACT CONTRACTOR FINDLEY DEMOLITION 12202 42 AV S. TUKWILA, WA 98168 JACOBSON JAMES 12202 42 AV S, TUKWILA WA 98168 JASON BLAND 1916 SW HOLDEN, SEATTLE, WA 98106 QUALITY STONE g TILE 1916 SW HOLDEN, SEATTLE, WA 98106 k*' k* k* kkk** kk* k**. pk -k*A *kkkA4k* * *A'kkkk.kAk *kkk *A k4kkkk** k*k*Kkkk-4 **kk *kkkkkk*kkh* *AkAk Permit Description: DEMOLITION AND REMOVAL OF BURNT OUT HOUSE. BACK FILL THE CRAWL SPACE HOLE, AND INSTALL IN-GROUND STORM DRAINS. ** k** k- A*I ***** ****k ****.kkAkkk1*AA* AkA,kk**# * *k 4kkkkk* Ak **kkkk**1*.4k***kkkkk******'** Construction Valuation: 4 14,000.00 PUBLIC WORKS PERMITS: k(Water Meter Permits Listed Separate) Eng. Appr: Curb Cut /Access /Sidewalk /CSS: N Fire Loop Hydrant: N No: Sizet in): .00 Flood Control Zone: N Hauling: N Start Time: End Time: Land Altering: N Cut: Fill: Landscape Irrigation: N Moving Oversized Load: N Start Time: End Time: Sanitary 5Ide Sewer: Y No: Sewer Main Extension: N Private: Storm Drainage: Y Street Use: N Water Main Extension: N Private: Public:: *** ** * * ** 444* *4•***4**4* 444* k*' kk' kkr4* kkk kkAtk* A* 4k44ASi4kA4444 *4k4kkkkkkkk'*4kk*•kk4*4l*Ak1 TOTAL DEVELOPMENT PERMIT FEES: i+ 96.50 444**** 4*• 444rlkk*kwk**4*4*4** *•k*444k444444'kkkkkkk4 *A 44444444* 44444kkkk4• 4444 4 *kk *kx Phone: Phone: 206 -387 -8462 Phone: 206-387-8462 Public: Permit Center Authorized ignature :,l Of .Y Un ! -. v .r itiate: ...9-17/aw I hereby certify that I have read and examined this permit and now 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 provision of any other state or local laws regulating construction or the performance of work. I am authorized to in for and obtain this development permit. Signature: Print Name: %A.44) ,.,-,„ Date: ..- F ..0 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 fora period of 180 days from the last inspection. lisp City of Tukwila (206) 431 -3670 Community Development / Public Works • 6300 Southcenter Boulevard, Suite 100 • Tukwila, Washington 98188 MISCELLANEOUS PERMIT WARNING: IF CONSTRUCTION BEGIN; BEFORE APPEAL PERIOD EXPIRES, APPLICANT IS PROCEEDING AT THEIR OWN RISK. Parcel No: 017900 -0005 Address: 12202 42 AV S Suite No: Location: Category: DEMO Type: MISCPERM Zoning: LOR Const Type: Gas /Elec.: Units: Setbacks: Water: Wetlands: 001 North: TUKWILA .0 South: Sewer: Slopes: Permit No: Status: Issued: Expires. MI2000 -190 ISSUED 09/01/2000 02/28/2001 Occupancy: DWELLING UBC: 1997 Fire Protection: .0 East: .0 West: .0 SEPTIC N Streams: Contractor License No: OUALISTOOSJJ OCCUPANT OWNER CONTACT CONTRACTOR FINDLEY DEMOLITION 12202 42 AV S, TUKWILA, WA 98168 JACOBSON JAMES 12202 42 AV S, TUKWILA WA 98168 JASON BLAND 1916 SW HOLDEN, SEATTLE, WA 98106 OUALITY STONE & TILE 1916 SW HOLDEN, SEATTLE, WA 913106 kkk*" k* kk* kk **k*kkk*k*'kkkk *k*kk*irk•k**** 4* *kk.k•* kk*** k,4 *k *k"k* *k*k**k"kk *k * *k 4kk**** *•k'k`k k` Permit Description: DEMOLITION AND REMOVAL OF BURNT OUT HOUSE. BACK FILL THE CRAWL SPACE HOLE, AND INSTALL IN- GROUND STORM DRAINS. * Aklk***** k*** k******* kkk` kkk**•*** kkkk* kkk* kk kkkk* k** k* kk*kk *kkkk*** **kk **k*k** *k*A*A Construction Valuation: $ 14,000.00 j PUBLIC WORKS PERMITS: *(Water Meter Permits Listed Separate) Eng. Appr: Curb Cut /Access /Sidewalk /CSS : N Fire Loop Hydrant: N No: S i z e ( i n) : .00 Flood Control Zone: N Hauling: N Start Time: End Time: Land Altering: N Cut: Fill: Landscape Irrigation: N Moving Oversized Load: N Start Time: End Time: Sanitary Side Sewer: N No: . Sewer Main Extension: N Private: Public: Storm Drainage: N Street Use: N Water Main Extension: N Private: Public: kk**• A*** kkk*** k* k" kk* kkkkkk*' k** kk** 4kk4k* kkkkkkk` kkkkkfk4* kk`kk*kkkkkkkkkkk'kk**Ak *kkkk* TOTAL DEVELOPMENT PERMIT FEES: $ 51.50 f • Akkk* kkkk` k****•* k*" k" kk* k4 A' k* kk• k' k*' k" k kkAkk' k* k**** kkk* kkkkkkkk "k*k *kkkk*kk*k**kk*Adikkkk"k* Phone: Phone: 206 - 387 -8462 Phone: 206-387-8462 Permit Center Authorized Signature: act-. Date: CF.' I hereby certify that I have read and examined th`i•rl permit and know the sane 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 provision of any other state or local lawn regulating construction or the performance of work. I am authorized to sign for and obtain this development permit. i g n a t u r e : �,.,— -,f� ►...�.e.cs �"X Date: �..�' ` � 012Q. Print Name:_ plc t�b4 i( 0_4 This permit shall become null and void if the work it 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. 1i Address: 12202 42 AV S Suite: Tenant: Type: MI CPERM Parcel #: 017900 -0005 ZEPAriOrt.�� CITY OF TUKWILA Permit No: MI2000 -190 Status: ISSUED Applied: 08/11/2000 Issued: 09/01/2000 . ********** k** k**** k* k* ** *****:k *k-k *•**kk*k *•k•k *"c *k **k** * *•kk•kk* **k *•*fk *"kk* *** Permit Conditions: 1. No changes wi11 be made to the plans unless approved by the Engineer and the Tukwila Building Division. 2. All construction to be-done in'conformance with approved plans and requirements of the Uniform Building Code (1997 Edition) as amended, Uniform Mechanical Code c(1997 Edition), and Washington .State:. Enor gv Code : (1997 Edition). Electrical permitsf...shai1 be obtained through the Washington State Division ol' Labor and Industries andall electrical work wi li`{be inspected by that agency (248- 6630) All per nits, inspe "ct i can records, . and approved plans". shall , be available at the f eb site prior to , the start of env ucon- struct iin r These " document are to he maintained and avail's, able/until .fine) inspeoti`on`• approval is granted: Tempu;rery erosion control measures shell be implemented as the'f$rsti order of business to prevent sedimentation off- sitib'£ or into ,existing storm° drainage facilities . The,Sito shall have permanent erosion control measures i p facie as soon as possible after final grading has been completed end prior to the aFinal Inspection. CSON 'RACTOR SHALL NOTIFY PUBLIC WORKS UTILTIY INSPECTOR MR. GR d VILLANUEVA 0(206)433 -017 9 OP COMMENCEMENT AND COMPLETION OF ,WORK AT LEAST 24 HOURS IN ADVANCE. Sewer ,and *ater,utllities shall be plugged at the mains if they are'to be abandoned. If they will be used again in the near future for a new building, they shall be capped at the :property line and at the :water meter respect i ve 1y 9. Any material spilled onto any ,street shall be cleaned up immediately. 10. Hauling over 50 Cy shall require application for a Hauling Perm;l t prior .: ", to any associated activity. 11. Any septic tanks. in the area 'shall . be r °pumped empty rand removed or f i l l e d .;.wi th sand. A copy # of documentation from the business that' perf ormed the pumping shall be provided to the. City Utilities "Irispeotor.. 1.2. THE CITY WILL NOT ALLOW CONNECTION -TO THE STORM DRAN SYSTEM FOR THE PURPOSE OF EROSION CONTROL. PROVIDE EROSION PREVENTION AND SEDIMENT CONTROL PER THE 1998 KING COUNTY SURFACE WATER DESIGN MANUAL, APPENDIX D. '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 viplate or cancel the provisions of any other work or local laws gt * *sl0444 4i****/,*0.4** Ah 4* 14****** A* 0*• dkA* 4 4, 4** Aiii•llr *0.4 * * *4.* *.4 *4***** trTY. OF TUKWILA. WA 1UNN3MX1 ` *+ * *ti4***k*** 0** Ak******** 4* 11*******• A *•A ***** *** #4** ** **A*4d* * * *0* TRANSMIT Number: 89000353 AA :aura: 45.00 09/07/00 13112 Piyment, Method: CHECK Notation: JASON OLAND} /nit: itl)J + Y •1 .• •. M • 4 I. 44 • • • I all a • 144 - r .a • 1 4 • .14.4 am 4 .0 H .a • • ••• K M ... f 4* 44 4 • . 4. 4, IN M . a 44 44 44 •••• • • a 4 .1 M w .1 • .4 .. u M Ponmit No: PAr•cm i No: Sits f ddrress: MI2000- -190 'type: MIFU PEKA MISCELLANEOUS PI:i1MZT 017900-0005 122102 42 AY 0 Total Foci:: This I 1 ymt,nt 45.00 1•atu 1 ALL Pmt*: IIo1 iit1eN: 41,4* * #*4 * *4 *40 ** *** *** 01144 *04* *001 A *0040 *A *A *404 *** -kO4 Account Code Dater i p t i can 000/345.030 PLAN CHECK UTILITY 412/342.400 XNOP FEE, STORM DRAIN 402/3.02.400 INgP ru AMC/S30 96 k 30 •00 * *4404 *A Amount 10.00 13.00 ' :'0.00 •• .I. M • •1 fr 1. •.e e• .a r! • N x. 7 .* r! eM p •. .• •f 4. .. e. • •• •• •i' t. r• •. Ir 1+11 •• n •. M +� • IPOC,:)6 / 9 • 7 4,4ititkivAikA krv- or TUR '*141444,4*,4*' RANSM/T PaYmo.nit M rt4.DCD 51,60 CHM, 51,50 ith.P,64 09/05/00 . 19 *k*, :71(Orhielk;*AA*4,1-4*AitkAkAkA TRANSMIT A6:10 0007 75fA Apouett: 51.50 09/01/00 1/214 Oltions jABON OLAND Initt'ILO .....;—.."..... 0,W08010,4444. FO.P401.10$0.4.3NO 4/argil 10 Typo: MISIIPERH MISCELLANEOUS PEOIT Meirci C,UY(f,aV64005 0, Site AdilressA 12202 4! AV $ TotRI Foust 51.5W Mit ptymtrinl; 'n.50 fatal ALL Pmtg3 51.60 Saldneet .00 0,44044**4*4*AA40****AkA4.44‘4*A.A*044*A4****k44*04**A*14,04****0**#4, 0e6cript1on Amount SUILVIND - NONREV 47.00 STATE OUIL0ING SUSCHAS1; K AccoUnt, .000/322.100 000/306.104 • IS° O. 444O,M0 *N 3* NI IN ** *i 31. MN el if ••• 0;03 IN 01 0, 4 IN 0 Or IN 3, OW 4 IN 11'• II* 00 *3 N, 3. 3,3 3, ,33 I. 33 0 00. 4, : • r AAkiith r kA* ** *kA A * * * *k. ** *kh4 AtA* 14**AA.r4 *4FA 1*A TV Air rawxtA! WA ( (: TRANSMIT *kA4.4 *** *. # * *h4*' ** 1 * • .4* ** *A *I* *** *444***kA *** ANfMIT Numhitr:. R9,000 350 Amount: 51 w tO 01/01/0p 11 a 14 aygron h. Mt thod CHCON Not:' t i On a JA3Ol4 O LAND 1 n i t : 4T.1 «lt. .00 0 Iii 0. M it •• M s{. .. r H r. t Y M f . • • . • a. 0 ! : r. s . .a s. Y i M • W 6* — •. mu • . - OM Os . ►. O., IOW .. f . • . rt r y. • • I — • s r Y. M'. 1. w. I'qr ,rit. Not M/2000-190 Typo: liWNERA 1119';;t:,ii.ANEDUS PERMIT �.. Parcel Not 0 t 7900 •'0045 Bits °MddPet t 12202'42 AV $ Total root: 31.30 Th i LPcyiiv.nt 51.50 1 oto l ALL Pmts s 51.50 Ilul.ncox .00 A** *4 **#4kAAA: * ; * *AkA**iii *4 * * *+ A441%** * * *k **004 * ** * *44 ** * ** *0** ** Account Coat* Dot r i pt i on Amount t 000/3 22.100 BUILDING f. NONRES 47.00 000/396.904 STATE BUILDING IMMUNE UNE 4 «30 M' ►k M 11► #. w► t! 1M b . M M . M w.. ♦ .M •. it ►. a. w. w s ►. . ti ►s w. +. M. • s • t M fit .w ► s f'- b •. w. I5* f s 0k l M .. ►. M: / • wk • s M Y 1 s w ►. r... ri • s . s w bp. '.1`',•+ Address: Suite: Tenant: type: Parcel $: 12202 42 AV MISCPERM 017900.0005 CITY OF TUKWILA Permit No: M12000 v- 190 Status: ISSUED Applied: 08/11/2000 Issued: 09/01/2000 ***:****•k k***** k*******• k***• A: k****** * * *-k ** * *k* *** **•kA ** * * *** * ** *k k * * * * *1 A kk P+erMi,,t Conditions: 1, No changes will be made to the plans unless approved by the Engineer and the Tukwila.8uilding..Dtvision, 2, All construction to be •,dr fle. :irr conforrriance with approved • ".plans and requirements of Lhe Un i forrn tlu $ l d i ng, Code (1997 Edition) as arnon•ded, Un l.f orin Mechanical Code 1.1997 Edition) , and Washingtoh Statef; Energ, ` :Code t 1997 Edition) . £1ectrical permiis ,sita11. be obtained, through the Washington St rte: Divalsion of`� Laibor and.Industr.�les and gill °:electrl`r:a1 work will f <5be .,ln%pecied by that agency '1248. 66,30) , {' All permtt�, `'lnspect;ian records, and approved plans sha1'�1 avai lebl :e at the job site, prior °to �t:he startt of `array struc',tr1on,. Thest `docurner is are to;; be maintained anc4;..avai ab 1 e/ t 11 f 1 na 1„ 1 nspect i•on' approVa 1 is granted :,- g Tromp ary erosion ..control measures Shall be i rnp) omen the. f 1 reti,, order of business tro prevent ,sedimentation sib+ or Into ;ex istaing storm: drainage facilities . The Site shall havo permanunt arosion control measures 1 p1a a as �sbon as µass►1blrr;o, tar f1na1 `gredin! has been'° corq sleted -and prior t,o this '1nai. In pection. CO 'J ACTOR',: SC(ALL NO1 tr Y PULL TC WORKS UTILI I Y INSPECTOR MR, MGR G';VILLANUEVA @ (2004.h-0179,0r COMMENCEMENT ANU COMPl;CTIO►N' or` 'WORK AT LEAST 74 OURS IN ADVANCE. i�p Sewer ain`d,waatern,Uti i'1;t1es shall be plugged at the mains' ,they ark t o be;� ;bandon'ed,, If they will ..bra' used,again the near �1? ture for a new `buzi i d tng, )they : ha 1 1 be` ogpp'c'd at the property lino and at the water meter respect i.it°e1y. 9. Any raterlal spilled onto any sItregt; shall be cleaned up immediately. 10., Mauling over 50 'c ys,Itraaaii require application : for a Hauling Perri. prior to any °asso.c;fatgd. activity,,. Any septic tanks in the' area Shall be pumped empty and removed or filled with sand, A copy of documentation from the business that performed the pumping shall be provided to the City Utilities Inspector, I2, THE CITY WILL NOT ALLOW CONNECTION TO THE STORM DRAN SYSTEM FOR THE PURPOSE OF EROSION CONTROL. PROVIDE EROSION ' PREVENTION AND SEDIMENT CONTROL PER THE 1998 KING COUNTY SURFACE WATER DESIGN MANUAL, APPENDIX 0. CITY OF '/KWI LA Permit Center 6300 Southccnter Boulevard, Suite 100 Tukwila, WA 98188 (206) 431 -3670 'IR STAFF USE ONLY Project Number: Permit Number: MI2000 — [CO Miscellaneous Permit Application 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: �-avra r )k ./bc 9 c Ave S. v City State/Zip: 7414/1414,4161. dI1ld i Value of Construction: .- /y, vvv Tax Parcel Number: ' ' #' O! 7' cV- -dO05 -O0 Phone: (: %) �/5) _ d7O6 0 1 Q Site Address : /P)e)D Property Owner: / r,--td qu ro■ k Street Address: /9 j/ s`t/ //e% ph 70. C�ty� tate/Zip: Fax #: ( ) 4, Contractor: Q ¢ �/� Sl✓ o /den See A WA Cit State/Zip: 611 «''6 Phone: (406 )35 y �-/�j `.2 Fax it: (�vg) !I / _ l� / (� 7� / g/ Street Address: f N. Architect: • Water • Sewer 0 Standby Phone: ( ) Street Address: City State/Zip: Fax #: ( Engineer: • .._,....�., Phone: ( ) Street Address: , ... City State/Zip: Fax #: ( I Contact Person: j / _ Phone: (ZbG ) 31? f9i2 L. !_Ac___ dress: / 9/ S W f' 4/ h 5-' ip: Fax #: (J ; ).zlG'7 /O l MISCELLANEOUS PERMIT REVIEW AND APPROVAL REQUESTED: (TO REFILLED OUT BY APPLICANT) Descri/p'tion of work, to he done (please be specific): situ /14 f't/ 4rid P. ua I ©.h 6,,e` or,r/ hC9I Q, 5at.*' C1 // il'/1G crawl 5-1.4 Lk. ha14 -/ oh() ioast,l1 ,h grd,rtd slat t-}ra''flS . Will there be storage of flammable/combustible hazardous material in the buildings' ❑ yes 70 no Attach /1st of rnnterinls and scorn a locution on se wine 8 1/2 X 11 a ier indicntin uannttittless &Material Snlety data Sheets Above Ground Tanks Antennas /Satellite Dishes Bulkhead/Docks Ll Commercial Reroof Demolition ❑ Fence ❑ Manufactured Hnusin! •RIplacement only Parkin Lots ❑ Rotainin Walls ❑ Tarn lora Faelifties lJ Treo Guttin IMINIMMINIMOMMIk L.J Channellzntlon /Striping ❑ Flood Control Zone ❑ Landscape Irrigation Storm Drainage ❑ Water Meter /Exempt 11 APPLICANT RE UEST rOR MISCELLANEOUS PUB LIC WORKS PERMITS :1 Turb cul/Access/Sidowalk a Fire Loop /Hydrant (main to vaultl #: Size(s). _ SI Land Altering: 0 Cut cubic yards • Fill-jCL cubic yards 0 _sq. ft,grading/clearing ❑ Sanitary Side Sower #: ��, ❑ Sewer Main Extension 0 Private 0 Public ❑ Street Use ❑ Water Main Extension 0 Private 0 Public 0 Deduct 0 Water Only ❑ Water Meter /Permanent #_,_,__,,,_ ❑ Water Motor Temp ❑ Miscellaneous Size(s): Sizo(s): Size(s): Est. quantity: gal Moving Oversized Load /Hauling Schedule: MONTHLY SERVICE BILLINGS TO: Name: , 1�r1 5 / — ra ' _ Address: /w2 c, a2 sit, tl.o ' ✓� .��� �.:.'a _.._._l 0 Metro :�1 ty. t eA_ % w q � l C I • Water • Sewer 0 Standby ONNIIMPIIIIIIIIIIIINIIMNIMP WATER METER DEPOSIT /REFUND BILLING: : • .._,....�., Name: .d1 holm 9.06 Address: 1 ��•d a 5w /y a � ��� _ City /Sta e /Zip: r' , , .e ��lg�_ p�' /� / 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,. ihe building official may extend the time for action by the applicant for a period not exceeding 180 days upon written request by the applicant ? . defined in Section 107.4 of the Uniform Building Code (current edition). No application shall be extended more than once. Date appl' anon expires: 1APIiccnbY:(iI1ifM] p n i Date appllcat acceattd: 1111.111, 1111•11110•111.1111111MIMMEIMIMPOskm 919174 nitsrpm,.dnc 00 • 1 AlI MISCILIANEOUS P IT APPLICATIOIyS MUST BE SUIMI )› ALL DRAWINGS SHALL BE AT A LEGIBLE SCALE AND NEATLY DRAWN D BUILDING SITE PLANS AND UTILITY PLANS ARE 1'O BE COMBINED WITH THE FOLLOWING: 2-I S ets ,/ ARCHITECTURAL DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED ARCHITECT STRUCTURAL CALCULATIONS AND DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED STRUCTURAL ENGINEER X- CIVIL/SITE PLAN DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED CIVIL ENGINEER (P.E.) ❑ 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 issued, unless the homeowner will be the builder OR submit Form H -4, "Affidavit in Lieu of Contractor Registration ". Building Owner /Authorized Agent If the opplic nt Is other than the owner, registered architect /engineer, or contractor licensed by the State of Washington, a notarized'lettor from the, property owner authorizing the agent to submit this ermlt application and obtain thr. permit will b_ a required as part of this submittal. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PER JURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNER OR AUTHORIZED AGENT: 'l111 \1II nP('I I( AI ION AND REQUIRE 1) (HE( KI ISIS 10R PERMIT REVIIW Submit checklist No: M -9 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 Phan City /State/Zip: e, _ �!% ❑ Antennas /Satellite Dishes Submit checklist No: M -1 ❑ Bulkhead /Dock Submit checklist No: M -10 ❑ Commercial Reroof Submit checklist No: M -6 5'gr Demolition Submit checklist No: M -3 ❑ Fences - Over 6 feet in Height Submit checklist No: M -9 Land Altering/Grading/Preloads Subrnit checklist No: M -2 ❑ Miscellaneous Public Works Permits Submit checklist No: H -9 ❑ Manufactured Housing (RED INSIGNIA ONLY) Submit checklist No: M -5 ❑ Moving Oversized Load /Hauling ,.:. II ' Submit checklist No: M -5 ❑ ❑ Parking Lots ', I Submit checklist No: M-4 -Retaining-Walls - Over 4 feet In height Submit checklist No: M-1 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 issued, unless the homeowner will be the builder OR submit Form H -4, "Affidavit in Lieu of Contractor Registration ". Building Owner /Authorized Agent If the opplic nt Is other than the owner, registered architect /engineer, or contractor licensed by the State of Washington, a notarized'lettor from the, property owner authorizing the agent to submit this ermlt application and obtain thr. permit will b_ a required as part of this submittal. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PER JURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNER OR AUTHORIZED AGENT: Signature: / , Date: . 2a � _ fir, x #: (2A 1 76 1_ )0 Print Hama: ► ,. <,, Phan City /State/Zip: e, _ �!% Address: ici /'6 G,/ . / "j • PlaCneU.(AV a„ k • • t 1-11 7 INSPECTION RECORD INSPECTION NO, CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd, #100, Tukwila, WA 98188 Retain a copy with permit PERMIT NO. (206)431-3670 Project: 4 . d Y i , ALI A Type of Ins ection: Ca, Address.,., ,., A A A 3 Date called: Special instructions: PlittYlik4pki415 i4Vt a Va i L Ptitcae vaih, ilia t demo th taiiiptettl/ WON/ed., . Date wanted: 71q-o2 . I Request r: Tra Phone: ,Approved per applicable codes. COMMENTS: Corrections required prior to approval. *47.00 REINSPECTION FRE REQUIRED. Prior to Inspection, fee must be paid at 6300 Southcenter Blvd Suite 100. Call to schedule reins ectIon. Receipt No: Date: >V; f fek -- . tr. „ 4_4 5 INSPECTION RECORD Retain a copy with permit INSPECTION NO, CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd, #100, Tukwila, WA 98188 ihr.-?ouo- Iy PERMIT NO (206)431-3670 Project: . AA • Type of Inspectipie, 1 efaer Address: e (4( u • ate cailed: Special Instructions: i'kpd ti ()LA i 0 re,T i 1 /1 e r 1 1-e.4-- Mir ,Krit, ciii-y, f- firm c. goon be #I( C. $ive hi, pe(A4.0‘3, wlher Date wanted: a.m. Requlter: -- , Phone: a L, e '76 JApproved per applicable codes, El Corrections required prior to apProval. COMMENTS: N t • i # A I / . II, . . Als•Nr , <.... i 9 • . * ..< <191111■1111111M101911■1•111i Inspector: Date: $47.00 REINSPECTION FIE ROUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reins ection. Receipt No: Date: tit' 4, ,1140:474' INSPECTION RECORD Retain a copy with permit INSPtCtION NO, CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd, #100, Tukwila, WA 98188 (206)431 -3670 Project: ,, ' t, ..' al Type of Inspection: a , i /74 i �u / -in0 Address: / r II , etl Date cal '• d: A 0 Special instructions: Iko!'c/: cant' h0 r rah f► d„ ...-i. d . --- ebt.Jd (j() 14 P055#Uy C/O ►t bate wanted: a.m. Date ,3 /o ___ Requeste%: 'OW l °4 'Wet % ;irk i!(y Phone: te51`67ti , fJApproved per applicable codes. Corrections required prior to approval, i; ❑ $47,00 REINSPECTION E E REQUIRED. Prior to Inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reins s action. ar INSPECTION NO CITY OF TUKWILA BUILDING DIVISION INSPECTION RECORD Retain a copy with permit 6300 Southcente; Blvd, #100, Tukwila, WA 98188 PE N(y. (206)431 -3670 Pr► • t: . Type of Inspection: Address: 1 Date calved: pec al instructions: Date wanted. „ _0 Requester: A r / a► • ad Phone: pproved per applicable codes. COMMENTS: Corrections required prior to approval. • Q $47.00 REINSPECTION FEE REQUIRED, Prior to inspec on, at 6300 Southcenter Blvd. Suite 100. Call to schedule reins Orl ee must be paid action. Receipt No: Date; • 1 urc.e.1 0;7900 -vv54 v+ 1—) L .ess Earl 306a, r3 /() k �. ,4144 ,fir. Seale /'x Po 1 brrvewa y 37' 1 i 6tib;a ►��aF'r" A+- 9 r 5, 02 146 0 ; r��� ,4 cc , ~,, C r Derrell q/Na Dr5w6e) by be 4 1 1 Via aplar CITY OF TUKWILA we/' AUG 1 1 MO ess PERMIT CENTER 111 `' Cpr «s 4 i ASBESTO TEST I N C O R P O R A T E D "GOOD FAITH" ASBESTOS SURVEY 12202 42 "d Ave. S. 'Tukwila WA 98168 Page I of 4 INH20072S July 19, 2000 Quality Stone & Tile 1916 SW Holden Seattk, WA 98106 Attn: Jason Bland Ph: 206 -387 -8462 Fax: 206-764-1813 Note to PSCAA: This house is a one story newer vintage wood frame home that has burned. Heating throughout the house was baseboard /wall electric. There was no ACM TSI located associated with the heating units. Vinyl and tile flooring materials were sampled per each located homogenous area. The drywall and taping materials were uniformly sampled. There was no asbestos detected in any of the samples taken. If there is any additional located suspect ACM prior to or during demolition or renovation (such as but not limited lo, those materials listed on page 4), that was not discovered In this survey, the material(,) should be PACM unless tested otherwise b ' laborntorLfnult �sls._ INTRODUCTION On July 14, 2000, Asbesto - 'Pest personnel conducted a "good faith" asbestos survey (per U.S.R.P.A. /A.H.E.R.A. guidelines as designated and specified by Puget Sound Clean Air Agency and Washington Slate) of the r ' e c 11 w - < - e ed 22 1 Zn° Ave, E.. Tukwila, Kisw C lv. IV,Qs ia ►►u 9kIbNLThis survey purpose is to identify any Asbestos Containing Materials that may be present and will require professional removal prkeenTUEKWIL, renovation or demolition of the structures. NARRATI VE OF FINDI_ NGS AUG 1 1 2000 BASIC CONSTRUCTION (Including siding and roofing types): The house is one -story ran' CENTER frame on concrete and wood foundation. The exterior siding is wood. The wood siding vapor barrier underlying material was sampled, The house three tab composition roofing was sampled. ATTIC /WALL INSULATION: There was no relating suspect ACM located, PLUMBING SYSTEM: There was no relating suspect ACM located, *INTERIOR CONSTRUCTION, FINISHES, AND FLOORINGS: The inside of the house is wood and drywall. The drywall /taping materials were uniformly sampled. Vinyl and tile flooring materials with relating backings and mastics were sampled per each located homogenous area. 8003 156th ST. SE • SNOHOMISH, WA 98296 • (425) 489-4040 • Seattle (206) 523 -5117 Pager (206) 699 -4629 CONTINUE PO PACE 2 Page 2 of 4 July 19, 2000 IN 00200725 Asbesto -rest, Inc. (425) 489 -4040 single family dwe/l/np and �eara�e (`7x,12202 2nd Ave. �„ Tukwila. Washington 98168 ELECTRICAL SYSTEM: The electrical wiring insulation is of newer vintage and not of the kind to be ACM and was not sampled, Any additional suspect electrical wiring insulation or any suspect TS! (Thermal System Insulation) found in around, or behind any located fuse or breaker boxes should be considered to be ACM (Asbestos Containing Material), unless determined otherwise by laboratory analysis, HEATING AND VENTILATION SYSTEM: The heating system is baseboard/wall electric throughout. There was no visible suspect ACM located associated with the electric heaters. Note: It was not possible to dismantle the baseboard/wall electric heating units to locate and/or evaluate any additional suspect ACM which may be Concealed, inside the units, or associated in hidden areas, It is our opinion any further handling of the heating units should be coordinated by the project manager and/or abatement contractor. If any additional relating suspect materials are located prior to and/or during any demolition or renovation, any and all additional related suspect materials should be considered to be ACM (Asbestos Containing Material), unless determined to be otherwise by laboratory analysis. Misc.: The window glazing was sampled. ADDITIONAL BUILDINGS INCLUDED IN SURVEY: There Is a garage behind the house, The structure is wood frame on a concrete slab. The rooting Is homogenous with the house, There was no gelatin_ sus ect ACM located. # of structures Included In survey: one house & one garage Requested by: Jason Bland eider, B.Se. tor, certified A.1- 1,E,R.A, red.#CLAY5327 (Expires 8/17/00) CONTINI11: TO PAGI: 3 pscety OITY AR TU WiLA AUG 1 1 2000 PERMIT CENTER • Page 3 of 4 July 19, 2000 IN8200725 Asbeslo -Tess, Inc. (425) 489 -4040 sinMIe family dwelling and ttarape Cal 12202 42Md Ave. E., Tukwila, Washington 98168 THERE WAS NO ASBESTOS DETECTED IN ANY OF THE SAMPLES TAKEN. ANALYSIS ID ASBESTOS //TYPE // s UANTITY OTHER MATERIAL 1.0) composition roofing NAD and underlying materials- house & garage homogenous 2.0) sheet vinyl flooring kitchen - color: brown 2.1) mastic -clear 3.0) sheet vinyl flooring bathroom - color: cream design 3.1) mastic -clear 4.0) window glazing 5.0) drywall 5.1) drywall taping compounds sampled per AFIERA protocol 6.0) wood siding vapor barrier NAD NAD NAD NAD NAD NAD NAD NAD NOT TO SCALaI?, non - fibrous materials, cellulose, tar, fiberglass non - fibrous materials, cellulose, fiberglass adhesive, cellulose non- fibrous materials, cellulose, fiberglass adhesive, cellulose non - fibrous materials, cellulose non - fibrous materials, cellulose non - fibrous materials, cellulose non - fibrous materials, cellulose, fiberglass, tar q RECEIVED CITY OF TUKWILA AUG 1 1 2000 PERMIT CENTER 42nd Ave. S A =HOUSE, 13.--.GARAGE continue to page 4 Page 4 of 4 July 19, 2000 I10200725 Asbesto -Tess, Ina (425) 489 -4040 single family dwelling and garage 12202 42nd Ave. E., Tukwila, Washington 98168 Some sample analyses listed may be a representative analysts of individual and separate samplings and analysis of homogenous materials, as prescribed by AJ! S. R.A. protocol. Samples taken are listed with their corresponding analyses. /fasbestos Is detected, those samples containing asbestos are listed first and noted with the initials "ACM". If, during demolition or renovation, any additional hidden or covered suspect materials similar to those identified in the survey are located [niay include but not limited to: sheet vinyl flooring, rile flooring, wall or ceiling texturings or paints, concrete siding or skirting, cement pipes, cemeint wallboard, electrical cloth, electrical wiring insulation, thermal paper, wallboard, joint compounds, vinyl wall coverings, spackling compounds, or any other suspect TSi (Thermal System Insulation)J, they should be treated as Asbestos Containing Materials unless determined to her noin•asbestos by laboratory analysis, Note: Asbcsto -Test, Inc. does not guarantee approximations of quantities of ACM, which may be listed with the analyses, It is therefore recommended professional abatement price and /or disposal quotes be obtained by inquiring as to fees per area of specific ACM material (i.e. square or linear foot, etc.), or by on site assessment, Any and all materials identifier/ as ACM In this report must be abated prior to ACA1 disturbance, renovation, or demolition. A licensed professional asbestos abatement contractor muss do the asbestos abatement, !f the structure is to undergo any kind of demolition or renovation and is not a single family dwelling. lithe structure is a single family dwelling and Is to undergo demolition, any and all materials ldentl/led as ACAI must be profvsslonally abated by a licensed asbestos abatement contractor prior to an talrlurbance. analytical it method: USIII'A 600/1(93/1 I6•* (I'LM) agYs ACM signlnes "Asbestos Containing Material" PACM signifies "Presumed Asbestos Containing Muturiul" CAD signifies "Concrete Asbestos Board" < signifies "less than" TSI signifies "Thermal System Insulation" IIVAC signifies "Heating Ventilating Air•Conditiontng" NAD signifies "No Asbestos Detected" "One percent is the USSIWA regulatory limit for asbestos in bulk samples. Pt.M has bean known to miss asbestos in %null percentages of some samples, which contain asbestos, thus negative PIM results cannot be guaranteed. Floor tiles and wipes should be tested with SI'..M or TEM, to insure analytical accuracy when reported in small percentages, Asbesto- Test. Inc. claims responslblllty,%ot• sample content only. ENt! OF REPORT RECEIVED CITY OF TUKWILA AUG 1 1 2000 PERMIT CENTER Ark: ' . chnei . r Analyt• 6 l Chemist, Q,Sc. PERMIT COORD COPY PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: MI20.00 -190 _ __ DATE: 8 -11 -2000 PROJECT NAME: LAURA FRIDLEY HOUSE DEMO SITE ADDRESS: 12202 42 AV S Original Plan Submittal Response to Correction Letter # Response to Incomplete Letter # _ Revision # After Permit Is Issued DEPARTMENTS: B it ing Division 1:2,1 Put I w) Lb I ifraK 1. H'w Fire ration Structural E21 Planning Tivision Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Incomplete.' ❑ Complete Comments: DUE DATE: 8- 15 -20Q0 Not Applicable El TUES/THURS ROUT G: Please Route Structural Review Required REVIEWER'S INITIALS: ❑ No further Review Required DATE: APPROVALS o CORRECTIONS: (ten days) Approved ❑ Approved with Conditions REVIEWER'S INITIALS: DUE DATE 9- 124OOQ Not Approved (attach comments) LJ DATE: CORRECTION DETERMINATION: Approved E Approved with Conditions ❑ REVIEWER'S INITIALS: *moult ix*. DUE DATE Not Approved (attach comments) ❑ DATE: ,,,.•..x -o••• ..•,,*..•,re...+,., mean. .w5.wa.'wcrc.+.r...w.4.>Aw.+P.Wg: 1, • .1.1%21N11, , ,'r., t N t•.1 • ., 1. , to •p.•i•,,WI!:.• • • REGISTERED AS PROVIDED BY LAW AS. I CONST CONT GENERAL REGIST. # EXP. DATE j. CCO1 QUALXST005JJ 03/02/2001 EFFECTIVE DATE 04/11/2000 1 I. 1 QUALITY'STONE & TILE 1916 SW HOLDEN ST SEATTLE WA ,'98106 ,•• • 4' it Signature !Milled by DiPAR'1•MI;NT OP LABOR AND INDUSTR113S t „�,. ,•, i, 1 1• •„ ± • y 111 ( �li•RI �!t. ' ,. ` ' t;.{! 'ti.t11 1, r , a • • t ij t t r ..','• $1411 • 1 ;i It1,f, r•,; 1 .! ,'' 1 ,• 1 t , .r i " 1411.1 ?S1! .; :t;''3 ;•}tip u.+ ! :1 • .,, •aF';; Mt' j ;'t +! } ; L.,t t: 1211,, • '�(F .1;':'.1;',41' ,(rs j,, .t it:.; rr t ' l :11 .•,11 � X1.„0 . • t't ,.i �'ti . r t ,L'1' •i•ti • '.' 5:; 1ij tr , • • It •'t '•t • t. • '1 • : •,. • • t.