HomeMy WebLinkAboutPermit MI99-0042 - SHAFLICK RESIDENCE - GARAGE DEMOLITIONM199-0042
4408 So. 122nd St.
EXPIRED
Gre
City of Tukwila (
(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: 334740 -1170
Address: 4408 S 122 ST
Suite No:
Location:
Category: DEMO
Type: MISCPERM
Zoning: R1.72
Const Type:
Gas /Elec.:
Units: 001
Setbacks: North:
Water: TUKWILA
Wetlands:
Permit No:
Status:
Issued:
Expires:
MI99 -0042
ISSUED
03/18/1999
09/14/1999
Occupancy: PRIVATE GARAGE
UBC: 1997
Fire Protection: NA
.0 South: .0 East: .0 West: .0
Sewer: SEPTIC
Slopes: N Streams:
Contractor License No: KLEENEIT055KA
OCCUPANT GREGG SHAFLICK
4408.S 122 ST, TUKWILA WA 98178
OWNER SHAFLIK GREGG
4410 S 122ND ST, TUKWILA WA 98178
CONTACT GORDY SHAFLICK
24516 43 AV S, KENT WA 98032
CONTRACTOR' KLEEN ENVIRONMENTAL TECH.INC Phone: 206 -285 -8010
754 GARFIELD, SEATTLE, WA 98109
* k *** k** *"k* ** * * *"k * *•k k'k* k***** * * * * * *** * * * * * * ** * * *"k *** *"k * * ** ** * * **:k *** * * *"k ** * * * ** * *"k
Permit Description:
DEMOLITION OF A 276 SO FT DETACHED GARAGE.
***************** k*********************************** * * * * * **** * * * * * * * * * *** * * **-k****
Construction Valuation: $ 2,000.00.
PUBLIC WORKS PERMITS: *(Water Meter Permits Listed Separate) Eng. Appr:
Curb Cut /Access /Sidewalk /CSS N
Fire Loop Hydrant:. N No: Size(in): .00
Flood Control Zone: N
Hauling: N Start Time:
Land Altering: N Cut:
Landscape Irrigation: N
Moving Oversized Load: N Start" Time:
Sanitary Side Sewer: N 'No:
Sewer Main Extension: N Private: Public:
Storm Drainage: N
Street Use: N
Water Main Extension: N Private: Public:
' k*************** k**********************: k************ * * * * * * * * * * * * ** * * * ** * *** *** * * * **
TOTAL DEVELOPMENT PERMIT FEES: $ ,51.50
k* k****** k*********************** k******************.* **.* * ** * ** * ** *** * * * * * * ** * * ** * **
Phone: 206 -722 -2104
Phone: (206)277 -3676
Phone; 253- 839 -6115
End Time:
Fill:
End Time:
Permit Center Authorized Signature :_J 1./11A:)114.;
�... Da t e .: —IE_!_1—_
I hereby certify that I have read and examined his 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 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 perm
Signature:___
Print Name:_
04.64411J!,„
Date:
This permit shall become null and void if the work is not commenced within
180 days from the date of issuance, or if the work is suspended or abandoned
for a period of 180 days from the last inspection.
RECEIVED
MAR 2 4 1999
TUKWILA
PUBLIC WORKS
CITY OF TUKWILA
Address: 4408 S 1.22 ST; Permit No MI99 -0042
Suite:
Tenant:
Type: MISCPERM
Parcel #: 334740 -1170
Status: ISSUED
Applied: 03/01/1999
Issued: 03/18/1999
*** k• k***• k** k**• k *k•k *•k•k*k:•k•k *•kkk * * *•k* * ** kli k' k* k* k* kk** 4. 4 .*4•k ***.kkk•k•k•kk*•k * *•k•kkkk
Permit Conditions:
1. Validity of ' Permit, The issuance of a permit or approval of
'plans, specifications, and !computat,I.ons shall not be con-
strued to be a permit tor,,;or 4ankrapproval of, an jjr hit in
:of any of the provision S :of'•the buiidlng 'co!le:,or of any
other ordinance of the 3ur.i d1ct 1o,»•.,: No per ait" re uming, to
give authority }tc•• viollate, or canoe ",1; the cfrovis'i`ons of this
code shall be' va 1 i d It rs
�.. Remove all weed ,, concrete, stone foundatithis,--,flat','an-
crete, concrete pat,i'os, masonry wa 1 1 s,,,,. gara'g e' t;l o,or d`r` i ve-
ways and Simi;'Jar truotures and x,11 loos.e::riscellatr %eous
mater l 1 . Pro er.ly,. ca saris., r ewer. ,
� - � p tia is and dater Conr;►.ec.
t ions, pro.perly f 1.11 or ;,otherwi se `protect al 1 base»ents ,
cella'rs, septic tank -1', a ris
and other excavations.
3. No C a`riges`'w.i 1 I be made to the, scope of work: un 1 es s
appr,`oved:`''b`y=,.Tuk.`wi1a. 13u B011ting,, Div s1on; r
CITY OF 7 'IKWILA
Permit Center
6300 Southcenter Boulevard, Suite 100
Tukwila, WA 98188
(206) 431 -3670
Miscellaneous Permit Application
Application and plans must be complete In order to be accepted for plan review.
Applications will not be accepted through the mall or facsimile.
Project Name/Tenant: „p A J
r Q4 11 I/,
h
Will there be storage of flammable /combustible hazardous material in the building? ❑ yes ❑ no
Attach list of materials and storage location on se•arate 8 1/2X 11 •a.erindicatin. •uantities & Material Safet Data Sheets
Value of Construction �O D^�,
Site Address: � p II City State /Zip:
'�� DS r '�i/l izz n 5 +. 1 c�{�w, f��j vv ` � {� $
Tax Parcel Number:
33 -L17°49 D --117D - D
Property Owner:
V
V. Shu-'l k
Phone
(_ob 72-Z-
Fax #:
_.
Phone( 339 - (/ LS'
Fax #:
Street Address: v�
3310 S .�`'-r4- I a.► C±. 'e�-Uie.
City State /Zip:
TWA • 9% ■ k
Contact Person:
("I 0,H, c,1 � 1,141 1
j!
Street Address: J City State /Zip:
,yS /� 1-/3 crP Ave. S. ke Kt- , bad .9gO3a
Contractor:
f- 'teen /En ✓(jvnrl�Pnlc(( 7Pe�/Aolo')ies13---;06
Phong:
(�vb) ad-5 -olO
Street Address: t— / /St / IOt e /Zip:
��Li l'10����P ct �(�r 1
Fax t)Y- �� 076, y/
(�Z ro
Architect:
Phone:
Street Address:
City State /Zip:
Fax #:
Engineer:
Phone:
Street Address:
City State /Zip:
Fax #:
MISCELLANEOUS. PERMIT REVIEW AND APPROVAL' REQUESTED::(TO•BE FILLED ;.OUT BYAPPLICANT).,
Description of work to be done: , // ,p /
�en10I/tial7 6) 714 �iyie, �ara )e(�7‘ - ,�f
Will there be storage of flammable /combustible hazardous material in the building? ❑ yes ❑ no
Attach list of materials and storage location on se•arate 8 1/2X 11 •a.erindicatin. •uantities & Material Safet Data Sheets
■ ,Above Ground Tanks ■ Antennas /Satellite Dishes ■ Bulkhead/Docks ■ Commercial Reroof
Fzi Demolition ❑ Fence ❑ Mechanical ❑ Manufactured Housing - Replacement only
in Parking Lots ❑ Retaining Walls ❑ Temporary Pedestrian Protection /Exit Systems
❑ Temporary Facilities ❑ Tree Cutting
APPLICANTREQUEST FOR MISCELLANEOUS PUBLIC WORKS PERMITS "' ;.
❑ Channelization /Striping ❑ Curb cut/Access /Sidewalk ❑ Fire Loop /Hydrant (main to vault) #: Size(s):
❑ Flood Control Zone ❑ Land Altering: 0 Cut cubic yards 0 Fill cubic yards 0 sq. ft.grading/clearing
❑ Landscape Irrigation ❑ Sanitary Side Sewer #: ❑ Sewer Main Extension 0 Private 0 Public
❑ Storm Drainage ❑ Street Use ❑ Water Main Extension 0 Private 0 Public
❑ Water Meter /Exempt # Size(s). 0 Deduct 0 Water Only
❑ Water Meter /Perrnanent # Size(s):
❑ Water Meter Temp # Size(s 1:_. Est. quantity: gal Schedule:
❑ Miscellaneous DI Moving Oversized Load/Hauling
MONTHLY SERVICE BILLINGS TO;
Name:
I Phone:
Address:
I
City /State /Zip:
0 Water
0 Sewer
0 Metro 0 Standby
WATER METER DEPOSIT /REFUND BILLING:
Name:
1 Phoriet5 W; r,.R° .E
Address:
City /State /Zip:
MAR 2 4 191-1
Value of Construction - In all cases, a value of construction amount should be entered by the applippnkahisAigure will be
reviewed and is subject to possible revision by the Permit Center to comply with current fee 4a4 4141.1S , WORKS
1
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 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 a atlo ccep 'Date ap No xplr Appllc n by: (Initials)
4IP
ALL MISCELLANEOUS PEA T APPLICATIONS MUST BE SUBMI ED WITH THE FOLLOWING:
Mpilb Hit BE AT A LEGIBLE SCALE AND NEATLY DRAWN
BUILDING SITE PLANS AND UTILITY PLANS ARE TO BE COMBINED
ARCHITECTURAL DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED ARCHITECT
STRUCTURAL CALCULATIONS AND DRAWINGS REQUIRE STAMP BY WASHINGTON
LICENSED STRUCTURAL ENGINEER
CIVIL/SITE PLAN DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED CIVIL ENGINEER
(P.E.)
❑
SUBMIT APPLICATION AND REQUIRED CHECKLISTS FOR
PERMIT REVIEW
Submit checklist., No:. M7,6
Abotie Ground Tattks/WettieTnnks - Supported :directly iapoh grade
exceeding 5;000 gallons and a ratio of height to•diametet or width
which exceeds 2 :1
❑
Antennas /Satellite Dishes ::.
Submit checklist No M -1:
❑
AWnings /Canopies - . No signage ,
Commercfal,Tenant ImproVemeht ,
Permit
❑
Bulkhead/Doak •
Submit checklist No M =ID
❑
Commercial Reroof.
Submit checklist No: M-.6:';.
cam,
Demolition
Submit checkis No M 3 M,..0a
❑
Fences - Over 6 feet in Height
Submit checklist. No M =9'
❑
Land Altering/Grading/Prelbade, •Submit
checklist • Nor M 2
❑
Loading.Docks
Commercclal TOnant •Imnprovetrierit
Permit ;: c Ubtnit checklist Not.H..1.7
Mechanical' (Residential;& Cotnm'erciel) • " ; '
,
Submit checklf §t ::Ni):-::M-8i!.
: Resideritial:only. :::.H.,6,:1-1,J(3,
❑
Miscellaneous: poolic Wor*Nermits
Submit checklist ' Not H49 •
❑
. Mariiutactured Housing ,(RED. INSIoNIA ONLY)
Submit checklist No , M =5
❑
Moving Oiaersized Load/Hauling
Submit checklist is No M -5:.
❑
Parking Lots
Submit checklist. No: M -4
❑
Residential Reroof - .EXempt with following exception: If roof structure
to, be: repaired or replaced
Residential Building Permit
Submit checklist :. No : . M -6:
❑
Retaiinlhg Walls - .Over.4.feet In height
Submit checklist " No M »i
❑
Temporary, FacilIties
Submit checklist . No M -7
❑
Temporary Pedestrian Protection/Exit Systems, :
Submit checkli §t • No M -4
❑
Tree'CUtting'
Submit checklist No 'M=2•4': .
,
❑ 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. the applicant Is other' than the owner, registered architect/060864.a contractor:IIcensed
by the State of Washington, a notarized letter from the property,oWner authorizing the agent to subn ii this permit application and
obtain the permit will be required as part of this submittal.
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS
PERMIT.
BUILDING OWN R OR AUTHORIZED AG T:
Signature: '
n (
Date: 3 ( C,
f u r c • -'_ �.....09--
Print name:
-1/41-c O
Phone: 2 6 s---..(5.6 I/v
Fax Ia:
Address:
7S`(
'�� �( 5�t f
.,,_/ Y
City /Stale /Zip:
5 'e`-1-7U) wA. 5 (1/.91
PP • 1 1•A`.
INSPECTIO
NO.
u.••^'1'ItY ' . 7MK..•• "t
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 98188
PERMIT NO.
(206)431 -3670
P roje�t!7 �) %, „�/'
r7 /�/ /'
Type o r' spe ion: e
yC��
A dr s:
-- S. • t
Date called:
Special instructions :' •
a;
Dat rid
�Q/ 9'
a.m.
Req [
Phone:
a'Ok, r g8�u \.—
�J
, �.w�/
t.J�/ /0
0 Approved per applicable codes.
COMMENTS:
rrections required prior to approval.
{
�. $47.00 REINSPECTION FEE REQUIRED. Prior to inspe tion, fee must be paid/
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
1 Receint Nn! I Date:
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 98188
PERMIT NO.
(206)431 -3670
Project' hap/ i ve
(� 9
Type of I[
Addres � /
Date calle
Special instructions:
Datewante /� �,.m. -,
/qq p.m.
Request emi. /1,
:hone: t (Y �0?Q .6� goo /U
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
�.,%2L Coe o LJ .
/947,4/f (T / A447/1 c"t 6'"
inspe97/
Dat
q q?
El $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. CaII to schedule reinspection.
si'ir1g •
5A-ruc,+u re$
--J
ur.: -,'I C:. :.
:.::) c. cro and omisslono
pl : : ;1 coos not authorize violation c;
a —pt:d codo or ordn Receipt of ccn tr
copy of approves , : �:.� • 9ed.
Dy
Data 3 je4//
frorrh Yaid
Pam*it No. Will
CITY OF TEJKWOIA
APPROVED
MAR 1 ;a 1999 •
AS NO I U)
rit111- 0INt:': t)IVi O
1
1
1
1
I
.T)I
i
1
I
1
1
0i4fh 1 Zg..nd S-1-re et
4/4(08 S ocd'V, 1 ,
Sarno* '•' •4
•1
3ar�oh? - r •C
U
amo,e ' +B! •—
RECEIVED
CITY OF TUKWILA
MAR 0 .1 1999
PERMIT CENTER
Figure 1. Kleen:Environmcntal:Teclino1c
General Site Layout, Sampling Locations
4408 South 122" Street Sea
Tukwila, WA 98178
nspeciled
�eteteturt�ucoromovo ts.. m• ay.. +a.ac.•n�..<m+v.� ofan h....�������`et y2�v.Ymesmctswo of vvOote .te..an<a. soompos “c eem∎ft. <mwmyon?wKvoty. Nf. N.rra y yaq
Figure 2.
General Site Layout — 3 Dimensional
4408 South 122nd Street
} Tukwila, WA 98178
K1een Enviro�imental T:eclinolu�ies.::;:. ,, , ,
Sc &!e'.Unspeci tea...,
40a0litom«.m+iw.aa M.N...p:o niir” ∎<ryar«al<patt # to tpfe w7 <zfxe.•uuit y?�gnf.i};ri}i<7t on. tI t<7haA 1 Cy OJlH! ?#!!f!f! ?!f} lift f'aoeaaam<}4a< !!!!:A'
-- 1
•
17'8
10'4 -1 7'4
u7
r
garage Side
l - 5'2
Area of Debris
5'2
Area of Debns
Workshop
r
Shelvin
Workbench/Chemical Products
Shelving /Chemical Products
4' 1. 3'4
10'4 - 7'4
Figure 3.
Garage Floorplan — Dimensional Layout
4408 South 122nd Street
Tukwila, WA 98178
17'8
Figure 4.
it Garage General Site Layout — 3 Dimensional
i, 4408*South 122" Street
Tukwila, WA 98178
.3D02
ACCOUNT: 334740- 1170 -0
TAXPAYER: SHAFLIK GREGG
LOT: 33 -34 BLK: 5
* LAND
ZONE ACTUAL
JURISDICTION
SQUARE FEET
WATER SYSTEM
SEWER
VIEW
OPEN SPACE
D A T A *
SR
TUKWILA
9600
•WTR DIST
PUBLIC
NO
TIDELANDS
WATERFRONT FEET
WFT LOCATION
WFT BANK
WFT RIGHTS ONLY
KING COUNTY DEPT OF ASSEL_,,.(ENTS BDO1 PAI11260 -5:
REAL PROPERTY CHARACTERISTICS 11/20/98 09:48:59.0
SITUS: 4408 S 122ND ST 98178
A QSTR: SE 10 23 04
PLAT: HILLMANS CD MEADOW GARDENS DIV NO. 01
JURS: TUKWILA
DATA * * BLDG 1 OF 2 *
MISC BLDG INFO
510 YEAR BUILT 1942
#STORIES 1.0
#LIVING UNITS
DAYLIGHT BSMT
HEAT SOURCE ELEC
HEAT SYSTEM ELEC BE
ACCESSORY IMPS
510 POOL AREA
POOL CONSTR
DET GARAGE AREA
CARPORT AREA
1 MOBILE HOME
* * B U I L D I N G
BLDG SQ FOOTAGE DATA
FIRST FLOOR
1/2 FLOOR
2ND FLOOR
UPPER FLOOR
TOTAL BSMT
FIN BSMT
BSMT GARAGE
TOTAL LIVING AREA
ATTACHED GARAGE
ROOMS
! BEDROOMS
CHOOSE ONE OPTION: PRESS
<PF4> FOR LEGAL, <PF6>
<PRINT> TO PRINT SCREEN,
FOR HISTORY, <PF7> FOR
( 0.1) ==
<ENTER> FOR NEXT BUILDING,
TAXES OR <PF8> TO END.
RECEIVED
CITY OF TUKWILA
MAR 0 1 1999
PERMIT CENTER
RPCI 334740117000
SHAFLIK GREGG A
4410 S-122ND
SEATTLE WA
LOT:33 -34
BLOCK:5
RY OY ST SC NC LEVY OM -LV
00 T 2411
99 T C 2411
98 T 2411
97 T 2411
96 T 2411
DATE
04/21/97
11/04/96
04/29/96
NUMBER
465200
502887
121036
RPCI 334740117000
DOC: 08 /05 /98CIVALUE ST:CURNT ACTIV.
5D9999 HILLMANS MEADOW GARDENS DIV #1
11/20/98
98178
AMOUNT
460.10
456.10
456.11
LAST LEGAL
IS 1
LAND IMPS
33,000 63,000
33,000 63,000
29,000 45,000
29,000 31,300
29,000
BILLED
.00
.00
1,052.79
920.19
31,300 912.21
TOTAL DUE:
INT /PENALTY YEAR DISTRIBUTION
.00 97
JUMP CODE:
.00 96
.00 96
PAID P
. 00
. 00
. 00 F
460.10 H
912.21
1,512.88
receipt datE
BD02,
KING COUNTY DEPT OF ASSECAENTS
REAL PROPERTY LEGAL DESCRIPTION
ACCOUNT: 334740-1170-0 SITUS: 4408 S 122ND ST 98178
TAXPAYER: SHAFLIK GREGG A
LEGAL DESCRIPTION - PAGE 1
LOT 33-34 BLOCK 5 •
HILLMANS'MEADOW GARDENS DIV #1
* END OF LEGAL DESCRIPTION *
BDO1 PAI11280-S:
11/24/98 07:54:47.6
QSTR: SE 10 23 04
JURS: TUKWILA
PLAT: HILLMANS CD MEADOW GARDENS DIV NO. 01
(
0.1)
CHOOSE ONE OPTION: PRESS <PRINT> TO PRINT SCREEN, <ENTER> FOR MORE LEGALS,
<PF2> FOR CHARACTERISTICS, <PF6> FOR HISTORY, <PF7> FOR TAXES OR <PF8> TO END.
ACORDr. CERTIFICATE( F LIABILITY INSURANC;
PRODUCER
PARKER, SMITH & FEEK, INC.
999 Third Avenue, 17th Floor
Seattle, Washington 98104
Ph: (206) 382 -7900 Fax: (206) 382 -1135
INSURED
KLEEN ENVIRONMENTAL TECHNOLOGIES, INC.
754 Garfield Street
Seattle, Washington 98109
DATE (MM/DD/YY)
03/17/99
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO
RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
INSURER A:
COMPANIES AFFORDING COVERAGE
UNITED CAPITOL INSURANCE COMPANY
INSURER B: UNITED CAPITOL INSURANCE COMPANY
INSURER C: UNITED CAPITOL INSURANCE COMPANY
I INSURER D:
I INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE POLICY NUMBER
POLICY EFFECTIVE
DATE (MWDD/YY)
POLICY EXPIRATION LIMITS
DATE (MWDDNY)
A
GENERAL.
X
LIABILITY
COMMERCIAL GENERAL LIABILITY
GLA 1003427
03/11/1999
03/11/2000
I EACH OCCURRENCE I $ 3,000,000
FIRE DAMAGE (Any one lire) I $ 50,000
X j CLAIMS MADE ^ I OCCUR
MED EXP (Any one person) 1 $ 5,000
PERSONAL & ADV INJURY I $ 3,000,000
'
X
DED, $1,000 EA. OCC/CLAIM INCL. LOSS
EXPENSE
GENERAL AGGREGATE I $ 3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS.COMP/OP AGG I $ 3,000,000
POLICY I JECT , LOC
I
AUTOMOBILE LIABILITY
LI ANY AUTO
I ALL OWNED AUTOS
LjSCHEDULED AUTOS
IJI HIRED AUTOS
I NON•OWNED AUTOS
iI I
COMBINED SINGLE LIMIT
(Ea accident) $
BODILY INJURY
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE
(Per accident) i $
GARAGE LIABILITY
ANY AUTO
I.-1
I
I
I
AUTO ONLY • EA ACCIDENT , $
OTHER THAN EA ACC I $
AUTO ONLY: AGG I $
I EXCESS LIABILITY
E-1 OCCUR CLAIMS MADE
_� DEDUCTIBLE
I RETENTION $
I
1
( I
EACH OCCURRENCE 1 $
AGGREGATE
I $
i$ —
I$
1 I $
I EMPLOYERS' LIABILITY
STOP GAP
B i
I
1
I
I
GLA 1003427
I
03/11/1999 03/11/2000
I I WC STATU• OTH•
I TORY LIMITS I X ER
1
. E.L. EACH ACCIDENT
$ 1,000,000
El, DISEASE • EA EMPLOYEE
$ 1,000,000
E.L. DISEASE • POLICY LIMIT I $ 1,000,000
;OTHER '
C CONTRACTORS POLLUTION LIABILITY 1 GLA 1003427
CLAIMS MADE i
I
03/11/1999 I 03/11/2000
EACH OCCURRENCE 1 $ 3,000,000
I AGGREGATE 1 $ 3,000,000
DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS
Evidence of Insurance Only,
CERTIFICATE HOLDER H ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
THE CITY OF SEATTLE - DEPARTMENT OF TRANSPORTATION
Executive Services Department
700 Third Avenue, #800
Seattle, WA 98104
SHOULD ANY OF THE ABOVE DESCRIBED
DATE THEREOF, THE ISSUING INSURER
WRITTEN NOTICE TO THE CERTIFICATE
POLICIES BE CANCELLED BEFORE
WILL ENDEAVOR TO MAIL
HOLDER NA • , THE LEFT,
OR • ILITY • F ANY KIND
L
THE EXPIRATION
30 DAYS
BUT FAILURE
UPON THE INSURER,
TO DO HAL • • SE NO OBLIGATION
ITS GENTS OR REPRE ENTA VES
A ORIZED REPRESSA A 0 •
2D02
.ICING COUNTY DEPT OF ASSES( .NTS BDO1 PAI11260 -S:
REAL PROPERTY CHARACTERISTICS 11/20/98 09:48:59.0
ACCOUNT: 334740 - 1170 -0 SITUS: 4408 S 122ND ST 98178
TAXPAYER: SHAFLIK GREGG A QSTR: SE 10 23 04
LOT: 33 -34 BLK: 5 PLAT: HILLMANS CD MEADOW GARDENS DIV NO. 01
* L A N D
ZONE ACTUAL
JURISDICTION
SQUARE FEET
WATER SYSTEM
SEWER
VIEW
OPEN SPACE
D A T A *
SR
TUKWILA
9600
•WTR DIST
PUBLIC
NO
TIDELANDS
WATERFRONT FEET
WFT LOCATION
WFT BANK
WFT RIGHTS ONLY
! * * B U I L D I N G
! BLDG SQ FOOTAGE DATA
! FIRST FLOOR
! 1/2 FLOOR
! 2ND FLOOR
! UPPER FLOOR
! TOTAL BSMT
! FIN BSMT
! BSMT GARAGE
! TOTAL LIVING AREA
! ATTACHED GARAGE
! ROOMS
! BEDROOMS
CHOOSE ONE OPTION: PRESS
<PF4> FOR LEGAL, <PF6>
JURS: TUKWILA
D A T A * * BLDG 10F2*
MISC BLDG INFO
510 YEAR BUILT 1942
#STORIES 1.0
#LIVING UNITS
DAYLIGHT BSMT
HEAT SOURCE ELEC
HEAT SYSTEM ELEC BE
ACCESSORY IMPS
510 POOL AREA
POOL CONSTR
DET GARAGE AREA
CARPORT AREA
1 MOBILE HOME
( 0.1) __
<PRINT> TO PRINT SCREEN, <ENTER> FOR NEXT BUILDING,
FOR HISTORY, <PF7> FOR TAXES OR <PF8> TO END.
RECEIVED
CITY OF TUKWILA
MAR 0 1 1999
PERMIT CENTER
MIgq- X42
A
c
I
RPCI 334740117000
SHAFLIK GREGG A
4410 S-122ND
SEATTLE WA
LOT:33 -34
•
. r v7r•. zr; t. x.. rn. rw:. rcar�o- xa:. vx. ,r.,.,,M...,,.�.....,« «.....«,.
BLOCK:5
RY OY ST SC NC LEVY OM -LV
00 T
99 T
98 T
97 T
96 T
2411
C 2411
2411
2411.
2411
DATE NUMBER
04/21/97 465200
11/04/96 502887
04/29/96 121036.
RPCI 334740117000
DOC:
5D9999
98178
AMOUNT
460.10
456.10
456.11
08/05/98 CJALUE ST:CURNT ACTIV:
HILLMANS MEADOW GARDENS DIV #1
11/20/98
LAST LEGAL
IS
LAND
33, 000
33,000
29,000
29,000
29,000
1
IMPS
63,000
63,000
45,000
31,300
31,300
INT /PENALTY
. 00
. 00
. 00
JUMP CODE:
BILLED
.00
.00
1,052.79
920.19
912.21
TOTAL DUE:
YEAR DISTRIBUTION
97
96
96
PAID P
.00
.00
.00 F
460.10 H
912.21
1,512.88
receipt datE
1
4
BD02.
UKING COUNTY DEPT OF ASSESC2NTS
REAL PROPERTY LEGAL DESCRIPTION
ACCOUNT: 334740-1170-0
TAXPAYER: SHAFLIK GREGG A
SITUS: 4408 S 122ND ST 98178
LEGAL DESCRIPTION - PAGE 1
LOT 33-34 BLOCK 5
HILLMANS MEADOW GARDENS DIV #1
* END OF LEGAL DESCRIPTION *
PLAT: HILLMANS CD MEADOW
BDO1 PAI11280-S:
11/24/98 07:54:47.6
QSTR: SE 10 23 04
JURS: TUKWILA
GARDENS DIV NO. 01
0.1)
CHOOSE ONE OPTION: PRESS <PRINT> TO PRINT SCREEN, <ENTER> FOR MORE LEGALS,
<PF2> FOR CHARACTERISTICS, <PF6> FOR HISTORY, <PF7> FOR TAXES OR <PF8> TO END
May 5, 2000
,...,..,�.�_.h7v :y s; •.•:4-J „w- <i,t. " +fcr^'N:t� 7j' +';%.z;cUr�dnra,ws+nnx
C
Cii of Tukwila
Steven M. Mullet, Mayor
Department of Community Development Steve Lancaster, Director
Gordy Shaflick
24516 43rd Ave S
Kent Wa 98032
RE: Permit Status MI99 -0042
4408 S 122nd St
Dear Mr Shaflick:
In reviewing our current permit files, it appears that your permit to demolish a detached garage,
issued on March 18, 1999, has not received a final inspection as of the date of this letter by the
City of Tukwila Building Division.
Per the Uniform Building Code and /or Uniform Mechanical Code, every permit issued by the
building official under the provision of this code shall expire by limitation and become null and
void if the building or work authorized by such permit is not commenced within 180 days from
the date of such permit, or if the building or work authorized by such permit is suspended or
abandoned at any time after the work is commenced for a period of 180 days.
Based on the above, if a final inspection is not called for within ten (10) business days from the
date of this letter, the Permit Center will close your file and the work completed to date will be
considered non - complying and not in conformance with the Uniform Building Code and /or
Mechanical Code.
Please contact the Permit Center at (206)433 -7165 if you wish to schedule a final inspection.
Thank you for your cooperation in this matter.
Sincerely,
GOAN11~
Bill Rambo
Permit Technician
Xc: Permit File No. M199 -0042
Duane Griffin, Building Official
PerTni+ C,orct. Copu PLAN REVIEW/ROUTING SLIP
ACTIVITY NUMBER: M199 -0042
PROJECT NAME: GREGG A. SHAFLICK RESIDENCE
XX Original Plan Submittal
DATE: 3 -1 -99
Response to Incomplete Letter
Response to Correction Letter # Revision # After Permit Is Issued
DEPARTMENTS:
Building �y�
Division
X3.411
yi'1. w 14
Fire Pre ention
3 -x-29
Structural
Plannin 'vision
Permit Coordinator di
DETERMINATION OF COMPLETENESS: (Tues, Thurs)
Complete E0 Incomplete n
Comments:
DUE DATE: 3 -4 -99
Not Applicable ❑
TUES /THURS ROUTING: Please Route
Routed by Staff
No further Review Required
(if routed by staff, make copy to master file and enter into Sierra)
REVIEWERS INITIALS: DATE:
APPROVALS OR CORRECTIONS: (ten days) DUE DATE: 4 -1 -99
Approved
Approved with Conditions Not Approved (attach comments) ❑
REVIEWERS INITIALS: DATE:
CORRECTION DETERMINATION: DUE DATE:
Approved
Approved with Conditions ❑ Not Approved (attach comments) ❑
REVIEWERS INITIALS: DATE:
\PR.Rnl1TF. nor
0a115 '99 16:1:3 I Li : LAM I EFFAX
Deparuncnt of Labor & Industries
Contractor Registration Section
PO Box 44450
Olympia WA 98504 -4450
FAX:
PAGE
REGISTRATION VERIFICATION
TEMPORARY
(360) 902-5226
FAX (360) 902 -522$
(--To \ C _ ..._ t r�xn
Regiotere 1 nxrtl�
K1 ! rCit)1'te'lri ]1Cia.11P 1li(•
Registration number S Rcgtstratum expires
LEENfTO t<
Contractor: Your Certificate of Registration will be sent from the Olympia office and •
should be received within 2 to 3 weeks. Please keep this record until you receive your
Certificate of Registration.
Ckedeip' eapireu
5 _ q J Thank you
F625-036-1100 registration verification 12-9a r.
1