HomeMy WebLinkAboutPermit D12-078 - RADOVICH BUILDING - WATER DAMAGE REPAIRJOHN C. RADOVICH
BiJILDING
6840 FORT DENT WY
D12-078
City oftukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Inspection Request Line: 206 - 431 -2451
Web site: http: / /www.Tukwila WA .gov
Parcel No.: 2954900425
Address: 6840 FORT DENT WY TUKW
Suite No:
Project Name: JOHN C RADOVICH BUILDING
DEVELOPMENT PERMIT
Permit Number: D12 -078
Issue Date: 03/12/2012
Permit Expires On: 09/08/2012
Owner:
Name: PEPPERWOOD HOLDINGS LLC
Address: 2835 82ND AVE SE #300 , MERCER ISLAND WA 98040
Contact Person:
Name: KAREN O'FARRELL
Address: 2835 82 AV SE #30 , MERCER ISLAND WA 98040
Contractor:
Name: FOUSHEE & ASSOCIATES CO INC
Address: BOX 3767 , BELLEVUE, WA 98009
Contractor License No: FOUSHAC 1580D
Lender:
Name:
Address:
Phone: 206 267 -6060
Phone: 425 746 -1000
Expiration Date: 08/12/2013
DESCRIPTION OF WORK:
WATER DAMAGE REPAIR
Value of Construction: $20,000.00 Fees Collected: $474.30
Type of Fire Protection: International Building Code Edition: 2009
Type of Construction: IIB Occupancy per IBC: 0008
Electrical Service Provided by: PUGET SOUND ENERGY
* *continued on next page **
doc: IBC -7/10
D12 -078 Printed: 03 -12 -2012
Public Works Activities:
Channelization / Striping: N
Curb Cut / Access / Sidewalk / CSS: N
Fire Loop Hydrant:
Flood Control Zone:
Hauling:
Land Altering:
Landscape Irrigation:
Moving Oversize Load:
Sanitary Side Sewer:
Sewer Main Extension:
Storm Drainage:
Street Use:
Water Main Extension:
Water Meter:
Permit Center Authorized Signature:
I hereby certify that I have read and
governing this work will be complie
N
N
N
• •
Number: 0 Size (Inches): 0
Start Time:
Volumes: Cut 0 c.y.
Start Time:
Private:
Profit: N
Private:
Date:
End Time:
Fill 0 c.y.
End Time:
Public:
Non - Profit: N
Public:
IZ
ned this permit and know the same to be true and correct. All provisions of law and ordinances
whether specified herein or not.
The granting of this permit does not
construction or the performance of wor
to this permit. )
Signature:
Print Name:
e to give authority to violate or cancel the provisions of any other state or local laws regulating
am authorized to sign and obtain this development permit and agree to the conditions attached
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.
PERMIT CONDITIONS:
1: ** *BUILDING DEPARTMENT CONDITIONS * **
2: All mechanical work shall be inspected and approved under a separate permit issued by the City of Tukwila Permit Center
(206/431- 3670).
3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to
start of any construction. These documents shall be maintained and made available until final inspection approval is
granted.
4: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary
sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other
excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of
this requirement.
5: All construction noise to be in compliance with Chapter 8.22 of the City of Tukwila Municipal Code. A copy can be
obtained at City Hall in the office of the City Clerk.
6: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the City of Tukwila
doc: IBC -7110
D12 -078 Printed: 03 -12 -2012
Building Department (206- 431 - 3670).
• •
7: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building
Department (206- 431 - 3670).
8: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of,
any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits
presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila
shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the
Building Official from requiring the correction of errors in the construction documents and other data.
doc: IBC -7/10
D12 -078 Printed: 03 -12 -2012
•
City Of Tukwila
Permit Center
6300 Southcenter Boulevard, Suite, 100
Tukwila, WA 98188
(206 431 -3670)
•
Application # Dc
ALTERNATE PLAN SUBMITTAL AUTHORIZATION
FOR LIMITED SCOPE OF WORK
I.B.C.& I.R.C. Section 104.1
Project name C. t
Address t9 y U i-o 11 N T (J 114/1
Description of work W A t2 Avv\,A(9 1/4-1R,
suave". 7o
FIELD ZIVSPCC-40101
Related reference number
IA Pc
The above project permit applicant, due to the limited scope of work is authorized to submit reduced
plan requirements described below.
1. Complete permit application required: (Note, all application must include; 1) property assessor
number, 2) copy of contractors license or completed owner waiver form.)
Building V Mechanical Other
2. Minimum plan and /or specification requirement:
Site plan Floor plan Elevations Foundation
Cross sections Roof plan W.S.E.C. Compliance Narrative
Structural calculations (stamped by Washington State licensed engineer )
Specific required information AirFdi02 w,9/i L _EA S,',cn; .vas
3. Other special instructions: /ie4a ss ;He- n/1,,urr 2 PF2 ,'i r - ,e32if to,:/c<
o.v /e
Authorization by,
TBD36/96 -form 12
Date 3- /2- 17
(Authorization void 30 days after the date issued.)
CITY OF TUKi�A
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http: / /www.TukwilaWA.gov
Building PeSit No. I/
Project No.
Date Application Accepted:
Date Application Expires:
(For office use only)
CONSTRUCTION PERMIT APPLICATION
Applications and plans must be complete in order to be accepted for plan review.
Applications will not be accepted through the mail or by fax.
* *Please Print **
SITE LOCATION
QQ , t 'y King Co Assessor's Tax No.: 2-61 41.4t 0 '0��
Site Address: C� y C� � � `�Q L�� Suite Number: Floor:
Tenant Name: � Q New Tenant: ❑ Yes ❑ .. No
PROPERTY OWNER
Name:
Address: �(� n 1 s* C<I,_,,,�
City. State: V� q Zip cI(�, _ j
1
Name: -' ) o -o-� �c�
_(S-.,a
LL-
Address
_.._ p
City:} \
I ti
(� ^
�l
City: y�„ n c c�\ State\
Iry ` i e n >a-�„'
ot
Zi
0
CONTACT PERSON - person receiving all project
communication
Name:
Address: �(� n 1 s* C<I,_,,,�
City. State: V� q Zip cI(�, _ j
Phone: 5'--1 `A 6- F �i-a - --n -141p- -2-) t13-1
Address: \\
;
`,sl
_.._ p
City:} \
I ti
(� ^
�l
State: q
Phone;
a c: („
7 -(
e)
Fax:
-bc�- aic-7- 1_00(_01
Emai
Email:
0_6/"/ \._
GENERAL CONTRACTOR INFORMATION
Company Name:
Address: �(� n 1 s* C<I,_,,,�
City. State: V� q Zip cI(�, _ j
Phone: 5'--1 `A 6- F �i-a - --n -141p- -2-) t13-1
Contr Reg No.: V. ^ ` � N,RSe .1?A, \ \
_ . ra 0 \ i
Tukwila Business License No.: ��
H:Wpplications\Forms- Applications On Line\2012 Applications'Permit Application Revised - 2 -7 -12 docx
Revised: February 2012
bh
ARCHITECT OF RECORD
Name:
Address:
Company Name:
Architect Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
ENGINEER OF RECORD
Name:
Address:
Company Name:
Engineer Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
LENDER/BOND ISSUED (required for projects $5,000 or
greater per RCW 19.27.095)
Name:
Address:
City: State: Zip:
Page 1 of 4
BUILDING PERMIT INFORMATION — 206- 431 -3670
Valuation of Project (contractor's bid pricer $ C'C') t"-)C5 Existing $ uilding Valuation: $
Describe the scope of work (please provide detailed information):_
Will there be new rack storage? ❑ ....Yes
..No If yes, a separate permit and plan submittal will be required.
Provide All Building Areas in Square Footage Below
PLANNING DIVISION:
Single family building footprint (area of the founda on of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the follow g:
Lot Area (sq ft): loor area of principal dwelling: Floor area of accessory dwelling:
*Provide documentation that show hat the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard: Compact: Handicap:
Will there be a change in use? ❑ Yes ❑ No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
❑ Sprinklers ❑ Automatic Fire Alarm ❑ None ❑ Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes ❑ No
If `yes', attach list of materials and storage locations on a separate 8 -1/2" x 11" paper including quantities and Material Safety Data Sheets.
'SEPTIC SYSTEM
❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health
Department.
H:1Applications\Forms- Applications On Line \2012 Applications\Fermit Application Revised - 2- 7- 12,docx
Revised, February 2012
bh
Page 2 of 4
Existing
Interior Remodel
Addition to
Existing
Structure
New
Type of
Construction • >.
IBC
Type of
Occupancy per
IBC
1St Floor
2nd Floor
3rd Floor
Floors thru
Basement
Accessory Structure*
Attached Garage
Detached Garage
Attached Carport
Detached Carport
Covered Deck
Uncovered Deck
PLANNING DIVISION:
Single family building footprint (area of the founda on of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the follow g:
Lot Area (sq ft): loor area of principal dwelling: Floor area of accessory dwelling:
*Provide documentation that show hat the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard: Compact: Handicap:
Will there be a change in use? ❑ Yes ❑ No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
❑ Sprinklers ❑ Automatic Fire Alarm ❑ None ❑ Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes ❑ No
If `yes', attach list of materials and storage locations on a separate 8 -1/2" x 11" paper including quantities and Material Safety Data Sheets.
'SEPTIC SYSTEM
❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health
Department.
H:1Applications\Forms- Applications On Line \2012 Applications\Fermit Application Revised - 2- 7- 12,docx
Revised, February 2012
bh
Page 2 of 4
PERMIT APPLICATION NOTES — •
1
Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject
to possible revision by the Permit Center to comply with current fee schedules.
Expiration of Plan Review — Applications for which no permit is issued within 180 days following the date of application shall expire by limitation.
The Building Official may grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be
requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition).
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OW R OR AUTH D AGENT:
Signature:
Print Name:
Mailing Address:
Date: — 1
4a �� Day Telephone: ,C") (r - (n1 -coo (rte
H:\Applications\Forms- Applications On Line\2012 Applications\Permit Application Revised - 2- 7- 12.docx
Revised: February 2012
bh
City State Zip
Page 4 of 4
r PUBLIC WORKS PERMIT INFO TION — 206 - 433 -0179
Scope of Work (please provide detailed information):
Call before you Dig: 811
Please refer to Public Works Bulletin #1 for fees and estimate sh t.
Water District
❑ .. Tukwila ❑ ...Water District # 125
❑ .. Water Availability Provided
Sewer District
❑ .. Tukwila
❑ .. Sewer Use Certificate
Septic System:
❑ On -site Septic System — For on -site septic system, provide 2 copies of a current ptic design approved by King County Health Department.
❑... Highline
❑ ...Valley View ❑ ... Renton
❑ ...Sewer Availability Provided
Renton
0... Seattle
Submitted with Application (mark boxes which apply):
❑ .. Civil Plans (Maximum Paper Size — 22" x 34")
❑ .. Technical Information Report (Storm Drainage)
❑ .. Bond 0... Insurance 0... Easement(s)
Proposed Activities (mark boxes that apply):
❑ .. Right -of -way Use - Nonprofit for less than 72 hours
❑ .. Right -of -way Use - No Disturbance
❑ .. Construction/Excavation /Fill - Right -of -way ❑
Non Right -of -way ❑
❑ .. Total Cut
❑ .. Total Fill
cubic yards
cubic yards
0...G technical Report
0...
aintenance Agreement(s)
❑ .. Traffic Impact Analysis
❑ .. Hold Harmless — (SAO)
❑ .. Hold Harmless — (ROW)
0... Right-of-way Use - Profit for less than 72 hours
0... Right-of-way Use — Potential Disturbance
0... Work in Flood Zone
❑...Storm Drainage
❑ .. Sanitary Side Sewer 0...A I don Septic Tank
❑ .. Cap or Remove Utilities ❑... • rb Cut
❑ .. Frontage Improvements 0.. ' avement Cut
❑ .. Traffic Control ■ .. Looped Fire Line
❑ .. Backflow Prevention - Fire Protection
Irrigation
Domestic Wate
0... Grease Interceptor
0... Channelization
❑...Trench Excavation
0... Utility Undergrounding
❑ .. Permanent Water Meter Size (1) " WO # (2) " WO # (3) " WO #
❑ .. Temporary Water Meter Size (1) " WO # (2) " WO # (3) " WO #
❑ .. Water Only Meter Size WO # ❑ .. Deduct Water Meter Size "
❑ .. Sewer Main Extension blic ❑ Private ❑
❑ .. Water Main Extension ' ublic ❑ Private ❑
FINANCE INFORMATION
Fire Line Size at Property Lin Number of Public Fire Hydrant(s)
❑ .. Water ■ .. Sewer ❑ .. Sewage Treatment
Monthly Service Billin
Name:
Mailing Address:
Water Meter Refu
Name:
illin
Day Telephone:
City
State
Zip
Day Telephone:
Mailing Address'`
Zip
City
State
H:\ Applications\Forms- Applications On Line \2012 Applications\Permit Application Revised - 2- 7- 12.docx
Revised: February 2012
bh
Page 3 of 4
•
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206 - 431 -3665
Web site: http: / /www.TukwilaWA.gov
Parcel No.: 2954900425
Address: 6840 FORT DENT WY TUKW
Suite No:
Applicant: JOHN C RADOVICH BUILDING
RECEIPT
Permit Number: D12-078
Status: APPROVED
Applied Date: 03/12/2012
Issue Date:
Receipt No.: R12 -01009
Initials:
User ID:
Payee:
JEM
1165
Payment Amount: $474.30
Payment Date: 03/12/2012 09:34 AM
Balance: $0.00
KAREN M O'FARRELL, JOHN C RADOVICH LLC
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd MC
Authorization No. 012427
ACCOUNT ITEM LIST:
Description
474.30
Account Code Current Pmts
BUILDING - NONRES
STATE BUILDING SURCHARGE
000.322.100 469.80
640.237.114 4.50
Total: $474.30
doc: Receiot -06 Printed: 03 -12 -2012
•
. • •
INSPECTION RECORD
Retain a copy with permit
SP CTION 0:
Di? - ale
PERMIT NO.
CITY0F.TUKWILA BUILDING DIVISION
•"6300 $outhcenter Blvd., #100, Tukwila. WA 98188 ta, (206) 431-36
Permit Inspection.Request Line (206) 431-2451
Project: . , .,,,,•'
4.4t1 4 IkAckavi'c K
Type of Inspection:
r,,,...iA (
Address: • — —
(0840 _•t-Orl-
Date Called:
Special Instructions:
.• •
• .
. • .
Date Wanted:.
3 -.7...2--
1-2.-
r.,Ir
• •
Requester:
Phone No:
151.6,0proved per applicable codes. Corrections required prior to approval.
COMMENTS;
• • CiDe..r wt .t 4 Or3-,A" (
R ECT1ON FEE RE UIRED. Prim/to next inspection. fee must be
p 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
• CITY OF' TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 I^ (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
DO- 07cg
•
Project:
-69/6rV A `9DCV/e fri
Type of Inspection:
'7—`G41 6
Address: ,\,-
fl _ _
Date Called:
Special Instructions:
•
Date Wanted:.
a.
Requester:
Phone No:
- 1/25 -4'66-47
01
Approved per applicable codes.
Corrections required prior to approval.
COMM €ITS:
r' pec - r:
/AL —1757
REINSP CTION FEE REQ RED. Prior to -next inspection, fee must be
aid
6300 Southcenter BIJd.. Suite 100. Call to schedule reinspection.
INSPECTION RECORD
Retain a copy with permit
• INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
Project:
(22)_ 6 A i .1'S S a/f /9(''6,5s 7/ i'-• ovz.ih0-2.
Type of Inspection: 0
/ d
Address: / D_ c _
Date Called:
Special Instructions:
7.� �'Q,,'o11
/42e0 b tr A 4
•
/Date
!
_
Wanted:.
s.12- Az__
a.m.
p.m.
Requester:
Phone No:
•
•
,•
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
(22)_ 6 A i .1'S S a/f /9(''6,5s 7/ i'-• ovz.ih0-2.
r� /�' "i ' ? (.� i i n� d/ % / p ,
• / Ai,5 t9" ,/ l61.
OA/S a1.k.b/
■
•
nspect
Date:
3 - /2 - i-2-
SPECTION FEE REQ IRED. Wor to next inspect %n. fee must be
aid at 6300 Southcenter BL d.. Suite 100. Call to schedule reinspection.
• _, ..� __._, �. �_
Contractors or Tradespeople Per Friendly Page
•
General /Specialty Contractor
A business registered as a construction contractor with L &I to perform construction work within the scope of
its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of
account and carry general liability insurance.
Business and Licensing Information
Name FOUSHEE & ASSOCIATES CO INC UBI No. 600259643
Phone 4257461000 Status Active
Address Po Box 3767 License No. FOUSHAC1580D
Suite /Apt. License Type Construction Contractor
City Bellevue Effective Date 9/4/1985
State WA Expiration Date 8/12/2013
Zip 98009 Suspend Date
County King Specialty 1 General
Business Type Corporation Specialty 2 Unused
Parent Company
Other Associated Licenses
License
Name
Type
Specialty
1
Specialty
2
Effective
Date
Expiration
Date
Status
BIRTCJV088LK
BIRTCHER / FOUSHEE A
JNT VNTR
Construction
Contractor
General
Unused
6/12/1992
6/12/1994
Archived
BIRTCCL093M6
BIRTCHER
CONSTRUCTION
LIMITED
Construction
Contractor
General
Unused
7/26/1991
7/11/1994
Archived
LEYSHL'150NR
LEYSHEE LTD
Construction
Contractor
General
Unused
8/19/1985
8/1/1992
Archived
LEYSHCL181MF
LEYSHEE COMPANY
LTD
Construction
Contractor
General
Unused
7/6/1982
6/28/1983
Archived
ROWLEFC236RW
ROWLEY /FOUSHEE
CONST CO INC
Construction
Contractor
General
Unused
12/16/1977
12/16/1985
Archived
Business Owner Information
Name
Role
Effective Date
Expiration Date
FOUSHEE, JEFFERY CHARLES
Chief Executive Officer
01/01/1980
Amount
KOCH, LISA HINES
Chief Financial Officer
08/01/2011
GL03790723
JONES, ERIC BRADLEY
President
08/01/2011
ANDERSON, LOCH GRAYDON
Secretary
01/01/1980
ZURICH
AMERICAN INS
CO
BARKER, RICHARD A
04/15/2006
01/01/1980
08/01/2011
Bond Information
Page 1 of 2
Bond
Bond Company Name
Bond Account Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Bond Amount
Received Date
7
SAFECO INS CO OF
AMERICA
5771144
08/12/2001
Until Cancelled
$12,000.00
07/23/2001
Assignment of Savings Information No records found for the previous 6 year period
Insurance Information
Insurance
Company Name
Policy Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Amount
Received Date
26
Zurich
American Ins Co
GL03790723
04/15/2010
04/15/2012
$1,000,000.0003
/02/2011
25
ZURICH
AMERICAN INS
CO
GL03790723
04/15/2006
04/15/2010
$1,000,000.0003
/04/2009
24
ZURICH
AMERICAN INS
CO
GL0379723
04/15/2005
04/15/2006
$1,000,000.0004
/15/2005
https: // fortress .wa.gov /lni/bbip /Print.aspx
03/12/2012