HomeMy WebLinkAboutPermit D12-147 - HALE RESIDENCE - DEMOLITIONHALE DEMOLITION
4735 S 158 ST
EXPIRED I1 -14-12
D12 -147
Parcel No.:
Address:
Suite No:
Project Name:
City oPI'ukwila
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.TukwilaWA.gov
8108600840
4735 S 158 ST TUKW
HALE DEMOLITION
DEVELOPMENT PERMIT
Permit Number:
Issue Date:
Permit Expires On:
D12 -147
05/17/2012
11/13/2012
Owner:
Name:
Address:
HALE RICHARD
4735 S 158TH STREET , TUKWILA WA 98188
Contact Person:
Name: RICHARD HALE
Address: 4735 S 158 ST , TUKWILA WA 98188
Contractor:
Name: OWNER AFFIDAVIT - RICHARD HALE
Address:
Contractor License No:
Lender:
Name:
Address:
Phone: 206 - 200 -2202
Phone:
Expiration Date:
DESCRIPTION OF WORK:
REMOVE OLD SHACK TO PLANT GARDEN AND LAWN. PUBLIC WORKS ACTIVITIES INCLUDE EROSION CONTROL AND LAND
ALTERING.
Value of Construction: $1,500.00
Type of Fire Protection:
Type of Construction: V -B
Electrical Service Provided by: SEATTLE CITY LIGHT
Fees Collected:
International Building Code Edition:
Occupancy per IBC:
$306.25
2009
0022
* *continued on next page **
doc: IBC -7/10
D12 -147
Printed: 05 -17 -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:
N
N
Y
Water Main Extension:
Water Meter: N
Permit Center Authorized Signature:
I hereby certify that I have read and
governing this work will be complie
•
Number: 0 Size (Inches): 0
Start Time:
Volumes: Cut 50 c.y.
End Time:
Fill 0 c.y.
Start Time: End Time:
Private:
Profit: N
Private:
Date:
Public:
Non - Profit: N
Public:
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 pre
construction or the performance of work.
to this permit.
Signature:
Print Name:
e to give authority to violate or cancel the provisions of any other state or local laws regulating
I am authorized to sign and obtain this development permit and agree to the conditions attached
i-4 (e.
Date.
• �/ 7� 7 U <Z
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: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the
Building Official.
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 plumbing and gas piping work shall be inspected and approved under a separate permit issued by the City of Tukwila
Building Department (206- 431 - 3670).
6: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building
doc: IBC -7/10
D12 -147 Printed: 05 -17 -2012
Department (206- 431 - 3670).
•
7: 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.
8: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * **
9: The applicant must notify the City Project Inspector at (206)433 -0179 upon commencement and completion of work at least
24 hours in advance. All inspection requests for utility work must also be made 24 hours in advance.
10: Any material spilled onto any street shall be cleaned up immediately.
11: If demolished building has its own septic system the septic tank shall be removed or abandoned in accordance with King
County Board of Health Code 13.04.054 and removal or abandonment shall be reported to the King County Health officer.
12: Any septic tanks in the area shall be pumped empty and removed or filled with sand. A copy of the documentation from
the business that performed the pumping shall be provided to the City Utilities Inspector.
13: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation
off -site or into existing drainage facilities.
14: From October 1 through April 30, cover any slopes and stockpiles that are 3H:1 V or steeper and have a vertical rise of
10 feet or more and will be unworked for greater than 12 hours. During this time period, cover or mulch other disturbed
areas, if they will be unworked more than 2 days. Covered material must be stockpiled on site at the beginning of this
period. Inspect and maintain this stabilization weekly and immediately before, during and following storms.
15: From May 1 through September 30, inspect and maintain temporary erosion prevention and sediment at least monthly. All
disturbed areas of the site shall be permanently stabilized prior to final construction approval.
16: The site shall have permanent erosion control measures in place as soon as possible after final grading has been .
completed and prior to the Final Inspection.
doc: IBC -7/10
D12 -147 Printed: 05 -17 -2012
CITY OF TUKNOA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http: / /www.TukwilaWA.gov
Building Pe No. 11)-r- 1 7
Project No.
Date Application Accepted:
Date Application Expires:
For o Ice use onl
S- 3 -4
1
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
Site Address: Li 7 3 5 15gt SS
Tenant Name: R e_
PROPERTY OWNER
Name: c..I,,o,e_j �\ e
Address: q--Bs s t 5��1, e.cc
City: I;ki„, , t .. State: W A Zip: 9 D)
CONTACT PERSON — person receiving all project
communication
Name: .,.).,,r..) ` ,
I�
`
Address:
City: State: Zip:
Phone:2,06 Z2b ax:
Email: t, c„k ct5 c2v S ps n'-'.i. Co'
GENERAL CONTRACTOR INFORMATION
Company Name:
Address:
Company Name:
City:
State:
Zip:
Phone:
Fax:
City:
State:
Contr Reg No.:
Phone:
Exp Date:
Tukwila Business License No.:
H:Wpplications\Forms- Applications On Line \2012 Applications\Permit Application Revised - 2- 7- 12.docx
Revised: February 2012
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King Co Assessor's Tax No.:
Suite Number: Floor:
New Tenant: ❑ Yes No
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 price): $ ) GO
Describe the scope of work (lease provide detailed information):
&el . -p1e,l 01 P7
•
1
Existing Buil4jng Valuation: $ 0
R, -emaua old she ]p1�,7�-
Will there be new rack storage? ❑ ....Yes 41,.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 foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): Floor area of principal dwelling: Floor area of accessory dwelling:
*Provide documentation that shows that 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:Wpplications\Forms- Applications On Line\2012 Applications\Permit Application Revised - 2- 7- 12.docx
Revised: February 2012
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Page 2 of 4
Existing
Interior Remodel
Addition to
Existing
Structure
New
Type of
Construction per
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 foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): Floor area of principal dwelling: Floor area of accessory dwelling:
*Provide documentation that shows that 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:Wpplications\Forms- Applications On Line\2012 Applications\Permit Application Revised - 2- 7- 12.docx
Revised: February 2012
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Page 2 of 4
PUBLIC WORKS PERMIT INF TION — 206 - 433 -0179
/r
Scope of Work (please provide detailed information):
Call before you Dig: 811
Please refer to Public Works Bulletin #1 for fees and estimate shee
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 septi • design approved by King County Health Department.
❑... Highline
❑...Valley View ❑ ... Renton
❑ ...Sewer Availability Provided
❑.. ' ton
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 ❑... 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
❑ .. Sanitary Side Sewer
❑ .. Cap or Remove Utilities
❑ .. Frontage Improvements
❑ .. Traffic Control
❑ .. Backflow Prevention - Fire Protection
Irrigation
Domestic Water
❑ .. Permanent Water Meter Size (1)
❑ .. Temporary Water Meter Size (1)
❑ .. Water Only Meter Size
❑ .. Sewer Main Extension P, die
❑ .. Water Main Extension • ublic
0... Geote nical Report
0... Mai enance Agreement(s)
❑ .. Traffic Impact Analysis
❑ .. Hold Harmless — (SAO)
❑ .. Hold Harmless — (ROW)
Right -of -way Use - Profit for less than 72 hours
...Right-of-way Use — Potential Disturbance
0... Work in Flood Zone
0... Storm Drainage
0... Aban on Septic Tank 0... Grease Interceptor
0... Cur Cut ❑...Channelization
❑...P. ement Cut ❑...Trench Excavation
0... ooped Fire Line ❑ ... Utility Undergrounding
WO # (2) >> WO # (3)
WO # (2) >' WO # (3)
WO # ❑ .. Deduct Water Meter Size
Private ❑
Private ❑
>> WO #
>> WO #
FINANCE INFORMATION
Fire Line Size at Property Li e Number of Public Fire Hydrant(s)
❑ .. Water .. Sewer ❑ .. Sewage Treatment
Monthly Service Bill' to:
Name: /
Mailing Addres$:
Zip
Day Telephone:
Water Meter Refund/Billing:
Name:
Mailing Address:
City
State
Day Telephone:
City
State Zip
H :Wpplicauons'Forms- Applications On Line\2012 Applications\Permit Application Revised - 2- 7- 12.docx
Revised: February 2012
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Page 3 of 4
PERMIT APPLICATION NOTES — •
Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject
to possible revision by the Permit Center to comply with current fee schedules.
Expiration of Plan Review — Applications for which no permit is issued within 180 days following the date of application shall expire by limitation.
The Building Official may grant one 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 OWNER OR AUT . ORIZED AGENT:
Signature:
Print Name: ` 1 (v f.
Mailing Address: , 35 S
H:1Applications\Forms- Applications On Line \20I2 Applications\Permit Application Revised - 2- 7- 12.docx
Revised: February 2012
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Date:
Day Telephone:- oG) Z d -2_?
-1-,. I W} l ci qcc/ s'r-
City State Zip
Page 4 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.: 8108600840
Address: 4735 S 158 ST TUKW
Suite No:
Applicant: HALE DEMOLITION
RECEIPT
Permit Number: D12 -147
Status: APPROVED
Applied Date: 05/03/2012
Issue Date:
Receipt No.: R12 -01609
Payment Amount: $23.50
Initials: JEM Payment Date: 05/17/2012 11:52 AM
User ID: 1165 Balance: $0.00
Payee: RICHARD HALE
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Cash
Authorization No.
ACCOUNT ITEM LIST:
Description
23.50
Account Code Current Pmts
PW LAND ALT PERMIT FEE
000.342.400 23.50
Total: $23.50
doc: Receiot -06 Printed: 05 -17 -2012
• .
City of Tukwila
tit Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -43 1 -3670
Fax: 206 - 431 -3665
Web site: http: / /www.TukwilaWA.ov
RECEIPT
ParcelNo.: 8108600840 Permit Number: D12 -147
Address: 4735 $ 158 ST TURIN Status: PENDING
Suite No: Applied Date: 05/03/2012
Applicant: HALE DEMOLITION Issue Date:
Receipt No.: R12 -01491
Initials:
User ID:
Payee:
WER
1655
Payment Amount: $282.75
Payment Date: 05/03/2012 03:35 PM
Balance: $0.00
RICHARD HALE
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Cash
Authorization No.
ACCOUNT ITEM LIST:
Description
282.75
Account Code Current Pmts
BUILDING - NONRES
PLAN CHECK - NONRES
STATE BUILDING SURCHARGE
000.322.100
000.345.830
640.237.114
Total: $282.75
210.00
68.25
4.50
doc: Receiot -06 Printed: 05 -03 -2012
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
u p
Project: t
q-A_, OP i0
. ---: O te d ±o oro d e (o-i-- error fn 4710J,.
T Type of Ins ection:
lAdAil kVi-1 -hv.4I
r
'rank -- pi or 4-o r-o d rnv (o+
Address: I� /� f
— OP40rA In _teed /of or Q-fl/Pt- 1,e 0410( 1eAl
Date Called: I
ti i
Special Instructions:
/))0(it ddvht 6 e
410 v..., t ly
is
Date Wanted:. I .
Cc' ii
pm.
Requester: 12:tdeNA (
Phone No: n ,,(, _
2
Approved per applicable codes. D Corrections required prior to approval.
COMMENTS:
. ---: O te d ±o oro d e (o-i-- error fn 4710J,.
Oumer -Fou4 ( art old . sP,ofiI✓ 4. nk.
CoArireted eturif ock-f recief1 -. 011 'Fi'(( fn
'rank -- pi or 4-o r-o d rnv (o+
'
— OP40rA In _teed /of or Q-fl/Pt- 1,e 0410( 1eAl
eroS(on rlf Co�o 1 IP170 r 40 f '6 . `
0 &)(' e-r ' sa at house wa .s hat ( teat a tk.A.v.
I )47PrA fn address I' R 1, PSG c9 r-r v i-
40 4&(.
Inspector:
TS
Date:
n REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
.SEX GRAVEL ACCESS RO
EXISTING SHACK DEMOLI110N
473B S 158TH ST 98188
EX. 20' X 20' SHACK
APPROX 400 SQJFT
TO BE DEMOLISHED
APPROX TERMINATED
GAS LINE
\ 46326'
;T7` _ - -,, _
25181'
133.93'
I_
— 13431-___ -
FELE C PY
Permit No., p 1)••1147
PI^- r-vint approval is subject to errors and omissions.
o:` construction documents does not authorize
::Son of any adopted code or ordinance. Receipt
1 grovel t°ie i Copy and oo ions is acknowledged:
By
Date: M� / /7J 2-0/2--
City OfTi,kwila
BUILDING DMSION
J
SE zRATE PERMIT
REQUIRED FOR:
altiebbanical
WEiectrical
&Plumbing
Ds Piping
of Tukwila
l DIVISION
APPROX TERMINATED
WATER LINE
NORTH
SCALE ,.. so.
EX. SINGLE -
WIDE
TRAILER
2094'
N- 328.98'
t
REVISIONS
No changes shall be made to the scope
of work r,,ithogt prior approval of
Th wiia Building Division.
+.:ions will require a new plan submittal
L:lci may include adcl:tional plan review fees.
TAX#81
PRIOR TO COMMENCING WITH DEMOLITION
A "pre -demo inspection" is required.
Contractors shall provide documentation that
an "asbestos survey" has been completed. If
needed, abatement procedures per "Puget
Sound Clean Air Agency" shall be completed
and documentation of compliance shall be
provided at time of final inspection.
REVIEWED`ROR
CODE COMPLIANCE
APPROVED
MAY 1 2012
City of Tukwila
BUILDING DIVISION
SITE PLAN
LOCATION: 4735 S 158TH ST 98188
OWNER RICHARD HALE
DRAWN 2 MAY 2012
SHEET 1 OF 1
1 Li 7
RECEIVED
MAY 0 3 2012
PIT CENTER
10 -01 -2012
City of Tukwila
Jim Haggerton, Mayor
Department of Community Development Jack Pace, Director
RICHARD HALE
4735 S 158 ST
TUKWILA WA 98188
RE: Permit No. D12 -147
HALE DEMOLITION
4735 S 158 ST TUKW
Dear Permit Holder:
In reviewing our current records, the above noted permit has not received a final inspection by the City of Tukwila Building
Division. Per the International Building Code, International Mechanical Code, Uniform Plumbing Code and /or the National
Electric Code, every permit issued by the Building Division under the provisions of these codes shall expire by limitation and
become null and void if the building or work authorized by such permit has not begun within 180 days from the issuance date
of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work has
begun for a period of 180 days. Your permit will expire on 11/14/2012.
Based on the above, you are hereby advised to:
1) Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 to schedule for the next or final inspection.
Each inspection creates a new 180 day period, provided the inspection shows progress.
-or-
2) Submit a written request for permit extension to the Permit Center at least seven (7) days before it is due to
expire. Address your extension request to the Building Official and state your reason(s) for the need to extend
your permit.
The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is determined that your
extension request is granted, you will be notified by mail.
In the event you do not call for an inspection and /or receive an extension prior to 11/14/2012, your permit will become null
and void and any further work on the project will require a new permit and associated fees.
Thank you for your cooperation in this matter.
Sincerely,
er Marshall
P t Technician
File:
Permit File No. D12 -147
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone 206 -431 -3670 • Fax 206 -431 -3665
PENNI GU WV
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: D12 -147
PROJECT NAME: HALE DEMOLITION
SITE ADDRESS: 4735 S 158 ST
X Original Plan Submittal Response to Incomplete Letter #
DATE: 05 -03 -12
Response to Correction Letter #
Revision # After Permit Issued
DEP RTMENTS:
Building ivislon
AV•gi Grp t
Public orks
fNiA-DCDS11
Fire Prevention
Structural
Planning Division
Permit Coordinator
M
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
E)
Incomplete
DUE DATE: 05 -08-12
Not Applicable
Comments:
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
Structural Review Required
REVIEWER'S INITIALS:
I I No further Review Required
DATE:
APPROVALS OR CORRECTIONS:
Approved 1-1 Approved with Conditions Not Approved (attach comments) ❑ 71
Notation:
REVIEWER'S INITIALS: DATE:
DUE DATE: 06 -05-12
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections:
Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
Documents /routing slip.doc
2 -28-02
After recording return to:
Richard Hale
4735 S. 158th St
Tukwilla, WA 98188
PACIFIC NW TIT FR 42.00
PAGE001 OF 001
05/16/2008 09:14
KING COUNTY, WA
1
FULL RECONVEYANCE
Grantor: Gerald F. Robison
Grantee: Richard Hale
Abbreviated Legal Description.
Assessor's Property Tax Number: W 9'4"
Reference Number of Document released: 20030328003010 RAGFiC NoR- ry,wEST TRT! E
The undersigned Trustee under that certain Deed of Trust, dated March 27th 2003
in which Richard Hale, a single man is grantor and Cecil G. Hendricks and Fanny D.
Hendricks, husband and wife is beneficiary, recorded on 03/28/2003, as Auditor's File
No. 20030328003010, records of King County, Washington, having received from the
beneficiary under said Deed of Trust a written request to reconvey, reciting that the
obligations secured by the Deed of Trust have been fully satisfied, does hereby reconvey,
without warranty, to the person(s) entitled thereto all right, title and interest now held by
said trustee in and to the property described in said Deed of Trust, situated in <County>
County, Washington.
Dated: May 15, 2008
erald F. Robison, Attorney at Law
STATE OF WASHINGTON County of
Y2,
This is to certify that 1 know or have satisfactory evidence that Gerald F. Robison, is the person
who appeared before me, and said person acknowledged that he signed this instrument, on oath stated that
he was authorized to execute the instrument and acknowledged it to be his free and voluntary act for the
uses and purposes mentioned in this instrument.
Date
440 : _� o
444. ,...
I S-, 2co g
(4f314.qQ°
Notary Public in and for thAState of ,
Washington, residing at
My Commission expires
IN)-r-
/�
RECEIVED
MAY 032012
PERMIT CENTER
•
CITY OF TUKWILA
Department of Community Development
6300 Southcenter Boulevard, Tukwila, WA 98188
Telephone: (206) 431-3670 FAX (206) 431 -3665
E- mail: tukplanaci.tukwila.wa.us
•
Permit Center /Building Division
206 431 -3670
Public Works Department
206 433 -0179
Planning Division
206 431 -3670
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
PERMIT NO: 7 I -Hi
STATE OF WASHINGTON)
) ss.
COUNTY OF KING )
gic)-70/cd
141e
[please print name]
, states as follows:
1. -I have made application for a permit from the City of Tukwila, Washington.
2. I understand that state law requires that all building construction contractors be registered with the
State of Washington. The exceptions to this requirement are stated under Section 18.27.090 of the
Revised Code of Washington, a.copy of which is printed on the reverse side of this Affidavit. I have
read or am familiar with RCW 18.27.990.
3. I understand that prior to issuance of a permit for work which is to be done by any contractor, the
City of Tukwila must verify either that the contractor is registered by the State of Washington, or that
one of the exemptions stated under RCW 18.27.090 applies.
4. In order to provide verification to the City of Tukwila of my compliance with this requirement, I
hereby attest that after reading the exemptions from the registration requirement of RCW 18.27.090,
I consider the work authorized under this permit to be exempt under number 11- , and will therefore
not be performed by a registered contractor.
5. I understand that the licensing provision of RCW 19.28.161 through 19.28.271 shall not apply to
persons making electrical installations on their own property or to regularly employed employees
working on the premises of their employer. The proposed electrical work is not for the construction
of a new building for rent, sale or lease.
I understand that I may be waiving certain rights that I might otherwise have under state law in any decision
to engage an unregistered contractor to perform construction work.
Owner /Owner's Agent*
Signed to
I Y ned and sworn tobefore me this
]
I ( day of ` 4
20 I Z
NOTARY PUBLIC in and for the State of Washington
,
Residing at
County
Name as commissioned: (./.,._ bC.4k
My commission expires: L -- 1
18.27.090 Exemptions. The region provisions of this chapter do not apply to
1. An authorized representative of the United States
government, the state of Washington, or any incorporated
city, town, county, township, irrigation district, reclamation
district, or other municipal or political corporation or
subdivision of this state;
2. Officers of a court when they are acting within the scope
of their office;
3. Public utilities operating under the regulations of the
utilities and transportation commission in construction,
maintenance, or development work incidental to their own
business;
4. Any construction, repair, or operation incidental to the
discovering or producing of petroleum or gas, or the
drilling, testing, abandoning, or other operation of any
petroleum or gas well or any surface or underground mine
or mineral deposit when performed by an owner or lessee;
5. The sale of any finished products, materials, or articles of
merchandise that are not fabricated into and do not become
a part of a structure under the common law of fixtures;
6. Any construction, alteration, improvement, or repair of
personal property performed by the registered or legal
owner, or by a mobile /manufactured home retail dealer or
manufacturer licensed under chapter 46.70 RCW who shall
warranty service and repairs under chapter 46.70 RCW;
7. Any construction, alteration, improvement, or repair
carried on within the limits and boundaries of any site or
reservation under the legal jurisdiction of the federal
government;
8. Any person who only furnished materials, supplies, or
equipment without fabricating them into, or consuming
them in the performance of, the work of the contractor;
9. Any work or operation on one undertaking or project by
one or more contracts, the aggregate contract price of
which for labor and materials and all other items is less
than five hundred dollars, such work or operations being
considered as of a casual, minor, or inconsequential nature.
The exemption prescribed in this subsection does not apply
in any instance wherein the work or construction is only a
part of a larger or major operation, whether undertaken by
the same or a different contractor, or in which a division of
the operation is made into contracts of amounts less than
five hundred dollars for the purpose of evasion of this
chapter or otherwise. The exemption prescribed in this
subsection does not apply to a person who advertises or
puts out any sign or card or other device which might
indicate to the public that he or she is a contractor, or that
he or she is qualified to engage in the business of
contractor;
10. Any construction or operation incidental to the
construction and repair of irrigation and drainage ditches
of regularly constituted irrigation districts or reclamation
districts; or to farming, dairying, agriculture, viticulture,
horticulture, or stock or poultry raising; or to clearing or
other work upon land in rural districts for fire prevention
purposes; except when any of the above work is performed
by a registered contractor;
11. An owner* who contracts for a project with a registered
contractor, except that this exemption shall not deprive . the
owner of the protections of this chapter against registered
and unregistered contractors. The exemption prescribed in
this subsection does not apply to a person who performs
the activities of a contractor for the purpose of leasing or
selling improved property he or she has owned for less than
twelve months;
12.* Any person working on his or her own property,
whether occupied by him or her or not, and any person
working on his or her personal residence, whether owned
by him or her or not but this exemption shall not apply to
any person who performs the activities of a contractor on
his or her own property for the purpose of selling,
demolishing, or leasing the property;
13. An owner* who performs maintenance, repair, and
alteration work in or upon his or her own properties, or
who uses his or her own employees to do such work;
14. A licensed architect or civil or professional engineer
acting solely in his or her professional capacity, an
electrician certified under the laws of the state of
Washington, or a plumber certified under the laws of the
state of Washington or licensed by a political subdivision of
the state of Washington while operating within the
boundaries of such political subdivision. The exemption
provided in this subsection is applicable only when the
person certified is operating within the scope of his or her
certification;
15. Any person who engages in the activities herein
regulated as an employee of a registered contractor with .
wages as his or her sole compensation or as an employee
with wages as his or her sole compensation;
16. Contractors on highway projects who have been
prequalified as required by RCW 47.28.070, with the
department of transportation to perform highway
construction, reconstruction, or maintenance work;
17. A mobile /manufactured home dealer or manufacturer
who subcontracts the installation, set -up, or repair work to
actively registered contractors. This exemption only applies
to the installation, set -up, or repair of the
mobile /manufactured homes that were manufactured or
sold by the mobile /manufactured home dealer or
manufacturer;
..p I CbO,Ody v. .
18. An entity who holds a validrelectii l'contractor's
license under chapter 19.28.RC,VN1'thatryemploys_a certified
journeyman electrician, a +ertified residential =specialty
electrician, or an electrical `tra nee:meeting the
requirements of chapter 19.28RCW to perfo rm p1 tubing
work that is incidentally, directly, and immediately
appropriate to the like -in -land replacement of a household
appliance or other small household utilization?fegnipment
that requires limited electric power'and;limited,waste
and /or water connections. An�electr`ical trainee must be
supervised by a certified electribian whilelperforming
plumbing work.
• Per Washington State Department of Labor and Industries. lessee has been
Interpreted to be equivalent to owner for the purpose of these exemptions.