HomeMy WebLinkAboutPermit D14-0083 - FILLEY RESIDENCE - REMODELFII.I.FY RESIDENCE
12258 42 AVE S
D14-0083
Parcel No:
Address:
Project Name:
Citv of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Inspection Request Line: 206-438-9350
Web site: http://www.TukwilaWA.aov
0179000100
12258 42 AVE S
FILLEY RESIDENCE
DEVELOPMENT PERMIT
Permit Number: D14-0083
Issue Date: 4/1/2014
Permit Expires On: 9/28/2014
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
License No:
HODGINS ARTHUR W
12258 42ND AVE 5, TUKWILA, WA,
98168
THOMAS FILLEY
225 FOURTH AVE, SUITE B-301,
KIRKLAND, WA, 98033
OWNER - THOMAS FILLEY
Lender:
Name: N/A ( $5,000
Address:
Phone: (425) 773-1972
Phone:
Expiration Date:
DESCRIPTION OF WORK:
GUTTING & REMODEL, TURN INTO 2 BEDROOMS, NEW WINDOWS, DOORS, KITCHEN, BATH, FLOORS, REPAIR
SIDING, PAINT HOUSE, FENCE
Project Valuation: $1,000.00 Fees Collected: $151.56
Type of Fire Protection: Sprinklers: NO
Fire Alarm: NO
Type of Construction: VB Occupancy per IBC: R-3
Electrical Service Provided by: TUKWILA FIRE SERVICE Water District: TUKWILA
Sewer District: TUKWILA SEWER SERVICE
Current Codes adopted by the City of Tukwila:
Internations Building Code Edition:
International Residential Code Edition:
International Mechanical Code Edition:
Uniform Plumbing Code Edition:
2012
2012
2012
2012
International Fuel Gas Code:
WA Cities Electrical Code:
WA State Energy Code:
2012
2012
2012
Public Works Activities:
Channelization/Striping:
Curb Cut/Access/Sidewalk:
Fire Loop Hydrant:
Flood Control Zone:
Hauling/Oversize Load:
Land Altering:
Landscape Irrigation:
Sanitary Side Sewer:
Sewer Main Extension:
Storm Drainage:
Street Use:
Water Main Extension:
Water Meter:
Volumes: Cut: 0 Fill: 0
Number: 0
No
Permit Center Authorized Signature:
„oil,
Date: 4-1-1 1
I hearby certify that I have read and examined this permit and know the same to be true and correct. All
provisions of law and ordinances governing this work will be complied with, whether specified herein or not.
The granting of this permit does not presume to give authority to violate or cancel the provisions of any other
state or local laws regulating construction or the performance of work. I am authorized to sign and obtain this
development permit and agree to the conditions attached to this permit.
Signati ,,�, Date: V1/11
Print Name: KZ, c-11Nh7% F"1 �c C'�
This permit sha come null and void if the work is not commenced within 180 days for 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 PERMIT CONDITIONS***
2: Work shall be installed in accordance with the approved construction documents, and any changes made
during construction that are not in accordance with the approved construction documents shall be
resubmitted for approval.
3: All permits, inspection record card and approved construction documents shall be kept at the site of work
and shall be open to inspection by the Building Inspector until final inspection approval is granted.
4: All construction shall be done in conformance with the Washington State Building Code and the
Washington State Energy Code.
5: There shall be no occupancy of a building until final inspection has been completed and approved by
Tukwila building inspector. No exception.
6: 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.
7: 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.
8: 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).
9: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila
Permit Center.
10: 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.
PERMIT INSPECTIONS REQUIRED
Permit Inspection Line: (206) 438-9350
1700 BUILDING FINAL**
0409 FRAMING
0606 GLAZING
CITY OF TUKti► A
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd, Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
Building Perna,t No. D 14-66 g_3
Project No.
cHiLt,irts
3�iuvt�
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
Site Address: 11_2 5 I4 2-1441 /q,/!,c s
Tenant Name: lTvM F (-Lei 61LSA-P A- 20'4- WA-)
PROPERTY OWNER
Name: b mil ; f i Lai ,k,S,hS 4, 7 .,
J
Address: 2�5 ti4,,,,Ayr-r g ?Di
City: Kt eK_ State: wit_ Zip: 1$
43
CONTACT PERSON — person receiving all project
communication
Name: „yi5 FIB/
Address: 22.5 i t-k A 4- 6_ 30 I
City: k i eiLkh,12 State: W 0..
Zip: 9eb 33
Phone: 415 ,n3 1172_ Fax: p/�
Email: -}-\.q hey 00,'hazil4-,► i2i--
GENERAL CONTRACTOR INFORMATION
Company Name: . r_
Address:
City:
State:
Zip:
Phone:
Fax:
Contr Reg No.:
Exp Date:
Tukwila Business License No.:
King Co Assessor's Tax No.: 011 4c>b 1 of
Suite Number: Floor:
New Tenant: gl Yes ❑ .. No
ARCHITECT OF RECORD
Company Name:
t /b
l
Architect Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
ENGINEER OF RECORD
Company Name:
',VA_
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:
A i
1 �l
,� s�
Address:
City:
State:
Zip:
H:\Applications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 1 of 4
BUILDING PERMIT INFORMATT - — 206-431-3670
Valuation of Project (contractor's bid price): $ /v°v Existing Building Valuation: $ 03 la J
Describe the scope of work (please provide detailed information): 6ignJ (,-- (1-5VIA DEC.,/ 7v er% /,-)T2s Z 8or Qfri
Ne-w 1-,1 �5 ! Doak I KiflH 1 BAnt( FLuD&S ►Re—Fn-4_ Sip - / Periar kv5Fi f,ev►C ,
Will there be new rack storage? ❑ .... Yes
,` 1
o If yes, a separate permit and plan submittal will be required.
Provide All Building Areas in Square Footage Below
Existing
Interior Remodel
Addition to
Existing
Structure
New
Type of
Construction per
IBC
Type of
Occupancy per
IBC
lA Floor
600
tpa
phi--
0
2"d Floor
A-m ertle
sgO�
5 S v
/0//e-
r Floor
P tAr
Floors thru
Basement
gliA—
Accessory Structure*
Wit
Attached Garage
/lf-
Detached Garage
Z a O
Der
P.
Attached Carport
pJ `A-
Detached Carport
PP -
Covered Deck
, )/k-
/-
Uncovered Deck
I/A-
L')1(
..)‹
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 tj Other (specify) 41.MLtt fr
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes ig No
1f "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:Wpplicationa\Fonns-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 2 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 0 AU NT:
Signs Date: g/S/ I y
Print Name: ThotK ol-m Fl Day Telephone: It-1-5 113 I ni ? Z—
Mailing Address:
-2- 5 y-^^ ,4 "60-1 I) r - 6 30 I
K
City
wk- 9847
State Zip
H:WpplicationsWonns-Applications On Line\2012 Applications\Pennit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 4 of 4
illitUBLIC WORKS PERMIT INF WATION — 206-433-0179
Scope of Work (please provide detailed information): r; vTt)('/— +/LE4+9 Q&L t To 4 N on-0 2-56:1) 424. -k. / N
W usD s , Pe0 A ( tt t0J (I�/ - / Fr1-09 441 il-4.0 s i V i ►s 67 P J^ - / $.1c� Pezc
Ca11 before you Dig: 811
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
Water District
ftg .. Tukwila 0 ...Water District #125
❑ .. Water Availability Provided
Sewer District
xp.. Tukwila
❑ .. Sewer Use Certificate
❑ ...Valley View
❑ ...Sewer Availability Provided
❑ ... Highline
❑... Renton
❑... Renton
❑... Seattle
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.
Submitted with Application (mark boxes which apply):
❑ .. Civil Plans (Maximum Paper Size — 22" x 34")
❑ .. Technical Information Report (Storm Drainage)
❑ .. Bond ❑...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 0
Non Right-of-way ❑
❑ .. Total Cut
,3 .. Total Fill
cubic yards
i0 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) " WO #
❑ .. Temporary Water Meter Size (1) " WO #
❑ .. Water Only Meter Size " WO #
❑ .. Sewer Main Extension Public ❑
❑ .. Water Main Extension Public ❑
Private ❑
Private 0
0... Geotechnical Report
0...Maintenance Agreement(s)
❑ .. Traffic Impact Analysis
❑ .. Hold Harmless — (SAO)
❑ .. Hold Harmless — (ROW)
El...Right-of-way Use - Profit for less than 72 hours
❑... Right-of-way Use — Potential Disturbance
0...Work in Flood Zone
❑... Storm Drainage
. Abandon Septic Tank
. Curb Cut
. Pavement Cut
. Looped Fire Line
0... Grease Interceptor
❑ ... Channelization
❑ ...Trench Excavation
❑... Utility Undergrounding
(2) " WO # (3) " WO #
(2) " WO # (3) " WO #
❑ .. Deduct Water Meter Size "
FINANCE INFORMATION
Fire Line Size at Property Line
❑ .. Water ❑ .. Sewer
Monthly Service Billing to:
Name: Flt,c1;7 /104-
114 4°'.- ISNir VOW- 1361 162g.t..1h'D i A- 100 33
City
Mailing Address:
Water Meter Refund/Billing: I \
Name: i=u t-Ce 1
Mailing Address:
Number of Public Fire Hydrant(s) I
❑ .. Sewage Treatment
Day Telephone: 42$' 713 l 7Z
State
Zip
Day Telephone:
v,Ati- 631)(, 4,-4y,1.41- 9$43
City
State
Zip
H:Wpplications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 3 of 4
DESCRIPTIONS
PerrriitTRAK
Cash Register Receipt
City of Tukwila
ACCOUNT
QUANTITY
PAID
$151,56
D14-0083 Address: 12258 42 AVE S Apn: 0179000100
$151.56
DEVELOPMENT
$147.23
PERMIT FEE
R000.322.100.00.00
$86.50
PLAN CHECK FEE
R000.345.830.00.00
$56.23
WASHINGTON STATE SURCHARGE
B640.237.114
$4.50
TECHNOLOGY FEE
$4.33
TECHNOLOGY FEE
TOTAL FEES PAID BY RECEIPT: R1470
R000.322.900.04.00
$4.33
$151.56
Date Paid: Friday, March 14, 2014
Paid By: YELLOW BRICK RD PARTNERS LLC
Pay Method: CHECK 2001
Printed: Friday, March 14, 2014 11:21AM 1 of 1
CI'''SYSTEMS
INSPECTION RECORD
Retain a copy with permit
DDLI-
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;•' icci
Type o Inspectior�
NJ 4
Addre: .....
Date Called:
_ a
Special Instructions:
Date tedi
f T
m:
Requester:
Phone No:
®Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
c�reti,� (ems
tF
Dates;
i
NSPECTION FEE R (WIRED. Pio r to next inspection. fee must be
id at 6300 Southcen r Blvd.. Suite 100. Call to schedule reinspection.
INSP
INSPECTION RECORD
Retain a copy with permit
7jf4 2O1J
PERMIT N0.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
Project: f p II
,oi
Type of inspection
Add es :
ixii
Date Called:
Special Instructions:
Date Wanted:
..
! +;Z -
'
p.m.
Requester:
Phone No:
Approved per applicable codes. DCorrections required prior to approval.
COMMENTS:
Inspe
Date: 5 2,
REINSPECTION (REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection:
INSPECTION RECORD
Retain a copy with permil` "
IN ' ECT ON N0. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION ` C--
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
Project: i�
ey
'hype of Inspection:
Addrf ss
! �2
i f��(�//,,(
4v'
Date {led:
� �
ff
tri
�-
1kr
Special Instructions:
Date Wanted: i 2
m-
Requester:
Phone No:
Approved per applicable codes.
ElCorrections required prior to approval.
COMMENTS:
lnspe
0\,'\
Date: I
n REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
INSPECTION RECORD
Retain a copy with permit
INSP PERMIT NO. , AA
CITY OF TUKWILA BUILDING DIVISION '",
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
Project:-' t /
r 1 ((
/ t ,
N.
Typ ..of Inspection:
i'1- A 1111L tT
("\Z-, I u
Addre s:
I .
42 ry
Date Called:
Special Instructions:
Date Wante
d
i
r 4 r".---4
Requester
Phone No:
Approved perapplicable codes.
oCorrections required prior to approval.
COMMENTS:
Date: _ 1 / 1-
REINSPECTION FEE REQUIRED Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd:, Suite 100. Cate to schedule reinspection.
INSPECTION RECORD
Retain a copy with permit
INSPE Tl N PERMIT NO
3)4-oo83
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
Project:
1�r
Type of Las(-,
PM. nv
A d r A
('
2 A� Jr
Date Cal � r Z, 6
/`I t rI
Special Instructions:
Date ante
i
aim
Requester:
Phone No:
El Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
r`f'Rac t Sit.
c, e°"-
Inspector:
Date-
11
REINSPECTION, FEE REQUIRED. Prior to next inspection, fee must. be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection:
REVISIONS
No changes shall be to the scope
of work without prior approval of
Tukwila Building Division.
I VOTE.: Revisions will require a new plan submittal
I end may include additional plan review fees.
Filley - Zingman Remodel
12258 42nd Ave S, Tukwila, WA 98168
Tax Parcel 017900100r xa
Current Floor Ilan
<!—Nortt
NAV
r.r rr 7Wei TV
PLANN NG APPROVED •
[ ,! ^ changes can be madeto these
plans without approval from the
Planning Division of DCD
,Approved By: ZA.�
Late: 3-- 191-19
s_r
FILE COPY
Permit No. 1 M 0063
Plan review approval is subject to errors and omissions.
ti:! of construction documents does not authorize
f:lon of any adopted code or ordinance. Receipt
&proved Field Copy and conditions is acknowledged:
Date
Project Description: Remodel Dwelling
Framing Work will include:
• Rebuilding a wall that was previously removed. (This
will make the dwelling a 2-bedroom house.)
• Reopen original bathroom door location.
• Close off an existing bathroom door
Park ing Area
/Lt.-0
City Of Tukwila
BUILDING DIVISION
SEPARATE PERMIT
REQUIRED FOR:
8'Ntechanicai
erEiectrical
[Plumbing
(gem Piping
City of Tukwila
Et '.LD1F'1G DIVISION
OFire Hydrant
QFire Hydrant
V\
t1'4OOS3
REVIEVVED FOR
CODE COMPLIANCE
APPROVED
MAR 2 0 2014
City of Tukwila
BUILDING DIVISION
RECEIVED
CITY OF TUKWILA
MAR 1 4 2014
PERMIT CENTER
Filley - Zingman Remodel
12258 42nd Ave S, Tukwila, WA 98168
Tax Parcel 017900100E M�
Proposed Floorplan
4—North
NV'
R315.1 Carbon monoxide alarms. (WSA)
For new construction, an approved carbon monoxide alarm
shall be installed by January 1, 2011, outside of each separate
sleeping area in the immediate vicinity of the bedroom in
dwelling units. In a building where a tenancy exists, the
tenant shall maintain the CO alarm as specified by the
manufacturer including replacement of the batteries.
R315.2 Where required in existing dwellings. (WSA)
.icistingdwellings shall be equipped with carbon monoxide
alarms by July 1, 2011.
Exception: Owner -occupied detached one -family
dwellings legally occupied prior to July 1, 2010.
R315.3 arm requirements.
Single s tion carbon monoxide alarms shall be listed as
cSn g with UL 2034 and -shall -be installed in accorI
with this code and the manufacturer's installation instructs
Project Description: Remodel Dwelling
Framing Work will include:
• Rebuilding a wall that was previously removed. (This
will make the dwelling a 2-bedroom house.)
• Reopen original bathroom door location.
• Close off an existing bathroom door
1A1313.1 Smoke alarms. Smoke alarms shall be installed in the
following locations;
711 In each sleeping room.
81 Outside each separate sleeping area in the immediate vicinity of
the bedrooms.
91. On each additional story of the dwelling, including basements
but not including crawl spaces and uninhabitable attics.
en one or more smoke alarm is required to be installed within
an individual dwelling unit the alarm devices shall be
interconnected in such a manner that the actuation of one ala*m will
activate all of the alarm in the individual unit. The .alarm shall be
clearly audible inn all bedrooms over background noise levels with
—1 intervenin doors closed.
R313.2 Power sour . In new construction the required smoke
alarms shall receive eir primary power from the building
wiring...wiring shall be permanent without disconnecting
switch...when pri power is interrupted, shall receive power
from a battery. -
Parking Area
OFire Hydrant
(Bedroom windows) EGRESS REQUIREMENTS
R310.1 Basements with habitable spaces and
every sleeping room shall have at least one
open able emergency escape and rescue
opening. Opening sill height shall be no more
than 44 inches above the floor.
R310.1.1 Minimum clear opening shall net
clear 5.7 square feet.
R310.1.2 Minimum opening height shall net 24
inches.
R310.1.3 Minimum opening width shall net 20
inches.
R310.1.4 Openings shall be openable from the
inside without the use of keys or tools.
REVIEWED FOR
CODE COMPLIANCE t
APPROVED I
MAR 2 0 2014
City of Tukwila
BUILDING DIVISION f
OFire Hydrant
RECEIVED
CITY OF TUK .. ILA
MAR 1 4 2014
PERMIT CENTER
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REVIEINF_D FOR
CODE COMPLIANCE
APPROVED
MAR 2 0 2014
City of Tukwila
BUILDING DIVISIOik, p
RECE!VET1
ClTYOFTUr...;LA
MAR 1 4 2014
PERMIT CENTER
PERMIT COORD COPY
PLAN REVIEW/ROUTING SLIP
PERMIT NUMBER: D14-0083 DATE: 03/14/14
PROJECT NAME: FILLEY RESIDENCE
SITE ADDRESS: 12258 42 AVE S
X Original Plan Submittal Revision # before Permit Issued
Response to Correction Letter #
Revision # after Permit Issued
DEPARTMENTS:
CL
Bing Division in
h'IPubZi�Wo Works
0' 4 .19
MIA OA—
Fire Prevention
Structural
lb\1$-1 LI
Planning Division 1111
Permit Coordinator
1
PRELIMINARY REVIEW:
Not Applicable ❑
(no approval/review required)
DATE: 03/18/14
Structural Review Required
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS:
Approved
Corrections Required
Approved with Conditions
Denied
(corrections entered in Reviews) (ie: Zoning Issues)
DUE DATE: 04/15/14
Notation:
REVIEWER'S INITIALS:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg 0 Fire 0 Ping 0 PW 0 Staff Initials:
12/18/2013
CITY OF TUKWILA
Department of Community Development
630o Southcenter Boulevard, Tukwila, WA 98188
Telephone: (206) 431-367o FAX (206) 431-3665
E-mail: tukplan@ ci.tukwila.wa.us
Permit Center/Building Division
206 431-367o
Public Works Department
206 433-0179
Planning Division
206 431-367o
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
PERMIT NO: tit 4, 00 U J
STATE OF WASHINGTON)
COUNTY OF KING )
ss.
AnA-s , states as follows:
[please print name]
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 18.27.090.
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 15 , 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.
Signed and sworn to before me this
5t
d of
1
,20 1
T ' Y PUBLIC in and for the State of Washington
Residing at
Name as commissioned:
My commission expires:
18.27.090 Exemptions. The regi, don 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 46.7o RCW who shall
warranty service and repairs under chapter 46.7o 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;
18. An entity who holds4o. 'd.electrical.contractor's
license under chapter ; c -thtl) `i> p yys a certified
journeyman electric' �' ., iffied iie` ,specialty
electrician, or an el t , ainee mee 'e the
requirements of ch4pter9.28 RCW to ' o plumbing
work that is incidentallj directly, and im - dri iely
appropriate to the lik&it ,kind acement o household
appliance or other sfiut ltopseh d utilizatiop equipment
that requires limited eiettjOomiitandli ited waste
and/or water connectioa4 eieetrtcaj.tr inee must be
supervised by a certified elecfritian's4hile performing
plumbing work.
• Per Washington State Department of Labor and Industries lessee has
been interpreted to be equivalent to owner for purposes of exemptions.