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HomeMy WebLinkAboutPermit D14-0156 - AT&T MOBILITY (SC78) - ANTENNAS AND CABINETSAT&T MOBIIdTY (SC78) 10868 E MARGINAL WAY S D14-0156 Parcel No: Address: City 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: htto://www.TukwilaWA.eov DEVELOPMENT PERMIT 0323049057 10868 EAST MARGINAL WAY S Project Name: AT&T MOBILITY (SC78) Permit Number: D14-0156 Issue Date: 12/30/2014 Permit Expires On: 6/28/2015 Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: Address: License No: Lender: Name: Address: SEA POLICE ATHLETIC ASSN IN 11030 E MARGINAL WAY S , TUKWILA, OR, 98168 ZACH PHILLIPS 1001 SE WATER AVE, STE 180 , PORTLAND, OR, 97214 Phone: (503) 708-9200 WESTOWER COMMUNICATIONS INC Phone: (407) 852-1755 9961 SYDNEY HAYES RD , ORLANDO, FL, 32824 WESTOCI975J8 Expiration Date: 12/14/2016 SELF -FUNDED BY AT&T DESCRIPTION OF WORK: MODIFY EXISTING WIRELESS FACILITY BY REMOVING (3) EXISTING ANTENNAS AND AN EXISTING ANTENNA MOUNTING FRAME, RELOCATING (6) EXISTING PANEL ANTENNAS, (3) RRH UNITS AND (1) SURGE SUPPRESSION UNIT. ADDING A NEW LOW PROFILE PLATFORM WITH HAND RAILING KIT ANTENNA MOUNTING FRAME. (6) LTE PANEL ANTENNAS, (9) RRH UNITS, AND (1) SURGE SUPPRESSION UNIT MOUNTED NEAR ANTENNAS. ALSO INSTALL NEW LTE EQUIPMENT CABINETS IN FENCED AREA. Project Valuation: $20,000.00 Fees Collected: $824.42 Type of Fire Protection: Sprinklers: Fire Alarm: Type of Construction: Occupancy per IBC: Electrical Service Provided by: TUKWILA FIRE SERVICE Water District: TUKWILA Sewer District: VALLEY VIEW SEWER SERVICE Current Codes adopted by the City of Tukwila: International Building Code Edition: International Residential Code Edition: International Mechanical Code Edition: Uniform Plumbing Code Edition: International Fuel Gas Code: 2012 2012 2012 2012 2012 National Electrical Code: WA Cities Electrical Code: WAC 296-46B: WA State Energy Code: 2014 2014 2014 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: Date: I i 27l 1 I hearby certify that I have read and - ed this permit and know the same to be true and correct. All provisions of law and ordinances gove 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 he conditions attached to this permit. Signature. Date: Print Name: This permit shall become null and void if th 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: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Permit Center. 6: 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. 7: Wireless Facilities permit approved on Dec 18, 2014. The appeal period expires on Jars 2, 2015. The applicant may proceed with construction within the appeal period at their own risk. 8: Install emergency power off switch for antenna array for emergency responders. PERMIT INSPECTIONS REQUIRED Permit Inspection Line: (206) 438-9350 1700 BUILDING FINAL** Tenant Name: AT&T MOBILITY (SC78) PROPERTY OWNER Name: SEATTLE POLICE ATHLETIC ASSOC. Address: 11030 E MARGINAL WAY S City: TUKWILA State: WA Zip: 98168 CONTACT PERSON — person receiving all project communication Name: JOSHUA ROBERTS Address: 506 2ND AVE., SUITE # 210 City: SEATTLE State: WA Zip: 98104 Phone: (206) 342-6382 Fax: Email: JROBERTS@PTSWA.COM GENERAL CONTRACTOR INFORMATION Company Name: WESTOWER COMMUNICATIONS Address: 7525 SE 24TH ST., STE. 500 City: MERCER ISLAND State: WA Zip: 98040 Phone: Fax: Contr Reg No.: WESTOCI975J8 Exp Date: 12/14/2014 Tukwila Business License No.: CITY OF TUKWILA Community Development Department Public Works Department Permit Center 6300 SouthcenterBlvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Building Permit No. 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 King Co Assessor's Tax No.: 0323049057 Site Address: 10868 EAST MARGINAL WAY SOUTH Suite Number: Floor: New Tenant: ❑ Yes ® .. No ARCHITECT OF RECORD Company Name: PACIFIC TELECOM SERVICES Architect Name: ZACH NESGODA Address: 506 2ND AVE., SUITE # 210 City: SEATTLE State: WA Zip: 98104 Phone: (206) 342-6382 Fax: Email: JROBERTS@PTSWA.COM ENGINEER OF RECORD Company Name: PACIFIC TELECOM SERVICES Engineer Name: Address: 506 2ND AVE., SUITE #210 City: SEATTLE State: WA Zip: 98104 Phone: (206) 342-6382 Fax: Email: LENDER/BOND ISSUED (required for projects $5,000 or greater per RCW 19.27.095) Name: NOT APPLICABLE Address: City: State: Zip: H:\Applications\Forms-Applications On Line\201 I Applications\Permit Application Revised - 9-9-I I.docx Revised: August 20l I bh Page I of 4 BUILDING PERMIT INFORMATIGir — 206-431-3670 Valuation of Project (contractor's bid price): $ 20,000 Existing Building Valuation: $ Describe the scope of work (please provide detailed information): AT&T PROPOSES TO MODIFY EXISTING WIRELESS FACILITY BY REMOVING (3) EXISTING ANTENNAS AND AN EXISTING ANTENNA MOUNTING FRAME, RELOCATING (6) EXISTING PANEL ANTENNAS, (3) RRH UNITS AND (1) SURGE SUPPRESSION UNIT AND ADDING A NEW LOW PROFILE PLATFORM WITH HAND RAILING KIT ANTENNA MOUNTING FRAME, (6) LTE PANEL ANTENNAS, (9) RRH UNITS, AND (1) SURGE SUPPRESSION UNIT MOUNTED NEAR ANTENNAS. AT&T ALSO PROPOSES TO INSTALL NEW LTE EQUIPMENT CABINETS IN FENCED AREA. Will there be new rack storage? ❑ Yes 0.. No 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 1st Floor 2`td Floor 3`a 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 0 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 VI 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:\Applications\Forms-Applications On Line\201 I Applications\Permit Application Revised - 8-9-1 I.docx Revised: August 2011 bh Page 2 of 4 PUBLIC WORKS PERMIT INFGA MATION — 206-433-0179 Scope of Work (please provide detailed information): NOT APPLICABLE Ca11 before you Dig: 811 Please refer to Public Works Bulletin #1 for fees and estimate sheet. Water District ❑ ...Tukwila 0 ...Water District #125 0 ...Water Availability Provided Sewer District ❑ ...Tukwila 0 ...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) O ...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 0 Non Right-of-way 0 ❑ ...Total Cut cubic yards ❑ ...Total Fill cubic yards ❑ ...Sanitary Side Sewer O ...Cap or Remove Utilities ❑ ...Frontage Improvements ❑ ...Traffic Control ❑ ...Backflow Prevention - Fire Protection Irrigation Domestic Water ❑ .. Geotechnical Report ❑ .. Maintenance 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 ❑ .. Work in Flood Zone ❑ .. Storm Drainage ❑ .. Abandon Septic Tank ❑ .. Curb Cut ❑ .. Pavement Cut ❑ .. Looped Fire Line ❑ .. Grease Interceptor ❑ .. Channelization 0 .. Trench Excavation ❑ .. Utility Undergrounding ❑ ...Permanent Water Meter Size... II WO # ❑ ...Temporary Water Meter Size.. WO # ❑ ...Water Only Meter Size WO # 0 ...Deduct Water Meter Size O ...Sewer Main Extension Public ❑ Private 0 ❑ ...Water Main Extension Public 0 Private 0 FINANCE INFORMATION Fire Line Size at Property Line Number of Public Fire Hydrant(s) O ...Water 0 ...Sewer Monthly Service Billing to: Name: 0 ...Sewage Treatment Day Telephone: Mailing Address: Water Meter Refund/Billing: Name: Mailing Address: City State Zip Day Telephone: City State Zip H:Wpplications\Fonns-Applications On Line \2011 Applications\Pennit Application Revised - 8-9-11.doec Revised: August 2011 bh 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 A Signature: [tom ZED-A(.1.15 .: Date: 05/23/2014 Print Name: JOSHUA ROBERTS Day Telephone: (206) 342-6382 Mailing Address: 506 2ND AVE., SUITE 210 SEATTLE WA 98104 City State Zip H:Wpplications\Fonre-Applications On Line\2011 Applications'Pennit Application Revised - 8-9-11.docx Revised: August 2011 bh Page 4 of 4 DESCRIPTIONS ACCOUNT QUANTITY PermitTRAK I PAID $471.62 D14-0156 Address: 10868 EAST MARGINAL WAY S Apn 0323049057 $471.62 DEVELOPMENT $447.50 PERMIT FEE R000.322.100.00.00 0.00 $443.00 WASHINGTON STATE SURCHARGE B640.237.114 0.00 $4.50 TECHNOLOGY FEE $24.12 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R3867 R000.322.900.04.00 0.00 $24.12 $471.62 Date Paid: Tuesday, December 30, 2014 Paid By: WESTOWER COMMUNICATIONS INC. Pay Method: CHECK 1511 Printed: Tuesday, December 30, 2014 12:57 PM 1 of 1 srsrrM5 Cash Register Receipt City of Tukwila DESCRIPTIONS ACCOUNT QUANTITY PAID PermitTTRAK $352.80 D14-0156 Address: 10868 EAST MARGINAL WAY S Apn; 0323049057 352.80 DEVELOPMENT $352.80 PERMIT FEE PLAN CHECK FEE TOTAL FEES PAID BY RECEIPT: R2213 R000.322.100.00.00 R000.345.830.00.00 0.00 0.00 $39.30 $313.50 $352.80 Date Paid: Wednesday, May 28, 2014 Paid By: WESTOWER COMMUNICATIONS INC Pay Method: CHECK 1148 Printed: Wednesday, May 28, 2014 9:15 AM 1 of 1 CRWSYSTEMS Ei- IN ION N INSPECTION RECORD Retain a copy with permit PERMIT NOE CITY OF TUKWILA BUILDING DIVISION 1N 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 P'raJ 1 f"r /('toL(( (I Type of s ctio : at 7 ( frig I Address: S©�C u •�-i ("y pate Called: 1/41 c'. pecial instructions: 9 Clate anted: 3 7p.m. a.m.�/1/� Requester: Phone No: Approved per applicable codes. E3 Corrections required prior to approval. C f MENTS: rOkc-- Inspector: Date: REINSPECi'ION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Cali to schedule reinspection. City of Tukwila Jim Haggerton, Mayor Department of Community Development Jack Pace, Director November 17, 2014 Zach Phillips 1001 SE Water Ave, Ste 180 Portland, OR 97214 RE: Request for Application Extension AT&T Mobility (SC78) —10868 East Marginal Wy S Dear Mr. Phillips, This letter is in response to your written request for an extension to Application Number D14-0156. The Building Official has reviewed your letter and considered your request to extend the above referenced application. It has been determined that the City of Tukwila Building Division will be extending your permit application and additional 90 days, through February 26, 2015. If you should have any questions, please contact our office at (206) 431-3670 extension 1. File: Permit D14-0156 W.\Permit Center\Extension Letters\Applications\2014014-0156App Extension Letter#1.docx 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 l' 4riT Sc 78 'EXte r)(' IQ4S ' 1 / 191z0V-1 D li-i —O is-4 c c--Nli of- i"-,Kwt,.q 4 4-Pt'J .- ""5-crtrt t E '_ t--I 414-Z 1-1. C -? ) J < kit & WA 1g I € 8 0Request for Extension # i Current Expiration Date: "1 J'Y , 3 l e 'Lhkw , ci cv a _ i Extension Request: CL�-iUG, 3 1 -3 6-1-5- AC for d days Approved / y ( �'� Denied (provide explanation) 0 V 1kV. ►}T ; Signature/Initials ( V VI-CA-Sc nrCC-eV,. 711-11 Lz7rE,1 3 0472 4- AdediiL51 1 o-L P P'PYu(.' T('j E T j•51oJ F fL- Pe-11 -ir # p14-0/5-4 I II1Ut'1 tt CLt1 1264g4tSrC7 Tl-lj7 t v "tit k k kerg LI A-7ti u Po -rt4-c I-I4N 4 e t tr A k1 rre&- 1 , 1 Viv0 -FP o Ic '2Ve Po G- 7"1AI C T' ('cr'+-zr j3 4 ( a,A Id 14)201c-1 Lis /f t& Z7. i- ' - f "41-t?_ (1)E11-1^-ir k.-.5 ' ®014-1) • .4) Vz5Vt .! P''!4.Ly ��tST i �L f�PPLlc��ro►r ExT'E�r S�v•,� C►�( ©1-4- 5 514C,4.0-0 Yo 4 #441c •4�`t OCT d'$PO) PLe'-se -"T. 4 T ,4? L LOLLEtA.6(At Z ict1- PL41u.leS Wlkv Ike) TiokL-/ cut--'. ?I-U P PN% J tct F-►toq -3-esot4 ao 9 ri vi -0 !S svo LoNGb-c ItrCl1" Oc.l�l ct7'�!/r�¢iv7. co,„ ,te �`"�i�It.�71�+''� /S CSe, 3) —o - g200 ~ `VAPSe k3km-cam Stom+c.e.tt:c.ti' xi a ��►ate.4,J 1.�. cifM1 i , / 1. , .-�.-�. City of Tukwila Department of Community Development October 10, 2014 JOSHUA ROBERTS 506 2 AVE, STE 210 SEATTLE, WA 98104 RE: Application No. D14-0156 AT&T MOBILITY (SC78) 10868 EAST MARGINAL WAY S Dear JOSHUA ROBERTS: Jim Haggerton, Mayor Jack Pace, Director Permit application D14-0156 for the work proposed at AT&T MOBILITY (SC78) (10868 EAST MARGINAL WAY S) has not been issued by the City of Tukwila Permit Center. Per the International Building, Residential, and Mechanical Codes as well as the Uniform Plumbing Code and/or the National Electric Code, every permit application not issued within 180 days from the date of application shall expire and become null and void. Currently your application has a status of COMMENTS OUT and is due to expire 11/28/2014. If you still plan to pursue your project, you are hereby advised to do one of the following: 1) If the plan review is completed for the project and your application is approved, you may pick up the application before the date of expiration. At the time of permit issuance the expiration date will automatically be extended 180 days. -or- 2) If the plan review is not completed submit a written request for application extension (7) seven days in advance of the expiration date. Address your extension request to the Building Official and state your reason(s) for the need to extend your application. The Building Code does allow the Building Official to approve one extension of up to 90 days. If it is determined that your extension request is granted, you will be notified by mail. In the event that your permit is not issued, we do not receive your written request for extension, or your request is denied your permit application will expire and your project will require a new permit application, plans and specifications, and associated fees. Thank you for your cooperation in this matter. Sincerely, f.44) r Marshall Technician Fi : D14-0156 6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 City of Tukwila Department of Community Development June 11, 2014 JOSHUA ROBERTS 506 2 AVE, STE 210 SEATTLE, WA'98104 RE: Correction Letter # 1 DEVELOPMENT Permit Application Number D14-0156 AT&T MOBILITY (SC78) - 10868 EAST MARGINAL WY S Dear JOSHUA ROBERTS, Jim Haggerton, Mayor Jack Pace, Director This letter is to inform you of corrections that must be addressed before your development permit can be approved. All correction requests from each department must be addressed at the same time and reflected on your drawings. I have enclosed comments from the following departments: PLANNING DEPARTMENT: Carol Lumb at 206-431-3661 if you have questions regarding these comments. • The project is adding three new antennae, which will require approval of a Type 1 Wireless land use permit prior to issuance of the building permit. Please address the comments above in an itemized format with applicable revised plans, specifications, and/or other documentation. The City requires that four (4) sets of revised plan pages, specifications and/or other documentation be resubmitted with the appropriate revision block. In order to better expedite your resubmittal, a 'Revision Submittal Sheet' must accompany every resubmittal. I have enclosed one for your convenience. Corrections/revisions must be made in person and will not be accepted through the mail or by a messenger service. If you have any questions, I can be reached at 206-431-3655. Sincerely, -7-,J) R-0,1 Bill Rambo Permit Technician File No. D14-0156 6300 Southcenter Boulevard Suite #100 • Tukwila Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 PERMIT COORD COPY PLAN REVIEW/ROUTING SLIP PERMIT NUMBER: - D14-0156 DATE: 11/14/2014 PROJECT NAME:. AT&T MOBILITY (SC78) SITE ADDRESS: 10868 EAST MARGINAL WY S Original Plan Submittal Revision # before Permit Issued Response to Correction Letter # 1 Revision # after Permit Issued DEPARTMENTS: A4)(,1\-.41"11 Building Division Public Works Fire Prevention Structural Mt, ,OC I)-NtS`)11 Planning Division II Permit Coordinator PRELIMINARY REVIEW: Not Applicable ❑ (no approval/review required) DATE: 11/18/14 Structural Review Required REVIEWER'S INITIALS: DATE: El APPROVALS OR CORRECTIONS: DUE DATE: 12/16/14 Approved Corrections Required Approved with Conditions Denied (corrections entered in Reviews) (ie: Zoning Issues) Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: 12/18/2013 PERMIT COOED COPY PLAN REVIEW/ROUTING SLIP PERMIT NUMBER: D14-0156 DATE: 05/28/2014 PROJECT NAME: AT&T MOBILITY (SC78) SITE ADDRESS: 10868 EAST MARGINAL WY S X Original Plan Submittal Response to Correction Letter # Revision # before Permit Issued Revision # after Permit Issued DEPARTMENTS: ri(A But ding uivision (� 90) 14 Public Works Fire Prevention Structural n C P1� Corr - (940-111 Planning Division Permit Coordinator PRELIMINARY REVIEW: Not Applicable ❑ (no approval/review required) DATE: 05/29/14 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: 06/26/14 Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: ( ` l t 1 Departments issued corrections: Bldg ❑ Fire ❑ Ping PW ❑ Staff Initials: 12/18/2013 Date: 1 l . 7 19 City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206-431-3670 Web site: http://www.TukwilaWA.gov Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Plan ChecWPermit Number: D I LI - 0 l S C ❑ Response to Incomplete Letter # IN Response to Correction Letter # ❑ Revision # after Permit is Issued mirvneltv,10 ❑ Revision requested by a City Building Inspector or Plans Examiner NOV Project Name: CCVIWN( ekeAHWN(S461 4 2014 Project Address: 10846 F as •i- 1 YIA,vo hA I Contact Person: ZA.L111 flit a l:r 5 Phone Number: 50 3. 7o $. R 200 Summary of Revision: (z4pI.t;Fs S +1, 1/1.tw to d-�.�1- pc -so tvv I-14:5 ink nil-. 514441 : zpkth;p s @ PTrs w it Sc (0m 4-�.rti, a 1- appl,c044v. AKA sviee,4;ki i n rw J4, rev 8;(1 kawtho's Sheet Number(s): "Cloud" or highlight all areas of revision including date of revision ct��i P� 11�I4�I ti Received at the City of Tukwila Permit Center by: Entered in TRAKiT on t t4 C:\Users\jennifer-m\AppData\LocahMicrosoh\Windows\Temporary Internet Files \Content.Outkak\DSTRCMFO\Revision Submittal Form.doc Revised: March 2014 WESTOWER COMMUNICATIO''TS INC Page 1 of 3 0 Washington State Department of Labor & Industries WESTOWER COMMUNICATIONS INC Owner or tradesperson APPLE, ROBERT ERNEST Principals APPLE, ROBERT ERNEST, PRESIDENT PITA, GEORGE LOUIS, VICE PRESIDENT DE CARDENAS, ALBERTO IGNACIO, SECRETARY MARTINICH, MATTHEW, VICE PRESIDENT (End: 01/26/2011) JARVIS, MIKE ARTHUR, PRESIDENT (End: 12/03/2014) BARKER, J JOHN EDWARD, VICE PRESIDENT (End: 12/03/2014) CARR, MICHAEL DOUGLAS, TREASURER (End: 12/03/2014) PAYNE, CALVIN JAY, DIRECTOR (End: 12/03/2014) Doing business as WESTOWER COMMUNICATIONS INC WA UBI No. 601 979 870 2460 SAND LAKE RD ORLANDO, FL32809 503-210-1000 Business type Corporation License Verify the contractor's active registration / license / certification (depending on trade) and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. WESTOCI975J8 Effective — expiration 04/28/2003-12/14/2016 Bond HARTFORD FIRE INSURANCE Bond account no. 52BSBAD6506 $12,000.00 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601979870&LIC=WESTOCI975J8&SAW= 12/30/2014