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HomeMy WebLinkAboutPermit D14-0317 - FORSBERG RESIDENCE - NEW SINGLE FAMILY RESIDENCEFORSBERG RESIDENCE 12207 50 AVE S D14-0317 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: http://www.TukwilaWA.gov COMBOSFR PERMIT 0179001770 Permit Number: 12207 50TH AVE S Project Name: FORSBERG RESIDENCE Issue Date: Permit Expires On: D14-0317 2/4/2015 8/3/2015 Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: FORSBERG SCOTTJ 36329 SE 56TH ST , FALL CITY, WA, 98024 JOHN TAMBURELLI 646 SW 134 ST, BURIEN, WA, 98146 SCOTTS CONCRETE & CONSTRUCTION Address: 36329 SE 56TH ST , FALL CITY, WA, 98024 License No: SCOTTCC941LK Lender: Name: SCOTT FORSBERG Address: PO BOX 580 , FALL CITY, WA, 98024 Phone: (206) 920-2220 Phone: (425) 222-6983 Expiration Date: DESCRIPTION OF WORK: CONSTRUCTION OF A NEW 2084 SQ FT SINGLE FAMILY RESIDENCE WITH 502 SQ FT ATTACHED GARAGE AND A 100 SQ FT UNCOVERED DECK Fire and Parks Impact fees not assessed as the new residence is replacing an existing residence being demo'd. Project Valuation: $283,434.38 Type of Fire Protection: Sprinklers: Fire Alarm: Type of Construction: V-B Electrical Service Provided by: TUKWILA FIRE SERVICE Fees Collected: $6,144.97 Occupancy per IBC: R-3 Water District: TUKWILA Sewer District: TUKWILA 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: 1 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: 60 Fill: 80 Number: 1 1 1 No Permit Center Authorized Signature: Date: 061-/0c//(S' 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 la s regulating construction or the performance of work. I am authorized to sign and obtain this development permit and agree he conditions attached to this permit. Signature: �i (, , Print Name: c 540 O ` o J � This permit shall become 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: Date: Z.-2 —/ 5 4: The attached set of building plans have been reviewed by the Fire Prevention Bureau and are acceptable with the following concerns: 1: An approved automatic fire sprinkler extinguishing system is required for this project. (City Ordinance #2436) 2: All new sprinkler systems and all modifications to existing sprinkler systems shall have fire department review and approval of drawings prior to installation or modification. New sprinkler systems and all modifications to sprinkler systems involving more than 50 heads shall have the written approval of Factory Mutual or any fire protection engineer licensed by the State of Washington and approved by the Fire Marshal prior to submittal to the Tukwila Fire Prevention Bureau. No sprinkler work shall commence without approved drawings. (City Ordinance No. 2436). 5: New and existing buildings shall have approved address numbers, building numbers or approved building identification placed in a position that is plainly legible and visible from the street or road fronting the property. These numbers shall contrast with their background. Address numbers shall be Arabic numbers or alphabet letters. Numbers shall be a minimum of 4 inches (102mm) high with a minimum stroke width of 0.5 inch (12.7mm). (IFC 505.1) 6: Adequate ground ladder access to rescue windows shall be provided. Landscape a flat, 12' deep by 4' wide area below each required rescue window. (City Ordinance #2435) 7: Maximum grade for all projects is 15% with a cross slope no greater than 5%. (City Ordinance #2435) 3: Contact The Tukwila Fire Prevention Bureau to witness all required inspections and tests. (City Ordinances #2436 and #2437) 8: Any overlooked hazardous condition and/or violation of the adopted Fire or Building Codes does not imply approval of such condition or violation. 9: These plans were reviewed by Inspector 511. If you have any questions, please call Tukwila Fire Prevention Bureau at (206)575-4407. 10: ***PUBLIC WORKS PERMIT CONDITIONS*** 11: The applicant or contractor must notify the Public Works 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. 12: Permit is valid between the weekday hours of 7:00 a.m. and 10:00 p.m. only. Coordinate with the Public Works Inspector for any work after 5:00 p.m. and weekends. 13: Work affecting traffic flows shall be closely coordinated with the Public Works Inspector. Traffic Control Plans shall be submitted to the Inspector for prior approval. 14: The City of Tukwila has an undergrounding ordinance requiring the power, telecommunications, and cable service lines be underground from the point of connection on the pole to the house. 15: Flagging, signing and coning shall be in accordance with MUTCD for Traffic Control. Contractor shall provide certified flagmen for traffic control. Sweep or otherwise clean streets to the satisfaction of Public Works each night around hauling route (No flushing allowed). Notify Public Works Inspector before 12:00 Noon on Friday preceding any weekend work. 16: Any material spilled onto any street shall be cleaned up immediately. 17: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation off -site or into existing drainage facilities. 18: 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. 19: The Land Altering Permit Fee is based upon an estimated 60 cubic yards of cut and 80 cubic yards of fill. If the final quantity exceeds this amount, the developer shall be required to recalculate the final quantity and pay the difference in permit fee prior to the Final Inspection. 20: From October 1 through April 30, cover any slopes and stockpiles that are 3H:1V 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. 21: 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. 22: Downspouts, driveway, patio and drainage from other impervious areas shall be collected in an on -site storm drain system. Drains shall be 4" minimum diameter, PVC schedule 40 or corrugated poly ethylene pipe with a minimum 1% slope for gravity discharge to location approved by the Public Works Department. Downspouts shall not connect to footing drains. Footing drain and downspouts may share a sing►e discharge pipe downstream of the lowest footing drain. 23: Install yard drain(s) and perforated pipe along the driveway, as necessary to prevent on -site ponding of storm water runoff. 24: 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 Public Works Inspector. 25: Driveways shall comply with City residential standards. Driveway width shall be a 10' minimum and 20' maximum. Slope shall be a maximum of 15%. Turning radii shall be a minimum of 5'. 26: Driveways shall be paved for a minimum distance of 20' from the edge of the existing road pavement. 27: Since the house must have a fire sprinkler system installed, it shall be verified in writing to the Public Works Inspector that the fire loop system for the building contains a WA State Department of Health approved Double Check Valve Assembly (DCVA). This shall be done prior to final inspection. Refer to attached Public Works Details for 1" FIRE/DOMESTIC SERVICE and/or 1" FLOW -THROUGH SYSTEM. Backflow device is optional if a FLOW -THROUGH SYSTEM is installed. Coordinate with the Public Works Inspector. 28: The house fire sprinkler system shall be designed by a Fire Sprinkler System Designer. Designer shall verify in writing to the Public Works Inspector that a 3/4-inch water meter and service line meets domestic water and fire flow requirements. If domestic water and fire flow requirements are not met, then a 1-inch water meter with a 1-inch service line is required. Refer to attached Public Works Details for 1" FIRE/DOMESTIC SERVICE and/or 1" FLOW -THROUGH SYSTEM. Coordinate with Public Works Project Inspector. 29: Pavement mitigation fees may apply to this permit. Amount estimated to be xxx sq. ft. x $xx.xx per sq. ft. = $x,xxx.xx. Final measurement to be made in the field by the Public Works Inspector prior to Public Works Final. 30: A bond or cash equivalent in the amount of 150% x cost of construction within the City right-of-way made out to the City of Tukwila for possible property damages caused by activites. 31: A copy of the Certificate of Insurance Coverage (minimum of $2,000,000 naming the City of Tukwila as additionally insured). 32: PRIOR TO ISSUING THIS PERMIT OWNER/APPLICANT SHALL SIGN W/NOTARY A HOLD HARMLESS AGREEMENT FOR WORK IN THE RIGHT-OF-WAY. 33: Prior to Public Works Final Inspection approval Owner/Applicant shall pay in full the current fee set for the King County Sewer capacity charge and provide proof of payment the City's Permit Center. City of Tukwila Ordinance no. 2177. 34: ***BUILDING PERMIT CONDITIONS*** 35: 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. 36: 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. 37: Truss shop drawings shall be provided with the shipment of trusses delivered to the job site. Truss shop drawings shall bear the seal and signature of a Washington State Professional Engineer. Shop drawings shall be maintained on the site and available to the building inspector for inspection purposes. 38: All construction shall be done in conformance with the Washington State Building Code and the Washington State Energy Code. 39: Notify the City of Tukwila Building Division prior to placing any concrete. This procedure is in addition to any requirements for special inspection. 40: All wood to remain in placed concrete shall be treated wood. 41: There shall be no occupancy of a building until final inspection has been completed and approved by Tukwila building inspector. No exception. 42: 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. 43: Every occupied space other than enclosed parking garages and buildings used for repair of automobiles shall be ventilated in accordance with the applicable provisions of the International Mechanical Code. 44: Water heaters shall be anchored or strapped to resist horizontal displacement due to earthquake motion. Strapping shall be at points within the upper one-third and lower one-third of the water heater's vertical dimension. A minimum distance of 4-inches shall be maintained above the controls with the strapping. 45: 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). 46: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Permit Center. 47: Preparation before concrete placement: Water shall be removed from place of deposit before concrete is placed unless a tremie is to be used or unless otherwise permitted by the building official. All debris and ice shall be removed from spaces to be occupied by concrete. 48: 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. 49: ***MECHANICAL PERMIT CONDITIONS*** 50: 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. 51: Manufacturers installation instructions shall be available on the job site at the time of inspection. 52: Except for direct -vent appliances that obtain all combustion air directly from the outdoors; fuel -fired appliances shall not be located in, or obtain combustion air from, any of the following rooms or spaces: Sleeping rooms, bathrooms, toilet rooms, storage closets, surgical rooms. 53: Equipment and appliances having an ignition source and located in hazardous locations and public garages, PRIVATE GARAGES, repair garages, automotive motor -fuel dispensing facilities and parking garages shall be elevated such that the source of ignition is not less than 18 inches above the floor surface on which the equipment or appliance rests. 54: ***PLUMBING/GAS PIPING PERMIT CONDITIONS*** 55: No changes shall be made to applicable plans and specifications unless prior approval is obtained from the Tukwila Building Division. 56: All permits, inspection records and applicable plans shall be maintained at the job and available to the plumbing inspector. 57: All plumbing and gas piping systems shall be installed in compliance with the Uniform Plumbing Code and the Fuel Gas Code. 58: No portion of any plumbing system or gas piping shall be concealed until inspected and approved. 59: All plumbing and gas piping systems shall be tested and approved as required by the Plumbing Code and Fuel Gas Code. Tests shall be conducted in the presence of the Plumbing Inspector. It shall be the duty of the holder of the permit to make sure that the work will stand the test prescribed before giving notification that the work is ready for inspection. 60: No water, soil, or waste pipe shall be installed or permitted outside of a building or in an exterior wall unless, adequate provision is made to protect such pipe from freezing. All hot and cold water pipes installed outside the conditioned space shall be insulated to minimum R-3. 61: Plastic and copper piping running through framing members to within one (1) inch of the exposed framing shall be protected by steel nail plates not less than 18 guage. 62: Piping through concrete or masonry walls shall not be subject to any load from building construction. No plumbing piping shall be directly embedded in concrete or masonry. 63: All pipes penetrating floor/ceiling assemblies and fire -resistance rated walls or partitions shall be protected in accordance with the requirements of the building code. 64: Piping in the ground shall be laid on a firm bed for its entire length. Trenches shall be backfilled in thin layers to twelve inches above the top of the piping with clean earth, which shall not contain stones, boulders, cinderfill, frozen earth, or construction debris. 65: The issuance of a permit or approval of plans and specifications shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the Plumbing Code or Fuel Gas Code or any other ordinance of the jurisdiction. 66: The applicant agrees that he or she will hire a licensed plumber to perform the work outlined in this permit. 67: All new plumbing fixtures installed in new construction and all remodeling involving replacement of plumbing fixtures in all residential, hotel, motel, school, industrial, commercial use or other occupancies that use significant quantities of water shall comply with Washington States Water Efficiency ad Conservation Standards in accordance with RCW 19.27.170 and the 2006 Uniform Plumbing Code Section 402 of Washington State Amendments PERMIT INSPECTIONS REQUIRED Permit Inspection Line: (206) 438-9350 5180 BACKFLOW - FIRE 0301 CONCRETE SLAB 5000 CURB, ACCESS, SDW 0610 ENERGY EFF CERT 5200 EROSION MEASURES 5210 EROSION MEASURES FNL 1400 FIRE FINAL 0201 FOOTING 0202 FOOTING DRAINS 0200 FOUNDATION WALL 0409 FRAMING 2000 GAS PIPING FINAL 0606 GLAZING 8004 GROUNDWORK 5040 LAND ALTERING 0502 LATH & GYPSUM 0703 MECH EQUIP EFF 1800 MECHANICAL FINAL 0608 PIPE INSULATION 0609 PIPE/DUCT INSULATION 1900 PLUMBING FINAL 1600 PUBLIC WORKS FINAL 0401 ROOF SHEATHING 0603 ROOF/CEILING INSUL 9002 ROUGH -IN GAS PIPING 0701 ROUGH -IN MECHANICAL 8005 ROUGH -IN PLUMBING 0602 SLAB/FLOOR INSUL 5090 STORM DRAINAGE 5100 STREET USE 0412 UNDERFLOOR FRAMING 9001 UNDERGROUND 0601 WALL INSULATION 0413 WALL SHEATHING/SHEAR CITY OF TUII 'LA Community Develoj,...ent Department Public Works Department Permit Center 6300 Southcenter Blvd, Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Combination _'ermit No. bIbt-o3k-7 Project No.: Date Application Accepted: 1--11Y-1 4 Date Application Expires: (For office use only) COMBINATION PERMIT APPLICATION — NEW SINGLE FAMILY 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 TaxANo.:O) �7 ? /7 70 Site Address: / 2 ZD 7 . Q a vt. Th I( vv' I vJ rr q I ?� PROPERTY OWNER Name: ©* fci,5e Address:0 City:eCa C t( _-, State Zip y0 CONTACT PERSON - person receiving all project_ communication Name: 3--thtn -1";l N<1lak.A ma I V\ Address: 6 r l s p `� 9 City: State: Zip: Phone./• \ q20- 2.1.6 Email: 1 Q w\ butte 1kt ein 44 ote31 t, CO WI J GENERAL CONTRACTOR INFORMATION Company Name 6 / e:/f) � /'_�f�d.4 se ( s Address:1? Vey,•"'k City. if , '' J- , State: Zipp Phone: /1,j 2 c2 - SZ e: Contr keg Now` 4 p Date: Tukwila Business License No.: ARCHITECT OF RECORD Company Name: Ai/if Architect Name: Address: City: State: Zip: Phone: Fax: Email: ENGINEER OF RECORD Company Nameifit kivi, ) Engineer Name: ill ' KeQ � 1,+ if I. t 1 / r/6 Address:7821, bile., a ve, v L State:. piZi City: KI-ale `0 vi t.@ d/ L , Pho 2S) 7 7./5-L�'c.�''��q Fax: Email: LENDER/BOND ISSUED (required for projects $5,000 or greater per RCW 19.27.095) Name:,5 l ! fejes. be Address:P) / City: Statj Zi9 H:\Applications\Porms-Applications On Line\2011 Applications\Combination Permit Application Revised 8-9-11.docx Revised: August 2011 bh Page 1 of 4 PROJECT INFORMATION — Valuation of project (contractor's bid price): $ /170� ()2, Scope of work (please provide detailed information): move._t�S DETAILED BUILDING INFORAMTION — PROJECT FLOOR AREAS PROPOSED SQUARE FOOTAGE Basement 1st floor Q c2._ 2nd floor / 13 1. Garage, carport ■ 50 2.- Deck — covered ■ uncovered TA,. /d O Total square footage Z(A q Per City of Tukwila Ordinance No. 2327, all new single family homes are required to have an automatic fire sprinkler system installed in the home. Please contact the Tukwila Fire Department for more information - 206-575-4407. EQUIPMENT AND FIXTURES — INDICATE NUMBER OF EACH TYPE OF FIXTURE TO BE INSTALLED AS PART OF YOUR PROJECT. MECHANICAL: Value of mechanical work $ Gi , 000. furnace <100k btu thermostat emergency generator fuel type: ❑ electric 14 gas appliance vent ventilation fan connected to single duct wood/gas stove water heater (electric) other mechanical equipment PLUMBING: Value of plumbing/gas piping work $ , .J bathtub (or bath/shower combo) dishwasher lavatory (bathroom sink) ) water heater (gas) bidet floor drain sink lawn sprinkler system 3 clothes washer shower water closet gas piping outlets H:\Applications\Forms-Applications On Line\2011 Applications\Combination Permit Application Revised 8-9-11.docx Revised: August 2011 bh Page 2 of 4 PUBLIC WORKS PERMIT INFOR TION — Scope of work (please provide detailed information):aPt moo, s ,e ,° ^ silt. fI „' s lei 'e s abate, i £xt,S4w.'1 S�p4 4 Kk, — *0�Co'is 'c' T .et�/tietfsti t � + le sty/ ®y ��ay� \'tom' i Q 4c `°` Co.�,O t ' s - t i Call before you Dig: 811 Please refer to Public Works Bulletin #1 for fees and estimate sheet. WATER DISTRICT Tukwila 0 ...Water District # 125 .. Letter of water availability provided ❑... Highline SEWER DISTRICT Tukwila ❑...Valley View ❑...Renton ❑.. Sewer use certificate ❑ ...Letter of sewer availability provided ❑ .. 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) 0... Geotechnical Report 0 ...Hold Harmless — (SAO) 0...Maintenance Agreement(s) .❑ ...Hold Harmless — (ROW) PROPOSED ACTIVITIES (MARK BOXES THAT APPLY): ❑ .. Right -Of -Way Use - Potential disturbance ❑...Construction/Excavation/Fill - Right -of -Way... ❑ -or- Non Right -of -Way.. 0 .. Total Cut .. Total Fill Sanitary Side Sewer .. Cap or Remove Utilities ❑ .. Frontage Improvements ❑ .. Traffic Control Cubic Yards Cubic Yards ❑ .. Permanent Water Meter Size ❑ .. Residential Fire Meter Size ❑ .. Deduct Water Meter Size ❑ .. Temporary Water Meter Size ❑ .. Sewer Main Extension 0...Work In Flood Zone ❑... Storm Drainage .... Abandon Septic Tank ❑... Curb Cut ❑... Pavement Cut 0...Looped Fire Line " WO # " WO# " WO# Public ❑ - or - Private 0 K.. Trench Excavation Utility Undergrounding ❑ ..Backflow Prevention - Fire Protection Irrigation Domestic Water ❑ .. Water Main Extension Public 0 - or - Private 0 FINANCE INFORMATION — THI INFORMATION IS REQUIRED TO BE FILLED OUT WHEN REQUESTING WATER OR SEWER SERVICE Fire line size at property line number of public fire hydrant(s) gl,.. water [sewer 0 .. sewage treatment MONTHLY SERVICE BILLING TO: Name: . r era Mailing Address: > .4 4 (. WATER METER REFUND/BILLING: Name: '^� f;i Day Telephon City State Zip Day Telephone: Mailing Address: City State Zip H:\Applications\Forms-Applications 0n Line\2011 Applications\Combination Permit Application Revised 8-9-11.docx Revised: August 2011 bh Page 3 of 4 PERMIT APPLICATION NOTES PPLICABLE TO ALL PERMITS IN TH. PPLICATION — 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. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY s. PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. PROPER Y PW zJ ! ' _ : ! ENT: Signature: y , Date: 8 24/171 Print N Day Telephoni- 7zs) Zo -8sz 8 Mailing Address: lib S W l 3 y'" B uti eei AI & /" 7,6 State Zip City H:\Applications\Forms-Applications On Line\2011 Applications\Combination Permit Application Revised 8-9-11.docx Revised: August 2011 bh Page 4 of 4 BULLETIN A2 TYPE C PERMIT FEE ESTIMATE' PLAN REVIEW AND APPROVAL FEES DUE WITH APPLICATION PW may adjus estimated fees ,cco4r4 S Co✓leke 4->L PROJECT NAME 1...0 7 SO - a Vim- 'So. PERMIT # If you do not provide contractor bids or an engineer's estimate with your permit application, Public Works will review the cost estimates for reasonableness and may adjust estimates. 1. APPLICATION BASE FEE 2. Enter total construction cost for each improvement category: Mobilization Erosion prevention Water/Sewer/Surface Water Road/Parking/Access A. Total Improvements 3. Calculate improvement -based fees: B. 2.5% of first $100,000 of A. C. 2.0% of amount over $100,000, but less than $200,000 of A. D. 1.5% of amount over $200,000 of A. 4. TOTAL PLAN REVIEW FEE (B+C+D) 200 Soo/50 ,t) SoG 5. Enter total excavation volume %o Cam-' Enter total fill volume cubic yards cubic yards f400 ao ©o 72 50 Use the following table to estimate the grading plan review fee. Use the eater of the excavation and fill volumes. QUANTITY IN CUBIC YARDS RATE Up to 50 CY Free ./ 51 — 100 ✓ $23.50 101 — 1,000 $37.00 1,001 — 10,000 $49.25 10,001 — 100,000 $49.25 for lsr 10,000, PLUS $24.50 for each additional 10,000 or fraction thereof. 100,001 — 200,000 $269.75 for 1sT 100,000, PLUS $13.25 for each additional 10,000 or fraction thereof. 200,001 or more $402.25 for 1ST 200,000, PLUS $7.25 for each additional 10,000 or fraction thereof. GRADING Plan Review Fees $ TOTAL PLAN REVIEW FEE DUE WITH PERMIT APPLICATIO (1+4+5) $ The Plan Review and Approval fees cover TWO reviews: 1) the first review associated with the submission of the application/plan and 2) a follow-up review associated with a correction letter. Each additional review, which is attributable to the Applicant's action or inaction shall be charged 25% of the Total Plan Review Fee. Approved 09.25.02 Last Revised 01/01/14 tlL1O3(7 RECEIVED CITY OF TUKWILA SEP 3 0 2014 PERMIT CENTER BULLETIN A2 TYPE C PERMIT FEE ESTIMATE PLAN REVIEW AND APPROVAL FEES DUE WITH APPLICATION PW may adjust estimated fees 6. Permit Issuance/Inspection Fee (B+C+D) 7. Pavement Mitigation Fee The pavement mitigation fee compensates the City for the reduced life span due to removal of roadway surfaces. The fee is based on the total square feet of impacted pavement per lane and on the condition of the existing pavement. Use the following table and Bulletin 1B to estimate the p Approx. Remaining Years Pavement Overlay and Repair Rate (per SF of lane width) 20-15 (100%) $10.00 15-10 (75%) $7.50 10-7 (50%) $5.00 7-5 (33%) $3.30 5-2 (25%) $2.50 2-1 (10%) $1.00 0-1 $0.00 8. GRADING Permit Review Fee Grading Permit Fees are calculated using the following table. Use the greater of the excavation and fill volumes from Item 5. QUANTITY IN CUBIC YARDS RATE 50 or less $23.50 '/ 51 —100 -/ $37.00 101 — 1,000 $37.00 for 1st 100 CY plus $17.50 for each additional 100 or fraction thereof. 1,001 — 10,000 $194.50 for lst 1000 CY plus $14.50 for each additional 1,000 or fraction thereof. 10,001 — 100,000 $325.00 for the 1st 10,000 CY plus $66.00 for each additional 10,000 or fraction thereof 100,001 or more $919.00 for et 100,000 CY plus $36.50 for each additional 10,000 or fraction thereof. Approved 09.25.02 Last Revised 01.01.11 2 $C(6) (7) (8) BULLETIN A2 TYPE C PERMIT FEE ESTIMATE PLAN REVIEW AND APPROVAL FEES DUE WITH APPLICATION PW may adjust estimated fees 9. TOTAL OTHER PERMITS A. Water Meter — Deduct ($25) B. Flood Control Zone ($50) C. Water Meter — Permanent* D. Water Meter — Water only* E. Water Meter — Temporary* * Refer to the Water Meter Fees in Bulletin Al Total A through E $ 0.00 (9) 10. ADDITIONAL FEES A. Allentown Water (Ordinance 1777) $ B. Allentown Sewer (Ordinance 1777) $ C. Ryan Hill Water (Ordinance 1777) $ D Allentown/Foster Pt Water (Ord 2177) $ E. Allentown/Foster Pt Sewer (Ord 2177) $ /Si oo i F. Special Connection (TMC Title 14) $ G. Duwamish $ H. Transportation Mitigation $ I. Other Fees $ Total A through I $ '(10) 50 DUE WHEN PERMIT IS ISSUED (6+7+8+9+10) $ 1 Q ,72. 9 -'. = ESTIMATED TOTAL PERMIT ISSUANCE AND INSPECTION FEE This fee includes two inspection visits per required inspection. Additional inspections (visits) attributable to the Permittee's action or inaction shall be charged $60.00 per inspection. WATER METER FEE Permanent and Water Only Meters Size (inches) Installation Cascade Water Alliance RCFC 01.01.2011-12.31.2011 Total Fee 0.75 $625 $6005 $6630 1 $1125 $15,012.50 $16,137.50 1.5 $2425 $30,025 $32,450 2 $2825 $48,040 $50,865 3 $4425 $96,080 $100,505 4 $7825 $150,125 $157,950 6 $12525 $300,250 $312,775 Approved 09.25.02 Last Revised 01.01.11 Temporary Meter 0.75" $300 2.5" $1,500 3 Clear Form 4 Cash Register Receipt City of Tukwila Receipt Number R4359 DESCRIPTIONS I ACCOUNT I QUANTITY I PAID PermitTRAK $4,233.61 D14-0317 Address: 12207 50TH AVE S Apn: 0179001770 $3,917.93 DEVELOPMENT $3,050.60 PERMIT FEE R000.322.100.00.00 0.00 $3,046.10 WASHINGTON STATE SURCHARGE 6640.237.114 0.00 $4.50 MECHANICAL $189.00 PERMIT FEE COMBOSFR R000.322.100.00.00 0.00 $189.00 PLUMBING $252.00 PERMIT FEE COMBOSFR R000.322.100.00.00 0.00 $252.00 PUBLIC WORKS $245.50 PERMIT ISSUANCE/INSPECTION FEE R000.342.400.00.00 0.00 $92.50 CONSTRUCTION PLAN REVIEW R000.345.830.00.00 0.00 $92.50 GRADING PLAN REVIEW R000.345.830.00.00 0.00 $23.50 GRADING PERMIT ISSUANCE R000.342.400.00.00 0.00 $37.00 TECHNOLOGY FEE $180.83 TECHNOLOGY FEE R000.322.900.04.00 0.00 $180.83 D15-0006 Address: 12207 50TH AVE S Apn: 0179001770 $315.68 PUBLIC WORKS $313.50 BASE APPLICATION FEE R000.322.100.00.00 0.00 $250.00 PERMIT ISSUANCE/INSPECTION FEE R000.342.400.00.00 0.00 $20.00 CONSTRUCTION PLAN REVIEW R000.345.830.00.00 0.00 $20.00 GRADING PERMIT ISSUANCE R000.342.400.00.00 0.00 $23.50 TECHNOLOGY FEE $2.18 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R4359 R000.322.900.04.00 0.00 $2.18 $4,2.33.61 Date Paid: Wednesday, January 28, 2015 Paid By: SCOTTS CONCRETE & CONSTRUCTION Pay Method: CHECK 6089 Printed: Wednesday, January 28, 2015 3:34 PM 1 of 1 CRSYSTEMS Cash Register Receipt City of Tukwila DESCRIPTIONS PermitTRAK ACCOUNT QUANTITY PAID $2,227.04 D14-0317 Address: 12207 50TH AVE S Apn: 0179001770 $2,227.04 DEVELOPMENT $1,977.04 PLAN CHECK FEE R000.345.830.00.00 0.00 $1,977.04 PUBLIC WORKS $250.00 BASE APPLICATION FEE TOTAL FEES PAID BY RECEIPT: R3190 R000.322.100.00.00 0.00 $250.00 $2,227.04 Date Paid: Tuesday, September 30, 2014 Paid By: SCOTTS CONCRETE & CONSTRUCTION Pay Method: CHECK 5902 Printed: Tuesday, September 30, 2014 12:02 PM 1 of 1 CiISYSTEMS INSPECTION RECORD Retain a copy with permit p/y-osr 7 PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila: WA 98188 (206) 431-367 Permit Inspection Request Line (206) 438-9350 Project: �� n Type pf In pectior� A �d � � fo J r Date Call Special Instructions: CAI( V%' '-((�,`e, Date Wanted: a.m. 7 / V `l3 p.m. Reque r: Phano: -` 2- 0 - C33-2—t Approved per applicable codes. E Corrections required prior to approval. OM M ENTS: or- *fo Inspector: Date:7 (Lf--(S REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. r6 INSPECTION RECORD Retain a copy with permit CTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Di(---a3(7 Project: sk / � c 41' Type oEf Ins coon: t ( 1 -yy Address: Date Called: SI pecial Instructions: kmRequester: Date Wan '� p /s a.m. p.m. Phone No: Approved per applicable codes. LJ Corrections required prior to approval. OM M ENTS: Inspector: Date7,,C3 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 1)1 0(7 PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 438-9350 (206) 431-3670 Pr ct: vs-IP.�5� Type of Inspe tiona c DatRt j6(r PtJ/ Address: 1 2-7 -S 8 f ` e-1J. Special instructions:4-111 Date Want e �� '_ /S a.m. p.m. Requester: CC.. o Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Inspector: Date: 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 TION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Doi—o3r7 P b Ir5,b r " SF �\ on: � Type of lnrectiGZ,r r,� �} Address: I v�7 .-o fie--b Date Called: ,,J Special Instructions: 4/4 Date Wanted: a.m. p.m. Requester: IC Phone No: Approved per applicable codes. 0 Corrections required prior to approval. OMMENTS: Inspector: Date:7 r 13 5- REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. ice INSPECTION RECORD Retain a copy with permit INS ° I0N NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 DfLO3(7 Permit inspection Request Line (206) 438-935 €JA t�fn E. Pro'ect:filoel „ )� n (� (� Type of Inspe �4on� A res z 7 �o t`` /ke.I3, Date Called: Special Instructions: Date Wan.: • =irk : is- a.m. p.m. Requete . Go 44, Phone No: Approved per applicable codes. LJ Corrections required prior to approval. COMMENTS: Inspector; Dal__ ef�1� re-C., ' C/ REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 438-9350 INSPECTION RECORD Retain a copy with permit INS ' % NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION (206) 431-3670 twl-0 s 17 Projec For�k r�� of Inspe,cti?n: f TYp( CLC4A I r 1 Address: j ZZ-J 7 ��® :pe Date Called: Special Instructions: �� Date Wanted: -1— 0— a.m. p.m. Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: _.` 6 / wit. - prt,v rde. q itio ect idstttdd-kep-- JtrJ cAllkW -I-00 to ft(O.OV. C 1adttli-" c tk-P?° e`f� ©115 A_ A r2, i4 e -4--Vlt4C 0 f1 (I- Ho0rr 54aft a kl '[(1( Cq ( ( (/,- rt-( e CA'C'a li Inspector: ire.....„, Dat - . 7 REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. R INSPECTION RECORD Retain a copy with permit ION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Project: SCo� �5ri Type of Inspection: Nkaat- kk Address: l Z2,0-7 CO Alit Date Called: Special Instructions: 4/4 Date Wanted: _ 7-7 _I S a.m. p.m. Requester:‘, 7C© '77 PhoneNo: ' f 7i Z a j.�Zc1 Approved per applicable codes. LJ Corrections required prior to approval. O'MMENTS: Inspector: Date" "�,. I s- REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. 111091.11 INSPECTION RECORD Retain a copy with permit IN ON NO. P V-03(7 PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., $100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Project: , ._. ztif. COU Typeirtsp_ectAion:, rrigjA..A Acr2t07 5--ePk_P-e-jo , Date Called: Special Instructions; Alti Date Wanted: it— 2J2 -- (5..— a.m. P.m. Requester: Phone No: Approved per applicable codes. El Corrections required prior to approval. Inspector: Date: REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Cali to schedule reinspection. 11P1111 Retain a copy with permit INSPECTION RECORD INS ON NO. D f - 0 3 (7 PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Projectrii_ , c4) /11;P- Type of Inspection: Address. 2-2-0 -7 5Vi'4ike,f0 , Date Called; Special Instructions: A_44 Date W nteci:_ f 7 -tr a.rn. P.m. Reques er: Phone No: Approved per applicable codes. COMMENTS: Inspector: Corrections required prior to approval. Datey 7 REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. 164 INSPECTION RECORD Retain a copy with permit (7 PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Proiect- _ r",* rgall fle4' Tof spection: W4 * Address: 174.07 5-01-4"t-fli-Vely, .1Aitki Date Cal ed: Special Instructions; phi Date tinted( (4 _ P.m. Requester: Phone No: Approved per applicable codes. JJ Corrections required prior to approval. OMMENTS: Inspector: DateLi f (s_ 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 INSPECTION NO, PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Ply- 63(7 Pro ,-K p- Type .91.1t1spection: k rr 41.kit ( v.j 'A Idyl 0 7 Jotit tiv,e_ .i_d, Date Called: Special Instructions: /1_44 Date Notatec jr: a. a.m. P•m• Requy.,.ster: / 7 ce fr Pone No: (' 7-6 o 47c-1) I:Approved per applicable codes. Corrections required prior to approval. COMMENTS: f r frt•-i k8 0/ PVT tilqe ,H4v1'14 0/11 yr 14y "Fr'grf Pert CAI 1 o Inspector: r Date: 4.7 REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. re 111I Retain a copy with permit INSPECTION RECORD INS ION O. PERMIT NO. .M-0 (7 CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd,, #100, Tukwila, WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Projefict; ,IC 5F Type of Inspection: KaArgik —.D.41 Ate-C-11 4ddress: 1-1%2A)7 50 fk A-A,50, Date CallYd: Special Instructions: if1-44 Date Wante7d: a.rn. Reques,ter. ) CO No: Phone No: Approved per applicable codes. ElCorrections required prior to approval. COMMENTS: Date: 3 -2-1( 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 INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 5outhcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Ptti 03 (7 Project TypeAf Inspection: k.--X-ok Ae-CA Address: I 7;2-o 7 3-0 ft-t telWE_Sc,, Date Calle : Special Instructions: . Date Winted: a.m. Request% rt ....)(..G Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: cetiiiLLII 4 42, aL. 5 Inspector: Date: 3-17 REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be —"" paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. oin INSPECTION RECORD _ Retain a copy with permit INSPECTION NO. PERMIT NO. inc.( 0-51 7 CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 0/(4wt1q( Project: ,a5F Type of InspectiorV ..- Add Etss: 12-1-7 r4"4-,/e_ so Date Cal d: Special Instructions: ,Phone Date Wanted: a.m. p.m. Reques ft 7-k 0 .55-24 LiApproved per applicable codes. COMMENT EJCorrections required prior to approval. • AQc-.17LcuikCc. vt PI-9 -figigati!r2 1'0 V t( Ott/ ' (q tr (Gtqq(A6ttlei (( 65Tr ec•Fr'o e;cc) f(101 K 4il .49-(J-1 "E F REINSPECTION FEE REQUIRED, Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. (C INSPECTION RECORD Retain a copy with permit 41- 0317 PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd,, #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Id Project: i P IC Type of Inspectioit:- it-C-*Ikeet , 1 Mt ky j Date Called: Ad ress: i 2- 1-0 7 5o I-i& ti-V42-40 - Special Instructions: Date Wanted: a.m. Request 474 Phone No: .gy--24s Approved per applicable codes. Corrections required prior to approval. COMMENTS: Inspector: F REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Cali to schedule reinspection. INSPECTION RECORD Retain a copy with permit Pq-0317 CITY OF TUKWILA BUILDING D V 6300 Southcenter EtIvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 438-9350 PERMIT NO. SION (206) 431-3670 Prsjr51._ iq f- Type of Irispectiory IA 4. .ety. siet b Address: 1 07 .5-Ti* 4,1e_ 5-0 Date Called: Special Instructions: A it4 Date Wanted: 2.— — (7 — 1-5— a.m. P-m• Requestr: _ k Phone No: 1425 2-60 E.'s2? TApproved per applicable codes. do ENTS: I:Corrections required prior to approval. Inspector: — r-- 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 Plii-031 PERMIT NO. CITY OF TUKVVILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 • Permit Inspection Request Line (206) 438-9350 • Project: licr A Type of Inspection: G r0k4 (Ad LA/6r t , 'Addr ss; i ziO 7 sz *14 41/42. co, Date Called: Special Instructions: Date Wanted;.., a,m. p.m. Requesser: ,5e. a it Phone. yo: lf 7 S 2-60 Z5- 2- ElApproved per applicable codes. 'COMMENTS: EJCorrections required prior to approval. Inspector: REINSPECTIDN FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Can 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) 438-9350 171'/or7 Project: J/J IZ Type of InspeGtion: r(>01147 Dircf r 't--1 „,.. ,nddress., — 12307 50 f* Av , Date Called: 1 SpeciaInstructions: 4 44 Date Wanted:re .... I 5_ a.m. P.m- Requester: Phone No: CgfApproved per applicable codes. ElCorrections required prior to approval. CO MENT : i)fr eh g„i a f i-t-u-af oil i__.--1 _ _ < , t 1 4,-(1;Pri4 (-IA e c 461- 69 , inspector: Dats)1 r 0 f s-- REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Etvd.. Suite 100. Call to schedule reinspection. . ' . ,1)(11- 03(7 INSPECTION RECORD Retain a copy with permit PT 11-tsit7 INSPEC IN NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (-1206) 431-3670 Permit Inspection Request Line (206) 438-9350 're,4_. Project; Als F- A Type of Inspection: r v foup der ftdAN teerf i 'Address: I `-.°10 7 co m A4/42_56, Date Called: Special Instructions: A 41 -Date Wanted: ' -.5--. / 5- a.rn. p.m. Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: nraverAd Inspector: -Date: f rREINSPECTION FEE REQUIRED, Prior to next inspection. fee must be I paid at 6300 Southcenter Blvd.. Suite 100, Cali to schedule reinspection. INSPECTION RECORD Retain a copy with permit INSPECTION NUMBER 1)11/ - c� 317 —oy PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 206-575-4407 Project: Type of Inspection: Address: r a,o-7 _ ;°v ,2/.$ Suite #: Contact Person: Special Instructions: Phone No.: V-Approved per applicable codes. Corrections required prior to approval. COMMENTS: cC • r -e — Of( Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: A c a-. Date: 71/1f4'' Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 3/14/14 T.F.D. Form F.P. 113 INSPECTION RECORD Retain a copy with permit INSPECTION NUMBER /C-5 0 (- it -I- PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 206-575-4407 Project: 6 / 7YI li c7 -"- fz / Type of Inspection: I*2,, Address: Suite #: / Z Z.. o —'1 4-Ve- Contact Person: Special Instructions: Phone No.: II/Approved per applicable codes. Corrections required prior to approval. COMMENTS: OK- (p)tia--(7"-- Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: . ,'di- - Date: y© y/j5 Hrs.: /, 0 / $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 3/14/14 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 206-575-4407 Project: Type of Inspectio . Address: Suite #: Contact Person: Special Instructions: Phone No.: f1Approved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 3/14/14 These pans ha t Nrev iewed by the Public Works epartment coinformanr. ith curr City sta dar Acc4tanc is s -.ject to er rs omission whi do au orize violations of adopted 4tand , )t nainces. The responsil y for the a' Iequacy of the de, ign rests totally we eth designer, dditio eletions or revisions to . the drawings ter tlitt date will oid this acceptanc and will equire a resubmitta of revised drawings for subse went approval. Z O Final acc tance is subject to the PubIici Works utilities ins Date: 714. field inspection by sector. COR ECTION LTR# RECEIVED CITY OF TUKWILA JAN 0 7 2015 PERMIT CENTER 8-24259 -COUPLING MEULLER 110 X ANGLE STOP -BALL FIN'SHED GROUND LINE 24' TO MAIN 1" FIRE SERVICE PARTS LIST: METER INSTALLED BY CITY TAILPIECE WITH FEMALE IRON PIPE THREADS SECTION GRAVEL - FOR DOMESTIC AND TYPE K COPPER 1-B-24258 - 1" COUPLING MUELLER 110 X ANGLE STOP - BALL 1-B-25028 - 1" CORP STOP - BALL 1 - TAILPIECE WITH FEMALE IRON PIPE THREADS NOTES: (OCVA) DOUBLE CHECK VALVE (OPTIONAL, FIRE SERVICE - TYPE K COPPER PIPE - PVC - POLY ETHYLENE 1. NO METER BOXES IN SIDEWALKS AND DRIVEWAYS WHERE POSSIBLE. 2. USE CLEAN 5/8" MINUS CRUSHED ROCK TO BACKFILL AROUND CORP STOP AND SERVICE LINE. 3. THE FIRE SPRINKER SYSTEM SHALL BE DESIGNED PER APPENDIX R AND NFPA 13D 4. REFER TO CHAPTER 7 OF THE STANDARDS. NOT TO SCALE City of Tukwila FLOW -THROUGH SYSTEM 1" FIRE / DOMESTIC FIRE SERVICE SHEET: XX-XX REVISION #1: 07.10 LAST REVISION: APPROVAL: PLAN VIEW THE WATER METER IS INSTALLED BY CITY STAFF 1' COUPLING MUELLER 110 X ANGLE STOP BALL VALVE B-24258 TO MAIN TYPE K COPPER -TYPE K COPPER PIPE - PVC OLY ETHYLENE FIRE TO SERVICE 1' MUELLER 300 BALL CURB VALVE FULL PORT B-20285 THIS VALVE IS ROTATED TO A VERTICAL POSITION THIS VALVE IS TO BE SEALED IN A OPEN POSITION 1' MUELLER RESID. FIRE SERVICE CONNECTION WITH F.I.P. CONNECTIONS & LOCKABLE ANGLE BALL VALVE THIS VALVE IS IN A HORIZONTAL POSTION \ - TYPE K COPPER PIPE - PVC - POLY ETHYLENE DOMESTIC TO SERVICE FITTINGS USED ON THE PIPES LEADING TO THE HOUSE FROM THE MUELLAR TEE SHALL BE MUELLER 110 TYPE FITTINGS OR EQUAL. FINISHED GROUND LINE 24" SECTION GRAVEL METER INSTALLED BY CITY MUELLER RES FIRE SERVICE CONNECTION TO MAIN ` TO SERVICE TYPE K COPPER 1" FIRE SERVICE PARTS LIST: 1-6-24258 - 1" COUPLING MUELLER 110 X ANGLE STOP - BALL 1-B-25028 - 1" CORP STOP - BALL 1 - TAILPIECE WITH FEMALE IRON PIPE THREADS NOTES: - TYPE K COPPER PIPE - PVC - POLY ETHYLENE 1. NO METER BOXES IN SIDEWALKS AND DRIVEWAYS WHERE POSSIBLE. 2. USE CLEAN 5/8" MINUS CRUSHED ROCK TO BACKFILL AROUND CORP STOP AND SERVICE LINE. 3. THE FIRE SPRINKER SYSTEM SHALL BE DESIGNED PER APPENDIX R AND NFPA 13D 4.THE DOUBLE CHECK VALVE SHALL BE INSTALLED WITHIN 5' OF THE WATER METER. 5. THE DOUBLE CHECK VALVE SHALL BE INSTALLED TO PROTECT FROM FREEZING. NOT TO SCALE City of Tukwila 1" FIRE / DOMESTIC SERVICE SHEET: REVISION #1: 1-11-2012 LAST REVISION: APPROVAL: ♦ MITCHELL ENGINEERING INC. • 7821 - 168th Ave. N.E. Redmond, WA 98052 (425) 747-1500 COMPLIANCE COODAPPROVED BUILDING niVIS ON PREPARED PROJECT RECEIVED CITY OF TUKWILA SEP 3 0 2014 PERMIT CENTER SUBJECT JOB NO. partial foundation plan sections are typical holddown shear walls shear walls 'MITCHELL ENGINEERING INC. beams lateral PREPARED BY PROJECT SHEET NO. OF DATE 1/4 1 2 / SUBJECT JOB NO. D //n2 MITCHELL ENGINEERING INC. PREPARED BY PROJECT SUBJECT 7821 - 168th Ave. N.E Redmond, WA 9805 (425) 747-150 NALL 12 tgiit ) LiO SHEET NO OF JOB NO lateral design criteria wind seismic MITCHELL ENGINEERING INC seismic dl shear front back PREPARED BY' ' PROJECT Zad 4 7 SHEET NO. OF JOB NO. ©' 2 1v 2 DATE //4// 2 SUBJECT 'MITCHELL ENGINEERING INC. shear7821 - 168th Ave. N.E. Redmond, WA 98052 (425) 747-1500 PROJECT 2vM SHEET NO OF SUBJECT JOB NO. 0/2-/o2 SWEAR WALL SCHEDULE Shear Wall Designation Nail Size Nail Spacing ALLOWABLE SHEAR Edges Studs Top/Btni. Plate Blocking Shear Wall Notes: 1. P1 - 7/16 A.P.A. rated Plywood or Orientated Strand Board (O. S.B.) on one side of wall. P2 - 7/16 A.P.A. rated Plywood or Orientated Strand Board (O.S.B.) on each side of wall. I.B.C. table 2306.4.1 3. Nails shall be 8d common. (d = .131 inch) 4. Where plywood is installed on both sides of wall plywood joints shall fall on separate studs each side. 5. All panel edges backed with 2-inch nominal framing for P1-6 & P1-4 shear wall. All panels edges backed with 3x framing at P1-3, P1-2, P2-3, & P2-2 shear walls. Install panels either horizontally or vertically. Space nails @ 10 inches on center @ intermediate supports. • 6. All anchor bolts shall be installed with hot dipped galvanized plate washers. 7. Refer to foundation plan for anchor bolt size, spacing and mudsill/rim connections. STRUCTURAL NOTES CODE: DESIGN IS IN ACCORDANCE WITH THE 2012 NTERNATIONAL BUILDNG CODE (I.B.C.) AS AMENDED BY THE LOCAL BUILDNG DEPARTMENT. LIVE LOADS: ROOF 25PSF FLOOR 40PSF LATERAL WIND EXPOSURE B, 85MPH/110MPH(ULT) SEISMIC SITE CLASS D FOUNDATIONS: EXTEND FOOTINGS TO FIRM UNDISTURBED SOIL, ASSUMED BEARING CAPACITY OF 1500PSF. ALL EXTERIOR FOOTINGS SHALL EXTEND A MINIMUM OF 1'-6" BELOW ADJACENT EXTERIOR GRADE. CAST -IN -PLACE CONCRETE: F'c=2500 PSI @ 28 DAYS. MINIMUM 5-1/2 SACKS OF CEMENT PER CUBIC YARD OF CONCRETE AND MAXIMUM OF 6-3/4 GALLONS OF WATER PER 94# SACK OF CEMENT. NO SPECIAL NSPECTION REQUIRED. MAXIMUM SIZED AGGREGATE IS 1-1/2 INCHES. MAXIMUM SLUMP IS 4 INCHES. ALL PHASES OF WORK PERTAINING TO THE CONCRETE CONSTRUCTION SHALL CONFORM TO BUILDNG CODE REQUIREMENTS FOR REINFORCED CONCRETE. ALL REINFORCING STEEL, DOWELS, ANCHOR BOLTS, AND OTHER INSERTS SHALL BE SECURED IN POSITION PRIOR TO POURING CONCRETE. ANCHOR BOLTS FOR PRESSURE TREATED SILL PLATES TO FOUNDATION WALLS TO BE 5/8 NCH DIAMETER WITH 7 INCH MINIMUM EMBEDMENT INTO CONCRETE AND MAXIMUM SPACNG OF 2 FEET ON CENTER. MNXMUM 2 BOLTS PER SILL PLATE PIECE. ONE BOLT TO BE PLACED WITHIN 6 INCHES OF EACH END OF THE SILL PLATE. DIPPED GALVANIZED CONNECTORS SHALL CONFORM TO ASTM STANDARD 153 AND HOT DIPPED GALVANIZED CONNECTORS SHALL CONFORM TO ASTM A653M CLASS G-185. STAINLESS STEEL FASTENERS AND CONNECTORS SHALL BE TYPE 304 OR 316. SIMPSON PRODUCT FINISHES CORRESPONDING TO THESE REQUIREMENTS ARE ZMAX (HOT DIPPED GALVANIZED) AND SST 300 (STAINLESS STEEL). FASTNERS FOR PRESSURE TREATED AND FIRE -RETARDANT TREATED WOOD SHALL BE ZMAX HOT DIPPED GALVANIZED (G185), STAINLESS STEEL, OR SHALL MEET ASTM 153 REQUIREMENTS PER IBC. SECTION 2304.9.5 AND IRC SECTION 319.3. REINFORCING STEEL: ALL REINFORCING STEEL SHALL BE PLACED IN CONFORMANCE WITH THE BUILDING CODE REQUIREMENTS FOR REINFORCED CONCRETE AND THE MANUAL OF STANDARD PRACTICE FOR REINFORCED CONCRETE CONSTRUCTION BY CRSI. DEFORMED REINFORCING STEEL BARS SHALL CONFORM TO ASTM A - GRADE 40 FOR #5 AND SMALLER REINFORCEMENT AND GRADE FOR #6 AND BEND) SHALL BE PROVIDED FOR ALL HORIZONTAL REINFORCEMENT. LAP ALL BARS A MINIMUM OF 48 BAR DIAMETERS UNLESS NOTED OTHERWISE. UNLESS OTHERWISE NOTED ON THE DRAWINGS REINFORCING STEEL SHALL HAVE THE FOLLOWING MINIMUM COVER: CONCRETE CAST AGAINST EARTH CONCRETE EXPOSED TO EARTH OR WEATHER: #6 THROUGH #18 BARS #5 BAR AND SMALLER 3 INCHES 2 INCHES 1-1/2 INCHES STRUCTURAL TIMBER: ALL GRADES SHALL CONFORM TO WWPA GRADING RULES FOR WESTERN LUMBER, LATEST EDITION. PROVIDE CUT WASHERS UNDER ALL NUTS AND BOLTS BEARING AGAINST WOOD. ALL WOOD IN CONTACT WITH CONCRETE SHALL BE PRESSURE TREATED -PER PRESERVATIVE -TREATMENT NOTE. ALL STRUCTURAL LUMBER SHALL BE NOTED BELOW: 2X FLOOR JOIST 2X ROOF RAFTERS 4X BEAMS 6X BEAMS COLUMNS LUMBER NOT NOTED HEM -FIR #2 Fb = 850 PSI HEM -FIR #2 Fb = 850PSI DOUG-FIR/LARCH #2Fb = 850 PSI DOUG-FIR/LARCH #2Fb = 875 PSI DOUG-FIR/LARCH #1Fb = 1000 PSI DOUG-FIR/LARCH #2Fb = 850 PSI MISCELLANEOUS HANGERS TO BE SIMPSON OR APPROVED EQUAL. ALL HANGERS SHALL BE FASTENED TO WOOD WITH PROPER NAILS. ALL HOLES SHALL BE NAILED. MACHINE BOLTS TO BE A-307. ANCHOR BOLTS INTO CONCRETE SHALL BE 5/8 INCH DIAMETER WITH 7 INCHES OF EMBEDDMENT INTO CONCRETE UNLESS NOTED OTHERWISE ON THE PLANS. ALL NAILS SHALL BE COMMON WIRE NAILS. NAILING SHALL BE IN ACCORDANCE WITH I.B.C. SCHEDULE. FLOOR SHEATHING: SHEATHING SHALL BE 3/4 INCH TONGUE & GROOVE, A.P.A. RATED SHEATHING. SPAN RATING 48/24 WITH LONG DIMENSION PERPENDICULAR TO SUPPORTS. UNLESS NOTED OTHERWISE NAIL WITH 8d COMMON NAILS AT 6 INCHES ON CENTER AT SUPPORTED PANEL EDGES & 10 INCHES ON CENTER AT INTERMEDIATE SUPPORTS. THE FLOOR SHEATHING SHALL BE GLUED TO THE JOIST AND THE TONGUE AND GROOVE JOINTS WITH AN APPROVED ADHESIVE. ROOF SHEATHING: SHEATHING SHALL BE 7/16 INCH A.P.A. RATED SHEATHING. SPAN RATING 32/16, INSTALLED WITH LONG DIMENSION ACROSS SUPPORTS. PANEL END JOINTS SHALL OCCUR AT SUPPORTS. NAIL PANEL EDGES WITH 8d NAILS AT 4 INCHES ON CENTER AND 10 INCHES ON CENTER AT INTERMEDIATE SUPPORTS. WALL SHEATHING: SHEATHING SHALL BE 7/16 INCH A.P.A. RATED SHEATHING, SPAN RATING 24/0. PANEL END JOINTS SHALL OCCUR AT SUPPORTS. NAIL PANEL EDGES WITH 8d NAILS AT 6 INCHES ON CENTER AND 10 INCHES ON CENTER AT INTERMEDIATE SUPPORTS UNLESS NOTED OTHERWISE ON THE DRAWINGS. GLUED -LAMINATED TIMBER: LAMINATED TIMBER SHALL BE DOUGLAS-FIR/LARCH KILN DRIED. STRESS GRADE COMBINATION 24F-V4 (Fb=2400 PSI, Fv=165 PSI) FOR SIMPLE SPANS AND 24F-V8 FOR CANTILEVER AND CONTINUOUS BEAMS. A.I.T.C. CERTIFICATE OF CONFORMANCE REQUIRED. GLU-LAMS SHALL CONFORM TO A.I.T.C. STANDARDS 117. FABRICATOR SHALL SUBMIT DETAILS AND SPECIFICATIONS TO THE ENGINEER AND BUILDING DEPARTMENT FOR APPROVAL PRIOR TO FABRICATION. FLOOR FRAMING: PROVIDE FULL DEPTH BLOCKING FOR JOIST AT THE SUPPORTS. FLUSH BEAMS (FB) AND HEADERS NOT CALLED OUT ON THE PLANS SHALL BE (2) 2X8. ALL VERTICALLY LAMINATED BEAMS AND HEADERS SHALL BE SPIKED TOGETHER WITH 16d NAILS AT 6 INCHES ON CENTER. BEARING WALL FRAMING: ALL DOOR AND WINDOW HEADERS NOT CALLED OUT ON THE PLANS SHALL BE (2) 2X8 DOUGLAS-FIR/LARCH #2 WITH ONE CRIPPLE AND ONE STUD EACH END FOR OPENINGS 4 FEET OR LESS AND TWO CRIPPLES AND ONE STUD FOR OPENINGS MORE THAN 4 FEET WIDE. ALL COLUMNS NOT CALLED OUT ON THE PLANS SHALL BE (2) STUDS. SPIKE LAMINATED COLUMNS TOGETHER WITH 16d NAILS AT 12 INCHES ON CENTER. PROVIDE TWO LAYERS OF ASPHALT IMPREGNATED BUILDING PAPER AT CONTACT SURFACES BETWEEN WOOD AND CONCRETE. WALLS SHALL HAVE A SINGLE BOTTOM PLATE AND A DOUBLE TOP PLATE. END NAIL TOP PLATES AND BOTTOM PLATES TO EACH STUD WITH 2-16d NAILS. FACE NAIL DOUBLE TOP PLATE WITH 16d NAILS AT 10 INCHES ON CENTER. LAP AND FACE NAIL PLATES WITH 2-16d NAILS AT EACH SPLICE, CORNER INTERSECTION. STAGGER SPLICES A MINIMUM OF 48 INCHES. FACE NAIL BOTTOM PLATE TO WITH 2-16d NAILS. ROOF TRUSSES: TRUSSES SHALL BE PLANT FABRICATE OF DOUGLAS-FIR/LARCH OR HEM -FIR. TRUSS MANUFACTURER SHALL SUBMIT SHOP DRAWINGS AND CALCULATIONS STAMPED, SIGNED AND DATED BY A WASHINGTON STATE LICENSED STRUCTURAL ENGINEER. SUBMIT TRUSS DRAWINGS TO THE ENGINEER OF RECORD FOR REVIEW AND APPROVAL PRIOR TO FABRICATION. SPECIAL CONDITIONS: THE CONTRACTOR SHALL VERIFY ALL DIMENSIONS AND CONDITIONS IN THE FIELD. ALL DISCREPANCIES SHALL BE REPORTED TO THE ARCHITECT OR A1i2 ENGINEER. THE CONTRACTOR SHALL PROVIDE ADEQUATE SHORING AS REQUIRED UNTIL PERMANENT CONNECTIONS AND STIFFENINGS HAVE BEEN INSTALLED. THE CONTRACTOR SHALL VERIFY SIZE AND LOCATION OF ALL OPENING IN THE FLOOR, ROOF AND WALLS WITH ALL THE APPROPRIATE DRAWINGS. THE CONTRACTOR SHALL COORDINATE WITH THE BUILDING DEPARTMENT FOR ALL BLDG. DEPT. REQUIRED INSPECTIONS. DO NOT SCALE THE DRAWINGS. THE DETAILS SHOWN ARE TYPICAL AND SHALL BE USED FOR LIKE OR SIMILAR CONDITIONS NOT SHOWN. W/3 MITCHELL ENGINEERING INC 7821 - 168th Ave. N.E. Redmond, WA 98052 (425) 747-1500 section 1 PREPARED BY 14a, PROJECT 20` 4 SHEET NO /4 OF DATE r l I l /2 SUBJECT JOB NO. 4-31 2 4..? 2 I lTC ELL ENGINEERING INC. 7821 - 168th Ave. N.E. Redmond, WA 98052 (425) 747-1500 PROJECT .27' SHEET NO. `5 OF Oil 2 -762 SUBJECT JOB NO. section 2 MITC ELL ENGINEE 5 ., ING INC, 7821 - 168th Ave. N.E Redmond, WA 9805 (425) 747-150 LIt..Ji Li m b PREPARED BY i i' PROJECT SHEET NO. OF DATE r r //2 SUBJECT JOB NO. •D/2 iv MITCHELL LNGINLL''.ING INC PREPARED BY PROJECT DATE / 4/02 SUBJECT 7821 - 168th Ave. N.E. Redmond, WA 98052 (425) 747-1500 4lza4 /7 r SHEET NO. OF JOB NO. 42 42 MITCHELL ENGINEERING INC. c:17i.J 7821 - 168th Ave. N.E. Redmond, WA 98052 (425)747-1500 o PREPARED BY PROJECT 2Q'4 SHEET NO /8 OF DATE //4, ' 2 SUBJECT JOB NO. �2 ��2 ` MITCHELL ENGINEERING INC SEW tivALL 6ale. (hJ d 7821 - 168th Ave. N.E. Redmond, WA 98052 (4251 747-1500 J24' 27z ti\i/ IC411 CC) v.aa4 -ra.-1-1/Aff4 PREPARED BY /" PROJECT SHEET NO / / OF v2 DATE //4/2 SUBJECT JOB NO O /2 _! MITCHELL ENGINEERING INC. 7821 - 168th Ave. N.E. Redmond, WA 98052 (425) 747-1500 PREPARED BY , PROJECT NO.OF SHEET DATE r/�//2 SUBJECT JOB NO. c..,12 /V Z "MITCHELL ENGINEERING INC a vex, 6k/ta ALL-. rat- 441--- 7821 - 168th Ave. N.E. Redmond, WA 98052 (425) 747-1500 c27‘ IdeAt--) PREPARED BY PROJECT 24 SHEET NO. OF DATE //4//2 SUBJECT JOB NO �/2•/!�2 YTCHELL ENGINEERING INC 1 WA 7821 - 168th Ave. N.E. Redmond, WA 98052 (425) 747-1500 PREPARED BY DATE ///2 PROJECT SUBJECT SHEET NO. OF JOB NO. `7/2 `b2 "MITCHELL ENGINEERING INC. 41,g.1_12,5 e F—Ac.1.4 r PREPARED BY "' PROJECT DATE //2 SUBJECT �/2 �2 JOB NO 7821 - 168th Ave. N.E. Redmond, WA 98052 (425) 747-1500 SHEET NO. 23 OF MITCHELL ENGINEERING INC CEDE 7821 - 168th Ave. N.E. Redmond, WA 98052 (425)747-1500 -71-L -74115 c:1A5tk 542‘..1214 4.2412-‘4.3TA :76,046 I TWA 14/141- .6c/-7,,,/ 4l1 iciPc b PREPARED BY 44-1 PROJECT 1 SHEET NO 2 OF 14 DATE / 4'/ 2 SUBJECT JOB NO. 0/2 AR 2 Indemnification and Hold Harmless and Permit Temporary in Nature Reference Number(s) of Related Document(s): D14-0317 Grantor: Scott Forsberg, an individual Grantee: CITY OF TUKWILA, a municipal corporation of King County, Washington Work Location: Along 50h Ave. South / 51st PL South and adjacent to 12207 50th Ave. South. Abbreviated Work Description: Work within the City Right -of -Way for driveway access, utilities, street use, and undergrounding of power. NOW, THEREFORE, the parties agree as follows: The Permittee shall indemnify, defend and hold harmless the City, its officers, agents and employees, from and against any and all claims, losses or liability, including attorney's fees, arising from injury or death to persons or damage to property occasioned by any act, omission or failure of the Permittee, its officers, agents and employees, in using the City's right-of-way under this permit. This indemnification and hold harmless shall not apply to any damage resulting from the sole negligence of the City, its agents and employees. To the extent any of the damages referenced by this paragraph were caused by or resulted from the concurrent negligence of the City, its agents or employees, this obligation to indemnify, defend and hold harmless is valid and enforceable only to the extent of the negligence of the Permittee, its officers, agents, and employees. Further, the right-of-way permit herein is wholly of a temporary nature and it vests no permanent right to use whatsoever to the Permittee. IN WITNESS WHEREOF, said individuals have caused this instrument to be executed this 2i day of may, , 20447- W/5 Property Owner / Grantor STATE OF WASHINGTON) )ss. County of King ) I certify that I know or have satisfactory evidence that Scott Forsberg is the person who appeared before me, and said individual acknowledged that they signed this instrument and acknowledged it to be their free and voluntary act for the uses and purposes mentioned in this instrument. Name: J 6c \ i 1V- NOTARY PUBLIC, in and for the State of Washington, residing at Cou AI My commission expires: ` ( - v DATED this GRANTEE: By: Print Name: Its: day P.9(tica...ru\___ CITY of TUKWILA Bob Giberson Public Works Director STATE OF WASHINGTON) )SS. COUNTY OF KING ) , 2015 On this day, before me personally appeared BOB GIBERSON to me known to be the PUBLIC WORKS DIRECTOR for the City of Tukwila, and executed this instrument on behalf of the City of Tukwila in his capacity as PUBLIC WORKS DIRECTOR and acknowledged that he is authorized to do so at his free and voluntary act and deed, for the uses and purposes therein mentioned. IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day and year first above written. LAURIE A. WERLE ' MAY 29, 2418 � Washington, residing at ) L C I\ cti r� Name: /-Q,L,(11 /4- C %r (/ `K NOTARY PUBLIC STATE OF WASHINGTON COMMISSION EXPIRES NOTARY PUBLIC, in and for the State of My commission expires: 6 5 —J2—/ e City of Tukwila Department of Community Development November 12, 2014 JOHN TAMBURELLI 646 SW 134 ST BURIEN, WA 98146 RE: Correction Letter # 1 COMBOSFR Permit Application Number D14-0317 FORSBERG RESIDENCE - 12207 50 AVE S Dear JOHN TAMBURELLI, 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. • All portions of the front of the house must be 20 feet from the front property line. See marked up site plan. PW DEPARTMENT: Dave McPherson at 206-431-2448 if you have questions regarding these comments. • 1. Provide a completed Residential Sewer Use Certification for this Building permit. (see enclosed) 2. Revise site plan to show / include (1) existing 3/4" water meter location (2) show and label any pavement cuts within streets — if applicable (3) show and label new paved driveway including connection to 50th Ave. South pavement with 5'radius (4) undergrounding of power from power pole to house (5) on -site drainage infiltration detail (6) drainage flow arrows across new driveway and downspout connection(s) to infiltration system (7) F.F. elevations, contours, and spot elevations (8) show & label on plan sheet any proposed sanitary sewer, storm drainage, power and other utilities (gas, cable, telephone, etc.) as applicable. (See sample site plans — enclosed) 3. Applicant shall contact Tukwila Permit Center at (206) 433-7165 and apply for a separate DEMOLITION PERMIT for removal of existing mobile home, septic abandonment and utility lines capping. PW will need cost estimate associated with erosion control and septic abandonment. Please note that the DEMOLITION PERMIT needs to be final before the D14-0317 building permit for the new house can be issued. 4. NOTE: The house fire sprinkler system shall be designed by a Fire Sprinkler System Designer. Designer shall verify in writing to the Public Works Project Inspector that a 3/4-inch water meter and service line meets domestic water and fire flow requirements. If domestic water and fire flow requirements are not met, then a 1-inch water meter with a 1-inch service line is required. Refer to attached Public Works Details for 1" FIRE /DOMESTIC SERVICE and/or 1" FLOW- THROUGH SYSTEM. 5. Allentown Phase 2 (Ordinance no. 2177) Sanitary Sewer assessment fee applies to this Building permit. Sanitary Sewer assessment fee (during 2014) is $18,600.00. 6. Any work within the 50th Ave. South & 51 st PL South Public right-of-way requires a Street Use permit as part of this Building permit. Bonding, insurance, and a Hold Harmless Agreement for work within the Public Right -of - Way are required. 7. Property is within the Allentown Flood Control Zone. Finished floor shall be at least lfoot above the base flood elevation of 10.4' per City of Tukwila. 6300 ,Crnithrvntar Rnu/p nrd .Giity iilnn • Tukwiln Wnchinotnn 9R1RR • Phnno 7n6-131-367/l • Fnr 7n6-a31-3665 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, Bill Rambo Permit Technician File No. D14-0317 6300 Southcen.ter Boulevard Suite #100 • Tukwila Washington. 9R1RR • Phone 206-4.31-3670 • Far 2A6-431-3665 PERMIT COORD COPY PLAN REVIEW/ROUTING SLIP PERMIT NUMBER: D14-0317 DATE: 01/07/15 PROJECT NAME: FORSBERG RESIDENCE SITE ADDRESS: 12207 50 AVE S Original Plan Submittal Revision # before Permit Issued X Response to Correction Letter # 1 Revision # after Permit Issued DEPARTMENTS: Building Division ❑ Public Works CAM C/ RiA( Fire Prevention Structural Planning Division Permit Coordinator 11 PRELIMINARY REVIEW: Not Applicable ❑ (no approval/review required) DATE: 01/08/15 Structural Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved Corrections Required (corrections entered in Reviews) DUE DATE: 02/05/15 Approved with Conditions FVf Denied (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 Notation: PERMIT COORD COPY PLAN REVIEW/ROUTING SLIP PERMIT NUMBER: D14-0317 DATE: 09/30/14 PROJECT NAME: FORSBERG RESIDENCE SITE ADDRESS: 12207 50 AVE S X Original Plan Submittal Revision # before Permit Issued Response to Correction Letter # Revision # after Permit Issued DEPARTMENTS: Building Division b C0yv Public Works 4-1 e. to—erm CPL Cow Fire Prevention lir Planning Division Structural Permit Coordinator PRELIMINARY REVIEW: Not Applicable ❑ (no approval/review required) DATE: 10/02/14 Structural Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved Corrections Required Approved with Conditions Denied (corrections entered in Reviews) (ie: Zoning Issues) 61-e ,( — Npcjs 4 DUE DATE: 10/30/14 REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: k D— 1 Lj Departments issued corrections: Bldg ❑ Fire ❑ Ping -- PW ' Staff Initials: 12/18/2013 IgKE-ntered in TRAKiT on 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.ci.tukwila.wa.us RECEIVED JAN 07 2015 COMMIJNI I Y DEVELOPMENT REVISION SUBMITTAL Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Plan Check/Permit Number: D 14-03 17 ❑ Response to Incomplete Letter # ® Response to Correction Letter # 1 ❑ Revision # after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner Project Name: Forsberg Residence Project Address: 12207 50 Ave S Contact Person: 0 To atoll!!' Phone Numbe(2.4q6) J i-e) ! 22'It, (/Jcnip/#kd Summary ofRevision: Lop a 0 %Qesin�n 'a 1 Seever2 titre Ceia.4'r , c *-i i e1 (opi e'S 64- / 0 t) t 1,41 a 1k j e.. 1P/4 0 Sheet Number(s): "Cloud" or highlight all areas of revision including date : re on Received at the City of Tukwila Permit Center by: 1--� [5 \applications\forms-applications on line\revision submittal Created: 8-13-2004 Revised: d`ILI-03l Department of Natural Resources and Parks Wastewater Treatment Division King County Residential Sewer Use Certification Sewage Treatment Capacity Charge • To be compieted for all new sewer connoctionE.;, re- connections, or change of use of existing connections. • This form does not apply to repairs or replacements of existing sewer connections within five years of disconnect. Please Print or Type roperty Street Address Levi / - t'tJ 71`6c City Owner's Name State ZIP 8o) Skc7 Owner's Mailing Address fct//C- ( State ZIP (yz5) 246-AS2.e wner's P one Number (with Area Code) yz5) 2..le® g.. roperty Contact Phone Number (with Area Code) Party to be Billed (if different than Owner): Name Street Address For King County Use Only Account # No. of RCEs Monthly Rate Sewer District / Agency Contact & Phone Number Date of Sewer Connection Side Sewer Permit Number O/7700/77 Required: Property Tax Parcel Number Subdivision Name Subdivision Number Lot Number City State ZIP Residential Customer Please check appropriate box: Equivalent (RCE) j Single-family (free standing, detached only) 1.0 Multi -Family (any shared walls): • Duplex (0.8 RCE per unit) ❑ 3-Plex (0.8 RCE per unit) • 4-Plex (0.8 RCE per unit) ❑ 5 or more (0.64 RCE per unit) No. of Units x 0.64 = ❑ Mobile home space (1.0 RCE per space) No. of Spaces x 1.0 = If Multi -family, will units be sold individually? ❑ Yes ❑ No If yes, will this property have a Homeowner's Association? ❑ Yes ❑ No 1.6 2.4 3.2 Building Name Block Nurtgeglitat. CITY OF TUKWILA JAN 0 7 2015 PERMIT CENTER Please report any demolitions of pre-existing building on this property. Credit for a demolition may be given under some circumstances. Demolition of pre-existing building? Yes ❑ No Was building on Sanitary Sewer? ❑ Yes gNo Was Sewer connected before 2/1/90? ❑ Yes ❑ No Sewer disconnect date: Type of building demolished?(f iI4- rTO W1€ Request to apply demolition credit to multiple buildings? ❑Yes ❑ No CORRECTION L7R# . I Pursuant to King County Code 28.84, all sewer customers who establish a new service which uses metropolitan sewage facilities shall be subject to a capacity charge. The amount of the charge is established annually by the Metropolitan King County Council as a rate per month per residential customer or residential customer equivalent for a period of fifteen years. The purpose of the charge is to recover costs of providing sewage treatment capacity for new sewer customers. All future billings can be prepaid at a discounted amount. Questions regarding the capacity charge or this form should be referred to King County Wastewater Treatment Division at 206-684-1740. I certify that the information given is correct. I unr'erstand tht any deviation will require resubmiof corr- 'ed data f Signature of Owner/Representative t apacity charge levied will be based on this information and urination of a revised capacity charge. Date 1 I = Print Name of Owner/Represents _ e . J 9kµvl Tat btt2 1 1 SCOTTS CONCRETE & CONST INr Page 1 of 1 Home Inicio en Espafiol Contact Search L&I A-Z Index Safety Claims & Insurance Workplace Rights SCOTTS CONCRETE & CONST INC Owner or tradesperson FORSBERG, SCOTT Principals FORSBERG, SCOTT, PRESIDENT Doing business as SCOTTS CONCRETE & CONST INC WA UBI No. 602 599 791 PO Box 580 FALL CITY, WA98024 425-222-6983 KING County Business type Corporation License Workers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID 050,157-01 Doing business as SCOTTS CONCRETE AND CONSTRUCT Estimated workers reported Quarter 3 of Year 2014 "11 to 20 Workers" L&I account representative TO / CAROLYN CRAWFORD (360)902-4715 - Email: CRAI235@Ini.wa.gov Account is current. Workplace safety and health No inspections during the previous 6 year period. CO Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602599791 &LIC=SCOTTCC941 LK&SAW= 02/04/2015