HomeMy WebLinkAboutPermit D16-0118 - SAGE ADULT FAMILY HOME - BATHROOM DOORSAGE
ADULT FA�IVIILY HOME
14800 46 A�TE S
D16-Ol 18
� 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
Parcel No: 0042000127
DEVELOPMENT PERMIT
Permit Number: D16-0118
Address: 14800 46TH AVE S Issue Date: 5/24/2016
�, � • ,P i mit,�xpires On� 11/20/2016
, . . '' : ,�
Projett Nam�:��t �S�GE ADULT FAMILY HOME ' , ,, ` `,�`
Owner:
Name: ADALTSGEREDAT
Address: 14800 46TH AVE S, SEATTLE, WA,
98168
Contact Person:
Name: TSEGEREDA ADAL
Address:
Contractor:
Name:
Address:
License No:
Lender:
Name:
2917 S COURT ST, SEATfLE, WA,
98144
OWNER AFFIDAVIT
,�
N/A - LESS THAN $5,000
Address: ,,,
DESCRIPTION OF WORK:
Phone: (206) 223-2082
Phone:
Expiration Date:
CHANGE BATHROOM DOOR
Project Valuation: $200.00 Fees Collected: $115.00
Type of Fire Protection: Sprinklers:
Fire Alarm:
Type of Construction: VB Occupancy per IBC: R-3
Electrical Service Provided by: TUKWILA Water District: 125
Sewer District: VALLEY VIEW
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:
Public Works Activities:
Channelization/Striping:
2012 National Electrical Code:
2012 WA Cities Electrical Code:
2012 WAC 296-466:
2012 WA State Energy Code:
2012
2014
2014
2014
2012
Curb Cut/Access/Sidewalk:
Fire Loop Hydrant:
Flood Control Zone:
Hauling/Oversize Load:
Land Altering: Volumes: Cut: 0 Fill: 0
Landscape Irrigation:
Sanitary Side Sewer: Number: 0
Sewer Main Extension:
Storm Drainage:
Street Use:
Water Main Extension:
Water Meter: No
Permit Center Authorized Signature: t/� 1d� •��'� Date:
I hearby certify that I have read and examined this permit and know the same to be true and correct. All
provisions of law and ordinances governing this work will be complied with, whether specified herein or not.
The granting of this permit does not presume to give authority to violate or cancel the provisions of any other
state or local laws regulating construction or the performance of work. I am authorized to sign and obtain this
development permit and agree to the conditions attached to this permit.
Signature: � Date: � ( G
� �7"��
Print Name: % , C �t� �'
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:
1: ***BUILDIN6 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: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap
the sanitary sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks,
welis, and other excavations. Final inspection approval will be determined by the building inspector based
on satisfactory completion of this requirement.
6: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila
Permit Center.
7: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an
approval of, any violation of any of the provisions of the building code or of any other ordinances of the City
of Tukwila. Permits presuming to give authority to violate or cancel the provisions of the code or other
ordinances of the City of Tukwila shall not be valid. The issuance of a permit based on construction
documents and other data shall not prevent the Building Official from requiring the correction of errors in
the construction documents and other data.
8: Applicant shall apply for the City's business license. Please contact Cindy Wilkins at 206-431-3680 to apply
for a business license. Also, please provide Information about the state license for the adult family home.
PERMIT INSPECTlONS REQUIRED
Permit Inspection Line: (206) 438-9350
1700 BUILDING FINAL**
0409 FRAMING
�vJILA �;,
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CITY OF TUKw 1�A
Comn:unity Development Department
Public Works Departrnent
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.TukwilaWA. gov
Building Permit No.
Project No. .
Date Application Accepted: :� [ �p
Date Application Expires: l(� �,� �,p _
use
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.:
SiteAddress:����0 ��Ue ..S SuiteNumber: Floor:
Tenant Name: �2����q � . � New Tenac�t: ❑.....Yes (,�..No
GENERAL CONTRACTOR INFORMATION
Company Name:
Address:
City: State: Zip:
Phone: Fax:
Contr Reg No.: Exp Date:
Tukwila Business License No.:
H:Wpplications�Forms-Applications On Line�2012 Applications�Permit Application Revised - 2J-12.docx
Revised: Febniary2072
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ARCHITECT OF RECOR]D
Company Name:
Architect Name:
Address:
City: State: Zip:
Phone: Fax:
Email:
ENGINEER OF RECORD
Company Name:
Engineer Name:
Address:
City: State: Zip:
Phone: Fax:
Email:
LENDER/BOND ISSUED (required for projects $5,000 or
greater per RCW 19.27.095)
Name:
Address:
City: State: Zip:
Page 1 of 4
BUILDING PERMIT INFORMATII - 206-431-3670
Valuation of Project (contractor's bid price): $�lj�- Existing Building Valuation: $
Describe the scope of work (please provide detailed information): �1 k��Q,�il�;y'�7J7Y! pC�z1y�
Will there be new rack storage? ❑.... Yes �..No If yes, a separate permit and plan submittal will be required.
Provide All Buildi�g Areas in Square Footage Below
Addition to Type of Type of
Existing Construction per Occupancy per
Existin Interior Remodel Structure New IBC IBC
151 Floor
2" FlOor
3` 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 mwner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard: Compact: Handicap:
Will there be a change in use? ❑....... Yes �.......No If "yes", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
�.......Sprinklers �.......Automatic Fire Alarm ❑....... None ❑....... Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑.......Yes ❑...... No
If "yes', attach list of materials and storage locations on a separate 8-1/2" x 11 " paper including guantities and Material Safery 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.
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A
�� PUBLIC �WORKS PERNIIT INFO. .ATION = 206-433-0179
Scope of Work (please provide detailed information): ���I,9i�'l� I���I,Yc�D�'/ Q�t��
Call before you Dig: 811
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
Water District
❑.. Tukwila ❑... Water District # 125 ❑... Highline
❑ .. Water Availability Provided
Sewer District
❑ .. Tukwila ❑ ...Valley View ❑... Renton
❑.. Sewer Use Certificate ❑...Sewer Availability Provided
❑... Renton
❑... Seattle
Septic Svstem•
❑ 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 aaalv):
❑.. Civil Plans (Maximum Paper Size – 22" x 34")
❑.. Technical Information Report (Storm Drainage) ❑... Geotechnical Report ❑.. Traffic Impact Analysis
❑ .. Bond ❑... Insurance ❑... Easement(s) ❑... Maintenance Agreement(s) ❑ .. Hold Harmless – (SAO)
❑ .. Hold Harmless – (ROW)
Proaosed Activities (mark boxes that apalv):
❑.. Right-of-way Use - Nonprofit for less than 72 hours ❑... Right-of-way Use - Profit for less than 72 hours
❑.. Right-of-way Use - No Disturbance ❑... Right-of-way Use – Potential Disturbance
❑ .. Construction/Excavation/Fill - Right-of-way ❑
Non Right-of-way ❑
❑ .. Total Cut cubic yards
❑ .. Total Fill cubic yards
❑ .. Sanitary Side Sewer
❑ .. Cap or Remove Utilities
❑ .. Frontage Improvements
❑ .. Traffic Control
❑ .. Backflow Prevention - Fire Protection
Irrigation
Domestic Water
❑... Work in Flood Zone
❑... Storm Drainage
❑... Abandon Septic Tank
❑... Curb Cut
❑... Pavement Cut
❑... Looped Fire Line
>,—
❑.. Permanent Water Meter Size (1) " WO #_
❑.. Temporary Water Meter Size (1) " WO #
❑.. Water Only Meter Size ........... " WO #
❑.. Sewer Main Extension............ Public ❑ Private ❑
❑.. Water Main Extension............ Public ❑ Private ❑
FINANCE INFORMATION
Fire Line Size at Property Line _
❑ .. Water ❑ .. Sewer
Monthly Service Billing to:
Mailing
Water Meter Refund/Biiline:
Mailing
�2)
�2)
❑...Grease Interceptor
❑... Channelization
❑... Trench Excavation
❑... Utility Undergrounding
_" WO # (3) " WO #
" WO # (3) " WO #
❑ .. Deduct Water Meter Size "
Number of Public Fire Hydrant(s)
❑ .. Sewage Treatment
Day Telephone:
City
Day Telephone:
City
State Zip
State Zip
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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 (cunent 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
Signature: �
Print Name
Mailing Ad
(
OR AUTHORIZED AGENT:
,� _ ..,..�1.. `�'. �dl
��cs���i
Date:.��� /%�
Day TelephoneC��� �� ' �✓ ��
State
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Date Paid: Monday, May 09, 2016
Paid By: TSEGAREDA ADAL
Pay Method: CHECK 3208
Printed: Monday, May 09, 2016 10:46 AM 1 of 1 �����srsreMs
W
, � , ItVSPECTION RECORD ���1 � l �
Refain a copy with permrt �
I E 0. PERMIT N0.
CITY 4F i'UKWI�A BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 9818$� �' (2�) 431-3670
Permit Inspection Request Line (206) 438-9350 �''C
Pr ject: ,, Type of Inspectior�:
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� REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite i00. Calt to scheduCe reinspectian.
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City of T'ukwil8
BUlLDfNG DIVISION
REVISIONS
No changes shali be ade to thA scope
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' �uk�Rrila Building Division.
���°��fd: E;�`✓�s:ort; wi(I require a nsw plan submitta� f
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. MAY 0 9 2016
PERI�i1T CENTER .
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PLAN REVIEW/ROUTING SLIP
PERMIT NUMBER: D 16-0118
DATE: OS/09/16
PROJECT NAME: SAGE ADULT FAMILY HOME
SITE ADDRESS: 14800 46 AVE S
X Original Plan Submittal
Response to Correctio» Letter #,
Revision #
Revision #
before Permit lssued
after Permit Issued
DEPARTMENTS:
A'S � � �-1 0-t � �l �J��-- .�'�-r-f �O �-`� N//�' �� � 3' ��
Building Division � Fire Prevention � Planning Division �
�� �l�- �� ��p
Public Works � Structural � Permit Coordinator
�
PRELIMINARY REVIEW: DATE: OS�10/16
Not Applicable ❑ Structuc•al Review Required �
(no approval/review reguired)
REVIEWER'S INITIALS:
DATE:
APPROVALS OR CORRECTIONS: DUE DATE: O6IO%�16
Approved
�
Corrections Required ❑
(cof•rections errtered i�� Reviews)
Notation:
REVI:EWER'S INITIALS:
Approved with Conditions �
Denied ❑
(ie: Zoni�ag Issues)
DATE:
Permit Cenler Use O�rly
CORRECTION LETTER 1VIAILED:
Departments issued corrections: I31dg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
12/18/2013
CITY OF TUKWILA Perm�t Center/Building Division
206 43i-36�o
• Depariment of Community Deuelopment Public Works Department
� 6,30o Southcenter Bouleuard, Tukwila, WA 98i88 206 433-0179
Telephone: (206) 43i-,36�o FAX (zo6) 431-,3665 Planning Division
..: 206 43i-36�o
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
PERMIT NO: a J 1�0 —C_.' l I�
STATE OF WASHINGTON)
) ss.
COUNTY OF KING )
� Q�t�Y �XG � l' f—lZ.it,� � , states as follows:
[please print name]
i. I have made application for a permit from the City of Tukwila, Washington.
2. I understand that state law requires that all building construction contractors be registered with the
State of Washington. The exceptions to this requirement are stated under Section i8.2�.090 of the
Revised Code of Washington, a copy of which is printed on the reverse side of this Affidavit. I have
read or am familiar with RCW i8.2�.090.
3. I understand that prior to issuance of a permit for work which is to be done by any contractor, the
City of Tukwila must verify either that the contractor is registered by the State of Washington, or that
one of the exemptions stated under RCW i8.2�.090 applies.
4. In order to provide verification to the City of Tukwila of my compliance with this requirement, I
hereby attest that after reading the exemptions from the registration requireme�t of RCW i8.2�.090,
I consider the work authorized under this permit to be exempt under number �, and will therefore
not be performed by a registered contractor.
5. I understand that the licensing provision of RCW i9.28.i6i through i9.28.2�i shall not apply to
persons making electrical installations on their own property or to regularly employed employees
working on the premises of their employer. The proposed electrical work is not for the construction
of a new building for rent, sale or lease.
I understand that I may be waiving certain rights that I might otherwise have under state law in any decision
to engage an unregistered contractor to perform construction work.
LAURIE A. WERLE
NOTARY PUBLIC
STATE OF WASHINGTON
COMMISSION EXPIRES
MAY 29, 2018
.I I _� /j /_i;�� �i i
� •
Signed and sworn to before me this
� da of l , 2oL.
� ,
.E�% -� .
`1VOTARY PUBLIC in and for the State of Washington
,
Residing at ��7 , County
Name as commissioned: ti��7 i�/�/�
My commission expires: �-S(c�'� �/ �
18.2'7.090 Exemptions. The registration provisions of this chapter do not apply to:
i. An authorized representative of the United States
government, the state of Washington, or any incorporated
city, town, county, township, irrigation district, reclamation
district, or other municipal or political corporation or
subdivision of this state;
2. Officers of a court when they are acting within the scope
of their office;
3. Public utilities operating under the regulations of the
utilities and transportation commission in construction,
maintenance, or development work incidental to their own
business;
4. Any construction, repair, or operation incidental to the
discovering or producing of petroleum or gas, or the
drilling, testing, abandoning, or other operation of any
petroleum or gas well or any surface or underground mine
or mineral deposit when performed by an owner or lessee;
5. The sale of any finished products, materials, or articles of
merchandise that are not fabricated into and do not become
a part of a structure under the common law of fixtures;
6. Any construction, alteration, improvement, or repair of
personal property performed by the registered or legal
owner, or by a mobile/manufactured home retail dealer or
manufacturer licensed under chapter 46.�o RCW who shall
warranTy service and repairs under chapter 46.�o RCW;
�. Any construction, alteration, improvement, or repair
carried on within the limits and boundaries of any site or
reservation under the legal jurisdiction of the federal
government;
8. Any person who only furnished materiais, supplies, or
equipment without fabricating them into, or consuming
them in the performance of, the work of the contractor;
9. Any work or operation on one undertaking or project by
one or more contracts, the aggregate contract price of
which for labor and materials and all other items is less
than five hundred dollars, such work or operations being
considered as of a casual, minor, or inconsequential nature.
The exemption prescribed in this subsection does not apply
in any instance wherein the work or construction is only a
part of a larger or major operation, whether undertaken by
the same or a different contractor, or in which a division of
the operation is made into contracts of amounts less than
five hundred dollars for the purpose of evasion of this
chapter or otherwise. The exemption prescribed in this
subsection does not apply to a person who advertises or
puts out any sign or card or other device which might
indicate to the public that he or she is a contractor, or that
he or she is qualified to engage in the business of
contractor;
io. Any construction or operation incidental to the
construction and repair of irrigation and drainage ditches
of regularly constituted irrigation districts or reclamation
districts; or to farming, dairying, agriculture, viticulture,
horticulture, or stock or poultry raising; or to clearing or
other work upon land in rural districts for fire prevention
purposes; except when any of the above work is performed
by a registered contractor;
u. An owner* who contracts for a project with a registered
contractor, except that this exemption shall not deprive the
owner of the protections of this chapter against registered
and unregistered contractors. The exemption prescribed in
this subsection does not apply to a person who performs
the activities of a contractor for the purpose of leasing or
selling improved property he or she has owned for less than
twelve months;
i2. Any person working on his or her own property,
ether occupied by him or her or not, and any person
working on his or her personal residence, whether owned
by him or her or not but this exemption shall not apply to
any person who performs the activities of a contractor on
his or her own property for the purpose of selling,
demolishing, or leasing the property;
i3. An owner* who performs maintenance, repair, and
alteration work in or upon his or her own properties, or
who uses his or her own employees to do such work;
i4. A licensed architect or civil or professional engineer
acting solely in his or her professional capacity, an
electrician certified under the laws of the state of
Washington, or a plumber certified under the laws of the
state of Washington or licensed by a political subdivision of
the state of Washington while operating within the
boundaries of such political subdivision. The exemption
provided in this subsection is applicable only when the
person certified is operating within the scope of his or her
certification;
i5. Any person who engages in the activities herein
regulated as an employee of a registered contractor with
wages as his or her sole compensation or as an employee
with wages as his or her sole compensation;
i6. Contractors on highway projects who have been
prequalified as required by RCW 4�.28.0�0, with the
department of transportation to perform highway
construction, reconstruction, or maintenance work;
i�. A mobile/manufactured home dealer or manufacturer
who subcontracts the installation, set-up, or repair work to
actively registered contractors. This exemption only applies
to the installation, set-up, or repair of the
mobile/manufactured homes that were manufactured or
sold by the mobile/manufactured home dealer or
manufacturer;
i8. An entity�who�hold,s,a�.,vralidaelectrical,:contractor..'s:.:r;-,
license unde5r chapter i9 28:;RCW that.employs a certified.
journeyman�electrician,� ce�;tifiedresidentialyspecialty ;;;
electrician, or an electrical•trainee meefing'the
requirements of chapter i9�28;RCW to perform'plumbing'
work that is�incidentally, directly;,and immedi�tely '
appropriate;�o the like-in-kind;replacement of a household
appliance or other small hou'sehold�.utihzation, eguipmerit '
that requires limite� e�ectric power �and limited waste
and/or water connections. An electrical trainee must be
supervised by a certified electrician while performing
plumbing work.
* Per Washington State Depariment of Labor and Industries lessee has
been interpreted to be equivalent to owner for purposes of eacemptions.