HomeMy WebLinkAboutPermit D17-0007 - LAI RESIDENCE - ADU DEMOLITIONLAI DEMO PERMIT
4443 S 144 ST
D17-0007
Parcel No:
Address:
Project Name:
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
DEVELOPMENT PERMIT
0040000395 Permit Number:
4443 S 144TH ST 1
LAI DEMO PERMIT
Issue Date:
Permit Expires On:
D17-0007
1/25/2017
7/24/2017
Owner:
Name:
Address:
NELSON RANDY
4836 12TH AVE S, SEATTLE, WA,
98108
Contact Person:
Name: HAN PHAN, PE
Address: 5130 S 166TH LANE , SEATAC, WA,
98188
Contractor:
Name:
Address:
License No:
Lender:
Name: PT HOLDING, LLC
Address: 5039 S 178TH ST, SEATTLE, WA, 98188
AFFIDAVIT
Phone: (206) 229-6422
Phone:
Expiration Date:
DESCRIPTION OF WORK:
DEMO ADU STRUCTURE - EXPIRED PERMIT D16-0102
Project Valuation: $5,000.00
Type of Fire Protection: Sprinklers:
Fire Alarm:
Type of Construction:
Electrical Service Provided by: TUKWILA
Fees Collected: $331.00
Occupancy per IBC:
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:
2015
2015
2015
2015
2015
National Electrical Code:
WA Cities Electrical Code:
WAC 296-46B:
WA State Energy Code:
2014
2014
2014
2015
Public Works Activities:
Channelization/Striping:
Curb Cut/Access/Sidewalk:
Fire Loop Hydrant:
Flood Control Zone:
Hauling/Oversize Load:
Land Altering:
Landscape Irrigation:
Sanitary Side Sewer:
Sewer Main Extension:
Storm Drainage:
Street Use:
Water Main Extension:
Water Meter:
Volumes: Cut: 0 Fill: 0
Number: 0
No
Permit Center Authorized Signature:
1 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:
Print Name:
Date:
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: ***BUILDING PERMIT CONDITIONS***
2: Work shall be installed in accordance with the approved construction documents, and any changes made
during construction that are not in accordance with the approved construction documents shall be
resubmitted for approval.
3: All permits, inspection record card and approved construction documents shall be kept at the site of work
and shall be open to inspection by the Building Inspector until final inspection approval is granted.
4: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap
the sanitary sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks,
wells, and other excavations. Final inspection approval will be determined by the building inspector based
on satisfactory completion of this requirement.
5: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the
City of Tukwila Building Department (206-431-3670).
6: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila
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: ***PUBLIC WORKS PERMIT CONDITIONS***
o
9: 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.
10: 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.
11: Any material spilled onto any street shall be cleaned up immediately.
12: Temporary erosion control measures shall be implemented as the first order of business to prevent
sedimentation off-site or into existing drainage facilities.
13: 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.
14: The applicant shall contact Water District #125 at (206) 242-9547 for capping the water service to the
house.
15: The applicant shall contact Valley View Sewer District at (206) 242-3236 for capping the sanitary sewer
service to the house.
PERMIT INSPECTIONS REQUIRED
Permit Inspection Line: (206) 438-9350
1700 BUILDING FINAL**
5200 EROSION MEASURES
5210 EROSION MEASURES FNL
0101 PRE -CONSTRUCTION
1600 PUBLIC WORKS FINAL
CITY OF TUKWILA
Community) Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
Building Permit No. 1:41-1X01
Project No.
Date Application Accepted: ^1 10 1
Date Application Expires: 't 101 1
1
(For office use only)
CONSTRUCTION PERMIT APPLICATION
Applications and plans must be complete in order to be accepted for plan review.
Applications will not be accepted through the mail or by fax.
**Please Print**
SITE LOCATION
Site Address:
11/e/1i3 S' /q f T 977
Tenant Name: GA. / 5,,t 7 % r6
PROPERTY OWNER
Name: /4[c -/J -c_
Addres 2 y(/ sr"
City: %-pge/4/44. State: 1,,,44 Zip:ggige
CONTACT PERSON — person receiving all project
communication
Name: /,L .,4 704.1.04/0
/dam
Address:
// 0 C" . /6671 L,4,6.
City: 5e4rAG State: tog. Zip:G�SI8
/
Phone: �� . 01,90.-C rot?
Email: / b6..e u4ec yAeloa. 427,14
GENERAL CONTRACTOR INFORMATION
Company Name:
Address:
Company Name:
City: 4-6-4723,e, State: ,4 Zip: qga
Phone:gfa '22'7.. FO yZ1i
City:
State:
S(78111 � .-k;1-
`...
Zip:
Phone:
Fax:
City:
State:
Contr Reg No.:
Phone:
Exp Date:
Tukwila Business License No.:
H:\ pplications\Forms-Applications On Line \2011 Applications\Permit Application Revised - 8-9-11.docx
Revised: August 2011
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King Co Assessor's Tax No.: QofiscOos lJ
Suite Number: Floor:
New Tenant: ❑ Yes ��..No
ARCHITECT OF RECORD
Company Name: plbc 1„4„C.,
Engineer Name: ,'4j / N' ��
Company Name:
City: 4-6-4723,e, State: ,4 Zip: qga
Phone:gfa '22'7.. FO yZ1i
Architect Name:
S(78111 � .-k;1-
`...
Address:
A
1
City:
State:
Zip:
Phone:
Fax:
Email:
ENGINEER OF RECORD
Company Name: plbc 1„4„C.,
Engineer Name: ,'4j / N' ��
Address: 5 -Go $ . (6‘121 44
City: 4-6-4723,e, State: ,4 Zip: qga
Phone:gfa '22'7.. FO yZ1i
Email: p66. 4'Jr)')4. via ,v.c n
LENDER/BOND ISSUED (required for projects $5,000 or
greater per RCW 19.27.095)
Name:
/:4mf* i d(/ Li— C
Address:
S(78111 � .-k;1-
`...
City: C
A
1
tate: _pCT ic,..11
1S0 a._\ l �)
Page 1 of 4
i
BUILDING PERMIT INFORMATION — 206-431-3670
Valuation of Project (contractor's bid price): $
-.)/000 c.0
Describe the scope of work (please provide detailed information):
Existing Building Valuation: $
Will there be new rack storage? ❑ Yes l(No If yes, a separate permit and plan submittal will be required.
Provide All Building Areas in Square Footage Below
PLANNING DIVISION:
Single family building footprint (area of the foundatio ' of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the followin
Lot Area (sq ft):
F •or area of principal dwelling: Floor area of accessory dwelling:
*Provide documentation that shows t . t the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: St. dard:
Will there be a change in use? I Yes
Compact: Handicap:
❑ No If "yes". explain:
FIRE PROTECTION/HAZ DOUS MATERIALS:
❑ Sprinklers 0 Automatic Fire Alarm 0 None ❑ Other (specify)
Will there be storage or use ' f flammable, combustible or hazardous materials in the building? ❑ Yes ❑ No
If `yes', attach list o aaterials and storage locations on a separate 8-1/2"x 11" paper including quantities and Material Safety Data Sheets.
SEPTIC SYSTEM
0 On-. ite Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health
partment.
H:\ Applications\Forms-Applications On Line\201 I Applications \Permit Application Revised - 8-9-I1.docx
Revised: August 2011
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Page 2 of 4
Existing
Interior Remodel
Addition to
Existing
Structure
New
Type of
Construct': per
I ,
Type of
Occupancy per
IBC
1st Floor ,
2"a Floor
3rd Floor
Floors thru
Basement
Accessory Structure*
Attached Garage
Detached Garage
Attached Carport
Detached Carport
Covered Deck
Uncovered Deck
PLANNING DIVISION:
Single family building footprint (area of the foundatio ' of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the followin
Lot Area (sq ft):
F •or area of principal dwelling: Floor area of accessory dwelling:
*Provide documentation that shows t . t the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: St. dard:
Will there be a change in use? I Yes
Compact: Handicap:
❑ No If "yes". explain:
FIRE PROTECTION/HAZ DOUS MATERIALS:
❑ Sprinklers 0 Automatic Fire Alarm 0 None ❑ Other (specify)
Will there be storage or use ' f flammable, combustible or hazardous materials in the building? ❑ Yes ❑ No
If `yes', attach list o aaterials and storage locations on a separate 8-1/2"x 11" paper including quantities and Material Safety Data Sheets.
SEPTIC SYSTEM
0 On-. ite Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health
partment.
H:\ Applications\Forms-Applications On Line\201 I Applications \Permit Application Revised - 8-9-I1.docx
Revised: August 2011
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Page 2 of 4
PUBLIC WORKS PERMIT INFORMATION — 206-433-0179
Scope of Work (please provide detailed information):
aL1,\''(4 SSC) F c rr7vc
Call before you Dig: 811
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
Water District
❑ ...Tukwila ... Water District #125
❑ ...Water Availability Provided
Sewer District
❑ ...Tukwila
❑ ...Sewer Use Certificate
.Valley View
❑ ...Sewer Availability Provided
❑ .. Highline
❑ .. Renton
❑ .. Renton ❑ .. Seattle
Septic System:
0 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 anplv):
0 ...Civil Plans (Maximum Paper Size — 22" x 34")
❑ ...Technical Information Report (Storm Drainage)
❑ ...Bond ❑ .. Insurance 0 .. Easement(s)
Proposed Activities (mark boxes that apply):
0 ...Right-of-way Use - Nonprofit for less than 72 hours
❑ ...Right-of-way Use - No Disturbance
...Construction/Excavation/Fill - Right-of-way 0
Non Right-of-way ❑
❑ ...Total Cut
0 ...Total Fill
cubic yards
cubic yards
Sir*. 4L 4.*J
❑ .. Geotechnical Report
O .. Maintenance Agreement(s)
❑...Traffic Impact Analysis
❑ ...Hold Harmless — (SAO)
❑ ...Hold Harmless — (ROW)
❑ .. Right-of-way - Profit for less than 72 hours
❑ .. Right -of -w. - Use — Potential Disturbance
.. Work in Flood Zone
0 .. Storm Drainage
❑ ...Sanitary Side Sewer ❑ .. Aban• •n Septic Tank
0 ...Cap or Remove Utilities 0 C • Cut
0 ...Frontage Improvements ■ . ' avement Cut
O ...Traffic Control % .. Looped Fire Line
O ...Backflow Prevention - Fire Protectio
Irrigation
Dome c Water
❑ ...Permanent Water Met- ize... WO #
❑ ...Temporary Water eter Size .. WO #
0 .. Grease Interceptor
❑ .. Channelization
❑ .. Trench Excavation
❑ .. Utility Undergrounding
0 ...Water Only • er Size WO # ❑ ...Deduct Water Meter Size
❑ ...Sewer Ma' xtension Public ❑ Private 0
0 ... Water . in Extension Public 0 Private 0
FIN I CE INFORMATION
Fire Line Size at Property Line Number of Public Fire Hydrant(s)
0 ...Water
0 ...Sewer 0 ...Sewage Treatment
Monthly Service Billing to:
Name:
Mailing Address:
Day Telephone:
Water Meter Refund/Billing:
Name:
Mailing Address:
City
State Zip
Day Telephone:
City
State Zip
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Page 3 of 4
PERMIT APPLICATION NOTES —
Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject
to possible revision by the Permit Center to comply with current fee schedules.
Expiration of Plan Review — Applications (or which no permit is issued within 180 days following the date of application shall expire by limitation.
The Building Official may grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be
requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition).
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER OR AUT 0 ED AGENT:
Signature: //��,,�j� LL A_ \
Print Name: HTV PT,t�""''v Day Telephone: / — ‘yor•Z
Mailing Address: 51? 6 S. /CC -at' Lf+/. c tom %)/(f-
City State Zip
..moi/i�L
Date: %f 0 ..5:x 7
H:\Applications\Forms-Applications On Line \2011 Applications\Permit Application Revised - 8-9-1 I.docx
Revised: August 2011
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Page 4 of 4
Cash Register Receipt
City of Tukwila
DESCRIPTIONS ACCOUNT QUANTITY
PermitTRAK
PAID
$331.00
D17-0007 Address: 4443 S 144TH ST 1 Apn: 0040000395
$331.00
DEVELOPMENT
$321.40
PERMIT FEE
R000.322.100.00.00
0.00
$192.06
PLAN CHECK FEE
R000.345.830.00.00
0.00
$124.84
WASHINGTON STATE SURCHARGE
6640.237.114
0.00
$4.50
TECHNOLOGY FEE
$9.60
TECHNOLOGY FEE
TOTAL FEES PAID BY RECEIPT: R10357
R000.322.900.04.00
0.00
$9.60
$331.00
Date Paid: Tuesday, January 10, 2017
Paid By: PT HOLDINGS
Pay Method: CHECK 1551
Printed: Tuesday, January 10, 2017 12:15 PM 1 of 1
ClSYSTEMS
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3671KM INSPECTION RECORD
Retain a copy with permit 17-0007
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
Project:
1 i D
T e of Inspection:
l.,b,,JC—
4-L
Address:
INZ/3 S icy Pi ST
Date Called:
Special Instructions:
Date Want
! '7
a.m.
p.m.
Request r:
Phone No:
finApproved per applicable codes.
Corrections required prior to approval.
COMMENTS:
/2 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
1)I? -000?
PERMIT NO:
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188
Permit Inspection Request Line (206) 438-9350.
(206) 431-3670
Project:)�
L4 1 1Y/00
T e of Inspection:
lZbiAJ6- Ii IAL
Address:
4Jy43S!4'tl7Sr'
Date Called:
Special Instructions:
1/4 6XiS Wf,- /41W
Date Wanted)3�
a:m.
m.
Requester.
Phone No:
_ 266 �- 4P/6- )i'Z
ElApproved per applicable codes.
Z.,86 - Z. -R - 6LiZl
Corrections required prior to approval.
COMMENTS:
Hoof RitovAic, ;,,i d., oat
Inspector: Ab
Date:
q17
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
INS' TION NO.
1 i? -000' 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:
,-4-/ ,Ogi 1Q
Type of Inspection:
A,!r' VL / T/O iV
Ad��s; � `T
/
Date Called:
1-A/US AAZ
Special Instructions:
Date Wanted:
/-27—/ 7
p.m.
Requester:
Phone No:
Approved per applicable codes. gCorrections required prior to approval.
COMMENTS:
'
1 "WM .5
)
1-A/US AAZ
i
ekliarr- ervi
it
/Ai -see -me -1/4i
ii554/7-7'
Inspector:
M
Date:
17
REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection:
INSPECTION RECORD
111011 Retain a copywith permit
INSP ON NO.
Do-oOo7
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:
ZIP iEvvlb
'
Type of Inspection:
EM -Di N6- FIPOI.
•
Address Sg l7
1
Date Called:
Special Instructions:
Date Wanted:a.m.
-17
t-24
Requester:
Phone No:
ElApproved per applicable codes.
Corrections required prior to approval.
COMMENTS:
f1
116e ) Anveya
1 Ar e
Inspector:
REINSPECTION FEE REQUIRED. Prior to next insperCtion. fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection,
L:\Working\R15590 — LAI Short
Jon 09, 2017 — 5:37pm
S. 144T1 -I' S'
-POINT_-OF.AC CE SS'. .
FOR DEMOLITJON,,.,
REVIEWED FOR
CODE COMPLIANCE
APPROVED
JAN 2 3 2017
A" -T- IAA(
City of Tukwila
BUILDING DIVISION
CAP GAS
COORDINATE WITH
PSE
iSPARATEPE IT
RECUlRED FOR:
L
J
G7'l echanical
Oniectricat
1DIumbing
(4as Piping
of Tukwila
�f
FING DIVISION
",,N82°51119'W 104.91'
CAP SIDE SEWER PIPE
COORDINATE WITH VALLEY
VIEW SEWER DISTRICT
(10 043SQ; FT)
EX. HOUS•O (536
TO BE DEMOLISHED.--_
1,8i51'49'W 128.91'
882°5199144, 128.89'
LOT4
•`.(6,508 SQ. FT)
N8241:49"4/ 128.88'
PLANNING APPROVED
No changes can be nadeirese
6,5085Q. FT
plans withcuf•approval from tie
PlanninDivision of DCD
Approved By;
'7°51'49"W 128.88
PLAN
HORIZONTAL GRAPHIC SCALE
20 10 0 10 20
1 inch = 20 ft.
REVISIONS
No changes shall be made to the scope'
of work without prior approval of
Tt t ,;if BtI'nding-D1visr
NOTE: Revisions will require a new plan submittal
and may inclride additional plan review tees.
FILE COPY
i Permit No. t t`7- 400 7
TAX PARCEL NUMBER
0040000395
LEGAL DESCRIPTION
LOT 9, BLOCK 3, ADAMS HOME TRACTS.
LEGEND
CONTACTS
PROPERTY LINE
RIGHT OF WAY LINE
— RIGHT OF WAY CENTERLINE
— ADJACENT PROPERTY LINE
APPLICANT
MICHAEL LAI
(206) 310-3325
CML ENGINEER=
PBG; LLC
5130 S. 166TH LANE
SEATAC, WA 98188
(206)446-1292
CONTACT: HAN PHAN, P.E.
SURVEYOR
LANKTREE LAND SURVEYING, INC.
421 18" STREET NORTHEAST
AUBURN, WA 98002
(253) 653-6423
CONTACT: TREVOR LANKTREE, P.L.S.
RECEIVED
JAN 1 Z 201?
TUKWILA
PUBLIC WORKS
RECEIVED
Pin review r,pproval is subject to errors and omissions CITY OF TUK1iVILA
fkpproval of construction documents does not authorize. JAN 1 0 2017
he violation of any adopted code or ordnance. Receipt
f approved Hieid Copy and conditions is acknowledged ERMIT CENTER
By: -.-1-4/32.07---N_
Date: • ///o / 7
City of Tukwila
BUILDING DIVISION
UTILITIES
Know what's below.
CaII before you dig.
REFERENCE
SHEET NO.
SP1
SHEET
1
OF
•1
SHEETS
Uco
W c
W0
V)
Q
(n�
co
DEMO SITE PLAN
0
w
co
0
O
0
0
z
0
DESIGNED BY
H. H. PHAN
m
z
0
CHECKED BY:
PROJ. MNGR:
WATER
KING COUNTY WATER DISTRICT #125
3460 SOUTH 148TH STREET
SEATAC, WA 98188
(206) 242-9547
•
TELEPHONE'
QWEST
1-800-526-3557
SEWER
VALLEY VIEW SEWER DISTRICT
3460 S. 148TH STREET, SUITE 100
SEATTLE, WA 98168
(206) 242-3236
GAS.
PUGET SOUND ENERGY
1-888-321-7779
POWER:
SEATTLE CITY LIGHT
700 FIFTH AVENUE, SUITE 3300
SEATTLE, WA98124
(206) 684-3000
CABLE:
COMCAST
1-866-771-2281
WOOO1
REVISION DESCRIPTION
0
z
° PERMIT COORD COPY
PLAN REVIEW/ROUTING SLIP
PERMIT NUMBER: D17-0007 DATE: 01/11/17
PROJECT NAME: LAI DEMO PERMIT
SITE ADDRESS: 4443 S 144TH ST
X Original Plan Submittal
Response to Correction Letter #
Revision #
Revision #
before Permit Issued
after Permit Issued
DEPARTMENTS:
?cw&s I I t1
Building Division
PW K I& < ti
ublic Works
NP << t� b M ktq-17
Fire Prevention
Structural
[I_l
El
Planning Division
Permit Coordinator n
PRELIMINARY REVIEW:
Not Applicable n
(no approval/review required)
DATE: 01/12/17
Structural Review Required
REVIEWER'S INITIALS: DATE:
n
APPROVALS OR CORRECTIONS: DUE DATE:
Approved ❑ Approved with Conditions
Corrections Required
❑ Denied
(corrections entered in Reviews) (ie: Zoning Issues)
Notation:
02/09/17
REVIEWER'S INITIALS: DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire 0 Ping ❑ PW ❑ Staff Initials:
12/18/2013
O
CITY OF TUKWILA
Department of Community Development
6300 Southcenter Boulevard, Tukwila, WA 98188
Telephone: (206) 431-367o FAX (206) 431-3665
E-mail: tukplan@ ci.tukwila.wa.us
O
Permit Center/Building Division
206 431-367o
Public Works Department
206 433-0179
Planning Division
206 431-367o
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
STATE OF WASHINGTON)
COUNTY OF KING )
ss.
>✓ PF/L/
[please print name]
, states as follows:
PERMIT NO: VIDM I
1. I have made application for a permit from the City of Tukwila, Washington.
2. I understand that state law requires that all building construction contractors be registered with the
State of Washington. The exceptions to this requirement are stated under Section 18.27.090 of the
Revised Code of Washington, a copy of which is printed on the reverse side of this Affidavit. I have
read or am familiar with RCW 18.27.090.
3. I understand that prior to issuance of a permit for work which is to be done by any contractor, the
City of Tukwila must verify either that the contractor is registered by the State of Washington, or that
one of the exemptions stated under RCW 18.27.090 applies.
4. In order to provide verification to the City of Tukwila of my compliance with this requirement, I
hereby attest that after reading the exemptions from the registration requirement of RCW 18.27.090,
I consider the work authorized under this permit to be exempt under number/ , and will therefore
not be performed by a registered contractor.
5. I understand that the licensing provision of RCW 19.28.161 through 19.28.271 shall not apply to
persons making electrical installations on their own property or to regularly employed employees
working on the premises of their employer. The proposed electrical work is not for the construction
of a new building for rent, sale or lease.
I understand that I may be waiving certain rights that I might otherwise have under state law in any decision
to engage an unregistered contractor to perform construction work.
Owner/Owner's Agent*
Signed and sworn to before me this
ig
v "/ day of J V1 , 20 11
NOTARY PUBLIC in and for the 'tate of Washington
Residing, at
urs
Name as commissioned:
My commission expires:
Ounty
p -\DA
18.27.090 Exemptions. The registration provisions of this chapter do not apply to:
1. An authorized representative of the United States
government, the state of Washington, or any incorporated
city, town, county, township, irrigation district, reclamation
district, or other municipal or political corporation or
subdivision of this state;
2. Officers of a court when they are acting within the scope
of their office;
3. Public utilities operating under the regulations of the
utilities and transportation commission in construction,
maintenance, or development work incidental to their own
business;
4. Any construction, repair, or operation incidental to the
discovering or producing of petroleum or gas, or the
drilling, testing, abandoning, or other operation of any
petroleum or gas well or any surface or underground mine
or mineral deposit when performed by an owner or lessee;
5. The sale of any finished products, materials, or articles of
merchandise that are not fabricated into and do not become
a part of a structure under the common law of fixtures;
6. Any construction, alteration, improvement, or repair of
personal property performed by the registered or legal
owner, or by a mobile/manufactured home retail dealer or
manufacturer licensed under chapter 46.70 RCW who shall
warranty service and repairs under chapter 46.70 RCW;
7. Any construction, alteration, improvement, or repair
carried on within the limits and boundaries of any site or
reservation under the legal jurisdiction of the federal
government;
8. Any person who only furnished materials, supplies, or
equipment without fabricating them into, or consuming
them in the performance of, the work of the contractor;
9. Any work or operation on one undertaking or project by
one or more contracts, the aggregate contract price of
which for labor and materials and all other items is less
than five hundred dollars, such work or operations being
considered as of a casual, minor, or inconsequential nature.
The exemption prescribed in this subsection does not apply
in any instance wherein the work or construction is only a
part of a larger or major operation, whether undertaken by
the same or a different contractor, or in which a division of
the operation is made into contracts of amounts less than
five hundred dollars for the purpose of evasion of this
chapter or otherwise. The exemption prescribed in this
subsection does not apply to a person who advertises or
puts out any sign or card or other device which might
indicate to the public that he or she is a contractor, or that
he or she is qualified to engage in the business of
contractor;
to. Any construction or operation incidental to the
construction and repair of irrigation and drainage ditches
of regularly constituted irrigation districts or reclamation
districts; or to farming, dairying, agriculture, viticulture,
horticulture, or stock or poultry raising; or to clearing or
other work upon land in rural districts for fire prevention
purposes; except when any of the above work is performed
by a registered contractor;
11. An owner* who contracts for a project with a registered
contractor, except that this exemption shall not deprive the
owner of the protections of this chapter against registered
and unregistered contractors. The exemption prescribed in
this subsection does not apply to a person who performs
the activities of a contractor for the purpose of leasing or
selling improved property he or she has owned for less than
twelve months;
12.* Any person working on his or her own property,
whether occupied by him or her or not, and any person
working on his or her personal residence, whether owned
by him or her or not but this exemption shall not apply to
any person who performs the activities of a contractor on
his or her own property for the purpose of selling,
demolishing, or leasing the property;
13. An owner* who performs maintenance, repair, and
alteration work in or upon his or her own properties, or
who uses his or her own employees to do such work;
14. A licensed architect or civil or professional engineer
acting solely in his or her professional capacity, an
electrician certified under the laws of the state of
Washington, or a plumber certified under the laws of the
state of Washington or licensed by a political subdivision of
the state of Washington while operating within the
boundaries of such political subdivision. The exemption
provided in this subsection is applicable only when the
person certified is operating within the scope of his or her
certification;
15. Any person who engages in the activities herein
regulated as an employee of a registered contractor with
wages as his or her sole compensation or as an employee
with wages as his or her sole compensation;
16. Contractors on highway projects who have been
prequalified as required by RCW 47.28.070, with the
department of transportation to perform highway
construction, reconstruction, or maintenance work;
17. A mobile/manufactured home dealer or manufacturer
who subcontracts the installation, set-up, or repair work to
actively registered contractors. This exemption only applies
to the installation, set-up, or repair of the
mobile/manufactured homes that were manufactured or
sold by the mobile/manufactured home dealer or
manufacturer;
18. An entity who holds a valid electrical contractor's
license under chapter 19.28 RCW that employs a certified
journeyman electrician, a certified residential specialty
electrician, or an electrical>trainee meeting
the:;
requirements of chapter 19:28 RCW to perform`p1umbing
work that is incidentally; ;directly, and immediately
appropriate to the like -iii, kindreplacement of a -household
appliance or other small°household utilization equipment
that requires limited electric power end limited, waste
and/or water connections"An`electrical traineemust be
supervised by a certified electrician while performing
plumbing work.
* Per Washington State Department of Labor and Industries lessee has
been interpreted to be equivalent to owner for purposes of exemptions.