HomeMy WebLinkAboutPermit D17-0070 - NGUYEN RESIDENCE - SHED DEMOLITIONHUNG LAM NGUYEN
RESIDENCE
14629 42 AVE S
D17-0070
Parcel No:
Address:
0
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
0040000947
14629 42ND AVE S Issue Date:
Permit Expires On:
DEVELOPMENT PERMIT
Permit Number:
Project Name: HUNG LAM NGUYEN RESIDENCE
D17-0070
3/31/2017
9/27/2017
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
License. No:
Lender:
Name:
Address:
FEDERAL NATIONAL MORTGAGE A
PO BOX 650043 , DALLAS, , 75265
JAMES MICHAEL
,,,
OWNER
,,,
Phone: (253) 632-9159
Phone:
Expiration Date:
DESCRIPTION OF WORK:
TEAR DOWN EXISTING SHED/AWNING STRUCTURE THAT WAS BUILT TO CLOSE TO PROPERTY LINE
Project Valuation: ' $1,080.00
Type of Fire Protection: Sprinklers:
Fire Alarm:
Type of Construction:
Electrical Service Provided by: TUKWILA
Fees Collected: $101.77
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:
WACities 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:
Cf.Ai
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:
Print Na e:
07A5 /14‘C.(4 IA(
Date: 3 3/ "17
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:
<NONE>
PERMIT INSPECTIONS REQUIRED
Permit Inspection Line: (206) 438-9350
1700 BUILDING FINAL**
CITY OF TULA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
Building PQit No. '11'.10010
Project No. pp
Date Application Accepted: %E 11
Date Application Expires: 1 D 11
(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:
Tenant Name:
King Co Assessor's Tax No.:
/'/9 Ind AV Set-
hi IAA1 4\ N9 i yJ
PROPERTY OWNER
Name:
140vi yC /t A is c pi A'�L
c'�► - Y� 7 ®� 6't
Address:
Name: sAivit^ c
A.
/►
{�
4 v� —
Phone
Address:
Email:
Phone:
Fax:
City:
State:
Contr Reg No.:
Zip:
CONTACT PERSON — person receiving all project
communication
Name:
140vi yC /t A is c pi A'�L
c'�► - Y� 7 ®� 6't
Address:
City:
State: Zip:
Phone
53 ‘.3a , f fgax:
V
Email:
Phone:
GENERAL CONTRACTOR INFORMATION
Company Name:
Address:
Company Name:
City:
State:
Zip:
Phone:
Fax:
City:
State:
Contr Reg No.:
Phone:
Exp Date:
Tukwila Business License No.:
H:Wpplications\Forms-Applications On Line\2012 Applications\Peimit Application Revised - 2-7-12.docx
Revised: February 2012
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Suite Number:
Floor:
New Tenant: ❑ Yes .. No
ARCHITECT OF RECORD
Name:
Address:
Company Name:
Architect Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
ENGINEER OF RECORD
Name:
Address:
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 INFORMATI-- 206-431-3670
0
Valuation of Project (contractor's bid price): $ `Q[)
Existing Building Valuation: $
Describe
the scope of work (please provide detailed information): '/
4AT (ALA
Will there be new rack storage? ❑ ....Yes ❑ ..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 foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): Floor area of principal dwelling: Floor area of accessory dwelling:
*Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard:
Compact: Handicap:
Will there be a change in use? ❑ Yes ❑ No If "yes", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
❑ Sprinklers 0 Automatic Fire Alarm 0 None 0 Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? 0 Yes ❑ No
If `yes', attach list of materials and storage locations on a separate 8-1/2" x 11" paper including quantities and Material Safety Data Sheets.
SEPTIC SYSTEM
❑ On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health
Department.
H:Wpplications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 2 of 4
Existing
Interior Remodel
Addition to
Existing
Structure
New
Type of
Construction per
IBC
Type of
Occupancy per
IBC
1St Floor
2nd 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 foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): Floor area of principal dwelling: Floor area of accessory dwelling:
*Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard:
Compact: Handicap:
Will there be a change in use? ❑ Yes ❑ No If "yes", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
❑ Sprinklers 0 Automatic Fire Alarm 0 None 0 Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? 0 Yes ❑ No
If `yes', attach list of materials and storage locations on a separate 8-1/2" x 11" paper including quantities and Material Safety Data Sheets.
SEPTIC SYSTEM
❑ On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health
Department.
H:Wpplications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 2 of 4
PUBLIC WORKS PERMIT INICMATION — 206-433-0179
Scope of Work (please provide detailed information):
Call before you Dig: 811
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
Water District
❑ .. Tukwila ❑ ...Water District #I25
❑ .. Water Availability Provided
Sewer District
0 .. Tukwila
0 .. Sewer Use Certificate
❑ :`..Valley View
0 ...Sewer Availability Provided
❑... Highline
❑ ... Renton
0...Renton
0... 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 apply):
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):
❑ .. Right-of-way Use - Nonprofit for less than 72. hours
❑ .. Right-of-way Use - No Disturbance
❑ .. Construction/Excavation/Fill - Right-of-way 0
Non Right-of-way 0
❑ .. Total Cut
❑ .. Total Fill
cubic yards
cubic yards
❑ .. Sanitary Side Sewer
❑ .. Cap or Remove Utilities
0 .. Frontage Improvements
❑ .. Traffic Control
❑ .. Backflow Prevention - Fire Protection
Irrigation
❑.
❑.
❑.
❑.
❑ .
❑.
Geotechnical Report
.. Maintenance Agreement(s)
0 .. Traffic Impact Analysis
❑ .. Hold Harmless — (SAO)
0... Hold Harmless — (ROW)
0...Right-of-way Use - Profit for less than 72 hours
0...Right-of-way Use — Potential Disturbance
0...Work in Flood Zone
0... Storm Drainage
.. Abandon Septic Tank
.. Curb Cut
.. Pavement Cut
.. Looped Fire Line
Domestic Water
❑ .. Permanent Water Meter Size (1)
❑ .. Temporary Water Meter Size (1)
❑ .. Water Only Meter Size
❑ .. Sewer Main Extension Public ❑
❑ .. Water Main Extension Public
0...Grease Interceptor
❑... Channelization
0... Trench Excavation
0...Utility Undergrounding
WO # (2) " WO # (3)
WO # (2) " WO # (3)
WO # 0 .. Deduct Water Meter Size
Private 0
Private 0
" WO#
" WO#
FINANCE INFORMATION
Fire Line Size at Property Line
Number of Public Fire Hydrant(s)
❑ .. 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
H:\Applications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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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 for which no permit is issued within 180 days following the date of application shall expire by limitation.
The Building Official may grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be
requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition).
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNEY�THORIZED /^NT:
Signature:
Print Name:
3\4/14 M,\ 1,L
Mailing Address:
Gate
7z-16' /15o
H:Wpplications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Date:
Day Telephone: 2(3 632 /\ J S`%
PLX-. guc c 1 c .4 g93 2 i
City State Zip
Page 4 of 4
Cash Register Receipt
City of Tukwila
Receipt: Number
DESCRIPTIONS
PermitTRAK
ACCOUNT QUANTITY
PAID
$101.77
D17-0070 Address: 14629 42ND AVE S
Apn: 0040000947
$101.77
DEVELOPMENT
$97.14
PERMIT FEE
R000.322.100.00.00
0.00
$92.64
WASHINGTON STATE SURCHARGE
B640.237.114
0.00
$4.50
TECHNOLOGY FEE
$4.63
TECHNOLOGY FEE
TOTAL FEES PAID BY RECEIPT: R11189
R000.322.900.04.00 0.00
$4.63
$101.77
Date Paid: Friday, March 31, 2017
Paid By: JAMES MICHAEL
Pay Method: CASH
Printed: Friday, March 31, 2017 12:20 PM 1 of 1
CRSYSTEMS
INSPECTION RECORD
Retain a copy with permit
INS 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
P��ro��'ect:
MIA/6 hi Ai A ettilG ,/
f Inspection: ��/�'�
TyLJIMiZrt�"//1A1-
Address:
0620
'.S.
Date Called:
Special Instructions:
Date Wanted?
V 7•p.m.
m.,
Requester.
Phone Na
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
Inspector:
Date q
REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
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