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Home My WebLink AboutPermit D17-0111 - MOSLEY RESIDENCE - REROOFMOSLEY RESIDENCE 11223 51ST AVE S D17-0111 Parcel No: Address: C 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.eov DEVELOPMENT PERMIT 3348401761 Permit Number: 11223 51ST AVE S Issue Date: Permit Expires On: Project Name: MOSLEY RESIDENCE D17-0111 4/25/2017 10/22/2017 Owner: Name: Address: Contact Person: Name: MOSLEY LONNIE R & LINDA A 11223 51ST AVE S , SEATTLE, WA, 98178 NAIDA KHAN Address: 9808 31 AVE SE , EVERETT, WA, 98208 Contractor: \ ` Name: HOME DEPOT AT-HOME SRVCS, THE Address: 2690 CUMBERLAND PKWY, SUITE 300 , ATLANTA, GA, 30339 License No: HOMED**972RQ Lender: Name: LINDA MOSLEY Address: 1122351ST AVE S , TUKWILA, WA, 98178 Phone: (360) 945-2787 Phone: (770) 7.79-1300 Expiration Date: 2/3/2017 DESCRIPTION OF WORK: RESIDENTIAL RE -ROOF Project Valuation: $9,423.00 Type of Fire Protection: Sprinklers: Fire Alarm: Type of Construction: Electrical Service Provided by: TUKWILA Fees Collected: $311.11 Occupancy per IBC: Water District: TUKWILA Sewer District: NONE 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: O 0 Volumes: Cut: 0 Fill: 0 Number: 0 Permit Center Authorized Signature: ` 1 i d W J y SLI Date: I hearby certify that I have read and examined this permit and know he 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 Nam Date: 4%25111" 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*** PERMIT INSPECTIONS REQUIRED Permit Inspection Line: (206) 438-9350 1700 BUILDING FINAL** 0 0 CITY OF TUKWILA Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TulcwilaWA.gov Building Permit No. BOJ 1 Project No Date Application Accepted: / Date Application Expires: (For office use only) CONSTRUCTION PERMIT APPLICATION Applications and plans must be complete in order to be accepted for plan review: Applications will not be accepted through the mail or by fax. **Please Print** Site Address: 11223 51st Avenue South King Co Assessor's Tax No.: Suite Number: Floor: Tenant Name: New Tenant: 0 Yes 0 ..No 3348401761 PROPERTY OWNER Name: Northwest Permit Inc. Name: Linda Mosley City: Everett State: WA Zip: 98208 Address: 11223 51st Avenue South Email: naida@nwpermit.com City: TUKWILA State: WA Zip: 98178 CONTACT PERSON — person receiving all project communication Name: Northwest Permit Inc. Address: 9808 31st St SE City: Everett State: WA Zip: 98208 Phone: (360) 945-2787 Fax: (888) 400-0383 Email: naida@nwpermit.com GENERAL CONTRACTOR INFORMATION Company Name: The Home Depot Address: 3600 Lind Ave SW #150 City: Renton State: WA Zip: 98057 Phone: (800) 381-5699 Fax: Contr Reg No.: HOMED**088RH Exp Date: 07/17/2018 Tukwila Business License No.: BUS -0101195 NAApplicatiort\Fomc-Applications On Line \2011 Applicatioca\Pcrmit Application Revised - 8-9.1 I.docx Revised: August 2011 bh ARCHITECT OF RECORD Name: owe. Company Name: Address: Architect Name: City: State: Address: City: State: Zip: Phone: Fax: Email: ENGINEER OF RECORD Name: owe. Company Name: Address: Engineer Name: City: State: Address: City: State: Zip: Phone: Fax: Email: LENDER/BOND ISSUED (required for projects $5,000 or greater per RCW 19.27.095) Name: owe. Address: City: State: Zip: Page 1 of 4 BUILDING PERMIT INFORMATION — 206.431-3670, Valuation of Project (contractor's bid price): $ 9,423 Existing Building Valuation: $ Describe the scope of work (please provide detailed information): REMOVE AND REPLACE 18.3 SQUARES COMP ROOFING. NO PLYWOOD REPLACEMENT. Will there be new rack storage? 0 Yes . No If yes, a separate permit and•plan submittal will be required. Provide All Building Areas in Square Footage Below 15` Floor Interior Remodel Addition to Existing Structure New" Type of Construction per IBC Type of Occupancy per IBC 2"d Floor 3'4 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: Will there be a change in use? 0 Yes Compact: _ Handicap: ❑ No If "yes", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: 0 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 0 No If yes', attach list of materials and storage locations on a separate 8-1/2 " x 11 " paper including quantities and Material Safety Data Sheets. SEPTIC SYSTEM ❑ On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health Department. H:\Applications\Foam-Applimtion On Line\201I Applications\Permit Application Rcviscd - 8-9-11.docx Revised August 2011 bb Page 2 of 4 PUBLIC WORKS PERMIT INFORMATION - 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 #125 ❑ ...Water Availability Provided Sewer District ❑ ...Tukwila ❑ ...Sewer Use Certificate ❑...Valley View ❑...Sewer Availability Provided ❑ .. Highline ❑ .. Renton 0 .. 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 apply): ❑ ...Civil Plans (Maximum Paper Size — 22" x 34") ❑ ...Technical Information Report (Storm Drainage) ❑ ...Bond ❑ .. Insurance ❑ .. Easement(s) ❑ .. Geotechnical Report ❑ .. Maintenance Agreement(s) ❑ ...Traffic Impact Analysis ❑ ...Hold Harmless — (SAO) ❑...Hold Harmless — (ROW) Proposed Activities (mark boxes that apply): 0 ...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 ❑ .. Work in Flood Zone ❑ ...Total Fill cubic yards 0 .. Storm Drainage ❑ ...Sanitary Side Sewer ❑ .. Abandon Septic Tank ❑ .. Grease Interceptor ❑ ...Cap or Remove Utilities ❑ .. Curb Cut 0 .. Channelization ❑ ...Frontage Improvements 0 .. Pavement Cut ❑ .. Trench Excavation ❑ ...Traffic Control ❑ .. Looped Fire Line ❑ .. Utility Undergrounding ❑ ...Backflow Prevention Fire Protection " Irrigation Domestic Water ❑ ...Permanent Water Meter Size... WO # ❑ ...Temporary Water Meter Size .. WO # ❑ ...Water Only Meter Size WO # ❑... Deduct Water Meter Size 0 ...Sewer Main Extension Public ❑ Private 0 ❑ ...Water Main Extension Public ❑ Private 0 FINANCE INFORMATION Fire Line Size at Property Line Number of Public Fire Hydrant(s) ❑ ...Water ❑ ...Sewer ❑ ...Sewage Treatment Monthly Service Billing to: Name: Day Telephone: Mailing Address: Water Meter RefundBilline: Name: Mailing Address: City State Zip Day Telephone: City State Zip 1 : AppliceriansWares-Applications On Line t201 I Applications\Permit Application Revised- 8-9-11.docs Revised: August 2011 bh Page 3 of 4 0 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 R OR i'0 ED AGENT: Signature: Date: 04/25/2017 Print Name..S .YLSvM ► igkA Day Telephone: Mailing Address: 9808 31ST AVE SE EVERETT WA 98208 State City HAApplicntionsWonm-Application On LincO2011 Applications \Pvsnit Application Revised - 8-9-11.docx Rcviscd: August 2011 bh Zip Page 4 of 4 Cash Register Receipt City of Tukwila DESCRIPTIONS PermitTRAK I ACCOUNT I QUANTITY I PAID $311.11 D17-0111 Address: 11223 51ST AVE S Apn: 3348401761 $311.11 DEVELOPMENT $296.51 PERMIT FEE R000.322.100.00.00 0.00 $292.01 WASHINGTON STATE SURCHARGE B640.237.114 0.00 $4.50 TECHNOLOGY FEE $14.60 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R11352 R000.322.900.04.00 0.00 $14.60 $311.11 Date Paid: Tuesday, April 25, 2017 Paid By: NORTHWEST PERMIT Pay Method: CHECK 10662 Printed: Tuesday, April 25, 2017 3:01 PM 1 of 1 CLLISYSTEMS INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION -O PI 6300 Southcenter Blvd., #100, Tukwila: WA 98188 Permit Inspection Request Line (206) 438-9350 (206) 431-3670 Project: ,� (i iSi. "' I6 f A£: � T pe of Inspection: u fl- �4L- Address: _ 1/Z2,3 : i uS Date Called: Special Instructions: Date W , t / am. 'P.in. Reques r. Phone No: Approved per applicable codes. ECorrections required prior to approval. COMMENTS: Insrm pector: 1/1 Date: /DC7 REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. HOME DEPOT, THE 0 Washington State Department of Labor & Industries 0 Home Fspaiiol Contact Safety & Health Claims & Insurance Search L&I \-L Index Help Page 1 of 4 My 1: &[ Workplace Rights Trades & Licensing HOME DEPOT, THE Owner or tradesperson Principals HOFFMANN, KEVIN ANDREW, CHIEF EXECUTIVE OFFICER WAITS, CHRISOPHER WAYNE, MEMBER INGRAM, STACY S, MEMBER BLANK, ARTHUR (End: 06/02/2010) DAY, MARSHALL L (End: 06/02/2010) MARCUS, BERNARD, (End: 06/02/2010) BRILL, RONALD (End: 06/02/2010) Doing business as HOME DEPOT, THE 2455 Paces Ferry Rd. C-11 Hm Svcs Compliance ATLANTA, GA 30339 770-433-8211 WA UBI No. Business type 601 262 719 Corporation Governing persons KELLY H BARRETT FRANCIS S BLAKE; ARTHUR M BLANK; RONALD M BRILL; JOHN COSTELLO; FRANK L FERNANDEZ; REBECCA I FLICK; JAMES INGLIS; BERNARD MARCUS; ROBERT L NARDELLI; STEVEN TAPLITS; CAROL B TOME; License Verify the contractor's active registration / license / certification (depending on trade) and any past violations. Construction Contractor Active. ........................................................................... Meets current requirements. License specialties GENERAL License no. HOMED**088RH Effective — expiration 12/08/1992— 07/17/2018 Bond _....._.._.. WESTCHESTER FIRE INS CO $12,000.00 Help us improve https://secure.lni.wa.gov%verify/Detail.aspx?UBI=601262719&LIC=HOMED* * 088RH&SAW= 4/25/2017 HOME DEPOT, THE Bond account no. K07246286 C) O Received by L&I Effective date 10/14/2005 11/01/2005 Expiration date Until Canceled Insurance _......._................._. Old Republic Ins Co $9,000,000.00 Policy no. mwzy310022 Received by L&I Effective date 02/22/2017 03/01/2017 Expiration date 03/01/2018 Insurance history Savings ..._............... No savings accounts during the previous 6 year period. Lawsuits against the bond or savings Cause no. 14-2-31770-1 SEA Complaint filed by ALEXANDER KOLMYKOV-ZOTOV Dismissed ................................. Complaint against bond(s) or savings K07246286 Complaint date Complaint amount 12/03/2014 $0.00 Cause no. 14-2-04919-4 Complaint filed by GUY & KRISTY KELLY Complaint date 07/16/2014, Cause no. 13-2-00183-3 Complaint filed by EMMETT & SONJA LENIHAN Complaint date 03/06/2013 Cause no. 12-2-25085.5SEA Complaint filed by METROPOLITAN PROPERTY & CASUALTY INS CO Complaint date 08/14/2012 Open .............. Complaint against bond(s) or savings K07246286 Complaint amount $0.00 Dismissed ................................. Complaint against bond(s) or savings K07246286 Complaint amount $140,000.00 Dismissed ................................ Complaint against bond(s) or savings K07246286 Complaint amount $8,823.46 L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period, but some debts may be recorded by other agencies. License Violations Infraction no. FDISH00613 Issue date 06/07/2013 Violation city Pacific Type of violation Satisfied ........................... RCW/WAC 43.22.435 RCW Violation amount $1,000.00 Page 2 of 4 Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601262719&LIC=HOMED* * 088RH&SAW= 4/25/2017 HOME DEPOT, THE FAS INFRACTION Description Failure to obtain an alteration permit before altering a mobile or manufactured home as required. Installed comp roof c Infraction no. FDISH00590 Issue date 11/13/2012 Violation city Pacific Type of violation FAS INFRACTION Description Failure to obtain an alteration permit before altering a mobile or manufactured home as required. Installed new roof Infraction no. FDISH00574 Issue date 08/10/2012 Violation city Pacific Type of violation FAS INFRACTION Description Failure to obtain an alteration permit before altering a mobile or manufactured home as required. Re roofed MFG home Satisfied ..._.................. RCW/WAC 43.22.435 RCW Violation amount $800.00 Satisfied ........................... RCW/WAC 43.22.435 RCW Violation amount $400.00 Workers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. This company has multiple workers' comp accounts. Active accounts L&I Account ID 706,094-00 Doing business as HOME DEPOT INC Estimated workers reported N/A L&I account representative (360)902-4817 Track this contractor rind Self Insured. This business is certified to cover its own workers' comp costs. No premiums due. Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Inspection results date 04/11/2014 Inspection no. 317271583 Location 1325 Fones Road Olympia, WA 98500 Inspection results date No violations Page 3 of 4 Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601262719&LIC=HOMED* *088RH&SAW= 4/25/2017 HOME DEPOT, THE 03/03/2014 Inspection no. 316966688 Location 6200 E Lake Samammish Pkwy SE Issaquah, WA 98029 Inspection results date 09/05/2013 Inspection no. 316868579 Location 1101 Kingswood Dr Sw Tumwater, WA 98512 Inspection results date 12/02/2011 Inspection no. 315576645 Location 580 7th Ave Longview, WA 98632 Violations No violations Violations Page 4 of 4 © Washington State Dept, of Labor & Industries. Use of this site is subject to the laws of the state of Washington. Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601262719&LIC=HOMED* *088RH&SAW= 4/25/2017