HomeMy WebLinkAboutPermit D17-0197 - BIDLACK RESIDENCE - SHED REPLACEMENTBIDLACK RESIDENCE
4261 S 144 ST
D17-0197
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.gov
0040000370
4261 S 144TH ST
Project Name: BIDLACK RESIDENCE
DEVELOPMENT PERMIT
Permit Number: D17-0197
Issue Date: 7/31/2017
Permit Expires On: 1/27/2018
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
License No:
Lender:
Name:
Address:
BIDLACK RICK+SHEILA) B COP
4261 S 144TH ST, TUKWILA, WA,
98168
RICK BIDLACK
4261 S 144TH ST, TUKWILA, WA,
98168
OWNER AFFIDAVIT - RICK BIDLACK
Phone: (206) 760-4954
Phone:
Expiration Date:
DESCRIPTION OF WORK:
DEMO EXISTING POOL SHED ATTACHED TO THE SOUTH WALL OF HOUSE AND REPLACE WITH NEW SHED
Project Valuation: $6;548.80
Type of Fire Protection:
Sprinklers: NO
Fire Alarm: NO
Type of Construction: VB
Electrical Service Provided by: TUKWILA
Fees Collected: $410.94
Occupancy per IBC: U
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: 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: 41A8(114 4°V Date: `— 3
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 Name:
Date: 7/507
This permit shall become null and void if the wor is not commenced within 180 days for the date of issuance, or if
the work is suspended or abandoned for a period •f 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: All construction shall be done in conformance with the Washington State Building Code and the
Washington State Energy Code.
5: There shall be no occupancy of a building until final inspection has been completed and approved by
Tukwila building inspector. No exception.
6: 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.
7: 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.
8: 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).
9: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila
Permit Center.
10: 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.
PERMIT INSPECTIONS REQUIRED
Permit Inspection Line: (206) 438-9350
1700 BUILDING FINAL**
0409 FRAMING
CITY OF TUKWILA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
gg
Building Permit No. pl'1 e 0 1C1
Project No.
IDate Application Accepted: �I
"
1
Date Application Expires:
III
(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: tja 6 1 . �� , -P144 et-,
Tenant Name:,1 l7 o f 121,4
King Co Assessor's Tax No.: VD /1 000--0 370— 011
Suite Number: Floor:
PROPERTY OWNER
f y
Name: 7.2.0„:5;c16.1" � f j(,&h lG'C-
Address: gib,
5 r 6 Lj"1 4,4 m bT
qq
City: .114)44
� c ll, State: w /1 Zip: g s 4(! ZSC�
CONTACT PERSON — person receiving all project
communication
Name: g his i / ( Kr I „
(�1�.� Ohl
Address:
City: State: Zip:
Phone: zap30 y lcp5l 1Fax:
Email: i4 -terliAtt.tl_6a riefit ium(
GENERAL CONTRACTOR INFORMATION
Company Name:
Address:
Company Name:
City:
State:
Zip:
Phone:
Fax:
City:
State:
Contr Reg No.:
..
Exp Date:
Tukwila Business License No.:
H:Wpplications\Forms-Applications On Line \2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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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 (requir d for projects $5,000 or
greater per RCW 19.27.095)
Name:
Address:
City: State: Zip:
Page 1 of 4
BUILDING PERMIT INFORMATIC, .'- 206-431-3670
Valuation of Project (contractor's bid price): $ -n Z * 2f'..7) Existing Building Valuation: $
Describe the scope of work (please provide detailed information):
17e-144o00k � 1 q deli.ri dt it 4 reit , j eo(sCecI da &14e1
✓Di,644v1 wed 4-11460-ikse
R t c'e i,>pw_ ..6ked
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:
Will there be a change in use?
0 Yes
FIRE PROTECTION/HAZARDOUS MATERIALS:
No
Compact:
Handicap:
If "yes", explain:
0 Sprinklers . Automatic Fire Alarm ii I 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 Sa ety I ata Sheets.
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.
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*
Attache
CSC
/19C31
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
FIRE PROTECTION/HAZARDOUS MATERIALS:
No
Compact:
Handicap:
If "yes", explain:
0 Sprinklers . Automatic Fire Alarm ii I 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 Sa ety I ata Sheets.
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.
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 INF �CyMATION — 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
❑... Highline
❑...Valley View ❑... Renton
❑ ...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)
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 ❑
Non Right-of-way ❑
❑ .. Total Cut
❑ .. Total Fill
cubic yards
cubic yards
❑ .. Sanitary Side Sewer
❑ .. Cap or Remove Utilities
❑ .. Frontage Improvements
❑ .. Traffic Control
❑ .. Backflow Prevention - Fire Protection
Irrigation
❑ ... Geotechnical Report
1:1 ... Maintenance Agreement(s)
❑ .. Traffic Impact Analysis
❑ .. Hold Harmless — (SAO)
❑ .. Hold Harmless — (ROW)
❑ ... Right-of-way Use - Profit for less than 72 hours
❑... Right-of-way Use — Potential Disturbance
10 ... Work in Flood Zone
10 ... Storm Drainage
❑... Abandon Septic Tank
❑... Curb Cut
❑... Pavement Cut
❑... Looped Fire Line
Domestic Water
53
❑ .. 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 ❑
❑ ... Grease Interceptor
❑... Channelization
❑... Trench Excavation
❑... Utility Undergrounding
(2) " WO # (3) " WO #
(2) " WO # (3) " WO #
❑ .. Deduct Water Meter Size
FINANCE INFORMATION
Fire Line Size at Property Line
Number of Public Fire Hydrant(s)
❑ .. Water ❑ .. Sewer ❑ .. Sewage Treatment
Monthly Service Billing to:
Name:
Mailing Address:
Day Telephone:
City
State
Zip
Water Meter Refund/Billing:
Name: Day Telephone:
Mailing Address:
City
State
Zip
H:Wpplications\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 OW i : : UTHOD AGEN
Signature:
Psi B'cil.
Print Name:
Mailing Address:
%gq(14
�T-
H. \Applications'Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
bb
Day Telephone:
/1/t lt1�iC(ci
City
Date: l V 17� za(7
20C, 760 i `7 f
lgi
W4 OI5
State Zip
Page 4 of 4
DESCRIPTIONS
PermitTRAK::
PAID
$155.36
D17-0197 Address: 4261,5 144TH ST
pn:"'0040000370,
$155.36
Credit Card Fee
R000.369.908.00.00
0.00
$4.53
DEVELOPMENT
$150.83
PLAN CHECK FEE
TOTAL FEES PAID BY RECEIPT: R11936
R000.345.830.00.00
0.00
$150.83
$155.36
Date Paid: Tuesday, July 18, 2017
Paid By: BIDLACK RICK
Pay Method: CREDIT CARD 351483
Printed: Tuesday, July 18, 2017 12:27 PM 1 of 1
C
SYSTEMS
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
D11 -o197
Pro'e %t:T
,dL6c1:34r
e of Inspection:
,Ids v,r4eti...
A r' ss : S.
(-2
PM-rt.��i
Date Cal led:
Special Instructions:
4 » O c
�" "� v� �
CfL o/
Date Wanted:
��
�r ��
a.m.
p.m.
Requester'
Ph a No: _ 4
( Nfl7C0-4OS—j
Approved per applicable codes. LJ Corrections required prior to approval.
OMMENTS:
FfrAft,,,\I
/4429444 9/z7/2_0/7
pApv.
Inspector:B i,
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 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
all -0/q7
Pr�,ject: /�
(iJiDAAC k' 6., -sit 'e
Types Inspection:
hAv41A &
Address:
/2-6 1 s )4iyfid S,
Date Called:
Special Instructions:
Date Want :
® z7 /7
C-
p.m.
Requester
Phone No:
MApproved per applicable codes.
L, Corrections required prior to approval.
COMMENTS:
Inspector:
REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite -100. Call to schedule reinspection.
8/1/2018
City of Tukwila
Department of Community Development
RICK BIDLACK
4261 S 144TH ST
TUKWILA, WA 98168'
RE: Permit No. D17-0197
BIDLACK RESIDENCE
4261 S 144TH ST
Dear Permit Holder:
Allan Ekberg, Mayor
Jack Pace, Director
In reviewing our current records, the above noted permit has not received a final inspection by the City of Tukwila Building
Division. Per the International Building Code, International Mechanical Code, Uniform Plumbing Code and/or the National Electric
Code, every permit issued by the Building Division under the provisions of these codes shall expire by limitation and become null
and void if the building or work authorized by such permit has not begun within 180 days from the issuance date of such permit, or if
the building or work authorized by such permit is suspended or abandoned at any time after the work has begun for a period of 180
days. Your permit will expire on 9/23/2018.
Based on the above, you are hereby advised to:
1) Call the City of Tukwila Inspection Request Line at 206-438-9350 to schedule for the next or final inspection. Each
inspection creates a new 180 day period, provided the inspection shows progress.
-or-
2) Submit a written request for permit extension to the Permit Center at least seven(7) days before it is due to expire.
Address your extension request to the Building Official and state your reason(s) for the need to extend your permit.
The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is determined that your
extension request is granted, you will be notified by mail.
In the event you do not call for an inspection and/or receive an extension -prior to 9/23/2018, your permit will become null and void
and any further work on the project will require a new permit and associated fees.
Thank you for your cooperation in this matter.
Sincerely,
Permit Technician
File No: D17-0197
Pa9
6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665
0
City of Tukwila
Allan Ekberg, Mayor
Department of Community Development - Jack Pace, Director
March 14, 2018
Rick Bidlack
4261 S 144th St
Tukwila, WA 98168
RE: Request for Extension #1
Permit Number D17-0197
Dear Mr. Bidlack,
This letter is in response to your written request for an extension to Permit D17-0197. The Building
Official, Jerry Hight, has reviewed your letter and considered your request to extend the above
referenced permit. It has been determined that the City of Tukwila Building Division will be granting an
extension to the permit through September 26, 2018.
If you should have any questions, please contact our office at (206) 431-3670.
Sincerely,
Bill Rambo
Permit Technician
File: Permit No. D17-0197
Tukwila City Hall • 6200 Southcenter Boulevard • Tukwila, WA 98188 • 206-433-1800 • Website: TukwilaWA.gov
Bill Rambo
From:
Sent:
To:
Subject:
Dear Rachelle and Bill,
rick signalsandnoises.com <rick@signalsandnoises.com>
Thursday, March 8, 2018 10:16 AM
Bill Rambo; Rachelle Ripley
Permit Extension
I hereby request an extension for permit 017-0197 for the construction of a small shed attached to my residence at
4261 S. 144th St. At this time the shed is complete with the exception of the external siding and the rain gutter. Due to
the fact that my wife and I are both self-employed, with extremely busy schedules, it is highly unlikely that we can
complete this work before our permit expires. However, we do expect to complete it before the end of May this year.
Sincerely,
Rick Bidlack
206-760-4954
Request for Extension #
Current Expiration Date: 3-2-?
Extension Request: 1
Approved for /C -U days
Denied (provide explanation)
Signature/Initials
1
RECEIVED
CITY OF TUKWILA
MAR 0 $ 2018
PERMIT CENTER
2/1/2018
Q
City of Tukwila
Department of Community Development
RICK BIDLACK
4261 S 144TH ST
TUKWILA, WA 98168
RE: Permit No. D17-0197
BIDLACK RESIDENCE
4261 S 144TH ST
Dear Permit Holder:
Allan Ekberg, Mayor
Jack Pace, Director
In reviewing our current records, the above noted permit has not received a final inspection by the City of Tukwila Building
Division. Per the International Building Code, International Mechanical Code, Uniform Plumbing Code and/or the National Electric
Code, every permit issued by the Building Division under the provisions of these codes shall expire by limitation and become null
and void if the building or work authorized by such permit has not begun within 180 days from the issuance date of such permit, or if
the building or work authorized by such permit is suspended or abandoned at any time after the work has begun for a period of 180
days. Your permit will expire on 3/26/2018.
Based on the above, you are hereby advised to:
1) Call the City of Tukwila Inspection Request Line at 206-438-9350 to schedule for the next or fmal inspection. Each
inspection creates a new 180 day period, provided the inspection shows progress.
-or-
2) Submit a written request for permit extension to the Permit Center at least seven(7) days before it is due to expire.
Address your extension request to the Building Official and state your reason(s) for the need to extend your permit.
The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is:determined that your
extension request is granted, you will be notified by mail.
In the event you do not call for an inspection and/or receive an extension prior to 3/26/2018, your permit will become null and void
and any further work on the project will require a new permit and associated fees.
Thank you for your cooperation in this matter.
Sincerely,
achelle Ripley
Permit Technician
File No: D17-0197
6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665
Building Permit Application
Rick Bidlack and Sheila Coppola
4261 South 144th St.
Tukwila, WA 98168
Parcel Number 0040000370
206-760-4954
rick@signalsandnoises.com
Project Description
Demolish existing 108ft2 (roof area) dilapidated and rotting pool shed which is attached to south wall of
house. Replace with slightly larger new structure (128 ft2 roof area) built to modern standards and with
greater roof slope. Pool shed is not insulated and has no electrical power. There is no passage between
house and shed.
Drawings
1. Site plan.
2. South elevation.
3. East and west elevations.
4. Framing plan and roof details.
Roof
REVIEWED FOR
CODE COMPLIANCE
APPROVED
JUL 2 7 2017
City of Tukwila
BUILDING DIVISION
EPDM roof to be installed by A Better Roofing Company, 4126 Airport Way S., Seattle, WA 98108.
Contractor license number: BETTERC 052 DT
RECEIVED
CITY OF TUKWILA
JUL 182017
PERMIT CENTER
Dl'I-0111
QERMIT CORD COPY
PLAN REVIEW/ROUTING SLIP
PERMIT NUMBER: D17-0197 DATE: 07/19/17
PROJECT NAME: BIDLACK RESIDENCE
SITE ADDRESS: 4261 S 144TH ST
X Original Plan Submittal
Response to Correction Letter #
Revision #. before Permit Issued
Revision # after Permit Issued
DEPARTMENTS:
A-3 No 1 11'1
Building Division
1\1/°\11
Public WorksI�1�1
NAS /IMO MO PM212.
Fire Prevention ��� Planning Division
Structural
❑ Permit Coordinator
PRELIMINARY REVIEW:
Not Applicable ❑
(no approval/review required)
DATE: 07/20/17
Structural Review Required
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS:
Approved
Corrections Required
DUE DATE: 08/17/17
El Approved with Conditions
❑ Denied
(corrections entered in Reviews) (ie: Zoning Issues)
Notation:
REVIEWER'S INITIALS:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg 0 Fire 0 Ping ❑ PW ❑ Staff Initials:
12/18/2013
0
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.tukwi]a.wa.us
Permit Center/Building Division
206 431-3670
Public Works Department
206 433-0179
Planning Division
206 431-3670
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
STATE OF WASHINGTON)
) ss.
COUNTY OF KING )
[please print name]
, states as follows:
PERMIT NO: I" I C
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 requiremnt of RCW 18.27.090,
I consider the work authorized under this permit to be exempt under number 2 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.
Signed and sworn to before me this
Svf-
day of
cb
NOTARY PUBLIC in and for the State of Washington
/r
Residing at Com)(/ - , County
Name as commissioned:, \AS f ! V CA C
tis -9
My commission expires:
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;
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;
ii. 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;
qty
18. An entity who holds a valid electric4l contractor's
license under chapteri9.28t RCW that employs a certified
journeyman electrician; a certifiedpres'idential:ispecialty
electrician, or an electrical trainee meeting the
requirements of chapter 19.28 RCW to perform plumbing
work that is incidentally, directly, and immediately
appropriate to the like -in-kind replacement of a household
appliance or other small household utilization equipment
that requires limited electric 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 Department of Labor and Industries lessee has
been interpreted to be equivalent to owner for purposes of exemptions.
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