HomeMy WebLinkAboutPermit D18-0048 - NGUYEN RESIDENCE - LAUNDRY ROOM FLOORINGTRI NGUYEN RESIDENCE
13222 MILITARY RD S
D18-0048
Parcel No:
Address:
0
City of Tukwila
4
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
7346600265
13222 MILITARY RD S
Project Name: TRI NGUYEN RESIDENCE
DEVELOPMENT PERMIT
Permit Number: D18-0048
Issue Date: 2/27/2018
Permit Expires On: 8/26/2018
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
License No:
NGUYEN TRI
4229 S 144TH ST, TUKWILA, WA,
98168
TRI NGUYEN
4229 S 144TH ST, TUKWILA, WA,
98168
OWNER AFFIDAVIT - TRI NGUYEN
Lender:
Name: N/A - UNDER $5000
Address:
Phone: (206) 375-9706
Phone:
Expiration Date:
DESCRIPTION OF WORK:
REPLACED FLOORING IN LAUNDRY ROOM DUE TO WATER LEAK
Project Valuation: $300.00
Type of Fire Protection: Sprinklers:
Fire Alarm:
Type of Construction: VB
Electrical Service Provided by: TUKWILA
Fees Collected: $74.12
Occupancy per IBC: R-3
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:
2017
2017
2017
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: Li
I N I 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 pe.(9_1A
mit an agree to the conditions attached to this permit.
Signature: i A2-
Print Name: T i N�
►V
Date: 2-A 7 Pi ig
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**
0409 FRAMING
CITY OF TUKI4
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
Building Permit No. 11)1 �
Ob�-X
Project No.
Date Application Accepted: $/
Date Application Expires:
1
(For ofce 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:
if 2,2_ Nakollizcct
King Co Assessor's Tax No.:
Suite Number:
New Tenant:
PROPERTY OWNER
Name: ¶,.0
eil
Company Name:
Name: T7.t, Af_r,
City:
City:
Address: 2�
f
14 s
Phone: 2
3 75-_ citio tax:
City: _.( ,(/v
�l� l�
State:
„Syr
Zip97
1s
PERSON — person receiving all project
communication
Name: ¶,.0
eil
Company Name:
Address:
City:
City:
State:
Zip:
Phone: 2
3 75-_ citio tax:
City:
Email:
Contr Reg No.:
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:Wppliations\Fonns-Applications On Line\2012 Applications\ Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Floor:
0 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 INFORMATIO1 06-431-3670
V
Valuation of Project (contractor's bid price): $ 6 Q ,
Describe the scope ofwbrlr(please provide detailed information):
Existin
Ming Valuation: $
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
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 ❑ None ❑ Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes 12 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\Form -Applications On Linee2012 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
la Floor
2"d 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 ❑ None ❑ Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes 12 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\Form -Applications On Linee2012 Applications Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 2 of 4
PUBLIC WORKS PERMIT INFO ATION — 206-433-0179 0
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
0 .. Tukwila 0 ...Water District # 125
❑ .. Water Availability Provided
Sewer District
❑ .. Tukwila
❑ .. Sewer Use Certificate
❑... Highline
❑ ...Valley View ❑... Renton
❑ ...Sewer Availability Provided
0... Renton
0... 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) 0... Geotechnical Report ❑ .. Traffic Impact Analysis
❑ .. Bond 0... Insurance 0... Easement(s) ❑... Maintenance Agreement(s) ❑ .. Hold Harmless — (SAO)
❑ .. Hold Harmless — (ROW)
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 ❑
❑ .. Total Cut
❑ .. Total Fill
cubic yards
cubic yards
❑ .. Sanitary Side Sewer
❑ .. Cap or Remove Utilities
❑ .. Frontage Improvements
❑ .. Traffic Control
❑ .. Backflow Prevention - Fire Protection
Irrigation
Domestic Water
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
0... Abandon Septic Tank
❑...Curb Cut
0... Pavement Cut
0...Looped Fire Line
If
f)
0...Grease Interceptor
❑... Channelization
❑...Trench Excavation
0... Utility Undergrounding
❑ .. Permanent Water Meter Size (1) WO # (2) " WO # (3)
❑ .. Temporary Water Meter Size (1) " WO # (2) " WO # (3)
❑ .. Water Only Meter Size WO # 0 .. Deduct Water Meter Size
❑ .. Sewer Main Extension Public ❑ Private 0
❑ .. Water Main Extension Public 0 Private 0
" WO#
" WO#
FINANCE INFORMATION
Fire Line Size at Property Line Number of Public Fire Hydrant(s)
0 .. Water ❑ .. Sewer 0 .. Sewage Treatment
Monthly Service Billing to:
Name: Day Telephone:
Mailing Address:
Water Meter Refund/Billing:
Name:
Mailing Address:
City
State Zip
Day Telephone:
City
State Zip
H:\Applications\Fonns-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 105.12 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 0 NER 1 R AUTHORIZED AGENT:
Signature:
Print Name:
WO ')/ *CV
Mailing Address: I.f 2 e
H:Wppliations\Forms-Applications On Line'2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
bh
Date: 2./2 7 Z -d' a
Day Telephone: (2-196') 3 75 - 706
City
State Zip
Page 4 of 4
Cash Register Receipt
City of Tukwila
DESCRIPTIONS I ACCOUNT
PermitTRAK
QUANTITY
PAID
$193.54
D18-0048 Address: 13222 MILITARY RD S Apn: 7346600265 $74.12
DEVELOPMENT $70.80
PERMIT FEE
R000.322.100.00.00
0.00
$66.30
WASHINGTON STATE SURCHARGE
B640.237.114
0.00
$4.50
TECHNOLOGY FEE $3.32
TECHNOLOGY FEE
1 R000.322.900.04.00
0.00
$3.32
PG18-0022 Address: 13222 MILITARY RD S Apn: 7346600265 $119.42-
119 42 -PLUMBING
PLUMBING$113.73
PERMIT FEE
R000.322.100.00.00
0.00
$80.58
PERMIT ISSUANCE BASE FEE
R000.322.100.00.00
0.00
$33.15
TECHNOLOGY FEE $5.69
TECHNOLOGY FEE
TOTAL FEES PAID BY RECEIPT: R13877
R000.322.900.04.00 0.00 $5.69
$193.54
Date Paid: Tuesday, February 27, 2018
Paid By: TRI NGUYEN RESIDENCE
Pay Method: CHECK 3446
Printed: Tuesday, February 27, 2018 11:34 AM 1 of 1
WSYSTEMS
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188
Permit Inspection Request Line (206) 438-9350
(206) 431-3670
Pro�ec :
T3. No LAYen!
Type of Inspection:
j3,�; l c\ F i d
Address: \
/3222 f I1 •Ral,
Date Called:
S gec�ial Insiruc ' ns:
C;r►�lL. �C /`�i pnu�
l242eOOp'Requester:
C242•00
)'l.
Date Wanted:
59— Zo18'
a.m.
.m.
P.m-
!/IV/
l y u eN
Phone N� ((/
_ I—Z0cp-37s-
Z'
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
Dlstr iPl o/I/ 0 te----
(Re.'kac i v PLaar /.r3C) due o 1...ccuk
LeA m .
Inspector: 31_0(7
Date: 5.-Q
REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
CITY OF TUKWILA
Department of Community Development
6300 Southcenter Boulevard, Tukwila, WA 98188
Telephone: (206) 431-3670 FAX (206) 431-3665
E-mail: tukplau(aci.tukwila.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
YI W1
[ leas print name]
, states as follows:
PERMIT NO: KIK OC�Y,
Pig I�6 f�YL2
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 cor#struction work.
614/
Owner/Owner's Agg
Signed/and sworn to before me this
1 day of ft
rakiii0i4
NOTARY PUBLIC i and for t State of Washington
Residing at
Name as commissioned
My commission expires: