HomeMy WebLinkAboutPermit B95-0058 - NC MACHINERY - SATELLITE ANTENNA City of Thkwt (206) 431-3670
Community Development / Public Works • 6300 Southcenter Boulevard, Suite 100 • Tukwila, Washington 98188
BUILDING PERMIT
Permit No: B95 -0058 Status: ISSUED
Type: B -BUILD Issued: 03/01/1995
Category: ACOM Expires: 08/28/1995
Address: 17035 WEST VALLEY HY Suite:
Location:
Parcel #: 252304 -9010
Zoning:
Type Const: N/A Type of Occupancy: EQUIPMENT
Gas /Elec:
Wetlands: Slopes: Y
Water: TUKWILA Sewer: TUKWILA
Contractor License No.: INFORCI077PN
TENANT NC MACHINERY CO
17035 W VALLEY HWY, TUKWILA WA 98188
OWNER NC MACHINERY CO
16711 W VALLEY HWY, TUKWILA WA 98188
CONTRACTOR INFORMATION CONTRACTORS INC. Phone: 206 485 -7662
P.O. BOX 1043, WOODINVILLE, W 98072
CONTACT SHAWN GRAHAM Phone: 206 485 -7662
P.O. BOX 1043, WOODINVILLE, 98072
******************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Permit Description:
INSTALL 1.0 M SATELLITE ANTENNA ON ROOFTOP.
SETBACKS
Units: 000 .Front: .0 Back: .0
Buildings: 000 Left: .0 Right: .0
Fire Protection: N/A
UBC Edition: 1991 Valuation: 1,000.00
Total Permit Fee: 45.75
******************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
• /
Per' i Center Authorize Signature Date
I hereby 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 for and
obtain this building permit.
Signature:� Date: C73"C s
Print Name: j A►.av` H ( Title: /2n,0/1.61:..
This permit shall become null and void if the work is not commenced within
180 days from the date of issuance, or if the work is suspended or
abandoned for a period of 180 days from the last inspection.
All PERMITS ISSUED FOR NEW CONSTRUCTION, REMODELING, OR DEMOLITION PROJECTS
REQUIRE CONSTRUCTION, DEMOLITION AND LANDCLEARING WASTE MATERIAL FROM THESE
PROJECTS TO BE RECYCLED AT A KING COUNTY LICENSED OR APPROVED FACILITY,
OR TAKEN TO REGIONAL DISPOSAL FACILITIES.
J�` CITY OF TUKWIL1-
94 Department of Co y.,nunity Development — Permit Cent r'
ej s,
k , kw .z'. 6300 Southcenter Boulevard - #100, Tukwila, WA 98188
C
lig (206) 431 -3670
Building Permit Application Tracking
PLAN CHECK PROJECT NAME "r
NUMBER A C. /V,AellI/Uee'j
.!
SITE ADDRESS SUITE NO,
PAS — O 0.5 6 c esT • A- i ,
INSTRUCTIONS TO STAFF
• Contacts with applicants or requests for information should be summarized in writing by staff so
that the status of the project may be ascertained at any time.
• Plan corrections shall be completed and approved prior to sending to the next department.
• Any conditions or requirements for the permit shall be noted in the Sierra system or summarized
concisely in the form of a formal letter or memo, which will be attached to the permit.
• Please fill out your section of the tracking chart completely. Where information requested is not
applicable, so note by using "N /A ", date and initial.
DEPARTMENTAL REVIEW
"X" in box indicates which departments need to review the project.
:DATE,
DEPARTMENT . DATE IN ` REQUIREMENTS / COMMENTS
:: :APPROVED <. ...
BUILDING - Z 2. 5 CONSULTANT: Date Sant - Date Ap - _
` c �G} u
initial review ___(ROUTED
S. 4.. A FIRE PROTECTION: Sprinklers Detectors ( ) N/A FIRE
4/791 - FIRE DEPT. LETTER DATED: INSPECTOR:
INIT:
+PLANNING r 2, Z_) . l - ZONING: IBAR/LAND USE CONDITIONS? el No
'Z(2 1t45' REFERENCE FILE NOS.:
INIT: c MINIMUM SETBACKS: N- S- E. W-
O PUBLIC N / UTILITY PERMITS REQUIRED? �]' � No
PUBLIC WORKS LETTER DATED:
WORKS J S INIT:
O OTHER
INIT:
r TYPE OF CONSTRUCTION: CERT. OF OCCUPANCY? UBC EDITION (year):
0 BUILDING - final review INIT: 4. Nfr g i WA 0 Y es ANo 1991
g BUILDING OFFICIAL /��� .
INIT : • ' .
REVIEW COMPLETED
AMOUNT CONTACTED
OWING: l_r._ 1 1 � - . //•� A • •
DATE NOTIFIED c BY:
E3
(init.)
2nd NOTIFICATION BY:
(init.)
3RD NOTIFICATION BY:
init.
01108103
BUILDINJ PERMIT
APPLICATION
CITY OF TUKWILA
Department of Community Development - Building Division
6300 Southcenter Boulevard, Tukwila WA 98188 DESCRIPTION AMOUNT `RCPT # ': 'DATE :<<
(206) 431 -3670 BUILDING PERMIT FEE.... ;OAP.
PLAN CHECK PLAN CHECK FEE •
NUMBER 906 (� BUILDING SURCHARGE
A PP LICATION OTH
_ 2.
TOTAL `i�� �
SITE ADDRESS SUITE # VALUE OF CONSTRUCTION - $
170 3 5 WESt- d'Attty $4°°°°—".
PROJECT NAME/TENANT ASSESSOR ACCOUNT #
./V J"JA_I wc-gy H-2 '2 ?oLf -- 9010 --0a,
'6 New Building U Addition 0 Tenant Improvement (commercial) U Demolition (building)
WORK: ❑ Rack Storage 0 Reroof 0 Remodel (residential) Zi Other: SA1li.t o-c VisN I NsTALL,tT,vIJ
DESCRIBE WORK TO BE DONE:
'',vs1 - 4LL, i,oii, SAIL -G[ ,t1 p l,) nA)A o f700F
BUILDING USE (office, warehouse, etc.)
NATURE OF BUSINESS:
WILL THERE BE A CHANGE IN USE? ❑ No 0 Yes If Yes, new building requirements may need to be met. Please explain:
SQUARE FOOTAGE - Building: Tenant Space: Area of Construction:
WILL THERE BE STORAGE OR USE OF FLAMMABLE, COMBUSTIBLE OR HAZARDOUS MATERIALS IN THE B ILDING?
0 No 0 Yes IF YES, EXPLAIN:
FIRE PROTECTION FEATURES: 0 Sprinklers 0 Automatic Fire Alarm System
PROPERTY OWNER /v C 14 q cN 1,o NKt/ PHONE
ADDRESS / 03S k' vILL6 Jwt _ ZIP
CONTRACTOR ` � i.>z�fi>aL PHONE 20_yZS" "1 Z
ADDRESS ZG-C � 3 L ciZtvv, llu UJJ ( Z- ZIP
C�U
WA. ST. CONTRACTOR'S LICENSE # wc_09.G 10 EXP. DATE t'p_
ARCHITECT PHONE
ADDRESS ZIP
1 HEREBY CERTIFY: THAT I HAVE READ. :AND : :EXAMINED :THIS APPLICATION KNOW THE SAME TO
BE TRUE AND CORRECT, :AND .1 AM? AUTHORIZED' TO:APPLV FOR ::THIS::PERMIT,
BUILDING OWNER SIGNATURE . DATE
OR
--� OZ— 0I —RS
AUTHORIZED PRINT NAME Slnctklh 1 , CS.rcxGat.,• PHONE o_ob- L{
AGENT ADDRESS 2 0 atx 1041 CITY/ZIP wf0.94v<UtI(Jl q 9o3-Z
CONTACT PERSON so.�0,A `� L � PHONE . 206_ L i 9S x-66 z
APPLICATION SUBMITTAL In order to ensure that your application is accepted for plan review, please make sure to fill out the
application completely and follow the plan submittal checklist on the reverse side of this form. Handouts are available at
the Building counter which provide more detailed information on application and plan submittal requirements.
Application and plans must be complete in order to be accepted for plan review.
VALUATION OF CONSTRUCTION Valuation for new construction and additions are calculated by the Department of
Community Development prior to application submittal. Contact the Permit Coordinator at 431 -3670 prior to submitting
application. In all cases, a valuation amount should be entered by the applicant. This figure will be reviewed and is
subject to possible revision by the Building Division to comply with current fee schedules.
BUILDING OWNER / AUTHORIZED AGENT If the applicant is other than the owner, registered architect/engineer, or contractor
licensed by the State of Washington, a notarized letter from the property owner authorizing the agent to submit this
permit application and obtain the permit will be required as part of this submittal.
EXPIRATION OF PLAN REVIEW Applications for which no permit is issued within 180 days following the date of application shall
expire by limitations. The building official may extend the time for action by the applicant for a period not exceeding 180
days upon written request by the applicant as defined in Section 304(d) of the Uniform Building Code (current edition).
No application shall be extended more than once.
If you have any que ut our process or plan submittal requirements, please
contact the Depart �' oWJunity Development Building Division at 431 -3670.
DATE APPLICATION
ACCEPTED FEB 2 2 1995 DATE APPLICATION EXPIRES
JT
a CX V• 1 ✓__ PPRM cC �/ - V a _ ��J
t,r 10/72/93
k.
SUBMITTAL CHECKLIST
COMMERCIAL ..... ,. ., . .. .. .. . ...........
d
State.licen
o COPA .... 1V 6 1 ! , . ,...s R : i r ie . t; d . T bi J ENA
Hdi :: . ..: r :p ' o Il'4 or I) ; : : :: 7 VEMEkta
- 4p011:‘Htl9n'.(:°::::•n6:;!:'r::i?4Pkl;::Sj;r!;;.;.::7P4;;7.;
Asessor•AcCount Nu
.' ... .. ....
NEW COMMERCIAL BUILCINGS/ADI)ITIONSI.•••..-:- :•„.... :,.. ,.......
7-2-T : CoMpletedbullding pe ,,,,„......,.,...‘.,..,. ,,...,-.......,,..,...::..•,.., ........„..: ......,,,....... .. , .,.,... .. ...... ,•,,... ... ,,. . ,...,,::.,,,,,,, ..,,...............,:,..,.... ,,,,::,,.,.;,,,,,..:..,,..::.
S .., ,..,......,„,.........,...: .,.. 1 j Assessor Account Number
:,-..::::::;•....::,:,::::-::::::,::.:::;-:: : . : ,: q .. . : nii: , .; , ' , ..: -. ..'. , :,.:,.. ; ,: - ,;.: : :::;',..i - : ::: : .;, - ... : . •: : . ,:,..„:: : : : .,.. , .,;,:,.11.. : , :. - , i . :h-, v , :.:i
.• • . . . • • ' • • . .' ' .: ... .. ' •'•••:fO.....tr68...06ii:plfttia•;':WIiiCfi....."friC...1.t.i...0e.....:.,:.,:.:1:,.:::.:„.:::.:!1:1:::.l.l.i....:,.....:',.....•:::::::,•.,:::::::•:::..!..:i.:::.!:.-.!;:•:;:::::::::::':':::::::::::::.:
-..•' (2) of the following t
....:...:- . :..,...,:„...:„::::,..,,...,ii;::....w,:..:.....„..i,..,.„..,....,,,,:::::,:::,,.,.... ,..u.i.s4(3,ple!.p..:.:,..i.::.„::„..i:.......i.,..,:i1:::„.,‘..,:::::,..,.,.,:si.::::;,..,,.:, ::::.:.x.i...i.;..,.,Ip.....,..,:...........iii........ii:.:.....,„..0i,;:,:m..,...i........:.....,:v,...:::x:m.i,..:im..,:..,...
F—•i . :.:...........,,
. • • . . • ‘.: .. . ' ''. ::'''''''''..•:•• .''''••••••:' ,...„:„.....,..„,...,.::.,........,,.:..,......,......:.?.. i.,,,,... ....,:,....i.„.......,.i....,......:..i
•• • hirigtri se,:.. ........,.,..„..........,
,....,•,:„....,.,..,:.,........::„...:•::,'wExnisctlisrig..:a. 2,.d.sr,„..r..no...,po.o.r.,a ,e.pdolri;ti.,r■<11,noif:,i,:.:•:0i:i.,ii.,-,:....:4::.....:ii;•,:....„...,,?!:j„..i..:•••:,,,..,,,:.:•••!i,.,......):„.,..?.:!...,!:::1.,...,!..:::!:,,..:............:::!!....,......:....,!..i..:............:.....!;.,.!........:
'• - • 7...:`:'•!:7...t. s..,,.t.a... W y' - - . ... . .. ••••-•:•-••••••••••.•••••••• : .:.:.„.,.::.,..,...
Fi.sollsiropor.t stamped by p.,. Washington
..... State , ticensed en:8 :' E ..... .0yerall bui .. ..R p lan
....—:.:........,,.... .. ... .. , . .. ...., .., , . . , .., ,,. . ,. .. ,. ,
:::::.i . ..,....,.,,..,...„,,..,.:.....
— ' .... 1:.suPIE) . ''.. • •• •• • :'''' 1 : 1.. ':: :: : '. .:! .'. ....! . ..'..:1 . :! : ::: :1 ::',... i . l : ;; : :: '..... i ...•'..', : . : .','......... .............................................................. .:.,.:,:::::..::,,..::::::::Ugb.-cit:Eidjatjenticorrlir.o...h..i.W., PI.1).::tentint':'i':::'P::::::::M...:':::::',::::::::::....::::i.:;::::::.;::::.:::.:.:i.::,.,:::!:::
-- Eriergycalcu . lationS: Stamped by a WeshingtOni:State:lIcen ......... is ' " ".•."'''::'."•':'.• iall-:d..ini prOpPerision s of.b ,U110ing:Or f . : Sciti ....:.. are .......„.. 160ta ...,......: (1!
...i..;.i
ongln Legal.descrip y- •• ' • :•••,•••-•••• ••:••-•.•-•.,:.•:::::•::::::::::::,::::::..,.,,,:::•:::.:::,...„. .:.E Floor:plan:of, proposed tenant :.s. 0:,..",.:00...,::::-,1„-,,,,.:•,:,i...:„..:...i..,:i.:,...„:::•1$1-,.....:.:,:c..... .....................................................................................................................................................
oor or architect:::: ......:::•... „::.......,...............,........,, . , ...... .
— .tion
':::..:-..... ... ... ......... .... •, • .. •. . ', ...... i ll , , ,J
,....„,,..„..:,,......:.:,.....,:,..:.„,,,:,..•::::„.,:,..;:,::::::...,...:,.,..„.:;...:,..,...:.:,
=, ‘,,,,torking drawing • Washington State licensed :',:;'.'!:;;:-.:;•-:•::''::::::::: ..1.....:::::..,::::,..:....„,...i. Tenant
Irsr E iti6 ; •esiting wi i ii: , :.of i o yia.,......7:.„....,....,,,...,..........:‘,...,,...,..........,...,....‘...
• --- architect, wh ich: inolude: :: -•....:-:',..:.••••;•••:::":"•••,•:••••:::•.'...........:.:.....,,...,:..,.:,:•:,:..:::,., ....1 :.constrijction detalls.,.•:•::••:•,...:•:••.%•-••••:••::::•••,:',...:•:•,:• ...';''......•:::.:......•:•;:;.:.....-,.::::::•.]:.,,i,,,,,.•,..,••••••••,-:.::..:,„:::::•.:,,,.:
Site Plan '' ••:::•'•••:•:. . ••••:•••• . i . ..::!; . ::::••••.:::::::..::::•••:::•::;:::•:•:::::'•:•.'.'•••::::•':',••••••:•••,•••'•.•:•:••••:•:••
• • • ' 'Architectural drawiriga:::...--::::•.::::.::-,•:•::,,,,,':',....-- -..-'," • - '.....:...,„:::,...,:.„,,,.......,.•.-..•:.
. • .' :
''' .:-•••••-• • • 'Mechanical draw...„ . .... ::: .. ,. .....:i r s : : r ot o i r i t, i 0 6:( c. b b t a tj
.re 06 1 ,s tar a,. siln 6te ti .lieen :•
g in s g;: . ' .... . :::::::::::::::::::::::::::::: .....:,'.:::::::::.,-,,'..;:',:"..:',..,,.....-„,......•"..•:.....,,,,......,:.„:,.::•::,,..::...::::::...,i.: :',.••••:•.',•:',:..:•.:•••::::::::::•-.........•..4.fltrt(l).,::harne.e.ct...rtiOs.r„.sflht:i°Owf.itinn9d7oeaitll'ine'..agh:..;!thi.,.•,•:::•,......,1.6..-..119....,.......7...,......',rn.„...e....,,th.,..::°...,...P,,......7!'...'....!,,',...,:..:...,,,..'!.
....:.:::''''' : • Elevati°ris' : , ...., ,..' ‘....,,
::":::".: : • :: . ' . •''."••••• neer may -: . ....:.:::...,,,......:...:,........,......„..., . : .. : ......,.::..:„..„,,,.....„ .. ngi. ,,... qUre Eilf" steuct uralworit laf.t0•:b,...
:::::..„ •:.•••:::::',:•....• ... Landscape plan ,:'..,.2...,.„....,.,........ ....,...:......:..........„....„.:...:„,-.•„...:...:;.,:::•.„.. . .:: . .:• j .: . :„ . ., , ,..: . . , .......: :: ... i . : . , : , ,...:,.„ .: : :: : ., .. :,i ..,..,....... , ... ......
. . . I i tone tire •:p.te199 :::...„....,...•-.„..:.:.•
Complpte ... •
... ....„......... . .„:„,........„,....„,.....„....:::::.
:.• 71 S .--'-. •. s
9:: for en
„.;':„...„':;:::.:..1......:...1:!...':::........'...:,..:,',.:.::..::...:'.:::,'...;:. :1, ,, F; Fip . . ..:,.....',..'. . :: ... . ........, .. ::::' :. :1'.:1........1.7,•.::%.:.':::::R:::•,:.;":::;::::]!..:::;:::::.,,....;.,:::::,
NOTE se Utili ...i'..:1:.:.":;:::::
':::: - 0 zy d ; permlt 1,t:.a..pp.1i.d.ation::a.0....0.,h.,fic..,.k.i.li..s.t. tor .spac Y ...:::.. 1 ...:....i , . : :,.• ::..::.i.:,. , .... ;:i:....:
1 i submitt a I re qu ire (73 6 .... n t a . , • :.: .... .,. : :. ,.: ... ..... ,. :. :.' . . -. .. . . . s '. . '. 1 :111Y': ,: taiad.buiidIng' permit .'appliCatio' ti...:a!!
i:'{-1:.C°n1P • • ' •••••• ' ' ' ' • -• : .::::.....i...... .:..,,,, .. ..
AssessorAcceen: .
.,,.........„:::,,,,,:::::::.,.:,,::::::,:::-:::„..•.„..,„:.•„„...............,..,..,:-.....:.... -
RAC STORAGE '.•.-.-:••.•.•....'.•:'..:.-•-•,.•:•• l .•: :•• • . . ' ,... : • -•. • •' ....•......:.„..•••••....•':''1::„.•'.....:.•:::..'::'•".::':::',..;•:•...:.: .. .. • . .. ni f■1 a . t
Comploted.bUitcling per ................ .,,..,:••:,..,.......,,...... . . . .. . ...,........„, .......,,,....,....,:..,..,........„ .wO rti /ice ............................
........ a :ridr,.td'.firal: 1 S0
n ,,..... ... q ..,. . o .... ., I s:. : andsign :.,
1 Assessdr•ACCoUnt•NUrn er,........ ..,..:..., .... ... ....,. off i 09p
ANTENN//847:1441: DISHES .... ...: : ',: . " . ..; : ......„:.::: : , „ . ..... ,,.. ....::::: ., .. , .. , , , ....' .. ... , ........ , ..: • '''. , '''' . ; ,.......„..:„..........,..... ......
.............,.........,......„:..,..,.......„..,.......„........„„„.......,,....,......,....).„...„.......
. •.- •TwO (2) sets•of plans;
1 Building floor: plan showing ......'::..•. . . . . r , .• . . . .. . , . . . ... . . , .... : 1 . . .::. , .. . . 1t plica tion
Entire spaCe ..':• .. :::':.'::: .. :-.::::" ... ,.,•:''..:'-',::":,:•-::::.,:-...'"-.:•••••:.-:.•:-..-.,......,......‘'....•
' ' ' . ••••'••• ''•:" •• 'Completed bulldin , , , , ...,. ... .
. - • • • • : tivhere racks Will be
, i loc .,. ated .... .;'........::::i•:':• . ' ,.. :1: : :::' ..., : : ... .P ()rm 7 . .. ... ...,-,.......::.:::::...::...•.:,,:...„.......,....,...... ..... ... ... .... . .........:,........:,....‘....
,
— t ur4dr.:....: •:....:::........•,,,....•,...............„„.,......,....... .,. ... :,‘
" • • Exit doors Assessor Number
''': •••••:;' ''• . y' ••. •: • ,...•.: .- :••:-.-:.:..:'::::!:.•••„,•,:',..'„,, : ::'•,•,.... •- : .., ....„.
• Dimensions of•all aisles :::*•. : : • • . ••
.:,... • ::•:......,....:..,:::!..:... .::::: . Tenant space c3 ...„... , (2):Seta:Ofplana;:.■iyhtch'include.
oxits ..,:,,:„....,,.....,„,.:.,....,..„..... . :,.... ........ ,.. . .
i . floOr plan showing rack.s.tiorango...layout,;iais17s.,..a7,....,....:,......,..,...,.;,....•:: ,:.1.._11.9
. :.s w it9. .. :,p . ..... 1 . , ... n . ..... i1:1 .. ,. . ; , ... :.:!1?: . :„,...ti ) !:.:ip....,:o ' ...,.. i i..;‘....,.....,,,, ' ...6ci.: ...,........ )...... . 9,. . „... ..... iii7,.../...:• i ti . , : i..ii...., .. te...68rissiiEd.i:iii4....6.,. . 14...iit:„......„:1,...,:oti...,,,,•:,.. , d::•,. : !........: ,
NOTE Include di .......:;.,..;:,......:.....:
' . • :•••••:•• '••• : • •••• ' •••••••"••••: . - - . •• •
77 ?!......i . %,•:""-..., . •;:a:':';'..'•••::
: nionsions of racks
. ..:(h . t .. , Ut and leng
and exit ways .,,..
. on plan ::::,•,, ,:.:,,,.,:.....:,..,:,,......., ., .... width
..,..... :.:-..' ......: ..: ..' : ... : : .,:.. ..,. .... . 1 ;4 '.. ,:.: .. ., :.:;: , : [_ D e IS 'antennii/dateIlte methrt ua
• 1 Structural calculations . stamped-bY:a Washington S .................. ::::..E---..7..,:::eSr.iteg°1c4(jc)r7ri/):)°ICyG:1.:.:.tirfiClii(,'!:';....ii:it....:di::6d..,::::.:.;..t.:...:,..,.•.:;:!..:::.•.:::.:..:.:..."..",.....'.....'::.1.":7:!":"....;...f....7::'..4.!;."...i.::!..::::.......:::1..:ii:...aeh....!:•:.:!:.;.°d
engineer (rack :......::!"'";-...1...:‘.'..;.....!!..1::::.:.
rackstorago and ..oye...r): . •:::•::•:::::•; -.......... . - ....
.'' - • - '''''' - - '
.....„.
RESIDENTIAL . . . . "........ • ...,,,:•••••••• ::.:: . : . ::. . SINGLE FAMILY DWE ::.::•:.,......::::::::.:::::, ::•'REs!pENTIA1......9 . .... ...,.........,:;•.•, .::::...,......::::::..,.....,.......,..::,:.::::.......::::,.,.:.:,.......„...„..:......:....:::t.,.......:.,..:::....:::,,,..::,...„....
NEW LLINGS/AppITIONS •:::::':„..1...,::'.,..,•..:..:...:..,....,....,......
:•Ei epsIsaoterdAcbct.i?iludinn....'tg: -0•LemrM."...iy....:•a...„':,p1,OI.::i.....id....,..i...:..a..:,..:.i..,...:tio....:::..,:n::,.:....(.....:,.0,::.;.:...n........‘.:.,e.'f?............:r:•',..,,e.....,..i.,:a.....,.....i...:9!:.:,.,.:,..:.....:,,......,,i,::::.!:.......,,.....i......:......„:F,..::•,........:::,..'.........i..°) •..:,....."....1:•:...:,"::.:,....'....::•il:.:,...:''''..i..:i.
-- Completed building peeMit applicatteri ... ..... . , ..
_____
Legal. description '..: ' '':'' ' '' ::: '' ..: ...:' - • ...... . .••:':).':',:;...::::"."....;:•:::::::::::::::::::::.:•::: :1 1..T.WO,..(?):.....i.......i?!.•:....,.....!..!),....c;!,.....'.i.:-...!...7,5,...!e..:.....!!....:i7:::::::::::::.,...,i,..i:‘,,:::.,..,,,;:,.i,:..,:-..,.......i,:;:::',,,:::::::.;...",:::::,,,.,..:.,::.....‘...,.:;.;...,.:::.,....:......:::...,...,..;,..,,,...,,,,:..;:.:....:.:•:...i,.
• ." " -- - • • -.. .. ...... . . . .... . .......„.......... .
— Assessor Account .... ., , ... ...... , ‘.. .. .,. .. , t,___.i . ., . , ...
- ing drawings which ' s:;:: iriclUd ..,.......,..::..„...‘::.,......., Fan
i ,cl., 6 p l t. .. i .e on ie :.c y . , a .. 1 ......: 0 ,9 , o i ii . 4 ........ (0 ; .),1 ,: i i.,.. .... 9)!,y , :;,.: : : . ,i , i . . : ,... :i . : ), ;,... ..: ,, t .. . :. ! :, ..... : ;:. :: : : .,: .. ....: , , .. ,: : , ,, ,, : . ! .; :: ; ; .... ,. . „: • ,•, ,: .: .;, ,,., ..... ,:,- : 1!i ..: :: :„. ..! ,,, .. 1 ' .:: :„.' .. ... , :.: :• .... :!!: : " :: !: ' . : : ;, ! :. !........:I i i ,. : : : .; :.. : •: ' :., .: . •! .. ...: ,, :' , : . , ! ; :f ..... !! .: . ! : : : :. : ,. :: : ,..,• •• • i ! .. ... , :: ' ,„ ::: : : . ...! :: ' , : .. ....i.. 1 : 1 .: ROO f I of work
. ...:.• •. ,• site pan : . • • •• • . p la n .:,§1 .....,.......,..,„.:: i
: .. , . : - .•.* FoUndation'plan-:':::: : ;::: : • •••:•:: : ! ! .:.,::•:::: : :. :: :: w ldll y. end lerTftt 9f....a....C9!,.)...::.'.::::: :i-'•-•:.:•••..:.•••••:::.:-•••''''
Root plan ' • • : • :: • • : '" • Floor.plan'....:..:':::':'i:i:::::••:.•'':.•::.....•:::.•• . .. : : : - ,.....,•... : „,, ::: -.... ••• Structural - - - 'fiEtenIng plans
':••::::::••:::::::::::::::::: : :::: :::::::;;: : :; . qii . N;; : .1.::::::N,:.!; , ,,..,..„:.1 . :;..:::.:,• . ? i , ,..::: • :..,: : : . ;; ;;; ... : ;: g;
1.•;:•:1•,,:....,,..........•,-:::::.,:,'::::::•:::::i.:::::W.-::::•:••::::::::::::::::;i:1.1.';:i:ii:::::Ml:'::ii! ,.jiiii6i•.ii..:eiiiiii:liiiiPIICOPC?!
plans !.:::::•:•.:::
-• - :. . - •••::. Building eieYatinna::(0".1i9Yv..)•".:•:'::•:••::•V:...„]:•.:':::::.p.:....,.:;:::::-.....:,::,:;.:.:;::::::::::::::::::::::::•::::. ....••i.:1/.,..:!!-•r*..: °.6.1.1#6:(1'......,-1s:t:ClEti...;!..:......?..c.:Ci7....1;!...,......(7,.....:.:iii:,..,,....,iiiii,:......::::::::;::i:..;..!...i:::::..;:.,:,1::::::::::::.g...::::41::::11:::::,:,.;:iiii::::::::::.:•.:•••,"-i:t.!.;:ki
' , .•:.....' Building cross section NOTE !'.::,-n--..:...::••,:',:,;••,::.::,,,,..:::,.1..,::::..::::::::..i::::..:;-.::::::;::i.:::::::::.;•:•::::::..:-.•::..:::... :e....*nd.,:mustie.......a....lO71!7'...-....,;•.:„:!..::.;..:;.,................: i . .i . , ........ „,.......,,..,....,...i .........:.,,::::::,........,
•• . ticc41.
1:Washington .State Energy„
HEROOFS
ri Completed utility, pa,application ,...........„,....-...:::.....:::i:::?::::::::::::::::::::::::::::::::•:::•:,:„.::::::•,,::::::::::•i:::::::::•::::::::::::::::,:sii::::::.:.•::,::::..1 ..-•'-:- •.:•:.::•••••••••:,.......:.••••,:••••••:.•:••::•••••,.::-"..,••:.,:,..••...191.. (one ?„.. P ................•,....:•::::::::;:::•:.:::::::„......:::::::::::.:
.....".....„..., : .,.:...:....,,,......,,,:.,....i.:.::•....-m:::,...,•.:::.:::.:,...::::::::::::::::...:::m„.•:,H11::1,,::::::;.:',:,::::,:::g.:;::; :::::1-1...060ploted4yIiiii
..........1:1qP.eithit tipo
...:: :.,.,,..•.,::,..,...,.......]::::::::::,„:.;....,•::::;;;;;I:•,...::ik,:i.,.::::::::...:;:::::::::;::;:;ii•:::::::::;!•:.:::;;:::::;::::::::::::::::::',•:::::::::::::0
• . ...... ... . ...... . , . si, . each
.-.1 (6) seta of site plena .
..,::::::::',',:'•::Y:,'::::;:::::::::'..". !
.i!:::: i....,..FT..., cil g [1 Assossor Aciunt Number
A/OTE;:: • ste'p/ait :ft;E:f Utf/ity..:Sire plan .
f'i°4b°.1c9111? : :•'' . ...•••••••••:••:r?i4f) . ..f!iii.... y .! . ! ... .. 1 :74! . : : )p . ;...... : Ilea:'! :: ::' :-.: !• 0 :."::':: ! •::.0::•Bil:::q:::iii i ii:jp;::•.,•i:::::: : :i: : :•,1..5;ii!: : :::ilii: :: 1::: : : : li . ii:1;:i:::i:',::: : " •. itg. :
Bulic li st:fOr i.s.pec1(14•..,sepItT...,....T17.:.f:, . • ..
0 i ...,...::...,.......i..,,.,,:..:::::::::::... 0 „... .„.. i,::i.'::.c*:•:::•:.::.:•'•,0r/01..::i.:sii::iiiii)':.kiiiii4gioi:i404i:0/1.:t.::::::
;:;., ibcii-E::.;;kiiirw.fidijiii:io.:Ip.t :rp9 1 f:::...:::::;:;::::::.;::;::.;:::;.:::;::::::: , ::::.;:::::;:::: . :k::::::::,:;: : : ; :;:::::: . ::: . : :;::::::;::: ! ::: ; ::.::rdi : :;;:;: : ;: : : i t: ::b: ,, : exisdng roof, material baing removed, and
‘ Pe r''''...T•,;'':f1 end.eheak ;:.;5'.;::::;..':':';'.':':•:.::::':''.'..':':':'''''''''.:;'''":'"';e;.::::;ig.:;itio-ozreo.# ,0(000; .:;:...;•;# . .; ; • -
Additional tional tdpdgiiiphiCala q
site.conditions.: ... : • • :
•:,:.,.:.... ..:......,-, . . ... . . --- •
1, 0.
***A*A.A** *** *A*•kk**** **k* kit**• kA•*• /**•.1*• ***A****A****:kA* ***•.1•*** **A GENERA 25.00
CITY OF TUKWILA, WA TRANSMIT GENERA 16.25
** kA** h* A**** Ak A****• k*** k*•********' k** * *k•k *•k * * *•l * **k *kAk *k * * * *h*A. GENERA 4.50
TRANSMIT Number: „940016:175 Amount: 45.75 02/22/95 16 :07 TOTAL, 45.75
Payment Method :'•CHECI( ,Notation: INFORMATION cola • Tnit: SAO CHECK 45.75
.. _....�...:._... ..»_..._._ _._._......... .._._...,..�...•,...,.._.. CHANGE Uh00.
t �" v Permit No: 093-003B Type: 0- I3UILi) BUILDING PEit 3/n5 0356A000 15 :11
Parcel Not 252'304-9010
Site Address: 16711 WEST VALLEY. HY 1/41.
Total Fees: 45.75
This Payment 45.75 Total • ALL Pmts; u 45.75
al.ance: .00
**lt * * * * * * * ** * * *A• *k* * *A *0 * k************* lg *k* * * * ** *A•ot * * * *•k * * *•A•k * **
,Account Code . D e s c r i p t i o n . Amount
000/322.100 BUILDING - NONRES 25.00
000/345.E330 PLAN CHECK ._ NONRI3 16.2;
000 /386.904 STATE BUILDING SURCHARGE 4.50
.2?. 4.. 14, . J50i{ , i'M IA. f Af._i; e1?, :,1,. .�_.; au {,.vet.t'f ..st.'e � „r •. _t.k,!!t. r'. a..?
. , ,
• 1
, •
k.._. INSPECTION RECORD c
. x
00156 i
Retain a copy with permit
E s" •. PERmrr NO.
CITY OF TUKWILA BUILDING DIVISION A , A '
6300 Southcenter Blvd., #100, Tukwila, WA 98188 f py 1, (206) 431-3670
1707 N c.„ ,,,„ Type ot Inspect .•. ,--
r fiAc61/ ivol ri NAL--
Address: Date Called: t
.. Special Instructions: Date Wanted:
qs' aG;7171.4 I
CA (-L. te....4 ■E'Z.1. Requester: L.,/ ,
/ c 0
0,0 "r14 AZ: ‘A CrS ' Phone No.: 985- 72-
Approved per applicable codes. El Corrections required prior to approval.
t
COMMENTS:
i 1
, r•
,
\ , ,
nspector: ' ik.
t..,
.,.. ,
0 s30 00 REINSPECTION FEE REQUIRED. Prior to reinspection, fee must be paid at
6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
1 Recept No.: 1 Uate:
. /
,, - ,s .. s , t. , , , , 4 e ..it ..,, ,, `.4.,... L , V:-.1fitest.44WWWIelwiair441144.0444***4•24." . ..........--...,,, • -
.,- . , ......... , . 21,1,,,,, 5 , Y•ZT.':: , :' ,, Z,-sW ,, ',NM's , WW`:',1441 , /,/+: 2 Se4.1V,,,', ., ,
:,
t
0
Lj INSPECTION RECORD 11
1 006 g 4
Retain a copy with permit '.
1 PE • 0. PERMIT NO. J
CITY OF TUKWILA BUILDING DIVISION
-,\
6300 Southcenter Blvd., #100, Tukwila, WA 98188 1 10 , - .. (206) 431-3670
Wge '-'"`,
1 nael(A4tAtil 60 Type olinspe . Ion:
F I N 1
( j „.-- •
Adtfre .
W. 04//ety1/4A-kr-- Date Called:
3-
Special Instructions: . Date Wanted. _ , 6 - 2 „
,t.- DK P.,(1(.6Y...C._ --i / — - CD
11 , , ,.:,- ,i(i j /A e k:, / Requester:
ra/V: z/(3' - 756)1
Approved per applicable codes.
Phone No.V
7(,6 —
_ i / A - 0-
El
vir/. Corrections required prlor to approval.
COMMENTS:
A cc b x oltNIG TO 114e Annolw pouls 1/W
LA NI r ,S i+NA L'.0 vimAr E...,.-e La C,A 7Z.-"j? 4 v e7L_. ..
'k
1,‘
_ A cO t_t . ( TN< _Di kn e- Sco 4.5 4 litrd
. .t...
O Al 714 E e Lae.) To KG-1-0(40-.5 rn
,,.
. , .
, .
. - I Inspector: e..... 0 Date: 3 7 1r
- 1 •-• :,,,,,:,:, '.:, ,,-...
0 $30 00 REINSPECTION FEE REQUIRED. Prior to reinspectlon, fee must be paid at
6300 Southcenter Blvd., Suite 100. Call to schedule relnspection.
' I ReceOt No.: Dato
, ' 't, ' ,-• , ' '
immilemirrimmes.
CITY OF TUKWILA
Address: 17035 WEST VALLEY HY Perm it.No: B95 -0058
Suite:
Tenant: NC MACHINERY CO Status: ISSUED
Type: B- BUILD Applied: 02/22/1995
Parcel #: 252304-9010 Issued: 03/01/1995
*• k k• k* k** k• k****" k' k** k k• k k***** kk• k' k*•/v** k' k***• k' k• k• k*• k• k*****• k• k ii* 'k'k **
Permit Conditions:
1. No changes w9 1 1 be made t�o',:the:'p:,1':ns `u r e:ss. approved by the
Arch i tec.t or. E ngineer; 'nand: *the Tukw°i '�`BU�i 1d�ilg i v 1 s i on .
2. Electrical per mits.:t. 11 be obtained, through "the'Washington
State Division,•,o of d 1 dusty { a d14a11 'e .' ' i
t � ,h n � e�:�r G l
work w i l l be, ,ti sp
ect b `th „age.ney (2 48 b630) . '�4 =t
A`, .,1 • f , �: ' % 2 n ij 45 f . ,, }• ;� 6�`,
3. All permi t ,x�Rj,nspect 1, , ,i {on f~ecrrds, and appro i,ans ``sh'a1,1 be
avai 1ab1e c�# /the jiob'�:r. i'te prior`? to ''the4, start Y o,f Y any cari ' ,,
'! struction'.; /''Thes'e, document's are to be mai'rrtairiedry and `:1�'-
,
able un„0.1/ fi�na < 1nspeet1on "a° p ,. iE o, t i'01 is gra \ �' ; , ` ,."
4. All cor3' uctiari to done:;ii t confide'rmance wi th,,ajpr"o ed s ' `;U ,,
pians 0nd xa r equiremdnts at' fie Unitor Building Cotle 9`1 1 ;
Edit1,on as, a mended, Uy Jtorm Mechanical Code (1991'.', Ed �' -``y
and i Wathi ng,t'on State Energy C�i de' '(•1. Edition) . '''' •, „,p� :,
j r � fi t: ��'a
5, Val i �,
d v f Fr
'oemi t T
. hee- i
-.ss. a)tc o a permt or appro'vil' of (f�
p1 ` y, Ji sp`e,c,i�fi , c hiputat \if" i
rons" sh,a11 not behcon ''
sty ' d to be aL per.:mi t ` fo ►` • or a $$a r v31 o.f,,, any v 16.) at�i b114, ;; i
of s a ' , :y of t ,, ptoo .v,i c i'on,s \oft", bi i ?lid t n , g' . Co ar• of eny' 4; :0 , ' k
o f lh r4 o r.d :i :n.a n o e H of the ,$ u r- s°dl c t i tin . N o- p m t p r e sup i rt'g . o ( gi t o •: , �r ti ance t re . y ^pr� off i 7 t ,i l gf d
. h , � „� Z � •,x � r , d' "" 'Z, ' J Jj1 �1 � b ,�i C
Gad' s it a. b e v a 1 is d � . f , .._ t . � , i'..4' .d. � . � i
g , jjr
\ Fi — :‘, c v i 4 , A. # e -) i .,„,. \ , . -4, j
\ ‘‘ 4 ,,,, :: , t ,,, i ,, , \,\ ‘,,,,,,,,,, ,, '1, 4, , , ,i4iiilt : ' 4 .,, ,,,,.., 4, ,.. : 41 . kvii "A°1\''' L } til e40*
to
1 y, .F 1 ; , •if a gii `? 0 , 4,4 fr. f r ya' }
4 e - , �.., •a ' ' ' F`` wT �+'. da «?v 't1 2 ' t' a�� „41,J.;s�
' , ;,,- 4 :1%.,' , ,; . ::-.:,. 1 ff 2 y= am✓ 1Y � 1`Yr .+
' s , 'k A Wy ss :,'^`wp.. a. � *ri3Ot +,J
yk4 w .. '' , 4X7 'w'
^,.'"- } .
RUBBER MATS
20 "x62" 17'0" 24'0 24'0 ' , 2 4'0" 24'0" 24 24'0 24'0 4. 17'0" 11'8"12"8" 12'8 1
6:
(0 1 1 "
420-. 04
W16x31 W16x31
W16x26 W16x26 W16x31 W16x31 - W16x31
ED I - ■
o
X LOCATION OF ANTENNA i Q W16x31 W16x31 W16x31 i 1 _ el
(OVER COLUMN) `
I
6'6" c r____ i i i
I'S OF ANTENNA BASE a
0
MATS I M
3BEP MA _
CITY OF
`'� E, 4. �
R
ANTENNA SIZE: DESIGN: "St .1 i --,, " � .
METER DISH w/N P M M 1.0 METER DISH 100 MPH - EXP. "C" }; co ', •
BLDG. CODE: BASE TYPE: NPM W/ 510 LBS OF BALLAST 1 4-
� '
1991 U.B.C. ,+ ' , \ ;'2 o
� _ ' Al ,
.AST INDICATED AT TITLE BLOCK °' f I
DTAL REQUIRED - DISTRIBUTE
RIVA KLEIN & TIMMONS —i�`, �.
4LLY ON ALL 4 SIDES OF MOUNT C D ,` T /. T+
S'3' �. C'F R 1_, ENGINEERS
4914 S.W. 72nd. AVE. MIAMI , FLORIDA 33155 ^
(305) 663 -0845 FAX (305) 663 - 0839 - ^--- -
RUBBER MATS
w 20 "x62" 17'0" 24'0 2 a'p,4ti ,. 2 4 O" r--=0" 24'0" 24'0" 24'0" 17'0" )1'8'128'i,12'8'
cn
I I • i • t
q N
z to
z x -
-
z c.i f -
LL. x 4 W16x2fi cNi
co 1 i i r r
0 0 4. W16x26 _ W16x31 L W16x31 _ W16x31 Wi6x31 W16x31 _
I-- . F
z
w 20 "x62" L i ! r r LOCATION OF ANTENNA ' ( i r M
` W16x31 _ W16x31 W16x31_
(OVER COLUMN) -
� i r
EXTENTS OF ANTENNA BASE l :
0
RUBBER MATS I 0
_ M
CI TY o f T
APPROV
illiThVithilittillillill-\ FE :2 i9 ..,. , T - RECEIVED T T _° CfIY OF SFSKWt PaRTI�L ROOF FR�IiI \G PLt1� �.-� �� FEB 2 2 i9.
■� PERMIT GENIE
4 f � ALL STRUCTURAL FRAMING INF
� PERTAINING MEMBER SIZES & 1
ALL DIMENSIONS TO BE FIELD AS WELL AS ALL DIMENSIONS]
� ` VERIFIED BY CONTRACTOR. PROVIDED BY THE INSTALLER.
II —r
PROJECT: SITE NO. DATE:
2 -20 -95
6 .6.. \ 6 ,6'' CASE - ANTENNA A CSE -SET10 REVISION:
`I1' ADDRESS: ..
WEST VALLEY HIGHWAY ='
TUKWILA, WA. 98188 t v V } ; :, .. , s
N j p p ANTENNA SIZE: DESIGN: :'StAkt` 4 'n-�'•
i . 0 W E T E R DISH w/ i V P IVI I!/I 1 METER DISH 100 MPH - EXP "C" '; -2 `"'
L
BLDG. CODE: BASE TYPE: -; „ :1
1991 U.B.C. NPM W/ 510 LBS OF BALLAST -J ' f'
BALLAST INDICATED AT TITLE BLOCK �, ,fit: ` '
IS TOTAL REQUIRED - DISTRIBUTE RIVA KLEIN & TIMMONS k ' - - .".
E ON ALL 4 SIDES OF MOUNT � � ! {+- �'
ST RUCTURAL ENC T NEERS
4914 S.W. 72nd. AVE. MIAMI , FLORIDA 33155 i ,_
(305) 663 -0845 FAX (305) 663 -0839
1. .
FILE COPY .. . :FINED
OF TUKWILA HUGHES
I understand that tho Plan Chocic u, ^.^;:..w', cro NETWORK SYSTEMS
'
ect to errors and omissions and cpc•::::I of F ° 2 2 1995
,• Subsidia 01
plans does not Authadrii the Violation of cny P: MIT CENTER Hughes Ah rrah Company
adopted code Of lltractor's
copy of uppmved p4IlA11 8101111111IdgId
SITE U • VEY REPORT
By
A. CUSTOME • DATA / r
CUSTOMER N .E Date C- I . , D3 I ��' ITE NUMBER C $ F S E T I )
T.
PES SITE N• • ='u LA"_. Jr, '_ %/ _:.• j -�.
SITE ADDRESS ` 0 73 5 Lic
CITY -FF K :•✓ I L /� 11 COUNTY ' l /f l u r- STATE IA ZIPS �J
NAME OF CONTACT f() kJ / (-S UN PHONE NUMBER ( ZO C) Z 9 ifOO
B. BUILDING MANAGEMENT
COMPANY NAME L. •
ADDRESS
CITY COUNTY STATE ZIP
NAME OF CONTACT PHONE NUMBER (
C. BUILDING OWNER I
COMPANY NAME J �, 1�I �I � e � , % - /JC . % L I / i l;; /t / ' j '•t:.i (.'e. ,( r�,')t,�: (-
ADDRESS I i17 S LJ . ✓Aar/ 1\1l.Jv,
CITY KC"/L14 COUNT_ k l IIIL STATE Ldn ZIP IES I ifb
NAME OF CO1 :TACT PHONE NUMBER ( )
D. BUILDING ARCHITECT /ENGINEERING FIRM
COMPANY
ADDRESS
CITY COUNTY STATE ZIP
NAME OF CONTACT PHONE NUMBER ( )
E. SITE SURVEY REPORT CERTIFICATION
I have performed the sury flat this, e; oerttfy the info In this report to be correct:
Signed J / `:. ; (_:;Gtt -r / � Date U2/ 03 /5 5
Print Name /"IARlr Ae0133Cil Title / /SfS 1 / 77cIr
Company 1- C N Phone (Z (J ) 'fir 7
(rmmninv Privnnol Po 1 - ... .
Structural S6te Survey Report
F. ACCESS INFORMATION
Any restrictions concerning A access to the property? Yes No V
If yes, please explain ?4 N4I5
G. PES SATELLITE INFORMATION
PRIMARY SECONDARY
Satellite to be used* lrT1ZS� �� . 5S 7L
Location (degrees W) r1 I" `N' 12:3'
Site Longitude (degrees) 11.1"16'
Site Latitude (degrees) ' 6 y7 7_.6
Antenna Elevation - ?. 3' J �1 15
Antenna Azimuth I'/0. Y 049,7`' X17_ qft J
170- Z S . S ° i�j`1 ` Y o� - a
* as specified on Customer Installation Specification -- p . ; Ca
To, 0376
H. SATELLITE ARC CLEARANCE
Is there an unobstructed view to the primary and secondary satellite?
Yes 1 No
If no: arc blocked from to west longitude (TRUE)
Items to be moved /removed for unobstructed view
I. SITE ELEVATIONS 6
Rooftop (floors) 2 . Roof Line (feet)
J. ANTENNA (as specified on work order)
ANTENNA SIZE: 1.0 meter 1.2 meter 1.8 meter 2.4 meter
K. MOUNT TYPE
NOTE: IF POSSIBLE, INDICATE 3 OPTIONS. INSERT OPTION # AFTER THE MOUNT TYPE:
POSSIBLE CONFIRMED
Attached Tall Pole Mount
Non - Penetrating Mount
Penetrating Mount
Wall Mount
Comments , J 1 •S l )L'C D )ti r� 1/ 4) . 0Q N! 4T-F �jLO(
NOTE: FOR ANY INSTALLATION OTHER THAN SHORT POLE GROUND MOUNT, CONSIDERATION
SHOULD BE GIVEN TO EASE OF ACCESS TO THE PES ANTENNA EQUIPMENT BY SERVICE PERSONNEL
EQUIPMENT SHOULD BE LOCATED SO THAT NO SPECIAL EQUIPMENT SUCH AS HOIST TRUCKS OR
CATWALKS ARE REQUIRED TO ACCESS THE ANTENNA EQUIPMENT SAFELY.
4 -10.92 (Company Private) Pg. 2
Structural Site Survey Report
L. ANTENNA SITE INFORMATION
DISTANCE FROM BUILDING TO NEAREST SITE PROPERTY BOUNDARY (FEE :):
NCRTH 40A SOUTH 3( EAST 1 VU ' WE. S: 5 (- +
ARE THE FOLLOWING REQD? ATP WM PRM NPM
EASEMENTS? YES NO YES NO YES NO YES NOi__
ZONING VARIANCE? YES NO YES NO YES NO YES NO_Y
CONSTRUCTION PERMITS? YES NO YES NO YES NO YES NO
ELECTRICAL PERMITS? YES NO YES NO YES NC YES NO >C
ARE THE FOLLOWING REQUIRED FOR PERMITS ?:
ARCHITECTURAL DWGS YES NO EXPLAIN
WIND LOAD STUDY YES NO EXPLAIN
P.E. STAMPED DWGS YES ' NO EXPLAIN
SPECIAL INST LICENSE YES NO EXPLAIN
ARE BLUEPRINTS AVAIL? YES NO NO EXPLAIN
ARE FUTURE BLDG ADDS /CHGS PLANNED? YES NO, EXPLAIN
STATE NAME /SOURCE OF ABOVE INFORMATION: J U k) )1 I.!; d(l
IF REQUIRED, DID YOU ATTEMPT TO OBTAIN EASEMENTS, VARIANCES, OR PERMITS?
YES NO CURRENT STATUS: OBTAINED DENIED IN PROCESS X
EXPLAIN r✓
ARE THERE ANY SA'�rELLITE, MICROWAVE OR OTHER ANTENNAS INSTALLED ON THE BLDG? YES V� NO
DESCRIBE :L AI 01.
NOTE: OBTAIN AND ATTACH ONE COPY OF ANY LOCAL ORDINANCES PERTAINING TO SATELLITE
INSTALLATIONS AND TWO COPIES OF PERMIT APPLICATION (IF PERMIT REQUIRED).
M. SITE ACCESS FOR INSTALLATION
EXTERIOR LADDER CRANE BOOM FREIGHT ELEVATOR _ STAIRS
INTERIOR LADDER CEILING HATCH /DIMENSIONS Ct / 30" X 7)0
HOIST TRUCK SCAFFOLD OTHER , (EXPLAIN)
N. SITE ACCESS FOR SERVICE
Will ladder, lift truck, scaffolding, etc. be required to access and service the
outdoor electronic equipment and antenna /antenna mount option? Be sure to reply for
each antenna mount option..
�� lC
Antenna Option 1: Yes No ;%� (Explain) � j Alti4
Antenna Option 2: Yes No (Explain)
Antenna Option 3: Yes No (Explain)
4.10.92 (Company Private) Pg. 3
•
•
Structural Site Survey Report
0. ROOF ANTENNA MOUNT (req'd for roof mount only) Not applicable
Roof Type: Flat and Level Flat and Sloped Pitched Canopy
Other
(CHECK AS MANY THAT APPLY:)
ROOF: STRUCTURAL SUPPORT
Wood Rafters Concrete Slab b Structural Steel cy
Dimensions & Centers:
ROOF: DECKING (OVER STRUCTURAL SUPPORT)
Concrete Plywood /Composite Corrugated Steel
Other
ROOF: WATERPROOFING /FINISH (OVER DECKING)
Asphalt Decking OS Wood Shingles /Shakes Tar / "Pea" Gravel
Surface Coat (non critical roof surface) Continuous Membrane
• Other /
Is roof membrane or other roofing finish now under warranty? Yes0 No
Is any particular roofing contractor required by building management or the roof
warranty: Yes No If 'Yes' identify:
Name of Helder of roofing warranty � i L i7 S � LVU F 0
Phone Number ( ) ( C -5-2 * ' Contact — S �u P6Mk
Are there any other structures on roof? Yes O\ No
Explain : /VVA C / A TE Z . L) / A 111(
Is the roof due to be refinished? If yes, when? / /
Are there any existing building entries for the IFL cable? YesIK No —
Explain:
NOTE: ATTACH DRAWING ELEVATION OF ROOF STRUCTURE FOR ROOF MOUNT (CROSS SECTION THROUGH
BEAM OR OTHER STRUCTURAL SUPPORT). CLEARLY SHOW ALL MATERIALS AND MEASUREMENTS. ATTACH
APPROPRIATE BLUEPRINT AND ARCHITECTURAL DRAWINGS IF AVAILABLE.
•
4-10-92 (Company Private) Pg, 4
Structural S ESurvey Report
P. WALL ANTENNA MOUNT /ATTACTED TALL POLE Not Applicable 4.
Wall Type: Building Exterior Mount Freestand ng/ all support
Penthouse Other
Is access to backside of wall available? Yes di Explain
Supporting Structure: Concrete Masonry it Structural Steel
Poured /Cast Concrete Wood etal "Stud" Frame
Other
Wall /Surface Finish Materia s:
Brick Concrete Masonry Una. Siding Shingles or Shakes Tile_
Metal(exposed) _ one ete Stucco Plywood /Sheathing Glass
Other
Are there any s•ructures mounted on or attached to the proposed wall attachment site?
Yes Nc - plain
Are ther- any existing building entries for the TVRO /IFL cables:
Yes Explain
o Explair.
NOTE: Attach drawing of wall mount and wall (cross section through column, block er structural
support). Attach appropriate blueprint and architectural drawings if available.
O. SOIL CONDITION INFORMATION (req'd for ground mounts Not a icable
Firm Rock Sand Clay Marsh Asphalt Parking Lot
Trench from antenna Footing to Buildi - Entry Point: (feet)
Will trenching require repair/ •lacement of any walkways or parking lot?
Yes No Explain
Frost Depth Per - al Bldg. Code:
•
4 -10 -92 (Company Private) Pg. 5
,
. ( (
Structural Site Survey Report
R. LOCATION OF INDOOR EQUIPMENT (Provide data for all options.)
DIU /O:
Location: f241-01-Y- c_..d ) " wk- V OL)ri1 ge 4e, ac tioo (UR /u) 6Lc-ZCl cLosc )
. Evironmentally controlled? YeslNoExplain
AC power outlet available? Yes. L No Power Strip Req'd? Yes No 0�.
Explain
Describe any AC power modifications or additions required for the DIU /O:
//
Total length of IFL cable required from ODU to DIU /O: Option 1 /l)c.) , Option 2
, Option 3 . Describe: cable route from ODU to DIU /O:
Opt.1: rU+ --Gw 4 . (Jim &.'(_ P134 'ti /fC nu►.J dc no.;f acvf', T1 C.A15S'►w■ Cok /Pu i n4ti3)
1'0 i' /JOAd( ( Lc, c'Z". (IC . Et Acv Dr1/ TfcR( 0. o tr As 4c."0 >,) nzr, CcnT
Opt.2:
Opt .3:
Type of IFL cable required: PVC Plenum Rated 0( IFL P/N
Is conduit required for IFL? Yes No, L. Explain_
Type of conduit: PVC Length (feet) EMT Length (feet)
S. VIDEO EQUIPMENT INFORMATION (check Customer lnst Spec for applicability) / /
'
Satellite Video Equipment Location: _ _
Is AC power outlet available for Video Equipment? Yes No Explain
Describe any AC power modifications or additions requi d for Video Equipment:
Total length of video cable from DIU /0 to video cation (feet):
Opt. 1: Opt. 2: Opt. 3:
Describe cable route from DIU /0 to vide ocation:
Opt.1:
Opt.2:
Opt.3:
Is conduit req'd or video coax? Yes No Explain
Type of condu' : PVC Length (feet) EMT Length (feet)
Is plenum -ted cable required? Yes No Explain
4 -10.92 (Company Private) Pg. 6
1
Structural Site Su Report
T. 120 VAC POWER AT ANTENNA LOCATION -DEICE ONLY (Provide data for all • ons.)
Distribution. Panel Location
Panel # Breaker Mfg :. Amperage Model
120 VAC service branch wiring to antenna loc- on:
Type Number of conduc size
Total length of new 120 VAC wi g required for each antenna option:
Option #1 (feet) •ption #2 (feet) Option #3 (feet)
•
Electrical Contr -- or to be used:
U. GROUND INFORMATION
Type of mount electrical grounding and location (must comply with HNS spec 70040A -1,
Field Service Bulletin #1057A, and all applicable local codes):
1' -0 vi ( to c\c, . &P.A.% iA P.e.
V. VOICE EQUIPMENT INFORMATION
(Check Customer Installation Spec for applicability)
Is voice termination equipment available? Yes No Explain:
Manufacturer
Model Number Telephone Lines Available
Two wire Four wi _ Explain.
Length between P 0/0 and voice termination equipment: (feet)
RJ -11 Jac equired? Yes No
. CUSTOMER DATA EQUIPMENT INFORMATION
(Check Customer Installation Spec for any ial requirements)
Type of Data Controller(s) F i � oe
Manufacturer of Data Controller(s)
Model number of Data Controller(s)
Location of Controller(s) if not to be located w /DIU /O
Length cf car.le run from DIU/0 to Data Controller(s) (feet)
4 -10 -92 (Company Private) Pg. 7
•
_ „...
• It
• • .
8
1.16471A 14
(01,10 rri DAN/.
JE
, 60 , m /blear
vs6
1
0Apisoc •
1 or RI, . 7) •
Roy A
•/. N
* ,r!
•
WW1 \ 0 urri
1111 4110 GNP MID 410 Loc-Afica OF
Nzettle OK
1 1
1
1
1
1
1
1
1
1
1
p .
nt
a
1
1
1
1
v
photos
photos
•
•
•
Structural Site Survey Report
SITE SURVEY APPROVAL FORM
CUSTOMER REPRESENTATIVE REVIEW
AS A CUSTOMER REPRESENTATIVE OF CA C , I HAVE REVIEWED
THE ANTENNA LOCATION IN THE ATTACHED PES SITE SURVEY.
SIGNE i DATE
PRINT NAME TITLE
BUILDING OWNER REPRESENTATIVE APPROVAL
AS AN AUTHORIZED AGENT OF THE OWNER OF THE ABOVE NAMED BUILDING, I APPROVE
THE LOCATIO OF THE PES IN ACCORDANCE WITH THIS DOCUMENT (PES SITE SURVEY).
SIGNED j \J i DATE �
PRINT NAME TITLE
SPECIAL INSTRUCTIONS, CONCERNS, ETC.
•
•
•
•
•
•
•
• 4 -10.92 (Company Private) Pg.17
UBI NUMBER EXPIRATION DATE
601 475 184 001 0001 06-30-1995
INFORMATION CONTRACTORS INC.
ICON
20210 142ND AVE NE
WOODINVILLE WA 98072
TAX REGISTRATION
INDUSTRIAL INSURANCE
MINOR WORK PERMIT
UNEMPLOYMENT INSURANCE
(FOLD HERE). .;
REGISTERED AS PROVIDED BY LAWAS A:
, REGISTRATION NUMBER ' BOX 1043