HomeMy WebLinkAboutPermit D02-060 - LEREN RESIDENCE - ADDITIONNorand Leren
Residence
4920 S 114 St
D 02 -0060
ACTIVITY NUMBER:
PROJECT NAME:
SITE ADDRESS:
Response to Correction Letter #
D02 -060 DATE: 3 -18 -02
NORAND LEREN RESIDENCE
4920 S. 114 ST
Original Plan Submittal Response to Incomplete Letter #
X Revision # 1 After Permit Is Issued
DEPARTMENTS:
Building Division
Public Works
PLAN REVIEW /ROUTING SUP
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
APPROVALS OR CORRECTIONS:
Approved
Notation:
REVIEWER'S INITIALS:
Documents/routing slip.doc
2.28.02
Fire Prevention ❑ Planning Division ❑
Structural ❑ Permit Coordinator ❑
Incomplete
DUE DATE: 3-19 -02
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS ROUTING:
Please Route ❑ Structural Review ' :.ui d ❑ No further Review Required Lam"
REVIEWER'S INITIALS: DATE: 3 "tq"Z 2 "
A.•r.ved with Conditions ❑ Not Approved (attach comments) ❑
�•, / U DATE: T•'« rZQ7Z
DUE DATE: 4 -16 -02
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
Not Applicable El
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PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: D02 -060
PROJECT NAME: NORAND LEREN RESIDENCE
SITE ADDRESS: 4920 S. 114 ST
DATE: 3 -18 -02
Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # X Revision # 1 After Permit Is Issued
DEPARTMENTS:
Building Division ❑
Public Works ❑
Fire Prevention
Structural
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete ❑ incomplete ❑
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS ROUTING:
Please Route ❑ Structural R
REVIEWER'S INITIALS:
APPROVALS OR CORRECTIONS:
Documenls/rouling slip.doc
2.25 -02
uired ❑ No further Review Required
REVIEWER'S INITIALS:
Planning Division
Permit Coordinator
DUE DATE: 3-19 -02
DATE: c \\Q7___
DUE DATE: 4 -16 -02
Not Applicable ❑
Approved ❑ Approved with Conditions ❑ Not Approved (attach comments) ❑
Notation:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
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ACTIVITY NUMBER: D02 -060
PROJECT NAME:
SITE ADDRESS:
NORAND LEREN RESIDENCE
4920 S. 114 ST
DATE: 3 -18 -02
Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # X Revision # 1 After Permit Is Issued
DEPARTMENTS:
Building Division
Public Works
Complete
PLAN REVIEW /ROUTING SUP
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
APPROVALS OR CORRECTIONS:
Fire Prevention
Structural
Incomplete
Planning Division
❑ Permit Coordinator
DUE DATE: 3 -19 -02
Not Applicable ❑
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ PIng ❑ PW ❑ Staff Initials:
TUES /THURS ROUTING:
Please Route ❑ Structural Review Required ❑ No further Review Required
REVIEWER'S INITIALS: DATE: 3-19
DUE DATE: 4-16-02
Approved ❑ Approved with Conditions ❑ Not Approved (attach comments) ❑
Notation:
REVIEWER'S INITIALS:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ PIng ❑ PW ❑ Staff Initials:
Documents/routing slip.doc
2 -28.02
DATE:
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DEPARTMENTS:
Building Division
Public Works
TUES /THURS ROUTING:
Please Route
IN
REVIEWER'S INITIALS:
APPROVALS OR CORRECTIONS:
Documents/routing slip.doc
2.28-02
•
PLAN REVIEW /ROUTING SUP
ACTIVITY NUMBER: D02 -060
PROJECT NAME: NORAND LEREN RESIDENCE
SITE ADDRESS: 4920 S. 114 ST
DATE: 3 -18 -02
Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # X Revision # 1 After Permit Is Issued
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete ❑ Incomplete ❑
Structural Review Required ❑ No further Review Required
REVIEWER'S INITIALS:
Fire Prevention ❑ Planning Division ❑
Structural ❑ Permit Coordinator ❑
DUE DATE: 3-19-02
DATE:
Not Applicable ❑
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
DUE DATE: 4 -16-02
Approved ❑ Approved with Conditions ❑ Not Approved (attach comments) ❑
Notation:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
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Value of Construction:
Type of Fire Protection:
Type of Construction:
Public Works Activities:
doc: Devperm
City of lukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 3348401711
Address: 4920 S 114 ST TUKW
Suite No:
Tenant:
Name: LEREN RESIDENCE
Address: 4920 S 114 ST, TUKWILA, WA
Owner:
Name: LEREN SUSAN E Phone:
Address: 4920 S 114 ST, TUKWILA WA
Contact Person:
Name: NORAND LEREN Phone: 206 - 722 -5479
Address: 4920 S 114 ST, TUKWILA, WA
Contractor:
Name: Phone:
Address:
Contractor License No: Expiration Date:
DESCRIPTION OF WORK:
ADDITION OF 240 SQ FT TO EXISTING SINGLE FAMILY RESIDENCE AND 120 SQ FT UNCOVERED DECK AREA.
$22,834.80
DEVELOPMENT PERMIT
Fees Collected: $967.11
Uniform Building Code Edition: 1997
Occupancy per UBC: 7
D02 -060
Permit Number: D02 -060
Issue Date: 03/08/2002
Permit Expires On: 09/04/2002
Curb Cut/Access /Sidewalk/CSS: N
Fire Loop Hydrant: N Number: 0 Size (Inches): 0
Flood Control Zone: N
Hauling: N Start Time: End Time:
Land Altering: N Volumes: Cut 0 c.y. Fill 0 c.y.
Landscape Irrigation: N
Moving Oversize Load: N Start Time: End Time:
Sanitary Side Sewer: N
Sewer Main Extension: N Private: N Public: N
Storm Drainage: N
Street Use: N
Water Main Extension: N Private: N Public: N
Water Meter:
Channelization / Striping:
** Continued Next Page
Printed: 03-08-2002
The granting of this per •
regulating construction .
Signature: lAK
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Permit Center Authorized Signature: Le' � c.:. ��� 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.
does not presume to give authority to violate or cancel the provisions of any other state or local laws
r th •erformance of work. I am authorized to sign and obtain this development permit.
e —cf
Date:
Print Name: AoX N73 6
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.
doc: Devperm
D02 -060
Printed: 03 -08 -2002
4
ready for issuance
ACTIVITY NUMBER: D02 -060 DATE: 03 -04 -02
PROJECT NAME: Norand Leren Residence
SITE ADDRESS: 4920 S 114 St
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # Revision # After Permit Is Issued
DEPARTMENTS:
Building Division
Public Works
Complete
Comments:
Approved C
Notation:
Documents/routing sl ip.doc
2 -2802
APPROVALS OR CORRECTIONS:
REVIEWER'S INITIALS:
PLAN REVIEW /ROUTING SLIP
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Permit Center Use Only
INCOMPLETE LETTER MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
LETTER OF COMPLETENESS MAILED:
TUES /THURS ROUTING:
Please Route n Structural Review Required C No further Review equired J(I
REVIEWER'S INITIALS: DATE:
Fire Prevention
Structural
Incomplete
Approved with Conditions
n
Planning Division
Permit Coordinator
C
n
DUE DATE: 03 -05 -02
Not Applicable
DUE DATE: 04-02 -02
Not Approved (attach comments) n
DATE: 5 j t QZ
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg 0 Fire ❑ Ping 0 PW ❑ Staff Initials:
PERMIT NO.: t) 02- OO
BUILDING PERMITS
INSPECTIONS
❑ 1 Progress Inspection Status
❑
2 Pre- construction
❑ 3 Investigation
❑ 4 OK to Occupy
❑ 5 Remove Stop Work Order
❑ 6 Follow -up
❑ 7 Pre -Move Inspection
❑ 50 WSEC Residential
❑ 60 WA Ventilation/Indoor AQC
❑ 70 NLEA Inspection /Modular Struct
❑ 71 Mobile Home Tie Down Insp
❑ 72 Marriage Lines
❑ 90 Resteel
❑ 95 Footing Drains
❑ 100 Foundation Footings
❑ 200 Foundation Walls
❑ 250 Foundation Insulation
❑ 300 Concrete Slab /Slab Insulation
❑ 350 Crawl Space
❑ 400 Shear Wall Nailing
❑ 450 Plywood Wall Sheathing
❑ 500 Roof Sheathing Nailing
❑ 525 Plywood Deck Nailing
❑ 550 Exterior Wall Sheathing
❑ 600 Masonry Chimney
610 Chimney Installation/All Types
700 Framing
0 750 Roof /Ceiling Insulation
O 800 Flour Insulation
❑ 801 Wall Insulation
❑ 802 Exterior Roof Insulation
❑ 803 Glazing Inspection
❑ 815 Lighting and Controls
❑ 900 Suspended Ceiling
❑ 1000 Interior Wallboard Fastening
❑ 1001 Exterior Wallboard Fastening
❑ 1 110 Pre -Move Inspection
❑ 1 115 Motor Inspection
❑ 1120 Pre -Demo
❑ 1140 Pre- reroof
0 140 Final -Fire
1700 Final - Building
1900 Final - Reroof
❑ 3100 Site Visit
❑ 4000 Special- Concrete
❑ 4001 Special -Bolts in Concrete
❑ 4001 Special - Mom/Resist Conc Frame
❑ 4003 Special -Reinf Steel Prestress
❑ 4004 Special- Welding
❑ 4005 Special -High- Strength Bolting
❑ 4006 Special - Structural Masonry
❑ 4007 Special -Reinf Gypsum Concrete
❑ 4008 Special - Insulating Conc Fill
❑ 4009 Special -Spray Fireproofing
O 4010 Special - Piling, Piers, Caissons
❑ 4011 Special - Shotcrete
❑ 4012 Special- Grading, Excav /Fill
❑ 4013 Special - Retaining Wall
❑ 4014 Special - Panels
❑ 4015 Special -Smoke Control System
‘0 TENANT NAME: Y
0 CIJAA Lere
CONDITIONS
000 No changes will be made to the plans unless approved
by the Engineer and the Tukwila Building Division
❑ 10002 Plumbing permits shall be obtained through King Co
10003 Electrical permits obtained through L & I
❑ 10004 All mechanical work shall be under separate permit
❑ 10005 All permits, insp records & approved plans available
❑ 10006 All structural concrete shall be special inspected
❑ 10007 All structural welding shall be done by WABO certified
inspector
❑ 10008 All high- strength bolting shall be special inspected
❑ 10009 Bolts installed in concrete shall be special inspected
❑ 10010 When special inspection is required...notify Tukwila
Building Division
❑ 1001 I The special inspector shall submit a final signed report
❑ 10012 Any new ceiling grid and light fixture installation
❑ 10013 Partition walls attached to ceiling grid
❑ 10014 Readily accessible access to roof mounted equipment
10015 Engineered truss drawings & calcs shall be on site
10016 Any exposed insulation backing material shall have
❑ 10017 Subgrade preparation including drainage, excavation
❑ 10018 A statement from the rooting contractor verifying tire
retardant class of roof
X10019 All construction to be done in conformance w /approved
plans
❑ 10020 Structural observation shall be provided for this project
❑ 10021 All food preparation establishments must have King Co
❑ 10022 Fire retardant treated wood shall have flame spread of
❑ I0023 Notify Building Division prior to placing any concrete
❑ 10024 All spray applied fireproofing shall be special inspected
❑ 10025 All wood to remain in placed concrete shall be treated
❑ 10026 All structural masonry shall be special inspected
/ 10027 Validity of Permit
❑ 10028 Rack storage requires separate permit
❑ 10030 No occupancy of building until final insp by Bldg Div
❑ 10031 Comply with requirements ofTIvIC 16.04
❑ 10032 Remove all weeds, concrete, stone foundations, flat
concrete
❑ 10034 Removal ot'septic tanks require approval and
compliance with King Co Health Dept.
❑ 10035 Contact PW Div to obtain insp for water /sewer connect
❑ 10036 Manufacturers installation Instructions required on site
❑ 10038 A C of O will be required for this permit
❑ 10039 Final approval for all TI w /in the limits of the SC Mall
❑ 10040 All construction noise to be in compliance with 8.2 TMC
❑ 10041 Ventilation is required for all new rooms & spaces
❑ l004 .Fuel burning appliances
❑ 10043 Appliances, which generate
❑ 10044 Water heater shall be anchored
❑ 10045 Reroof
❑ "Anchoring — All new construct and substantial
improvement shall be anchored to pr vent flotation"
Plan Reviewer:
Permit Tech:
Date:
Date: 3 .5 .o?.
DEPARTMENTS:
Building Division
Public Works
Complete n
TUES /THURS ROUTING:
Documents/routing slip.doc
2 -28 -02
n
ACTIVITY NUMBER: D02 -060
DATE: 03 -04 -02
PROJECT NAME: Norand Leren Residence
SITE ADDRESS: 4920 S 114 St
Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # Revision # After Permit Is Issued
APPROVALS OR CORRECTIONS:
PLAN REVIEW /ROUTING SLIP
Fire Prevention
Structural
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Incomplete
n
Approved Approved with Conditions ❑
Notation:
REVIEWER'S INITIALS:
Planning Division
Permit Coordinator
Permit Center Use Only
INCOMPLETE LETTER MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
LETTER OF COMPLETENESS MAILED:
Comments:
Please Route n uctural Review Required ❑ No further Review Required
REVIEWER'S INITIALS: 3 DATE: 3 ( ( 2 -
n
DUE DATE: 03-05 -02
Not Applicable ❑
DUE DATE: 04 -02 -02
Not Approved (attach comments) ❑
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections:
Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
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ACTIVITY NUMBER: D02 - 060
DATE: 03 -04 -02
PROJECT NAME: Norand Leren Residence
SITE ADDRESS: 4920 S 114 St
Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # Revision # After Permit Is Issued
DEPARTMENTS:
Building Division
Public Works
Complete
Comments:
n
APPROVALS OR CORRECTIONS:
Approved n
Notation:
Documents/rouling slip.doc
2.29.02
PLAN REVIEW /ROUTING SLIP
Fire Prevention
Structural
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Incomplete n
Planning Division
❑ Permit Coordinator
DUE DATE: 03 -05-02
Not Applicable ❑
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS ROUTING:
Please Route n Structural Review Required n No further Review Required `S
REVIEWER'S INITIALS: DATE: - " 02
DUE DATE: 04-02-02
Approved with Conditions n Not Approved (attach comments) n
REVIEWER'S INITIALS: DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
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ACTIVITY NUMBER: D02 - 060
PROJECT NAME: Norand Leren Residence
SITE ADDRESS: 4920 S 114 St
A Original Plan Submittal
DATE: 03 -04 -02
Response to Incomplete Letter #
Response to Correction Letter # Revision # After Permit Is Issued
DEPARTMENTS:
Building Division
Public Works
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete n
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS ROUTING:
Please Route Structural Review Required
REVIEWER'S INITIALS:
APPROVALS OR CORRECTIONS: OA 5 5 6:S%'
Approved with Condi ions
Approved n
Notation:
REVIEWER'S INITIALS:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
Documents/routing slip.doc
2.28 -02
n
PLAN REVIEW /ROUTING SLIP
Fire Prevention
Structural
Incomplete n
n
n
Planning Division
Permit Coordinator
DUE DATE: 03 -05 -02
Not Applicable LI
No further Review Required
DATE: • 3 -o2.
DUE DATE: 04-02-02
Not Approved (attach comments)
DATE: 3/17 0 Z.
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Project Name/Tenant: tuJRA /1)0 /
..0
Is this site served by: S21 Sewer ❑ Septic (King County Health Dept. approval required - 296 -4722)
Value of Construction /v/ C70 v(j)
Site Address:
City State2i :
Tax Parcel Number.
Property Owner:
�D��N� ��
/v
*For an Accessory dwelling, provide the,following:
Lot area Floor area of principal dwelling Floor area of accessory dwelling
- ? 2 - - 2 - Phone:
Street Address:
Citv State/Zip:
Fax #: ,
Contractor:
Phone:
Street Address:
City State/Zip:
Fax #:
Architect:
Owuv4
Phone:
Street Address:
City State/Zip:
Fax #:
Engineer:
C ti4 R
Phone:
Street Address:
City State2ip:
Fax #:
Contact Person:
V UJ rZ (i <
Phone:
Street Address:
City State/Zip:
Fax #:
Description of work to be done: li X AAA:, 4.1 ..(- 44$101, beikunnoL,
Type of work: ❑ New Single - Family Residence St Addition - Single - Family Residence
❑ Interior Remodel- Single - Family Residence . ❑ Residential Accessory Structure'
❑ RemodeVAddition to Accessory Structure ❑ Garage(s)
❑ Deck(s) - Covered & Uncovered ❑ Residential Reroof
Is this site served by: S21 Sewer ❑ Septic (King County Health Dept. approval required - 296 -4722)
Existing Square Footage for Structure: ( R00 sq. ft. Dwelling sq. ft. Covered Deck(s)
700 sq. ft. Garage/Carport sq. ft. Accessory Structure(s) sq. ft. Uncovered Deck
Proposed New Square Footage: L I 0 sq. ft. Dwelling sq. ft. Covered Deck(s)
sq. ft. Garage/Carport sq. ft. Accessory Structure(s) I -IC-) sq. ft. Uncovered Deck
Floor Area Ratio: (total floor area of all structures divided by the area of the lot) 0. O'7 a ( .
*For an Accessory dwelling, provide the,following:
Lot area Floor area of principal dwelling Floor area of accessory dwelling
• Provide documentation that shows the principal owner lives in one of the dwellings as his or her primary residence.
Single - Family Residential Permit Application
i� � f �; ` , ,t �A`.;� r �'�. `m u .a •iii )kg41 V2;1'1 7
•
CITY OF TUK' /ILA
Permit Center
6300 Southcenter Blvd., Suite 100, Tukwila, WA 98188
(206) 431 -3670
Application and plans must be complete In order to be accepted for plan review.
Applications will not be accepted through the mall or facsimile.
APPLICANTI EQ .g i' FQR 11.03.14 r;W ' , f{.` �. IJ . ( . .. pf:
..�,( Addi tlonpF►�svlew�t- 'ihslhtie;de ti ti�l- pti + ":t•;
-ono
❑ Channelization/Striping ❑ Curb cut/Access/Sidewalk ❑ Fire Loop/Hydrant (main to vault) #: Size(s):
❑ Flood Control Zone ❑ Hauling ❑ Land Altering: 0 Cut cubic yds. 0 Fill cubic yds.
❑ Moving an Oversized Load: Start Time: End Time:
❑ Sanitary Side Sewer #: ❑ Sewer Main Extension 0 Private 0 Public
❑ Storm Drainage ❑ Street Use ❑ Water Main Extension 0 Private 0 Public
❑ Water Meter /Permanent # Size(s):
❑ Water Meter Temp # Size(s): Est. quantity: gal Schedule:
❑ Miscellaneous
Value of Construction - In all cases, a value of construction amount should be entered by the applicant. This figure will be re-
viewed 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 ex-
pire by limitation. 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 107.4 of the Uniform Building Code (current edition). No application shall
be extended more than once.
Date application accepted:
Date application expires:
, II - 0 �
Application taken by: (Initials)
PLEASE SIGN BACK OF APPLICATION FORM
SFPERMIT.DOC 2/13/97
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:BUILDING
ALL SINGLE - FAMILY RESIDENTIAL PERMIT APPLICATIONS MUST BE UBMITTED WITH THE FOLLOWING:
➢ DRAWINGS PREPARED Bl REGISTERED ARCHITECT OR PRC .SSIONAL ENGINEER MAY BE
REQUIRED,BY BUILDING OFFICIAL
➢ ALA: 13AWINGS;SHALL BE AT A LEGIBLE SCALE AND NEATLY DRAWN
➢ BUILDING SITE PLANS AND UTILITY PLANS ARE TO BE COMBINED
WA SUBMITTED
alt L"r ; o�iy of recorded Legal Description from King County dr 4,
•
Certificate of water/fire flow availability (Form H-118). Contact the Public Works Department
(206) 433 -0179 for servicing district.
❑ ❑ Certificate of sewer availability (Form.H -11). Contact the Public Works Department (206) 433 -
0179 for servicing district.
❑ ❑ Metro: Residential Sewer Certification (If Tukwila Sewer District) (Form H -12)
❑ ❑ King County Health Department approval for septic - 296 -4722
of working drawings, which include
Site Plan (see example Form H -16)
1. Existing fire hydrant location(s).
2. Proposed access road.
3. Driveway location - driveway shall be 10' wide minimum and 20' wide maximum. If driveway is over
150' long, driveway shall be 20' wide and have an approved turnaround (City Ordinance 1741).
4. North arrow and scale.
5. Building setback from property lines. Any proposed or existing easements must be shown on plan.
6. Public Works review requires the following on site plan: driveway location (10' min., 20' max. width);
show proposed and existing power, water and sewer lines, existing storm drainage system,
downspouts and foundation drains, and where drains tie -in.
7. Parking plan.
8. Lowest building elevation (if in Flood Control Zone).
9. Estimated /proposed topography at 2' intervals and proposed elevation of lowest floor level.
10. Identify location of sensitive areas slopes 20% or greater, wetlands, watercourses and their buffers.
11. Identify location and•Size, of.significfint.trres.that are;I4cate'd, in sertsit(ve areas and buffers or the
shoreline zone. Of those, identify which are to be removed (Title 18, City of Tukwila Zoning Code).
12. Identify location of high watermark of the Green /Duwamish River if site is located within 200' of the
high water mark. .
13. See Public Works Checklist for detailed site plan information required for Public Works Review (Form
H -9).
❑ Foundation plan arid details - 1:71 0
❑ (, Floor plan •
❑ Roof plan .
❑ ❑ Building elevations (all views) - e - ij �.
❑ . ❑ Building height
❑ Building cross - section t cur( .CZ4 4 4 r
❑ Structural framing plans and details necessary to completely describe construction
❑ ❑ Washington State Energy Code Data (Gas/Electric./011/Propane/Heat Pump) Form H -15 available
at Permit Center OR Prescriptive Heating System Sizing Chap 9 Form H -6.
❑ ❑ Complete Land Use Applications if not previously submitted (i.e., Reasonable Use Exception,
Variance, Shoreline or Tree Permit).
❑ ❑ Attach plans, reports or other documentation required to comply with Sensitive Area Ordinance
and other land use or SEPA decisions.
❑ ❑ If dwelling has a septic tank, and a bedroom or bathroom are added, provide written approval
from the King County Health Department or the Tukwila Public Works Department prior to
submittal of permit application.
❑ ❑ Copy of Washington State Department of Labor and Industries Valid Contractor's License. If
not available at the time of application, a copy of this license will be required before the permit
is issued, unless the homeowner will be the builder OR submit Form H -4, "Affidavit in Lieu of
Contractor Registration ".
Bul/d/ng?Owner/Authorlred'A9slt "f th6 app /icant tiit''rTian th » Qwper,: leg! lstere arch .ONderigl0; licensed .
by the'$teta'of :.Washington, i� Oktei tr if ttellitiit iiik `r $ ►i 'a i hl� zlii Ilia age' »t to su& )I`th1s'pem f eppircati nand
obtain; thepormItwill,be.'r gUIt�eda,�7a OlthISiiSil ,,!ttll�l.�.ti7 }t ^�; >i 'r`^� ?` try • ?:�i;li i::t`ht 4t,r:,1'�tz:i�F ,'sty '.:
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF
PERJURY BY THE L4 OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
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I, Norand Leren, to the best of my knowledge state that the following
pictures, 1 thru 10 and the following pages 1 thru 6, accurately depict
the 12 x 20 addition, constructed on 07- 07 -89.
PENNY R. NOBIS
STATE OF WASHINGTON
NOTARY—* PUBLIC
MY OOINISSi0N DORM -OI
ACKNOWLEDGMENT -- ORDINARY
STATE OF W SHINGTON } ss.
County of _IC
On this 'd ersonally appeared before me
Ahmuqd
to me known to be the individyal described in and who executed the within and foregoing instrument and
acknowledged to me that r)P signed the same as / (td free and voluntary act and deed for the
purposes the • ntioned.
Y R OF gt and : r my hand and official seal this
pEN �ASHIN��Ot�
gZ ATE N IQub 'c in and for the State of Washington, residing
to COS Tt42-e2
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Penny R Nobis
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CIT OF VILA
MAR - 4 2002
c'EF MIT CENTEP
Doe- ova
Project: j�
U'el/I RPSIC '9ine f
Type of Inspection:
V ( nol 1
Address:
)1C /X) 1) 1 $-
Date called:
3 I R - o a,
Special instructions:
Date wanted:
,�. . m om .
~ 15��e Nay
Requester:
Phone:
MA gal.' rfe �: ri;ritiYyrasT i' ur+ Rwk' t ": £cE
rmN'�:�r vrc;
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 98188
' ✓ 4 '•` O (O
(206)431 -3670 �((�
PERMIT NO.
pproved per applicable codes. ❑ Corrections required prior to approval.
COMMENTS:
9 1 0 C owl
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Inspector: - D haillte S T
Date: 3_ g a 2
El $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No:
Date:
a;FS3: ''t;.. � .?idit'FGnv
roject:
t2Ei 51DE X
Type of Inspection:
'( ( A/ C,
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Addres :
‘qq00 //L/ sr
Drate called:
9-13 -(A
Special instructions:
Date wanted:
i .--. (
a.m:
p.m.
Requester:
- '5k +
Phone: ULo I2, 2-
V7
V k pproved per applicable codes.
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA' 98188
PERMIT NO.
(206)431 -3670
COMMENTS:
Corrections required prior to approval.
4 Otl 4 FEE REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No:
Date:
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COMMENTS:
Special instructions:
Date wanted: Requester:
INSPE/ CT ON NO.
ri Approved per applicable codes.
•
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 98188
PERMIT NO.
(206)431-3670
Corrections required prior to approval.
Inspector: Date:
Zfait" eti
Ei $47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No:
Date:
Projeck
Type of Inspection:
Date ca led:
Special instructions:
Date wanted, Requester:
Phone:
INSPE ION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 98188
El Approved per applicable codes.
INSPEC ON RECORD
Retain a copy with permit
(206)431-3670
Inspector:
Date:
Corrections required prior to approval.
$47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No:
Date:
FLOOR plan
PLA
RECEIVE
CITY OF TUK
MAR 1 6 02
PERMIT CENT
2 -Q(0o
1
l understand that the Plan Check approvals are
subject to errors and omissions and approval of
plans does not authorize the violation of any
adopted code or ordinance. Receipt of con-
tractor's copy of approved plans acknowledged.
B
FILE COPY
Date . 3 --U O --
Permit No t7O 2'0C40
REViSIONS TO
NO CHANGES SHALL BE MADE
°- tE SCOPE OF WORK WITHOUT PROS ,
72 OVAL OF TUI ILA BUILDING DIV120,
IsIOTE: REVISIONS WILL REQUIRE A NEW PLAN SUBMITT MAY INCLUDE ADD IONAL PLAN REVIEW FEES.
SEPARATE PERMIT
REQUIRED FOR:
'MECHANICAL
[,ELECTRICAL
LJ / LUMBJNG
Eir GAS PIPING
CITY OF TUJKWILA
BUILDING DIVISION
CITY Of TUKWILA
APPROVED
MAR - 7 2002
RECEIVE
CITY
MAR - 4 2002
PERMIT CENTER
construction foundation
walls floor and roof
headers for windows and sliding door
header at existing house
sill plate
exterior walls and roof
roof pitch
roof asphalt
plywood site map
calculations
construction interior walls sheet rock insulation walls r-11
insulation floor and roof r-30
windows and sliding door aluminum thermopane
exterior siding stucco lathe and plaster
plumbing electrical
CITY OF TUKWILA
APPROVED
MAR - 7 2002 BUILDING C11 / toN MAR - 4 2002
PERMIT CENTER
footings
addition drawing
existing foundation all rebar wire tied
drilled holes
epoxyed rebar stubs
site map
top view
floor plan
APPROVED
MAR - 7 2002
MAR - 4 2002
PERMIT CENTER
roof cross section
ACTIVITY NUMBER:
PROJECT NAME:
SITE ADDRESS:
Original Plan Submittal
Response to Correction Letter #
D02 -060
NORAND LEREN RESIDENCE
4920 S. 114 ST
DATE: 3 -18 -02
Response to Incomplete Letter #
X Revision # 1 After Permit Is Issued
DEPARTMENTS:
Buildig "'Division
Public Works
VA nu 31
TUES /THURS ROUTING:
Please Route
Documents/routing slip.cloc
2 -2B -02
PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
Structural Review Required
Structur'a� ❑
Fire Prevention
Incomplete ❑
REVIEWER'S INITIALS:
APPROVALS OR CORRECTIONS:
Approved (J Approved with Conditions ❑
Notation:
REVIEWER'S INITIALS:
❑ No further Review Required
PERMIT COORD COPY
D1(1
Plan iq Division
Permit
DUE DATE: 3-19-02
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete u
Comments:
Not Applicable ❑
Permit Center Use Only
INCOMPLETE LETTER MAILED:
Departments determined incomplete: Bldg ❑
LETTER OF COMPLETENESS MAILED:
Fire ❑ Ping ❑ PW ❑ Staff Initials:
DATE:
DUE DATE: 4-16 -02
Not Approved (attach comments) ❑
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑
Staff Initials:
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Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted
through the mail, fax, etc.
Date: —/
0 Response to Incomplete Letter #
0 Response to Correction Letter #
Revision # I after Permit is Issued
City of Tukwila
Department of Community Development - Permit Center
6300 Southcenter Blvd, Suite 100
Tukwila, WA 98188
(206)431 -3670
Project Name: L4.(2_ !%-) r` l o4 iv)
Project Address: "l C t Z-0 I I'4 1
Contact Person: rvde-
Plan Check/Permit Number: —
Summary of Revision:
C4Akk)C -)4 Sc_ rim. f o Roo
Sheet Number(s):
"Cloud" or highlight all areas of revision including date of revision
Received at the City of Tukwila Permit Center by: 1�.
k r Entered in Sierra on 345 'OZ
Phone Number: c)'- S (-I �dl
RECEIVED
CITY ; /r r;Jh'.^''ILA
MI li Il 1 � � 'j rj " jh
08/30/00
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Signature
doc: Conditions
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 3348401711
Address: 4920 S 114 ST TUKW
Suite No:
Tenant: LEREN RESIDENCE
1: ** *BUILDING DEPARTMENT * **
2: No changes will be made to the plans unless approved by the Engineer and the Tukwila Building Division.
3: Electrical permits shall be obtained through the Washington State Division of Labor and Industries and all electrical work will be
inspected by that agency
(248- 6630).
4: All permits, inspection records, and approved plans shall be available at the job site prior to the start of any construction. These
documents are to be
maintained and available until final inspection approval is granted.
5: Any exposed insulations backing material shall have a Flame Spread Rating of 25 or less, and material shall bear identi- fication
showing the fire performance
rating thereof.
6: All construction to be done in conformance with approved plans and requirements of the Uniform Building Code (1997 Edition) as
amended, Uniform Mechanical Code
(1997 Edition), and Washington State Energy Code (1997 Edition).
7: Validity of Permit. The issuance of a permit or approval of plans, specifications, and computations shall not be con- strued to be a
permit for, or an approval
of, any violation of any of the provisions of the building code or of any other ordinance of the jurisdiction. No permit presuming to
give authority to violate
or cancel the provisions of this code shall be valid.
I hereby certify that I have read these conditions and will comply with them as outlined. 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 provision of any other work or local laws
regulating construction or the performance of work.
Print Name: /l�& ( c /? ��....
PERMIT CONDITIONS
D02 -060
Permit N umber: D02 -060
Status: ISSUED
Applied Date: 03/04/2002
Issue Date: 03/08/2002
Date:
Printed: 03 -08 -2002
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CITY OF TUI ILA
Permit Center
6300 Southcenter Boulevard, Suite 100, Tukwila, WA 98188
Telephone: (206) 431 -3670
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
STATE OF WASHINGTON )
COUNTY OF KING
R.A-/v n I )
1. I have made application for a building 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 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 building 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 building permit to be exempt under No. , and
will therefore not be performed by a registered contractor.
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.
AFFCONT 1/13/00
0 1•--m f/)
ss.
, states as follows:
APPLICANT
H -4
Signed and sworn to before me this
$ +h day of /Ma , 20 0 2 .
a . ,a.e,,,,c(
NOTARY PUBLIC in and for the State of Washington,
residing at Ki h
County.
Name as commissioned: A l i c e , A. Deacy
My commission expires: -16-04
1 4.27.060 Exemptions. This chapter shall.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 or installation of any finished products,
materials, or articles of merchandise which are not
actually fabricated into and do not become a
permanent fixed part of a structure;
6. Any construction, alteration, improvement, or repair
of personal property, except this chapter shall apply
to all mobile /manufactured housing. A
mobile /manufactured home may be installed, set up,
or repaired by the registered or legal owner, by a
contractor licensed under this chapter, or by a
mobile /manufactured home retail dealer or
manufacturer licensed 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 $500, 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
AFFCONT 1/13/00
� 1{YipSSa�aii'��lT�"5nh" .A fU Krr..,x «..
•
of the operation is made into contracts of amounts
less than $500 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 is a
contractor, or that he is qualified to engage in the
business of contractor;
10. 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;
11. An owner who contracts for a project with a
registered contractor;
12. Any person working on his own property, whether
occupied by him or not, and any person working on
his residence, whether owned by him or not but this
exemption shall not apply to any person otherwise
covered by this chapter who constructs an
improvement on his own property with the intention
and for the purpose of selling the improved property;
13. Owners of commercial properties who use their own
employees to do maintenance, repair, and alteration
work in or upon their own properties;
14. A licensed architect or civil or professional engineer
acting solely in his professional capacity, an
electrician licensed under the laws of the state of
Washington, or a plumber licensed under the laws 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 licensee is operating within the scope
of his license;
15. Any person who engages in the activities herein
regulated as an employee of a registered contractor
with wages as his sole compensation;
16. Contractors on highway projects who have been
prequalified as required by chapter 13 of the Laws of
1961, RCW 47.28.070 with the department of
transportation to perform highway construction,
reconstruction, or maintenance work.
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ACTIVITY NUMBER: D02 -060
PROJECT NAME: Norand Leren Residence
SITE ADDRESS: 4920 S 114 St
DATE: 03 -04 -02
Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # Revision # After Permit Is Issued
DEPARTMENTS:
Buil ing Division F Fire Prevention Plannin g D vision Le
AWL 3•6 'V 3.54 S , f 02
Public Works Structural n Permit Coordinator
DIkIM *1* 3.1.01-
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS ROUTING: -vr Please Route Structural Review Required
APPROVALS OR CORRECTIONS:
Documents/routing slip.doc
2 -28 -02
PLA REVIEW/ROOTING SLIP
Incomplete n
n
DUE DATE: 03-05-02
Not Applicable n
No further Review Required
REVIEWER'S INITIALS: DATE:
DUE DATE: 04-02-02
Approved n Approved with Conditions Rf Not Approved (attach comments) r
Notation:
REVIEWER'S INITIALS: DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
PERMIT COORD COPY
pictures photos
RECEIVED
CITY OF TUKWILA
OAR - 4 2.00Z
PERMIT CENTER
pictures photos
RECEIVED
CITY OF TUKWILA
MAR - 4 2002
PERMIT CENTER
pictures photos
PERMIT CENTER
RECEIVED
CITY OF TUKWILA
MAR - 4 200?
PERMIT CENTER
finished home pictures photos
picture photo
picture photo
received permit center
RECEIPT
Parcel No.: 3348401711 Permit Number: D02 -060 -J O :
Address: 4920 S 114 ST TUKW Status: PENDING 0
Suite No: Applied Date: 03/04/2002
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Applicant: NORAND LEREN RESIDENCE Issue Date: co �
Receipt No.: R020000302 Payment Amount: 117.81 g Q .
N:
Initials: KAS Payment Date: 03/04/2002 01:21 PM H w
User ID: 1684 Balance: $367.00 Z H
Type Method Description = w al
Payment Check 9
Payee:
TRANSACTION LIST:
ACCOUNT ITEM LIST:
doc: Receipt
City of 1 ukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
S & S INTERIORS
Current Pmts
Amount
PLAN CHECK - RES
Description Account Code
000/345.830 117.81
Total: 117.81
444 03/07 9716 TOTAL 1.17.01
Printed: 03 -04 -2002
Payee:
ACCOUNT ITEM LIST:
doe: Receipt
S &S INTERIORS
Current Pmts
Amount
BUILDING - RES
PLAN CHECK - RES
STATE BUILDING SURCHARGE
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
RECEIPT '
Parcel No.: 3348401711 Permit Number: D02 -060 U O
Address: 4920 S 114 ST TUKW Status: APPROVED 0
Suite No: Applied Date: 03/04/2002 w H
A pplicant: LEREN RESIDENCE Issue Date: 0
.W O
Receipt No.: R020000323 Payment Amount: 849.30 LL Q
Initials: SO Payment Date: 03/08/2002 10:49 AM = a
User ID: 1165 Balance: $0.00 I— _
TRANSACTION LIST: 01—
Type Method Description W W
Payment Check 9229 849.30 I.Ll Z
Description Account Code
000/322.100
000/345.830
000/386.904
726.50
118.30
4.50
Total: 849.30
46 30 03/11 9716 TOTAL 049,30
0
Printed: 03 -08 -2002
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Facsimile Cover Sheet
To:
Company:
Phone:
Fax:
From:
Company:
Phone:
Fax:
0.082 -0f72-902
Dave Larsen
City of Tukwila
206 -431 665
SHARON MANN
RE /MAX EASTSIDE BROKERS
206 -241 -5300 OR 206 - 200 -3616
206 -244 -2843
Date: 3/18/02
Pages including this 2
cover page:
Comments:Any questions — please call me on my mobile 206- 200 -3616
P.S. In advance –I apologize if the spelling of your name is Larson.
Thanks
Sharon
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eLS s o t 20 6 t .JeW
menAvervIroffironVINWINAMASAVOMM
The Roil Estate Leaders
s„,
2•d
REMk
March 18, 2000
City of Tukwila
6100 Southcenter Blvd.
Tukwila, WA 98168
Attention: Dave Larsen
Dear Sir,
This letter is to assure you that the buyer and the buyer's agent of the home
located 4920 S. 114 in Tukwila has been made aware that the bedroom located in the
Southwest corner of the basement of the subject property is noted as a den, not a
bedroom.
Sincerely,
Sharon Mann, Agent
RE/MAX Eastside Brokers
C 82 —istr2 -902
FED
l:'.'L? 7 C 2002
Dt P ARTS
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Sharon Mann
Marketing Specialist
RE/MAX Eastside Broker, Inc.
11555 S.E. 8th Street • Bellevue, WA 98004. Office: (206) 241 -5300 • Fax: (206) 244-2843 • Cellular: (206) 200 -3616
Each RE /MAX" office is independently owned and operated, ( ;
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RECEIVED
MAR '102002
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