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HomeMy WebLinkAboutPermit D02-265 - SOUTHGATE MOBILE HOME PARK #19SOUTHGATE MOBILE PARK -SPACE 19 14005 42 AV S D02 -265 _._I ! . . ' , , • , { " fir W .0+ . ... . ,, C ity of Tukwila Me Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 , DEVELOPMENT PERMIT z /-w Parcel No.: 1610000076 Permit Number: D02 -265 Address: 14005 42 AV S TUKW Issue Date: 09/04/2002 6 m . Suite No: Permit Expires On: 03/03/2003 U O to 0 to iii Tenant: 11J z Name: SOUTHGATE MOBILE PARK #19 —J t Address: 14005 42 AV S, TUKWILA WA V_ WO Owner: g � < Name: ANDERSON CARL AUGUST Phone: Address: 10212 NE 43RD, KIRKLAND WA 2 d t`W Contact Person: Z H Name: CARL A ANDERSON Phone: 206 -439 -1055 I O ; Address: 14005 42 AV S, TUKWILA WA w t j Dp Contractor: V w Name: OWNER AFFIDAVIT - CARL ANDERSON Phone: CI D H'. Address: , w w Contractor License No: Expiration Date: i 0 . {{ O DESCRIPTION OF WORK: Z ' -- . ' • • • a A City of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / 206 431 -3670 Permit Center Authorized Signature: J�G zt- Date: 9- S-o Z 1 hereby certify that I have read and examined this permit and know the same to be true and correct. All provisions of law and � V ' ordinances governing this work will be complied with, whether specified herein or not. � O p.. i 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 perforce n :As f work. I am authorized to sign and obtain this development permit. CO w Signature: ) " kLZ / . _ ' �'Z.._.w Date: 9 "0G- oz._ 15 Print Name: I- w 2. 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 H- p suspended or abandoned for a period of 180 days from the last inspection. Z p' O W W' • Z 0 N O Z . ( i„ A ji 1 , i'i.. y� doc: Devperm 002 -265 Printed: 09 -04 -2002 7,r '�:air - _ Ci- ■ . /� / - , c� --ate Signature: �= iA � /,( Date: • Print Name: i i E I: ..y „, . ,' ' ' f ,,,,,7p;':;'t. , ;;',:k 'x'' . »P.' , :,,4:4, t . doc: Conditions D02 -265 Printed: 09 -04 -2002 'r : ` s >t ( ? 0. . 1 . W „. CITY OF TU''WILA ...S R STAFF USE ONLY 4 10 11 Permit Center $ `% Project Number: 6300 Southcenter Blvd., Suite 100, Tukwila, WA 98188 �1/ ie '� (206) 431 -3670 Permit Number: DO . - 0 Single-Family Residential Permit Application Application and plans must be complete in order to be accepted for plan review. Applications will not be accepted through the mail or facsimile. Project Name/Tena6� a 4164,4 Gr/j * / Value of Construction; C 9 9 Site Address: " j y � Cit S to /Zip: Tax Parcel Number: lgoos -- 42 — 4 S©• z% 76'MR Property Owne • Phone: Q on. 0' 0 6 - 9gg - 4 ,67 -6 — Street Address: s t City State /Zip: Fax #: Contractor: Phone: Street Address: City State /Zip: Fax #: Architect: Phone: Street Address: City State /Zip: Fax #: Engineer: Phone: Street Address: City State /Zip: Fax #: Z Contact Person: , L / _ _ 0 ., Phone: _ H w (/a X06 4/..??_ /os s C Street Address: ( �J City State /Zip: Fax #: 6 U —4/39 /35 -J o U) C Description of work to be done: V' OI dil de/nr�c a.6%2o.2flear/244 J Zta � emu. ",,/, `rv146 4 do 2d i Ce) 4r *For an Accessory dwelling, provide the following: O Z Lot area Floor area of principal dwelling Floor area of accessory dwelling U cq * Provide documentation that shows the principal owner lives in one of the dwellings as his or her primary residence. ~ O H Z APPLICANT,REQUEST FOR PUBLIC WORKS SITE/CIVIL PLAN REVIEW OF THE FOLLOWING: (Additional reviews shall be determined by the Public Works Department) ❑ Channelization /Stri in i p' g ❑Cur cut /Access /Sidewalk El 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 El Street Use El 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 t., t 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. p I' '�, l Date application accepted: . Date application expires: Application taken by: (initials) ;l . g 2102 2 -,21-6 9 ) Aa1A i i 1_I PLEASE SIGN BACK OF APPLICATION FORM i SFPERMIT.DOC 2/13/97 Law um. ara of :.:ti'.. '•t.'.,.i :;;.d,i a +u: ..ea• taY,zct :t O.b.4 x w ,� •!: . , ^:.. 'P'.YYmt ^ +'.'S:• "`;, owren.x�. «., ... _ .. • , . r . . . _ - ALL SINGLE- FAMILY RESIDENTIA.' • ERMIT APPLICATIONS MUST BE S T MITTED WITH THE FOLLOWING: DRAWINGS PREPARED BY it .EGISTERED ARCHITECT OR PROFL . SIONAL ENGINEER MAY BE REQUIRED BY THE BUILDING OFFICIAL D ALL DRAWINGS SHALL BE AT A LEGIBLE SCALE AND NEATLY DRAWN > BUILDING SITE PLANS AND UTILITY PLANS ARE TO BE COMBINED N/A SUBMITTED ❑ ❑ Copy of recorded Legal Description from King County ❑ ❑ Certificate of water /fire flow availability (Form H -11a). 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. ❑ ❑ M etro: Residential Sewer Certification (if Tukwila Sewer District) (Form H -12) ❑ ❑ K ing County Health Department approval for septic - 296 -4722 Four (4) sets 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), Z show proposed and existing power, water and sewer lines, existing storm drainage system, • downspouts and foundation drains, and where drains tie -in. 1- z w � 7. Parking plan. m 8. Lowest building elevation (if in Flood Control Zone). o 9. Estimated /proposed topography at 2' intervals and proposed elevation of lowest floor level. v o 10. Identify location of sensitive areas slopes 20% or greater, wetlands, watercourses and their buffers. u w 11. Identify location and size of significant trees that are located in sensitive areas and buffers or the _J ~ ' shoreline zone. Of those, identify which are to be removed (Title 18, City of Tukwila Zoning Code). u) u. 0 i 12. Identify location of high water mark of the Green /Duwamish River if site is located within 200' of the 2 high water mark. 13. See Public Works Checklist for detailed site plan information required for Public Works Review (Form u H -9). = a ❑ 1:1 Foundation plan and details z i ❑ ❑ Floor plan z O ❑ ❑ Roof plan w 1711 171 Building elevations (all views) v ❑ ❑ Building height o I— ❑ ❑ Building cross - section w ❑ in Structural framing plans and details necessary to completely describe construction IL I- ❑ ❑ Washington State Energy Code Data (Gas /Electric /Oil /Propane /Heat Pump) Form H -15 available Ili N at Permit Center OR Prescriptive Heating System Sizing Chap 9 Form H -6. H I In E3 Complete Land Use Applications if not previously submitted (i.e., Reasonable Use Exception, z Variance, Shoreline or Tree Permit). Cl ❑ 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 ". , w Building Owner /Authorized Agent If the applicant is other than. the owner, registered a; `aecbengineer, or contractor licensed ` `' " by the State of Washington, a notarized letter from the property owner authorizing the agent to„ 'limit this'permit application and . ;ice o p 'obtain the ermit will be required. as part of this submittal. E � �, I. 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 1 AM AUTHORIZED TO APPLY FOR THIS PERMIT. .1 ;. .' - BUILDING OWNER AUTO ED ; ENT: 1 • Signature: GG G Date: 9 39 ri ' Print name: Phone: Fax #: Address: City /State /Zip: !Lai SFPERMIT.DOC 2/13/97 rim I : • 41111 11111k • ' 7CiglY.ui ,w..,....:+F...•:. nor .•y.,...n:v.:w' /Mwiinwl'lw. ..• . •4 _w 1 1 - .. . -- - -- -1„ r - , - .1 • ) • \ . • , 8.411 City of Tukwila . ifa x ' # 1901I 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431-3670 , RECEIPT , ... z , „, rc 5 6 D . Parcel No.: 1610000076 Permit Number: D02-265 _I o o o Address: 14005 42 AV S TUKW Status: APPROVED . W 0 Suite No: Applied Date: 08/21/2002 g ILI 11.1 I -J Appl icant: SOUTHGATE MOBILE PARK #19 Issue Date: . ; o I 2 Receipt No.: R020001309 Payment Amount: 28.00 g 5 u. < Initials: SKS Payment Date: 09/04/2002 09:45 AM W a User ID: 1165 Balance: $0.00 I— LLI X. Z 1— 1— 0 Z 1— Payee: CARL ANDERSON w 11.1 2 m D CI C.) •0 D TRANSACTION LIST: 1 CI 1— (U -1-• Type Method Description W • • .....", Amount •I-- u_ ■ • Payment Check 2411 28.00 liZ • i V) 0 — P m o '— 1. ACCOUNT ITEM LIST: Description Account Code . Current Pmts • BUILDING - RES 000/322.100 23.50 STATE BUILDING SURCHARGE 000/386.904 4.50 Total: 28.00 1,,j';71:Lh ,P*T' 1E4 'TA, t; 1 Ekifa tl . q!..444A4 Vil 4 A*mu doc: Receipt Printed: 09-04-2002 ritt .:...-.:.,,....: 1 . . - . . .,- - -k c r . I ) Z < , . 1-- Z ' III ',. f , : : , , ■ rt •S ?2. . ..' . i _i 0 '< ,,,.... ".) ' ') INSPECTION RECORD , , , , co a te, u) ILI t,„ ".• ' 1 -•" °- Retain a copy with permit - " ,, -. • ' INSPECTION NO. P 4 IT s. CITY OF TUKWILA BUILDING DIVISION , uJ 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431-3670 Pro' ct: Type of Inspection: i n ....-IA . u. < ittlV/t r (__ , ‘-: Address: • . , f Date Called — a I f d tg /4„,..5 1 9 1 -/i-o, , x :t. Special Instructions: Date Wanted: (. 4a.n 3. 4) 4' - /9 - 6 P--- 1 ' Requyster: ul ui Z....40W/ 2 n D C3 Phone NG: 0 0 — a 1-- Approved applicable codes. 0 Corrections required prior to approval. ,.. ' : CO : Sim ENTS ii.l u j . , Z uJ i W 0 - — i ::-- . . l- it • . . , :..,.. . , . . ,...........„ oio..444: „ it,,,,I , .I • 1 1 :1 . . : ' ' Inspector: t--- Date: `" ,?-- . . -, El $47.00 REINSPECT N FEE REQUIRED. Prior to inspection, fee must be , 1 paid at b300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: Date: .... , . i ,.. 4 .i : u .:: , :.: . .:. : : ‘.... . . ....., .' , C/v4iktie044'114;0 ',.1f■i'sbcf4 1 . 1 1 , . . Q • J ` c4 C ' ,. INSPECTION RECORD ) Ww ..,.. Retain a copy Z� - 2 � S . py with permit I N ~ INSPECTI •N N0. PERM O, w LL 0 • CITY OF TUKWILA BUILDING DIVISION • .:V • - 2 -, Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 pg 5 .' Project: ( Q yJ�,,(�/ � jn�� Type of Inspection: }f/.� �] U. tD ° l' , ` IV "..�✓`'R .� Imo• ~y!�"�I r w , f / ` - u, `r Address: , �•+v`_R Date Called: i f" w > 11 -(005 - ) k 1 AVT J z/o 2 Z 1- Special Instructions: Date Wanted: , F' O ` / / / Z I- LUD Requg stet: � � l'" V N Pone No: - - {�[- .c.l` -.e g F- �/ i U :^:,,, a Approved per applicable codes. j;4Corrections required prior to approval. 1 = COMMENTS: O , N R6? S s Z ~ ,..., _. 0. , , 5 .-,16-,,,,e,,,,..6-, . \..'::'\' ` • , , ,--., . K • .• i i.r: .m,;,,,,o,:iv ...„ i Inspector: Date: a ,{l :- fit r 1 i21a"7e1 q.._ _l/ �-- ■ §y{y j : 547.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be A', 0 paid att300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: . Date: , i s :.. } ► _ -1 . . -- v - _ -- . _.f., S ���, . } . : ' i ce ! }� ,� C 1' .. ! „ Pte' . . INSPECTION REPORT V O e�' ' C - 7 ? , r s �; ,� �k :,, .. � ;� :, ,. 7 V4 City of Tukwila Building Division ' ; , � �. 1 ; � ^ t A , as ;1£V `` • (, J il Project: Southgate Mobile Home Park 1. ` "' � �! . i �':�' - �.: V v Add 14005 42 °d A Sth re ss: - v enue ou lV1 `”' 6-d■WeiCt° ' `` Tukwila, WA 9 8168 Z ,li_: /lam IX LLI ' . -- -- - _ -- .— . \ ., - ,, ... INSPECTION REPORT City of Tukwila Building Division , Project: Southgate Mobile Home Park Address: 14005 — 42 °d Avenue South ' = Tukwila, WA 98168 Z ' i ■ Date: July 5, 2002 6 = J O Trailer # f to 0 to tu tu = Findings: co . ,-,, PERMIT NO 2 65 TENANT NAME:SINVICIATE NI lit p * pf BUILDING PERMITS INSPlECTIONS CONDITIONS ❑ 1 Progress Inspection Status S 10001 No changes will be made to the plans unless approved ❑ 2 Pre - construction by the Engineer and the Tukwila Building Division ' 3 Investigation ❑ 10002 Plumbing permits shall be obtained through King Co 4 OK to Occupy ❑ 10003 Electrical permits obtained through L & I 10004 All mechanical work shall be under S Remove Stop Work Order separate permit z El Follow -up 10005 All permits, insp records & approved plans available .. = Z 10006 All structural concrete shall be special i ,t- W 7 Pre -Move Inspection spa inspected 50 WSEC Residential 10007 All structural welding shall be done by WABO certified g 60 WA Ventilation/Indoor AQC inspector ❑ 70 NLEA Inspection/Modular Struct ❑ 10008 All high- strength bolting shall be special inspected U O 71 Mobile Horne Tie Down Insp ❑ 10009 Bolts installed in concrete shall be special inspected N p 72 Marri Litres ❑ . 10010 When special inspection is required...notify Tukwila N W 90 Regal Building Division W I 95 Footing Drains ❑ 10011 The special inspector shall submit a final signed report U) ❑ 100 Foundation Footings ❑ 10012 Any new ceiling grid and light fixture installation w O ❑ 200 Foundation Walls ❑ 10013 Partition walls attached to ceiling grid 2 ❑ 250 • Foundation Insulation ❑ 10014 Readily accessible access to roof mounted equipment g :J O 300 Concrete Slab/Slab Insulation ❑ . 10015 Engineered truss drawings & cafes shall be on site u.. Q 0 350 Crawl Spas • ❑ 10016 Any exposed insulation backing material shall have v) d 400 • Shear Wall Nailing ❑ 10017 Subgrade preparation including drainage, excavation Z W 450 Plywood Will Sheathing ❑ 10018 A statement from the roofing contractor verifying fire Z 1.- 500 Roof Sheathing Nailing retardant class of roof • 525 • Plywood Deck Nailing I 10019 All construction to be done in confonnance w /approved Z O ❑ 550 Exterior Wall Sheathing Plans al O 600 Chimney Installation/All Types ❑ 10020 Structural observation shall be provided for this project - U N ❑ 700 Framing ❑ 10021 All food preparation establishments must have King Co 0 — ❑ 10022 Fire retardant treated wood shall have flame spread of 750 � Roof/Ceiling Insulation 800 Floor Insulation ❑ 10023 Notify Building Division prior to placing any concrete W al U • 1101 Wall Insulation ❑ 10024 All spray applied fireproofing shall be special inspected i- 2 1102 Exterior Roof Insulation ❑ 10025 All wood to remain in placed concrete shall be treated LL- O , ❑ 803 Glazing Inspection 10026 All structural masonry shall be special inspected iii Z ❑ 815 Lighting and Controls gi 10027 Validity of Permit U Cl) ❑ 900 Suspended Ceiling ❑ 10028 Rack storage requires separate permit ~O ❑ 1000 Interior Wallboard Fastening Z ❑ 1001 Exterior Wallboard Fastening ❑ 10030 No occupancy of building until final insp by Bldg Div ❑ 1110 Pre - Move Inspection ❑ 10031 Comply with requirements of TMC 16.04 ❑ 1115 Motor Inspection ❑ 10032 Remove all weeds, concrete, stone foundations, flat . O 1120 Pre -Demo concrete ❑ 1140 • Pre - reroof ❑ 10034 Removal of septic tanks require approval and all 1400 Final-Fire compliance with King Co Health Dept. is 1700 Final-Building 0 10035 Contact PW Div to obtain insp for water /sewer connect 1900 Final- Reroof 3100 Site Visit 0 10036 Manufacturers installation instructions required on site 4000 Special- Concrete ❑ 10038 A C of O will be required for this permit 4001 Special-Bolts in Concrete ❑ 10039 Final approval for all TI w /in the limits of the SC Mall ❑ 4001 Special- Mom/Resist Cone Frame ❑ 4003 Special-Reinf Steel Prestress ❑ 10040 All construction noise to be in compliance with 8.2 TMC ❑ 4004 Special- Welding ❑ 10041 Ventilation is required for all new rooms & spaces ❑ 4005 Special- High - Strength Bolting - ' "i ❑ 4006 Special- Structural Masonry ❑ 10042 Fuel burning appliances 4007 Special Reinf Gypsum Concrete Appliances, which generate s { ❑ 10043 Applihich genate " '`' s Y - O 4008 Special- Insulating Conc Fill ❑ 10044 Water heater shall be anchored f "' , ,1 ,+ ❑ 4009 Special-Spray Fireproofing ❑ 10045 Reroof x �f" ❑ 4010 Special- Piling, Piers, Caissons ❑ "Anchoring - All new construct and substantial it�. ; , n i ❑ 4011 Special- Shotcrete improvement shall be anchored to prevent flotation , ❑ 4012 Special- Grading, Excav/Fill ; .iix� ❑ 4013 Special- Retaining Wall 1 1 ' �4 qa ' �. �� Pla Reviewer Date: CS O"7 =�" ❑ 4014 Special- Panels �• ❑ 4015 Special-Smoke Control System „ r;t dr���aa -2p-(22- ,,,,..,,,,,,,. Permit Tech: I 1 _ Date: r/ . ,,,,, , ,, FAO ii . .. ..t...•.........nu. nw, .c.. e.n• ..nr,wtnr' +. zwN+i! M21 T. F3tClIlYN<kU'�WRDs ., , ; 1 • PERMIT COORD CODS PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D02 -265 DATE: 08 -21 -02 4 PROJECT NAME: SOUTHGATE MHP — SPACE #19 z , SITE ADDRESS: 14005 42 AVENUE SOUTH `- z tu X Original Plan Submittal Response to Incomplete Letter # 0 0 i Response to Correction Letter # Revision # _ After Permit Is Issued w = . Qu ui O 2 DEPARTMENTS: J K t4 Atou ta.4.O ' LL. Building Division In Fire Prevention ❑ Planning Division ❑ = C! Public Works ❑ Structural ❑ Permit Coordinator Al 1-- = W ZI— I — O Z I— w DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 08 -22 -02 2 0 Complete [ Incomplete ❑ Not Applicable ❑ 0 D- - Comments: = W , �U Permit Center Use Only. lil Z INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: I= I Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: z i Z TUES /THURS ROUTING: Please Route L' Structural Review Required ❑ No further Review Required ❑ ■ REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 09-19-02 Approved ❑ Approved with Conditions Q1 Not Approved (attach comments) ❑ Notation: i 4 REVIEWER'S INITIALS: DATE: . . '' � " 01 Permit Center Use Only t CORRECTION LETTER MAILED: r Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: ;NZ t {4a i`' i :„:v i I COVrw L ��I . Documents/routing sIIp.doe e i .s M^ , , , b .:f. r .., ..;$ '�.: t.Et t' •.: !'S .4 .,. :L `.J.• r. L ruefa ».r. ne+vwr....w.wu.. . w ..,-w...... n. n ..............,..,....•........ ., »...w..- .wv.....e..T+,•rr w.,lv'vf,N}hnN >Yl/iA . I mo. .. ' . `1 PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D02 -265 DATE: 08 -21 -02 PROJECT NAME: SOUTHGATE MHP - SPACE #19 z . SITE ADDRESS: 14005 42 AVENUE SOUTH ~ z �w X Original Plan Submittal Response to Incomplete Letter # v v0 co 0 Response to Correction Letter # Revision # _ After Permit Is Issued w = J I— i - w0 2 DEPARTMENTS: g a Building Division jk Fire Prevention El Planning Division El � 0 = d Public Works ❑ Structural ❑ Permit Coordinator ❑ W z H I- O Z F - W DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 08-22 -02 ? 0 Complete * Incomplete ❑ Not Applicable ❑ 0 • N O F- Comments: = Li.' . i ~ h- u 0 Permit Center Use Only ii w j Z i INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: 0 = I- O ~ Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ . PW ❑ Staff Initials: Z TUES /THURS ROUTING: Please Route ❑ Structural Review Required ❑ No further Review Required it., . l ■ REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 09-19-02 . Approved ❑ Approved with Conditions si t Not Approved (attach comments) ❑ ..- ;, Notation: . ._ REVIEWER'S INITIALS: 61,,... DATE: 5 ( -- . :i Permit C enter Use Only a CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: °, :�; j tt ti,5'}, .try .P low 0r,... • i1 Via Documents/routing slip.doc 2 -28 -02 raZStt ', 1. ' 7 7 P + , X• � � {,, .. ... ,., .. .,y., . .. ..,t.. ' �u? .n•�tfa.x }iAtix..ti:.6:'a...n..,. .t, a., r.. A.4 r[NK+Nya+.n+.ana.«. raw w.. .:......�..+... -. .. _• ......«....._...,. ......,.,,,., .. .. .. , 1 . _ , , - -I 7 .- .7 - - 'r • N.{., • k w� CITY OF TUKWILA io a �_1 � Permit Center H.14 1 es�� 0 6300 Southcenter Boulevard, Suite 100, Tukwila, WA 98 188 '`%. fl f Telephone: (206) 431 -3670 1909 AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION Z. STATE OF WASHINGTON ) x w COUNTY OF KING ) ss 6 Ce U f 00 CO CD ILI i C 3/4- g 4 '4/ 4 Ji/D rL SoA , states as follows: I Co 1. I have made application for a building permit from the City of Tukwila, Washington. 2 g In 2. I understand that state law requires that all building construction contractors be registered with the u. o State of Washington. The exceptions to this requirement are stated under Section 18.27.090 of the = w Revised Code Washington, a copy of which is printed on the reverse side of this Affidavit. I have Z i read or am familiar with RCW 18.27.090. W 3. I understand that prior to issuance of a building permit for work which is to be done by any w 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. w - 1 2 V 4. In order to provide verification to the City of Tukwila of my compliance with this requirement, I hereby F- P. ' j attest that after reading the exemptions from the registration requirement of RCW 18.27.090, I z consider the work authorized under this building permit to be exempt under No. , and Cu 0 will therefore not be performed by a registered contractor. o 1 z 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 w• . 1 t i r i a4a?/Z PLICANT %,,Aa4 '%, Signed and sworn to before me this ''''\‘''.. 7 , . ... ''. i f 4.); . si o r v }' day of X l �2G / , 20 OZ-- . 47,101 r • ! OM M .Wi: LEW:, y % ! ; �! ng ; , �' NOTARY PUBLIC in and for the State of Washington, • ` s to ■ residing at 14 " - .ClAii County. . '4' . '44 Name as commissioned: 1(.- ( Js a� &\ �1-�1 . M h :rc , My commission expires: `> " (ci - 0 (o 0 7 AFFCONT 1/13/00 ' t • �` " ... .,MgevsauiMw. Mta ......... ww+ wnu. wrv+ a.- ronwrwnrax.... 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