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HomeMy WebLinkAboutPermit D02-271 - SOUTHGATE MOBILE HOME PARK #45 - HANDRAILS, STAIRS, LANDING AND SKIRTINGSOUTHGATE MHP #45 14005 42 AV S D02 -271 ., • i.. C i Tukwila ,.. . ro Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 . DEVELOPMENT PERMIT z ¢ Parcel No.: 1610000076 Permit Number: D02 -271 W re Address: 14005 42 AV S TUKW Issue Date: 09/04/2002 6 j Suite No: Permit Expires On: 03/03/2003 U O u) 0 Tenant: 0 w Name: SOUTHGATE MOBILE PARK #45 W H A ddress: 14005 42 AV S, TUKWILA, WA N u-' I w O Owner: . } CARL AUGUST u_ < Name: ANDERSON CA UGUS Phone: u_ ¢ Address: 10212 NE 43RD, KIRKLAND WA V) d I ~ W. Contact Person: Z H : Name: CARL A ANDERSON Phone: 206 439 -1055 i - 0 Address: 14005 42 AV S, TUKWILA, WA W • W Contractor: 0 0 CI Name: OWNER AFFIDAVIT - CARL ANDERSON Phone: 0 Address: Contractor License No: Expiration Date: H 0 DESCRIPTION OF WORK: ▪ Z PROVIDE HANDRAILS AT EACH STAIR; STAIRS AT 2ND ENTRY AND LANDING; REPLACE MISSING SKIRTING 0 N O '- i z Value of Construction: $100.00 Fees Collected: $28.00 . Type of Fire Protection: Uniform Building Code Edition: 1997 Type of Construction: Occupancy per UBC: 0007 ‘ ' Public Works Activities: 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: 4 n '`' , ° Sanitary Side Sewer: N ; t -- 1 4.�''f , " Sewer Main Extension: N Private: N Public: N ' Storm Drainage: N } :. w S �. ��w)j Street Use: N Water Main Extension: N Private: N Public: N Water Meter: `�, q rr' y Channelization / Striping: • 3�f1e t- ** Continued Next Page ** ;Al' <<� ! fit) * , i ^� N mss 5, 'r {. r•: doe: Devperm D02 -271 Printed: 09 -04 -2002 � , t 1 . f - �I of Tukwila ,9 • • • • eArefit Ci y Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 Permit Center Authorized Signature: Date: 7 5� D ? F' ILI ( 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 6 5 . ordinances governing this work will be complied with, whether specified herein or not. U O U) The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws w = regulating constructio . ' e perf•rm of" k. I am authorized to sign and obtain this development permit. N e r Signature: ' -' / / Date: '?" �-- W O g J U.Q. Print Name: = a' . F- W 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 ? F suspended or abandoned for a period of 180 days from the last inspection. z O. D �. 0 — C F-: W W . F li. O t ..Z O N H • I t 1)} z • i R• a7 u =i +". doc: Devperm D02 -271 Printed: 09 -04 -2002 :,. .- r ,' ... .. - .... • . .. . r l'. . ..L... L...Yr...W...w.ur .. ... • .. ., ..........«... .... r ..:.+Y+:- .l'w.uu..w:wr.aY.�rwi wIr A r .wn•.aM 1 , r _ , • ZK.! v • • • � AP 4 S . ti' ' ' 81'4 ,,, City of Tukwila MS , Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 , 1 , 7 - - - � °�'W ;;' N s , CITY OF T1.1-WILA OR STAFF USE ONLY r Z �� '�; .; . � 9 Permit Center Project Number: 6300 Southcenter Blvd., Suite 100, Tukwila, WA 98188 ' %Obi (206) 431 - 3670 Permit Number: 3)02471 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 NameTTena Tour a 4. 9 , 64 , 1 • , i) a , L� Value o nstruction: Site Address: C it S to /Zip: ax Parcel Numb a. — la — (�, S©. /4 Property Owne — �� /K � Phone: 9,39 r /e67 -6 - Street Address: s Omtti.. 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 Q � Contact Person: ,,, lam ,� Phone �'�- 0 06 - y ' /Oj"S' F_ z Street Address: ( GL'UWAJ City State /Zip: Fax #: 6 --y39_ /35"S -i o Description of work tt be done: / n 4-1/3 - �"`/2 co w al i .I � �!L� i`r12 d( 574,, S 4-a gu "• ` �,� H 6/44a . w w ( Type of work: • New Single- Family Residence ❑ Addition - Single - Family Residence 2 ❑ Interior Remodel- Single - Family Residence ❑ Residential Accessory Structure* ❑ Remodel /Addition to Accessory Structure ❑ Garage(s) " j m a Deck(s) - Covered & Uncovered ❑ Residential Reroof = I- 1 - 1 - 1 Is this site served by: ❑ Sewer ❑ Septic (King County Health Dept. approval required - 296 -4722) Z H Existing Square Footage for Structure: sq. ft. Dwelling sq. ft. Covered Deck(s) Z O sq. ft. Garage /Carport sq. ft. Accessory Structure(s) sq. ft. Uncovered Deck g w . D C) Proposed New Square Footage: sq. ft. Dwelling sq. ft. Covered Deck(s) 0 u) sq. ft. Garage /Carport sq. ft. Accessory Structure(s) sq. ft. Uncovered Deck C.1 I— wW Floor Area Ratio: (total floor area of all structures divided by the area of the lot) = U u_ E- ' For an Accessory dwelling, provide the following: ! O Lot area Floor area of principal dwelling Floor area of accessory dwelling tii U - * Provide documentation that shows the principal owner lives in one of the dwellings as his or her primary residence. I- Z APPLICANT REQUEST FOR PUBLIC WORKS SITE/CIVIL PLAN REVIEW OF THE FOLLOWING: (Additional reviews shall be determined by the Public Works Department) ❑ Channelization /Striping ❑ Curb cut /Access /Sidewalk ❑ Fire Loop /Hydrant (main to vault) #: Size(s): ' ❑ Flood Control Zone ❑ Hauling El 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 r ❑ Storm Drainage ❑ Street Use El Water Main Extension 0 Private 0 Public ❑ Water Meter /Permanent # Size(s): �I ❑ 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- � l viewed and is subject to possible revision by the Permit Center to comply with current fee schedules. ,•: � i �, 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 1.P.' 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. I - Date application accepted: Date application expires: Application taken b :initials PP P PP P PP Y (initials) i ; c92/ t z Z z / -d3 -AS I ru PLEASE SIGN BACK OF APPLICATION FORM ice... it ,MI SFPERMIT,DOC 2/13/97 �i Win; A f ALL SINGLE -FA ' IL Y RESIOENTI i I- -- • ERMIT APPLICATIONS MUST BE -- 1 MITTED WITH THE FOLLOWING: DRAWINGS PREPARED BY A. , •EGISTERED ARCHITECT OR PROFhsSIONAL ENGINEER MAY BE REQUIFIWY .BUILDING OFFICIAL ALL DRA91III46S 614ALL 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 -11 a). 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 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), = • show proposed and existing power, water and sewer lines, existing storm drainage system, I-- z downspouts and foundation drains, and where drains tie -in. re 7. Parking plan. 6 D 8. Lowest building elevation (if in Flood Control Zone). 0 0 9. Estimated /proposed topography at 2' intervals and proposed elevation of lowest floor level. u) w 10. Identify location of sensitive areas slopes 20% or greater, wetlands, watercourses and their buffers. 11. Identify location and size of significant trees that are located in sensitive areas and buffers or the u) u- uj 0 shoreline zone. Of those, identify which are to be removed (Title 18, City of Tukwila Zoning Code). 2 12. Identify location of high water mark of the Green /Duwamish River if site is located within 200' of the J high water mark. u- 13. See Public Works Checklist for detailed site plan information required for Public Works Review (Form = d H -9). I- _ ❑ Foundation plan and details zI- ❑ ❑ Floor plan w 0 ILI ❑ ❑ Roof plan M m ❑ . ❑ . Building elevations (all views) o to ❑ ❑ Building height in W ❑ ❑ Building cross - section p u' ❑ ❑ Structural framing plans and details necessary to completely describe construction z w co ❑ ❑ Washington State Energy Code Data (Gas /Electric /Oil /Propane /Heat Pump) Form H -15 available o at Permit Center OR Prescriptive Heating System Sizing Chap 9 Form H -6. z ~ ❑ ❑ 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 ". rp :. ..- 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. �' ' I HEREBY CERTIFY THAT/ HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF i . , ... PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING O OR 7ZED ENT: '�' Signature: Date: O � � � Print name: Phone: Fax #; Address: City /State /Zip: SFPERMIT.DOC 2/13/97 L`` `t ..... • ,..,.a. -..«- - . y ...........,, _it, ,^'+/,S!!aa.%co. " ,., s*' '4'i„,:4 iiYu'�,.kYv hall, , e nt2 I,,ifS i ,K9tik'tk•' '`.,L-=.6:i�1 ria=" ''.'..::a„Wi .:.....,- ,:..,-,. ,. ...-..,..:.:... .:w:- ...:...,..,...._;...�,... ,_.. _ I - - - - 't.47 - --�, 1 • c ���Pa Tukwila C of 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 , Z RECEIPT , 11 , Parcel No.: 1610000076 Permit Number: D02-271 - U Address: 14005 42 AV S TUKW Status: APPROVED , : 0 Suite No: Applied Date: 08/21/2002 W = Applicant: SOUTHGATE MOBILE PARK #45 Issue Date: J N U W 2 Receipt No.: R020001297 Payment Amount: 28.00 g J . u- Initials: SKS Payment Date: 09/04/2002 09:30 AM N a y = a . User ID: 1165 Balance: $0.00 F— _ Z 1- O Payee: CARL ANDERSON W UO .O D TRANSACTION LIST: p 1— Type Method Description OW 1' Amount F , 2 U.. ~Of Payment Check 2411 28.00 Z Iii fa , . O I- ACCOUNT ITEM LIST: Z Description Account Code 0 Current Pmts BUILDING - RES 000/322.100 23.50 STATE BUILDING SURCHARGE 000/386.904 4.50 Total: 28.00 . { i j ptp { , � , M � ;,;7 i r I ?,� ' S q { P`,1, . i ,. il doc: Receipt Printed: 09 -04 -2002 N , . #;;. ••__- - — - -. ,- -'.4 , • r Z ~ W no C { - r J V , to 0 INSPECTION RECORD s 7 / J i • Retain a copy with permit , co LL INSPECTION NO. ,'ERMIT NO. .t W 0 �' �'� CITY OF TUKWILA BUILDING DIVISION 4 • 2 • -- — -- - LLI•: Provide a landing at secondary exit door. The landing shall not be more than 1" lower z 9 than the threshold of the doorway. Stair landing shall have a dimension measured in the U cn direction of travel not less than the width of the stairway. Such dimension need not 0 1 exceed 36 inches where the stair has a straight run. . z Provide a guardrail for landings greater than 30 inches above grade level. Top of • guardrail shall be not less than 36 inches. Open guardrails shall have intermediate rails or an ornamental pattern such that a sphere 4 inches in diameter cannot pass through. Provide foundation skirting where missing. Skirting must be made of materials suitable for ground contact. Metal fasteners must be made of galvanized, stainless steel or other corrosion resistant material. Ferrous metal members in contact with the earth (unless galvanized or stainless steel) must be coated with an asphalt emulsion. All skirting must be recessed behind the siding or trim so as to not trap water between the skirting and RECEIVED __ siding or trim. CITY OF TUKWILA '�..r ,1 4 I: C,\ 1 111 {9 AUG 21 2002 ` '. r a ver _ ok , { i 6 j - PERMIT CENTER b rio , p,\ ('� �,r eve wr,, 0, -V �r y7 1 -0ta . 11 `t �l 'fl RQ «�� �� �� PP. k,. y t4 �J „' r � n 'ry aa F it iL+i((�� IDUILDNF*� PLAN IC.,I���.,11 :. , .n _.. _. .. `:��7l tikes.II Itl I„� 1 1�`�7. 7 r; t3w: 1II_�S*O ?t.S WILL crOUIRE A NEW PI.A ENV REVIE r-1 , w � , c�, — .CO �t.,.v I�c�t4o� �otri��. �� " OZ•z .4 ,...„..,,,,,.:,. .. , , , _ , . . . . __ , . r — — __ •_T • 4,1 • • • 1 pER Cop PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D02 -271 DATE: 08 -21 -02 PROJECT NAME: SOUTHGATE MHP - SPACE #45 a = I; SITE ADDRESS: 14005 42 AVENUE SOUTH re -- .— • . - 4., - ■ 1414* e".441S ' , PLAN REVIEW /ROUTING SLIP ii ACTIVITY NUMBER: D02 -271 DATE: 08 -21 -02 PROJECT NAME: SOUTHGATE MHP - SPACE #45 a _ t SITE ADDRESS: 14005 42 AVENUE SOUTH '� z r 1 6 n X Original Plan Submittal Response to Incomplete Letter # v 0 -- 0 Response to Correction Letter # Revision # After Permit Is Issued CO = _ 1 J I ! CO u_ DEPARTMENTS: g Q Building Division Fire Prevention ❑ Planning Division ❑ = d Public Works I.- W ❑ Structural ❑ Permit Coordinator = z1 W W DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 08-22 -02 U D Complete X Incomplete ❑ Not Applicable ❑ 0 C omments: = W . H ► --".'1 PERMIT NO.: DOZ -' 2.11 TENANT NAME: T *AT , M or 4k y5 BUILDING PERMITS INSPECTIONS 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 [] 5 OK to Occupy ❑ 10003 Electrical permits obtained through L & I Remove Stop Work Order 10004 All mechanical work shall be under separate permit ❑ 6 Follow -up 10005 All permits, insp records & approved plans available Q 7 Pre -Move Inspection 10006 All structural concrete shall be special inspected H W Ce 0 SO WSEC Residential ❑ 10007 All structural welding shall be done by WABO certified ❑ 60 WA Ventilation/Indoor AQC inspector 10008 All high-strength bolting shall be special inspected ❑ 70 NLEA Inspection/Modular Struct ❑ Bh 8� 8 P P _i U n 71 Mobile Home Tie Down Insp ❑ 10009 Bolts installed in concrete shall be special inspected C.) 0 0 72 Marriage Lines ❑ 10010 When special inspection is required...notify Tukwila N ❑ 90 Rested Building Division W = ❑ 95 Footing Drains ❑ 10011 The special inspector shall submit a final signed report N f IL 1 0012 Any new ceiling grid and light fixture installation ❑ 100 Foundation Footings ❑ Y 8 Sri Sh O ❑ 200 Foundation Walls ❑ 10013 Partition walls attached to ceiling grid 0 ❑ 250 Foundation Insulation ❑ 10014 Readily accessible access to roof mounted equipment 2 F_ ❑ 300 Concrete Slab/Slab Insulation ❑ 10015 Engineered truss drawings & talcs shall be on site § Q ❑ 350 Crawl Space ❑ 10016 Any exposed insulation backing material shall have n ❑ 400 Shear Wall Nailing ❑ 10017 Subgrade preparation including drainage, excavation D a ❑ 450 Plywood Wall Sheathing ❑ 10018 ........ A statement from the roofing contractor verifying fire I- _ ❑ 500 Roof Sheathing Nailing retardant class of roof Z I.-. ( ❑ 525 Plywood Deck Nailing ' 10019 All construction to be done in conformance w /approved I- 0 ❑ 550 Exterior Wall Sheathing plans Z W { 0 600 Masonry Chimney 10020 Structural observation shall be provided for this pro ect = p 610 Chimney Installation/All Types 750 RooflCeiling Insulation ❑ P P U 700 Framing ❑ 10021 All food preparation establishments must have King Co O to CI I. ❑ 10022 Fire retardant treated wood shall have flame spread of 800 Floor Insulation ❑ 10023 Notify Building Division prior to placing any concrete W W 801 Wall Insulation ❑ 10024 All spray applied fireproofing shall be special inspected I U 0 802 Exterior Roof Insulation ❑ 10025 All wood to remain in placed concrete shall be treated u 1- 10026 All structural masonry shall be special inspected — O ❑ 815 Lighting and ntrols 11 10027 Va of Permit cu Z co ❑ 900 Suspended Ceiling ❑ 10028 Rack storage requires separate permit U = ❑ 1000 Interior Wallboard Fastening p I- , ❑ 1001 Exterior Wallboard Fastening ❑ 10030 No occupancy of building until final insp by Bldg Div Z ❑ 1110 Pre -Move Inspection ❑ 10031 Comply with requirements of TMC 16.04 a ❑ 1115 Motor Inspection 10032 Remove all weeds concrete, stone foundations, flat 1120 Pre -Demo concrete ❑ 1140 Pre -reroof ❑ 10034 Removal of septic tanks require approval and 1400 Final -Fire compliance with King Co Health Dept. 1700 Final - Building ❑ 10035 Contact PW Div to obtain insp for water /sewer connect 1900 Final - Reroof ❑ 10036 Manufacturers installation instructions required on site ❑ 3100 Site Visit ❑ 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 Conc 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 ❑ 4006 Special - Structural Masonry ❑ 10042 Fuel burning appliances 't '7" i - ' 1 , ❑ 4007 Special - Reinf Gypsum Concrete ❑ 10043 Appliances, which generate 10044 Water heater shall be anchored k,‘ i „ ❑ 4008 Special - Insulating Conc Fill ❑ `' ..'.1.13T', a 4009 Special -Spray Fireproofing ❑ 10045 Reroof ❑ r'ri 1 4010 S ial -Pilin ,Piers, Caissons ❑ "Anchoring -All new construct and substantial : r ` . 4 ❑ 4011 Special - Shotcrete improvement shall be anchored to prevent flotation" •_" " ❑ 4012 Special- Grading, Excav/Fill ❑ 4013 Special- Retaining Wall ` O ; ,,: ❑ 4014 Special - Panels Plan Reviewer: Date: D •.. i . .it , , ,, . t ❑ 4015 Special -Smoke Control System c+ I Permit Tech:_ Date: �' g r x 4.r ` f .'!� Nype•.INMMW..-.un + rtwww . w...v...... w..•............ ... _....,.... r...w.••••• •,........... _.. ..........r..r .M+..r... V+..nw.vi.fv N.txn fn✓ NF!.. w++:w....a.u.+r- .u.........i... . w:..:.Kixt4.Y..f.M<Y.t' i I - .-- . `1.6r �i A 1 4 , w ',si CITY OF TUKWILA -- H..4 � � 1� i a o Permit Center 1 '%" ''i. 6 6300 Southcenter Boulevard, Suite 100, Tukwila, WA 98188 X-, . -� ''�' # Telephone: (206) 431 -3670 1808 AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION z . STATE OF WASHINGTON ) a z ) ss. Ce w COUNTY OF KING ) 6 D i 0 , states as follows: W u, 1. I have made application for a building permit from the City of Tukwila, Washington. w o 2. I understand that state law requires that all building construction contractors be registered with the N a State of Washington. The exceptions to this requirement are stated under Section 18.27.090 of the = d Revised Code Washington, a copy of which is printed on the reverse side of this Affidavit. I have f- _ read or am familiar with RCW 18.27.090. z ~ ►- o z I-- 3. I understand that prior to issuance of a building permit for work which is to be done by any j o contractor, the City of Tukwila must verify either that the contractor is registered by the State of c) co Washington, or that one of the exemptions stated under RCW 18.27.090 applies. o - w 4. In order to provide verification to the City of Tukwila of my compliance with this requirement, I hereby 1- 0 attest that after reading the exemptions from the registration requirement of RCW 18.27.090, I - o consider the work authorized under this building permit to be exempt under No. , and , o will therefore not be performed by a registered contractor. i z I understand that I may by waiving certain rights that I might otherwise have under state law in any decision to engage an unregistered contractor to perform construction w 1 , Ge/iZI, .idemaY__--- PLICANT .••' AD ,-•, Signed and sworn to before me this • "40.. !v.1' '' • d : ,..- ;: `. lkiL day of frL/ tV /1 f/ , 20 OZ . +a r, J UDLAG rz 6c /--�_ . . c ' . • ti j S` K „.st d .. 1 ' . �„ ;,,� NOTARY PUBLIC in and for the State of Washington, i residing at V/1, i'�' �-CLA County. Name as commissioned: 6R ( e- -) �'� My commission expires: > "lei -0 f,s AFFCONT 1/13/00 ; , i,.1 . _ . . .. i. , ,. .. i.r.kV<,: x..rvu..f'4.. .r•. .. ... v., !ry M i. rtl vn,.a..rn.. ...._. ....mv.r.... i.....o. + «...i.w..v....+...... ..., ..n......... • .. ......... .. ..... rn .. ...en., ..... ..