HomeMy WebLinkAboutPermit D97-0380 - HAMASAKI RESIDENCE - DOG SHELTER ROOFCity of Tukwila (
Community Development / Public Works • 6300 Southcenter Boulevard, Suite 100 • Tukwila, Washington 98188
WARNING: IF CONSTRUCTION BEGINS BEFORE APPEAL PERIOD EXPIRES,
APPLICANT IS PROCEEDING AT THEIR OWN RISK.
Parcel No: 032304 -9200
Address: 10215 BEACON AV S
Suite No:
Location:
Category: NACC
Type: DEVPERM
Zoning: LDR
Const Type:
Gas /Elec.:
Units: 001
Setbacks: North: .0 South: .0 East: .0 West: .0
Water: SEATTLE Sewer: SEATTLE..
Wetlands: Slopes: N Streams:
Contractor License No:
DEVELOPMENT PERMIT
OCCUPANT HAMASAKI ,'NOBUYOSHI Phone: 206 722 -4945
10215 BEACON AV S, TUKWILA WA 98178
OWNER HAMASAKI NOBUYOSHI Phone: 206 722 -4945
10215 BEACON AV S, TUKWILA WA 98178
CONTACT KAZUE HAMASAKI
10225 BEACON AV S., TUKWILA WA. 98178
r****************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * *'k*
Permit Description:
EXPAND ,DOG SHELTER. ROOF FROM 17', 6" TO 10', 9 ".
COMPOSITION.
r**************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Construction Valuation: $ 100.00
PUBLIC WORKS PERMITS: *(Water Meter Permits Listed Separate) Eng. Appr:
Curb Cut/Access/Sidewalk/CSS: N
Fire Loop Hydrant: N No: Size(in): .00
Flood Control Zone: N
Hauling: N Start Time: End Time:
Land Altering: N Cut: Fill:
Landscape Irrigation: N
Moving Oversized Load: N Start Time: End Time:
Sanitary Side Sewer: N No:
Sewer Main Extension: N Private: N Public: N
Storm Drainage:. N
Street Use: N
Water Main Extension: N Private: N Public: N
k************************,e*************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
TOTAL DEVELOPMENT PERMIT FEES: $ 39.15
k********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * *]k' * * * * * * * * * * * ** * * * * * * * * ** * * * * ***
Permit Center Authorized Signature:
Occupancy:
UBC: 1994
Fire Protection: N/A
(206) 431 -3670
Permit No: D97 -0380
Status: ISSUED
Issued: 12/18/1997
Expires: 06/16/1998
Phone: 206722 -4945
Date:
I hereby certify that I have read and examin '• 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 provision of any other state or local laws regulating construction
or the performance of work. I am authorized to sign for and obtain this
development permit.
S ignature : 2:Gr_,6�
Print Name: _ILIM,
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.
Date: Jam,-- le,- '47
dress: :'10215',BEACON ;A
Su
T enant
T ype DEVPERM
arse l :# 032304-9200
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ermit: aondi:tions:
o: change: wi ll be made '-to the
04 a Building Division..
1.1 p remit , inSpection-- co r plans shall
al, at) le :at th .1),OW 0, prior to the w • any r ed
.t n
7eset. otiunien s :ar 'v,k � mai a e
n�a i :`appr oval} 'i� g.tan�ted
ruc.tion T! ` °d t e t b • t ii' 'd arrd.a
rb`:l e until : f i k .
11 -T construction to +2 > e donea ins rohformancel't ith app,r owed •
clans and ;r rements of the r 0,11 icBuilding ,i qp9
¢a`s�famended ", lln far^`m'' Mechan i a l Code ` 1334 Ed I t c�ri )
►rl Wa,sh;ingtonr St•atr'e Ener 9Y:cod air (1 994' Ed'it40n
' t3P05.E0 WORM 0`ALLE01 FCIR, N I ; THIS' APFL IcAT ION ��ANG NOT ,NE E ;
ARRIL ;a0E'�CRIBEL or
THE, G GS SHALL COMPLY 'WITH 'ALL r;;
P.•PLI�cABL0 :, IR MENTa ;OF THE UNIFORM • BUILDING CODE AND t '
tP,PROV�AL OE SAID WORE' d SHALL BEF ,UBJEC:T TO FIELD INSPE� TIs N :: :,
falipity`'of`Permit 'the is5ciance or `a permit :.or a`ppro`val of • ►lac 'specifications .and computations �ha1l • not be corl -E
qtr reri to oe aa,permittifor�, `ar an::apprL'oval ot, any v�olation ,,f
h5 t • j
th x d
►t f iy of tale tiprovisi of; e ir �'` + bui,lding code •nr ,of any
t'h,ed ot„d, the~ -tilurii ,$ dict "ion fdNo _:permit pr e3uming to ,
u lve 1 rautho ity ,to violate O1A\canceq the provision.' of this
o flsha1`'t ;be valid t ,�,
3� a " ';
P C i
Pe:r ?riri t ,:No G97 -03&30
Status ISSUED •
Applied: 12/05/'1997.
Issued 12/18/1997:.
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p•1ans:u►
Project/Name/Tenant:.
- f / 1/)'i a )../
6 7079
Value of Construction:
io e `..e--
_45
Site Address:
/ D� /A 'L= Ae_U�/ Ave 5,
City State/Zip:
ruKupe,4, an
Ta el Number:
�D ti— 6
Property Owner:
1�Jo gu yDs 1 14-- M A S AKI
sq. ft. Garage /Carport //5 , /3 sq. ft. Accessory Structure(s) sq. ft. Uncovered Deck
Phone: ,,
C.; c (, 7,-? - � i S
Street Add ess: - City State /Zip:
/ Dam c h e-Ad 1),0 AVE- SO. / iiKwl' t(JA %ii
Fax #:
Contractor:
Z.F
r
Phone:
Street Address:
City State /Zip:
Fax #:
Architect:
Phone:
Street Address:
City State /Zip:
Fax #:
Engineer:
Phone:
Street Address:
City State /Zip:
Fax #:
Contact Person:
jZ/FzUE (K/9y) i417
Phone:
Street Address:
/ o a a A &'�,v, ✓G £ , '14
City State /Zip: Fax #:
ALL/ 97/7r
Description of work to be done: 00/)/ . e "."/"746'"/
- gp/i 126& o& (p r) s//4 K ro / 7 rT 6 /V. h' /6 PT 9 /ti/, (Roes e , ' 2 ' 4 -y)
Type of work: ❑ New Single - Family Residence ❑ Addition - Single - Family Residence
❑ Interior Remodel- Single - Family Residence 51 Residential Accessory Structure'
❑ Remodel /Addition to Accessory Structure ❑ Garage(s)
❑ Deck(s) - Covered & Uncovered ❑ Residential Reroof
Is this site served by: ❑ Sewer ❑ Septic (King County Health Dept. approval required - 296 -4722)
Existing Square Footage for Structure: sq. ft. Dwelling sq. ft. Covered Deck(s)
sq. ft. Garage /Carport /0 0 sq. ft. Accessory Structure(s) sq. ft. Uncovered Deck
Proposed New Square Footage: sq. ft. Dwelling sq. ft. Covered Deck(s)
sq. ft. Garage /Carport //5 , /3 sq. ft. Accessory Structure(s) sq. ft. Uncovered Deck
Floor Area Ratio: (total floor area of all structures divided by the area of the lot)
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.
CITY OF T II'CWILA
Permit Center
6300 Southcenter Blvd., Suite 100, Tukwila, WA 98188
(206) 431 - 3670
OR STAFF USE ONLY
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.
SFPERMIT.DOC 2/13/97
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 ❑ 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 appl Wes: 11
Appllk taken : (initials)
PLEASE SIGN BACK OF APPLICATION FORM
BUILDING OWNER OR AUTHORIZED AGENT:
Signature• . . ' ,
,
. . ' 4 . ^ • ' 0,1 . - y ✓ . F
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Date: !
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Print name: ''/
Phone:
Fax #:
Address:
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City /State /Zip:
- , - u I:. /L A . 1,6A ` /k1/7L ;
ALL SINGLE- FAMILY RESIDENTIAL PERMIT APPLICATIONS MUST BE BMITTED WITH THE FOLLOWING:
➢ DRAWINGS PREPARED BY I, . .1EGISTERED ARCHITECT OR PROI- _SSIONAL ENGINEER MAY BE
REQUIRED BY. OFFICIAL
➢ ,3 !mot DRAWING 'SHALL BE AT A LEGIBLE SCALE AND NEATLY DRAWN
➢ BUILDING SITE PLANS AND UTILITY PLANS ARE TO BE COMBINED
N/A SUBMITTED
❑ Cl 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,
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 significant trees that are located in sensitive 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 water mark 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 and details
❑ ❑ Floor plan
❑ ❑ Roof plan
❑ ❑ Building elevations (all views)
❑ ❑ Building height
❑ ❑ Building cross - section
❑ El Structural framing plans and details necessary to completely describe construction
El ❑ Washington State Energy Code Data (Gas /Electric /Oil /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.
El ❑ 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 - "Affidavit in Lieu of
Contractor Registration ".
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
PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
SI'PLI:M IT. DOC 2 /13/97
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.4- it * ic.
CxtY.'0F 'i.0 �lTLA.tA �� Ca TRANSMIT:
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T Number . :q:92.O0GB9',: Am6unt. ; 39.15 12/)5/97 .13 5k3:,,
Pavm €ni ::Me.th'ud:. ":C11,,ECIC , Netdi.t•i'ari: K(.ZUL.HIAMASAKI.. Irtit: Wfl
Per ,m,tt: Na ' D.87- 0380' ' ,Type!; DE "PERM ` DE.VELOI?MI•NT KAPUT
P,ar.cell o : 03 30 "4, -9.200
a` Addre's :10215 BEACON. AV .5 r
Total, Fee'i 39..5
1'Iii s P�iwmetnt '33.15` Total ALL'Pm $9'.15
H al ancG': .00
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•.A.ccaurit Coda :Description Amount
00.0/322.100 r!U]:l.Dl:No' - . NGNRES 21.00
. 000/34 ,.8'30, PLAI1 CHI:CIf . - ' N0NREr3 13.65
. 000/U06..9.0 . 4 . - E f ATE RUiLDING SURCHAI UE, 4.50
Project:
�' ay ua - !'t.�
Type of ins • : orb
�
Address:
/ORiS Y,ea eon AU-
Date cal -d-
I-5-X
Special instructions:
-()144 f- ia414a , u Jp1
Date wanted: / G
l'`LO 11
a.m.
p.m.
Requester: t/
% /140 . I :• ei(
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Phone No.: -- a a _ L 9 L s
INSPECTION NO.
CITY OF ; TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 9818
Approved per applicable codes.
COMMENTS:
INSPECTION RECORD
Retain a copy with pLnit
PERMIT NO.
(206) 431 -3670
Corrections required prior to approval.
Date: 1 ., 15 „... c78
/ /CAL:-
$42.00 hEINSPECTION E REQUIRED. Prior to inspection, fee must
be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date;
Project: 7J
/w� /�� .
Type of inspection:
Address: ��..n,._
( b7-(S
A z —
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Date called:
I 3 - 7
Special instructions:
is
1:
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t
ei'Gv1
Date wanted: 1 /
a
' Requester Iis , 1.—ak f,
,.
Phone No.: ..-- /ZZ , �
INSPECTION REc aD
Retain a copy with ,init
INSPECTION NO. s. S
CITY OF T BUILDING DIVISION
6300 Southcenter Blvd. #100, Tukwila, WA 9818
Approved per applicable codes.
COMMENTS:
(j
1 '
d,. e
t%10
PERMIT NO.
(206) 431- 3670
Corrections required pHloito. approval.
4J P""e(C/
Inspector: // -i Date/2
I $42.00 REINSPECTIOId FEE REQUIRED. Prior to inspection, fee must
be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
I Receipt No.:
Date:
ie4';',• :ir �:4�,�fii::+.;:5i':t >'4ir ivS;.,i3d1o!{.`!f si.'/ 6:++1 �7�it1t7. E s. v)* 4Ar3Yii :'GfiF�:�iyb?'J:g73lK:�'i::
ACTIVITY NUMBER
PROJECT NAME
DEPARTMENT:
I■G DIVISION �J
Ug, 1p -Gf -�-
LI WOR
• COMPLETE
•
COMMENTS •
ROUTED BY STAFF
REVIEWERS INITIAL
REVIEWERS INITIAL
REVIEWERS INITIAL
C:ROUTE -F
P C.o
PLAN REVIEW /ROUTINE SLIP
D97 -0380
HAMASAKI
FIRE PREVENTION
fL E
DETERMINATION OF COMPLETENESS: (T,Th) DUE DATE 12/9/97
NOT COMPLETE l • NOT APPLICABLE
TUES /TE URS ROUTING: PLEASE ROUTE fl NO FURTHER REVIEW REQUIRED El
(If routed by staff, make copy to master file & enter Sierra.)
APPROVALS OR CORRECTIONS: (ten days)
DATE
APPROVED n APPROVED WI CONDITIONS E NOT APPROVED (attach comments) Q
CORRECTION DETERMINATION:
APPROVED I 1 APPROVED W/ CONDITIONS
DATE
DATE
t ctb3? ?t alt. dt3 ?R.!
DATE 12/5/97
(Cerditcaaon of occupancy required.
j DIVISION El
C O IW cif _67.7
INATOR
DUE DATE 17/93/97
DUE DATE
NOT APPROVED (attach comments) 0
1
,^ A0) 71:.<$;`, W:}' l+ i/4. 10M o..∎ k∎i.::`r1.EyT't. "hx:i:- 'M TP.:1N k'4fii1Y:X9N;*.. TIAl!:uC..i■sYa 4447 +Yt.YOR.K ?...: i n", S? Atf tSY0h nA a7in 9H. ,Vre.7411Pt}.^'�MTW? #Yryf.�'RY
ACTIVITY NUMBER
PROJECT NAME
DEPARTMENT:
BUILDING DIVISION IN
PUBLIC WORKS
PLAN REVIEW / ROUTING SLIP
D97 -0380
HAMASAKI
FIRE PREVENTION ❑ PLANNING DIVISION ❑
STRUCTURAL ❑ PERMIT COORDINATOR ❑
I
DETERMINATION OF COMPLETENESS: (T,Th)
• • COMPLETE
COMMENTS
NOT COMPLETE ❑ NOT APPLICABLE ❑
TUES /TSURS ROUTING: PLEASE ROUTE ❑ NO FURTHER REVIEW REQUIRED
ROUTED BY STAFF ❑ (If routed by staff, make copy to master file & enter Sierra.)
REVIEWERS INITIAL
REVIEWERS INITIAL
C:ROUTE -F
APPROVALS OR CORRECTIONS: (ten days)
APPROVED n APPROVED W/ CONDITIONS
REVIEWERS INITIAL
CORRECTION DETERMINATION:
DATE 12-9-97
DUE DATE 12/9/97
-40
I
DUE DATE I2/71/4i
NOT APPROVED (attach comments) ❑
DATE 12 9. -- 0 7
DATE 12/5/97
DUE DATE
APPROVED ❑ APPROVED WI CONDITIONS ❑ NOT APPROVED (attach comments) ❑
DATE
(Cerdficadon of occupancy tsquited.
T... VdtAtidlia4,1:4«ittVAliee,`
PROJECT NAME
COMPLETE n
COMMENTS
PLAN REVIEW / ROUTING SLIP
ACTIVITY NUMBER
D97 -0380
HAMASAKI
DEPARTMENT:
BUILDING DIVISION ❑ FIRE PREVENTION III PLANNING DIVISION 0
PUBLIC WORKS ❑ STRUCTURAL ❑ PERMIT COORDINATOR ❑
DETERMINATION OF COMPLETENESS: (T,Th)
•
TUES /THURS ROUTING: PLEASE ROUTE fl NO FURTHER REVIEW REQUIRED
ROUTED BY STAFF I I (If routed by staff, make copy to master file & enter Sierra.) //��"
REVIEWERS INITIAL r . � ' 5
APPROVALS OR CORRECTIONS: (ten days)
REVIEWERS INITIAL St cf
CORRECTION DETERMINATION:
APPROVED ! 1 APPROVED W/ CONDITIONS
REYIEWE S� S INITIAL
C:ROUTE -F
DATE 12/5/97
DUEDATE 12/9/97
NOT COMPLETE ❑ NOT APPLICABLE ❑
DATE C��/ /9' I
APPROVED APPROVED WI CONDITIONS ❑ . NOT APPROVED (attach comments) 11
DATE / Z // f
DUEDATE 19/93/47 •
DATE
DUE DATE
NOT APPROVED (attach comments) ❑
(Cerdfrcadoa of occupancy required.
• COMPLETE Fl
COMMENTS
C
ACTIVITY NUMBER
PROJECT NAME
DEPARTMENT:
APPROVED
REVIEWERS INITIAL
APPROVED
REVIEWERS INITIAL
C:ROUTE -F
D97 -0380
HAMASAKI
CORRECTION DETERMINATION:
PLAN REVIEW / ROUTING SLIP
BUILDING DIVISION [J FIRE PREVENTION E PLANNING DIVISION .
PUBLIC WORKS STRUCTURAL El PERMIT COORDINATOR Q
1
4
DETERMINATION OF COMPLETENESS: (T,Th)
NOT COMPLETE E NOT APPLICABLE 0
TUES /TEURS ROUTING: PLEASE ROUTE C NO FURTHER REVIEW REQUIRED a
ROUTED BY STAFF n (If routed by staff, make copy to master file & enter Sierra.)
REVIEWERS INTTIAL AA DATE i Z" (`( (�
APPROVED WI CONDITIONS
APPROVED W/ CONDITIONS
DATE
DATE
DATE 12/5/97
DUE DATE 12/9/97
APPROVALS OR CORRECTIONS: (ten days) DUE DATE 19/93/97
NOT APPROVED (attach comments) Q
�t-I t(1--
t
DUE DATE
NOT APPROVED (attach comments) Q
(Certification of occupancy required.
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I
PUBLIC WORKS
COMPLETE ❑
COMMENTS •
REVIEWERS INITIAL
PLAN REVIEW / ROUTING SLIP
ACTIVITY NUMBER
PROJECT NAME
DEPARTMENT:
BUILDING DIVISION ❑l
D97 -0380
HAMASAKI
4
DETERMINATION OF COMPLETENESS: (T,Th)
TUES /THURS ROUTING: PLEASE ROUTE fl NO FURTHER REVIEW REQUIRED
ROUTED BY STAFF ❑ (If routed by staff, make copy to master file & enter Sierra.)
APPROVALS OR CORRECTIONS: (ten days) DUE DATE 17771/47
APPROVED ❑ APPROVED W/ CONDITIONS C. NOT APPROVED (attach comments) 0
REVIEWERS INITIAL
CORRECTION DETERMni TATION:
APPROVED ❑ APPROVED WI CONDITIONS
REVIEWERS INITIAL
C:ROUTE -F
DATE 12/5/97
FIRE PREVENTION ❑ PLANNING DIVISION ❑
STRUCTURAL ❑ PERMIT COORDINATOR ❑
DUE DATE 12/9/97
NOT COMPLETE ❑ NOT APPLICABLE ❑
DATE ∎ 2. j .
DATE
DATE
DUE DATE
NOT APPROVED (attach comments) ❑
(Cerdficadoa of occupancy required.
•
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Land Surveyor's Certificate: °; -The MF �.F vg_ 3' "e 3 -4-
This Boundary Line Adjustment /Lot Consolidation correctly
represents a survey* made by me or under my direction in
conformance with the requirements of appropriate State statute.
Name: 7 (. e° z'ai 418
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Date. -3 /5/9.3
Certificate No. 95 7
*A lot consolidation does not require a survey of tlje
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perimeter unless the lines are adjusted.
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DEC 0 5 1997
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APPROVED
DEC 1 5 1997
AS ra l;i :D
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CITY OF TUKWILA
DEC 051997
PERMIT CENTER