03-101310 City of Federal Way Building - Commercial Permit #: 03 — 101310 — 01 — CO
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: FEDERAL WAY NATIONAL LITTLE LEAGUE FIELD HOUSE
Project Address: 450 SW CAMPUS DR Parcel Number: 192104 9004
Project Description: NEW-Construction of a new 2-story field house building and occupy lower level as concession area
and completing shell of upper level remaining unfinished with occupancy to be granted under separate
permit. No plumbing or mechanical under this permit.
Owner Applicant Contractor Lender
FEDERAL WAY NAT LITTLE LEAC GOODWIN ARCHITECTS*MARK( FEDERAL WAY NAT LITTLE LEAC FEDERAL WAY NAT LITTLE LEAC
1911 SW CAMPUS DR GOODWIN ARCHITECTS 1911 SW CAMPUS DR
FEDERAL WAY WA 98023-6473 3121 W GOVERNMENT WAY 1911 SW CAMPUS DR FEDERAL WAY WA 98023-6473
SEATTLE WA 98199 FEDERAL WAY WA 98023-6473
Includes:
Census category: 318-New al #1 11 #2 7 #3 #4
Occupancy Group B IL I-- r-- -
Construction Type: Type V-N�� 1____J
Occupancy Load: 68 k{
Floor Area(Sq Ft) 1024
1st Floor Proposed Sq.Feet 1024 Building Pre-con.Meeting Required No
Census Category 318-New amusement,social, Mechanical No
Number of Stories 2 Permit for Building Shell Only No
Plumbing No Special Inspection Required Yes
Will Certificate of Occupancy be Issued9 Yes Sensitive Areas9 No
Zoning Designation RS 15.0
CONDITIONS:
Prior to the issuance of a Certificate of Occupancy for the proposed Field House Building,one of the following must occur:
1.The City will proposed and adopt a Code amendment permitting signs at sports fields oriented towards the ball fields; or
2.A The Little League Organization shall remove all illegal signs from the Federal Way site; or
2.B The Little League Organization shall enter into a Voluntary Compliance Agreement with the City in anticipation of a
Code amendment permitting the illegal signs.Should the code amendment not be adopted,the agreement will provide
conditions for the removal of all illegal signs.
3.Landscape Inspection is required prior to Occupancy.Contact Rox Burhans at 253-661-4082 to schedule.
4.Please be advised,the approved plans DO NOT depict all known easements.
5.This decision shall not waive compliance with future City of Federal Way codes,policies,or standards relating to the
subject proposal.
PERMIT EXPIRES August 30,2005.
Permit issued on March 3,2005
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal ' ay.
Owner or agent: r1 e" �� Date: 05
r
[—VI 915 9 '1 i
•
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the Uniform Building Code certifying that at
the time of issuance,this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: FEDERAL WAY NATIONAL LITTLE LEAGUE FIELD HO Permit number: 03 - 101310-01
Address: 450 SW CAMPUS
#1 #2 #3 #4
Occupancy Group:
B
P Y P
Construction Type: Type V-N _
Occupancy Load: 68 1
Floor Area(Sq.Ft.): 1024
Owner FEDERAL WAY NAT LITTLE LEAGUE *FEDERAL WAY NAT LITTLE LE *
Name: 1911 SW CAMPUS DR
Address: FEDERAL WAY WA 98023-6473
f
i717Z ,4t7,%1
Building Official Da c
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which experience has shown most severely
affect the health and safety of the general public. Although the City has made as complete a review and inspection as is reasonably possible(within budgetary time
and personnel limitations),the City neither guarantees nor warrants to the owner/occupant or to any other person that this Certificate evidences strict compliance
with each and every ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon which it is
situated. Such compliance is the responsibility of the owner and/or occupant of the premises.
City of Federal Way
Community Development Services Building - Commercial Permit #:03 - 10 310 - 00 - CO
33530 1st Way S
Federal Way.WA 98003-6210
Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050
Project Name: FEDERAL WAY NATIONAL LITTLE LEAGUE FIELD HOUSE
Project Address: 450 SW CAMPUS DR Parcel Number: 192104 9004
Project Description: NEW-Construction of a new 2-story field house building and occupy lower level as concession area and
upper level as office/meeting room. No plumbing or mechanical under this permit.
Owner Applicant Contractor Lender
FEDERAL WAY NAT LITTLE LEAG GOODWIN ARCHITECTS*MARK C SNE. FEDERAL WAY NAT LITTLE LEAG
1911 SW CAMPUS DR GOODWIN ARCHITECTS V tON 1911 SW CAMPUS DR
FEDERAL WAY WA 98023-6473 3121 W GOVERNMENT WAY FEDERAL WAY WA 98023-6473
SEATTLE WA 98199 �J
Includes:
Census category: 318-New al #1 #2 #3 #4
Occupancy Group: —� B - - ----
Construction Type: Type V-N
Occupancy Load: 68
Floor Area(Sq.Ft.): 1024
AL
1st Floor Proposed Sq.Feet 1024 2nd Floor Proposed Sq.Feet 1024
Building Pre-con.Meeting Required No Census Category 318-New amusement,social;
Fire Sprinklers No Mechanical No
Number of Stories 2 Permit for Building Shell Only No
Permit for Foundation Only No Plumbing No
Special Inspection Required Yes Total Proposed Sq.Feet 2048
Will Certificate of Occupancy be Issued? Yes Sensitive Areas? No
Zoning Designation RS 15.0
CONDITIONS:
Prior to the issuance of a Certificate of Occupancy for the proposed Field House Building,one of the following must occur:
1.The City will proposed and adopt a Code amendment permitting signs at sports fields oriented towards the ball fields; or
2.A The Little League Organization shall remove all illegal signs from the Federal Way site; or
2.B The Little League Organization shall enter into a Voluntary Compliance Agreement with the City in anticipation of a
Code amendment permitting the illegal signs.Should the code amendment not be adopted,the agreement will provide
conditions for the removal of all illegal signs.
3.Landscape Inspection is required prior to Occupancy.Contact Rox Burhans at 253-661-4082 to schedule.
4.Please be advised,the approved plans DO NOT depict all known easements.
5.This decision shall not waive compliance with future City of Federal Way codes,policies,or standards relating to the
subject proposal.
PERMIT EXPIRES February 16,2004.
Permit issued on August 20,2003
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and o use will be in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: Date: �' 3
Cityof Federal Wa W
Y
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code certifying that at
the time of issuance,this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: FEDERAL WAY NATIONAL LITTLI Permit number: 03 - 101310-00
Address: 450 SW CAMPUS
#1 #2 #3 #4
Occupancy Group: B Construction Type: Type V-NE1M Occupancy Load: 68
Floor Area(Sq.Ft.): 1024
Owner FEDERAL WAY NAT LITTLE LEAGUE*FEDERAL WAY NAT LITTLE LE *
Name: 1911 SW CAMPUS DR
Address: - FEDERAL WAY WA 98023-6473
Building Official Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which experience has shown most severely
affect the health and safety of the general public. Although the City has made as complete a review and inspection as is reasonably possible(within budgetary time
and personnel limitations),the City neither guarantees nor warrants to the owner/occupant or to any other person that this Certificate evidences strict compliance
with each and every ordinance or regulation'of the City or the State of Washington affecting the construction or use of said structure or the land upon which it is
situated. Such compliance is the responsibility of the owner and/or occupant of the premises.
•
•
CITY 'OF FEDERAL WAY
BUILDING DEPARTMENT
ALL PERSONS ARE HEREBY ORDERED TO AT ONCE
STOP WO R
PERTAINING TO CONSTRUCTION, ALTERATIONS, REPAIRS
GRADING OR REGULATED F)UIPMENT
On these Premises at 14-50 SW Ccimp S Pr,
This order is issued because Apirw I rag/u l re 108,,t1-
Sec.
O ttsec. 202(e)U.B.C. Office of Building Official
Posted � � : /3- 0. A p r•l 15 IA 1)► Y
The failure to stop work, the resuming of work without permission from the
WARNING Building Official, or the removal, mutilation, destruction or concealment of
this Notice is punishable by fine and imprisonment.
ANP-005 2/90
• ' •• •• _ , . .
• � .
r
DEMENT OF COMMUNITY DEVELOPMENT SERVICES
33325 8'h Ave S
CITY OF
A.,T.. Ali U PO Box 9718
� r� Federal Way WA 98063-9718
Federal a �A� O 3 2005253-835-2607;Fax 253-835-2609
www.cityoffederalway.com
APPLICATION FOR BUILDING REVISION
Original Permit Number: i(co ' f ici' ` 0 . - &, C)0 O
Site Address: 4 ' vJ tAM Pus Oa-
Building Owner/Tenant: Why Aharla/JA V
1711f *C&
Contact Person: 11 V/' fbl) t0-$ Phone: 2C46'110-2 •5.7
192-0›/C4Ncr I
Nature of Revision(s): 4EliV • G.19br,c io,1 esf a n Sys) - semr -b-
1
(-loam .61/6648 CK01.- o ej 6 tA1EY' ( &T1 as CoA C- io n
a (-EA.- cind. &orvveLin -ni,gil df uef,‘Nr- wEis rEyvro r. J
(Jm-i nms - w rfk 66(19^41 4 t 5f-cvticat, vr15b'Y' 5
YM ` 1
Revision Valuation: $
-fN Lt- W
Owner/Agent: *IT —— ----, Date: 9. . .o.E
Bulletin#112—September 7,2004 Page 1 of 1 k:\Handouts—Revised\Application for Bldg Revision
i
rgAGs•-i? y "J
/ l S92h
96' �� �6
• POS'tHIS CARD ON THE FRONT OF BUILDI i
rc of
Federal Way BUILDING DIVISION
INSPECTION RECORD
INSPECTION REQUEST PHONE#: 2E3-835-3050
PERMIT #: 03-101310-40-CO
OWNER'S NAME: FEDERAL WAY NAT LITTLE LEAGUE *FEDERAL WAY NAT
SITE ADDRESS: 450 SW CAMPUS �
() �,y/FOOTINGS/SETBACKS 4/2/(1V r IO () FOUNDATION WALL
DO NOT POUR CONCRETE UNTIL THE ABOVE IS APPROVED
( ) DRAINAGE: Line ( ) Connection
DO NOT POUR SLAB UNTIL THE ABOVE IS APPROVED
() UNDERFLOOR FRAMING 3 - L
O RCUGH PLUMBING: DWV Water piping
( ) ROUGH MECIIANICAL Gas piping
( ) SHEATHING kccf `1 / I' 7 �i is
( ) SHEAR WALLS /e1 "VV /l F
( ) ELECT:I:CAL ROUC-i-_N Ditch Cover
FIRE/DRAF7T3TO7S �'> 4/�� ( zI q/ ZS
'T"' oNtNtri, CVED 'RI"O .!R ~- gi4 O`er1.
( ) F2AMING/FIRESTCP?1NG
THE AT: iV c MUST BE APPROVED PRIOR TO INSULATING OR SHEETROCKING
( ) INSULATION: Floors_ 3-17-64- FiA Walls 3 --17-0- &F Attic 3-/7-aS
r.
THE ABOVE MUST BE APPROVED PRIOR TO APPLYING SIIEETROCK. ,
a
O WALLBOARD NAILING 3 /7 Cr fz- ) SUSPENDED CEILING
THE ABOVE MUST BE APPROVED PRIOR TO TAPING OR INSTALLING CEILING TILE==
( ) ELECTRICAL FINAL
( ) PLANNING FINAL (.3J2 L/ a�
( ) I'UBLIC WORKS FINAL /< -h- -I" 371/7/o.c'
� 1
( ) FIRE FINAL —,L �/i y Q2�
THE ABOVE MUST BEAP ROVED PRIOR TO,BUILDING DEPARTMENT FINAL
( ) BUILDING FINAL 374i70,1—
c:
/ of
- DO NOT OCCUPY THISBUILDING UNTIL BUILDING FINAL IS APPROVED
INSPECTION LOG
DATE INSPECTOR OK CORR/REJ AREA AND TYPE'OF INSPECTION
, r
051_0 '714--, rp.9 7►r 1:f A a h h w i l el l4r P
1003 4°1 ,_ 4 f11' fi' tH7l WrXII -For f i ' 1)141
.I/11g � - ) 17V -rni rc I'oc - wA I I
I 11)/Ill liff / ..Fip-1149-5._.4(Q- I r - i‘ i "i , r , ,
T Gl�43i far Y ley go 01 S Wy)f
re1al rh14J fry pi_
y -9 -oY cm) ' frt - cine ,wter) per, sm
z. 11-®r r.t, ,e di* ZA4(/o,ig7trA/ ae &` iCi‘It z
c9itre,y — ol<
3- 1-44- n frialiniev4. Fat to-keit- leap/
40~- Thio--rsrPliozer f'
3`1'0( `l" /phi ri1yN, LI/'ideas, L4,J7-640uuS Owiyi
3-7-ar �2e , fiNsut,,,,,iu lr/'t'Geel- 1Pti`lvA-i i- 5 „:,--ive--j.
3 _
/
•
CEIVED CONSTRUClON PERMIT APPLICATION
CITY Of APPLICATION NUMBER: 0 3 - I 0 1 3 1 C - 00 CQ
Federal Way APR 0 3 2003 APPLICATION NUMBER: -
CITY OFftFEDERAL
TTWAY APPLICATION NUMBER: - -
* The followi��F�'Y��JTr��In ormation—Please print(in ink)or type"
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application. I gil
- . ■'.PROPERTY INFORMATION - .
SITE ADDRESS: ' f .t/ (4--pTPci 9,2i L'1 ASSESSOR'S TAX/PARCEL #: L '� C7 , - l i
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): P�,fuJ
■ PROTECT INFORMATION
TYPE OF PROJECT(This application): I�LDING o PLUMBING 0 MECHANICAL 0 DEMOLITIONS �� Pi—L.1\43 I
0 ELECTRICAL 0 ENGINEERING ❑ FIRE PREVENTION SYSTEM 'lra Me-L N ic'
PROJECT DESCRIPTION (Provide detailed description): oli" 7 '- '? f(114/ Z,04- -W f 2- 571./27
6t,/)(;?, Po _Gym rA-rN G'i7"TLi GLI / r L -f G, 1,,
e/ONCzESSIVI ,,
PROJECT NAME: 173 �,l2t?V 1A,ti AA4TIQAA-t- ! !Z-E ..'t ?/e/i/) pc;t1.f E
• PEOPLE INFORMATION .
PROPERTY OWNER: NAME:
I/� p� /�/��,/yy�,/�'' //��q �n I //� ���j �p DAYTIME PHONE'
u . D( �V MAlIING ADDRESS(STREET ADDRE ,CITY,STATE,ZIP):
rederd/ IAJ •'a1Of'1I I IA II'le /tee Vvcr (42 ) 6✓ j - z4zoliZiI
(ala 5AJ Ga ii Pv'iv& #Z..(4- Neal weLij t/,4- cl9Q`3
CONTRACTOR: ( NAME: � j � ` fir j�� � i DAYTIME PHONE:
1 ,fT/cia"l I w`i i J`
MAILING ADDRESS(STREET ADDRESS;CITY,STATE.ZIP): �. EVENING PHONE
( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: I FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER: - )
I EXPIRATION DATE:
(copy of card required) I / /
APPLICANT: NAME: �/ f , I DAYTIME PHONE
�f /k (57o
l v(,a t& L I ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
/� ����� ! EVENING PHONE'
1 'IIT- VII/ V 0✓�✓H �2 ir.f Gilt `iff 117 (' b ) -0
! S 816
REI IONSHIP TO PROJECT: / i FAX NUMBER:
ARCHITECT 0 TENANT o OTHER( DESCRIBE): (2l rb ) ay'� -°66(, V
E-MAIL ADDRESS:(/ V4
CONTACT
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER PPLICANT U CONTRACTOR I C�3(gD(L,oty\•aYGaVSv, ' `
--■ DETAILED BUILDING INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: f/E1.0 PlOdif PROPOSED VALUATION FOR IMPROVEMENTS: $ / 6'0/OD
SPRINKLERED BUILDING? 0 YES cmTO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES o NO
WATER SERVICE PROVIDER: a.' KEHAVEN ❑ HIGHLINE U TACOMA II PRIVATE(WELL)
SEWER SERVICE PROVIDER: te6KEHAVEN 0 HIGHLINE D PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION OF* •
.�
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
i
• PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
07/Eir 6 ��a ti 0 24
SECOND O 1, 02-et" l f U�4
THIRD
FOURTH
--------------------
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS? 77 �L
TOTAL: 4. 048
2-- _
■ FIXTURES
Indicate number of each type of fixture
•
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S) 1
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) REPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) F ACE(S)
DUCT(S) GAS E OUTLET(S) HEAT SOURCE: ❑ ELECTRIC o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) '` URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
■ DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the Information furnished by me is true and correct to the best of my knowledge,and
further,that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I
further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in the
investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of
Federal Way,but only where such claim arises out of the reliance of the city,including its officers and employees,upon the accuracy
of the information supplied to the city as a part of this application.
NAME/TITLE: " �
1DATE: 4/3 /0 S
❑ PROPERTY OWNER APPLICANT o CONTRACTOR
FOR OFFICE USE ONLY:
,d"NEW. ',, :p ADDITION a ALTERATION- -01 '6 REPAIR S. ',TENANT IMPROVEMENT"7"
CENSUS CODE =-i Y 4V4Et ..- . -LOT
ZONING DESIGNATION„ ,; " :47
.BUILDING'SHELL ONLY?}'❑YES i NO
COMP.PLAN DESIGNATIO • = , tBASIC PLAN? "o YES o NO
SUCTION%', , TOWNSHIP I-RANGEDNEW ADDRESS REQUIRED? ' . oYES ❑ NO
PLATTED LOT?, '`❑YES : ❑ NO CHANGE OF USE? ❑YES'T=❑ NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www,dtvoffedera Iway.com
0
FILE
King County Certificate
King County of Water Availability
Department of Development and Environmental RECEIVED
Building Services Division
900 Oakesdale Avenue Southwest
Renton,Washington 98055-1219 APR 0 3 2003 Alternative formats available
(206)296-6600 TTY(206)296-7217 upon request
CITY OF FEDERAL WAY
BUILDING DEPT.
King County Certificate of Water Availability
This certificate provides the Seattle King County Department of Public Health and the Department of Development and
Environmental Services with information necessary to evaluate development proposals.
Do not write in this box
number name
.k�uilding Permit 0 Preliminary Plat or PUD
0 Short Subdivision 0 Rezone or other
Applicant's name:fr E AL ( iJc ( t A t G 1Jft l 1--(TLC
Proposed use: C._6 c s-L — CotJCi-SS fp r> STtr /u26ST-621ZN`S
Location: soh 5�� Cf�r,�P�lS ( f bE-te-fA-L
P _c_eC1 . - 9 Lta
(attach map and legal description if necessary)
Water purveyor information:
1. a. Watervail+be provided by service connection only to an existing k . ✓' (size)water main
that is Q. (:)-4.— ✓ feet from the site.
OR
0 b. Water service will require an improvement to the water system of:
O (1) feet of water main to reach the site; and/or
O (2) The construction of a distribution system on the site; and/or
O (3) Other(describe)
2. A( a. The water system is in conformance with a County approved water comprehensive plan.
OR
❑ b. The water system improvement is not in conformance with a County approved water comprehensive
plan and will require a water comprehensive plan amendment. (This may cause a delay in issuance of a permit or
approval).
a Tha nrnnncarl nrniect is within the corporate limits of the district. or has been granted Boundary Review Board
fr,,,,..i 0
. , a
K •,s •
King County Certificate of
King County -7.'77 '
7
Sewer Availability
Dept. of Development and Environmental Services'"_JEI v "" gat`
Building Services Division
900 Oakesdale Avenue Southwest (1r;� :1 r
Renton, Washington 98055-1219 APR 0 3 Alternative formats available : 7, i2:;
(206)296-6600 TTY(206)296-7217
CITY OF FEDERAL WAY upon request ,p
BUILDING
King County Certificate of Sewer Availability
r' , 0
This certificate provides the Seattle King County Department of Public Health and the Department of r., r, N
Development and Environmental Services with information necessary to evaluate development proposals. RT' o
Do not write in this box c;.
n. - E
3n
`r.^ til by
number name M i :-:! a
V
..,c:-. t4 2
CpL7
Building Permit ❑ Preliminary Plat or PUD cc-, A
0 Short Subdivision 0 Rezone or other �`
•
0.
Applicant's name: fE,i)e- L. (JA-Lt ),)A---T7 D 'JAL, LA7-1L E LGii Crag
Proposed use: C p t,/\n,`F,(z-C(AL.. -- Cc.PCE SS In,J STA-0 0 / ES-r2.00JA
Location: rbc St,., crA,rlPus. I -. 1 ( i✓K-io LoALIL)--)o . 1_1a(O(-( — cloOti
(attach map and legal description if necessary)
Sewer agency information:
cart
1. J a. Sewer service wiif be provided by side sewer connection only to an existing �' '' size sewer
n)J fcct from the site and the sewer system has the capacity to serve the proposed use.
OR
0 b. Sewer service will require an improvement to the sewer system of:
❑ (1) feet of sewer trunk or lateral to reach the site; and/or
•
DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
CITY OF ` 33530 First Way South
PO Box 9718
Federal Way Federal Way WA 98063-9718
253-661-4000;Fax 253-661-4129
. •. ai-a- . . . .0
Affidavit in Lieu of General Contractor Registration
State of Washington )
County of King )
I, IA r` 41_. (kES , state as follows:
(Print name as signed)
1. I have made application for a building permit from the City of Federal Way, 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 of Washington(RCW), a copy of which is printed on the reverse side of this affidavit.
3. I understand that prior to issuance of a building permit for work that is to be done by any contractor,
the City of Federal Way 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 Federal Way of my compliance with this requirement, I
hereby attest that after reading the exemptions from the registration requirement(4 RCW 18.27.090, I
consider the work authorized under this building permit to be exempt under No. 12. ,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
decisi• to engage an unregistered contractor to perform construction work.
Mor
ditani
• PPLICANT'S SIGNATURE
S'ign$and swop to before me this
0 Day of fru ,20_0i.
�O\B 1) "elf�, �II ��j Not. 's Name(Print)
111
404,5iTARA.AV 1%
NS
is " . - 2 oN t'ry's Signature
/�/ 1.. NOTARY PUBLIC in and for the State of
/ O S• Washington,residing at I(' N'- County
My Commission expires: 6
Bulletin#116—December 23,2002 Page 1 of 2 k:\Handouts—Revised\Contractor's Affidavit
•
Revised Code Of Washington
18.27.090 Exemptions. This chapter shall not apply to:
1) An authorized representative of the United States division of the operation is made into contracts of
government,the state of Washington,or any amounts less than$500 for the purpose of evasion
incorporated city,town,county,township,irrigation of this chapter or otherwise.The exemption
district,reclamation district,or other municipal or prescribed in this subsection does not apply to a
political corporation or subdivision of this state; person who advertises or puts out any sign or card
or other device which might indicate to the public
2) Officers of a court when they are acting within the that he is a contractor,or that he is qualified to
scope of their office; engage in the business or contractor;
3) Public utilities operating under the regulations of the 10) Any construction or operation incidental to the
utilities and transportation commission in construction and repair of irrigation and drainage
construction,maintenance,or development work ditches of regularly constituted irrigation districts or
incidental to their own business; reclamation districts;or to farming,dairying,
agriculture,viticulture,horticulture,or stock or
4) Any construction,repair,or operation incidental to poultry raising;or to clearing or other work upon
the discovering or producing of petroleum or gas,or land in rural districts for fire prevention purposes;
the drilling,testing,abandoning,ro other operation except when any of the above work is performed by
of any petroleum or gas well or any surface or a registered contractor;
underground mine or mineral deposit when
performed by an owner or lessee; 11) An owner who contracts for a project with a
registered contractor;
5) The sale or installation of any finished products,
materials,or articles of merchandise which are not 2) Any person working on his own property,whether
actually fabricated into and do not become a occupied by him or not,and any person working on
permanent fixed part of a structure; his residence,whether owned by him or not,but this
exemption shall not apply to any person otherwise
6) Any construction,alteration,improvement,or repair covered by this chapter who constructs an
of personal property,except this chapter,shall apply improvement on his own property with the intention
to all mobile/manufactured housing.A mobile/ and for the purpose of selling the improved
manufactured home may be installed,set up,or property;
repaired by the registered or legal owner,by a
contractor licensed under this chapter,or by a 13) Owners of commercial properties who use their own
mobile/manufactured home retail dealer or employees to do maintenance,repair,and alteration
manufactured licensed under chapter 45.70 RCW; work in or upon their own properties;
7) Any construction,alteration,improvement,or repair 14) A licensed architect or civil or professional engineer
carried on within the limits and boundaries of any acting solely in his professional capacity,an
site or reservation under the legal jurisdiction of the electrician licensed under the laws of the state of
federal government; Washington,or a plumber licensed under the laws
of the state of Washington while operating within
8) Any person who only furnished materials,supplies, the boundaries of such political subdivision.The
or equipment without fabricating them into or exemption provided in this subsection is applicable
consuming them in the performance of,the work of only when the licensee is operating within the scope
the contractor; of his license;
lI. #iJfc=�'?.���
9) Any work or operation on one undertaking or project 15) Any person who engagK33 n4eFIttivlig herein
by one or more contracts,the aggregate contract regulated as an em ,raicaigeret c9ntiactor
price of which for labor and materials,and all other with wages as his4bole ,%15 en��tipn `tet
items,is less than$500,such work or operations
being considered as a casual,minor,or 16) Contractors on high ayproject ivho habebeen
inconsequential nature.The exemption prescribed in prequalified as reguii d by ctr7apIor 13 of the Laws
this subsection does not apply in any instance of 1961,RCW 47: 8. ,Q ?i h the department of
wherein the work or construction is only a part of a transportation to peFfbrriighway construction,
larger or major operation,whether undertaken by reconstruction,or mai ftRnanee work.
the same or a different contractor,or in which a
Bulletin#116—December 23,2002 Page 2 of 2 k:\Handouts—Revised\Contractor's Affidavit