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HomeMy WebLinkAboutPermit PG08-061 - SOUTHGATE MOBILE HOME PARK #19SOUTHGATE MOBILE HOME PARK #19 14005 42 AV S PG08-061 Parcel No.: 1523049008 Address: Suite No: Cityif Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: http: / /www.ci.tukwila.wa.us 14005 42 AV S TUKW PLUMBING /GAS PIPING PERMIT Permit Number: Issue Date: Permit Expires On: PG08 -061 03/13/2008 09/09/2008 Tenant: Name: SOUTHGATE MOBILE HOME PARK #19 Address: 14005 42 AV S , TUKWILA WA Owner: Name: STEPPING STONE VENTURES L L Address: 20303 10TH AVE W , LYNNWOOD WA Contact Person: Name: ERIN O'LEARY Address: 20303 10 AVE W , LYNNWOOD WA Contractor: Name: OWNER AFFIDAVIT - ERIN O'LEARY Address: 20303 10 AV W , LYNNWOOD WA Contractor License No: Phone: Phone: 206 - 484 -3840 Phone: 206 - 484 -3840 Expiration Date: DESCRIPTION OF WORK: HOOK UP WATER AND SEWER Value of Plumbing /Gas Piping: Fees Collected: $100.00 $114.00 Plumbing Bathtub or combination bath/shower Bidet Clothes washer, domestic Dental unit, cuspidor Dishwasher, domestic, with independent drain Drinking fountain or water cooler (per head) - - Food -waste grinder, commercial Floor drain Shower, single head trap Lavatory - Wash fountain Receptor, indirect waste Sinks Urinals Water Closet Uniform Plumbing Code Edition: 2006 International Fuel Gas Code Edition: 2006 FIXTURE TYPE AND OUANTITY Plumbing (cont.) 0 Building sewer and each trailer park sewer 1 0 Rain water system - per drain (inside bldg) 0 0 Water heater and /or vent 0 0 Industrial waste treatment interceptor, including 0 its trap and vent, except for kitchen type 0 grease interceptors - 0 0 Repair or alteration of water piping and/or water 0 treatment equipment 0 0 Repair or alteration of drainage or vent piping 0 0 Medical gas piping system serving (1 -5) 0 inlets /outlets for a specific gas 1 0 Medical gas piping (6 +) inlets /outlets 0 0 Gas Piping 0 Gas piping outlets (0 -5) 0 0 Gas piping outlets (6 +) 0 * *continued on next page ** doc: UPC -10/06 PG08 =061 Printed: 03 -13 -2008 City ofTukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: http: / /www.ci.tukwila.wa.us Permit Number: PG08 -061 Issue Date: 03/13/2008 Permit Expires On: 09/09/2008 Permit Center Authorized Signature: Clr,1 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. 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�erformanc fwork. I am authorized to sign and obtain this plumbing /gas piping permit. Signature: Print Name: __12 Date: 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: UPC -10/06 PG08 -061 Printed: 03 -13 -2008 • • City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: http: / /www.ci.tukwila.wa.us PERMIT CONDITIONS Parcel No.: 1523049008 Address: Suite No: Tenant: 14005 42 AV S TUKW SOUTHGATE MOBILE HOME PARK #19 Permit Number: Status: Applied Date: Issue Date: PG08 -061 ISSUED 02/26/2008 03/13/2008 1: ** *PLUMBING AND GAS PIPING * ** 2: No changes shall be made to applicable plans and specifications unless prior approval is obtained from the Tukwila Building Division. 3: All permits, inspection records and applicable plans shall be maintained at the job and available to the plumbing inspector. 4: All plumbing and gas piping systems shall be installed in compliance with the Uniform Plumbing Code and the Fuel Gas Code. 5: No portion of any plumbing system or gas piping shall be concealed until inspected and approved. 6: All plumbing and gas piping systems shall be tested and approved as required by the Plumbing Code and Fuel Gas Code. Tests shall be conducted in the presence of the Plumbing Inspector. It shall be the duty of the holder of the permit to make sure that the work will stand the test prescribed before giving notification that the work is ready for inspection. 7: No water, soil, or waste pipe shall be installed or permitted outside of a building or in an exterior wall unless, adequate provision is made to protect such pipe from freezing. All hot and cold water pipes installed outside the conditioned space shall be insulated to minimum R -3. 8: Plastic and copper piping running through framing members to within one (1) inch of the exposed framing shall be protected by steel nail plates not less than 18 guage. 9: Piping through concrete or masonry walls shall not be subject to any load from building construction. No plumbing piping shall be directly embedded in concrete or masonry. 10: All pipes penetrating floor /ceiling assemblies and fire - resistance rated walls or partitions shall be protected in accordance with the requirements of the building code. 11: Piping in the ground shall be laid on a firm bed for its entire length. Trenches shall be backfilled in thin layers to twelve inches above the top of the piping with clean earth, which shall not contain stones, boulders, cinderfill, frozen earth, or construction debris. 12: The issuance of a permit or approval of plans and specifications shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the Plumbing Code or Fuel Gas Code or any other ordinance of the jurisdiction. * *continued on next page ** doc: Cond -10/06 PG08 -061 Printed: 03 -13 -2008 • • City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: http: / /www.ci.tukwila.wa.us 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. Signature: Print Name: &2. Date: 13 -CZ doc: Cond -10/06 PG08 -061 Printed: 03 -13 -2008 CITY OF TUKWIyik ,Community Deyelopmeleriepartment Public Works Department Permit Center 6300 Southcenter B/vd., Suite 100 Tukwila, WA 98188 http://wwwatukwila.wa.us Applications and plans must be complete in order to be accepted for plan review • Applications will not be accepted through the mail or by fa. • **Please Print** King Co Assessor's T Site Address: 1 005 Llahc° Ave, . Suite N • Tenant Name: an/ 4"IN ktt M 14 P Property Owners Name: Mailing Address: 3014 ber: Tenant: ; &F1)11 Ve.rvivr•es Floor: .... Yes D..No Name: Day Telephone: Mailing Address: ao3o2 I _ v1/4(2, Li■TLIAAL400c0 WA qg3c9 City State Zi Fax Number: Lea5 aa3.5 - 4421* i-‘ Company Name: 3E (!.0)‘.c-iy-vdtof..) fn Mailing Address: '7V 9 F$ 5 G.--4 AG R.,4 ‘...) kb L)oot iA cl8aey City State Zip Contact Person: Pon So Ili Day Telephone: o gas, 58 b f • E-Mail Address: Fax Number: 3(90 856 431/ Contractor Registration Number: W Pt OS4'.' 1131 i 1 1 i?) Expiration Date: 65f C. aff000 K A fa10E Company Name: Mailing Address: Contact Person: E-Mail Address: Company Name: Mailing Address: City Day Telephone: Fax Number: City Day Telephone: Fax Number: State Zip Contact Person: E-Mail Address: Q: \ApplicationsWorms-Applications On Line13-2006 - Permit Applieation.doc Revised: 9-2006 bit State Zip Page 1 of 6 s a:tiv11u :.1.11,11.! ,v t ▪ 4‘.091 Valuation of Project (contractor's bid pnce): $ I'3 0 0 Existing A...Alding Valuation: $ r Scope of Work (please provide detailed infonnation): —__Iv' SS+4, I ! , 32 tuft ( o � L- t--11 0 Will there be new rack storage? ❑. -.: Yes ike. No If yes, a separate permit and plan submittal will be required. kn a Sr a `.. .: - i s4ng: r tr x�,.„ s fin �i tenor 'till el... ?Additiot#i {o ,e°7 . c bl > F ,� i i Cons( c ip per S ix3 acbu an ,- Ot',' no, of '43T . ti- t %SCE v'5...`. ii �/^' ,�'{��,.� F1 i- 'i h�u �_ r rAttaelie�ciMfage 17etTehad >Cai ort Coved Dec= Jnirovered' eck_ .,, PLANNING DIVISION: Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) For an Accessory dwelling, provide the following: Lot Area (sq ft): Floor area of principal dwelling: Floor area of accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence: Number of Parking Stalls Provided: Standard: - Compact: Handicap: Will there be a change in use? ❑ - Yes ❑ No If "yes", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ Sprinklers ❑ Automatic Fire Alarm ❑ None ❑ Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes ❑ No If "yes', attach list of materials and storage locations on a separate 8 -1/2 "x 11 "paper including quantities and Material Safety Data Sheets. SEPTIC SYSTEM ❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. Q: Applications\Fonns- Applications On Linell -2006 - Permit Applicriion.doc Revised: 9 -2006 bh Page 2 of 6 Scope of Work (please provide detailed information): _T� pp 1<,+-� - rho 1 L& �Q jti► (� _ xc i - - i lr..�( s2iO4C)Y._ pAr . K Call before you Dig: 1- 800 - 424 -5555 Please refer :to:Public Works Bulletin .#1,:: for ;fees and estimate sheet. Water District ❑ ...Tukwila ❑ ...Water Availability Provided ...Water District # 125 Sewer District ❑ ...Tukwila AC. ValVue ❑ ...Sewer Use Certificate ❑..: Sewer Availability Provided ❑ .. Highline ❑ .. Renton ❑ ...Renton ❑ ...Seattle Septic System: ❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. Submitted with Application (mark boxes which apply): ❑ ...Civil Plans (Maximum Paper Size — 22" x 34 ") ❑ ...Technical Information Report (Storm Drainage) ❑ .. Geotechnical Report ❑ ...Bond ❑ .. Insurance ❑ .. Easement(s) ❑ .. Maintenance Agreement(s) ❑...Traffic Impact Analysis - ❑ ...Hold Harmless — (SAO) ❑ ...Hold Harmless — (ROW) Proposed Activities (mark boxes that apply): ❑ ...Right -of -way Use - Nonprofit for less than 72 hours ❑ .. Right -of -way Use Profit for less than 72 hours ❑ ...Right -of -way Use - No Disturbance ❑ :: Right -of -way Use - Potential Disturbance ❑ ...Construction/Excavation/Fill - Right -of -way Non Right -of -way ❑ ...Total Cut cubic yards ❑ ...Total FiII cubic yards ❑ ...Sanitary Side Sewer ❑ ...Cap or Remove Utilities ❑ ...Frontage Improvements ❑ ...Traffic Control ❑ ...Backflow Prevention - Fire Protection Irrigation Domestic Water ❑ .. Work in Flood Zone ❑ .. Storm Drainage . Abandon Septic Tank . Curb Cut . Pavement Cut Looped Fire Line ❑ ...Permanent Water Meter Size... ❑ ...Temporary Water Meter Size.. ❑ ...Water Only Meter Size ❑ ...Sewer Main Extension -- Public ❑ ...Water Main Extension Public ff 11 ❑ .. Grease Interceptor ❑ .. Channelization ❑ .. Trench Excavation ❑ .. Utility Undergrounding WO # WO #__ WO # ❑...Deduct Water Meter Size Private _ Private )f FINANCE INFORMATION Fire Line Size at Property Line Number of Public Fire Hydrant(s) ❑ ...Water ❑ ...Sewer ❑ ...Sewage Treatment Monthly Service Billing to: Name: Day Telephone: Mailing Address: Water Meter Refund/Billing: Name: Mailing Address: City State Zip Day Telephone: City State Zip Q :WppliationsTonns- Applications On Linc\3 -2006 - Permit Appliation.doc Revised: 9 -2006 hh Page 3 of 6 MECHANICAL CONTRACTOR INFORMATION Company Name: N.)/ it - Mailing Address: City State Zip Contact Person: Day Telephone: - E-Mail Address: Fax Number: Contractor Registration Nfunber: Expiration Date: ■■■ Valuation of Mechanical work (contractor's bid price): $ _ Scope of Work (pIdase provide detailed it-IN—melon): Use: Residential: New .... Replacement .. Conunercial: New .... Replacement .... 0 Fuel Type: Electric Gas ....0 Other: Indicate type of mechanical work being installed and the quantity below: ulijoist*. :. Acnoir. : .., :::...' :.'_ :'QtY,i' 11. 7:Qtr.f:A.,3:01101, -. _ if*foriv: ' 1 "I .+;25, Furnace<1 oak BTU Air Handling Unit >10,000 CFM Fire Damper 0-3 HP/100,000 BTU Fumace>100K BTU Isagt• 1 -1 Evaporator Cooler Diffuser • 3-15 HP/500,000 BTU Floor Furnace Ventilation Fan Connected to Single Duct Thermostat 15-30 HP/1,000,000 BTU Suspended/Wall/Floor Mounted Heater Ventilation System Wood/Gas Stove 30-50 HP/1,750,000 BTU Appliance Vent Hood and Duct Emergency Generator 50+ HP/1,750,000 BTU Repair or Addition to Heat/Refrig/Cooling System • Incinerator - Domestic Other Mechanical Equipment Air Handling Unit <10,000 CFM - - Incinerator — Comm/Ind QAApplications \Forms-Applications Oi LiaeV-2006 - Palma Applicatian.dac Revised: 9-2006 bh Page 4 of 6 PLUMBING AND GAS PIPING CONTRACTOR INFORMATION Company Name: Mailing Address: - City State Zip Day Telephoner —AO (p ■T `� '10 Fax Number: Expiration Date: Contact Person: �l� -1 tNi t ►0 E -Mail Address: -- Contractor Registration Number: ,ero Valuation of Plumbing work (contractor's bid price): $ 001 Valuation of Gas Piping work (contractor's bid price): $ —472)-7 ___- Scope of Work (please provide detailed information): Building Use (per Intl Building Code): • Occupancy (per Intl Building Code): - Utility Purveyor: Water: - Di S4 _ 1 Off? Sewer: 1 �GL 1 V Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below: aF urC.1, 4 w ... fy )F.1:#00 Tk. ' . Qt7 . = i u TY ,e?. _ ... ::Qty _ .74.01 e..M1: _ t' Y Bathtub or combination bath/shower _ - Drinking fountain or water cooler (per head) Wash fountain Gas piping outlets Bidet Food -waste grinder, commercial Receptor, indirect waste Clothes washer, domestic Floor drain Sinks Dental unit, cuspidor _ Shower, single head trap_ Urinals Dishwasher, domestic, with independent drain Lavatory Water Closet Building sewer or trailer park sewer i Rain water system — per drain (inside building) Water heater and/or vent itt Additional medical gas inlets/outlets —six or more Industrial waste pretreatment interceptor, including its trap and vent, except for kitchen type grease interceptors - Repair or alteration of water piping and/or water treating equipment I Repair or alteration of drainage or vent piping Medical gas piping system serving one to five inlets/outlets for specific gas Q:\ Applications\Forms- Applications On Line\ -2006 • Permit Applicatton.doc Revised: 9 -2006 bh Page 5 of 6 Value of Construction — In all eases, a value of construction amount should be entered by the applicant. This figure will be reviewed 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 expire by limitation. Building and Mechanical Permit The Building Official may grant one or more extensions of time for additional periods not exceeding 90days each. The extension shall be requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition). Plumbing Permit The Building Official may grant one extension of time for an additional period not exceeding 180 days. The extension shall be requested in writing and justifiable cause demonstrated. Section 103.4.3 Uniform Plumbing Code (current edition). 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 I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING 0 ,_a; n. OR Signature: ED AGE Print Name: Mailing Address:o Date: _ Day Telephone: c CC ' 9 7 P ity State Date Application Accepted: :),--)-6-0"&e Date Application Expires: O ff Staff Initials: Q: 1ApplicationiFonns- Applications On Linen -2006 - Permit Application.doc Revised: 9 -2006 eh Page 6 of 6 City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us RECEIPT Parcel No.: 1523049008 Permit Number: PG08 -061 Address: 14005 42 AV S TUKW Status: APPROVED Suite No: Applied Date: 02/26/2008 Applicant: SOUTHGATE MOBILE HOME PARK #19 Issue Date: Receipt No.: R08 -00741 Initials: WER User ID: 1655 Payment Amount: $114.00 Payment Date: 03/13/2008 10:53 AM Balance: $0.00 Payee: STEPPING STONE VENTURES TRANSACTION LIST: Type Method Descriptio Amount Payment Check 6805 114.00 ACCOUNT ITEM LIST: Description Account Code Current Pmts PLUMBING - RES 000.322.103.00.0 114.00 Total: $114.00 9890 03/13 ;'710 TOTAL 337.98 ring Rarpint -08 Printart• n3- 1. -7nnR P6 v& —DC0( PERMIT NO. 4-4 INSPECTION NO. INSPECTION RECORD Retain a copy with permit CITY OF TUKWILA BUILDING DIVISION cz. 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 P�,aect: "� � .r J 1 P Type of In p+ clio / // to (/ Address: f ry (4 J 4 Z �--- Date Called: Special Instructions: / Date Wanted: a '' dr 4...nri-: Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: i) c) Inspector: Date: r ,L -t El $58.00 REINSPECTION FEE REQUIRED. Prior o inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection. Receipt No.: Date: INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION e. 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)43 1 -3670 Project: p4 Type of speed n: Address. 14 0 .> ) '(?. /. , s x... 0 Date Called: ( /DUJ - .1P -.14 St bwef pe_A-4 IP_J4 A? .. Special Instructions: -F, (' Date Wanted: -( -ve) a.m. -pm Requester: Phone No: ElApproved per applicable codes. Corrections required prior to approval. COMMENTS: . C. t J1/1 . 9i'C.r 101 1 4 /j/ ,./\ 4711. ( /DUJ - .1P -.14 St bwef pe_A-4 IP_J4 A? .. Inspector: ' ' Date: ❑ $58.00 REINSPECTION FEE REQUIRED. Prior o inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection. Receipt No.: Date: I INSPECTION NO. INSPECTION RECORD Retain a copy with permit PCdd-ay! PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 11✓ 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 P SC ik As 44 a l (p Insrr: 1.1 — I 4.1 4) itt.'� Address: Date Called: Special Instructions: lRequester: ( -It � Date Wanted: a.m. LI --2 —OE, c Phone: qrj 1_ l Q j S Approved per applicable codes. Corrections required prior to approval. COMMENTS: 1'L' S` I. Dl t' ++1 Inspect or: 0 "--d Dater - 33 - v` $58.00 REINSPECTION FEE REQUIRED. Prior o inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call the schedule reinspection. Receipt•No.: Date: ■ \f) INSPECTION RECORD Retain a copy with permit INSPECTION NO. P MIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Pro h /7//i /9/f ® Type of spectt io n al f / B7 Address: Date Called: Special Instructions: Date ted: ,Fea Requester: Phone No: \EgApproved per applicable codes. Corrections required prior to approval. COMMENTS: $58.00 REINSPECT! QN FEE REQUIRED. Prior o inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection. Receipt No.: Date: • CITY OF TUKWILA Department of Community Development 6300 Southcenter Boulevard, Tukwila, WA 98188 Telephone: (206) 431 -367o FAX (206) 431 -3665 E -mail: tukplanc ci.tukwila.wa.us Permit Center /Building Division 206 431 -367o Public Works Department 206 433 -0179 Planning Division 206 431-3670 AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION STATE OF WASHINGTON) ) ss. COUNTY OF KING ) N O'4 --E� [please print] PERMIT NO: f Go Q- 0 (3 0 , states as follows: 1. I have made application for a 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 of Washington, a copy of which is printed on the reverse side of this Affidavit. I have read or am familiar with RCW 18.27.o9o. 3. I understand that prior to issuance of a 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 i CW 18.27.090, I consider the work authorized under this permit to be exempt under No. , and will therefore not be performed by a registered contractor. 5. I understand that the licensing provision of RCW 19.28.161 through 19.28.271 shall not apply to persons making electrical installations on their own property or to regularly employed employees working on the premises of their employer. The proposed electrical work is not for the construction of a new building for rent, sale or lease. 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 perfor ►► construction w rk. Owner /Owner's Agent Signed and sworn to before me this 1 day of 1 \ 1 itVC- , 20 0 5, NOTARY PUBLIC in and for the State of Washington Residing at Name as commissioned: My commission expires: