HomeMy WebLinkAboutPermit M09-068 - FANCEY RESIDENCEFANCEY RESIDENCE
4418 S 164 STREET
M09.068
Parcel No.:
Address:
Suite No:
doc: IMC -10/06
5379800580
4418 S 164 ST TUKW
Tenant:
Name: FANCEY RESIDENCE
Address: 4418 S 164 ST , TUKWILA WA
Owner:
Name: FANCEY LINDA B
Address: PO BOX 68455 , SEATTLE WA
Contact Person:
Name: LINDA FANCEY
Address: PO BOX 68455 , SEATTLE WA
DESCRIPTION OF WORK:
INSTALL GAS FIREPLACE
Value of Mechanical: $3,700.00
Type of Fire Protection:
Furnace: <100K BTU
>100K BTU
Floor Furnace
Suspended/Wall/Floor Mounted Heater
Appliance Vent
Repair or Addition to Heat /Refrig /Cooling System....
Air Handling Unit <10,000 CFM
>10,000 CFM
Evaporator Cooler
Ventilation Fan connected to single duct
Ventilation System
Hood and Duct
Incinerator: Domestic
Commercial /Industrial
City0f 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
Contractor:
Name: ADVANCED INSTALLATION INC.
Address: 16504 HWY 99 STE 101 , LYNNWOOD WA
Contractor License No: ADVANII033DU
MECHANICAL PERMIT
EOUIPMENT TYPE AND QUANTITY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
* *continued on next page **
M09 -068
Permit Number:
Issue Date:
Permit Expires On:
Phone:
Phone: 206 - 246 -6013
Phone:
Expiration Date: 03/13/2010
M09 -068
06/11/2009
12/08/2009
Fees Collected: $175.39
International Mechanical Code Edition: 2006
Boiler Compressor:
0 -3 HP /100,000 BTU 0
3 -15 HP /500,000 BTU 0
15 -30 HP /1,000,000 BTU.. 0
30 -50 HP /1,750,000 BTU.. 0
50+ HP/1,750,000 BTU 0
Fire Damper 0
Diffuser 0
Thermostat 0
Wood/Gas Stove 1
Water Heater 0
Emergency Generator 0
Other Mechanical Equipment 0
Printed: 06 -11 -2009
Permit Center Authorized Signature:
doc: IMC -10/06
S
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
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 he performance of work. I am authorized to sign and obtain this mechanical permit. ,
Signature: A) 96r /��iy�.[,?.� Date: /! / ..1 Date: 009
Print Name: t he al F-a Yl e
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.
Permit Number: M09 -068
Issue Date: 06/11/2009
Permit Expires On: 12/08/2009
M09 -068 Printed: 06 -11 -2009
Parcel No.: 5379800580
Address:
Suite No:
Tenant:
4418 S 164 ST TUKW
FANCEY RESIDENCE
1: ** *BUILDING DEPARTMENT CONDITIONS * **
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
Permit Number:
Status:
Applied Date:
Issue Date:
M09 -068
ISSUED
06/11/2009
06/11/2009
2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the
Building Official.
3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to
start of any construction. These documents shall be maintained and made available until final inspection approval is
granted.
4: Manufacturers installation instructions shall be available on the job site at the time of inspection.
5: Except for direct -vent appliances that obtain all combustion air directly from the outdoors; fuel -fired appliances
shall not be located in, or obtain combustion air from, any of the following rooms or spaces: Sleeping rooms,
bathrooms, toilet rooms, storage closets, surgical rooms.
6: Equipment and appliances having an ignition source and located in hazardous locations and public garages, PRIVATE
GARAGES, repair garages, automotive motor -fuel dispensing facilities and parking garages shall be elevated such that
the source of ignition is not less than 18 inches above the floor surface on which the equipment or appliance rests.
7: Water heaters shall be anchored or strapped to resist horizontal displacement due to earthquake motion. Strapping shall
be at points within the upper one -third and lower one -third of the water heater's vertical dimension. A minimum
distance of 4- inches shall be maintained above the controls with the strapping.
8: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the Cityof Tukwila
Permit Center.
9: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building
Department (206- 431 - 3670).
10: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of,
any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits
presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila
shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the
Building Official from requiring the correction of errors in the construction documents and other data.
doc: Cond -10/06
* *continued on next page **
M09 -068 Printed: 06 -11 -2009
•
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: �() 9.
Print Name: d c � , ra
doc: Cond -10/06
Date: I I Ji n C91
M09 -068 Printed: 06 -11 -2009
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
httc://www.ci.tukwila.wa.us
MECHANICAL PERMIT APPLICATION
Mechanical Permit No. M 09, 0 (,c3
Project No.
(For office use only)
Applications and plans must be complete in order to be accepted for plan review.
Applications will not be accepted through the mail or by fax.
* *Please Print **
Site Address: — T 4 / i7 S, / St
Tenant Name: p
Property Owners Name: i h q iJ. Fa vi n
Mailing Address: r, D, 2S i
CONTACT PERSON - Who do we contact when your permit is ready to be issued
Name: )--ly a Fa ni',e
Mailing Address: D. &X 6,,MC S .
Company Name:
Mailing Address: //�� t _
Contact Person: l art
Company Name:
Mailing Address:
va he to a Zaisfq n ]hG
H:\Applications\Forms- Applications On Line\2009 Applications \I -2009 - Mechanical Permit Application.doc
Revised: 1.2009
bh
King Co Assessor's Tax No.: 3
Suite Number: Floor:
New Tenant: ❑ Yes ❑..No
IO
Contractor Registration Number: A ID V FJ N 0 33 \K
Contact Person:
E -Mail Address:
' Pa"tt le" �) A q A /62-4° '/s--
Stale Zip
City
Day Telephone: c:::'[7 6 a 4 0/3
sea tt 1L P- 92/4 o 4 1 s "S"
City State Zip
E -Mail Address: Fax Number:
MECHANICAL CONTRACTOR INFORMATION
State Zip
Ci
Day Telephone: 4& '74 s -- cri / .�7
7
E -Mail Address: Fax Number:
Expiration Date:
ARCHITECT OF RECORD — All plans must be wet stamped by Architect of Record
State
City
Day Telephone:
Fax Number:
ENGINEER OF RECORD — All plans must be we stamped by Engineer of Record
Company Name:
Mailing Address:
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
State
Zip
Zip
Page 1 of 2
Unit Type:
Qty '
Unit Type:
Qty
Unit Type:
Qty _'
Boiler /Compressor: ;
Qty
Furnace <100K BTU
Air Handling Unit >10,000
CFM
Fire Damper
0 -3 HP /100,000 BTU
Furnace >100K BTU
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
I
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
Valuation of Project (contractor's bid price): $ ? / V , D (
Scope of Work (please provide detailed information):__ — Q !() QCi Ire -1)IQ e e.
Fuel Type: Electric ❑
Use: Residential: New ❑ Replacement ❑
Commercial: New ❑ Replacement ❑
Indicate type of mechanical work being installed and the quantity below:
Gas ❑ Other:
PERMIT APPLICATION NOTES -
Value of Construction — In all cases, 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.
The Building Official may grant one extension of time for additional periods not to exceed 90 days each. The extension shall be requested in writing
and justifiable cause demonstrated. Section 105.3.2 International Building 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 OWNER OR AUTHQRIZ D AGENT:
Signature..ih.Iv) 4 };< • ' 7
Date: /( jail C)C
1-
Print Name: - +) C4OI 8 y , Y? e l Day Telephone:D
Mailing Address: `RR D, �& 1t <g)/ 6 ��t /`2_ IA) /9 9g/6 O z/s
Date Application Expires:
I Date Application Accepted:
H:.Applications\Forms- Applications On Line\2009 Applications \I-2009 - Mechanical Permit Application.doc
Revised: 1.2009
bh
City State Zip
Staff Initials:
Page 2 of 2
Parcel No.: 5379800580
Address: 4418 S 164 ST TUKW
Suite No:
Applicant: FANCEY RESIDENCE
Receipt No.: R09 -00876
Initials: WER
User ID: 1655
Payee: LINDA FANCEY
ACCOUNT ITEM LIST:
Description
•
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
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 7118 175.39
Authorization No.
MECHANICAL - RES
RECEIPT
Account Code Current Pmts
000.322.102.00.0 175.39
Total: $175.39
Permit Number: M09 -068
Status: PENDING
Applied Date: 06/11/2009
Issue Date:
Payment Amount: $175.39
Payment Date: 06/11/2009 02:49 PM
Balance: $0.00
PAYMENT
RECEIVED
doc: Receipt-06 Printed: 06 -11 -2009
CO)bIMENTS: 1
/ (4 5 i/77 ? /r m /.A/ e"
,-- 4/
` \
?) /2th f, h —./
/9/1 /Me"
$7
Date Called:
7 tvi , - 0I
/A f( /4- 4 /
anted:
Date Wanted:
`7— /— a /
---.'.*:
--
p.m.
Requester:
Phone No:
X6'6 —.:, y6 — 64/
3
/' N
Project:
`A y A 4.5
Type of Inspection:
f/.vea/
` \
Address:
/V /c S
/C%
$7
Date Called:
Specialdnstructions:
1
anted:
Date Wanted:
`7— /— a /
---.'.*:
--
p.m.
Requester:
Phone No:
X6'6 —.:, y6 — 64/
3
,1■
/2265' -048
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION v
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3
Approved per applicable codes.
Corrections required prior to approval.
EINSPECTION FEE RQUI D. Prior to inspection, fee must be
6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
R cei[( No.:
'Date:
Bond
Bond
Company
Name
Bond
Account
Number
Effective
Date
Expiration
Date
Cancel
Date
Impaired
Date
Bond
Amount
Received
Date
4
DEVELOPERS
SURETY &
INDEM CO
437546C
02/28/2002
Until
Cancelled
03/31/1997
$12,000.00
03/13/2002
3
DEVELOPERS
SURETY &
INDEM CO
437546C
12/29/200002/28
/2002
$6,000.00
07/18/2001
2
DEVELOPERS
INS CO
437546C
03/01/199812/29
/2000
$6,000.00
1
DEVELOPERS
INS CO
437546C
03/01/199703/01
/1998
$6,000.00
Name
Role
Effective Date
Expiration Date
TAYLOR, ROBERT S
Cancel
Date
01/01/1980
Amount
TAYLOR, ROBERT W
PRESIDENT
02/14/2002
01CG31 901 31 0
TAYLOR, ASHLEY D
SECRETARY
03/31/1997
Insurance
Company Name
Policy
Number
Effective
Date
Expiration
Date
Cancel
Date
Impaired
Date
Amount
Received
Date
7
AMERICAN STATES INS
CO
01CG31 901 31 0
05/31/2004
Can Cancelled
Can
$1,000,000.00
03/18/2004
6
AMERICAN STATES INS
01CG3190131005
/31/200305/31/2004
$1,000,000.0003 /21/2003
Untitled Page
Business Owner Information
Bond Information
Insurance Information
•
•
General /Specialty Contractor
A business registered as a construction contractor with L &I to perform construction work
within the scope of its specialty. A General or Specialty construction Contractor must
maintain a surety bond or assignment of account and carry general liability insurance.
Business and Licensing Information
Name
Phone
Address
Suite /Apt.
City
State
Zip
County
Business Type
Parent
Company
,d
ADVANCED INSTALLATION
INC
4257455977
16504 HWY 99 STE 101
LYNNWOOD
WA
98037
SNOHOMISH
Corporation
UBI No.
Status
License No.
License Type
Effective Date
Expiration
Date
Suspend Date
Specialty 1
Specialty 2
601749093
ACTIVE
ADVANII033DU
CONSTRUCTION
CONTRACTOR
3/31/1997
3/13/2010
GENERAL
UNUSED
Page 1 of 2
https://fortress.wa.gov/lni/bbip/Detail.aspx
06/11/2009