HomeMy WebLinkAboutPermit M09-148 - PHIPPS - PILGRAM RESIDENCEPHIPPS- PILGRAM RESIDENCE
13838 37 AV S
M09 -148
Parcel No.: 8864000770
Address:
Suite No:
Value of Mechanical: $4,752.81
Type of Fire Protection:
doc: IMC -10/06
13838 37 AV S TUKW
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
Cityf Tukwila
Tenant:
Name: PHIPPS - PILGRAM RESIDENCE
Address: 13838 37 AV S , TUKWILA WA
Owner:
Name: PHIPPS JESSICA G +PILGRIM SY
Address: 13838 37TH AVE S , TUKWILA WA
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: GLENDALE HEATING & A/C
Address: 12462 DES MOINES WY S , SEATTLE, WA
Contractor License No: GLENDHA053Q2
DESCRIPTION OF WORK:
REPLACE OLD OIL FURNACE WITH NEW OIL FURNACE
MECHANICAL PERMIT
Contact Person:
Name: RITA WALTERS
Address: 12462 DES MOINES MEMORIAL DR , SEATTLE WA
EQUIPMENT TYPE AND QUANTITY
1
0
0
0
0
0
0
0
0
0
0
0
0
0
* * continued on next page **
M09 -148
Permit Number: M09 -148
Issue Date: 11/17/2009
Permit Expires On: 05/16/2010
Phone:
Phone: 206 - 243 -7700
Phone: 206 - 243 -7700
Expiration Date: 11/02/2011
Fees Collected: $184.57
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 0
Water Heater 0
Emergency Generator 0
Other Mechanical Equipment
Printed: 11 -17 -2009
Permit Center Authorized Signature:
doc: IMC -10/06
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 Number: M09 -148
Issue Date: 11/17/2009
Permit Expires On: 05/16/2010
- ZtAt Date:
�� - «-0 I
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 performance of work. I am authorized to sign and obtain this mechanical permit.
Signature: 6/4a- Date: I /11 7/ 0_9
/
Print Name: <" .' wv ` r Nu
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.
M09 -148 Printed: 11 -17 -2009
Parcel No.: 8864000770
Address:
Suite No:
Tenant:
1383837AVSTUKW
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
PHIPPS - PILGRAM RESIDENCE
PERMIT CONDITIONS
Permit Number:
Status:
Applied Date:
Issue Date:
M09 -148
ISSUED
11/17/2009
11/17/2009
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 -148 Printed: 11 -17 -2009
Signature:
Print Name:
doc: Cond -10/06
•
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.
Date:
Pp 7/0
M09 -148 Printed: 11 -17 -2009
Name:
Mailing Address:
Contact Person:
Company Name:
Mailing Address:
•
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila. WA 98188
http://www.ci.tukwila.wa.us
MECHANICAL PERMIT APPLICATION
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 LOCATION
Site Address: l 5630 31
V, S
P h'
Property Owners Name:
Mailing Address: '�
7�J�S 3 t'1 y ve ' t
E -Mail Address:
Company Name: g
Mailing Address: 2
Contractor Registration Number: 01 -
ARCHITECT : OF RE A1I plans mast be wet stamped by Architect of Record
E -Mail Address:
H:WpplicanonsWorms- Applications On Line\2009 Applications11-2009 - Mechanical Permit Applicotion.doc
Revised: 1 -2009
bh
Mechanical Permit No. .M0q, 1
Project No.'
(For office use only)
King Co Assessor's Tax No.: (4cO011 0
Suite Number: Floor:
New Tenant: ❑ Yes ❑..No
City
City
State
State
Zip
Day Telephone:
Zip
Fax Number:
'city State Zip
Day Telephone: 2 01(7 —f 7 0 0
E -Mail Address: Fax Number: 2.() (, �a-l3 — O 3 4
Expiration Date: 1:7-1
State
- • - • r:/$
Zip
City
Contact Person: Day Telephone:
Fax Number:
ENGINEER OF RECORD — All plans must be wet stamped by Engineer of Record
Company Name:
Mailing Address:
State
Zip
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
Page 1 of 2
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Boiler /Compressor:
Qty
Furnace <100K BTU
1
Air Handling Unit >10,000
CFM
Fire Damper
0 -3 HP /100,000 BTU
Furnace >IOOK 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
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): $ Lf 1 S Z , p 1
Scope of Work (please provide detailed information):
Use: Residential: New ❑ Replacement j
Commercial: New ❑ Replacement ❑
Fuel Type: Electric ❑
Gas ❑
Indicate type of mechanical work being installed and the quantity below:
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.
BUI • ING ! ER OR AU O. ' IZED AGENT:
i $ , --
Sig
Print Name: l - &_ iCL- V� -U 5
Mailing Address: 1 zwp Z Des *-''(61►.,S
Date Application Expires:
I Date Application Accepted:
H:\Applications\Forms- Applications On Line\2009 Applications \1.2009 - Mechanical Permit Application.doc
Revised. 1 -2009
bh
Date: \ I \ b y
Day Telephone: 7-0
City
State Zip
Staff Initials:
Page 2 of 2
Payee: GLENDALE HEATING
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 62686 184.57
Authorization No.
ACCOUNT ITEM LIST:
Description
MECHANICAL - RES
•
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.: 8864000770 Permit Number: M09 -148
Address: 13838 37 AV S TUKW Status: PENDING
Suite No: Applied Date: 11/17/2009
Applicant: PHIPPS - PILGRAM RESIDENCE Issue Date:
Receipt No.: R09 -01832 Payment Amount: $184.57
Initials: WER Payment Date: 11/17/2009 11:39 AM
User ID: 1655 Balance: $0.00
Account Code Current Pmts
000.322.102.00.00 184.57
Total: $184.57
I .
PAYMENT
ECEIVED
doc: Receiot -06 Printed: 11 -17 -2009
P +'ect _ 0 A
�.L4' .L. I"A/✓r
e
0.
Typ M Inspectio :
lib i L` .I
.1 it /
Date Called:
40 ij
Special Instructions:
1 44 '�
Date Wanted:
I "`
a.
p.m.
Requester:
?
�^
-..� Ca-
(
^ .
Y �(f
Pho /
c� .....
74 ~ I
__
INSPECTION RECORD
Retain a copy with permit
009-1 2 1 2
PERMIT NO.
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION re-
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
..,Approved per applicable codes.
R 4 ‘' Le itA- "'■) A t.,etisa*e_e
I 1 frog. l6 tP / A
COMMENT
EINSPECTION E1 EQUIRED. P
pai 300 Southc enter lvd','•Suite 100
Date
/ �
for to inspection, fee must bego
Call to schedule reinspection.
A
Receip `ro.:
1. ( Date:
Corrections required prior to approval.
License
Name
Type
Specialty 1
Specialty 2
Effective
Date
Expiration
Date
Status
GLENDH0110PU
GLENDALE
HEATING
It OIL CO
INC
CONSTRUCTION
CONTRACTOR
GENERAL
UNUSED
10/31/1989
11 /2/1995
ARCHIVED
GLENDO *237DM
GLENDALE
OIL CO
INC
CONSTRUCTION
CONTRACTOR
BOILER /STEAM
FIT /PROC
PIPING
AIR
HEAT,VENTILATION,EVAPORAT
3/14/1977
11/2/1989
ARCHIVED
Bond
Bond
Company
Name
Bond
Account
Number
Effective
Date
Expiration
Date
Cancel
Date
Impaired
Date
Bond
Amount
Received
Date
1
FIDELITY Et
DEPOSIT
CO
30132423
11/02/1987
11/02/1988
01/01/1980
ATWOOD, STANLEY
AGENT
Name
Role
Effective Date
Expiration Date
HOEFER, ARTHUR A
Impaired
Date
01/01/1980
Received
Date
HOEFER, GERALD A
01/01/1980
FULTON, DAVID C
01/01/1980
ATWOOD, STANLEY
AGENT
01/01/1980
Savings
Assignment of
Savings Account
Number
Effective
Date
Release
Date
Assignment
Type
Impaired
Date
Amount
Received
Date
2
Untitled Page
•
m
General /Specialty Contractor
A business registered as a construction contractor with LEtI 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
GLENDALE HEATING Et A/C
INC
2062437700
12462 DES MOINES WY S
SEATTLE
WA
981682266
KING
Corporation
UBI No.
Status
License No.
License Type
Effective Date
Expiration
Date
Suspend Date
Specialty 1
Specialty 2
600003167
ACTIVE
GLENDHA053Q2
CONSTRUCTION
CONTRACTOR
11/22/1995
11/2/2011
GENERAL
UNUSED
Other Associated Licenses
Page 1 of 2
Business Owner Information
Bond Information
Assignment of Savings Information
https: // fortress .wa.gov /lni/bbip/Detail.aspx 11/17/2009