HomeMy WebLinkAboutPermit 0048-M - National MedicalCITY OF TUKWILA
Building Division
6200 Southcenter Boulevard
Tukwila, Washington 98188
(206) 433 - (SP? BUILDING PERMIT
Work to be done
Site Address 12698 GATEWAY DR.
Building Use iA
Property Owner BEDFORD PROP.
Address 3470 MT. DIABLY BLVD #200
HVAC
PERMIT # Ude'n-
Control # 88 -043 -M
u to enant
Contractor _PAC AIRE
Address
1 1 P 1
Assessors Account # NIA
Phone #
LAFAYETTE, CA
Phone #
FOR BUILDING PERMIT ONLY
WA
APPROVED FOR ISSUANCE BY:
(415)283 -8262
Zip 98549
395 -4004
Zip 98032
K-N-V
Sq. Ft. 1�.
Office
Storage/
Warehouse
Retail
Other
Occ.
Load
Znd F1.
3rd F1.
Total
Fire Protection: ❑ Sprinklers ❑ Detectors
Zoning Type of Construction
Fees
sq. ft. 9 1st F1. S
sq. ft. A 2nd Fl. S
sq. ft. a other $
sq. ft. @ other $
Total Valuation
Bldg. Permit Fee
Plan Check Fee
Demolition
Surcharges
Other
Other
TOTAL
of Construction
S 9.400
Receipt # sq $ 39.50
Receipt # g S 9.88
Receipt # $
Receipt # S
Receipt # $
Receipt 0 $
$ 41.38
Special Conditions
FUR SIGN PERMIT ONLY
❑ Permanent ❑ Temporary
['Single Face
❑ Double Face U Wall Mounted (] Free Standing ❑ Other
Building face
Setbacks: Front Side Side Rear
Square Footage of each sign face Total square footage of sign
Special Conditions
THIS PERMIT 9ECUMES NULL ANO 11010 IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 OAKS, OR IF CONSTRUCTION OR WURK 15 '+'jSvE.UEO OR
A8ANOONEU FuR A P1R100 OF 180 DANS AT ANN TIME AFTER WORK IS COMMENCED.
THAT 1 HAVE READ ANO EKAMINED THIS APPLICATION ANO KNOW THE SAME TO 9E TRUE AND CORRECT. ALL PROVISIONS OF LAWS AN0 0p0INANCES
OF K WILL /L�p�!l��0M0L110 WI M WHETHER SPECIFIED HEREIN ON NOT. TIE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUtnORITN TO
PRONN MEN STATE ON LOCAL LAW REGULATING C9GSTRUCTION ON THE RFDR[IIANC1 OF CONSTRUCTION.
Oats J I ( )
LI ENSED CONTRACTORS DECLARATION
100 Gust and Professions Code, aM lion 1 in fu ij,fo and effect.
Date L2
I HEREON CER
GOVERNING T
VIOLATE
Signed
I hereby affirm that 1 M
Contractor (signature/
OWNER - BUILDER DECLARATION
( 1 1. as owner of the property, or •y employees, with wages as their sole compeasation, will d0 the wort, and the structure is not 'wended or
offered for sale.
) 1, as owner of the property, M exclusively contracting with !Samson contractor's to construct the project.
Owner (signature) Date
CITY OF TUKWILA
Building Division ("
6200 Southcenter Bo'L.evard
Tukwila, Washington 98188
(206) 433-1110 184 BUILDING PERMIT
Work to be done
Site Address
Building Use
Property Owner
Address
Contractor
Address
HVAC
12698 G
PERMIT # UO`-f c6-
Control f 88 -043 -M
TEWAY DR.
BEDFORD PROP.
3470 MT. DIABLY BLVD
PAC AIRE
#200
uite enant
Assessors Account N a A
Phone f
LAFAYETTE, CA
Phone f
FOR BUILDING PERMIT ONLY
APPROVED FOR ISSUANCE BY:
Sq. Ft.
111-117-
'Office
Wstorag arees use
ho
Retail
Other
Occ.
Load
Znd Fl.
3rd F1.
ota _
Fire Protection: ❑ Sprinklers ❑ Detectors
Zoning Type of Construction
Special Cunditiuii
FOR SIGN PERMIT ONLY
(415)283 -8262
Zip 98549
395 -4004
Zip 98032
Fees
sq. ft. W
sq. ft. 0
sq. ft. IP
sq. ft. B
1st Fl. S
2nd Fl. S
other S
other S
Total Valuation of Construction S 9.400
Bldg. Permit Fee Receipt ifj or S 39.50
Plan Check Fee Receipt # sv S 9.88
Demolition Receipt d $
Surcharges Receipt d S
Other Receipt 0 S
Other Receipt 0 S
$4).38
TOTAL
❑ Permanent ❑ Temporary
❑ Single Face ❑ Double Face 0 Wall Mounted ❑ Free Standing ['Other
Building face Setbacks: Front Side Side Rear
Square Footage of each sign face Total square footage of sign
Special Conditions
THIS PERMIT BECUNES NULL ANO VOID 1P'110MS OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 1110 DAYS. OR IF CONSfIUCTION OR rURK IS '06"EsUED OR
ASANOONEU full A PERIOD OF 11M Mrs AT ANV TINE AFTER WORK IS COIIENCED.
THAT I NAVE READ AN) CIAMINEO TNIS APPLICATION AND KNOW THE SANE TO III TRUE ANO CORRECT. ALL PROVISIONS OF LAWS ANU ORDINANCES
WILL 110 WI N NETHER SPECIFIED HEREIN OA NOT. THE GRANTING OF A PERMIT DOES NOT PRESIIE tU GIVE AuTP4001Tr to
NOV 9F OTHER STATE ON LOCAL LAM REHR.ATIND C9NSTRUCTION 1M Tit gmFcsormict OF CONSr*UCTION.
Date
I HERESY CEN
GOVERNINI T
VIOLATE
Signed
I hereby Affirm that I M
Contractor (signature)
( I
LI ENSED CONTRACTORS DECLARATION
1011 Syal and Profession Cab. aHI Iic 1 In Iul f0 and effect.
Date
OWNER - BUILDER DECLARATION
I. as owner of the property. or ry employees, with wages as their sole co eensatl*N. will do the work. and the structure ,s not .n'rnaea
offered for sale.
1 1 i, as owner of the property. M nCIUSIVely contracting with licensed contractor's to construct the project.
Date
Owner (signature)
or
• CITY OF TUKWILA
Suildinp Division
6200 Southcantar Boulevard
Tukwila, Washinoton 94188
(206) 433 -1849
INSPECTI501 RECORD
PERMIT # 6 Q -{e -,4
-- ?
Date
Type of Inspection ( Date Wanted )444144y 474:DP.m.
Project LILagin.0__ _ _t4e!,__
Phone # AZ .54,/ - 945-F
5-F
Site Address /)- 9:
Requestor
Special Instructions
,/,
Inspection Results /Comments:
Inspector
Date.
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CITY OF TUKWILA
Building Division
6200 Southcenter Boulevard
Tukwila, Washinotnn 44188
(206)- 433 -1849
MECHANICAL PERMIT APPLICATION
Site Address 21 6 Ir- 1 b
Project Name /Tenant .�... ti�y �. c
Valuation of work ciA/OC3 Assessors Account # 4'1 f,
Property Owner ,+.a.O rt C.4a4' Ci Pv.c.) p•to Phone y/6 - „,n3 -gat, 2
Address.3(d 0 int, ao.h.L() .44L#0O, taco Gil .6, (,A � Zip gg64q
Applicant � C.. L� . -- ` Phone . 9•.`� '�POOY
Address 0 4, f 7 4 r to t Zip 9' 3 2..
CONTROL#♦ � 2
sta4.5
z
Floor#
Architect /Engineer
Address
Contractor
Address
P‘
Describe work to be done )4.
Phone
t Zip
License# C. 4 * /S11 ,3 2. Phone
Zip
Indicate the type of equipment to be installed, rating /size of equipment, and number of each:
TYPE
_ g t...R - -bilk- Ptst.t
(6- 1C,)
RATING /SIZE
6 0 ono 3v1&.
Py non 3` r4.,
NUMBER
1
1
Two (2) sets of plans must be submitted meeting the application requirements of Section 302(b)
and (c), 1985 Uniform Mechanical Code. Roof -top equipment work requires submission of building
elevations.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND
CORRECT AND THAT I HAVE THE PROPERTY OWN 'S AUT OR ZATION TO D THIS WORK.
a e
Date - -61
Applicant /Authorized Agent (signature) dit�
(print name) RoIQ R,,,a. i-- PIA C.I.. IteiA
Contract Person (please print) 8 v1�,ir...-
Phone 3 9 rd% cf
OFFICE USE ONLY
FEES: Basic Permit Fee (000/322.100)
Unit Fee (000/322.100)
Plan Check Fee (000/345.830)
Other ( / )
BLDG
PLNG
TOTAL
$ lS,Sd�p
X9.88
Receipt#_ -y Date Paid
Receipt#► Date Paid
Receipt# Date Paid
Receipt# Date Paid
..y g1 g _ (OWES: $
Approved for Issuance
yq, 38
Approved (Initials)