HomeMy WebLinkAboutPermit PG12-056 - STENSEN RESIDENCESTENSON RESIDENCE
4434 S 150 ST
PG1 2-056
City otkukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -43 1 -3670
Inspection Request Line: 206 - 431 -2451
Web site: http: / /www.TukwilaWA.gov
Parcel No.: 0042000070
Address: 4434 S 150 ST TUKW
Project Name: STENSEN RESIDENCE
PLUMBING /GAS PIPING PERMIT
Permit Number: PG12 -056
Issue Date: 04/13/2012
Permit Expires On: 10/10/2012
Owner:
Name: STENSEN CONNIE M
Address: 4434 S 150TH ST , TUKWILA WA 98188
Contact Person:
Name: GREG JENSEN Phone: 206 824 -7717
Address: PO BOX 98647 , DES MOINES WA 98198
Email:
Contractor:
Name: JENSEN PLUMBING LLC
Address: PO BOX 98647 , DES MOINES WA 98198
Contractor License No: JENSEPL041RQ
Phone: 206 824 -7717
Expiration Date: 11/26/2012
DESCRIPTION OF WORK:
REPLACE WATER HEATING IN BASEMENT
Value of Plumbing /Gas Piping:
Fees Collected:
Electrical Service Provided by:
Permit Center Authorized Signature:
I hereby certify that I have read and
governing this work will be complied \with, whether specified herein or not.
$985.00 Uniform Plumbing Code Edition: 2009
$47.25 International Fuel Gas Code Edition: 2009
Date:
0-(141--
d this permit and know the same to be true and correct. All provisions of law and ordinances
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 plumbing /gas piping permit and agree to the conditions
on the back of this t.
Signature:
Print Name:
0--0 h Yli Q VlA r r Sf-eAS-ei)
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.
doe: UPC -4/10
PG 12 -056 Printed: 04 -13 -2012
PERMIT CONDITIONS •
Permit No. PG12-056
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.
doc: UPC -4/10
PG12-056 Printed: 04 -13 -2012
SITE LOCA'
CITY OF TUKW
Community DevelopmWDepartment
Permit Center
6300 Southcenter Blvd, Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
PLUMBING
GAS PIPING PERMIT APPLICATION
Applications an plans must be complete in order to be accepted for plan review.
App cations will not be accepted through the mail or by fax.
* *Please Print **
pa "';•i�,r,,rid'fiiq ��; .'. '3s �ia3.�..�•Y?d,`` ?t•d�i;n,J�'it«.Y�t,r'`s ���'p�. +..�;
King Co Assessor's Tax No.: 001 l "t
Site Address: - 3 EDGct-k WPSuite Number: Floor:
Tenant Name: CY Qt4 V1'I S +eVtse-✓) New Tenant: ❑ Yes No
"PROPERTrY'�OWNER ""
Name:(
,1.Vl1
VV ac:le, c - vS-e-v
Address: 4
3 i4 Lout t SOTS_
City: TiA1
, vies lit
I I a State: W- Zip: qg . l8
CONTACT PERSON - person receiving all project s
� u�r � tr � +ert f� n � �
i. s� �' S !Yx r� f i
communtcatlon;t iya "x'
Name: G. r J4av1Se h
�.J
Address :T? 3. -,� s � li E/ I 7
Address: -P E 0.,i. 6 9 7
Phone ate,. /' 3. 0. q _--Tr 1 lax: '-}%l% rE0,4 t
City:T State:
.✓A6'I
Zip:Gf Q/qg
, vies lit
1 UU
Phone:l/)�66.xN_77 /7F .
Email:
PAANAING_CONTRACTORINFORMATI . , t, ,;
Company Name: Je.A4 S-e v, �l u 141 LL&
`
�.J
Address :T? 3. -,� s � li E/ I 7
city:.- De„ 1 Vle s State: IJ f,4_ Zip: 98/5 0
Phone ate,. /' 3. 0. q _--Tr 1 lax: '-}%l% rE0,4 t
Contr Reg No.: 070t,_ 8a Ii- -2717 Exp Date: latel 12..
Tukwila Business License No.:
Valuation of Project (contractor's bid price): $ I y S s o() j ��1 e j'
Sco e of Work (please provide detailed information): -7(ti• ) VL. V\ t/a1 ` fir
J
Building Use (per Int'l Building Code):
Occupancy (per Int'I Building Code):
Utility Purveyor: Water: Sewer:
H:\Applications\Forms- Applications On Line \2011 Applications\Plumbing Permit Application Revised 8- 9- 11.docx
Revised: August 2011
bh
Page 1 of 2
Indicate type of plumbing fixtures and/o
Fixture Type
Qty
or combination
bath/shower
Dishwasher, domestic with
independent drain
Shower, single head trap
Sinks
Rain water system — per
drain (inside building)
Grease interceptor for
commercial kitchen ( >750
gallon capacity)
I
Each additional medical
gas inlets /outlets greater
than 5
Atmospheric -type vacuum
breakers not included in
lawn sprinkler backflow
protections (1 -5)
iping outlets being installed and the quantity glow:
Fixture Type
Qty
Bidet
Drinking fountain or water
cooler (per head)
Lavatory
Urinal
Water heater and /or vent
Repair or alteration of
drainage or vent piping
I
Repair or alteration of
water piping and/or water
treatment equipment
Backflow protective device
other than atmospheric -
type vacuum breakers 2
inch (51 mm) diameter or
smaller
Atmospheric -type vacuum
breakers not included in
lawn sprinkler backflow
protections over 5
Fixture Type '
Qty
Clothes washer,
domestic
Food -waste grinder,
commercial
Wash fountain
Water closet
Industrial waste
treatment interceptor,
including trap and vent,
except for kitchen type
grease interceptors
Repair or alteration of
drainage or vent piping
Backflow protective
device other than
atmospheric -type
vacuum breakers over 2
inch (51 mm) diameter
Gas piping outlets
Fixture Type
Qty
Dental unit, cuspidor
Floor drain
Receptor, indirect waste
Building sewer and each
trailer park sewer
Each grease trap
(connected to not more
than 4 fixtures - <750
gallon capacity
Medical gas piping
system serving 1 -5
inlets /outlets for a specific
gas
Each lawn sprinkler
system on any one meter
including backflow
protection devices
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 an additional period not to exceed 180 days. The extension shall be requested in writing
and justifiable cause demonstrated. Section 103.4.3 International 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 OW ER OR AUTHORIZED AG
Signature: L /ft-N Date:' /g
011 hVtC, Yie. (54-e S•PV-)
Print Name:
Mailing Address: 4434 SUuL.4-k 1
D a y Telephone: 4 S 13 — (A- 1 L I`
H: \Applications\Forms- Applications On Line \2011 Applications\Plumbing Permit Application Revised 8- 9- 11.docx
Revised: August 2011
bh
City State Zip
Page 2 of 2
•
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.TukwilaWA.gov
Parcel No.: 0042000070
Address: 4434 S 150 ST TUKW
Suite No:
Applicant: STENSEN RESIDENCE
RECEIPT
Permit Number: PG 12 -056
Status: PENDING
Applied Date: 04/13/2012
Issue Date:
Receipt No.: R12 -01315
Initials: JEM
User ID: 1165
Payment Amount: $47.25
Payment Date: 04/13/2012 03:19 PM
Balance: $0.00
Payee: CONNIE M STENSEN
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 1297 47.25
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
PLUMBING - RES
000.322.103.00.00 47.25
Total: $47.25
doc: Receiot -06 Printed: 04 -13 -2012
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION'
6300 Southcenter Blvd., #100, Tukwila. WA 98188 vz. (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
Project:
Type of Inspection:
Addr``e��s: ff `iti
Date Called:
Special Instructions:
07--<S (42)
Date Wanted. .
ca.mr
Requester:
Phone No'
%
:-. _#✓ J`7
Approved per applicable codes. El Corrections required prior to approval:
COMMENTS:
•
-"x
i I i
Insptector:
' k
Ak_,
n REINSPECTION FEE REQUIRED. Priokto next inspection, fee must • be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule:reinspection,
Dater
09 -04 -2012
•
City of Tukwila
•
Jim Haggerton, Mayor
Department of Community Development - - - Jack Pace, Director
GREG JENSEN
PO BOX 98647
DES MOINES WA 98198
RE: Permit No. PG12 -056
STENSEN RESIDENCE
4434 S 150 ST TUKW
Dear Permit Holder:
In reviewing our current records, the above noted permit has not received a fmal inspection by the City of Tukwila Building
Division. Per the International Building Code, International Mechanical Code, Uniform Plumbing Code and/or the National
Electric Code, every permit issued by the Building Division under the provisions of these codes shall expire by limitation and
become null and void if the building or work authorized by such permit has not begun within 180 days from the issuance date
of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work has
begun for a period of 180 days. Your permit will expire on 10/10/2012.
Based on the above, you are hereby advised to:
1) Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 to schedule for the next or fmal inspection.
Each inspection creates a new 180 day period, provided the inspection shows progress.
-or-
2) Submit a written request for permit extension to the Permit Center at least seven (7) days before it is due to
expire. Address your extension request to the Building Official and state your reason(s) for the need to extend
your permit.
The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is determined that your
extension request is granted, you will be notified by mail.
In the event you do not call for an inspection and/or receive an extension prior to 10/10/2012, your permit will become null
and void and any further work on the project will require a new permit and associated fees.
Thank you for your cooperation in this matter.
Sincerely,
Bill Rambo
Permit Technician
File: Permit File No. PGI2 -056
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone 206-431 -3670 • Fax 206 -431 -3665
Contractors or Tradespeople 1ter Friendly Page
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
JENSEN PLUMBING LLC
2068247717
Po Box 98647
Des Moines
WA
98198
King
Limited Liability Company
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
601741086
Active
JENSEPL041RQ
Construction Contractor
12/18/1996
11/26/2012
General
Unused
Business Owner Information
Name
Role
Effective Date
Expiration Date
JENSEN, GREG
Partner /Member
01/01/1980
Amount
JENSEN, SUE M
Partner /Member
01/01/1980
98BJZ5345
Bond Information
Page 1 of 1
Bond
Bond Company Name
Bond Account Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Bond Amount
Received Date
2
STATE FARM FIRE a
CAS CO
98CE99406
11/26/2001
Until Cancelled
$12,000.00
10/24/2001
Assignment of Savings Information No records found for the previous 6 year period
Insurance Information
Insurance
Company Name
Policy Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Amount
Received Date
11
State Farm Fire
&CasCo
98BJZ5345
11/26/2011
11/26/2012
$1,000,000.00
10/17/2011
10
STATE FARM
FIRE & CAS CO
98BJF325
11/26/2010
11/26/2011
$1,000,000.00
10/19/2010
9
STATE FARM
FIRE & CAS CO
98BGT3917
11/26/2009
11/26/2010
$1,000,000.00
12/02/2009
8
STATE FARM
FIRE & CAS CO
98BCP0169
11/26/2008
11/26/2009
$1,000,000.00
10/30/2008
7
STATE FARM
FIRE a CAS CO
98E351073F
11/26/2003
11/26/2008
$300,000.00
11/18/2003
Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period
Warrant Information No unsatisfied warrants on file within prior 6 year period
https://fortress.wa.gov/Ini/bbip/Print.aspx
04/13/2012