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Home My WebLink AboutPermit M13-075 - HIGHLINE MENTAL HEALTH RESIDENCE - REPLACE FURNACE This record contains information which is exempt from public disclosure pursuant to the Washington State Public Records Act, Chapter 42.56 RCW as identified on the Digital Records Exemption Log shown below. M13-075 Highline Mental Health Residence nd 14835 42 Ave S DIGITAL RECORDS (DR) EXEMPTION LOG THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION Page # Code Exemption Brief Explanatory Description Statute/Rule The Privacy Act of 1974 evinces Congress' intent that social security numbers are a private concern. As such, individuals’ social security Personal Information – numbers are redacted to protect those Social Security Numbers 5 U.S.C. sec. individuals’ privacy pursuant to 5 U.S.C. sec. DR1 Generally – 5 U.S.C. sec. 552(a); RCW 552(a), and are also exempt from disclosure under section 42.56.070(1) of the Washington 552(a); RCW 42.56.070(1) State Public Records Act, which exempts under 42.56.070(1) the PRA records or information exempt or prohibited from disclosure under any other statute. Redactions contain Credit card numbers, debit card numbers, electronic check numbers, credit Personal Information – expiration dates, or bank or other financial RCW 9 DR2 Financial Information – account numbers, which are exempt from 42.56.230(5) disclosure pursuant to RCW 42.56.230(5) RCW 42.56.230(4 5) , except when disclosure is expressly required by or governed by other law. HIGHLINE MENTAL HEALTH RESIDENCE 14835 42 AV S M13-075 City oPI'ukwila 1 Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206-431-3670 Inspection Request Line: 206-431-2451 Web site: http://www.TukwilaWA.aov MECHANICAL PERMIT Parcel No.: 0041000230 Address: 14835 42 AV S TUKW Project Name: HIGHLINE MENTAL HEALTH RESIDENCE Permit Number: M13-075 Issue Date: 04/24/2013 Permit Expires On: 10/21/2013 Owner: Name: HIGHLINE W S MENTAL HEALTH Address: PO BOX 69080 , SEATTLE WA 98168 Contact Person: Name: DAVID FULTON Address: 12462 DES MOINES MEMORIAL DR , SEATTLE WA 98168 Email: Contractor: Name: GLENDALE HEATING & A/C Address: 12462 DES MOINES WY S , SEATTLE, WA 98168 Contractor License No: GLENDHA053Q2 Phone: 206 243-7700 Phone: 206-243-7700 Expiration Date: 11/02/2013 DESCRIPTION OF WORK: GAS TO GAS REPLACEMENT FURNACE Value of Mechanical: $2,813.60 Type of Fire Protection: UNKNOWN Electrical Service Provided by: Permit Center Authorized Signature: I hereby certify that I have read and governing this work will be complie x• with Fees Collected: $177.10 International Mechanical Code Edition: 2009 Date: ot-(auIl3 ed this permit and know the same to be true and correct. All provisions of law and ordinances 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 and agree to the conditions on the back of this permit. Signature: ,�� Date: 2 / %ir . I i Print Name: 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. •14') A,G fl.:..& -A. AA flA ff17 PERMIT CONDITIONS Permit No. M13-075 1: ***BUILDING DEPARTMENT CONDITIONS*** 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 City of Tukwila Building Department (206-431-3670). 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: IMC -4/10 M13-075 Printed: 04-24-2013 CITY OF TUKW LA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov • Mechanical Permit No. AA' Project No. Date Application Accepted: 01412_t1 13 Date Application Expires: (For office use only) 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: Tenant Name: 1..LV Au King Co Assessor's Tax No.: Suite Number: Floor: New Tenant: ❑ Yes ❑ ..No PROPERTY OWNER Name: Name: t.1 .P Tor 0 J -tV 1 l` 4 Address: `1. D — 4 Jo %� City: 6)&lik Tukwila Business License No.: 0 a /1 z 0 1) / State: IL A Zip: au CONTACT PERSON — person receiving all project communicati Name: 1 Address: I a,1/ _ \l/ ) I yid W � �� l i O I � Address: � a��z� Iyl,��l YU �i { l r UUUII�" -1 1 City: 61L4..1 4..1 State: Na Zip: 61g r rPhone:4/ Ilil ,3 ; , —ow Fax: \ hj,,1 7 9 Zj 1.�7 1� "' EmaiI-/,dalt AltkiliAily,A,CO� J obi-IIDiv 2 �a . MECHANICAL CONTRACTOR INFORMATION Company Name: V I` 1 ,,) \b1, `� 1 �l�l VI v) (l1\,),1),04 Address: I a,1/ _ \l/ ) I yid W � �� l i O I � .,moo City: n ��\ I, State: via Zip: ( Q) le Phone: AND '11).,, 1 -Tv DU Fax: l Dr , at,,2 , )N a(Zlcp Contr Reg No.: (' L E iv 1>u p A� Date: n .D )) ,f� f 1 Tukwila Business License No.: 0 a /1 z 0 1) / rtpl G 2,//t4 ttit-f vh a, ce_ Valuation of project (contractor's bid price): $ Describe the scope of work in detail: Use: Residential: New ❑ Replacement 1E7 Commercial: New ❑ Replacement ❑ Fuel Type: Electric ❑ Gas Other: H:\Applications\Forms-Applications On Line\201 I Applications\Mechanical Permit Application Revised 8.9.1 I.docx Revised: August 2011 bh Page 1 of 2 • Indicate type of mechanical work being installed and the quantity below: Unit Type Qty Furnace <100k btu Furnace >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 Unit Type Qty Air handling unit >10,000 cfm Evaporator cooler Ventilation fan connected to single duct Ventilation system Hood and duct Incinerator — domestic Incinerator — comm/industrial Unit Type Qty Fire damper Diffuser Thermostat Wood/gas stove Emergency generator Other mechanical equipment Boiler/Compressor Qty 0-3 hp/100,000 btu 3-15 hp/500,000 btu 15-30 hp/1,000,000 btu 30-50 hp/1,750,000 btu 50+ hp/1,750,000 btu 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 1 AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNEAUTI-IO'_Z . 1 GE ► T: Signature: Print Name: C C 'i T.( (k4 Mailing Address: Date: 02 r3 Day Telephone: City H:\Applications\Forms-Applications On Line \2011 Applications\Mechanical Permit Application Revised 8-9-1 I.docx Revised: August 2011 bh 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 RECEIPT Parcel No.: 0041000230 Permit Number: M13-075 Address: 14835 42 AV S TUKW Status: PENDING Suite No: Applied Date: 04/24/2013 Applicant: HIGHLINE MENTAL HEALTH RESIDENCE Issue Date: Receipt No.: R13-01412 Payment Amount: $177.10 Initials: JEM Payment Date: 04/24/2013 12:39 PM User ID: 1165 Balance: $0.00 Payee: GLENDALE HEATING AND AIR CONDITIONING TRANSACTION LIST: Type Method Descriptio Amount Payment Check 67768 177.10 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts MECHANICAL - RES 000.322.102.00.00 177.10 Total: $177.10 Drin}er!• nd29d_9n1Q INSPECTION RECORD Retain a copy with permit INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 1 (206) 431-3670 Permit Inspection Request Line (206) 431-2451 Al I3 -o75 PERMIT NO. Project: IG W a 1 (11E1351‘1.- (+ Type of Inspection: A1.iTA 1-c c • Address: / i I -IA.& -41---) 2. AU S Dateled: c1-ACt-1" -NN.,.1 Special Instructions: Date Wanted:. I� ,.� ( (a.m. ( p.m. Requester: Phone No: Com- a /)k4'7 12 Approved per applicable codes. Corrections required prior to approval. COMMENTS: E) I?avvv h -,N _/ mot*" Kin.` (/,-; Contractors or Tradespeople litter Friendly Page i General/Specialty Contractor A business registered as a construction contractor with Lftl 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 a A/C INC 2062437700 12462 Des Moines Memorial Dr 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 11/2/2013 General Unused Other Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status GLENDHO110PU GLENDALE HEATING 8 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/Prot Piping Air Heat,Ventilation,Evaporat 3/14/1977 11/2/1989 Archived Business Owner Information Name Role Effective Date Expiration Date HOEFER, GERALD ARTHUR President 11/22/1995 Received Date FULTON, DAVIDCURTIS Secretary 11/22/1995 Until Released ATWOOD, STANLEY Agent 01/01/1980 06/26/2012 HOEFER, ARTHUR A Treasurer 01/01/1980 09/30/2011 Bond Information No records found for the previous 6 year period Assignment of Savings Information Page 1 of 2 Savings Assignment of Savings Account Number Effective Date Release Date Assignment Type Impaired Date Amount Received Date 3 3/11/1977 1/20/2009 Bond 0715288 $1,000.00 1/20/2009 Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date 12 Continental Western Ins Co CDP2976203 11/02/2012 11/02/2013 $1,000,000.00 10/31/2012 11 WESCO INSURANCE COMPANY WPP101953800 11/02/2010 11/02/2013 $1,000,000.00 10/17/2012 10 FEDERATED MUTUAL INS CO 0715288 11/02/2004 11/02/2011 11/23/2010 $1,000,000.00 09/27/2010 Summons/Complaint Information No unsatisfied complaints on file within prior 6 year period httns://fortress.wa. i?ov/lni/bbin/Print.asnx 04/24/2013