HomeMy WebLinkAboutPermit D17-0178 - WEIER LAW FIRM - PRE-REROOFWEIER LAW FIRM
331 ANDOVER PARK E
COMPLEX
EXPIRED 01/23/18
D17-0178
Parcel No:
Address:
0
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Inspection Request Line: 206-438-9350
Web site: http://www.TukwilaWA.gov
DEVELOPMENT PERMIT
0223200051
331 ANDOVER PARK E COMPLEX
Project Name: WEIER LAW FIRM
Permit Number: D17-0178
Issue Date: 7/24/2017
Permit Expires On: 1/20/2018
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
License No:
Lender:
Name:
Address:
STEVEN D WEIER INC PS
320 AUBURN WAY N , AUBURN, WA,
98003
BRIAN TRAVIS
7004 VANDERMARK RD E , BONNEY
LAKE, WA, 98391
GOLDEN BANNER INC
7004 VANDERMARK RD E , BONNEY
LAKE, WA, 98391-8660
GOLDEBI962RB
STEVEN D WEIER INC PS
320 AUBURN WAY N , AUBURN, WA,
98003
Phone: (206) 510-5313
Phone:
Expiration Date: 7/18/2019
DESCRIPTION OF WORK:
OVERROOF 1 LAYER CAP SHEET WITH 60 MILTPO
Project Valuation: $48,000.00
Type of Fire Protection: Sprinklers:
Fire Alarm:
Type of Construction: VB
Electrical Service Provided by: TUKWILA
Fees Collected: $1,673.66
Occupancy per IBC: B
Water District: TUKWILA
Sewer District: TUKWILA
Current Codes adopted by the City of Tukwila:
International Building Code Edition:
International Residential Code Edition:
International Mechanical Code Edition:
Uniform Plumbing Code Edition:
International Fuel Gas Code:
2015
2015
2015
2015
2015
National Electrical Code:
WA Cities Electrical Code:
WAC 296-46B:
WA State Energy Code:
2014
2014
2014
2015
Public Works Activities:
Channelization/Striping:
Curb Cut/Access/Sidewalk:
Fire Loop Hydrant:
Flood Control Zone:
Hauling/Oversize Load:
Land Altering:
Landscape Irrigation:
Sanitary Side Sewer:
Sewer Main Extension:
Storm Drainage:
Street Use:
Water Main Extension:
Water Meter:
Volumes: Cut: 0 Fill: 0
Number: 0
Permit Center Authorized Signature: i ?' (Ii/t
I hearby certify that I have read and examined this permit and know e 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 regulatin: construction or the performance of work. I am authorized to sign and obtain this
development permit•o01!I— ,. • n• t i•' s attached to this permit.
AI‘opIP'
Signature: /�, /// �J�/,
Print Name: i ! /i7ii -t l/ 7 /�'T-
This permit shall become null and void if the work is not commenced within 180 days for the date of issuance, or if
the work is suspended or abandoned for a period of 180 days from the last inspection.
PERMIT CONDITIONS:
1: ***BUILDING PERMIT CONDITIONS***
2: Work shall be installed in accordance with the approved construction documents, and any changes made
during construction that are not in accordance with the approved construction documents shall be
resubmitted for approval.
3: All permits, inspection record card and approved construction documents shall be kept at the site of work
and shall be open to inspection by the Building Inspector until final inspection approval is granted.
4: Readily accessible access to roof mounted equipment is required.
5: All construction shall be done in conformance with the Washington State Building Code and the
Washington State Energy Code.
6: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap
the sanitary sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks,
wells, and other excavations. Final inspection approval will be determined by the building inspector based
on satisfactory completion of this requirement.
7: Prior to final inspection for this building permit, a copy of the roof membrane manufacturer's warranty
certificate shall be provided to the building inspector.
8: 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.
PERMIT INSPECTIONS REQUIRED
Permit Inspection Line: (206) 438-9350
1700 BUILDING FINAL**
0103 PRE-REROOF
CITY OF TUK
Community Development Department
Public Works Department
Permit Center -
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188'
http://www.TukwilaWA.gov
Project No.
Building Permit No.
Date Application Accepted:
Date Application Expires:
(For 'office use only)
CONSTRUCTION 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: 3 a /
Tenant Name:
tvo 6-14.14ti
e4King Co Assessor's Tax No.:
- Suite Number: Floor:
PROPERTY OWNER
Name: gJ'u.
Name:
64-444e
Wei e6i-
Address: 3.31
A4yl.4ip
i4
City: lit t
;
1 4. ,
State: tAinti, L Zip:
CONTACT PERSON - person receiving all project
communication
Name: gJ'u.
Name: v i ,1•,� ..n " ' t•
-r
Company Name:
Addres ,p_40 /.
-
Address:
qtrel v ,ytdai. wtmk__.
b E_-
.,
City: we" State:
i.
,,,,,,3
I
Phor�.�n 5 - Fax:
sip
Tukwila Business License No.:,
State:
Email:
Phone:
Fax:
GENERAL CONTRACTOR INFORMATION
Name: gJ'u.
Company Name: e, _ _.__----'
541um_ V-
Company Name:
Addres ,p_40 /.
-
City: CState: Zit
(
Phone:�t'G '
Address:
Contr Reg No.: 'Exp Date:
City: P
Tukwila Business License No.:,
State:
H:\Applications\Forms-Applications On Line \2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
bh
New Tenant: ❑ Yes 10 No
ARCHITECT OF RECORD
Name: gJ'u.
,,n
f taei e_g_-
Company Name:
Architect Name:
�E,/ �C
C
"c
Address:
� .
City: P
City:
State:
Zip:
Phone:
Fax:
Email:
ENGINEER OF RECORD
Name: gJ'u.
,,n
f taei e_g_-
Company Name:
Engineer Name:
�E,/ �C
C
"c
Address:
� .
City: P
City:
State:
Zip:
Phone:
Fax:
Email:
LENDER/BOND ISSUED (required for projects $5,000 or
greater per_JRCW 19.27.095),,
Name: gJ'u.
,,n
f taei e_g_-
r
Address: 33(
�E,/ �C
C
"c
� .
City: P
4/
State: , n y.�
Zip: Tom
Page 1 of 4
BUILDING PERMIT INFORMATII — 206-431-3670 /
Valuation of Project (contractor's bid price): $
Describe the scope of work (p ease provide tailed information):Go
Existing Buildi Valuation: $
)cJP = c -o
!
Will there be new rack storage? ❑ .... Yes� ' If yes, a separate permit and plan submittal will be required.
Provide All Building Areas in Square Footage Below
PLANNING DIVISION:
Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): Floor area of principal dwelling: Floor area of accessory dwelling:
*Provide documentation that shows that the principal owner lives in one of the dwellings as hi's or her prima}•y residence:
Number of Parking Stalls Provided: Standard: Compact: a Handicap:
Will there be a change in use? ❑ Yes 0 No If "yes", explain:
FIRE PROTECTION/HAZARDOU$-MATERIALS:
❑ Sprinklers �� Automatic Fire Alarm❑ None 0 Other (specify)
Will•there be storage or use of flammable, combustible or hazardous materials in the building? 0 Yes 0 No
If` yes', dttach,list of materials and storage locations on a separate 8-1/2" x 11" paper including quantities'and Material Safety Data Sheets.
j'SEPTIC SYSTEM 1t a t j .I j r
N }
❑ On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health
Department.
H:\Applications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 2 of 4
Existing
Interior Remodel
Addition to
Existing
Structure
New
Type of
Construction per
IBC
Type of
Occupancy per
IBC
1St Floor
2_ b 0
' ,
2nd Floor
3`d Floor
Z e ,y� p
V
Floors thru
Basement
0.
Accessory Structure*
-
Attached Garage
Detached Garage
Attached Carport
Detached Carport
Covered Deck
•i .*t
.
Uncovered Deck
PLANNING DIVISION:
Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): Floor area of principal dwelling: Floor area of accessory dwelling:
*Provide documentation that shows that the principal owner lives in one of the dwellings as hi's or her prima}•y residence:
Number of Parking Stalls Provided: Standard: Compact: a Handicap:
Will there be a change in use? ❑ Yes 0 No If "yes", explain:
FIRE PROTECTION/HAZARDOU$-MATERIALS:
❑ Sprinklers �� Automatic Fire Alarm❑ None 0 Other (specify)
Will•there be storage or use of flammable, combustible or hazardous materials in the building? 0 Yes 0 No
If` yes', dttach,list of materials and storage locations on a separate 8-1/2" x 11" paper including quantities'and Material Safety Data Sheets.
j'SEPTIC SYSTEM 1t a t j .I j r
N }
❑ On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health
Department.
H:\Applications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 2 of 4
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 or more extensions of time for additional periods not exceeding 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
Signature:
ENT:
Date:
24. r
Print Name:
Mailing Address:
arc.V4a Ct LGf
City State
Day Telephone:
H:\Applicationaorms-Applications On Line\2012 ApplicationsJ'ermit Application Revised - 2-7-t2.docx
Revised: February 2012
bh
Page 4 of 4
PUBLIC WORKS PERMIT INhZMATION - 206-433-0179
Scope of Work (please prov e detailed inf ion): 0 tom'
c-ct (J•S 1A -c...) w 't-'? 0
Ld
Call before you Dig: 811
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
Water District
�� ❑ .. Tukwila ❑ ...Water District #125 ❑... Highline
. ❑ ', Wate Availability Provided
-Sewer District \ .) _, c, v - \ \ 7 \ ‘ 1. �,
12-. . Tukwila '`
0 ...Valley View El...Renton � - 0... Seattle !
❑ .. Sewer`Use Certificate 0 ...Sewer Availability Provided ,
Septic System: . -
❑ On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health Department.
1/4
❑... Renton
Submitted with Application (mark boxes which apply):
❑ .. Civil Plans (Maximum Paper Size — 22" x 34")
0 .. Technical Information Report (Storm Drainage)
L Bund
❑ ... Geotechnical Report ❑ .. Traffic Impact Analysis
nsurance ❑... Easement(s) 0...Maintenance Agreement(s) ❑ .. Hold Harmless — (SAO)
❑ .. Hold Harmless — (ROW)
Proposed Activities (mark boxes that apply):
❑ .. Right-of-way Use - Nonprofit for less than 72 hours
0 .. Right-of-way Use - No Disturbance
❑ .. Construction/Excavation/Fill - Right-of-way 0
Non Right-of-way 0
❑ .. Total Cut
0 .. Total Fill
cubic yards
cubic yards
0 .. Sanitary Side Sewer
❑ .. Cap or Remove Utilities
❑ .. Frontage Improvements
❑ .. Traffic Control
0 .. Backflow Prevention - Fire Protection
Irrigation
0...Right-of-way Use - Profit for less than 72 hours
0...Right-of-way Use — Potential Disturbance
0...Work in Flood Zone
O... Storm Drainage
0...Abandon Septic Tank
0...Curb Cut
0...Pavement Cut
0...Looped Fire Line
Domestic Water
0...Grease Interceptor
❑... Channelization
0... Trench Excavation
0... Utility Undergrounding
❑ .. Permanent Water Meter Size (1) " WO # (2) " WO # (3) " WO #
❑ .. Temporary Water Meter Size (1) " WO # (2) " WO # (3) " WO #
0 .. Water Only Meter Size WO # ❑ .. Deduct Water Meter Size "
0 .. Sewer Main Extension Public 0 Private 0
❑ .. Water Main Extension Public 0 Private 0
FINANCE INFORMATION
Fire Line Size at Property Line Number of Public Fire Hydrant(s)
❑ .. Water ❑ .. Sewer ❑ .. Sewage Treatment
Monthly Service Billing to:
Name: Day Telephone:
Mailing Address:
Water Meter Refund/Billing:
Name:
Mailing Address:
City
State Zip
Day Telephone:
City
State Zip
H:Wpplications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 3 of 4
DESCRIPTIONS I ACCOUNT QUANTITY
PermitTRAK
'.': PAID
$608.11
D17-0178 Address: 331 ANDOVER PARK E COMPLEX' , Apn: 0223200051
$608.11 •
Credit Card Fee
$17.71
Credit Card Fee R000.369.908.00.00
0.00
$17.71
DEVELOPMENT
$590.40
PERMIT FEE R000.322.100.00.00
TOTAL FEES PAID BY RECEIPT: R11980
0.00
$590.40
$608.11
Date Paid: Monday, July 24, 2017
Paid By: BRIAN TRAVIS
Pay Method: CREDIT CARD 097458
Printed: Monday, July 24, 2017 11:44 AM 1 of 1
CISYSTEMS
DESCRIPTIONS I ACCOUNT I QUANTITY I: PAID
PermitTRAK �'" �. ry s., $1,065.55
- D17-0178' 'Address: 331 ANDOVER PARK E COMPLEX ' A pn. 0223200051
$1;065.55 2
DEVELOPMENT
' $1,016.98 '
PERMIT FEE
R000.322.100.00.00
0.00
$381.04
PLAN CHECK FEE
R000.345.830.00.00
0.00
$631.44
WASHINGTON STATE SURCHARGE
B640.237.114
0.00
$4.50
TECHNOLOGY FEE
' $48.57
TECHNOLOGY FEE R000.322.900.04.00 0.00
TOTAL FEES PAID BY RECEIPT: R11848
$48.57
$1,065.55
Date Paid: Wednesday, July 05, 2017
Paid By: GOLDEN BANNER INC
Pay Method: CHECK 7008
Printed: Wednesday, July 05, 2017 9:30 AM 1 of 1
CRSYSTEMS
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila: WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 438-9350
P7-6178
Project:
Iti /E7i inhi/ f7,R/79
Type of Inspection:
/XIS -/Q RCSO/C.
Address:
33 / IMIDOVER ,%fl
Date Called:
Special Instructions:
Date Wanted:
7-z?
---/7
a.m.
Requester:
Phone No:
Approved per applicable codes. 0 Corrections required prior to approval.
COMMENTS:
— PRa - t2�RocC
Inspector:
Date:
7-27-0
REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
f.}
FILE COPY
Permit No. Jai- Oh V
Plan review approval is subject to errors and omissions.
Approval of construction documents does not authorize
the violation of any adopted code or ordinance. Receipt
of approved Field Copy and .,;,,,_
� wledged:
By:
Date:
City of Tukwila
BUILDING DIVISION
REVISIONS
No changes shall he made to the scope
of work without prior approval of
Tukwila Building Division.
1
NOTE: Revisions will require a new plan submittal
and may include additional plan review fees.
SEPARATE PEANUT
REQUUP:D FOR:
'M cilanical
Electncal
(Plumbing
eGas Piping
City of Tukwila
BUILDING DIVISION
bri-.o (70
REVIEWED FOR
CODE COMPLIANCE
APPROVED
JUL 21 2017
City of Tukwila
BUILDING DIVISION
RECEIVED
CITY OF TUKWILA
JUL 052017
PERMIT CENTER
4-//://
3.31 Actog_eA___.
Tac,o,c( /4 -
RECEIVED
CITY OF TUKWILA
JUL 0 5 2011
PERMIT CENTER
zy�
tn or7g
EverGuard® TPO 60 mil Membrane
Applicable Standards
UL Listed, FM Approved, Miami -Dade County Approved, Florida Building Code Approved, CRRC Listed, Title 24
Compliant", ENERGY STAR®Qualified",ASTM D6878.
*White, Energy Gray, and Energy Tan Membranes Only
Product Data
* *ENERGY STAR®only valid in the USA
(220323
Method
6)201D6878 f
EverGuard°
Q�Q�llWei ht
tad ta) Data
1. Certain data is provided in MD (machine direction) x CMD (cross machine direction) format.
2. Data is based upon typical product performance, and is subject to normal manufacturing tolerance and variance.
Nominal Thickness
ASTM D751
0.039" (min.) (0.99 mm)
0.060" (1.52 mm)
Breaking Strength
ASTM D751 Grab Method
220 lbf/in. (38.5 kn/m)
305 lbf x 290 lbf (454 x 432 kg/m)
Factory Seam Strength
ASTM D751
66 lbf (98.34 kg/m)
135 lbf (membrane failure) (201.1 kg/m)
Elongation at Break
ASTM D751
15%
30%
Heat Aging
ASTM D573
90% Retention of Breaking Strength
and Elongation at Break
100%
Tear Strength
ASTM D751 8" x 8" (203 x 203 mm) Sample
55 lbf (81.95 kg/m)
75 lbf x 130 lbf ((1 1.8 x 193.7 kg/m)
Puncture Resistance
FTM 101C Method 2031
Not Established
380 lbs. (172 kg)
Cold Brittleness
ASTM D2137
-40°C
-40°C
Permeance
ASTM E96
Not Established
0.08 Perms
Dimensional Change
ASTM D1204 @158°F (70°C), 6 hrs.
+/-1%
0.4%
Water Absorption
ASTM D471 @158°F (70.C), 1 week
+/-3.0% (top coating only)
0.7%
Hydrostatic Resistance
ASTM D751 Method D
Not Established
430 psi
Ozone Resistance
ASTM D 1 149
No visible deterioration @ 7 x
magnification
No visible deterioration @ 7 x
magnification
Reflectivity (white) Initial/Aged
ASTM Cl 549
N/A
0.76/0.68
Emissivity (white) Initial/Aged
ASTM Cl 371
N/A
0.90/0.83
Weather Resistance
ASTM GI 55/D6878
10,080 KJ/(m2 • nm) at 340 nm
>25,000 KJ/(m2- nm) at 340 nm
Heat Aging
ASTM D573
240°F (115°C) for 32 weeks
60 weeks
Thickness Above Scrim
ASTM D7635
Min 30% of Total Thickness
22.1 mil (Nominal)
Guarantee
Up to 25 years
*White, Energy Gray, and Energy Tan Membranes Only
Product Data
* *ENERGY STAR®only valid in the USA
(220323
Note: Product sizes, dimensions, and widths are nominal values and are subject to normal manufacturing/packaging tolerance
and variation.
Colors
Q�Q�llWei ht
C�Dl3I�
1�G�DWei ht
Q�G7D
White, Tan, Gray,
10' x 100'
322 lbs. (146 kg)
5' x 100'
162 lbs. (73.5 kg)
Energy Tan,
(3.05 x 30.5 m)
(1.52 x 30.5 ml
Energy Gray
(1,000 sq. ft.
(500 sq. ft.
[92.9 sq.m])
[46.5 sq.m])
8' x 100'
257 lbs. (1 17 kg)
4' x 100'
128.8 lbs. (58.4 kg)
(2.44 x 30.5 m)
(1.21 x 30.5 m)
(800 sq. ft.
(400 sq. ft.
[74.3 sq.m])
[37.1 sq.m])
Note: Membrane rolls sh pped horizontally on pallets, stacked pyramid -style and banded.
Store rolls on their sides on pallets or shelving in a dry area.
Storage
titaVEThittio
Membrane rolls are heavy. Position and install by at least two people.
Quality You CanTruat...
From North America's
Largest Roofing Manufacturer!"
02015 GAF 9/15 • #342
or/
RECEIVED
CITY OF TUKWILA
JUL 0 5 2017 gaf.cam
PERMIT CENTER
12/1/2017
City of Tukwila
Department of Community Development
BRIAN TRAVIS
7004 VANDERMARK RD E
BONNEY LAKE, WA 98391
RE: Permit No. D17-0178
WEIER LAW FIRM
331 ANDOVER PARK E
Dear Permit Holder:
Allan Ekberg, Mayor
Jack Pace, Director
In reviewing our current records, the above noted permit has not received a final 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 1/23/2018.
Based on the above, you are hereby advised to:
1) Call the City of Tukwila Inspection Request Line at 206-438-9350 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 1/23/2018, 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,
Rachelle Ripley
Permit Technician
File No: D 17-0178
6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665
. c5
PERMIT COORD COPY:.
PLAN REVIEW/ROUTING SLAP
PERMIT NUMBER: D17-0178 DATE: 07/05/17
PROJECT NAME: WEIER LAW FIRM
SITE ADDRESS: 331 ANDOVER PARK E
X Original Plan Submittal
Revision #
before Permit Issued
Response to Correction Letter # Revision # after Permit Issued ..
DEPARTMENTS:
ittod -7440'1 7
Building Division
Public Works
fro paiv-
Fire Prevention
Structural
Planning Division
❑ Permit Coordinator
PRELIMINARY REVIEW:
Not Applicable ❑
(no approval/review required)
DATE: 07/06/17
Structural Review Required
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS: DUE DATE: 08/03/17
Approved
Corrections Required
❑ Approved with Conditions ❑
❑ Denied ❑
(corrections entered in Reviews) (ie: Zoning Issues)
Notation:
REVIEWER'S INITIALS:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire 0 Ping 0 PW 0 Staff Initials:
12/18/2013
GOLDEN BANNER INC
Home I:spanpl Contact •
Safety & Health Claims & Insurance
0 Washington State Department of
Labor & Industries
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Workplace Rights Trades & Licensing
GOLDEN BANNER INC
Owner or tradesperson
Principals
TRAVIS, BRIAN KENNETH, PRESIDENT
TRAVIS, HISAKO KIKUCHI, VICE
PRESIDENT
TRAVIS, HISAKO K, PRESIDENT
(End: 01/14/2011)
TRAVIS, BRIAN K, VICE PRESIDENT
(End: 01/14/2011)
TAYLOR, JOHN S, VICE PRESIDENT
(End: 01/14/2011)
Doing business as
GOLDEN BANNER INC
WA UBI No.
602 443 088 .
7004 VANDERMARK RD E
BONNEY LAKE, WA 98391
253-941-3774
PIERCE County
Business type
Corporation
Governing persons
BRIAN
KENNETH
TRAVIS
HISAKO KIKUCHI TRAVIS;
License
Verify the contractor's active registration / license / certification (depending on trade) and any past violations.
Construction Contractor Active.
Meets current requirements.
License specialties
GENERAL
License no. -
GOLDEBI962RB
Effective — expiration •
12/02/2004- 07/18/2019
Bond
American Contractors Indem CO
Bond account no.
100209799
Received by L&I
11/30/2012
Bond history
Insurance
MESA UNDERWRITERS SPECIALTY IN
Policy no.
MP01460030000070
$12,000.00
Effective date
11/30/2012
Expiration date
Until Canceled
$1,000,000.00
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GOLDEN BANNER INC
Received by L&I
11/30/2016
Insurance history
Savings
No savings accounts during the previous 6 year period.
Lawsuits against the bond or savings
Cause no.
12-2-07344-4
Complaint filed by '
DUSTINN HUTCHUNSON
Complaint date
03/27/2012
Effective date
11/30/2016
Expiration date
11/30/2017
Closed/Satisfied
Complaint against bond(s) or savings
46BCO21310
Complaint amount
$0.00
L&I Tax debts
No L&I tax debts are recorded for this contractor license during the previous 6 year period, but some debts
may be recorded by other agencies.
License Violations
Infraction no.
FJACH00717
Issue date
01/12/2012
Violation city
Kent
Type of violation
FAS INFRACTION
Description
Failure to obtain an alteration permit before
altering a mobile or manufactured home as
required. (Reroofing manufactured home
without an Alteration Permit)
Satisfied
RCW/WAC
43.22.435 RCW
Violation amount
$200.00
Workers' comp
Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums.
L&I Account ID
046,027-01
Call L&I account representative for
account status.
Doing business as
LIVING WATER
Estimated workers reported
Incomplete premium report received.
L&I account contact
T4 / DAVID CORNWALL (253)596-3847 - Email: CORD235@Ini.wa.gov
Public Works Strikes and Debarments
Verify the contractor is eligible to perform work on public works projects.
Contractor Strikes
Contractors not allowed to bid
Workplace safety and health
No inspections during the previous 6 year period.
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