HomeMy WebLinkAboutPermit D04-067 - SOUTHCENTER MALL - T-MOBILE - WALLT- MOBILE
719 SOUTHCENTER
MALL
D04 -067
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..._ �g Cit y of Tukwila
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Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
DEVELOPMENT PERMIT
Parcel No.: 2623049004 Permit Number: D04-067
Address: 719 SOUTHCENTER MALL TUKW Issue Date: 02/19/2004
Suite No: Permit Expires On: 08/17/2004
Tenant:
Name: T- MOBILE
Address: 719 SOUTHCENTER MALL, TUKWILA WA
Owner:
Name: JG SOUTHCENTER LTD Phone:
Address: 25425 CENTER RIDGE RD, CLEVELAND OH
Contact Person:
( Name: JEFF LUNDGREN Phone: 801815-0057
i Address: 4431 W 8200 S, WEST JORDAN UT
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Contractor:
Name: BUSH DECOR & FIXTURE Phone: 801- 280 -0424
j Address: 3949 W YORKSHIRE DR, SOUTH JORDAN, UT
i Contractor License No: BUSHDFI005LR Expiration Date: 01 /18/2006
DESCRIPTION OF WORK:
I INSTALLATION OF ONE 8' X 10' DIVIDING WALL TO BLOCK PUBLIC VIEW OF STORAGE OF PRODUCT AND MONEY
HANDLING.
Value of Construction:
$ $1,000.00
Fees Collected: $68.44
Type of Fire Protection:
SPRINKLERS /AFA
Uniform Building Code Edition: 1997
Type of Construction:
Occupancy per UBC: 0023
Public Works Activities:
Channelization / Striping:
N
Curb Cut / Access / Sidewalk / CSS: N
Fire Loop Hydrant:
N
Number: 0
Size (Inches): 0
Flood Control Zone:
Hauling:
Start Time:
End Time:
Land Altering:
Volumes: Cut
0 c.y. Fill 0 c.y.
Landscape Irrigation:
Moving Oversize Load:
Start Time:
End Time:
Sanitary Side Sewer:
Sewer Main Extension:
Private:
Public:
Storm Drainage:
Street Use:
Profit:
Non - Profit:
Water Main Extension:
Private:
Public:
Water Meter:
N
doc: Devperm
D04 -067
Printed: 02 -19 -2004
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City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
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Permit Center Authorized Signature: Date:
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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
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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
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regulating construction or the performance of work. I am authorized to sign and obtain this development permit.
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Print Name: e �� nriR 12�"e f1
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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
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suspended or abandoned for a period of 180 days from the last inspection.
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doc: Devperm 004-067 Printed: 02-19-2004
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�.. City of Tukwila
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Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
PERMIT CONDITIONS
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Parcel No.: 2623049004 Permit Number D04-067
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Address: 719 SOUTHCENTER MALL TUIKW Status: ISSUED
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Suite No: Applied Date: 02/19/2004
Tenant: T- MOBILE Issue Date: 02/19/2004
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1: ** *BUILDING DEPARTMENT CONDITIONS * **
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2: No changes will be made to the plans unless approved by the Engineer and the Tukwila Building Division.
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3: All permits, inspection records, and approved plans shall be available at the job site prior to the start of any
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construction. These documents are to be maintained and available until final inspection approval is granted.
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4. All construction to be done in conformance with approved plans and requirements of the Uniform Building Code (1997
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Edition) as amended, Uniform Mechanical Code (1997 Edition), and Washington State Energy Code (1997 Edition).
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5: Validity of Permit. The issuance of a permit or approval of plans, specifications, and computations shall not be
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construed to be a permit for, or an approval of, any violation of any of the provisions of the building code or of any
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other ordinance of the jurisdiction. No permit presuming to give authority to violate or cancel the provisions of this
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code shall be valid.
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I hereby certify that I have read these conditions and will comply with them as outlined. All provisions of law and ordinances
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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.
Signature:
Print Name:
Date: '2-1 - �►
doc: Conditions D04 -067 Printed: 02 -19 -2004
CITY OF IKWILA
Permit Center
6300 Southcenter Boulevard, Suite 100
Tukwila, WA 98188
(206) 431 -3670
Application #. \ c ) 1 +-N2-7
ALTERNATE PLAN SUBMITTAL AUTHORIZATION
FOR LIMITED SCOPE OF WORK
U.B.C. Section 106.3.2 exception
Project name
Address V, 0 04-'� Z Le �
Description of work is
Related reference number
The above project permit applicant, due to the limited scope of work is authorized to submit reduced plan
requirements describe as noted below.
1. Complete permit application required: ( Note, all application must include; 1) property assessor
number, 2) copy of contractors license or completed owner waiver form. )
Building i-� Mechanical Other
i 2. Minimum plan and /or specification requirement:
Site plan_ Floor plan >` Elevations Foundation
Cross sections Roof plan W.S.E.C. compliance Narrative
Structural calculations ( stamped by Washington State licensed engineer )
Specific required information I h�td t or Kk i I U
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3. Other special instructions: `�"�"✓� t'� �� r V 1
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Authorization ��'� t ) Date r
( Authorization void 30 days after the date issued. )
TBD3 /96 -form 1
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CITY OF TUKWILA
i Community Development Department
Public Works Department
Permit Center
' 90B 6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
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.
SITE,LOCATION „
"Please Print
King Co Assessor's Tax No.: (wZ307 700
Site Address: Suite Number: Floor:
Tenant Name: / _ d� New Tenant: E) .... Yes E] ..No
Property Owners Name:
Mailing Address:
City State Zip
CONTACT PERSON
Name:
Mailing Address:
E -Mail Address:
Day Telephone:
City State Zip
Fax Number:
GENERAL CONTRACTOR INFORMATION ,,
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+t:
Company Name:
Mailing Address:
City State Zip
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
Contractor Registration Number: Expiration Date:
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance"
ARCHITECT.OF`RECO". All `plans must be.wet stamped .by` Architect of Rccord
Company Name:
Mailing Address:
Contact Person:_
E -Mail Address:
City
Day Telephone:
Fax Number:
ENGINEER OF RECORD, - All plans must be'wet stamped by Engineer of,Record
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
State Zip
Stale Zip
\applications \permit application (3.2003)
3/2003 Page 1
a..:,.." � ..:. fiwa�ry�? e�. xr' ?a3!, �aYr: �snirtnass�rsu,rxrarx�rrp
City
Day Telephone:
Fax Number:
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Valuation of Project (contractor's bid pric Existing Btg Valuation: $
Scope of Work (please provide detailed information): 'X 10' +r
N n�� Shock-\can a t IZV C.. U\C VJ O� S )1r)9-aR1-
Will there be new rack storage? [ ❑ .. No If "yes ", see Handout No. for requirements.
Provide Ail 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 for accessory dwelling:
*Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard: Compact: Handicap:
Will there be a change in use? ❑ ....Yes ❑ ..No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
❑.. Sprinklers []..Automatic Fire Alarm []..None ❑ . Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? [:]..Yes ❑ ..No
If "yes ", attach list of materials and storage locations on a separate 8 -112 x 11 paper indicating quantities and Material Safety Data Sheets.
\applications \permit application (3.2003)
3/2003 Page 2
1
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(.: WUKiK� '•YLt°KM1111V1+'UKMA'11V1V LUb- 433 -U1 i
Scope of Work (please provide detailed infWtion): {
Call before you Dig: 1- 800 - 424 -5555
Please, refer to Public Works Bulletin #1 for fees and`estimate sheet:
Water District
❑ ...Tukwila C] ... Water District # 125 ❑ .. Highline ❑ ...Renton
❑ ... Water Availability Provided
Sewer District
❑ ...Tukwila ❑... Va1Vue ❑ .. Renton ❑ ...Seattle
❑ ...Sewer Use Certificate ❑ ... Sewer Availability Provided ❑ .. Approved Septic Plans Provided
❑ ...Septic System - For onsite septic system, provide 2 copies of a current septic design approval by King County Health Department.
Submitted with Application (mark boxes which apply):
❑ ...Civil Plans (Maximum Paper Size — 22" x 34 ")
❑ ...Technical Information Report (Storm Drainage) ❑ .. Geotechnical Report ❑...Traffic Impact Analysis
❑ ...Bond ❑ .. Insurance ❑ .. Easement(s) ❑ .. Maintenance Agreement(s) ... Hold Harmless
Proposed Activities (mark boxes that a
❑ ...Right -of -way Use - Nonprofit for less than 72 hours
❑ ...Right -of -way Use - No Disturbance
❑ ...Construction/Excavation/Fill - Right -of -way
Non Right -of -way _
❑ ...Total Cut cubic yards
❑ ...Total Fill cubic yards
❑ .. Right -of -way Use - Profit for less than 72 hours
❑ .. Right -of -way Use — Potential Disturbance
❑ .. Work in Flood Zone
❑ .. Storm Drainage
E]..* Sanitary Side Sewer ❑ .. Abandon Septic Tank ❑ .. Grease Interceptor
❑ ...Cap or Remove Utilities ❑ .. Curb Cut ❑ .. Channelization
❑ ...Frontage Improvements ❑ .. Pavement Cut ❑ .. Trench Excavation
❑ ...Traffic Control ❑ .. Looped Fire Line [3.. Utility Undergrounding
❑ ...Backflow Prevention - Fire Protection "
Irrigation "
Domestic Water "
❑ ... Permanent Water Meter Size... 7t WO#
❑ ...Temporary Water Meter Size.. WO#
❑ ...Water Only Meter Size............ WO# ❑' ... Deduct Water Meter Size........ "
❑ ...Sewer Main Extension ............ Public Private
❑ ... Water Main Extension ............. Public Private
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: Ci State zip
Water Meter Refund/Billing:
Name:
Day Telephone:
Mailing Address: City State zip
V13plicationApermit application (34003)
3/2003
Page 3
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MECHANICAL PERMIT INF&AATION' - .2Q6= 431 3670
MECHANICAL CONTRACTOR INFORMATION
Company Name:_
Mailing Address:
Contact Person:
City State Zip
Day Telephone:
E -Mail Address: Fax Number:
Contractor Registration Number: Expiration Date:
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
Valuation of Project (contractor's bid price): $
Scope of Work (please provide detailed information):
Use: Residential:
New
.... F
Replacement
....
Commercial:
New
.... EJ
Replacement
.... r-1
Fuel Type Electric
..... ❑
Gas ....
Other:
0 -3 HP /100,000 BTU
Indicate type of mechanical work being installed and the quantity below:
.UnibType: .. ,
Qty.
UnitType:
Qty
Unit Type::
Qty
Qty '
Qty
Furnace <IOOK BTU
Air Handling Unit
>= 10,000 CFM
Other Mechanical
Equipment
0 -3 HP /100,000 BTU
Furnace >IOOK BTU
Evaporator Cooler
3 -15 HP /500,000 BTU
Floor Furnace
Ventilation Fan
15 -30 HP /1,000,000 BTU
Suspended /Wall /Floor
Mounted Heater
Ventilation System
30 -50 HP /1,750,000 BTU
Appliance Vent
Hood
50+ HP /1,750,000 BTU
Heat/Refrig/Cooling
System
Incinerator - Domestic
Air Handling Unit
<= 10,000 CFM
Incinerator — Comm /Ind
PERMIT APPLICATION NOTES App11C ble to all perm><ts in th>ts appl><cahon
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 extend the time for action by the applicant for a period not exceeding 180 days upon written request by the applicant as
defined in Section 107.4 of the Uniform Building Code (current edition). No application shall be extended more than once.
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
AGENT:
Signature: Date: 2- 1 - C 1'
Print Name: _ e�� Lt �(� �� �'� Day Telephone: ��C2 \• 6 - 0 0 -
Mailing Address: e wPs� -2t�,� A f=3 � op,9-1
City State Zip
Date Application Accepted: l Date Application Expires: Staff Initials:
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\applications \permit application (3.2003)
32003 Page 4
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Cit y of Tukwila
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6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
RECEIPT
Parcel No.: 2623049004
Address: 719 SOUTHCENTER MALL TUKW
Suite No:
Applicant: T- MOBILE
Permit Number:
Status:
Applied Date:
Issue Date:
D04 -067
PENDING
02/19/2004
Receipt No.: R04 -00201
Initials: SKS
User ID: 1165
Payment Amount:
Payment Date:
Balance:
68.44
02/19/2004 01:25 PM
$0.00
Payee: JEFF LUNDGREEN
TRANSACTION LIST:
Type Method Description Amount
---- - - - - -- -- - - - - -- --------------------- - - - - -- ------ - - - - --
Payment Cash 68.44
ACCOUNT ITEM LIST:
Description Account Code Current Pmts
------------------------ - - - - -- ---------- - - - - -- ------ - - - - --
BUILDING - NONRES 000/322.100 38.75
PLAN CHECK - NONRES 000/345.830 25.19
STATE BUILDING SURCHARGE 000/386.904 4.50
Total: 68.44
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X 7.0 r -Ij TOTAL 68 ►
doc: Receipt 02 -19 -2004
INSPECTION RECORD
Retain a cop with permit
INSPECTION N0. p PERM
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Pro' i
Type of In a pion:
Add' s:
i�
Date Called:
Special Instructions:
Date Wanted:
p.m.
Requester
Ph V .r V 0 nc�
_ pproved per applicable codes. Corrections required prior to approval.
COMMENTS:
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• INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PE I N
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)43'1 -3670
Project:
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Type of Inspection:
-TN OED i t GAT 10 tJ
Address:
Date Called:
Special Instructions:
Date Wanted: a.m.
C T �C''i
Requester:
P, �D b r(C'(AI C! �
Pho a No: _ _
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a Approved per applicable codes
Corrections required prior to approval.
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COMMENTS:
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M $47.00 REINSPECTION qE REQUIRED.Pior to inspection, fee must be
paid at 6300 Southcenter Ivd., Suite 100. Call to schedule reinspection.
INSPECTION RECORD
Retain a copy with permit 1
INSPEC NO. ;PE qR
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (-3670
Project: (
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Type of Inspection:
Add s : � � n
1
Date C Iled.
Special Instructions:
Date Wanted:,jj�,
P .M. ') I :��b Lcq
Requester:
Phone No
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Fl Approved per applicable codes. Corrections required prior to approval.
`'' paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
teceipt No.: Date:
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INSPECTION RECORD O ��
Retain a copy with permit 7 Q�jg
INSPECTION NO. PERM I
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Pr 'ec :
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Type of In
ection:
Address:
PSpecial
Date Called:
C
ctions:
j X
Date Wanted:
p.m.
Requester:
Phte&
Approved per applicable codes. Corrections required prior to approval.
Inspector: LZI Date:
$47.00 REINSPECTION F E REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.: Date:
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NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEAR THAN
THIS NOTICE IT IS DUE TO THE QUALITY OF THE DOCUMENT.
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02/18/2004 17:34
8012800336
Detach And Display certificate --�
REGISTERED AS PROVIDED BY LAW ,A,SI
CONST
..REGIS'T_ :: ## . ;...:....EXP .. DATE
CC01 °'''BUSHDFI005'I;R 01/18/2006
EFFECTIVE PATE 06/19/2000
BU$)4 DECOtiR'' &''FIXTURE. `fNC ' •' -;`"
3949 W YORKSHIRE DR
SOU TH JO D :095
5ignatucc '
Issued y EPART1.vtU 0 OR ANA INDUSTRIES J
Please Remove
And Sign
Identification
Card Before
Placing In
Billfold
R
State of
Washington
DEPARTMENT OF LABOR & INDUSTRIES
PO BOX 44450
OLYMPIA WA 985014 -4450
BUSH DECOR & FIXTURE INC
3949 W YORKSHIRE DR
SOUTH JORDAN UT 84095
HAUL by
FIRST CLASS MAIL.
US POSTAGF
PAID
OLYMPIA WA
PERMIT 140 312
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r--- Detach And Display Certificate - -,
DEFAIZTMENT Or LABOR AND TND.US.i., - S'
RGI STEREO 'AS `PROVIDED B "LAw S
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CONST C G8NERAL
B�tJS14. DEG k &...FI TURE :INC
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