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HomeMy WebLinkAboutPermit M07-118 - GROUP HEALTH COOPERATIVEGROUP HEALTH 12401 EAST MARGINAL WY S EXPIRED 07 -21 -08 M07 -118 Parcel No.: Address: Suite No: Tenant: Name: Address: Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: Address: 7340600480 12400 EAST MARGINAL WY S TUKW DESCRIPTION OF WORK: REPLACE 3 KITCHEN EXHAUST FANS Value of Mechanical: $5,000.00 Type of Fire Protection: doc: IMC-1 0/06 Cityf 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.ci.tukwila.wa.us GROUP HEALTH 12400 EAST MARGINAL WAYS , TUKWILA WA GROUP HEALTH COOPERATIVE JIM DOUMA PROPERTY MGMT , 521 WALL ST BRIAN FULKER 12401 EAST MARGINAL WAYS , TUKWILA WA PSR PO BOX 27073 LAKE CITY STATION , SEATTLE WA Contractor License No: PSR * * * *936JP Furnace: <100K BTU >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 >10,000 CFM Evaporator Cooler Ventilation Fan connected to single duct Ventilation System Hood and Duct Incinerator: Domestic Commercial/Industrial MECHANICAL PERMIT xOUIPMENT TYPE AND OUANTITY 0 0 0 0 0 0 0 0 0 3 0 0 0 0 * *continued on next page ** Permit Number: Issue Date: Permit Expires On: Phone: (206)448 -4699 Phone: 206 -988 -7561 Phone: 206 367 - 2500 Expiration Date: 12/31/2008 M07 -118 10/22/2007 07/21/2008 Fees Collected: $211.95 International Mechanical Code Edition: 2003 Boiler Compressor: 0-3 HP/100,000 BTU 0 3 HP /500,000 BTU 0 15-30 HP /1,000,000 BTU.. 0 30-50 HP/ 1,750,000 BTU.. 0 50+ HP /1,750,000 BTU 0 Fire Damper 0 Diffuser 0 Thermostat 0 Wood/Gas Stove 0 Water Heater 0 Emergency Generator 0 Other Mechanical Equipment 0 M07 -118 Printed: 02 -06 -2008 Permit Center Authorized Signature: Signature: doc: IMC -10/06 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.ci.tukwila.wa.us LAIAJ, Permit Number: M07 -118 Issue Date: 10/22/2007 Permit Expires On: 07/21/2008 Date: 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 ordinance: 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 mechanical permit. Date: C. 2' Print Name: j `cr 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 suspende or abandoned for a period of 180 days from the last inspection. M07 -118 Printed: 02 -06 -2008 Parcel No.: Address: Suite No: Tenant: Name: Address: Owner: Name: Address: Contact Person: Name: Address: 7345600490 12401 EAST MARGINAL WY S TU KW DESCRIPTION OF WORK: REPLACE 3 KITCHEN EXHAUST FANS Value of Mechanical: $5,000.00 Type of Fire Protection: GROUP HEALTH 12401 EAST MARGINAL WAYS , TUKWILA WA GROUP HEALTH COOPERATIVE JIM DOUMA PROPERTY MGMT , 521 WALL ST BRIAN FULICER 12401 EAST MARGINAL WAYS , TUKWILA WA Contractor: Name: P S R Address: PO BOX 27073 LAKE CITY STATION , SEATTLE WA Contractor License No: PSR * * * *936JP Furnace: <100K BTU >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 >10,000 CFM Evaporator Cooler Ventilation Fan connected to single duct Ventilation System Hood and Duct Incinerator: Domestic Commercial/Industrial doc: IMC -10/06 Cityl,f 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.ci.tukwila.wa.us MECHANICAL PERMIT EOUIPMENT TYPE AND QUANTITY 0 0 0 0 0 0 0 0 0 3 0 0 0 0 * *continued on next page ** Permit Number: Issue Date: Permit Expires On: Phone: (206)448 -4699 Phone: 206 - 988 -7561 Phone: 206 367 -2500 Expiration Date: 12/31/2008 M07 -118 10/22/2007 04/19/2008 Fees Collected: $211.95 International Mechanical Code Edition: 2003 Boiler Compressor: 0-3 HP /100,000 BTU 0 3 -15 HP /500,000 BTU 0 15-30 HP /1,000,000 BTU.. 0 30 -50 HP /1,750,000 BTU.. 0 50+ HP /1,750,000 BTU 0 Fire Damper 0 Diffuser 0 Thermostat 0 Wood/Gas Stove 0 Water Heater 0 Emergency Generator 0 Other Mechanical Equipment 0 M07 -118 Printed: 10-22 -2007 Permit Center Authorized Signature: Signature: doc: IMC -10/06 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.ci.tukwila.wa.us Permit Number: MO7 -118 Issue Date: 10/22/2007 Permit Expires On: 04/19/2008 Date: 1 0 - 0 7 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 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 regulatinc construction or the performance of work. I am authorized to sign and obtain this mechanical permit. Date: t 2 v Print Name: i c t - ikt/ 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 suspender or abandoned for a period of 180 days from the last inspection. M07 -118 Printed: 10 -22 -2007 1: ** *BUILDING DEPARTMENT CONDITIONS * ** 1sr' City of Tukwila Parcel No.: 7340600480 Address: 12400 EAST MARGINAL WY S TUKW Suite No: Tenant: GROUP HEALTH Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 - 431 - 3665 Web site: http: / /www.ci.tukwila.wa.us PERMIT CONDITIONS Permit Number: M07 -118 Status: ISSUED Applied Date: 05/29/2007 Issue Date: 10/22/2007 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 mechanical work shall be inspected and approved under a separate permit issued by the City of Tukwila Permit Center (206/431 - 3670). 4: 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. 5: 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. 6: Manufacturers installation instructions shall be available on the job site at the time of inspection. 7: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building Department (206- 431- 3670). 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. doc: Cond -10/06 * *continued on next page ** M07 -118 Printed: 02 -06 -2008 City of Tukwila Signature: I hereby certify that I have read these conditions and will comply with them as outlined. 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 provision of any other work or local laws regulating construction or the performance of work. doc: Cond -10/06 Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: http: / /www.ci.tukwila.wa.us Print Name: /-ter c4 Date: 02 - M07 -118 Printed: 02 -06 -2008 City of Tukwila Parcel No.: 7345600490 Address: 12401 EAST MARGINAL WY S TUKW Suite No: Tenant: GROUP HEALTH 1: ** *BUILDING DEPARTMENT CONDITIONS * ** doc: Cond -10/06 Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us PERMIT CONDITIONS Permit Number: M07 -118 Status: ISSUED Applied Date: 05/29/2007 Issue Date: 10/22/2007 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 mechanical work shall be inspected and approved under a separate permit issued by the City of Tukwila Permit Center (206/431 - 3670). 4: 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. 8: 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. 6: Manufacturers installation instructions shall be available on the job site at the time of inspection. 7: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building Department (206 - 431- 3670). 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. * *continued on next page ** M07 -118 Printed: 10 -22 -2007 Print Name: it Ct.---■ 1 ki ✓ doc: Cond -10/06 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.ci.tukwila.wa.us I hereby certify that I have read these conditions and will comply with them as outlined. 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 provision of any other work or local laws regulating construction or the performance of work. Signature: Date: / C,22 CJ M07 -118 Printed: 10 -22 -2007 CITY OF TUKWIL Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us 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: la Li 01 FAST MA R (1-7 &JAL- wA y S_ Suite Number: Tenant Name: G R O u p 416A L T M New Tenant: ❑ Yes ljl • • NNo Property Owners Name: ...A . — M - 6 14e akt - Mailing Address: Sc w c ) CONTACT PERSON - who do we contact when your permit is ready to be issued Name: g F UL k Q Mailing Address: 1. � 401 EAST MARL -TAz.. 14-4y % E -Mail Address: - C i ker . 6 0 3v1G • U r GENERAL CONTRACTOR INFORMATION — (Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5)) Company Name: YJO (-E,v E2A Mailing Address: Zip Company Name: yA RTC, F GRovP, 10C, Q: Applications\Fonns- Applications On Line \3 -2006 - Permit Application.doc Revised: 9 -2006 bb Building Perm `No. Mechanical Permit No. 140 1 le Plumbing/Gas Permit No. Public Works Permit No. Project No. (For office jice use only) King Co Assessor's Tax No.: / 3 S 10Q —0 City State State Floor: Zip Day Telephone: aoC - q - 6 J TO k■rr_A IN 9Xt 6 g City State Zip Fax Number: aye - cl B r. .277c City Day Telephone: Fax Number: Contact Person: E -Mail Address: Contractor Registration Number: Expiration Date: ARCHITECT OF RECORD - All plans must be wet stamped by Architect of Record Mailing Address: City Contact Person: Day Telephone: E -Mail Address: Fax Number: State Zip ENGINEER OF RECORD - All plans must be wet stamped by Engineer of Record Company Name: Mailing Address: 19Q 51 36'"'' Ave . W Sul A 1...yt0N14r„0 LEA ago36 City State Zip Contact Person: CH R S kI R T - T Day Telephone: 1 4,2C- 774- 3g y E -Mail Address: C i w ' - ,, h+ e r ic- rcv.,� - Cr >vr, Fax Number: 1 -1,2-"C - 672 - ,-06 Page 1 of 6 BUILDING PERMIT INFORM "ION — 206 -431 -3670 Valuation of Project (contractor's bid price): $ t O Cd Existing Building Valuation: $ 5U 1 Scope of Work (please provide detailed information): Re PI-Ar. F Z 11Rt E kL T C 1-I E,) 6x - 14 F4 k) S. Will there be new rack storage? ❑ Yes )g.. No 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 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 -1/2 "x 11 "paper including quantities and Material Safety Data Sheets. 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. Q:Wpplications\Forms- Applications On Line\3 -2006 - Permit Application.doc Revised: 9 -2006 bh Page 2 of 6 Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC l' Floor 2 Floor 3' Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck BUILDING PERMIT INFORM "ION — 206 -431 -3670 Valuation of Project (contractor's bid price): $ t O Cd Existing Building Valuation: $ 5U 1 Scope of Work (please provide detailed information): Re PI-Ar. F Z 11Rt E kL T C 1-I E,) 6x - 14 F4 k) S. Will there be new rack storage? ❑ Yes )g.. No 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 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 -1/2 "x 11 "paper including quantities and Material Safety Data Sheets. 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. Q:Wpplications\Forms- Applications On Line\3 -2006 - Permit Application.doc Revised: 9 -2006 bh Page 2 of 6 PUBLIC WORKS PERMIT INh,,,.1MATION — 206 - 433 -0179 Scope of Work (please provide detailed information): Water District ❑ ...Tukwila ❑...Water District #125 ❑ ...Water Availability Provided Sewer District ❑ ...Tukwila ❑ ...Sewer Use Certificate Please refer to Public Works Bulletin #1 for fees and estimate sheet. 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. Submitted with Application (mark boxes which apply): ❑ ...Civil Plans (Maximum Paper Size — 22" x 34") ❑ ...Technical Information Report (Storm Drainage) ❑ ...Bond ❑ .. Insurance Proposed Activities (mark boxes that apply): ❑ ...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 ❑ ...Sanitary Side Sewer ❑ ...Cap or Remove Utilities ❑ ...Frontage Improvements ❑ ...Traffic Control ❑ ...Backflow Prevention - Fire Protection Irrigation Domestic Water ❑ ...Permanent Water Meter Size... ❑ ...Temporary Water Meter Size .. ❑ ...Water Only Meter Size ❑ ...Sewer Main Extension Public _ ❑ ...Water Main Extension Public _ ❑ ... ValVue ❑ .. Renton ❑ ... Sewer Availability Provided ❑ .. Easement(s) ❑ . ❑ . ❑ . ❑ . Q: Applcations\Forms- Applications On Line13 -2006 - Permit Application.doc Revised: 9 - 2006 bh Call before you Dig: 1- 800 -424 -5555 . Abandon Septic Tank . Curb Cut . Pavement Cut . Looped Fire Line ❑ .. Highline WO # WO # WO # Private Private ❑ .. Geotechnical Report ❑ .. Maintenance Agreement(s) ❑ .. Work in Flood Zone ❑ .. Storm Drainage ❑ .. Renton ❑ .. Seattle ❑ .. Right -of -way Use - Profit for less than 72 hours ❑ .. Right -of -way Use — Potential Disturbance ❑...Deduct Water Meter Size ❑...Traffic Impact Analysis ❑ ...Hold Harmless — (SAO) ❑ ...Hold Harmless — (ROW) ❑ .. Grease Interceptor ❑ .. Channelization ❑ .. Trench Excavation ❑ .. Utility Undergrounding If FINANCE INFORMATION Fire Line Size at Property Line ❑ ...Water ❑ ...Sewer ❑ ...Sewage Treatment Monthly Service Billing to: Name: Day Telephone: Mailing Address: Water Meter Refund/Billing: Name: Mailing Address: Number of Public Fire Hydrant(s) City State Zip Day Telephone: City State Zip Page 3 of 6 Unit Type: Qty Unit Type: Qty Unit Type: Qty Boiler /Compressor: Qty Furnace<100K BTU Air Handling Unit >10,000 CFM Fire Damper 0 -3 HP /100,000 BTU Furnace >100K BTU Evaporator Cooler Diffuser 3 -15 HP /500,000 BTU Floor Furnace Ventilation Fan Connected to Single Duct Thermostat 15 -30 HP /1,000,000 BTU Suspended/Wall/Floor Mounted Heater Ventilation System Wood/Gas Stove 30 -50 HP /1,750,000 BTU Appliance Vent Hood and Duct Emergency Generator 50+ HP /1,750,000 BTU Repair or Addition to Heat/Refrig/Cooling System Incinerator - Domestic Other Mechanical Equipment Air Handling Unit <10,000 CFM Incinerator — Comm/Ind MECHANICAL PERMIT INFL IATION - 206 -431 -3670 • MECHANICAL CONTRACTOR INFORMATION 0 o■e.- ` ... . Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: Contractor Registration Number: Expiration Date: Valuation of Mechanical work (contractor's bid price): $ Scope of Work (please provide detailed information): Use: Residential: New .... ❑ Replacement .... ❑ Commercial: New .... ❑ Replacement .... ❑ Fuel Type: Electric ❑ Gas .... Other: Indicate type of mechanical work being installed and the quantity below: Q:\Applications\Fonns- Applications On Line\3 -2006 - Permit Application.doc Revised: 9 -2006 bh Page 4 of 6 Fixture Type: Qty Fixture Type: Qty Fixture Type: Qty Fixture Type: Qty Bathtub or combination bath/shower Drinking fountain or water cooler (per head) Wash fountain Gas piping outlets Bidet Food -waste grinder, commercial Receptor, indirect waste Clothes washer, domestic Floor drain Sinks Dental unit, cuspidor Shower, single head trap Urinals Dishwasher, domestic, with independent drain Lavatory Water Closet Building sewer or trailer park sewer Rain water system — per drain (inside building) Water heater and/or vent Additional medical gas inlets /outlets — six or more Industrial waste pretreatment interceptor, including its trap and vent, except for kitchen type grease interceptors Repair or alteration of water piping and/or water treating equipment Repair or alteration of drainage or vent piping Medical gas piping system serving one to five inlets /outlets for specific gas PLUMBING AND GAS PIPING RMIT INFORMATION 206 - 431'70 PLUMBING AND GAS PIPING CONTRACTOR INFORMATION Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: Contractor Registration Number: Expiration Date: Valuation of Plumbing work (contractor's bid price): $ Valuation of Gas Piping work (contractor's bid price): $ Scope of Work (please provide detailed information): Building Use (per Int'l Building Code): Occupancy (per Int'1 Building Code): Utility Purveyor: Water: Sewer: Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below: Q:Wpplcations\Forns- Applications On Linel3 -2006 - Permit Application.doc Revised: 9 -2006 bit Page 5 of 6 f iERMIT APPLICATION NOTES — Applicable to all permits in this application 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. Building and Mechanical Permit 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). Plumbing Permit The Building Official may grant one extension of time for an additional period not exceeding 180 days. The extension shall be requested in writing and justifiable cause demonstrated. Section 103.4.3 Uniform 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 OWNER OR AUTHORIZED AGENT: Signatur Print Name: (A l A- N V' U 1 - lC i t� Mailing Address: tog CAST MA- R F2,`t,4t, wA4 y $ , Tv k wTL A w/ - q K 168 City State Zip Date Application Expires: II _ Date Application Accepted: r )-� - Q:WpplicationsTonns- Applications On Line \3 -2006 - Permit Application.doc Revised: 9 -2006 bh Date: Day Telephone: .2 °l - �S6 Staff Initials: Page 6 of 6 Receipt No.: R07 -02312 Payee: GROUP HEALTH TRANSACTION LIST: Type Method Description ACCOUNT ITEM LIST: Description MECHANICAL - NONRES 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.ci.tukwila.wa.us RECEIPT Parcel No.: 7345600490 Permit Number: M07 -118 Address: 12401 EAST MARGINAL WY S TUKW Status: APPROVED Suite No: Applied Date: 05/29/2007 Applicant: GROUP HEALTH Issue Date: Initials: WER Payment Date: 10/22/2007 04:13 PM User ID: 1655 Balance: $0.00 Amount Payment Check 4156461 175.56 Account Code Current Pmts 000/322.100 175.56 Total: $175.56 Payment Amount: $ 175.56 ,_.. _ y_. .tc T2TAL __, doc: Receiot -06 Printed: 10 -22 -2007 Receipt No.: R07 - 00956 Initials: WER User ID: 1655 Payee: CASH TRANSACTION LIST: Type Method Description PLAN CHECK - NONRES 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.ci.tukwila.wa.us RECEIPT Parcel No.: 7345600490 Permit Number: M07 -118 Address: 12401 EAST MARGINAL WY S raw Status: PENDING Suite No: Applied Date: 05/29/2007 Applicant: GROUP HEALTH Issue Date: Amount Payment Cash 36.39 ACCOUNT ITEM LIST: Description Account Code Current Pmts 000/345.830 36.39 Total: $36.39 Payment Amount: $36.39 Payment Date: 05/29/2007 11:10 AM Balance: $175.56 8657 05/29 9710 TOTAL 36.39 doc: Receiot -06 Printed: 05-29 -2007 Project: Type f Ins ec ion: Address: / 24 OL ,a.w i.- ,..., W Date Called: Special Instructions: nn P I _ C'` O } lL ,A, K- ( 3 Date Wanted: i 2 3 � 1 / 4 3 ` 1 • �p m' Requester: Phone No: 257 — 2 — 5642--- 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 -36 Approved per applicable codes. 0 Corrections required prior to approval. COMMENTS: 1 1nspecT Th I 0 ❑ $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call the schedule reinspection. 'Receipt No.: Date: Prob t,: C r /447/LI2- Type of Inspection: %v9 V Address: / 2 11 0/ �/g ,1 1 /G✓/v'9 Date Called: 7 ei.* 5 Special Instructions: Date Wanted: / — 2_.2-0e a.m p.m. Requester: Phone No: .206 . 4 /23-27&f, INSPECTION RECORD Retain a copy with permit tne7 // v INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION `- 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3 7 El Approved per applicable codes. 0 Corrections required prior to approval. COMMENTS: ec __1/I G c / 2 ( — `7 J / ✓ Di J . Inspectoe Date: 2 Z - J $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection. 'Receipt No.: IDate: COMMENTS: Type of Inspection: F ///1/4 / - Address: /2 7 Y 0/ C-0 .4---c-A v 2_ ki C i4_ Date Called: / S-o r� evJA- �0k`f S ' -f Special Instructions: _,1 5 i� - h/\ - l� , l„1: ti re s( e (r Ae -- Mm Akt or Tu �. F P 25-3 - 2_6/ -s "6, Proje : (7 rl7io /l Type of Inspection: F ///1/4 / Address: /2 7 Y 0/ 7 f /19,1,-//-i%4 Date Called: / _ Special Instructions: Date Wanted: / C — o , 6-313.- p.m. Requister: P 25-3 - 2_6/ -s "6, INSPECTION NO. PERMIT NCI CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 ❑ Approved per applicable codes. El Corrections required prior to approval. Inspect C. INSPECTION RECORD Retain a copy with permit ino - 7 /J Date: C f 06 1 El $58.00 REINSPECTIONFEE REQUIRED. Prior to inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection. 'Receipt No.: 1Date: 06 -05 -2008 BRIAN FULKER 12401 EAST MARGINAL WAY S TUKWILA WA 98168 RE: Permit No. M07 -118 12400 EAST MARGINAL WY S TUKW Dear Permit Holder: 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 and/or the International Mechanical Code, every permit issued by the Building Division under the provisions of this code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 180 days from the date of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days. Based on the above, you are hereby advised to: Call the City of Tukwila Inspection Request Line at 206 -431 -2451 to schedule for the next or final inspection. This inspection is intended to determine if substantial work has been accomplished since issuance of the permit or last inspection; or if the project should be considered abandoned. If such determination is made, the Building Code does allow the Building Official to approve one or more extensions of time for additional periods not exceeding 90 days each. Extension requests must be in writinf and provide satisfactory reasons why circumstances beyond the applicants control have prevented action from being taken. In the event you do not call for the above inspection and receive an extension prior to 07/21/2008 , 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, xc: er Marshall, Pert iit Technician Permit File No. M07 -118 City of Tukwila Jim Haggerton, Mayor Department of Community ■ Development Jack Pace, Director 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 10-02 -2007 BRIAN FULKER 12401 EAST MARGINAL WAY S TUKWILA WA 98168 RE: Permit Application No. M07 -118 12401 EAST MARGINAL WY S TUKW Dear Permit Applicant: City of Tukwila a Steven M. Mullet, Mayor Department of Community Development Steve Lancaster, Director In reviewing our current permit application files, it appears that your permit application applied for on 05/29/2007 , has not been issued by the City of Tukwila Permit Center. Per the International Building Code and/or the International Mechanical Code, every permit application not issued within 180 days from the date of application shall expire by limitation and become null and void. Your permit application expires on 11/25/2007 . If you choose to pursue your project, a written request for extension of your application addressed to the Building Official, demonstrating justifiable cause, will need to be received at the Permit Center prior to your expiration date of 11/25/2007. If it is determined that an extension is granted, your application will be extended for an additional 90 days from the expiration date. In the event we do not receive your written request for extension, your permit application will become null and void and your project will require a new permit application, plans and specifications, and associated fees. Thank you for your cooperation in this matter. Sincerely, xc: 'fer Marshall 't Technician Permit File No. M07 -118 A2 All Cn..tl.nentew Rn..h,,arA C..it• di /MI • ThLu,il, Wachinrrtnn OR1RR • Phnno• 21M- e'1 -2A71) • P,v 711d5- 421 -2AiSS HERMIT COORD COP?' PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: M07 -118 DATE: 05 -29 -07 PROJECT NAME: GROUP HEALTH SITE ADDRESS: 12401 EAST MARGINAL WAY S X Original Plan Submittal _ Response to Incomplete Letter # Response to Correction Letter # Revision # After Permit Issued DEPARTMENTS: pit A1N,6) -/ 1 Builtling Division 56 wL 64-m -0 1 Fire Prevention X Public Works ❑ Structural ❑ Permit Coordinator n DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete APPROVALS OR CORRECTIONS: Documents /routing slip.doc 2 -28-02 Incomplete n Planning Division Not Applicable Comments: DUE DATE: 06-28-07 DUE DATE: 05-31 -07 n Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES/THURS ROUTI G: Please Route Structural Review Required ❑ No further Review Required n REVIEWER'S INITIALS: DATE: Approved ❑ Approved with Conditions Not Approved (attach comments) n Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: License Information License PSR * * * *936JP Licensee Name P S R Licensee Type CONSTRUCTION CONTRACTOR UBI 600122060 Ind. Ins. Account Id 34222200 Business Type CORPORATION Address 1 PO BOX 27073 LAKE CITY STATION Address 2 City SEATTLE County KING State WA Zip 981251473 Phone 2063672500 Status ACTIVE Specialty 1 GENERAL Specialty 2 UNUSED Effective Date 4/17/2007 Expiration Date 12/31/2008 Suspend Date Separation Date Parent Company PUGET SOUND REFRIGERATION INC Previous License PUGETSR169CB Next License Associated License Business Owner Information Name Role Effective Date Expiration Date ROCHFORD, JERRY D 04/17/2007 ROCHFORD, BOBBIE J 04/17/2007 MILLER, ROBERT JR 04 /17/2007 ROCHFORD, JERRY D JR 04/17/2007 iwv Washington State Department of Labor and Industries 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. Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date https: // fortress .wa.gov /lni/bbip /printer.aspx ?License= PSR * * * *936JP 10/22/2007 EXHAUST FAN SCHEDULE EQUIP. TAG MFG' / MODEL NUMBER CFM E.S.P. INCHES W.G. FAN MOTOR DRIVE CONFIGURATION WEIGHT AREA SERVED REMARKS HP OR WATTS VOLTS PH. EF -1 ACME / PNU365RGM 8800 1.12 3 480 3 BELT UPBLAST 500 HOOD EXHAUST 2, 3 EF -2 ACME / PNU165RGG 1200 0.88 0.5 480 3 BELT UTILITY SET 200 HOOD EXHAUST 2, 3 EF -3 ACME / PNU165RGG 1200 0.88 0.5 480 3 BELT UTILITY SET 200 DISHWASHER EXHAUST 1, 2, 3 GENERAL NOTES: C 1. REPLACE EXISTING FANS IN CURRENT LOCATIONS. 2. CONTRACTOR TO REMOVE & DISPOSE OF EXISTING FAN. 3. PROVIDE 115 VOLT CONVENIENCE OUTLET AT EACH FAN. 4. REPLACE ELECTRICAL WIRING FOR EACH FAN. 5. BALANCE & ADJUST FANS TO QUANTITIES SHOWN ON SCHEDULE. PLAN NORTH O PARTIAL ROOF PLAN 40" SCALE: NTS NOTES: 1. PROVIDE WITH BACK DRAFT DAMPERS 2. PROVIDE NEW VENTILATED CURBS AND /OR CURB ADAPTORS 3. PROVIDE DISCONNECTS MOUNTED ON ROOF NEAR FANS. DO NOT PHYSICALLY LOCATE DISCONNECTS ON FAN. EXHAUST FAN CURB BY MF'G. ROOF BACKDRAFT DAMPER DISHWASHER HOOD DETAIL EF-3 PLAN NORTH (EXISTING)16 GAUGE WELDED STAINLESS STEEL DUCT (TYPICAL) 3" MINIMUM CLEARANCE 12" MAXIMUM 40" (EXISTING) METAL CLOSURE AREA OF WORK C PLAN NORTH rilaaSigtn No c: shall be mad:: to t".n V- - v thetft re.c7 7. NOTE: r v::.icns w I requ re a rc. and may include additional plan rcv ;;:vi ffcs. E t 21 2008 KEY PLAN O EXHAUST FAN VENTILATED CURB BY MF'G. (EXISTING) ROOF (EXISTING) 1 —HR SHAFT BY GENERAL CONTRACTOR (EXISTING) RANGE HOOD BY OTHERS KITCHEN RANGE HOOD DETAIL (EF-1 AND EF -2) SCALE: NTS Plan review approval Is subject to errors and omit; Approval of construction d does not authorize the violation cf any accepied code or ordlnanCe. Receipt of approvca r:Y.j Copy and conditions is acknowledged: Date: „_— 2 2— City of Tukwila BUILDING DIVLSION • 577 PERMIT r:- ,:TIRED FOR O Mechanical L'zc - ical • F:urrr5ing © Ge IS Piping City of Tukwila BUILDING DIVISION RECEIVED MAY 2 9 2001 PERMIT CENTER MO7 118 REVISIONS 0: 0 C� W rn w� ens ON C O. —C) U t—(/) J._. co Co r d W DATE: 05/29/07 SCALE: NOTED DRAWN: AL CHECKED: CW I� � /iz /oa EXPIRES 7/ 12/08 M110 07-072