HomeMy WebLinkAboutPermit M05-096 - BEST RESIDENCEBEST RESIDENCE
Parcel No.: 1670400185
Address: 14115 55 AV S TUKW
Suite No:
Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
Contractor
DESCRIPTION OF WORK:
Value of Mechanical: $1,850.00
Type of Fire Protection: NONE
doc: IMC- Permit
City oil ` Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206- 431 -3665
Web site: ci.tulnvila.iva.us
BEST RESIDENCE
14115 55 AV S, TUKWILA WA
MICKELSON SUSAN M
14115 55TH AVE S, TUKWILA WA
MECHANICAL PERMIT
DIANE ELLYSON
4864 NE SHELTERED BAY LN, HANSVILLE WA
AFFORDABLE GAS SERVICE
4864 NE SHELTERED BAY LN, HANSVILLE WA
License No: AFFORGS072D5
Furnace: <100K BTU 0
>100K BTU 0
Floor Furnace 0
Suspended /Wall /Floor Mounted Heater 0
Appliance Vent 0
Repair or Addition to Heat/Refrig /Cooling System
Air Handling Unit <10,000 CFM 0
>10,000 CFM 0
Evaporator Cooler 0
Ventilation Fan connected to single duct 0
Ventilation System 0
Hood and Duct 0
Incinerator: Domestic 0
Commercial /Industrial 0
* *continued on next page **
M05 -096
Permit Number:
Issue Date:
Permit Expires On:
EQUIPMENT TYPE AND QUANTITY
Phone:
Phone: 360- 638 -0091
Phone: 206 - 367 -5333
Expiration Date: 03/16/2006
Steven M. Mullet, Mayor
Steve Lancaster, Director
M05 -096
06/27/2005
12/24/2005
Fees Collected: $150.63
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 1
Wood /Gas Stove 0
Water Heater 0
Emergency Generator 0
Other Mechanical Equipment
Printed: 06 -27 -2005
Signature:
doc: IMC- Permit
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: ci.tukwila.wa.us
Permit Center Authorized Signature: , itea 42// 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
ordinances governing this work will be complied with, whether specified herein or not.
Permit Number: M05 -096
Issue Date: 06/27/2005
Permit Expires On: 12/24/2005
The granting of this p - it-doe o presume t• give authority to violate or cancel the provisions of any other state or local laws
regulating constructio or the performance
ork. I am authorized to sign and obtain this mechanical permit.
M05 -096
Date:
Steven M. Mullet, Mayor
Steve Lancaster, Director
Print Name: ) &f"7
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.
Printed: 06 -27 -2005
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
z
a •
Parcel No.: 1670400185 Permit Number: M05 -096 t t
Address: 14115 55 AV S TUKW Status: ISSUED
CC m
Suite No: Applied Date: 06/27/2005 v
Tenant: BEST RESIDENCE Issue Date: 06/27/2005 0 0
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2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the M
Building Official. g 5
3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to
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start of any construction. These documents shall be maintained and made available until final inspection approval is z H
granted.
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4: All construction shall be done in conformance with the approved plans and the requirements of the International ILI a
Building Code or International Residential Code, International Mechanical Code, Washington State Energy Code. v o
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5: Ventilation is required for all new rooms and spaces of new or existing buildings and shall be in conformance with the o H
International Building Code and the Washington State Ventilation and Indoor Air Quality Code. = uui
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6: Except for direct -vent appliances that obtain all combustion air directly from the outdoors; fuel -fired appliances u- 5
shall not be located in, or obtain combustion air from, any of the following rooms or spaces: Sleeping rooms, Cu co
bathrooms, toilet rooms, storage closets, surgical rooms. v =
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1: ** *BUILDING DEPARTMENT CONDITIONS * **
7: 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 Tess than 18 inches above the floor surface on which the equipment or appliance rests.
8: 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.
9: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the Department of
Public Health - Seattle and King County (206/296- 4932).
10: All electrical work shall be inspected and approved under a separate permit issued by the Washington State Department
of Labor and Industries (206/248- 6630).
11: 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: Conditions
PERMIT CONDITIONS
* *continued on next page **
M05 -096
Printed: 06 -27 -2005
z
1
1
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 permi •oes not presume to give authority to violate or cancel the provision of any other work or local laws
regulating constr rformance of work.
Signature:
doc: Conditions
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
ame: 5/X �f2�
M05 -096
Date: 6-7--o_s
Printed: 06 -27 -2005
SITE LOCATION
.— Site Address: / 1 -0 15 55 A/ 5
Tenant Name:
CITY OF TUKWIL. -,
Community Development Department
Public Works Department
Permit Center
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.
* *Please Print **
Property Owners Name: &/(SQf 8- eS 1t-
Mailing Address: /' l / / S — 55 4 '' A1/C. 5'.
CONTACT PERSON
Name: SuEan T - ae-r
Mailing Address: oink CLO a,/l5Yi
E -Mail Address:
GENERAL CONTRACTOR INFORMATION - (Mechanical Contractor information on back page)
Company Name: J4 FFord a bl e Cias Seevt ee
Mailing Address: 48104 / Y rE Skid 4ere
City State Zip
Day Telephone: 36,0 &3 O p 00q
E -Mail Address: Z ° Cl s .0.• • n & in Si . Com Fax Number: 3600 63E DO 5 2
Contractor Regist r •n Number: Wor A S 07 2 b 5 Expiration Date: ' — 1 — 0
* *An origin: -or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
Contact Person: 2Q /l e- ) /
ARCHITECT OF RECORD — All plans must be wet stamped by Architect of Record
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
y:llpermils pluslice changes\parnil application (7 -2044)
Revised: 6-8 -05
bh
Page 1
Building Permit No.
Mechanical Permit No. t4 o 7 r
` t p
Public Works Permit No.
Project No.
(For office use only)
King Co Assessor's Tax No.: /010 O/ 5 j
Suite Number:
New Tenant:
City
City
Floor:
❑ Yes ❑..No
W14
State
State
Zip
Day Telephone: Zoo 431 - 58 64-
Zip
411*
Fax Number:
State
Zip
City
Day Telephone:
Fax Number:
ENGINEER OF RECORD All plans must be wet stamped by Engineer of Record
Company Name:
Mailing Address:
State
Zip
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Boiler /Compressor:
Qty
Fumace <I00K BTU
1
Air Handling Unit >10,000
CFM
Fire Damper
0 -3 HP /100,000 BTU
Furnace >100K BTU
Evaporator Cooler
Diffuser
3 -15 14P /500,000 BTU
Floor Fumace
Ventilation Fan Connected
to Single Duct
Thermostat
1
I5-30 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
Water Heater
5(H HP /1.750,000 BTU
Repair or Addition to
Heat/Refrig/Cooling
System
Incinerator - Domestic
Emergency
Generator
Air Handling Unit
<10,000 CFM
Incinerator— Comm/Ind
Other Mechanical
Equipment
MECHANICAL PERMIT INFORMATION — 206- 431 -3670
MECHANICAL CONTRACTOR INFORMATION
/
Company Name: /'ty'I ()r-dcl b/ a s er V / e
Mailing Address: 451'04 a E Spiel ter e.cl q L . f-a k ?SV l (le State WA q g34 0
Contact Person: /0-Me) 6/ 1 L j S 6 In Day Telephone: 300 (0 3 d o q/
E -Mail Address: 7 O.SYY1Ctt/ P VYIsk7 . corms Fax Number: 31o6 1032 -- D 69 2
Contractor Registration Number: A 'F - Fb e-.6 S 07 7 _b ) Expiration Date: 03 -1 - O S
* *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): $ 1 ' 3 a) ' '-'c) - �y
Scope of Work (please provide detailed information): IV ST �eVt.(� -CL UT
V1 c-riaQ 4 b_Do�Do
SOO Si I� s{rt e) • os -�urv�ae_ (Vep acteme \4- . 1 +Tsf &L1
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V°A 4 . a Ire_ . - Mu 4 tk
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Use: Residential: New .... ❑ Replacement ....
Commercial: New .... ❑ Replacement .... ❑
Fuel Type: Electric ❑ Gas....F Other:
Indicate type of mechanical work being installed and the quantity below:
PERMIT 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.
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.
BUILDINGQWNER OR AUTHORIZ D AGENT:
Signature: . I'LL)
q:\lpernuts pluslicc changeslpetnut application (7 -3004)
Revised: 6-8-05
bh
Print Name: I) f I Yk G� , SDI)
Mailing Address4g64 H Skel iet'Pd Tecti Ltel
Page 4
Date: la T e
Da Telephone: 31O l(/ ✓ �
(4ZIgyi WA (g3
City State Zip
Date Application Accepted:
6' Da
Date Application Expires:
1
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 1670400185
Address: 14115 55 AV S TUKW
Suite No:
Applicant: BEST RESIDENCE
RECEIPT
Permit Number: M05 -096
Status: APPROVED
Applied Date: 06/27/2005
Issue Date:
Receipt No.: R05 -00930 Payment Amount: 150.63
Initials: BLH Payment Date: 06/27/2005 12:17 PM
User ID: ADMIN Balance: $0.00
Payee: JEFFREY N PORTTEUS DBA /AFFORDABLE GAS SERVICE
TRANSACTION LIST:
Type Method Description Amount
ACCOUNT ITEM LIST:
Description
doc: Receipt
Payment Check 7363
MECHANICAL - RES
150.63
Account Code Current Pmts
000/322.100 150.63
Total: 150.63
4492. 06/27 9716 TOT ;L 150.63
Printed: 06 -27 -2005
P�raject: `` �n� J / ,
Type of Inspe qn: " "1
A dress:
c
Called:
� lc<
a.m.
Instruction's:
Sptc I1I
Date Wanted:
Requester: �p
1 J i /l..w
�
( •j(--/
Prie is 3 - & ..... 1
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
Approved per applicable codes. ❑ Corrections required prior to approval. -
O MMENTS:
(rsp ct
eipt No.:
INSPECTION RECORD
Retain a copy with permit
PERM
•
IDate:
20 • )431 -3670
Date:
$ 8.00 REINSPECTION EE REQUIRED. 1: to inspection, fee must be
id at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
P •'ect: I ^ I
1I) 1!i., � - _
Type of I ,sec f
' ` !A .1 `.
Ai1dm
Date Cal ed:
Special Instructions:
Date Wanted: / a,^
in\
Requester:
1 11 ['
P I i tpy) f v 3 - 60 9 i
INSPECTION NO.
);21,62 per applicable codes.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
(206) 1 -3670
El Corrections required prior to approval.
COMMENTS:
`VT- t.hE cJ e.s rev 4 ! -S
---
Ocrwlf, 1i bra
Date:-
Et S 8.00 REINSPECTION FEE REQUIRED. Prior . inspection, fee must be
aid at 6300 Southcenter Blvd., Suite 100. Ca l to sechedule reinspection.
'Receipt No.: 'Date:
Sy?
Pro - t:
•
, 1
' • AILLA......L
Type of spection:
_40 . -.-iii
Ad . ress:
ii-i1(6
B5 A
Date •. lei: - f I o .
Special Instructions:
C .-.."
Date Wan - , . .
ID ,a1AU
P. 5
Requeste .
SLAAr
Phone NoL.,..-,
t-e3R
INSPECTION RECORD
Retain a copy with permit
• INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 981 88
(2 6)43 1 -3670
El Approved per applicable codes:
Corrections required prior to approval.
COMMENTS:
e57 f 747 c}k
,oeq ii-fe 4 rsz,
r
Cc. r
3) "
c &t i Ld A
'Date:
2,0 1
E J $58. EINSPECTION Fif REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
1 Recelpt No.:
!Date:
s.
341-04
ALL phases of this installation must comply with NATIONAL, STATE AND LOCAL CODES
IMPORTANT — This Document is customer property and is to remain with this unit.
Please return to service information pack upon completion of work.
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111111111111111111111 11111 11 11111111111111111111111111111111111
18- CD19D7- 14
hstaUer's Gude
Upflow / Horizontal — Downflow / Horizontal,
Gas -Fired Furnaces, "Fan Assisted
Combustion System"
*UD040C -K *UD100C -K *DD040C -F *DD100C -F
*UD060C -K *UD120C -K *DD060C -F *DD120C -F
*UD080C -K *UD140C -K *DD080C -F *DD140C -F
'First letter may be "A" or "T"
For VENT SIZING INFORMATION see:
USA —
National Fuel Gas Code ANSI Z223.1/NFPA 54 (latest version)
CANADA —
Natural Gas Installation Code CAN/CGA-B149.1 (latest version)
Propane Installation Code CAN /CGA- B149.2 (latest version)
USA/CANADA ALTERNATE —
Category I Venting Guide Pub. No. 18- CH23D1 -2
*Horizontal Conversion for these furnaces may be left or right side rotation.
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0 0 0 0 0 a
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Upflow / Horizontal* Downflow / Horizontal*
A341789P01
License Information
License
AFFORGS072D5
Licensee Name
AFFORDABLE GAS SERVICE
Licensee Type
CONSTRUCTION CONTRACTOR
UBI
601452255 Verify Workers Comp Premium
Status
Ind. Ins. Account
Id
1439000
Business Type
INDIVIDUAL
Address 1
4864 NE SHELTERED BAY LN
Address 2
City
HANSVILLE
County
KITSAP
State
WA
Zip
98340
Phone
2063675333
Status
ACTIVE
Specialty 1
SHEET METAL
Specialty 2
UNUSED
Effective Date
3/25/1993
Expiration Date
3/17/2006
Suspend Date
Separation Date
Parent Company
Previous License
Next License
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License
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of account and carry general liability insurance.
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https : / /fortress.wa. gov /lni/bbip/Detail. aspx ?License= AFFORGS072D5
j
06/27/2005
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