HomeMy WebLinkAboutPermit M04-016 - BICKNELL RESIDENCEBICKNELL
RESIDENCE
13722 41ST AVENUE
SOUTH
M04 -016
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Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
City of Tukwila
Parcel No.: 7360600315
Address: 13722 41 AV S TUKW
Suite No:
Tenant:
Name: BICKNELL RESIDENCE
Address: 13722 41 AV S, TUKWILA WA
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
Contractor
BICKNELL ELIZABETH M ET AL
13722 41ST AVE S, SEATTLE WA
ELIZABETH BICKNELL
13722 41 AV S, TUKWILA WA
PERFORMANCE HEATING
7649 S 180 ST, KENT WA
License No: PERFOHA15ORT
MECHANICAL PERMIT
DESCRIPTION OF WORK:
LIKE FOR LIKE CHANGE OUT OF GAS FURNACE (SEE PLAN IN FILE)
Value of Construction: $6,000.00
Type of Fire Protection: N/A
Permit Center Authorized Signature:
Print Name:
doe: Mech
M04 -016
Permit Number:
Issue Date:
Permit Expires On:
Phone:
Phone: 206 243 -1263
Phone: 425 251 -0356
Expiration Date: 04/29/2005
M04 -016
01/30/2004
07/28/2004
Fees Collected: $65.00
Uniform Mechnical Code Edition: 1997
d-sieQ■ Date: �
ary
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
regulating constructionpr t performance of work. I am authorized to sign and obtain this mechanical permit.
Signature: U/� Date:
V CC Lee f( /1 6
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: 01 -30 -2004
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City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 7360600315
Address: 13722 41 AV S TUKW
Suite No:
Tenant: BICKNELL RESIDENCE
PERMIT CONDITIONS
1: ** *BUILDING DEPARTMENT CONDITIONS * **
2: No changes will be made to the plans unless approved by the Engineer and the Tukwila Building Division.
3: All permits, inspection records, and approved plans shall be available at the job site prior to the start of any
construction. These documents are to be maintained and available until final inspection approval is granted.
4: All construction to be done in conformance with approved plans and requirements of the Uniform Building Code (1997
Edition) as amended, Uniform Mechanical Code (1997 Edition), and Washington State Energy Code (1997 Edition).
5: Validity of Permit. The issuance of a permit or approval of plans, specifications, and computations 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 ordinance of the jurisdiction. No permit presuming to give authority to violate or cancel the provisions of this
code shall be valid.
6: Manufacturers installation instructions required on site for the building inspectors review.
7: Appliances which generate flame, spark or glowing ignition, shall be elevated 18 inches above the floor (U.M.C.
303.1.3.).
8: Fuel burning appliances may not be installed in sleeping rooms, U.M.C. 304.5.
9: Water heater shall be anchored to resist earthquake (U.P.C. 510.5).
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: Conditions
� / Date: 1 a ^ -zcaNf
Signature: G�' a L _
Print Name: l C (Ac (
M04 -016
Permit Number: M04 -016
Status: ISSUED
Applied Date: 01/30/2004
Issue Date: 01/30/2004
Printed: 01 -30 -2004
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CITY OF TUKWILA fl
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 **
7SIT E)<O
ATI
Site Address: J37 — y/ $1 'e •
Tenant Name: � 2 ` l beck /lekNc $1
Property Owners Name: sit(2 - atck - 1 1
Mailing Address: / 3/ 2 r » e- S-
Name: Oil /Sick W-e 11
Mailing Address: /3 7 2'Z /ft St 19•
E -Mail Address:
GEN ERA L''(
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
$ '9 f
Si c 7C
King Co Assessor's Tax No.: f l 3 D &L56 3 1 .E
Suite Number: Floor:
New Tenant: .... Yes 2
City
State
Zip
Day Telephone: 206- Z- V.3 -- / 24-3
7'vkv 1 I fl
City
Fax Number:
State Zip
r
Contractor Registration Number: Pu - 0Lt c 1 r6 !L'f Expiration Date: i1/4-?/
5
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
ARC
plans must be wet stamped by Architect of Recoil
•
Company Name:
Mailing Address:
Zip
Contact Person:
E -Mail Address:
;ENGINEE OFFRECI
k y
Contact Person:
E -Mail Address:
%applications\permit application (34003)
3/2003
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planslmust:
stamped by Eng�ncer.oE
Page 1
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City State Zip
Day Telephone: %f 2 Ti `G3T�v
Fax Number: 7 Z r 2 5 - 1 028
City
Day Telephone:
Fax Number:
ecord k
State
Company Name:
Mailing Address:
City
Day Telephone:
Fax Number:
State
Zip
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JJILDINGTERMIT;INFO TION '206=43.1 -36
� s
; � �..
Valuation of Project (contractor's bid price): $
tappiications \permit application (3.2003)
3/2003
Scope of Work (please provide detailed information):
Will there be new rack storage? ❑ ..Yes ❑ .. No If "yes ", see Handout No. for requirements.
'Provide: All Building Areas, in Square Footage Below
..1 ":Floor;
2"°. Floor
3` °Floor
Floors
thru
.!Basement
'Accessory Structure :, :.
AttachedGarage -;::.
:Detached: Garage
: Attached;Carport
;; Detached Cargo
:'Covered Deck.
Uncovered Deck
Existing
Addition to'
Existing
Structure
Type of
Construction
per UBC:
Type of
Occupancy per .'
• -UBC
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:
0.. 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 I1 paper indicating quantities and Material Safety Data Sheets.
Page 2
Existing Building Valuation: $
Scope of Work (please provide detailed information):
Water District
❑ ...Tukwila 0... Water District #125
❑ ...Water Availability Provided
Submitted with Application (mark boxes which apply):
❑ ...Civil Plans (Maximum Paper Size — 22" x 34 ")
❑ ...Technical Information Report (Storm Drainage)
❑ ...Bond ❑ .. Insurance ❑ .. Easement(s)
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
❑ ...Total Fill
❑ ...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 _
\applicationatpermit application (3.2003)
3/2003
cubic yards
cubic yards
„
„
Call before you Dig: 1- 800 - 424 -5555
Please, raferto Public :Works Bulletin #1 for fees and;estimate sheet
Sewer District
❑ ...Tukwila 0... ValVue ❑ .. Renton ❑ ...Seattle
❑ ...Sewer Use Certificate 0... 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.
❑ .. Abandon Septic Tank
❑ .. Curb Cut
❑ .. Pavement Cut
❑ .. Looped Fire Line
WO#
WO#
WO#
Private
Private
❑ .. Highline
❑ .. Geotechnical Report ❑...Traffic Impact Analysis
❑ .. Maintenance Agreement(s) ❑...Hold Harmless
❑ .. Right -of -way Use - Profit for less than 72 hours
❑ .. Right -of -way Use — Potential Disturbance
❑ .. Work in Flood Zone
❑ .. Storm Drainage
FINANCE INFORMATION
Fire Line Size at Property Line
❑ ...Water ❑ ... Sewer ❑ ... Sewage Treatment
Monthly Service Billing to:
Name:
Mailing Address:
Water Meter Refund/Billing:
Name:
Mailing Address:
Number of Public Fire Hydrant(s)
Day Telephone:
City
State
Zip
Day Telephone:
City
State
Zip
Page 3
❑ ...Renton
❑ .. Grease Interceptor
❑ .. Channelization
❑ .. Trench Excavation
❑ .. Utility Undergrounding
❑ ...Deduct Water Meter Size It
Unit Type: : :.
Qty .
Unit Type:
Qty .
Unit Type: ::
Qty :
r - Boiler/Compressor:
Qty
Furnace <100K BTU
(
Air Handling Unit
>= 10,000 CFM
Other Mechanical
Equipment
0 -3 HP /100,000 BTU
Furnace>100K BTU
Evaporator Cooler
3 -15 HP /500,000 BTU
15 -30 HP /1,000,000 BTU
Floor Furnace
Ventilation Fan
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
ANIC INFORMATION `- `206 -431 -367
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MECHANICAL CONTRACTOR INFORMATION p
Company Name: 1l f FOg l't" an c t- 14 c-4-1
Mailing Address: 7 �O Y? ,
City
Contact Person: 't h L E1/414 r Day Telephone: 9z r 2 rl - ' 3 r .
E -Mail Address: r 0 ter 4 ft et C Lb e@.4-t ..� • Cdr Fax Number: L2 r 2/1 — v 2S1'6
Contractor Registration Number: 19- «'Tckat 1 Yo Jc r 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): $ 4 6 ao
Scope of Work (please provide detailed information): 114,s i-e4 I I 7 Q t-^'t jD /o G 4s '..,„ 4 C t
G A Pt/ l P 3 e btic* -,a r L-
Use: Residential: New ....❑
Commercial: New ....❑
BUILDING OWNER OR AUTHORIZED AGENT:
Signature:
Print Name:
Date Application Accepted:
lapplicationdpermit application (3-2003)
3/2003
7ri0.b .tvt J
Mailing Address: 7 (.' yC/ S /fr
ri
Replacement ...:�
Replacement ....❑
Indicate type of mechanical work being installed and the quantity below:
State Zip
/a
Fuel Type: Electric ❑ Gas _21 Other:
ilicablefo all;perlmits m tbis�
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.
Date Application Expires:
Page 4
Date: rf ZVc
Day Telephone: 92 'f Z r /— 0 3
City State Zip
Staff Initials:
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
RECEIPT
Parcel No.: 7360600315 Permit Number: M04 -016
Address: 13722 41 AV S TUKW Status: PENDING
Suite No: Applied Date: 01/30/2004
Applicant: BICKNELL RESIDENCE Issue Date:
Receipt No.: R04 -00103 Payment Amount: 65.00
Initials: SKS Payment Date: 01/30/2004 02:15 PM
User ID: 1165 Balance: $0.00
Payee: CONSTANCE GOWAN
TRANSACTION LIST:
Type Method Description Amount
doc: Receipt
Payment Check 19536
ACCOUNT ITEM LIST:
Description
MECHANICAL - RES
PLAN CHECK - RES
65.00
Account Code Current Pmts
000/322.100 52.00
000/345.830 13.00
Total: 65.00
7134 02/02 1710 TOTAL 65.00
,CITY Of T IJKWILA
RE^EEIPT'
P'W DCD 65.00
CHECK 65.00
02/02/04 10
04:43 0097 7134 •
Printed: 01 -30 -2004
COMMENTS:
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Sptcial Instructions:
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Date Wanted.
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Phone No:
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INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
154 ,4pproved per applicable codes.
pal
Re • t No.:
tor:
INSPECTION RECORD
Retain a copy with permit
'Date:
PERMI
❑ Corrections required prior to approval.
I F
$4700 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
crs
(206)431 -3670
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NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEAR!HAN
THIS NOTICE IT IS DUE TO THE QUALITY OF THE DOCUMENT.
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