HomeMy WebLinkAboutPermit M03-010 - POWELL RESIDENCEPOWELL RESIDENCE
14926 57 AVENUE
SOUTH
M03 -010
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Value of Construction:
Type of Fire Protection:
Signature:
Print Name:
doc: Mech
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 1157200402
Address: 14926 57 AV S TUKW
Suite No:
Tenant:
Name: POWELL, JOANNE
Address: 14926 57 AV S, TUKWILA, WA
Owner:
Name: BERGSTROM CARL H +BENNER DOR
Address: 14926 57TH AVE S, TUKWILA WA
Contact Person:
Name: DENNY CAMPBELL
Address: 3411 C STREET NE, BAY 8, AUBURN, WA
Contractor:
Name: NORDIC HEATING INC
Address: 3411 C ST NE BAY 8, AUBURN WA
Contractor License No: NORDIHI099BJ
DESCRIPTION OF WORK:
CHANGE OUT FURNACE AND WATER HEATER. ELECTRIC TO GAS.
$4,500.00
N/A
Permit Center Authorized Signature: _ '�% -c�:.- Jlr� -ce -r Date: /—.2-1 z3
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 constru do • • .. - rformance of work. I am authorized to sign and obtain this mechanical permit.
MECHANICAL PERMIT
M03 -010
Permit Number: M03 -010
Issue Date: 01/23/2003
Permit Expires On: 07/22/2003
Phone:
Phone: 253 931 -0503
Phone:
Expiration Date: 01/09/2004
Fees Collected:
Uniform Mechnical Code Edition:
Date: / j --ezy
$62.65
1997
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 -23 -2003
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Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Upplicationstpennit application (1.2003)
1/2003
CITY OF TUKWILA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
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Name: Oen/I " / Y✓1 bit
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Mailing Address: ' 3 QO.�/ g
E -Mail Address: /
Page 1
. :sITE.,LOCATIO
Site Address:
Tenant Name: � /
Property Owners Name: /9' 2(( i9 37 9 , J, rj e i;u tiA
:Betiding Permit N o
Mechrttcal Permtt �No�`�
Public Wdrks Permit No
(For. offic use: oirly
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 **
King Co Assessor's Tax No.: /l 5 i 2 '2
Suite Number: Floor:
New Tenant: [] .... Yes [] ..No
Mailing Address:
City
Fax Number:
State
State
State
Zip
Day Telephone:(25 ).- ?3/ - O
rzt Lll ,
City State Zip
Fax Number:
Company Name: P fd ,` h e t f + 1C/
��/f
Mailing Address: 3 (� ti c y �J L( 6U i2i1J We.? . 9ezv Zi
City S tate Zip
Contact Person: Day Telephoned , 9 3 —03 — 03 )
E -Mail Address:
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 OR RECORD All must be:.wet siamped by Architect otRecoird
Zip
City
Day Telephone:
Fax Number:
•ENGINEER OFTRECORD: -All plans .must be wet stamped by Engineer:of Record
Zip
City
Day Telephone:
Fax Number:
' BUILDINGPERMIT INFORMt. tON Z06 431 -3670 `:
Valuation of Project (contractor's bid price): $ Existing Building Valuation: $
Scope of Work (please provide detailed information):
Will there be new rack storage? 0... Yes ❑ .. No
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 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
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 indicating quantities and Material Safety Data Sheets.
UTILITY DISTRICTS:
Note: If the utility district is not City of Tukwila, you must provide written verification and approval from that utility district at the time of permit
application.
Water
❑ .. City of Tukwila Water District 0.. Water District U125 ❑... Highline Water District ❑...City of Renton Water District
Sewer
❑ .. City of Tukwila Sewer District ❑ .. Val Vue Sewer District ❑...City of Renton Sewer District ❑...City of Seattle Sewer District
❑ .. Septic System (If property is served by a septic system, 2 copies of approved septic design from King County Health Department must be
submitted at the time of permit application)
\applications%permit application (1.2003)
1(200)
If "yes ", sec Handout No.
0.-None ❑ .. Other (specify)
Page 2
for requirements.
Existing
Interior.
Remodel
Addition to
Existing
Structure
New
Type of
Construction .
per UBC
Type of
Occupancy per
UBC
I" Floor
2 Floor
3 Floor
Floors thru
Basement
Accessory Structure
Attached Garage
Detached Garage .
Attached Carport
Detached Carport
Covered Deck
Uncovered Deck
' BUILDINGPERMIT INFORMt. tON Z06 431 -3670 `:
Valuation of Project (contractor's bid price): $ Existing Building Valuation: $
Scope of Work (please provide detailed information):
Will there be new rack storage? 0... Yes ❑ .. No
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 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
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 indicating quantities and Material Safety Data Sheets.
UTILITY DISTRICTS:
Note: If the utility district is not City of Tukwila, you must provide written verification and approval from that utility district at the time of permit
application.
Water
❑ .. City of Tukwila Water District 0.. Water District U125 ❑... Highline Water District ❑...City of Renton Water District
Sewer
❑ .. City of Tukwila Sewer District ❑ .. Val Vue Sewer District ❑...City of Renton Sewer District ❑...City of Seattle Sewer District
❑ .. Septic System (If property is served by a septic system, 2 copies of approved septic design from King County Health Department must be
submitted at the time of permit application)
\applications%permit application (1.2003)
1(200)
If "yes ", sec Handout No.
0.-None ❑ .. Other (specify)
Page 2
for requirements.
PUBLIC WORKS PERMIT INFO .tMATION 206 - 433 -017
Scope of Work (please provide detailed information):
Street Use:
❑ .. Street Use
Land Altering and /or Hauling:
❑.. Land Altering: ❑...Cut
Storm Drainage:
0.. Storm Drainage ❑.,.Flood Control Zone
Sewer Information:
❑ .. City of Tukwila Sewer District 0.. Val Vue Sewer District ❑...City of Renton Sewer District ❑ ..City of Seattle Sewer District
❑ .. Sanitary Side Sewer ❑ .. Sewer Main Extension ❑ .. Private ❑ .. Public
Water Information:
❑ .. City of Tukwila Water District ❑.. Water District # 125 ❑... Highline Water District 0... City of Renton Water District
0.. Water Main Extension ❑ .. Private ❑...Public
❑ .. Water Meter/Exempt: Size(s): ❑ .. Deduct ❑...Water Only
❑ .. Water Meter Permanent #: Size(s):
❑ .. Water Meter Temporary #: Size(s): ❑ .. Est. Quantity: gallons
❑ .. Fire Loop/Hydrant (main to vault) #: Size(s): ❑ .. Landscaping Irrigation
❑ .. Miscellaneous:
Monthly Service Billing to:
Name:
Mailing Address:
Water Meter Refund/Billing:
Name:
Mailing Address:
\applicationalpennit application (1.2007)
I/2t103
Water...
Call before you Dig: 1- 800 - 424 -5555
Please refer to Public Works Bulletin #1 for fees and estimate sheet:
❑... Channelization /Striping
❑...Curb cut/Access/Sidewalk
cubic yards ❑... Fill cubic yards ❑ .. Hauling
City
Sewer ... ❑ Sewage Treatment
Page 3
City
Day Telephone:
State
Fire Line ....
Zip
Day Telephone:
State Zip
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Unit Type:.
Qty
; Unit Type:
Qty .
Unit Type:
Qty .
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
Floor Furnace
Ventilation Fan
15 -30 HP /1,000,000 BTU
Suspended/Wall /Floor
Mounted Heater
Ventilation System
30 -50 HP/I,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
HANICALvPERMITINFORMATION =;206 =431 = 3670:;
MECHANICAL CONTRACTOR INFORMATION
Company Name: /U t /L L) 1 C [left t,v 1 1 �N c • �>
Mailing Address: 3 C r5 T [ , /3/91 6 gei tv cAn . eNovz-
City State Zip
Contact Person: fl ei 4 / CAn4 i7 e-/ Day Telephone: 25 '73 / —05
E -Mail Address: Fax Number: 3 3
Contractor Registration Number: / .119A- l- !'hrr:J 9 ej Expiration Date: / - 9' —� /
* *An original or notarized copy of current Washington State Contractor License must be present at the time of permit issuance **
Valuation of Project (contractor's bid price): $ 9:57,a 0 L
Scope of W k (please provide detailed information):) dne P �� t�� /�o, c •(— ri(JC,(/ 2
h c- J ee ad/
Se_
Residential: New ....❑ Replacement ....
Commercial: New .... ❑ Replacement .... ❑
Fuel Type: Electric ❑ Gas Other:
Indicate type of mechanical work being installed and the quantity below:
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 0 E: • ' - HORIZED AGENT:
Signature:
Print Name: /
Mailing Address:
\applications\permit application (1.2007)
1/2003
( fit
City
Date Application Accepted:
Date Application Expires:
Staff Initials:
1
Page 4
Date: A23 3 "-Y
Day Telephone: 9 .3/ —OS
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Signature:
doc: Conditions
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 1157200402
Address: 14926 57 AV S TUKW
Suite No:
Tenant: POWELL, JOANNE
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: Fuel burning appliances may not be installed in sleeping rooms, U.M.C. 304.5.
8: Appliances which generate flame, spark or glowing ignition, shall be elevated 18 inches above the floor (U.M.C.
303.1.3.).
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.
7e- e
Print Name: >�°y 1 �/
/ v
PERMIT CONDITIONS
M03 -010
Permit Number: M03 -010
Status: ISSUED
Applied Date: 01/23/2003
Issue Date: 01/23/2003
Date: / `3
Printed: 01 -23 -2003
doc: Receipt
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 1157200402 Permit Number: M03-01O
Address: 14926 57 AV S TUKW Status: PENDING
Suite No: Applied Date: 01/23/2003
Applicant: POWELL, JOANNE Issue Date:
Receipt No.: R03 -00075 Payment Amount: 62.65
Initials: SKS Payment Date: 01/23/2003 02:34 PM
User ID: 1165 Balance: $0.00
Payee: NORDIC HEATING INC
TRANSACTION LIST:
Type Method Description Amount
Payment Check 8553
ACCOUNT ITEM LIST:
Description
MECHANICAL - RES
RECEIPT
62.65
Account Code Current Pmts
000/322.100 62.65
Total: 62.65
4667 01/24 97.1.6 TOTAL 62.65
Printed: 01 -23 -2003
COMMENTS:
C O Y'' r tQ'A$ - k Ire ►r-\
Type of spection: ,
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All e sci c
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pp, ooed
g ate Called:
/
T - \ v-,A - ,(:, Y 1/0, ( ' aw p I e
Special Instructions:
OVA r0i
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Date Wanted:
1
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Requester:.
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Proj•ct:
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Type of spection: ,
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All e sci c
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g ate Called:
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Special Instructions:
e II
Date Wanted:
1
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: .m.
Requester:.
i
P one No:
„
5
pproved per applicable codes.
• .INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
Z63 -a
0
PERMIT
(206)431- 670
Corrections required prior to approval.
Inspector.
Date: 0_ -
$47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Cali to schedule reinspection.
'Receipt No.:
'Date:
• ^ ; , . • i,�xrj i,r �.. •, .;; .' (t1y k:}:}:t�..,.�a;'r,?„h'�Y r ti" '• .. ��::; x��� r-
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COMMENTS:
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Address:
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Date Wanted:
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Requester:
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Type of Inspection:
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Address:
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Date Called:
01,( 9
Special Instructions:
Date Wanted:
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Requester:
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INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
PERMIT NO
(206)431 -3670
0 Approved per applicable codes. Corrections required prior to approval.
Inspector n () ` fi
Date: --) 03
$47.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
F ReceIPt No.:
'Date:
APR-11-02 03:04 PM
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