HomeMy WebLinkAboutPermit M03-044 - NISHIMURA RESIDENCENISHIMpj
RESIDENCE
16207 48 AV S
M03 -044
Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
DESCRIPTION OF WORK:
GAS TO GAS CHANGE OUT
Print Name: A &I c;
doc: Mech
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 5379800446
Address: 16207 48 AV S TUKW
Suite No:
NISHIMURA HIROMI
16207 48TH AVE S, TUKWILA WA
NISHIMURA HIROMI
16207 48TH AVE S, TUKWILA WA
CANDACE GALLAGHER
Address: 2800 THORNDYKE AV W, SEATTLE, WA
Contractor:
Name: WASHINGTON ENERGY SERVICES CO
Address: 2800 THORNDYKE AVE W, SEATTLE
Contractor License No: WASHIES990CW
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MECHANICAL PERMIT
M03 -044
Permit Number:
Issue Date:
Permit Expires On:
Phone:
Phone: 206 482 -4700
Phone: 206 282 -4700
Expiration Date: 02/16/2005
M03 -044
03/12/2003
09/08/2003
Value of Construction: $2,586.00 Fees Collected: $34.15
Type of Fire Protection: N/A Uniform Mechnicai Code Edition: 1997
. ` �2' , c , .G>r:2cr4- Date: -.:. ` -
Permit Center Authorized Signature: � .i - ,�
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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
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 construc ion o0he pert• mance of work. I am authorized to sign and obtain this mechanical permit.
Signature: /LEI i . Cv �/ / /r 4S Date: 3
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: 03 -12 -2003
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City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 5379800446
Address: 16207 48 AV S TUKW
Suite No:
Tenant: NISHIMURA HIROMI
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.
Signature:
Print Name:
doc: Conditions
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PERMIT CONDITIONS
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Permit Number: M03-044 w 2
Status: ISSUED 6 v
Applied Date: 03/12/2003 (.) 0
Issue Date: 03/12/2003
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Date: " /Z + °3
M03 -044 Printed: 03 -12 -2003
Site Address:
Tenant Name:
Name:
Mailing Address:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Company Name:
Mailing Address:
CITY OF TUKWIL4
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
King Co Assessor's Tax No.: 53 7ck Ecv., I T L ? i ( 1
1 () a - 0� 2 -7' E j 'v Suite Number:
Property Owners Name: - } - 11rDIAAA . l'v t S v 1 m UP -
Mailing Address: S
we SLED
\applications \permit application (3.2003)
3/2003
ZSoa
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 **
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Page 1
Building Permit No.
Mech Permit
Public Works Permit No
Project No
For use only)
City
Day Telephone:
City
Fax Number:
Floor:
New Tenant: D .... Yes ..No
State
L_ Cu .A
State
State
State
State
Zip
Zip
GENERAL. CONTRACTOR INFORMATION
Zip
City
Day Telephone:
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 RECORD ',AI1 Plans must be wet stamped by:Architeet of Record,
Zip
City
Day Telephone:
Fax Number:
°ENGINEER.OF Ali plans must be wet Stamped by,Engmeer, of Record
Zip
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
BU ILDIN G , ,2 - 431 -
Valuation of Project (contractor's bid price): $ Existing Building Valuation: $
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
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:
Will there be a change in use? El ....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 indicating quantities and Material Safety Data Sheets.
\applications ■permit application (] 2003)
3/2003
Page 2
Compact: Handicap:
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
BU ILDIN G , ,2 - 431 -
Valuation of Project (contractor's bid price): $ Existing Building Valuation: $
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
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:
Will there be a change in use? El ....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 indicating quantities and Material Safety Data Sheets.
\applications ■permit application (] 2003)
3/2003
Page 2
Compact: Handicap:
PUBLIC;WORKS; PERlyfITINFrM'MATION :206- 433 - 0179.
Scope of Work (please provide detailed information):
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
Water District
❑...Tukwila ❑...Water District #125
❑ ...Water Availability Provided
Sewer District
❑ ...Tukwila ❑... 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.
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 Tess 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 _
\applications \permit application (3 -2003)
3/2003
cubic yards
cubic yards
11
❑ .
❑•
❑ .
❑ .
Call before you Dig: 1- 800 - 424 -5555
. Abandon Septic Tank
. Curb Cut
. Pavement Cut
. Looped Fire Line
WO#
WO#
WO#
Private
Private
❑ .. Highline
❑ ...Renton
❑ .. 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
Page 3
❑ .. Grease Interceptor
❑ .. Channelization
❑ .. Trench Excavation
❑ .. Utility Undergrounding
❑...Deduct Water Meter Size
FINANCE INFORMATION
Fire Line Size at Property Line
❑...Water ❑...Sewer
Monthly Service Billing to:
Name:
Mailing Address:
Water Meter Refund/Billing:
Name:
Mailing Address:
Number of Public Fire Hydrant(s)
❑ ... Sewage Treatment
Day Telephone:
City
State
Zip
Day Telephone:
City
State
Zip
Unit Type:
Qty
Unit Type:.
Qty
Unit Type:
Qty
Boiler /Compressor:
Qty
Furnace <100K BTU
i
1
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 /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
MECHANICAL PERMIT:INF.O�tMATION 206 -431 -3670
MECHANICAL CONTRACTOR INFORMATION
Company Name: COGS C—C)
g 2 -` muyna ' __ 740 - Lc) Sep: /1 '�
Mailing Address: j,(�
City Stale Zip
Contact Person: Ca- V1CA 1. C e. 641 . --r Day Teleph6P° 1 7 4 g 4 7')Q
E -Mail Address: Fax Number:
Contractor Registration Number: I Alt; ; 1 -, 5 9 GT) ( /,O Expiration Date: 1 (01 (,) 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): $ e S , (e
Scope of Work (please provide detailed information): az 6-0 A
Use: Residential: New ....❑ Replacement ....[v�
Commercial: New .... ❑ eplacement .... 0
Fuel Type: Electric ❑ Gas.... [+ Other:
Indicate type of mechanical work being installed and the quantity below:
P,ERMIT;APPLICATIONANOTES Applicable •to: all permits in this applicat><on';
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 1 AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER OR AUTHORIZED AGENT:
Signature: � �• ' 7 _ Uvri i L• 6
Print Name: L / %/7 (�L� /' ?O /` f U Ii/
Mailing Address: ? 0 ��h
\applicationslpermit application (3.2003)
3/2003
Page 4
Date:
Day Telephone: /z- 6?-7- 3 7 ? 3
Le tgo
City State Zip
Date Application Accepted:
Date Application Expires:
Staff Initials:
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Payee:
TRANSACTION LIST:
ACCOUNT ITEM LIST:
Description
doc: Receipt
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
THE PERMIT GROUP
MECHANICAL - RES
RECEIPT
re LLI
Parcel No.: 5379800446 Permit Number: M03 -044 _i o
Address: 16207 48 AV S TUKW Status: PENDING co a
Suite No: Applied Date: 03/12/2003 w iw
Applicant: NISHIMURA HIROMI Issue Date: 9 ,
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Receipt No.: R03 -00306 Payment Amount: 34.15 g 5 cc
Initials: SKS Payment Date: 03/12/2003 03:27 PM H W
User ID: 1165 Balance: $0.00 Z i
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Type Method Description Amount 1-- -.
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Payment Check 20321 34.15 fW Z'
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Account Code Current Pmts
000/322.100 34.15
Total: 34.15
(FT}) ri 6 TOTAL
Printed: 03 -12 -2003
Pc9jecti . A ,. ,
Iti f 6444 IV Sk il ilAttla
Type of Inspection: "
Address: , . v.., i L
1 CaD 07 WN
/fin . __Y) e
Date Called:
Special Instructions:
.
Date Wanted: / / ......?
RerijsaL:f iiiii tf/1 A
Phorallo:
_ ( D(;) 34 (n q
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
A-763 -bct
PERMIT N
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)43
Approved per applicable'codes. El Corrections required prior to approval.
70
COMMENTS:
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Date: /
.00 REINSPECTION F E REQUIRED. Pri r to inspection, fee must be
p d at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
R- eipt No.:
'Date:
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Type of Irpspe4tion:
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Address _ 415*I'kut
Date Called: 3 03
Special Instructions:
'
Date Wanted / 0 3
p.m.
Reque3
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Approved per applicable codes.
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
PERMIT
•
(2.6)4
Corrections required prior to approval.
COMMENTS:
C/,, - y cm-
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• or: Date:
1 )' cti1/4. ) 3 /3 (
$47.00 REINSPECTION FEE REQUIRED. to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
70
F6.2f 2. i.°7)
CONST CONT GENERAL
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County of Snohomish
State of Washington
I certify that this is a true and correct copy of said document as of this date
Date: rn oo
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Title
My Appointment Expires on io/ci/O3
DEPARTNIENT OF LABOR AND INDUSTRIES re LLI
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REGISTERED AS PROVIDED BY LAW AS w
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CCO1 WASHIES990CW 02/16/2005
EFFECTIVE DATE 02/16/2001 g 5
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WSHINGTON ENERGY SERVICES CO
2800 THORNDYKE AVE W
SEATTLE WA 98199-2997
Detach And Di.piay Certificate