HomeMy WebLinkAboutPermit M03-125 - RIVERSIDE INNRIVERSIDE INN
14060 INTERURBAN AV S
M03 -125
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Parcel No.: 0002800033 Permit Number: M03 -125 1 z
Address: 14060 INTERURBAN AV S TUKW Issue Date: 08/01/2003
Suite No: Permit Expires On: 01/28/2004 6 v
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Tenant: w =
Name: RIVERSIDE INN J u_
Address: 14060 INTERURBAN AV S, TUKWILA WA w
Owner: g 5
Name: B.B.N.TRUST Phone: u. a
Address: 14060 INTERURBAN AVE S, TUKWILA WA 92 O
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Contact Person: z !
Name: CANDICE GALLAGHER Phone: 206 282 -4200 z 0
Address: 2800 THORNDYKE, SEATTLE WA Ili ? '
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Contractor: 0 co
Name: WASHINGTON ENERGY SERVICES CO Phone: 206 282 -4700 0 '-
Address: 2800 THORNDYKE AVE W, SEATTLE w w
Contractor License No: WASHIES990CW Expiration Date: 02/16/2005 -
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DESCRIPTION OF WORK:
GAS TO GAS WATER HEATER CHANGE OUT
Value of Construction: $1,000.00 Fees Collected: $51.75
Type of Fire Protection: N/A Uniform Mechnical Code Edition: 1997
Permit Center Authorized Signature: Gr--"ce•c Date: cr- e /-D3
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 cons uction or the performance of work. I am authorized to sign and obtain this mechanical permit.
Signature: I,A/ J . rA/ -1/1 e
t) Date:
Print Name: Li 40 ,9,4 77or QUlit
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.
doc: Mech
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
MECHANICAL PERMIT
M03 -125
Printed: 08 -01 -2003
•
doc: Conditions
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
PERMIT CONDITIONS
Parcel No.: 0002800033 Permit Number: MO3 -125
Address: 14060 INTERURBAN AV S TUKW Status: ISSUED
Suite No: Applied Date: 08/01/2003
Tenant: RIVERSIDE INN Issue Date: 08/01/2003
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* P Date: s/[ /
Print Name: L(&) 2 4 77-to✓i'1 C,2 t)/j7
M03 -125
Printed: 08 -01 -2003
•
King Co Assessor's Tax No.:
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Tenant Name: e R 1VeJ flCL. -- ' k7 Yl
Site Address:
Property Owners Name: / ,± _ - �/�
Mailing Address: 1 L( 7 (oo i- - ,—GI `` �'� �`Trjz cf r
6 F6--/e
City
Name: ezeMice (cuescv)
Mailing Address: 2-8 r
E -Mail Address:
Company Name: L.i)(P -
Mailing Address: irr-9 7 C O?
Contact Person: rolul (C e 674. 11 j
E -Mail Address:
Contractor Registration Number: (.v f1 '7aCc -c/
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
\applications \permit application (3.2003)
3/2003
CITY OF TUKWILA
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 **
Page 1
Building Permit No
Mechanical Permit No.
Public Works Permit No.
Project No
Suite Number:
Day Telephone: 2/3 Z y >on
cuA
State Zip
City
Fax Number:
City
(For ojflce "rise only)"
State
State
-
Floor:
New Tenant: 0 .... Yes fl ..No
State Zip
:GENERAL: CONTRACTOR INFORMATION:
ff-/
State Zip
Day Telephone: - 2 a '7rr7
Fax Number:
Expiration Date: a--
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
'ARCHITECT OF RECORD LL,Alfrilans must; be wet stamped by Architect of Record
Zip
City
Day Telephone:
Fax Number:
:ENGINEER OF RECORD `= All plans must be wet stamped by Engineer*" Record
Zip
City
Day Telephone:
Fax Number:
.,_... .;,; .,:;l:A�.i '=1Y. �.ti<��i..4• ;s atr: „• , 11,1
BUILDING PERMIT.INFORMATION
\applicationalpermit application (3.2003)
3/2003
206- 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? E] ..Yes D.. 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: Compact:
Will there be a change in use? j ....Yes ❑ ..No If "yes ", explain:
FIRE PROTECTION /HAZARDOUS MATERIALS:
❑..Sprinklers D ..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.
Page 2
Handicap:
Existing
Interior
Remodel
Addition to
Existing
• Structure
New
Type of
Construction
per UBC
Type of
Occupancy per
UBC
I" Floor
2 "O. Floor
3f0 Floor .
Floors thru
Basement
Accessory Structure*
Attached Garage
Detached Garage
Attached Carport
Detached Carport
Covered Deck
Uncovered Deck
BUILDING PERMIT.INFORMATION
\applicationalpermit application (3.2003)
3/2003
206- 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? E] ..Yes D.. 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: Compact:
Will there be a change in use? j ....Yes ❑ ..No If "yes ", explain:
FIRE PROTECTION /HAZARDOUS MATERIALS:
❑..Sprinklers D ..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.
Page 2
Handicap:
PUBLIC=WORKS'PERMIT, ThRMATION`= ;206433 =0179.
7.
Scope of Work (please provide detailed information):
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
Water District
❑ ...Tukwila ❑... Water District #I25
❑ ...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 less than 72 hours
❑ ...Right -of -way Use - No Disturbance
❑ ...Construction/Excavation/Fill - Right -of -way
Non Right -of -way
❑ ...Total Cut
0 ...Total Fill
\applications \permit application (3-2003)
3/2003
cubic yards
cubic yards
❑..:Sanitary Side Sewer
❑ ...Cap or Remove Utilities
❑ ...Frontage Improvements
❑ ...Traffic Control
❑ ...Backllow Prevention - Fire Protection
Irrigation
Domestic Water
❑ ...Permanent Water Meter Size...
0 ...Temporary Water Meter Size..
❑ ... Water Only Meter Size
❑ ...Sewer Main Extension Public
0 ...Water Main Extension Public_,.,
tf
❑ .. Abandon Septic Tank
❑ .. Curb Cut
0 .. Pavement Cut
❑ .. Looped Fire Line
17
CaII before you Dig: 1- 800 - 424 -5555
fl
WO#
W O#
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
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
Page 3
❑ ...Renton
❑ .. Grease Interceptor
❑ .. Channelization
❑ .. Trench Excavation
❑ .. Utility Undergrounding
❑...Deduct Water Meter Size
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Boiler /Compressor:
Qty
Furnace <100K BTU
Air Handling Unit
>= 1 0,000 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 PERMITIN RIVIATION = 431 -3670
MECHANICAL CONTRACTOR INFORMATION
W
Company Name: � Co
Mailing Address:
Contact Person: i/L)ier 6 4-1 /Q S 4
E -Mail Address:
BUILDING OVv!9ER OR AkJTFIORIZED AGENT:
Signature:
Print Name: L i k 77
Mailing Address:
\applications \permit application (3.2003)
3/2003
n�u
Ursf
Page 4
LJ ?
City
Stale Zip
Day Telephone: acre Z$ 2 y 7ca
Fax Number:
r--
Contractor Registration Number: �, � - E' ! D C — Expiration Date: Z- ` 4 "d`�
**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): $ / 6,Z-20 ,
Scope of Work (please provide detailed information):
V 'tLI //41.6—
Use: Residential: New ....0 Replacement .... D
Commercial: New ....0 Replacement ....ck
Fuel Type: Electric 0 Gas ....k 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 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 1 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.
Day Tele hone: ¥ 70 -3 2-8 °o
ceD
City
Date: Y` ( • 63
State
Zip
Date Application Accepted:
' — / - -z' 3
Date Application Expires:
I Staff Initials:
1
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RECEIPT 1t`
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Parcel No.: 0002800033 Permit Number: M03 -125 6 m
Address: 14060 INTERURBAN AV S TUKW Status: PENDING 0 0 .
Suite No: Applied Date: 08/01/2003 co w
Applicant: RIVERSIDE INN Issue Date: W F :
CO IL,
W O,
Receipt No.: R03 -00936 Payment Amount: 51.75 15
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Initials: SKS Payment Date: 08/01/2003 09:15 AM =
User ID: 1165 Balance: $0.00 Z H
Payee:
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Type Method Description Amount I — U '
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Payment Check 2462 51.75 IIJZ`
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BLUE DOT
TRANSACTION LIST:
ACCOUNT ITEM LIST:
Description
doc: Receipt
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
MECHANICAL - NONRES
PLAN CHECK - NONRES
Account Code Current Pmts
000/322.100 41.40
000/345.830 10.35
Total: 51.75
_O5 O}i /Oi ?i'ii.O TOTAL 51
Printed: 08 -01 -2003
Pr i -ri14 -( d.P
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Type nspection: •
� '
dress:
�r
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Date Called:
/-- .20 -- 0 V
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Special Instructions:
.
Date Wanted: L/ a.m.
^-n?/ — T p•m
Requ er:
Phone No:
_ (2 A )Yi/ -- /37
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
El Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
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1(f .,G1 i/ (../41 Z6
Date: � 2 / 5 l �/
$47.00 REINSPECTION EE REQUIRED. Prior to Inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. CaII to schedule reinspection.
Receipt No.:
'Date:
Project: • , • •
) // a
Type of Inspection:
-7:Z-7/ -; .
Address:
Date Called:
2Y
Special Instructions:
Date Wanted:
/G
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,a m,,
p•m•
Requester:.-
Phone No:
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
COMMENTS:
"PAS neeie6
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let? t? /'tP.'' el �-v5
ve tee 2 -z4S — t�
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El Approved per applicable codes.
Ej $4' 7.00 REINSPECTIbN FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
'Date:
INSPECTION RECORD
Retain a copy with permit
Corrections required prior to approval.
(206)431 -3670
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June 14, 2004
Candice Gallagher
2800 Thorndyke
Seattle, WA 98199
RE: Permit Application No. M03 -125
14060 Interurban Avenue South
Dear Permit Holder:
City of Tukwila
Department of Community Development Steve Lancaster, Director
In reviewing our current records the above noted permit has not received a final inspection by the City of Tukwila
Building Division. Per the Uniform Building Code and /or Uniform Mechanical Code, every permit issued by the
Building Official 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 Permit Center at (206) 431 -3670 to arrange 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 a one -time
extension up to 180 days. Extension requests must be in writing 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 or request and receive an extension prior to July 19, 2004,
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,
Stefania Spencer
Permit Technician
Xc: Permit File No. M03 - 125
Bob Benedicto, Building Official
Steven M. Mullet, Mayor
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206.431.3670 • Fax: 206 - 431 -3665
December 8, 2003
Candace Gallagher
2800 Thorndyke Avenue West
Seattle, Wa 98199
Dear Permit Holder:
Sincerely,
• _........,.. 40,
Stefani
Permit Technician
City of Tukwila
RE: Permit Application No. M03 -125
14060 Interurban Avenue South
Based on the above, you are hereby advised to:
Thank you for your cooperation in this matter.
Xc: Permit File No. M03 -125
Bob Benedicto, Building Official
Steven M. Mullet, Mayor
Department of Community Development Steve Lancaster, Director
In reviewing our current records the above noted permit has not received a final inspection by the City of Tukwila
Building Division. Per the Uniform Building Code and/or Uniform Mechanical Code, every permit issued by the
Building Official 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.
• Call the City Of Tukwila Permit Center at (206) 431 -3670 to arrange 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 a one -time
extension up to 180 days. Extension requests must be in writing 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 or request and receive an extension prior to January 28,
2004, your permit will become null and void and any further work on the project will require a new permit and
associated fees.
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
•
•
F625 ;.S . ,; 'ry
State of Washington
B ounty of Snohomish
I certify that this is a true and correct copy of said document as of this date
Date: m 3, Q.200
Title
My Appointment Expires on JO/q /O3
DEPARTMENT OF LABOR AND INDUSTRIES
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL
REGIST #.1,:_. 'EXP. DATE
CCO1 WASHIES990CW 02/16/2005
EFFECTIVE DATE 02/16/2001
W?iSHINGTON ENERGY SERVICES CO
2800 THORNDYKE AVE W
SEATTLE WA 98199 -2997
Detach And Diplay Certificate