HomeMy WebLinkAboutPermit M03-142 - WILBUR ELLISWI LBUR-ELLIS
1630Q CHRISTENSEN
ROAD
M03 -142
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 2523049078
Address: 16300 CHRISTENSEN RD TUKW
Suite No:
Tenant:
Name: WILBUR -ELLIS
Address: 16300 CHRISTENSEN RD, TUKW ILA WA
Owner:
Name: MCELROY GEORGE & ASSOC INC
Address: 3131 S VAUGHN WAY STE 301, AURORA CO
Contact Person:
Name: SHAUN CLANCY
Address: 2791 152 AV NE, REDMOND WA
Contractor:
Name: ELECTROMATIC SALES /SERVICE INC.
Address: 800 MERCER STREET, SEATTLE, WA
Contractor License No: ELECTI`233NE
DESCRIPTION OF WORK:
RELOCATING 7 CEILING DIFFUSERS
MECHANICAL PERMIT
$3,000.00 Fees Collected:
Type of Fire Protection: Uniform Mechnical Code Edition:
Value of Construction:
Permit Center Authorized Signature:
Signature: . ,(1.?/j2 /7 � /,/-
Print Name: c J Pfe l kAceJ \E.(
doc: Mech
M03 -142
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Permit Number: M03 -142
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Issue Date: 09/15/2003
Permit Expires On: 03/13/2004 6 0
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Phone: 206 624 -3370 Z 0
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Phone: 206 624 -3370
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Expiration Date: 08/23/2004 U
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$46.50
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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.
Date: %' "LS c m
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 construcJ)on or the performance of work. I am authorized to sign and obtain this mechanical permit.
Date: ��J "
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: 09 -15 -2003
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 2523049078
Address: 16300 CHRISTENSEN RD TUKW
Suite No:
Tenant: WILBUR -ELLIS
PERMIT CONDITIONS
Permit Number: M03 -142
Status: ISSUED
Applied Date: 09/02/2003
Issue Date: 09/15/2003
1: ** *BUILDING DEPARTMENT CONDITIONS * **
2: No changes will be made to the plans unless approved by the Engineer and the Tukwila Building Division.
3: Electrical permits shall be obtained through the Washington State Division of Labor and Industries and all electrical
work will be inspected by that agency (206- 835 - 1111).
4: 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.
5: 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).
6: 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.
7: Manufacturers installation instructions required on site for the building inspectors review.
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: ( /, lei 7;LL1:ZL1
Print Name: 3 01
doc: Conditions
M03 -142
Date: 15 `03
Printed: 09 -15 -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**
Site Address:
Tenant Name:
Property Owners Name:
Mailing Address:
Name:
Mailing Address:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Contact Person:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Vpplicationi\pennit application (3.2003)
3/2003
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.ENGIN ER O :RECORD:. -.A plans p y" g
E F, 11' must be ed b En ineer:of Record
•
Page 1
King Co Assessor's Tax No.: 2.-'4-2 rc7d''
Suite Number:
City
New Tenant: (] .... Yes E ..No
State
;CONTACT.TERS
Day Telephone: 'Z ? (0 - (0 2- - 3570
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City
Fax Number:
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S Zip
City
Day Telephone:
Fax Number:
State
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 Ati`plans' m ust be wet stamped by Architect of Recari
Company Name:
Mailing Address:
State
Floor:
Zip
Zip
Zip
City
Day Telephone:
Fax Number:
City State Zip
Day Telephone:
Fax Number:
BUILDING PERMIT INFORMA""')N 206.-431 -367
• :
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.
rovide All Building Areas in Square Footage Below _.
I" Floor
2n°,Floor
3 Floor
Floors ' •
Basement
Accessory Structure*
Attached Garage •.;
Detached Garage
Attached Carport
Detached Carport;
Covered Deck.
Uncovered Deck
°Interior:,
Remodel
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:
❑.. Sprinklers El-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.
tappliutionsy+trtnit application (3.2003)
3/2003
Page 2
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.•P.UBLIC WORI PERMIT INF TION:_ `206.433 =0179
Scope of Work (please provide detailed information):
• - .Please refer.tO Public' ;Works , Bulletin. #t,for.lees and estimate sheet.
Water District
❑ ...Tukwila 0... 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 less than 72 hours
❑ ...Right -of -way Use - No Disturbance
❑ ... Construction /Excavation/Fill - Right -of -way
Non Right -of -way
❑ ...Total Cut
❑ ...Total Fill
cubic yards
cubic yards
❑...Sanitary Side Sewer
p ...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
lapptiutioni\permit application ().2003)
312003
„
„
❑ .. Abandon Septic Tank
❑ .. Curb Cut
❑ .. Pavement Cut
❑ .. Looped Fire Line
„
Call before you Dig: 1-800-424-5555
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
Page 3
❑ ...Renton
❑ .. Grease Interceptor
❑ .. Channelization
❑ .. Trench Excavation
❑ .. Utility Undergrounding
❑ ...Deduct Water Meter Size "
FINANCE INFORMATION
Fire Line Size at Property Line
❑ ... Water 0... 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
Type:
Qty
Boiler /Compressor:
Qty
Furnace <100K BTU
Air Handling Unit
>= 10,000 CFM
Other Mechanical
Equipment
0 -3 HP /100,000 BTU
Fumace>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 CONTRACTOR INFORMATION
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Company Name:
Mailing Address:
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Contact Person: 3 1 r\e-vr1
E -Mail Address:
Use: Residential: New ....0
Commercial: New ....D
Valuation of Project (contractor's bid price): $
Signature: c, ,Lte a/
ens Acck r
Mailing Address: 2 7 7 71 l/ 7 A ALC
Print Name:
Vppliutionaipermit application (3.2003)
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Contractor Registration Number: ELE E LT\ 2 3 Li
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City
Day Telephone:
Fax Number:
Expiration Date:
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State Zip
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* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
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Scope of Work (please provide detailed information): 10Cctk■Of\ O ' C e e tV(N3
Replacement ....
Replacement ...,.
Fuel Type: Electric jJ Gas....D Other:
Indicate type of mechanical work being installed and the quantity below:
' PERMIT = APPLICATION' NOTES = . Applicable : to all permits in this
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 OWNER R AUTHORIZED NT / zsi
City
Pa e /
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Date: - 2 - w
Day Tel hone: ZO' CDL'' 53'70
410 c Lt A90.2
State Zip
Date Application Accepted:
I Date Application Expires:
Staff Initial
i
TRANSACTION LIST:
ACCOUNT ITEM LIST:
doc: Receipt
City of Tukwila
Description
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
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RECEIPT 1
Parcel No.: 2523049078 Permit Number: M03 -142 _i B
Address: 16300 CHRISTENSEN RD TUKW Status: APPROVED U O
Suite No: Applied Date: 09/02/2003 co w
Applicant: WILBUR -ELLIS Issue Date: LLI H :
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Receipt No.: R03 -01123 Payment Amount: 46.50 g a
Initials: SKS ' Payment Date: 09/15/2003 09:38 AM = d
User ID: 1165 Balance: $0.00 w
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Payee: ELECTROMATIC SALES & SERVICE, INC v o
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Type Method Description Amount H U
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Payment Check 66139 46.50 z'
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MECHANICAL - NONRES
PLAN CHECK - NONRES
Account Code Current Pmts
000/322.100 37.20
000/345.830 9.30
Total: 46.50
2694 09/16 9710 TOTAL 46.50
Printed: 09 -15 -2003
INSPECTION NO. ....
:CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd.; #100, Tukwila, WA 98188
Approved per appl cable codes.
Retain a copy with permit EIMII
INSPECTION RECORD
PERMIT
(206)431 -3670
Pro'ect:
AA
Address
:. L'.c r � J -) C-feores
Special Instructions:
Type of Ins ction:
hn
Dat ailed:
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Date Wanted:
Reque ter: - - -
..G> -Cl aft
Phone No:
20 ca — J / O — .577
Corrections required prior to approval.
$47.00 REINSPECT! FEE REQUIRED. Prior to inspection, fee must be
: Paid :att300 -nter Blvd., Suite 100. Cali to schedule reinspection.
1
ACTIVITY NUMBER: M03 -142
PROJECT NAME: WILBUR -ELLIS
SITE ADDRESS: 16300 CHRISTENSEN RD
DATE: 09 -02 -03
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # Revision # after permit Is Issued
DEPARTMENTS:
Building b'vision
Public Works
PERMIT COORD COP
PLAN REVIEW /ROUTING SLIP
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Fire��revention l � Planning Division
Structural ❑ Permit Coordinator
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DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 09 -04 -03
Complete [r Incomplete ❑
Comments:
Not Applicable ❑
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS R9UTING:
Please Route Structural Review Required ❑ No further Review Required ❑
REVIEWER'S INITIALS: DATE:
DUE DATE: 10 -02 -03
Approved ❑ Approved with Conditions [►( Not Approved (attach comments) ❑
Notation:
APPROVALS OR CORRECTIONS:
REVIEWER'S INITIALS:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
Documents /routing slIp.doc
2-28.02
PERMIT COORD COPY
REGISTERED AS PROVIDED BY LAW AS
CONST CONT. GENERAL..
# - EXP. DATE;
CCOr
EFFECTIVE DATE 08/05/1977
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• .- •
ELECTROMATIC SALES/SERVICE INC
2791 152ND AVE NE
REDMOND WA 98052
Signacure
Issued by DEPARTIM NT OF LABOR AND INDUSTRIES
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My Commissiori E
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This is an unaltdapro& 4 original certificate
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MANUAL. AIR
VOLUME DAMPER
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TYPICAL CEILING DIFFUSER INSTALL
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CITY OF TUKWILA
BUILDING DIVISION
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FILE. COPY
understand that the Plan Check approvals are
suPe';', to errors and omissions and approval of
plans does not authcnze the violation of any
adcpted code or ordnance. Recespt of con-
tractor's copy of approved plans acknowledged.
PDByeatrme7:11 7 /Z7
RECEIVED
CITY OF TUKWILA
SEP 0 2 2
PERMIT CENTER
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