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HomeMy WebLinkAboutPermit M02-043 - ARTHUR RESIDENCEMO2 -043 Arthur Residence 1644453P1S Value of Construction: Type of Fire Protection: doc: Mech City of Tukwila Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 Parcel No.: 7796400120 Address: 16444 53 PL S TUKW Suite No: Tenant: Name: ARTHUR RESIDENCE Address: 16444 53RD PL S, TUKWILA, WA Owner: Name: MATHEU VICTOR & BONNIE Phone: 206 - 824 -2284 Address: 16444 53 PL S, TUKWILA WA Contact Person: Name: PA fniE c) 14111 Address: y,, Contractor: Name: FAST WATER HEATER CO Address: 12601 132ND AVE NE, KIRKLAND WA Contractor License No: FASTWHCO52DF DESCRIPTION OF WORK: REMOVE AND REPLACE GAS WATER HEATER. LIKE FOR LIKE Permit Center Authorized Signature: $449.00 N/A Signature: (//r - MECHANICAL PERMIT Print Name: � ^'t n . � - ,r, f 4 Permit Number: MO2 -043 Issue Date: 03/04/2002 Permit Expires On: 08/31/2002 Phone: 425 1314 -3S2q !c 1 311 Phone: 'Sat. 4 boast. Expiration Date: 02/16/2003 Fees Collected: Uniform Mechnical Code Edition: Date: $34.15 1997 I hereby certify that I have read and examined this permit and know the same to be true and correct. All provisions of law and ordinances governing this work will be complied with, whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws regulating construction or the performance of work. I am authorized to sign and obtain this mechanical permit. 3 -q - z This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection. Date: 3 — �'- MO2 -043 Printed: 03 -04 -2002 Project Name/Tenant: Arthur Residence ValuFgf Alrcttanical Equipment: L}9y UU Site Address : uy State/Zip: 16444 53rd P1 S Tukwila WA 9818$ c '�� Pro ay Owner: H� Jim Arthur Date:-2 P h8e 6 -27 -7892 Street Address: same Tukwila WA 98188 City State/Zip: Fax It: ( ) Contractor: Fast Water Heater P(� 425 -8 -3124 Street Address: 126 132 ave NE Kirkland WA t t tp: 99�� Fax N: ) 4 - 814 -3124 Contact Person: Pamela Hill Phone: ( ) X133 Street Address: City State/Zip: Fax 11: ( ) BUILDING OWNER OR AUTHORIh D AGENT: Signature: Y l/�,, �� �%✓ /} / ✓— ms's l l rJ,r Date:-2 22 0.2 ,71// l Print name: Pamela C Hill Phone ( ) Fax N: ( 425 -814 -3124 ) AT 601 132 Ave NE ci`y /sKirkland WA 98034 CITY OF TUKWIL Th Permit Center 6300 Southcenter Boulevard, Suite 100 Tukwila, WA 98188 (206) 431 -3670 IOR SIAF( US( ON Project Number. Permit Number. 1 /11 9'5 Mechanical Permit Application Application and plans must be complete in order to be accepted for plan review. Applications will not be accepted through the mail or facsimile. MECHANICAL PERMIT REVIEW AND APPROVAL REQUESTED: (TO BE FILLED OUT BY APPLICANT) Description of work to be done (please be specific): Remove /replace gas water heater Current copy of Washington State Department of Labor and Industries Valid Contractor's License. If not available at the time of application, a copy of this license will be required before the permit is issued OR submit Form H-4, "Affidavit in Lieu of Contractor Registration ". Building Owner /Authorized Agent: If the applicant is other than the owner, registered architect/engineer, or contractor licensed by the State of Washington, a notarized letter from the property owner authorizing the agent to submit this permit application and obtain the permit will be required as part of this submittal. 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. 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 114.4 of the Uniform Mechanical Code (current edition). No application shall be extended more than once. Date application accepted: 3 . 4 •1 Date application expires: Applicat�� y: (initials) 1. 1 1/215 5 t 1 , 1-0 Z I— LL! v O 0 1- W LJ U u O z . w 0 O Z Signature: doc: Conditions City of Tukwila Parcel No.: 7796400120 Address: 16444 53 PL S TUKW Suite No: Tenant: ARTHUR RESIDENCE PERMIT CONDITIONS MO2 -043 Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 Permit Number: MO2 -043 Status: ISSUED Applied Date: 03/04/2002 Issue Date: 03/04/2002 1: ** *BUILDING DEPARTMENT * ** 2: No changes will be made to the plans unless approved by the Engineer and the Tukwila Building Division. 3: Plumbing permits shall be obtained through the Seattle -King County Department of Public Health. Plumbing will be inspected by that agency, including all gas piping (296- 4722). 4: Electrical permits shall be obtained through the Washington State Division of Labor and Industries and all electrical work will be inspected by that agency (248- 6630). 5: 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. 6: Readily accessible access to roof mounted equipment is required. 7: Any exposed insulations backing material shall have a Flame Spread Rating of 25 or less, and material shall bear identi- fication showing the fire performance rating thereof. 8: 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). 9: Validity of Permit. The issuance of a permit or approval of plans, specifications, and computations shall not be con- strued 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. 10: Manufacturers installation instructions required on site for the building inspectors review. 11: Ventilation is required for all new rooms and spaces of new or existing buildings in conformance with the Uniform Building Code and the Washington State Ventilation and Indoor Quality Code, Chapter 51 -13 WAC. 12: Fuel burning appliances may not be installed in sleeping rooms, U.M.C. 304.5. 13: Appliances which generate flame, spark or glowing ignition, shall be elevated 18 inches above the floor (U.M.C. 303.1.3.). 14: Water heater shall be anchored to resist earthquake (U.P.C. 510.5). 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. Date: 3- Printed: 03 -04 -2002 0 co co W Nu. W 2 g Q N d F. uj D p co 0 0 I- w w F Z - V L I O ll • Z V N O TRANSACTION LIST: ACCOUNT ITEM LIST: doc: Receipt City of Tukwila 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670 Parcel No.: 7796400120 Permit Number: MO2 -043 Address: 16444 53 PL S TUKW Status: PENDING Suite No: Applied Date: 03/04/2002 Applicant: ARTHUR RESIDENCE Issue Date: Receipt No.: R020000301 Payment Amount: 34.15 Initials: SKS Payment Date: 03/04/2002 11:57 AM User ID: 1165 Balance: $0.00 Payee: FAST WATER HEATER COMPANY Payment Check 014461 34.15 Current Pmts Amount MECHANICAL - RES RECEIPT Type Method Description Description Account Code 000/322.100 34.15 Total: 34.15 45.43 03/07 9716 TOTAL 34.1.5 Printed: 03 -04 -2002 Proy • /`l /�/�i� ?/ 2 ,� Type of Inspection: /- / A/.9 / c es y4/9 .5. ?i,... 5 Date cal l- a - 02- Special instructions: Date wanted: / 0 - 0 2....- a.m. p.m. Requester:,.. 'z// f11 Phone: aZ b 6 - -.-277 - 78 2.- r • ' 4in; ,.CaiaS.ii!.,a•:- :yl:u?:yi.,',r _�•;; .;;:;; INSPECTION RECORD Retain a copy with permit INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd, #100, Tukwila, WA 98188 , .. 02^ 0 Y3 PERMIT NO. (206)431 -3670 Approved per applicable codes. 0 Corrections required prior to approval. COMMENTS: )2 /,;f r&-/Ip ���(� (')4 ector: x 7.00 REINSPECTION FE REQUIRED. rior to inspection, fee must be paid . at 6300 Southcenter Blvd., uite 100. all to schedule reinspection. Receipt No: Date: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I LTR I TYPE OF INSURANCE POLICY NUMBER DATE MM /DD/YY) DATE �MM /DD/ LIMITS INSURER A. PACIFIC EMPLOYERS INSURANCE CO. A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY I-IDOG 20580252 02/16/2002 02/16/2003 EACH OCCURRENCE 5 1,000,000 X FIRE DAMAGE (Any one fire) $ 50,000 1 CLAIMS MADE X OCCUR MED EXP (Any one person) 5 5,000 PERSONAL 8 ADV INJURY 5 1,000,000 GENERAL AGGREGATE $ 2,000.000 GEN'L 1 AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG 5 2,000,000 POLICY Flea n LOC A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ISA 1- 107684460 02/16/2002 02/16/2003 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ' BODILY INJURY (Per person) $ XXXXXXX X BODILY INJURY (Per accident) $ XXXXXXX X PROPERTY DAMAGE (Per accident) $ XXXXXXX GARAGE LIABILITY ANY AUTO NOT APPLICABLE AUTO ONLY - EA ACCIDENT 5 XXXXXXX OTHER THAN EA ACC 5 XXXXXXX AUTO ONLY: AGG 5 XXXXXXX 13 EXCESS LIABILITY OCCUR rXl CLAIMS MADE UMBRELLA DEDUCTIBLE FORM X 1024A 1 A02 02/16/2002 02/16/2003 EACH OCCURRENCE $ 5,000.000 AGGREGATE $ 5,000,000 $ XXXXXXX 5 XXXXXXX RETENTION 5 5 XXXXXXX A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WLRC 43111814 (AOS) SCFC 43126611 (MA) 02/16/2002 02/16/2003 X TORY LIMITS ERH E.L. EACH ACCIDENT 5 1,000,000 E L. DISEASE - EA EMPLOYEE 5 1,000,000 E.L. DISEASE - POLICY LIMIT 5 1,000.000 OTHER DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS WORKERS' COMPENSATION COVERAGE ADDED FOR CALIFORNIA OPERATIONS EFFECTIVE 7/20/00. ACORD CERTIFICAT c OF LIABILITY INSURANCE ,M 02/ I G/2003 � DATE DD/YY( 02/ 2 /13/ 13/2002 PRODUCER LOCKTON COMPANIES 444 W. 47TH STREET, SUITE 900 (816) 960 -9000 KANSAS CITY MO 64112 -1906 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED FAST WATER HEATER COMPANY 1001299 A BLUE DOT SERVICES COMPANY 12601 132ND AVE., N. E. KIRKLAND WA 98034 I INSURER A. PACIFIC EMPLOYERS INSURANCE CO. INSURER B' AEGIS ' INSURER C INSURER D : INSURER E : COVERAGES CERTIFICATE HOLDER ACORD 25 -S (7/97) YA ADDITIONAL INSURED; INSURER LETTER: _ CANCELLATION 981471 EVIDENCE OF INSURANCE [1[1[1[1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE © ACORD CORPORATION 1988