HomeMy WebLinkAboutPermit M96-0147 - SHAWLEY MD11() 11:1
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City of Tukwila (206) 431 -3670
Community Development / Public Works • 6300 Southcenter Boulevard, Suite 100 • Tukwila, Washington 98188
Permit No: M96 -0147
Type: B -MECH
Category: RES
Address: 15811 53 AV S
Location:
Parcel #: 115720 -0070
Contractor License No: GLENDHA053Q2
MECHANICAL PERMIT
Status: ISSUED
Issued: 11/07/1996
Expires: 05/06/1997
TENANT SHAWLEY M D
15811 53 AV S, TUKWILA WA 98188
OWNER SHAWLEY M D
15811 53 AV 5, TUKWILA WA 98188
CONTACT SHAWLEY Phone: 206 242 -533
15811 53 AV S, TUKWILA WA 98188
CONTRACTOR GLENDALE HEATING & A/C Phone: 206 243 -7701
12462 DES MOINES WAY SOUTH, SEATTLE, WA 981682266
* * * * ** ** * * * * ** * * * * *, rat********************** * * * * ** * ** ** * * ** * * ** * * * * * * * * * *,
Permit Description:
CHANGE OUT - OIL FURNACE TO GAS. INSTALL GAS HOT
WATER TANK.
UMC•Edition: 1994 Valuation: 2,965.00
Total Permit Fee: 54.69
** * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ,
..6&t5
Permit Cente Authorized Signature Date
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 nc
The granting of this permit does not presume to give authority to violatc
or cancel the provisions of any other state or local laws regulating
construction or the performance • work. I am authorized to sign for an
obtain this b ldin perms
7 �v� Date:
Title;
11 % .
This permit shall become null and void if the work is not commenced with
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.
AV
Nis
CITY OF TUKWILA
Permit M96 -0]47.
Address: 1 .5
Suite:
Tenant: SHAWLEY M.D.
Type: B -MECH
Parcel #: 1157201 -0070
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Permit Condition:.:
1. No changes will be made to the plans unless approved by the
Architect or Engineer and the :Tukwila . :Building Division.
2. All ` permits, inspection records, . appr oved plans shall be
available at the job — site' prior to the start of any con -
struction. These .documents ''are to be maintained and avail-
able until 'final inspection approval is granted.
3. All construction to be done in conformance with approved
plans . and regii i rernents ;� of the ,Uniform Bu i l d i ng.slCode ' (1994
Edition) 'a amended,' Uniform 'Mechanical ' : Code ` (1994 Edition) ,
and Wash' State Energy Code. (1994 Edition).
4. .Validity - Permit. •:'The issuance .of a permit, or' approval;' ".of
pian5.. speciticati;ons, and computations shall not be con-:
strued, :to' ' be a permit for, or an approval of any violation;;`
of any' of the p r o v i s i o n s of t h e - b u i l d i n g code or of any
other or d i nance of the i ur i sd,i ct i on. No permit presuming t.'
give: autho,rity to violate or cancel "the provisions of this
codeshall be valid.
5. MANUFACTURERS IN'S.TALLAT ION INSTRUCTIONS REWIRED ON SITE
FOR THE, B L4ILDING INSPE CTORS,�RE'VIEW.'
6. Ele perinits . shai i 'be •.obtained thr.ou9h the Washington
Division of , ` a Industr ies and all electrical'+
work wi 11 ` be �`inspe,cte''d rb .tha't'�•'agency (,24'3 -6630)
7. P kiinb•ing pet ~in`i,ts sh {1' "be`' obtal.n : ed f through the
Cod 0y D•eOar�tment of Public Healt ' P1umbing.will ., be,
inspected , 6i tf at agency, i nc l ud i ng :a1 1 • :.gas piping '
e 9
(296 - 4722 ) ..
Status: ISSUED
Applied: 10/30/1996
Issued: 11/07/1996
Project me nant ,��
, �
Descrip ion of work to be done: --r
:. C &- 00 ' – ® c L /o t2 o L C' /or 4 S' r ,4 N S r/?--C L - 14 AIL) . IA N 1
Value t _ —Eli
Site Address* e
5
/ , City State/Zip:
•.aIcai C4 81'8
Tax Parcel Nuumber:
I/S 2.0 –0 D
Property Owner:
V .. ID , 5 �;� `/
Phone:
Phone:
�G� -- -S '3 3 ,6z.
Fax #:
Street Address: ✓
�• �-5� S�����t�
Cit Sate /Zi
Contact Person:
5 2 1
City /State /Zip:
Phone:
Street Address:
City State2ip:
Fax #:
Contrac Qr:
i
C N
Phone:
6.14 3 - 7 7co a
Street Address:
City State2ip:
Fax #:
Architect:
Phone:
Street Address:
City State /Zip:
Fax #:
Engineer:
Phone:
Street Address:
City State /Zip:
Fax #:
MISCELLANEOUS PERMIT REVIEW'AND;APPROVAL REQUESTED: (T'O BE FILLED OUT BY. APPLICANT)
Descrip ion of work to be done: --r
:. C &- 00 ' – ® c L /o t2 o L C' /or 4 S' r ,4 N S r/?--C L - 14 AIL) . IA N 1
Will there be storage of flammable /combustible hazardous material in the building? ❑ yes ❑ no
of materials and stoagre location on so•arate 8 1/2 X 11 •a•orindlcatln •uantitles & Material Safet Data Sheets
in list
L_1 Above Ground Tanks U Antennas /Satellite Dishes ■ Bulkhead/Docks ■ Commercial Reroof
❑ Demolition ❑ Fence ❑ Mechanical ❑ Manufactured Housing - Replacement only
❑ Parking Lots ❑ Retaining Walls ❑ Temporary Pedestrian Protection /Exit Systems
❑ Temporary Facilities ❑ Tree Cutting
MONTHLY SERVICE BILLINGS TO:.
"
Name:
Phone:
Address:
City /State /Zip:
0 Water
0 Sewer
0 Metro
0 Standby
CITY OFt "'VKWILA
Permit Center
6300 Southcenter Boulevard, Suite 100
Tukwila, WA 98188
(206) 431 -3670
Miscellaneous Permit Application
Application and plans must be complete in order to be accepted for plan review.
Applications will not be accepted through the mall or facsimile.
' APPLICANT 'REQUEST.FORMISCELLANEOUS PUBLIC•WORKS PERMITS'`':
❑ Channelization/Striping
❑ Flood Control Zone
❑ Landscape Irrigation
❑ Storm Drainage
❑ Water Meter /Exempt #
❑ Water Meter /Permanent #
❑ Water Meter Temp #
❑ Miscellaneous
❑ Curb cut/Access /Sidewalk ❑ Fire Loop /Hydrant (main to vault) #: Size(s):
❑ Land Altering: 0 Cut cubic yards 0 Fill cubic yards 0 sq. ft.grading/clearing
❑ Sanitary Side Sewer #: ❑ Sewer Main Extension 0 Prid'ublic
• Street Use
❑ Water Main Extension 0 Private 0 Public CITY OF TUKWILA
0 Deduct
Size(s):
Size(s):
Sizes : Est. quantity:
all Moving Oversized Load/Hauling
0 Water OnQ C T (' 9
gal Schedule PCR MIT CENTER
WATER METER DEPOSIT /REFUND.BiLLING: •
Name:
Phone:
Address:
City /State/Zip:
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.
Date application accepted:
Per C , Iart &
MISCPMT.DOC 7/11/96
Date application expires:
A Pg.( W, 10%1/
Application taken by: (initials)
BUILDING 0
T (7e.
I
NT:
Antennas /Satellite Dishes : `
Signature:
�
Awnings /Canopies - No signage .
"..
/
Date:
Print name: ,49;
TG ok
Commercial Reroof
4, c
/ / ��
/ E
A____
Pho 7
El
Fax #:
3 _ ( 61
Address: ! v4/ 6 Z . 6
., /' /d /
5 ,r C/g DAL,
4)
City /State /Zip: A ` a7.0_ 9 r/ ir
ri
SUBMIT APPLICATION AND REQUIRED CHECKLISTS FOR
Above Ground Tanks/Water. Tanks - Supported directly upon grade
exceeding 5,000 gallons and a ratio of height to diameter or width .
which exceeds 2:1;
PERMIT REVIEW
Submit checklist No M -9 .:
®
Antennas /Satellite Dishes : `
Submit checklist No . M-1
El
Awnings /Canopies - No signage .
"..
Commercial Tenant. Improvement
'Permit •-
0
Bulkhead/Dock ..
Submit checklist No M.10
El
Commercial Reroof
"Submit checklist • No: .M-6*
0
Demolition:
Submit checklist No; M3, M= 3a:":"
El
Fences - Over 6 feet in Height
Submit checklist No: M -9
El
Land Altering/Grading/Preloads..
Submit checklist No: M -2
E
Loading Docks
,Commercial Tenant Improvement
Permit.. SubmitchecklistNo: H -17
CI
Mechanical' (Residential & Commercial)
Submit checklist : No M -8,
Residential only - H -6, H -16
El
Miscellaneous ' , Public ; WorksPermits
Submit checklist No H-9
E
Manufactured Housing (RED INSIGNIA ONLY).
Submit checklist No: M-5
0
Moving.Oversized:Load/Hauling
Submit checklist No: M -5'.
El
Parking Lots
Submit checklist No: M -4.
0
Residential Reroof - Exempt with following exception; If roof structure
to be. repaired "or replaced
Residential Building Permit
Submit checklist No: M -6
Retaining Walls - Over 4 feet in height
Submit checklist . No:. M -1
Ell
Temporary Facilities ..
Submit checklist , No: M -7
0
Temporary Pedestrian' Protection/ExitSystems `::
Submit checklist No M -4
0
Tree Cutting
Submit checklist No: M -2
ALL MISCELLANEOUS PE? T APPLICATIONS MUST BE SUB
ED WITH THE FOLLOWING:
➢ ALL DRAWINGS SHALL BE AT A LEGIBLE SCALE AND NEATLY DRAWN
➢ BUILDING SITE PLANS AND UTILITY PLANS ARE TO BE COMBINED
➢ ARCHITECTURAL DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED ARCHITECT
➢ STRUCTURAL CALCULATIONS AND DRAWINGS REQUIRE STAMP BY WASHINGTON
LICENSED STRUCTURAL ENGINEER
➢ CIVIL/SITE PLAN DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED CIVIL ENGINEER
(P.E.)
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, unless the homeowner will be the builder 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.
MISCPMT.DOC 7/11/96
RECEIVED
CITY OF TUKWILA
OCT 3 0 1996
PERMIT CENTER
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. OF: ,'rUKwILA. WA C (c c , 0 l �t 7 TRANSMIT
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TRANSMIT Number: R9600507 Amount„ 54.69 11/07/96 15 :52
Payment Method: CHECK Notation: OLLND LE HEATING Init: «.JP
Permit eta: M% -0147 Type: D -MECH MECHANTCAt PERMIT
Parcel No: 115720.007()
Site Address: 15911 53 AV S
This Payment 54.69
Total Fe.es: 54.69
Total ALL Pnits: 54.69
.Balance: x '00
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Account Code Description Amount
000/345.1)30 PLAN CHECK -• RES 10.94
000/322.100 MECHANICAL - RES
4751 11/12 9611 TOTAL 54.69
Project: 3 nl:W1/4),e.
Type of inspectio
O '
Address: 1
`
NI 5
Date called:
1 ..— ..
Special instructions:
Date wanted:
'' ^^ a.m.
Requester:
o , r)
Phone No.:
1 3
Approved per applicable codes. fg.Corrections required prior to approval.
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 9818
Inspector:
$42.00 REINSPECTION FEE REQUIRED. Prior to inspect on, fee must
be paid at 6300 Southcenter Blvd., Suite 100, Call to schedule reinspection.
Receipt No.:
Date:
Date: if IL q/.
MIIPCNIINTMVPMIWOM
r
- INSPECTION RECORD ftn � Retain a copy with permit
PERMIT NO.
(2�) 434 70
COMMENTS:
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