HomeMy WebLinkAboutPermit M96-0183 - KACZMARSKI VERNONtt1/4kmRh I, \Jf4O4
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Macs -oil,
City of Tukwila i
Community Development / Public Works • 6300 Southcenter Boulevard, Suite 100 • Tukwila, Washington 98188
Permit No: M96 -0183
Type: B -MECH
Category: RES
Address: 15240 40 AV S
Location:
Parcel #: 004300 -0227
Contractor License No: NORTHWH103R2
TENANT KACZMARSKI VERNON .
15240 40 AV S, TUKWILA, WA 98188
OWNER BARNETT RALPH E
15240 40TH S, SEATTLE WA. 98188
CONTRACTOR NORTHWEST WATER HEATER, INC: Phone: 206 282 -4700
2800 THORNDYKE AVENUE "WEST, SEATTLE ,:_WA98199
CONTACT LYNH ROWE . • Phone: 206 241 -0256
2800 THORNDYKE,:SEATTL "E WA 98199
******************************************** ** ** * * * * * * ** * ** * * * ** * * * * * * * * * **
Permit Description:
OIL TO.GAS FURNACE REPLACEMENT
UMC Editi.an'i' 1994
***************************************** * * * * * * * * * * * * * * * * * * * * * ** * * * * * * **
Permit Center Authorized Signature Date
I herebycer.tify that I have read. and examined' this permit and know the
same to b.e true. and correct. All provisions of law and ordinances,
governin this work will be complied with,'whether specified herein or not.
The granting of. this permit does no .presume to give authority t,o;violate
or cancel: the provisions of a othe" - ate or local laws regulating
construct:i on or the perfor t - ce o o. k. lam authorized to sign for and
obtain this..;building per
Signature:
MECHANICAL PERMIT
Valuation:
Total Permit Fee:
Status: ISSUED
Issued: 01/09/1997
Expires: 07/08/1997
(206) 431-3670
2,042.00
42.81
Print Name: Title:
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"l "ast inspection.
Address: 15240 40 AV S
Suite:
Tenant: KACZMARSKI VERNON
Type : B -MECH
Parcel #: 004300 -0227
CITY OF TUKWILA
Permit No: M96 -0183
•
Status: ISSUED
Applied: 12/24/1996
Issued: 01/09/1997
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Permit Conditions:
1. No changes will be made to the plans unless approved by the
Architect or Engineer and the Tukwila Building Division.
All permits, inspection'records, aria approved plans shall be
available at the 3 site prior to the "st'art ; any con-
struction. These ��doc are to. `be maintained and avail-
able until final inspection approval is granted.
3. All construction to be 'done in conformance with approved
plans plans and:. requirements: of the form Building Code ` (1994
Edition); amended,' Uniform Mechanic al'. Code (1994 ; Edition),
and Washington State Energy Code' (1994 Edition).
4. Validity,of Permit. .` The issuance of a permit, or approval of
plans; 4pecifications, and;'computations shall not be con-
strued, ued to ,be a permit for, or an approval of, any v i o l a t i o n
of any of` :the p r o v i s i o n s of the building code or of any
other ordinance of the. jurisdiction.: No permit presuming to
ty' to violate or-cancel . the provisions of this
code, shall`be valid.
5. MANUFACTURERS' INSTALLATION 'INSTRUCTIONS - REQUIRED ON SITE
FORTHE " . BUILD,INGs INSPECTORS } REVIE4!
6. Plu,mbing,per mits shall' be'obtained `through the Seattle King
County : De partment °.of Pub l;i c iHea l th .. Plumping will pe
Inspected `` t �i . ncl ud i`ng' ,all,,. gas piping
(.29,6' - 4722) `± s
7 E l ectr i ca_l f permi is shall be obta i ned' through the Washington,
Stat ;of Labor and Industries "t and .,ail electrical
work�;;w,;i i l_ be;''inspected b_y. that agency` (2'4,8 -6630)
Project Name/Tenant:
Description of work to be done: 6
.... /4/1,A
(E ` � /A C �
Value of Construe ' n
Site Address:
-
"^"(
City tate /Zip:
_ . J .4 A,
Tax Parcel Numb =r.
• I / A �.
Property Owner:
(..-� / ,�/
U �r -�1 V AA KI C' -� l A
k / C M /Q
/ .
Phone: , 4/— pr- �CJ
Street Address:
• l 1 ._
City State/ i.:
.Ii III Lk : li
Fax #:
Contact Person:
L t //1114 i Or
0 Metro
Street Address: �s _ 77/(Le 7) / (e
/
/ / Cit tat i
4
Contractor: / i `� // X / �
J
Street Address:
r
6 / ..--, 4#
City tale/Zi•
.% I of
Architect:
Phone:
Street Address:
City State /Zip:
Fax #:
Engineer:
Phone:
Street Address:
City State /Zip:
Fax #:
MISCELLANEOUS PERMIT REVIEW AND APPROVAL. REQUESTED: ' (TO "BE FILLED OUT BY APPLICANT)
Description of work to be done: 6
.... /4/1,A
(E ` � /A C �
Will there be storage of flammable /combustible hazardous material in the building? ❑ yes ❑ no
Attach list of materials and storage location on se 'mete 8 1/2 X 11 •a •uantities & Material Safet Data Sheets
■ Above Ground Tanks ■ 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:
Date application expires: S Q q _ ^_ l
Appllcatlan��• (initials)
Name: ,_.._......
- -_ ,— ...... 4„„,„, .
maim i 41 efiaig
Phone:
Address:
a _....,
Iv
City /State /Zip:
0 Water
0 Sewer
0 Metro
0 Standby
Date application accepted: I _ a q – q c0
Date application expires: S Q q _ ^_ l
Appllcatlan��• (initials)
Miscellaneous Permit Application
APPLICANT REQUEST FOR MISCELLANEOUS 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 Private 0 Public
❑ Street Use ❑ Water Main Extension 0 Private 0 Public
Size(s): 0 Deduct 0 Water Only
Size(s):
Size(s): Est. quantity: gal Schedule:
❑ Moving Oversized Load/Hauling
WATER METER DEPOSIT /REFUND BILLING:
Name:
Address:
CITY OF T''KWij. EI TUKWIIA
Permit Center
6300SouthcenterBoulevard; tlitte t0tt ire
Tukwila, WA 98188
(206) 431 -3670
Application and plans must be complete in order to be accepted for plan review.
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.
MISCPMT.DOC 7/11/96
Applications will not be accepted through the mail or facsimile.
PERMIT CENTER
F•' STAFF USE ONLY
Project Number:
Permit Number: 1 (fi I < CI3
Phone:
City /State /Zip:
BUILDING OWNER OR AUTHORIZE
ENT:11 „. 'S 1
PERMIT REVIEW
Submit checklist No: M -9
0
Signature: L., =
' .
Date:
77‘-
Print name:
(,
2
7 `
Commercial Reroof :
Phone:
Ei
I Fax #:
Address:
ri
Fences - Over 6 feet in Height
Submit checklist No: M -9
0
City /State /Zip:
Submit checklist No: M -2
El
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
0
Antennas /Satellite Dishes.
Submit checklist No:. M -1
EI
Awnings /Canopies- No.signage =
Commercial`TenantImprovement
Perm
El
Bulkhead/Dock
Submit checklist ,: No M -10
El
Commercial Reroof :
Submit•checklist No: M -6. .
Ei
Demolition,
Submit checklist,. No: M -3; •"M -3a
ri
Fences - Over 6 feet in Height
Submit checklist No: M -9
0
Land Altering/Grading/Preloads
Submit checklist No: M -2
El
Loading Docks
Commercial Tenant Improvement
Permit.. Submit checklist No: H-17
0
Mechanical (Residential & Commercial)
Submit checklist No M -8,°
Residential only - H -6, H -16
Miscellaneous Public Works Permits
Submit checklist . No H -9.
Manufactured Housing (RED INSIGNIA ONLY):
Submit checklist No: M -5
0
Moving Oversized Load/Hauling
Submit checklist No: M -5”
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
El
Temporary Facilities
Submit checklist No; M -7
D
TemporaryPedestrian Protection/Exit Systems' .
Submit checklist No:. M -4
El
Tree Culling
Submit checklist No: M -2
ALL MISCELLANEOUS P ' IT 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
➢ CIVIUSITE 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
********* ***• A**** 11A** IDCPC n --nic ** i%* ** �l ****A**A***�k�r***k0 * ***.** ****
I' OF TUKl�ILA:. NA x' TR ANSMIT
**11** **A. * *4c* ** * ** *• ** l , * i; ** *•. *•A * * * * * * * * * * *M.;lliA * * **
TRANSMIT Number: 89700528 Amount: 42.81 01/09f47 13:59
Payment Method: CHECK Notation: WOE INCORPORATED Init: SLB
Permit No: M96 -0183 Type: B-MECH MECHANICAL PERMIT
Parcel No: 004300 -0227.
Site Address: 15240 40 AV S
Total Fees: 42.81
42.81 Total ALL Pmts: 42.01
Tlh i a Payment
Balance: .00 •
* * * * * * *14 *A* * * **• ** * •1t* * * * * * * ** * * * a. * * ** * * *1 ** * ** * * *# * * * **A*** * * **
Account Code
000/345.830
000/322.100
'Description
PLAN CHECK - RES.
MECHANICAL w RES
Amount
34.25
6307 01/10 96,1.7 TOTAL
COMMENTS: r._ ,,
- +�-
0/75 ,/,/,&& // rs� c?
T e of Inspe lion:
,, cr &-, CbciA -fry'
l uo u a
,L/07 ,4 e.--4':4 i Ceple_ ,4- _
Date called ('. j�� _-1 c1
Special instructions: 1:?_ :
12-' PI Y 1 E '
i no l mail
Date wanted: .....
l f 1
a.
2/
k eta 7 ,tr on 6072/
P te. em., /7 C,e1-,
/ it A /,4r4'1 C o 4e: ..e,4
P o ect:
T e of Inspe lion:
l uo u a
v s
Date called ('. j�� _-1 c1
Special instructions: 1:?_ :
12-' PI Y 1 E '
i no l mail
Date wanted: .....
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a.
R / / Q ne r/� m
\ n Vocz 1 1
(1rto) ( --02.7
vita..... ..4V,
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INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 98188
PERMIT NO. V
(206)431 -3670
El Approved per applicable codes. .corrections required prior to approval.
$47,00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Date:
Receipt No:
May 26, 1999
Dear Ms. Rowe:
City of Tukwila
Department of Community Development Steve Lancaster, Director
Lynh Rowe
Northwest Water Heater
2800 Thorndyke Avenue W
Seattle, WA 98199
RE: Permit Status M96 -0183
15240 40 Avenue S
In reviewing our current permit files, it appears that your permit for a gas furnace replacement
issued on January 9, 1997 has not received a final inspection as of the date of this letter 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 provision 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, if a final inspection is not called for within ten (10) business days from the
date of this letter, the Permit Center will close your file and the work completed to date will be
considered non - complying and not in conformance with the Uniform Building Code and /or
Mechanical Code.
Please contact the Permit Center at (206)431 -3670 if you wish to schedule a final inspection.
Thank you for your cooperation in this matter.
Sincerely,
L igtaa,
Brenda Holt
Permit Coordinator
Xc: Permit File No. M96.0183
Duane Griffin, Building Official
John W Rants, Mayor
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • (206) 431-3670 • Fax (206) 431-3665
Department of Labor & Industries
Contractor Registration Section
PO Box 44450
Olympia WA 98504-4450
Ti,
***** ik‘cilitercd name
AP ‘ 1 / 3 ?3 Y5 Olympia licadquartcr
s
From
nu
. 4t 2 o.cAthek - t r krig. 1 tDet..ui 5
cgi tA)
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Registration expires
103 Oc.._ J.?-:?-D--9-1.____
Contractor: Your Certificate of Registration will he sent from the Olympia office and
Certificate of Registration.
should be received within 2 to 3 weeks. Please keep this record until you receive your
F625-036.000 registnaion verifica i ion 2.1)5 r
Retzipt evires
? — ?"4 t i q..7....... 1 Thank 9
.1.1•••••■• •••■••■■•■•
41111
41/4164
Stcphant P. Ramirez
Notary Public in and for the State of Washington.
My Commission Expires on September 1, 1998
REGISTRATION VERIFICATION
TEMPORARY
(360) 902.5226
FAX (3(U) 902-5228