HomeMy WebLinkAboutPermit PG07-093 - HUREMOVIC RESIDENCEHUREMOVIC
RESIDENCE
4526 S 140 ST
PGO7-093
Parcel No.:
Address:
Suite No:
Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
Address:
7347600547
4526 S 140 ST TUKW
HUREMOVIC RESIDENCE
4526 S 140 ST , TUKWILA WA
MARTZ BRIAN D
4526 S 140TH ST , SEATAC WA
SUADA HUREMOVIC
4526 S 140 ST , TUKWILA WA
Contractor:
Name: OWNER AFFIDAVIT - SUADA HUREMOVIC
Address:
Contractor License No:
DESCRIPTION OF WORK:
REPAIR OR ALTERATION OF DRAINAGE OR VENT PIPING FOR SINGLE FAMILY RESIDENCE.
Value of Plumbing /Gas Piping: $200.00
Fees Collected: $88.00
Plumbing
Bathtub or combination bath/shower 0
Bidet 0
Clothes washer, domestic 0
Dental unit, cuspidor 0
Dishwasher, domestic, with independent drain 0
Drinking fountain or water cooler (per head) 0
Food -waste grinder, commercial 0
Floor drain 0
Shower, single head trap 0
Lavatory 0
Wash fountain
Receptor, indirect waste 0
Sinks 0
Urinals 0
Water Closet 0
doc: UPC -10/06
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 -431 -3665
Web site: http: //www.ci.tukwila.wa.us
PLUMBING /GAS PIPING PERMIT
0
* *continued on next page **
Permit Number:
Issue Date:
Permit Expires On:
Expiration Date:
Uniform Plumbing Code Edition: 2003
International Fuel Gas Code Edition: 2003
FIXTURE TYPE AND OUANTITY
Phone:
Phone: 206 -931 -3543
Phone:
Steven M Mullet, Mayor
Steve Lancaster, Director
PG07 -093
04/10/2007
/ —o1
Plumbing (cont.)
Building sewer and each trailer park sewer 0
Rain water system - per drain (inside bldg) 0
Water heater and/or vent 0
Industrial waste treatment interceptor, including
its trap and vent, except for kitchen type
grease interceptors 0
Repair or alteration of water piping and/or water
treatment equipment 0
Repair or alteration of drainage or vent piping 1
Medical gas piping system serving (1 -5)
inlets /outlets for a specific gas 0
Medical gas piping (6 +) inlets /outlets 0
Gas Piping
Gas piping outlets (0 -5) 0
Gas piping outlets (6 +) 0
PG07 -093 Printed: 04 -10 -2007
Permit Center Authorized Signature:
City of Tukwila
doc: UPC-10 /06
Department of community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 -431 -3665
Web site: http: / /www.ci.tukwila.wa.us
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 to sign and obtain this plumbing /gas piping permit.
Signature: (4 � � cL c... V I t Date: 4710/0 -
Print Name: J U F} J)/ /Z E/(O \I ( C
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.
Permit Number: PG07 -093
Issue Date: 04/10/2007
Permit Expires On:
Steven M Mullet, Mayor
Steve Lancaster, Director
Date: 4—to -01
PG07 -093 Printed: 04 -10 -2007
Parcel No.: 7347600547
Address: 4526 S 140 ST TUKW
Suite No:
Tenant:
1: ** *PLUMBING AND GAS PIPING * **
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 - 431 -3665
Web site: http: / /www.ci.tukwila.wa.us
HUREMOVIC RESIDENCE
PERMIT CONDITIONS
* *continued on next page **
Permit Number:
Status:
Applied Date:
Issue Date:
PG07 -093
ISSUED
04/10/2007
04/10/2007
2: No changes shall be made to applicable plans and specifications unless prior approval is obtained from the Tukwila
Building Division.
3: All permits, inspection records and applicable plans shall be maintained at the job and available to the plumbing
inspector.
4: All plumbing and gas piping systems shall be installed in compliance with the Uniform Plumbing Code and the Fuel Gas
Code.
5: No portion of any plumbing system or gas piping shall be concealed until inspected and approved.
6: All plumbing and gas piping systems shall be tested and approved as required by the Plumbing Code and Fuel Gas Code.
Tests shall be conducted in the presence of the Plumbing Inspector. It shall be the duty of the holder of the permit to
make sure that the work will stand the test prescribed before giving notification that the work is ready for inspection.
7: No water, soil, or waste pipe shall be installed or permitted outside of a building or in an exterior wall unless,
adequate provision is made to protect such pipe from freezing. All hot and cold water pipes installed outside the
conditioned space shall be insulated to minimum R-3.
8: Plastic and copper piping running through framing members to within one (1) inch of the exposed framing shall be
protected by steel nail plates not less than 18 guage.
9: Piping through concrete or masonry walls shall not be subject to any load from building construction. No plumbing
piping shall be directly embedded in concrete or masonry.
10: All pipes penetrating floor /ceiling assemblies and fire- resistance rated walls or partitions shall be protected in
accordance with the requirements of the building code.
11: Piping in the ground shall be laid on a firm bed for its entire length. Trenches shall be backfilled in thin layers to
twelve inches above the top of the piping with clean earth, which shall not contain stones, boulders, cinderfill,
frozen earth, or construction debris.
12: The issuance of a permit or approval of plans and specifications shall not be construed to be a permit for, or an
approval of, any violation of any of the provisions of the Plumbing Code or Fuel Gas Code or any other ordinance of the
jurisdiction.
doc: Cond - 10/06 PG07 -093 Printed: 04 -10 -2007
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 - 431 -3665
Web site: http: / /www.ci.tukwila.wa.us
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:
Print Name:
doc: Cond -10/06
P iedLok
cc
1-k ‘,,c---t-to
vl C
Date: 7/ 7o Z
PG07 -093 Printed: 04 -10 -2007
CITY OF TUKWILA
Community Developm' Department
Permit Center Nib,'
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.ci.tukwila.wa.us
PLUMBING / GAS PIPING PERMIT APPLICATION
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 LOCATION
King Co Assessor's Tax No.: 154 'O?
Suite Number: Floor:
/ New Tenant: ❑ .... Yes 0 ..No
Property Owners Name: )i k V E 5) A DBE //V & &7-(O
14O 4S4. • 71 to w i ' fc.
Site Address:
Tenant Name:
Mailing Address: 4SZ C S.
u, 5 ( 4 - 0 'i—
City
State
Zip
CONTACT PERSON — Who do we contact when your permit is ready to be issued
Name:
Mailing Address:
Zip
E -Mail Address:
Company Name:
Mailing Address: 4--S G S.
Contact Person: SLI A Del
E - Mail Address: 130 Ks 1 ' T
Contractor Registration Number:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
GI'�iF% L , CO R
Q: 1Applications\Forms- Applications On LineO -2006 - Plumbing -Gas Piping Permit Application.doc
Revised: 4-2006
bh
Day Telephone:
City
Fax Number:
State
PLUMBING / GAS. PIPING CONTRACTOR INFORMATION
Wrl t,v, �16P
City State Zip
Day Telephone: 2-0 — 334 — 3 S4_
Fax Number: 2.0 i; — z 4 4— 2 C 6c?
Expiration Date:
ARCHITECT OF RECORD - All plans must be wet stamped by Architect of Record
City
Day Telephone:
Fax Number:
State
Zip
ENGINEER OF RECORD - All plans must be wet stamped by Engineer of Record
Zip
State
City
Day Telephone:
Fax Number:
Page 1 of 2
Valuation of Project (contractor's bid pn4.3,260, Ca
Scope of Work (please provide detailed information):
j VLSI C t t. cu-vc3 2 v` oe t,u o K e,
Building Use (per Intl Building Code):
Occupancy (per Intl Building Code):
Utility Purveyor: Water:
Indicate type of plumbing
Fixture Type:
Bathtub or combination
bath/shower
Bidet
Clothes washer, domestic
Dental unit, cuspidor
Dishwasher, domestic,
with independent drain
Building sewer or trailer
park sewer
Industrial waste
pretreatment interceptor,
including its trap and vent,
except for kitchen type
grease interceptors
Qty
Fixture Type:
Drinking fountain or water
cooler (per head)
Food -waste grinder,
commercial
Floor drain
Shower, single head trap
Lavatory
Rain water system — per
drain (inside building)
Repair or alteration of water
piping and/or water treating
equipment
Qty
Fixture. Type
Wash fountain
Receptor, indirect
waste
Sinks
Urinals
Water Closet
Water heater and/or
vent
' epair or alteration
of drainage or vent
iping
Fixture Type: "i
Gas piping outlets
Additional medical gas
inlets/outlets — six or more
Medical gas piping system
serving one to five
inlets/outlets for specific gas
Qty
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 grant one extension of time for an additional period not to exceed 180 days. The extension shall be requested in writing
and justifiable cause demonstrated. Section 103.4.3 International Plumbing Code (current edition).
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 OLL ER OR AUTHORIZEDAGENT:
Signature: CM" ��Q J, /� - .C-
Print Name: cSUA DA HU,( EY1 D v i Cc
Mailing Address: 43 - 2 S. 14'o' 61-
Date Application Expires:
/ - 07
Date Application Accepted:
y — i0 -07
1) -
Sewer:
fixtures and/or gas piping outlets being installed and the quantity
Q:\Applications\Forms- Applications On Line\3 -2006 - Plumbing -Gas Piping Permit Application.doc
Revised: 4 -2006
bh
below:
Date: 00 /c 7
Day Telephone: 206 53 4 - 3S
/u6 4 a' /6c12
City State Zip
Page 2 of 2
Doc: RECSETS -06
RECEIPT NO: R07 -00545
Initials: BLH
User ID: ADMIN
Payee: JAKUB HUREMOVIC
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 -431 -3665
Web site: http: //www.ci.tukwila.wa.us
SET ID: S000000727 SET NAME: Trap set/Initialized Activities
SET TRANSACTIONS:
Set Member Amount
EL07 -019 75.00
PG07 -093 88.00
TOTAL: 163.00
TRANSACTION LIST:
Type Method Description
ACCOUNT ITEM LIST:
Description
ELECTRICAL PERMIT - RES
PLUMBING - RES
SET RECEIPT
Payment Date: 04/10/2007
Total Payment: 163.00
Amount
Payment Check 2769 163.00
TOTAL: 163.00
Account Code Current Pmts
000.322.101.00.0 75.00
000/322.100 88.00
TOTAL: 163.00
6953 04/10 9716 TOTAL 163.00
Project:
Type of Inspection:
Address: s/
Date Cl :
6/522 S2 /
Special nstructions:
Date Wantedd:
171 P.m.
Requester:
Phone No:
2c6-9,3/--?5
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
Approved per applicable codes.
INSPECTION RECORD
Retain a copy with permit
7- 1
Corrections required prior to approval.
COMMENTS:
P el'en ( 1 11- -7 4I,
Inspector
A
Date:
-v 7
I AAA .4.4.4.
0 $58.00 NSPECTION FEE RE UIRED. i rrior to inspection, fee must be
paid at 6 00 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
Receipt No.:
Date:
Project
Type f Inspection:
A _Sr,
Date Called:
Special Instructions:
Date Wanted:
Requester:
Phone No:
2
''.
3/ 1
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
PER
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 981 88 (2
COMMENTS:
)
(. ht, 4
a 0/9 - I V - A o d7 4/ 41
Re ipt No.:
Date:
.00 REINSPECTIOJ4 FEE RE IRED. Prior to inspection, fee must be
d at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
Date:
Approved per applicable codes. Corrections required prior to approval.
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
STATE OF WASHINGTON)
COUNTY OF KING
SSA DAV
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
G
PERMIT NO.: (P60-70
ss.
if C , states as follows:
[please print]
1. I have made application for a building permit from the City of Tukwila, Washington.
2. I understand that state law requires that all building construction contractors be registered with the State of
Washington. The exceptions to this requirement are stated under Section 18.27.090 of the Revised Code of
Washington, a copy of which is printed on the reverse side of this Affidavit. I have read or am familiar with RCW
18.27.090.
3. I understand that prior to issuance of a building permit for work which is to be done by any contractor, the City of
Tukwila must verify either that the contractor is registered by the State of Washington, or that one of the exemptions
stated under RCW 18.27.090 applies.
4. In order to provide verification to the City of Tukwila of my compliance with this requirement, I hereby attest that
after reading the exemptions from the registration requirement of RCW 18.27.090, I consider the work authorized
under this building permit to be exempt under No. /3 , and will therefore not be performed by a registered
contractor.
I understand that I may be waiving certain rights that I might otherwise have under state law in any decision to engage an
unregistered contractor to perform construction work.
IICANT
Signed and sworn to before me this
S S - . 04 i
i 4
/ / ,' o F s 29, 1�G`�
\applications\8 -2004 affidavit in lieu of contractor registration
�d day of
Residing at
, a 66)1--(---(
Y PUBLIC in and for the State of Washington,
Name as commissioned:
cz9
My commission expires: / 029 -/ C�
Permit Center /Building Division:
206 -431 -3670
Public Works Department:
206 - 433 -0179
Planning Division:
206 - 431 -3670
, 206
, County.
h- G{ -6/ /