HomeMy WebLinkAboutPermit PG07-123 - STORVICK RESIDENCESTORVICK RESIDENCE
4451 S 146 ST
PGO7-123
Parcel No.: 0040000748
Address:
Suite No:
Tenant:
Name:
Address:
Owner:
Name:
Address:
4451 S 146 ST TUKW
Contact Person:
Name: DARRELL STORVICK
Address: 4457 S 146 ST , TUKWILA WA
DESCRIPTION OF WORK:
REPLACE WATER SERVICE
Value of Plumbing /Gas Piping:
Fees Collected:
Plumbing
Bathtub or combination bath/shower
Bidet
Clothes washer, domestic
Dental unit, cuspidor
Dishwasher, domestic, with independent drain
Drinking fountain or water cooler (per head)
Food -waste grinder, commercial
Floor drain
Shower, single head trap
Lavatory
Wash fountain
Receptor, indirect waste
Sinks
Urinals
Water Closet
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
STORVICK RESIDENCE
4451 S 146 ST , TUKWILA WA
STORVICK DARRELL M
4451 S 146TH ST , TUKWILA WA
PLUMBING /GAS PIPING PERMIT
Contractor:
Name: OWNER AFFIDAVIT - DARRELL M STORVICK
Address:
Contractor License No:
Expiration Date:
FIXTURE TYPE AND OUANTITY
* *continued on next page **
Permit Number:
Issue Date:
Permit Expires On:
Phone:
Phone: 206 431 -0857
Phone:
$0.00 Uniform Plumbing Code Edition:
Steven M Mullet, Mayor
Steve Lancaster, Director
PG07 -123
05/09/2007
11/05/2007
2003
$88.00 International Fuel Gas Code Edition: 2003
Plumbing (cont.)
0 Building sewer and each trailer park sewer 0
0 Rain water system - per drain (inside bldg) 0
0 Water heater and/or vent 0
0 Industrial waste treatment interceptor, including
0 its trap and vent, except for kitchen type
0 grease interceptors 0
0 Repair or alteration of water piping and/or water
0 treatment equipment 1
0 Repair or alteration of drainage or vent piping 0
0 Medical gas piping system serving (1 -5)
0 inlets /outlets for a specific gas 0
0 Medical gas piping (6 +) inlets /outlets 0
0 Gas Piping
0 Gas piping outlets (0 -5) 0
0 Gas piping outlets (6 +) 0
PG07 - 123 Printed: 05-09 -2007
Permit Center Authorized Signature:
I hereby certify that I have read and a ed this permit and know the same to be true and correct. All provisions of law and ordinances
governing this work will be complied , 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 plumbing /gas piping permit.
Signature:
Print Name:
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
Permit Number: PG07 -123
Issue Date: 05/09/2007
Permit Expires On: 11/05/2007
Steven M Mullet, Mayor
Steve Lancaster, Director
Date: pc1O t t,
Date: S 7
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.
PG07 -123 Printed: 05-09 -2007
Parcel No.: 0040000748
Address: 4451 S 146 ST TUKW
Suite No:
Tenant:
1: ** *PLUMBING AND GAS PIPING * **
doc: Cond -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
STORVICK RESIDENCE
PERMIT CONDITIONS
* *continued on next page **
Permit Number:
Status:
Applied Date:
Issue Date:
PG07 -123
ISSUED
05/07/2007
05/09/2007
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: 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.
11: 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.
PG07 -123 Printed: 05-09 -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: Pai.ae m * X Date: r 7
Print Name: 9) wt. S�(J2 KCL
doc: Cond -10/06
PG07 -123 Printed: 05-09 -2007
Mailing Address: 4
Contact Person:
E -Mail Address:
CITY OF TUKWILA
Community Developme !epartment
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.ci.tukwila.wa.us
Contractor Registration Number:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
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
LL King Co Assessor's Tax No.: 0 '# 0000 74 8
�`T S� S, /�it�o S f /ukcv � 9E /loci Suite Number: Floor:
New Tenant: ❑ .... Yes ❑ ..No
Site Address:
Tenant Name:
Property Owners Name: ► -PJ' M r- vi l ,k
Mailing Address: 1 t4 ' �� S , f �7`�' 4 S-� (c kAf r
Name: �� � I l_
s S 46
E -Mail Address: de s4 r raft t i1 `2:4
Q:Wpplicationst.orms- Applications On Line\3 -2006 - Plumbing -Gas Piping Permit Application.doc
Revised: 4 -2006
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City
G✓t
City
Fax Number:
VA /68 — s11�
State Zip
CONTACT PERSON =Who do we contact when your permit is ready to be issued
Day Telephone: 206 — —Og S 7
State
State
State
State
g8 -44
Zip
PLUMBING / GAS PIPING CONTRACTOR INFORMATION
Company Name:
Mailing Address:
City
Day Telephone:
Fax Number:
Zip
Expiration Date:
ARCHITECT OF RECORD - All plans must be wet stamped by Architect of Recor
City
Day Telephone:
Fax Number:
Zip
Contact Person:
E -Mail Address:
ENGINEER -OF RECORD — Ail plans must be wet stamped by Engineer of Record
Company Name:
Mailing Address:
City
Day Telephone:
Fax Number:
Zip
Page 1 of 2
Valuation of Project (contractor's bid P1 $
Scope of Work (please provide detailed information):
ID66,2 WO4y rv►'C
Building Use (per Intl Building Code):
Occupancy (per Intl Building Code):
Utility Purveyor: Water: 14 '
Sewer:
Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below:
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
iF ixture.Type:
Wash fountain
Receptor, indirect
waste
Sinks
Urinals
Water Closet
Water heater and/or
vent
Repair or alteration
of drainage or vent
piping
Q ty
::FixtureType
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 0
Signature:
Mailing Address:
Date Application Accepted:
NER OR AUTHORIZED AGENT:
Print Name: 1 LQ rrc t M. S`'C ' U i a-
' Sr( M 5+
Q:\Applications\Forms- Applications On Linet3 -2006 - Numbing-Gas Piping Permit Application.doe
Revised: 4-2006
bh
Date: 2net
47x7
Day Telephone 266 -1 0 -0 a s
-/ 4 &I 9R169
City State Zip
Date Application Expires:
ti [
Page 2 of 2
i
Parcel No.: 0040000748
Address: 4451 S 146 ST TUKW
Suite No:
Applicant: STORVICK RESIDENCE
Receipt No.: R07 -00789
Payee: DARRELL M STORVICK
ACCOUNT ITEM LIST:
Description
PLUMBING - RES
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
RECEIPT
Initials: JEM Payment Date: 05/09/2007 04:11 PM
User ID: 1165 Balance: $0.00
TRANSACTION LIST:
Type Method Description Amount
Payment Check 2847 88.00
Account Code Current Pmts
000/322.100 88.00
Total: $88.00
Permit Number: PG07 -123
Status: APPROVED
Applied Date: 05/07/2007
Issue Date:
Payment Amount: $88.00
8084 05/10 9710 TOTAL 88.00
doc: Receiot -06 Printed: 05-09 -2007
Prof
7ier 7
Type of I r� S ection:
Address:
- 4 5/g5 / S / yG s /
Date Called:
Special Instructions:
Date Wanted:
7- 30 -0
a.m.
Requester:
Phone No:
a0C- 5 -G
INSPECTION RECORD
Lain a copy with permit
INSP N NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
1 /z 3
• v- li.x� .,.s.,.eu. ° ... `.. - ... -, .w '°�.. a -ak .6a.,,4 ,410-
Approved per applicable codes. El Corrections required prior to approval.
COMMENTS:
ol
(/#
I nspect
Receipt No.:
4 f
.00 REINSPECTION FEE REQUIRED. Prirlr to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. ll the schedule reinspection.
Date)
'Date:
Project:
-0r � /..: /�� -
Type f Inspection;-, ( ' J J)is
- -
Add a s: __
Date Called:
Special Instructions:
Date Wanted:
7 -- 2 0 -O
Requester:
Phone No. - z /3'-
6 ,
- 2
INSP CTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
N)4 COMMENTS:
J Da te, 70—")
Approved per applicable codes. Corrections required prior to approval.
A'i_ /
8.00 REINSPECTION1 E REQUIRED: Prior to inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection.
'Receipt No.:
'Date:
INSPECTION RECORD
Retain a copy with permit
� / 772,
PERM
IFILBCCIPV
Nan review approval b aft= I D arms and omndont
of does not althorns
the
approved Flee Copy and .. b
a
LAWN
Bathroom Group x 2 12
Dishwasher 2
Kitchen Sink 2
Washing Machine 2
Siiicock x 4 12
TOTAL FIXTURE UNITS 30
•
•
•
Q
it
146th STREET
SIDEWALK
LAWN
EXISTING 5/8" X 3/4" WATER METER
REPLACE EXISTING 3/4" WATER
SERVICE WITH 1" PE CLASS 200 PSI
18" MIN BURIAL DEPTH WITH 12 GA
TRACER
28'
Legal Description: 9-10 6 ADAMS HOME TRS N 95 FT OF E 28.8 FT OF 9 & N 95 FT OF 10
Parcel: 0040000748
Address: 4451 S 146TH ST TUKWILA, WA 98168-4444
REPLACE SHUT -OFF VALVE
NEW 1' TYPE K RIGID COPPER
I THRU FOUNDATION
(11/2" OR 2" PVC SLEEVE)
F 13'
No changes shei1 be made to the scope
07 work without prior approval cf
Tukwila Building Divis:Ica.
NOTE: Revisions will require a new plan submittal
and may Include additional plan review fees.
LAWN
SIDE SEWER -- - - - - --
(APPROX LOC)
LAWN
e
T
N
REVEEWED FOR
CODE COMPLIANCE
APPROVED
MAY - 8 2007
_KW
- - -city Of Tukwila
BUILDING DNISION
gNp � � it1K � nnu+
MAY 0 7 2007
PF.flG1►TCENTER
Vir)11—
ACTIVITY NUMBER: PG07 -123 DATE: 05 -07 -07
PROJECT NAME: STORVICK RESIDENCE
SITE ADDRESS: 4451 S 146 ST
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # Revision # After Permit Issued
DEPARTMENTS:
Buil ing Division
Public Works ❑
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
Comments:
APPROVALS OR CORRECTIONS:
Notation:
REVIEWER'S INITIALS:
Documents routing slip.doc
2 -28-02
PERMII COORD COPY
PLAN REVIEW /ROUTING SLIP
Fire Prevention
Structural
Incomplete ❑
TUES/THURS ROUTING:
Please Route y Structural Review Required
REVIEWER'S INITIALS:
Planning Division
❑ Permit Coordinator
n
n
DUE DATE: 05-08-07
Not Applicable C
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
No further Review Required
DATE:
DUE DATE: 06-05-07
Approved ❑ Approved with Conditions F Not Approved (attach comments) ❑
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
Permit Center /Building Division:
206 -431 -3670
Public Works Department:
206 -433 -0179
Planning Division:
206 -431 -3670
STATE OF WASHINGTON)
COUNTY OF KING
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
ss.
v 1 , states as follows:
[please print)
PERMIT NO.: Thv4 t
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. , 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.
lapplications\8 -2004 affidavit in lieu of contractor registration
APPLICANT
Signed and sworn to before me this
I t day of fie 7 , 20 67
teeLat-
NOTARY PUBLIC in and for We State of Washington,
Residing at Kind , County.
Name as commissioned: A//C A. AQC
My commission expires: 6-/6-08
18.27.090 Exemptions. This chapter shall not apply to:
1.
2. An authorized representative of the United States
Government, the State of Washington, or any
incorporated city, town, county, township,
irrigation district, reclamation district or other
municipal or political corporation or subdivision of
this state;
3. Officers of the court when they are acting within
the scope of their office;
4. Public utilities operating under the regulations of
the utilities and transportation commission in
construction, maintenance, or development work
incidental to their own business;
5. Any construction, repair or operation incidental to
the discovering or producing of petroleum or gas,
or the drilling, testing, abandoning, or other
operation of any petroleum or gas well or any
surface or underground mine or mineral deposit
when performed by an owner or lessee;
6. The sale or installation of any finished products,
materials, or articles of merchandise which are not
actually fabricated into and do not become a
permanent fixed part of the structure;
7. Any construction, alteration, improvement or
repair of personal property, except this chapter
shall apply to all mobile, manufactured housing. A
mobile/manufactured home may be installed, set
up, or repaired by the registered or legal owner,
by a contractor licensed under this chapter, or by
a mobile /manufactured home retail dealer or
manufacturer licensed under chapter 46.70 RCW;
8. Any construction, alteration, improvement, or
repair carried on within the limits and boundaries
of any site or reservation under the legal
jurisdiction of the federal government;
9. Any person who only furnished materials,
supplies, or equipment without fabricating them
into, or consuming them in the performance of, the
work of the contractor,
10. Any work or operation on one undertaking or
project by one or more contractors, the aggregate
contract price of which for labor and materials and
all other items is less than $500.00, such work, or
operations being considered as of a casual, minor,
or inconsequential nature. The exemption
prescribed in this subsection does not apply in all
instance wherein the work or construction is only a
part of a larger or major operation, whether
undertaken by the same or a different contractor,
or in which a division of the operation is made into
\applications\8 -2004 affidavit in lieu of contractor registration
contracts of amounts less than $500.00 for the
purpose of the evasion of this chapter or
otherwise. The exemption prescribed in this
subsection does not apply to a person who
advertises or puts out any sign or card or other
device which might indicate to the public that he is
a contractor, or that he is qualified to engage in
the business of contractor;
11. Any construction or operation incidental to the
construction and repair of irrigation and drainage
ditches of regularly constituted irrigation districts
or reclamation districts; or to farming, dairying,
agriculture, viticulture, horticulture, or stock or
poultry raising; or to clearing or other work upon
land in rural districts for fire prevention purposes;
except then any of the above work is performed
by a registered contractor,
12. An owner who contracts for a project with a
registered owner;
13. Any person working on his own property, whether
occupied by him or not, and any person working
on his residence, whether owned by him or not but
his exemption shall not apply to any person
otherwise covered by this chapter who constructs
an improvement on his own property with the
intention and for the purpose of selling the
improved property;
14. Owners of commercial properties who use their
own employees to do maintenance, repair, and
alteration work in or upon their own properties;
15. A licensed architect or civil or professional
engineer acting solely in his professional capacity,
an electrician licensed under the laws of the state
of Washington, or a plumber licensed under the
laws of the state of Washington while operating
within the boundaries of such political subdivision.
The exemption provided in this subsection is
applicable only when the licensee is operating
within the scope of his license;
16. Any person who engages in the activities herein
regulated as an employee of a registered
contractor with wages as his sole compensation;
17. Contractors on highway projects who have been
prequalified as required by chapter 13 of the Laws
of 1961, RCW 47.28.070 with the department of
transportation. to perform highway construction,
reconstruction, or maintenance work.