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Home My WebLink AboutPermit PG07-156 - RIVERTON MOB AND P SCHUSTER OFFICERIVERTON MOB & P SCHUSTER OFFICE 13030 MILITARY RD S EXPIRED 12-03-07 PG07.156 Parcel No.: 1623049171 Address: Suite No: 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:Ilwww.ci.tukwila.wa.us 13030 MILITARY RD S TUKW Tenant: Name: RIVERTON MOB & P SCHUSTER OFFICE Address: 13030 MILITARY RD S , TUKWILA WA Owner: Name: HIGHLINE COMMUNITY HOSPITAL Address: 16251 SYLVESTER RD SW , SEATTLE WA Contact Person: Name: CHRISTINE JOHNSON Address: PO BOX 249 , AUBURN WA Contractor: Name: AUBURN MECHANICAL INC Address: PO BOX 249 , AUBURN, WA Contractor License No: AUBURMI163BA DESCRIPTION OF WORK: INSTALL NEW LAVATORY IN PRE - EXISTING BUILDING Value of Plumbing /Gas Piping: Fees Collected: 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 1 Wash fountain Receptor, indirect waste 0 Sinks 0 Urinals 0 Water Closet 0 doc: UPC -10/06 $3,000.00 $88.00 PLUMBING /GAS PIPING PERMIT Uniform Plumbing Code Edition: 2003 International Fuel Gas Code Edition: 2003 FIXTURE TYPE AND OUANTITY 0 * *continued on next page ** Permit Number: Issue Date: Permit Expires On: Phone: Phone: 253 838 -9780 Phone: (253)838 -9780 Expiration Date: 09/12/2008 Steven M Mullet, Mayor Steve Lancaster, Director PG07 -156 06/06/2007 12/03/2007 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 ldtchen type grease interceptors 0 Repair or alteration of water piping and/or water treatment equipment 0 Repair or alteration of drainage or vent piping 0 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 - 156 Printed: 06-06 -2007 Permit Center Authorized Signature: 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 -156 Issue Date: 06/06/2007 Permit Expires On: 12/03/2007 Steven M Mullet, Mayor Steve Lancaster, Director Date: UlX i Diet b4" I hereby certify that I have read and e 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 wor I am authorized to sign and obtain this plumbing /gas piping permit. s k i Date: - (- ;— 0 7 Signature: �.�. Print Name: h (2 ' < 5 ' 7 /74 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 -156 Printed: 06-06 -2007 Parcel No.: 1623049171 Address: Suite No: Tenant: 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 13030 MILITARY RD S TUKW RIVERTON MOB & P SCHUSTER OFFICE 1: ** *PLUMBING AND GAS PIPING * ** PERMIT CONDITIONS * *continued on next page ** Permit Number: Status: Applied Date: Issue Date: PG07 -156 ISSUED 06/06/2007 06/06/2007 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. 8: 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. PG07 -156 Printed: 06-06 -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 h /a de._ Date: PG07 -156 Printed: 06-06 -2007 Company Name: Mailing Address: CITY OF TUKWILA Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 htto://www.ci.tukwila.wa.us Name: C A A Vb 5v'') Mailing Address: F. b. o x. 2.9 *VIOL) v n , (,j E -Mail Address: C,AI'IS*xv1 t.(0,SVbu vn lanit I • (A)yvl Company Name: Pt Wout,Y a-11 1 Gal t in 4 - Mailing Address: P. 0 . 24 °l Contact Person: C i ' 1 S - J O ItivlS on OVA Covr►+Y Contractor Registration Number: 81(3()(2 M Z-L (v 3 P) P1 Expiration Date: Contact Person: E -Mail Address: Company Name: Mailing Address: City Contact Person: Day Telephone: E -Mail Address: Fax Number: Q:Wpplications\Forms- Applications On Line3-2006 - Permit Application.doc Revised: 4 -2006 bh x Ca Building Permit No. Mechanical Permit No. `` �� "" Plumbing/Gas Permit No. �� - � (p Public Works Permit No. Project No. (For office use only) 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.: (to2 O y q 1 1 Site Address: (,O I'Yl i I t 1'0V 9 mad SO 01- h � Suite Number: Floor: Tenant Name: 1l V tV-♦-O n ow, of 'P. 5(J 1 v S t'?- -v O t j ± 1 Cfc. New Tenant: ❑ Yes '[!(No Property Owners Name: NV i'X f 'b Yl Pr p fY+1 t S Mailing Address: t.(3 m i. I ci-aKt RA 5 T ku)lI City City wf9 State Zip CONTACT PERSON Day Telephone: 253 83R •9) / v State 8v'? Zip Fax Number: GENERAL CONTRACTOR INFORMATION — (Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5) ) Ai v ( o,g57 City State Z Day Telephone: 253 ' 3 ii' • 91 b E -Mail Address: aik* tSt 1 Yl t e a4kw r n rnf c-ha n 1 r .a 1. cc m Fax Number: 9 /12/ 0 1 ARCHITECT OF RECORD - All plans must be wet stamped by Architect of Record State State Zip City Day Telephone: Fax Number: ENGINEER OF RECORD - All plans must be wet stamped by Engineer of Record Zip 7a ti Page 1 of 6 BUILDING PERMIT INFORMATION — 206 - 431 -3670 Valuation of Project (contractor's bid price): $ Existing Building Valuation: $ Scope of Work (please provide detailed information): Will there be new rack storage? ❑..Yes ❑...No Provide All Building Areas in Square Footage Below PLANNING DIVISION: Single- family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq ft): Floor area of principal dwelling: Floor area for accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Compact: Handicap: Will there be a change in use? ❑ .... ❑ ..No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: 0.. Sprinklers ❑..Automatic Fire Alarm 0..None ❑ ..Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑.. Yes ❑.. No If "yes", attach list of materials and storage locations on a separate 8 -1/2 x 11 paper indicating quantities and Material Safety Data Sheets. SEPTIC SYSTEM: ❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. Q:\Applications\Forms- Applications On Line \.3-2006 - Permit Application.doc Revised: 4 -2006 bh (If yes, a separate permit and plan submittal will be required) Page 2 of 6 Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC I Floor r Floor 3` Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck BUILDING PERMIT INFORMATION — 206 - 431 -3670 Valuation of Project (contractor's bid price): $ Existing Building Valuation: $ Scope of Work (please provide detailed information): Will there be new rack storage? ❑..Yes ❑...No Provide All Building Areas in Square Footage Below PLANNING DIVISION: Single- family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq ft): Floor area of principal dwelling: Floor area for accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Compact: Handicap: Will there be a change in use? ❑ .... ❑ ..No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: 0.. Sprinklers ❑..Automatic Fire Alarm 0..None ❑ ..Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑.. Yes ❑.. No If "yes", attach list of materials and storage locations on a separate 8 -1/2 x 11 paper indicating quantities and Material Safety Data Sheets. SEPTIC SYSTEM: ❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. Q:\Applications\Forms- Applications On Line \.3-2006 - Permit Application.doc Revised: 4 -2006 bh (If yes, a separate permit and plan submittal will be required) Page 2 of 6 Sewer District ❑ ...Tukwila ❑ ...Sewer Use Certificate ❑ ...Total Cut ❑ ...Total Fill cubic yards cubic yards PUBLIC WORKS PERMIT INFORMATION — 206 -433 -0179 Scope of Work (please provide detailed information): 1 Please refer to Public Works Bulletin #1 for fees and estimate sheet. Water District ❑ ...Tukwila 0... Water District #125 ❑ ...Water Availability Provided Submitted with Application (mark boxes which apply): ❑ ...Civil Plans (Maximum Paper Size — 22" x 34 ") ❑ ...Technical Information Report (Storm Drainage) ❑ ...Bond ❑ .. Insurance ❑ .. Easement(s) Proposed Activities (mark boxes that apply): ❑ ...Right -of -way Use - Nonprofit for less than 72 hours ❑ ...Right -of -way Use - No Disturbance ❑ ...Construction/Excavation/Fill - Right -of -way Non Right -of -way ❑ ...Sanitary Side Sewer ❑ .. Abandon Septic Tank ❑ .. Grease Interceptor ❑ ...Cap or Remove Utilities ❑ .. Curb Cut ❑ .. Channelization ❑ ...Frontage Improvements ❑ .. Pavement Cut ❑ .. Trench Excavation ❑ ...Traffic Control ❑ .. Looped Fire Line ❑ .. Utility Undergrounding ❑ ...Backflow Prevention - Fire Protection " Irrigation " Domestic Water ❑ ...Permanent Water Meter Size... " ❑ ...Temporary Water Meter Size .. " ❑ ...Water Only Meter Size If ❑ ...Sewer Main Extension Public Private ❑ ...Water Main Extension Public Private FINANCE INFORMATION Fire Line Size at Property Line Number of Public Fire Hydrant(s) ❑ ...Water ❑ ...Sewer ❑ ...Sewage Treatment Monthly Service Billing to: Name: Day Telephone: Mailing Address: City State Zip Water Meter Refund/Billing: Name: Day Telephone: Mailing Address: City State Zip Q:Wpplications\Forms- Applications On Line\3.2006 - Permit Application.doc Revised: 4 -2006 bh Call before you Dig: 1- 800 - 424 -5555 ❑ .. Highline ❑ .. Renton ❑ .. Seattle ❑ ... ValVue ❑...Sewer Availability Provided ❑ .. Approved Septic Plans Provided ❑ .. Geotechnical Report ❑ .. Maintenance Agreement(s) ❑ .. Renton ❑ .. Right -of -way Use - Profit for less than 72 hours ❑ .. Right -of -way Use — Potential Disturbance ❑ .. Work in Flood Zone ❑ .. Storm Drainage ❑ ...Deduct Water Meter Size " ❑...Traffic Impact Analysis ❑ ...Hold Harmless — (SAO) ❑...Hold Harmless — (ROW) Page 3 of 6 Unit Type: Qty Unit Type: Qty Unit Type: Qty Boiler /Compressor: Qty Furnace <100K BTU Air Handling Unit >10,000 CFM Fire Damper 0 -3 HP /100,000 BTU Furnace >100K BTU Evaporator Cooler Diffuser 3 -15 HP /500,000 BTU Floor Furnace Ventilation Fan Connected to Simile Duct Thermostat 15 -30 HP /1,000,000 BTU Suspended/Wall/Floor Mounted Heater Ventilation System Wood/Gas Stove 30 -50 HP /1,750,000 BTU Appliance Vent Hood and Duct Water Heater 50+ HP /1,750,000 BTU Repair or Addition to Heat/Refrig /Cooling System Incinerator - Domestic Emergency Generator Air Handling Unit <10,000 CFM Incinerator — Comm/Ind Other Mechanical Equipment MECHANICAL PERMIT INFORMATION - 206- 431 -3670 MECHANICAL CONTRACTOR INFORMATION Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: Contractor Registration Number: Expiration Date: Valuation of Project (contractor's bid price): $ Scope of Work (please provide detailed information): Use: Residential: New .... ❑ Replacement .... ❑ Commercial: New .... ❑ Replacement .... ❑ Fuel Type: Electric ❑ Gas ....0 Other: Indicate type of mechanical work being installed and the quantity below: Q:\Applications\Forms- Applications On Line'3 -2006 - Permit Application.doc Revised, 4 - 2006 bh Page 4 of 6 Fixture Type: Qty Fixture Type: Qty Fixture Type: Qty Fixture Type: Qty Bathtub or combination bath/shower Drinking fountain or water cooler (per head) Wash fountain Gas piping outlets Bidet Food -waste grinder, commercial Receptor, indirect waste Clothes washer, domestic Floor drain Sinks Dental unit, cuspidor Shower, single head trap Urinals Dishwasher, domestic, with independent drain Lavatory I Water Closet Building sewer or trailer park sewer Rain water system — per drain (inside building) Water heater and/or vent Industrial waste pretreatment interceptor, including its trap and vent, except for kitchen type grease interceptors Repair or alteration of water piping and/or water treating equipment Repair or alteration of drainage or vent piping Medical gas piping system serving one to five inlets/outlets for specific gas Additional medical gas inlets/outlets — six or more Ito PLUMBING AND GAS PIPING PERMIT INFORMATION — 206- 431 -3670 PLUMBING AND GAS PIPING CONTRACTOR INFORMATION Company Name: TILLbI.U' v I r M`1.1 h I L ) Mailing Address: 12. 0, P)pX 241 A(.tbu,Y ri (A I ?1 D') n 1 • . `` �" City State Zip Contact Person: �:MYIS - ti rI`Ei Jb h Y1`atll Day Telephone: 29I • g3K •97 O E -Mail Address: C,lil -x lSf I YID PA)19uXYI Yn'L lila Yl I ( 1 • U/YYl Fax Number: Contractor Registration Number: AUE?U ln",I?2t4 Expiration Date: ') / 12_10c' Valuation of Project (contractor's bid price): $ 3 b 0 0 Scope of Work (please provide detailed information): butocli y9 Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below: Q:1Applications\Forms- Applications On LineU -2006 - Permit Application.doc Revised 4 -2006 bh Page 5 of 6 PERMIT APPLICATION NOTES — Applicable to all permits in this application 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. 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 OWNER OR AUTHORIZED AGENT: Signature: Building and Mechanical Permit The Building Official may grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition). Plumbing Permit The Building Official may grant one extension of time for an additional period not exceeding 180 days. The extension shall be requested in writing and justifiable cause demonstrated. Section 103.4.3 Uniform Plumbing code (current edition). C "Vft �Yt M Print Name: Jp15 6Y) Mailing Address: PO, 8 () A( 241 Date Application Accepted: cQtokl,01- Q: tApplicationsWorms- Applications On Line U-2006 - Permit Application.doc Revised: 4 -2006 bh Date Application Expires: Date: S1/4/4-5- Day Telephone: 253 • 3 $ -') t7 Au buv trI 9)30- City State Zip tZtote tb Staff Initials: I /I Page 6 of 6 4 Receipt No.: R07 -01045 Payee: AUBURN MECHANICAL ACCOUNT ITEM LIST: Description PLUMBING - NONRES 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 Parcel No.: 1623049171 Permit Number: PG07 -156 Address: 13030 MILITARY RD S TUKW Status: APPROVED Suite No: Applied Date: 06/06/2007 Applicant: RIVERTON MOB & P SCHUSTER OFFICE Issue Date: Initials: JEM Payment Date: 06/06/2007 11:00 AM User ID: 1165 Balance: $0.00 TRANSACTION LIST: Type Method Description Amount Payment Check 0009211 88.00 Account Code Current Pmts 000/322.100 88.00 Total: $88.00 Payment Amount: $88.00 9008 06/06 9716 TOTAL 838.00 rdnr.• RAnnint -f16 Printer. OM)A -9nn7 11 -06 -2007 CHRISTINE JOHNSON PO BOX 249 AUBURN WA 98071 RE: Permit No. PG07 -156 13030 MILITARY RD S TUKW Dear Permit Holder: Cizy of Tukwila Steven M. Mullet, Mayor Department of Community Development Steve Lancaster, Director In reviewing our current records the above noted permit has not received a final inspection by the City of Tukwila Building Division. Per the Uniform Plumbing Code and/or International Fuel Gas Code, every permit issued by the Building Division under the provisions 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, you are hereby advised to: Call the City of Tukwila Inspection Request Line at 206 -431 -2451 to schedule for the next or fmal inspection. This inspection is intended to determine if substantial work has been accomplished since issuance of the permit or last inspection; or if the project should be considered abandoned. If such determination is made, the Plumbing and/or Gas Code does allow the Building Official to approve one extension of time for an additional period not exceeding 180 days. Extension requests must be in writing and provide satisfactory reasons why circumstances beyond the applicants control have prevented action from being taken. In the event you do not call for the above inspection and receive an extension prior to 12/03/2007 , your permit will become null and void and any further work on the project will require a new permit and associated fees. Thank you for your cooperation in this matter. Sincerely, J er Marshall, Permit Technician xc: Permit File No. PG07 -156 6300 Southcenter Boulevard. Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 License Information License AUBURMI163BA Licensee Name AUBURN MECHANICAL MC Licensee Type CONSTRUCTION CONTRACTOR UBI 600074968 Ind. Ins. Account Id 20423000 Business Type CORPORATION Address 1 PO BOX 249 Address 2 City AUBURN County KING State WA Zip 98071 Phone 2538389780 Status ACTIVE Specialty 1 GENERAL Specialty 2 UNUSED Effective Date 1/1/1984 Expiration Date 9/12/2008 Suspend Date Separation Date Parent Company Previous License AUBURMI 184LA Next License Associated License Business Owner Information Name Role Effective Date Expiration Date THODAY, DAVID V Cancel Date 01/01/1980 Bond Amount THODAY, STACY A #3 01/01/1980 LPM8047218 Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date #3 FIDELITY & DEPOSIT CO OF MD LPM8047218 09/01/2001 Until Cancelled $12,000.00 09/12/2001 Look Up a Contractor, Electrici qn or Plumber License Detail Page 1 of 3 Washington State Department of Labor and Industries General/Specialty Contractor A business registered as a construction contractor with L &I to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. https: // fortress .wa.gov /lni/bbip /printer.aspx ?License= AUBURMI163BA 06/06/2007