HomeMy WebLinkAboutPermit PG07-190 - SOUTHCENTER SQUARE - BUILIDNG SSOUTHCENTER SQUARE
BUILDING S
17250 SOUTHCENTER PY
PGO7-190
Parcel No.: 2623049117
Address:
Suite No:
Tenant:
Name:
Address:
Value of Plumbing /Gas Piping:
Fees Collected:
doc: UPC -10/06
Cityf 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
17250 SOUTHCENTER PY TUKW
SOUTHCENTER SQUARE - BUILDING S
17250 SOUTHCENTER PY , TUKWILA WA
Owner:
Name: WIG PROPERTIES LLC -SS
Address: 4811 134TH PL SE , BELLEVUE WA
Contact Person:
Name: BRENT ADKISSON
Address: 2020 S 320 ST #C -90 , FEDERAL WAY WA
Contractor:
Name: D1S MECHANICAL
Address: 2020 S 320 ST #C -90 , FEDERAL WAY WA
Contractor License No: D 15MEM *930BT
DESCRIPTION OF WORK:
INSTALL (14) GAS LINES TO FUTURE TENANT SPACES
$5,000.00
$188.75
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
PLUMBING /GAS PIPING PERMIT
FIXTURE TYPE AND OUANTITY
0
* *continued on next page **
Permit Number:
Issue Date:
Permit Expires On:
Phone:
Phone: 360 888 -5433
Phone: 360 888 -5433
Expiration Date: 01/30/2009
PG07 -190
08/15/2007
02/11/2008
Uniform Plumbing Code Edition: 2006
International Fuel Gas Code Edition: 2006
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 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) 5
Gas piping outlets (6 +) 9
PG07 -190 Printed: 08-15 -2007
Permit Center Authorized Signature:
I hereby certify that I have read and
governing this work will be complied
doc: UPC -10/06
City &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
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 pe • rmance of w • k. am au _• • - • . • and obtain this plumbing /gas piping permit. Q
Ai Signature: / ._J / , Date: V /� G
Print Name:
Permit Number: PG07 -190
Issue Date: 08/15/2007
Permit Expires On: 02/11/2008
Date: (Al IC W
permit and know the same to be true and correct. All provisions of law and ordinances
er specified herein or not.
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 -190 Printed: 08 -15 -2007
Parcel No.: 2623049117
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
17250 SOUTHCENTER PY TUKW
SOUTHCENTER SQUARE - BUILDING S
1: ** *PLUMBING AND GAS PIPING * **
PERMIT CONDITIONS
* *continued on next page **
Permit Number:
Status:
Applied Date:
Issue Date:
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.
PG07 -190
ISSUED
07/18/2007
08/15/2007
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: 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 -190 Printed: 08-15 -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: // / 7 / v Date: 5-0
Print Name:
doc: Cond -10/06
PG07 -190 Printed: 08 -15 -2007
King Co Assessor's Tax No.: 241/,,,,t 1(
Site Address: / 7,256 5 1 kCe t,d el Pc. v/k& c' y Suite Number: Floor:
Tenant Name: S.L o( t5 "
Property Owners Name: W 1 �j / re5 L
Mailing Address: qv/ /34'7 pL . $ E ge //e V to e
CONTACT PERSON'' —Who do we contact when your permit is ready to be issued
Name:
Mailing Address: 2fp20 5' 3? 71 ' ,sf L ( ) / fed e vaA w c y L14 } ,Foc 3
City / State Zip
E -Mail Address:
PLUMBING / GAS PIPING CONTRACTOR INFORMATION
Company Name: J)I� J i e r Cc
Mailing Address: •6026 5 / 3,20 Ilk 51 . C- -0
Contact Person: JR fN T -
E -Mail Address:
Contractor Registration Number: 2) /S / EM W 930,7
ARCHITECT OF RECORD — All plans must be wet stamped by. Architect of Record
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
CITY OF TUKWIL=
Community Development Department
Permit Center
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**
,E7jQ rA/T /4O1 k /ff C4' Day Telephone: 36 — o 'g- S 'j3
Q: Applications\Forms- Applications On Line\3 -2006 - Plumbing -Gas Piping Permit Application.doc
Revised: 42006
bh
City
Fax Number:
New Tenant: .... Yes JJ ..No
w4- 98'
State Zip
Fedeira.( w cJ4- 98110
City State Zip
360 - 888 - 5y33
Day Telephone:
Fax Number:
Expiration Date: 0 / /.-3'/ 2007
City
Day Telephone:
Fax Number:
State
Zip
City
Day Telephone:
Fax Number:
State
Zip
Page 1 of 2
Fixture Type: ",
Qt3'
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
l 4L
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
Water Closet
Building sewer or trailer
park sewer
Rain water system — per
drain (inside building)
Water heater and/or
vent
Additional medical gas
inlets/outlets — six or more
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
Valuation of Project (contractor's bid price): $ . j 0
Scope of Work (please provide detailed information):
:T3v5 1-4d I / E4 6s L-i iveS to 1 Re
Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below:
BUILDING OWN
Signature:
OR AUTHORIZED AGENT:
Q:\Applications\Fonns- Applications On Line\3 -2006 - Plumbing -Gas Piping Penni Applieation.doc
Revised: 4 -2006
bh
Date:
Ti v, - , »c c5,
Building Use (per Mel Building Code):
Occupancy (per Intl Building Code):
Utility Purveyor: Water: Sewer:
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.
7 - 1r O7
Print Name: 9/ f/1 T 4) k SSw, Day Telephone: 360 — 8'o I s 933
Mailing Address: 20 .Z0 S, .v.0 5 #c , c Fed�&.i wa �„ �i 4 - r T �'cCcJ-
city / State Zip
Date Application Accepted:
Date Application Expires: O D t 1 Q /c
Staff Initials:
Page 2 of 2
Payee:
Parcel No.:
Address:
Suite No:
Applicant:
Receipt No.: R07 -02097
Initials: WER
User ID: 1655
doc: Receiot -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
2623049117
17250 SOUTHCENTER PY TUKW
SOUTHCENTER SQUARE - BUILDING S
BRENT ADIKISSON
TRANSACTION LIST:
Type Method Description
Payment Cash
ACCOUNT ITEM LIST:
Description Account Code
GAS - NONRES 000/322.100
PLAN CHECK - NONRES 000/345.830
RECEIPT
Permit Number:
Status:
Applied Date:
Issue Date:
Payment Amount: $26.25
Payment Date: 09/26/2007 11:42 AM
Balance: $0.00
Amount
26.25
Current Pmts
21.00
5.25
Total: $26.25
PG07 -190
ISSUED
07/18/2007
08/15/2007
Printed: 09 -26 -2007
RECEIPT NO: R07 -01419
Initials: JEM
User ID: 1165
Payee: BRENT ADKISSON
City of Tukwila
SET TRANSACTIONS:
Set Member Amount
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: 0718 SET NAME: D15 MECHANICAL
PG07 -189 180.00
PG07 -190 188.75
TOTAL: 368.75
TRANSACTION LIST:
Type Method Description
Payment Cash 368.75
TOTAL: 368.75
ACCOUNT ITEM LIST:
Description
GAS - NONRES
PLAN CHECK - NONRES
SET RECEIPT
Payment Date: 07/18/2007
Total Payment: 368.75
Amount
Account Code Current Pmts
000/322.100 295.00
000/345.830 73.75
TOTAL: 368.75
•O D7/20 9716 - NTAE 368.75
Project: ,.'
Jr' it /i�1 ,-,���i �7/ < /
"Type of Inspection: _
4 1-S . /�< S
Address: C /
/ 72 ., o S cr)/ /h (1' it 1/
Date Palled:
/
Special Instructions:
Date Wanted: (_ a.mt:
/ l /2 /Cn ph.
Requester:
Phone
C'o - r -.S c( 3
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERM
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
proved per applicable codes. El Corrections required prior to approval.
COMMENTS:
I
El $58.00 REIN ECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 63 Southcenter Blvd., Suite 100. Call the schedule reinspection.
'Receipt No.:
'Date:
Project:
S c r, rill / Sc :, -, e (3, / t 1
T pe of Inspection: /
s r' ,nrz,h- i' t�
Address: D P
/ 2- 50 5" / 9j
Date Called:
Special Instructions:
Date Wanted: 7,
/(7 /// /cr7
•Cm.-
p.m.
Requester:
Phone No. 5 y 3
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
COMMENTS:
Approved per applicable codes. El Corrections required prior to approval.
Inspec
Dates /f /r7
$58.00 REINSPEC`T(ON FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call the schedule reinspection.
'Receipt No.:
'Date:
Pr ect:
�l cf4J $
Typ f Inction:
� spe � i�- /4/
6.4#7 S
Ad ress / n
?Z 7 o ca., th@a 9 Y
pate Calle
Special Instructions:
Date Wanted:
_j /,- d - 7
•
p.m.
Requester:
Phone No:
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
VI - Approved per applicable codes.
COMMENTS:
tI5 /` �, ;t G -
(Ins v ector:
al
Date
REINSPECTION FEE EQUIRED. Pp to inspection, fee must be
at 6300 Southcenter Blvd., Suite 100. Call the schedule reinspection.
(Recei• No.: 'Date:
El Corrections required prior to approval.
PG-6 7 -i S"cl
July 30, 2007
Brent Adkisson
2020 S 320 St, #C -90
Federal Way WA 98003
RE: CORRECTION LETTER #1
PIumbing/Gas Piping Permit Application Number PG07 -190
Southcenter Square Building S —17250 Southcenter Py
Dear Mr. Adkisson:
This letter is to inform you of corrections that must be addressed before your plumbing/gas piping
permit(s) can be approved. All correction requests from each department must be addressed at the same
time and reflected on your drawings. I have enclosed comments from the Building Department.
Building Department: Allen Johannesen, at 206 433 -7163, if you have questions regarding
the attached memo.
Please address the attached comments in an itemized format with applicable revised plans,
specifications, and/or other documentation. The City requires that two (2) complete sets of revised
plans, specifications and/or other documentation be resubmitted with the appropriate revision
block.
In order to better expedite your resubmittal, a `Revision Submittal Sheet' must accompany every
resubmittal. I have enclosed one for your convenience. Corrections/revisions must be made in person
and will not be accepted through the mail or by a messenger service.
If you have any questions, please contact me at (206) 433 -7165.
Sincerely
encl
arshall
hnician
xc: File No. PG07 -190
City of Tukwila
P:\Pem* Centcr\Correction Letters\2007\PG07 -190 Correction Ltr #1.DOC
jem
Steven M. Mullet, Mayor
Department of Community Development Steve Lancaster, Director
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
Building Division Review Memo
Date: July 27, 2007
Project Name: Southcenter Square - Bldg S
Permit #: PG07 -190
Plan Review: Allen Johannessen, Plans Examiner
Tukwila Building Division
Allen Johannessen, Plan Examiner
The Building Division conducted a plan review on the subject permit application. Please
address the following comments in an itemized format with revised plans, specifications and /or
other applicable documentation.
(GENERAL NOTE)
PLAN SUBMITTALS: (Min. size 11x17 to maximum size of 24x36; all sheets shall be the same size).
(If applicable) Structural Drawings and structural calculations sheets shall be original sinned wet
stamped, not copied.)
1. Please provide specific location as to where the pipes shall be installed and identify with a detail how
the pipes shall be supported.
Should there be questions concerning the above requirements, contact the Building Division at 206-431-
3670. No further comments at this time.
ACTIVITY NUMBER: PG07 -190 DATE: 09 -20 -07
PROJECT NAME: SOUTHCENTER SQUARE - BLDG S
SITE ADDRESS: 17250 SOUTHCENTER PY
Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # X Revision # 1 After Permit Issued
DEPARTMENTS:
Bu Id g DMsion
Plihlir Wnrkc
Complete
Comments:
Please Route
TUES/THURS ROUTING:
REVIEWER'S INITIALS:
APPROVALS R CORRECTIONS:
Documents/routing slip.doc
2 -28 -02
PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
Fire Prevention
Structural
I •• W
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Incomplete ❑
Structural Review Required
❑ Permit Coordinator n
DUE DATE: 09-5-07
Not Applicable ❑
DATE:
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:
Planning Division
n
DUE DATE: 10-23-07
Approved Approved with Conditions n Not Approved (attach comments) n
Notation:
REVIEWER'S INITIALS:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: PG07 -190 DATE: 08 -13 -07
PROJECT NAME: SOUTHCENTER SQUARE, BLDG S
SITE ADDRESS: 17250 SOUTHCENTER PY
Original Plan Submittal Response to Incomplete Letter #
X Response to Correction Letter # 1
Revision # After Permit Issued
DEPARTMENTS: S: 6 -AO
But rig uivision
Public Works ❑
Structural
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
Please Route
TUES/THURS ROUTING:
APPROVALS OR CORRECTIONS:
Fire Prevention n Planning Division
Incomplete
Comments:
Structural Review Required
❑ Permit Coordinator X
DUE DATE: 08 -14 -07
Not Applicable
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
❑ No further Review Required
REVIEWER'S INITIALS: DATE:
DUE DATE: 09 -11 -07
Approved ❑ Approved with Conditions Not Approved (attach comments) C
Notation:
REVIEWER'S INITIALS: DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
Documents/routing slip.doc
2 -28 -02
ACTIVITY NUMBER: PG07 -190 DATE: 07 -18 -07
PROJECT NAME: SOUTHCENTER SQUARE - BLDG S
SITE ADDRESS: 17250 SOUTHCENTER PY
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter #
Revision # After Permit Issued
DEPART ENTS:
e A -1•21.0
Bui ing D ion MI
Public Works ❑
Complete
Comments:
Documents/routing slip.doc
2 -28 -02
PERMIT COORD COPY `•-
PLAN REVIEW /ROUTING SLIP
APPROVALS OR CORRECTIONS:
Fire Prevention
Structural
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Incomplete n
TUES/THURS ROU ING:
Please Route Structural Review Required
REVIEWER'S INITIALS:
DATE:
Planning Division
Permit Coordinator
No further Review Required
❑
DUE DATE: 07-19-07
Not Applicable ❑
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
n
DUE DATE: 08-16-07
Approved ❑ Approved with Conditions ❑ Not Approved (attach comments)
Notation:
REVIEWER'S INITIALS: DATE:
Permit Center Use Only
CORRECTION LETTER MAILED: °410I°1'
Departments issued corrections: Bldg] Fire ❑ Ping ❑ PW ❑ Staff Initials:
REVISION
NO.
DATE RECEIVED
STAFF
INITIALS
ISSUED DATE
STAFF
INITIALS
1
0 129 01—
10
9 `) -ce-o 1
Summary of Revision: froot9 ( 6-A astir 'S - 6/0 Yet, 4 1..1 K/f1Z
Summary of Revision:
Received by: Al £.v r 44 16-5 So h
Received by:
REVISION
NO.
DATE RECEIVED
STAFF
INITIALS
ISSUED DATE
STAFF
INITIALS
1
0 129 01—
10
9 `) -ce-o 1
Summary of Revision: froot9 ( 6-A astir 'S - 6/0 Yet, 4 1..1 K/f1Z
Summary of Revision:
Received by: Al £.v r 44 16-5 So h
Received by:
Received by:
REVISION
NO.
DATE RECEIVED
STAFF
INITIALS
ISSUED DATE
STAFF
INITIALS
1
0 129 01—
10
9 `) -ce-o 1
Summary of Revision: froot9 ( 6-A astir 'S - 6/0 Yet, 4 1..1 K/f1Z
Summary of Revision:
Received by: Al £.v r 44 16-5 So h
Received by:
REVISION
NO.
DATE RECEIVED
STAFF
INITIALS
ISSUED DATE
STAFF
INITIALS
1
0 129 01—
10
9 `) -ce-o 1
Summary of Revision: froot9 ( 6-A astir 'S - 6/0 Yet, 4 1..1 K/f1Z
Summary of Revision:
Received by: Al £.v r 44 16-5 So h
Received by:
REVISION
NO.
DATE RECEIVED
STAFF
INITIALS
ISSUED DATE
STAFF
INITIALS
1
0 129 01—
10
9 `) -ce-o 1
Summary of Revision: froot9 ( 6-A astir 'S - 6/0 Yet, 4 1..1 K/f1Z
Summary of Revision:
Received by: Al £.v r 44 16-5 So h
Received by:
REVISION
NO.
DATE RECEIVED
STAFF
INITIALS
ISSUED DATE
STAFF
INIITJALS
1
0 129 01—
10
9 `) -ce-o 1
Summary of Revision: froot9 ( 6-A astir 'S - 6/0 Yet, 4 1..1 K/f1Z
Received by: Al £.v r 44 16-5 So h
PROJECT NAME: C - _ PERMIT NO:
SITE ADDRESS: ` P ORIGINAL ISSUE DATE:
REVISION LOG
(please print)
(please print)
(please print)
(please print)
(please print)
Date: / - ,2o -- d 7
(, /1 tS .
Entered in Permits Plus on
\applications\forms- applications on line\revision submittal
Created: 8 -13 -2004
Revised:
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
Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through
the marl, fax, etc.
Plan Check/Permit Number: 1 — 1 ° I, 0
❑ Response to Incomplete Letter #
❑ Response to Correction Letter #
▪ Revision # I after Permit is Issued
❑ Revision requested by a City Building Inspector or Plans Examiner
Project Name: SD [A. ti Ce r.. fel SQ Itia ft_ / Pte 5 5 1i¢ieN
Project Address: / 7 2 $C //(wV //
Contact Person: RQ EA. r /,►d4 k,'$ 5cr Phone Number: 360 or S 33
Summary of Revision:
4 s c t, - /ef s r /7.Q ..4.¢,e,() 174/Ac
Sheet Number(s):
"Cloud" or highlight all areas of revision including date o
Received at the City of Tukwila Permit Center by: Ij
revision
RF CC NCD
CITY ofrU iL4
5E P 2 0 2007
Date:
City of Tukwila
REVISION SUBMITTAL
Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through
the mail, fax, etc.
Response to Incomplete Letter #
• Response to Correction Letter #
❑ Revision # after Permit is Issued
❑ Revision requested by a City Building Inspector or Plans Examiner
Project Name: Southcenter Square, Bldg S
Project Address: 17250 Southcenter Py
Contact Person: 8� � K 1 S�o� Phone Number: : 5V33
Summary of Revision:
V "(S
Sheet Number(s):
"Cloud" or highlight all areas of revision including date of revvis'on
Received at the City of Tukwila Permit Center by:
Si Entered in Permits Plus on 8-k 7
\applications\forms- applications on line\revision submittal
Created: 8 -13 -2004
Revised:
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
Plan Check/Permit Number: PG07-190
Steven M. Mullet, Mayor
Steve Lancaster, Director
R ECE/VED
CITY of TUM
AUS 13 2001+
a E i i7 CFNT E — p
License Information
License
D15MEM *930BT
Licensee Name
D15 MECHANICAL
Licensee Type
CONSTRUCTION CONTRACTOR
UBI
601841514
Ind. Ins. Account Id
Business Type
INDIVIDUAL
Address 1
2020 S 320TH ST #C -90
Address 2
City
FEDERAL WAY
County
KING
State
WA
Zip
98003
Phone
3608885433
Status
ACTIVE
Specialty 1
AIR HEAT,VENTILATION,EVAPORAT
Specialty 2
SHEET METAL
Effective Date
1/30/2007
Expiration Date
1/30/2009
Suspend Date
Separation Date
Parent Company
Previous License
Next License
Associated License
Business Owner Information
Name
Role
Effective Date
Expiration Date
ADKISSON, BRENT
OWNER
01/30/2007
Look Up a Contractor, Electrician or Plumber License Detail
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.
Bond Information
No Matching Information
Savings Information
Savings
Bank
Name
Bank
Branch
Location
Assignment
of Savings
Number
Effective
Date
Release
Date
Assignment
Type
Impaired
Date
Amount
Received
Date
Page 1 of 2
https: // fortress .wa.gov /lni/bbip /printer.aspx ?License= D15MEM *930BT 08/15/2007
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