HomeMy WebLinkAboutPermit PG07-191 - JENSEN RESIDENCEJENSEN RESIDENCE
4106 S 130 ST
EXPIRED 10-04-08
PGO7-191
Parcel No.: 7340600769
Address:
Suite No:
Tenant:
Name:
Address:
Owner:
Name:
Address:
Value of Plumbing/Gas Piping:
doc: UPC -10/06
4106 S 130 ST TUKW
City f 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
JENSON RESIDENCE
4106 S 130 ST , TUKWILA WA
JENSEN JOEL +SOPHIA L
4106 S 130TH ST , TUKWILA WA
Contact Person:
Name: JOEL JENSON
Address: 4106 S 130 ST , TUKWILA WA
Contractor:
Name: OWNER AFFIDAVIT - JOEL JENSON
Address: 4106 S 130 ST , TUKWILA WA
Contractor License No:
PLUMBING /GAS PIPING PERMIT
DESCRIPTION OF WORK:
PLUMBING TO I TUB, 1 SHOWER, 2 LAVATORIES AND 1 TOILET ON 2ND FLOOR
Fees Collected: $216.00
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
Permit Number:
Issue Date:
Permit Expires On:
Expiration Date:
Phone:
Phone: 206 - 353 -3479
Phone:
$0.00 Uniform Plumbing Code Edition:
FIXTURE TYPE AND QUANTITY
Plumbing (cont.)
1 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
0 its trap and vent, except for kitchen type
0 grease interceptors
0 Repair or alteration of water piping and/or water
0 treatment equipment
Repair or alteration of drainage or vent piping
2 Medical gas piping system serving (1 -5)
0 inlets/outlets for a specific gas
0 Medical gas piping (6 +) inlets/outlets
0 Gas Piping
0 Gas piping outlets (0 -5)
1 Gas piping outlets (6 +)
* *continued on next page **
PG07 -191
International Fuel Gas Code Edition:
PG07 -191
07/18/2007
01/14/2008
2006
2006
0
0
0
0
0
0
0
0
1
0
Printed: 07 -18 -2007
Permit Center Authorized Signature:
Print Name:
doc: UPC -10/06
City o '`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 -191
Issue Date: 07/18/2007
Permit Expires On: 01/14/2008
Date: - 1-1Q-0
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 am ., thorized • si d obtain this plumbing/gas piping permit.
Signature: �.ff�+� �� Date:
IF
0 j'f'
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 -191 Printed: 07 -18 -2007
Parcel No.: 7340600769
Address: 4106 S 130 ST TUKW
Suite No:
Tenant: JENSON RESIDENCE
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
PERMIT CONDITIONS
* *continued on next page **
Permit Number: PG07 -191
Status: ISSUED
Applied Date: 07/18/2007
Issue Date: 07/18/2007
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.
PG07 -191 Printed: 07 -18 -2007
Signature:
Print Name:
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
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.
Dater g al-
PG07 -191 Printed: 07 -18 -2007
Tenant Name:
Name:
Mailing Address:
E -Mail Address:
Contact Person:
E - Mail Address:
E -Mail Address:
CITY OF TUKWIL
Community Developmenrriepartment
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.ci.tukwila.wa.us
Site Address: 1/m6 Jmti ► (30 T
Property Owners Name: Joan T cJ EHJ t f
Mailing Address: q, c) & de-a? /30r" ST
CONTACT PERSON -Who do we contact when your permit is ready to be issued
t_ T.
Q:\Applications\Forms- Applications On Line\3 -2006 - Plumbing -Gas Piping Permit Application.doc
Revised: 4 -2006
bh
0 (RI
Plumbing/Gas Permit No
Project No.
For o, f ce use only
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.: 7 3 C) (DO - lP
Suite Number: Floor:
New Tenant: ❑ .... Yes ❑ ..No
City
GA1 9104.4R
State Zip
au NG C. Day Telephone: oCe) 3 —343
C� 4
City State Zip
Fax Number: (i7-3') ZZ $ — 6 6 4 `t
PLUMBING / GAS PIPING; CONTRACTOR INFORMATIO
Company Name:
Mailing Address:
City
Day Telephone:
Fax Number:
State
Contractor Registration Number: Expiration Date:
ARCHITECT OF RECORD - All plans must be wet stamped by Architect of Record
Company Name:
Mailing Address:
Zip
Contact Person:
E -Mail Address:
City
Day Telephone:
Fax Number:
State
ENGINEER OF RECORD All plans must be wet stamped by Engineer of Record
Company Name:
Mailing Address:
Zip
Contact Person:
City
Day Telephone:
Fax Number:
State
Zip
Page 1 of 2
Fixture Type:.
Qty
. ,Fixture Type
Qxy
Fixture Type
Qty
Fixture .Type:
Qty
Bathtub or combination
bath/shower
rp
Lie'
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
14
Dental unit, cuspidor
Shower, single head trap
1
Urinals
Dishwasher, domestic,
with independent drain
Lavatory
I
Water Closet
I
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): $ 7eX5
Scope of Work (please provide detailed information): P L t} (M. \
- StAr1CS fi TOIL €TS 60V 2N■
Building Use (per Intl Building Code):
Occupancy (per Intl Building Code):
Utility Purveyor: Water:
Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below:
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 OWNE ' 0 '_• AU . 0 ED AGENT:
Signature:
Print Name
Mailing A • dress:
Date Application Accepted:
Q:\Applications\Forms- Applications On Line G-2006 - Plumbing -Gas Piping Permit Application.doc
Revised: 4 -2006
bh
9.6.57 d6-t"t1 )44—
51A c e ,g4
Sewer:
£ 19-1 l ert ST
10 -TLcg siintA9Gr
Day Telephone:
Tar-wg
City
Date: 1! ® "I-
Cam) W3 � �
9fc"7
State Zip
Date Application Expires:
Staff Initials:
Page 2 of 2
i
Receipt No.: R07 -01428
Initials: WER
User ID: 1655
Payee: JOEL JENSEN
ACCOUNT ITEM LIST:
Description
GAS - RES
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
Parcel No.: 7340600769 Permit Number: PG07 -191
Address: 4106 S 130 ST TUKW Status: PENDING
Suite No: Applied Date: 07/18/2007
Applicant: JENSON RESIDENCE Issue Date:
Payment Date:
Balance:
TRANSACTION LIST:
Type Method Description Amount
Payment Cash 216.00
Account Code Current Pmts
000/322.100 88.00
000/322.100 128.00
Total: $216.00
Payment Amount: $216.00
07/18/2007 05:31 PM
$0.00
0462 07/20 9716 TOTAL 266.00
doc: Receipt-06 Printed: 07 -18 -2007
PrqjpI
%., A/5 / •
Type of I -
-
Address
i ldi
/di , S ao p (
Date Called:
Special Instructions:
Date Wanted:
4 / — 7 — 04:3:
1.1.
Requester:
Phone No
INSPECTION RECORD •
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 981 88
PERMIT NO.
g• -
(206)431-3670
i A pproved per applicable codes.
COMMENTS:
IDate:,/h/
Inspector: ,-.
LI Corrections required prior to approval.
LI $58 FEE REQUIRED. Prior to inspection, fee must be
pai at 6300 Southcenter Blvd., Suite 100. Call the schedule reinspection.
Receipt No.:
IDate:
Projec
Fiv�N 'Qs ■
Type at Inspectipn: ,
/ •N
/
Addre J / / s
1365-1
Date Called:
Special Instructions:
Date Wa d:
/0 / ?d
a.m.
cr-
Requester:
Phone No:
- j'
35/79
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
proved per applicable codes. Corrections required prior to approval.
COMM ENT
Inspector'
I Dat,7) /0--)
58A0 REINSPECTION FEE REQ IRED. Pr ior to inspection, fee must be
a d at 6300 Southcenter Blvd., Stl 100. Call the schedule reinspection.
Receipt No.: 'Date:
INSPEGIION RECORD
Retain a copy with permit
PERMIT NO.
(206)431 -3670
P 7 J S n/
S
Type of Inspection:
(Zm s k — , - P lZc,v
Address:
() ( S
I U S
Date Called:
Special Instructions:
/L
Date Wanted:
i
a.m.
Requester:
Phone No:
:0, -7
5 _ 5 -c 2
f)
INSPECTION RECORD
Retain a copy with per
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -367
Approved per applicable codes., Corrections required prior to approval.
COMMENTS:
/ • 7wcy m47/--
Inspector/
Lt..ry -
I
$58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection.
Receipt No.:
IDate:
09 -08 -2008
JOEL JENSEN
4106 S 130 ST
TUKWILA WA 98168
RE: Permit No. PG07 -191
4106 S 130 ST TUKW
Dear Permit Holder:
In reviewing our current records the above noted permit has not received a fmal inspection by the City of Tukwila Building Division.
Per the International Codes, Uniform Plumbing/Fuel Gas Code and/or the National Electrical Code, every permit issued by the
Building Division under the provisions of the 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 issuance, 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 International Codes, Uniform Plumbing/Fuel Gas Code and/or the National Electrical 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 10/04/2008 , your permit will become null and
void and any further work on the project will require a new permit application and associated fees.
Thank you for your cooperation in this matter.
Sincerely,
f‘19
fer Marshall
Permit Technician
xc: Permit File No. PG07 -191
City of Tukwila
Jim Haggerton, Mayor
Department of Community Development Jack Pace, Director
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
03 -05 -2008
JOEL JENSEN
4106 S 130 ST
TUKWILA WA 98168
RE: Permit No. PG07 -191
4106 S 130 ST TUKW
Dear Permit Holder:
In reviewing our current records the above noted permit has not received a final inspection by the City of Tukwila Building Division.
Per the International Codes, Uniform Plumbing/Fuel Gas Code and/or the National Electrical Code, every permit issued by the
Building Division under the provisions of the 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 issuance, 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 final 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 International Codes, Uniform Plumbing/Fuel Gas Code and/or the National Electrical 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 writinE 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 04 /09/2008 , your permit will become null and
void and any further work on the project will require a new permit application and associated fees.
Thank you for your cooperation in this matter.
Sincerely,
xc:
fer Marshall
t Technician
Permit File No. PG07 -191
city of Tukwila
Jim Haggerton, Mayor
Department of Community Development Jack Pace, Director
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
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.
jcw J
[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.
G e. A. Dk:a;Itr
PJ AsSION L'k t
i • U C�OTA,? % : ',
• N' • PUBLIC :'2
r
CIE-
_ , WASN.� ,
\applications\8 -2004 affidavit in lieu of contractor registration
A
Sign
and sworn to be ore me this
PERMIT NO.: "Vb 0 7
, states as follows:
� *,6 day of . uIy/ , 20 07
NOTARY PUBLIC in and for th State of Washington,
Residing at kinj , County.
Name as commissioned: /7/l Ce /7• £ ac y
My commission expires: 1646 -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.