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Home My WebLink AboutPermit PG07-294 - CHIPOTLE MEXICAN GRILLCHIPOTLE MEXICAN GRILL 17250 SOUTHCENTER PY PGO7-294 Parcel No.: Address: Suite No: Tenant: Name: Address: Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: Address: doc: UPC - 10/06 2623049117 17250 SOUTHCENTER PY TUKW CHIPOTLE MEXICAN GRILL 17250 SOUTHCENTER PY , TUKWILA WA WIG PROPERTIES LLC -SS 4811 134TH PL SE , BELLEVUE WA BRENT ADKISSON 2020 S 320 ST #C - 90 , FEDERAL WAY WA D15 MECHANICAL 2020 S 320 ST #C -90 , FEDERAL WAY WA Contractor License No: DI5MEM *930BT 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 Cit 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 $500.00 $110.00 FIXTURE TYPE AND OUANTITY * *continued on next page ** PLUMBING /GAS PIPING PERMIT Permit Number: Issue Date: Permit Expires On: Expiration Date: 01/30/2009 DESCRIPTION OF WORK: INSTALL 2 EACH NEW GAS LINES TO 2 EACH ROOF TOP UNITS FROM EXISTING 2" GAS LINE IN SPACE Phone: Phone: 360 - 888 -5433 Phone: 360 888 -5433 PG07 -294 12/06/2007 06/03/2008 Uniform Plumbing Code Edition: 2006 International Fuel Gas Code Edition: 2006 Plumbing (cont.) O 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 O Repair or alteration of water piping and/or water O treatment equipment 0 0 Repair or alteration of drainage or vent piping 0 O Medical gas piping system serving (1 -5) 0 inlets /outlets for a specific gas 0 0 Medical gas piping (6 +) inlets /outlets 0 O Gas Piping 0 Gas piping outlets (0 -5) 2 O Gas piping outlets (6 +) 0 PG07 -294 Printed: 12 -06 -2007 Permit Center Authorized Signature: Signature: doc: UPC -10/06 City oYTukwila 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 LALA Permit Number: PGO7 -294 Issue Date: 12/06/2007 Permit Expires On: 06/03/2008 Date: 49 'O 7 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 wor I am authorize d sigrt and obtain this plumbing /gas piping permit. Zt!� Print Name: � k [" 7 /4 i $S ,\ Date: C--c 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 - 294 Printed: 12 -06 -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 CHIPOTLE MEXICAN GRILL 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. PGO7 -294 ISSUED 11/01/2007 12/06/2007 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: 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. 8: 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. 9: 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 -294 Printed: 12 -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: doc: Cond - 10/06 Print Name: £ Ni 0k ) - Sfn... Date: /2- 6 PG07 -294 Printed: 12 -06 -2007 CITY OF TUKWILk Community DevelopmenTDepartment 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** King Co Assessor's Tax No.: a (p 4— 0 q a ' - ] Site Address: 1 7250 t�-f /�C2 ✓ w V Suite Number: / O Floor: 1 New Tenant: .... Yes D ..No Tenant Name: C k , O - t / e Property Owners Name: W Mailing Address: '/ /( 5 I 13 5' 77.• /az L LC -SS if e j /e U u e City CONTACT PERSON -Who do we contact when your permit is ready to be issued Name: e £,'1 Ad k`s$o Mailing Address: 2 O S , . -o S7' #(4)0 E -Mail Address: -. PLUMBING / GAS PIPING CONTRACTOR INFORMATION Company Name: Mailing Address: 1/.c- C ,)„.O St 0 St Contact Person: i-1/7 p f k,SS■ E -Mail Address: n q Contractor Registration Number: 1 /S /V A4 C / ,.9d e 7 Expiration Date: W State ?ems 6 State Zip Day Telephone: 3 _4913 Sy33 Fed w G.1/1- 78043 City State Zip Fax Number: C-41:7 f do a) w . c^r4- �cro.3 State Zip City Day Telephone: 3& e -e 5933 Fax Number: / -3U -200, 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: ENGINEER OF RECORD - All plans must be wet stamped by Engineer of Recor Company Name: Mailing Address: Contact Person: E -Mail Address: Q:Wpplications\Fonns- Applications On LineG -2006 - Plumbing -Gas Piping Permit Application.doc Revised. 4-2006 bh State City Day Telephone: Fax Number: Zip Page 1 of 2 Fixture Type: Qty ° "Fixture Type: Qty , 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 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): $ Scope of Work (please provide detailed information): _Z 1 9 ew C 5 L ,', - 70 I-10 ✓ Top (AAA FICAM E I'S , ti 2 tr S , ,',R./ 5-Ace Building Use (per Int'l Building Code): Occupancy (per Int'l 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 OWN Signature: Date Application Accepted: OR AUT 0 ZED :. EN : Print Name: r- 7 / 4! x o 5 Mailing Address: Qo RO 5-t 520 S f # IO Q:Wpplications\Forms- Applications On Line\3 -2006 - Plumbing -Gas Piping Permit Application.doc Revised: 4 -2006 bh Sewer: Day Telephone: fed Cit Date: 7 ?66 -UT -5 State Zip Date Application Expires: Staff Initials: Page 2 of 2 Receipt No.: R07 -02682 Payee: BRENT ADKISSON TRANSACTION LIST: Type Method Description ACCOUNT ITEM LIST: Description GAS - 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.: 2623049117 Permit Number: PG07 -294 Address: 17250 SOUTHCENTER PY TUKW Status: APPROVED Suite No: Applied Date: 11/01/2007 Applicant: CHIPOTLE MEXICAN GRILL Issue Date: Initials: WER Payment Date: 12/06/2007 03:03 PM User ID: 1655 Balance: $0.00 Amount Payment Cash 88.00 Account Code Current Pmts 000/322.100 88.00 Total: $88.00 Payment Amount: $88.00 5745 12/06 9710 TOTAL 973.31 doc: Receiot -06 Printed: 12 -06 -2007 Receipt No.: R07 -02398 Payee: BRENT ADKISSON TRANSACTION LIST: Type Method Description ACCOUNT ITEM LIST: Description PLAN CHECK - 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.: 2623049117 Permit Number: PG07 -294 Address: 17250 SOUTHCENTER PY TUKW Status: PENDING Suite No: Applied Date: 11/01/2007 Applicant: CHIPOTLE Issue Date: Initials: WER Payment Date: 11/01/2007 03:23 PM User ID: 1655 Balance: $88.00 Amount Payment Cash 22.00 Account Code Current Pmts 000/345.830 22.00 Total: $22.00 Payment Amount: $22.00 TDTL 200_E doc: Receiot -06 Printed: 11 -01 -2007 Project: h E N b-tc,e VY < .,1 Type of Inspection: - - lyvi (-- ‘ Address: Date Called: Special Instructions: / Dat Wanted: . a. LI -I 6-40 Requester: Phone No 2 6 — p, - s-tr3 INSPECTION RECORD Retain a copy with permit PPa ' INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION Fz 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Approved per applicable codes. Corrections required prior to approval. COMMENTS: u.! i t , 1 c P Inspect: Date:4 — $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection. 'Receipt No.: - Date: Pro ,st/ / ,� Type of s r— `, Address: a jewlLnG / /pate Called: Special Instructions: Date d:/ /,,, Requester: P o "- 3 00‘....g.-- -Ca J , INSPECTION RECORD Retain a copy with permit INSPECTION NO. CITY OF TUKV(/ILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 PERMIT NO. (206)431 -3 Approved per applicable codes. ❑ Corrections required prior to approval. COMMENTS: .00 REINSPECTION FE REQUIRED. Pri aid at 6300 Southcenter : lvd.. Suite 100 (Receipt No.: to inspection, fee must be 11 the schedule reinspection. 'Date: "Chipotle" Southcenter Square Gas Pipe Plan for HVAC Roof Top Units FILE COPY Penn/ No, Ran review approval Is subject to enure and omissions. Approval of construction documents does not authorize the violation of any adopted code or ordinance. Receipt of approved Field Copy and cola= Is acknosiedged: BY, D ate:, City of Tukwila BUILDING DIVISION 2" Square Washer w/nut Bar Joist 3/8" All Thread Loop Pipe Hanger 64,611116,116.616666.6, SEPARATE PERMIT REQUIRED FOR: DirMechanical t Electrical El Plumbing o Gas Piping City of Tukwila Rin_rmG DIVISION •••■■ stmonsars MVOS. Single Gas Line Hanging Detail Beam Clamp Bar Joist 3/8" All Thread Loop Pipe Hanger REVISIONS Nio changes shall be made to the scope of work without prior approval of Tukwila Building Division. NOTE: Revisions will require a new plan submittal 4nd may include additional plan review fees. 1 --, NSW WSW* MSS. 7'7'7 *71 fr r ; • 114,SIN • •M• RV. t Vt. NI 0,0 MORIPM MINA .11111111/1041 MI. IMPS New 1" Gas Line • .1,41111 . 11VV=111.M , 1,1.111PtteMIIIMBNI 4 NROMMINEMO • 11,11.11,11111111M SIII*44••••• iNO,A11.=1511•1 ▪ HIIIIMMINA.1 111,11.41111.111•11111.14111.111 ittrISMIYISSISstsa 16411 , S ssrassme S sr - ma... mom yr susta—os 1151. btr,34, WM' Ir W VIM'. • REVIEWED FOR CODE COMPLIANCE APPROVED NOV 3 0 2007 BUILDING DIVISION a 1) a)' -r TGD`i 2_9g Of Tukwi a .6. z CD CD 0 Polni of Connection 03 Cl) tt = 1 = k CD il cn . - ' "'..7r . ........ .... 0. .........., F WAN t ea. a-t.n.'....it0,,,,,,,,,,P4R41,5,-,!....0•N,,,Av.S.AVrniktnNgtoemno..44p.,......T.p.,,,,y,,,,,,stoWe4...,,,,,%,71,. ,,,,,;,,,g, t,,,,,,t, t.,,,',..„4$ rtpf .1 t.4 ,L1 Ii MONVant.001 .(411.1,1WPC ttssetts*westatest WIPPeent...11 giVte.1.44.40 • • "“-s 7•7""7"° _11 Gas Pipe Plan KEW NOV_ - 1 2007 PERMIT GENIE PERMIT COORD COPS PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG07 -294 DATE: 11 -01 -07 PROJECT NAME: CHIPOTLE SITE ADDRESS: 17250 SOUTHCENTER PY SUITE 108 X Original Plan Submittal Response to Correction Letter # Response to Incomplete Letter # Revision # After Permit Issued DEPARTMENTS: 21 M B i .j ng uivision Public Works Structural DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Incomplete ❑ Complete Comments: Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES/THURS ROUTING: Please Route Documents/routing slip.doc 2 -28 -02 Fire Prevention Structural Review Required Planning Division ❑ Permit Coordinator C DUE DATE: 11 -6 -07 Not Applicable ❑ No further Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved ❑ Approved with Conditions DUE DATE: 12 -4 -07 Not Approved (attach comments) n Notation: REVIEWER'S INITIALS: DATE: n Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: 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 Page 1 of 2 L., 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 https: // fortress .wa.gov /lni/bbip /printer.aspx ?License =D 15MEM *930BT 12/06/2007