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HomeMy WebLinkAboutPermit PG07-302 - BROOME RESIDENCEBROOME RESIDENCE 3320 S 132 ST PGO7-302 Parcel No.: 1523049058 Address: 3320 S 132 ST TUKW Suite No: Tenant: Name: Address: Contact Person: Name: PADDY BROOME Address: 3320 S 132 ST , TUKWILA WA DESCRIPTION OF WORK: REPLACE EXISTING ELECTRIC WATER HEATER doc: UPC -10/06 Cityf Tukwila Owner: Name: BROOME PADDY M Address: 3320 S 132ND ST , TUKWILA WA Contractor: Name: OWNER AFFIDAVIT - PADDY BROOME Address: 3320 S 132 ST , TUKWILA WA Contractor License No: BROOME RESIDENCE 3320 S 132 ST , TUKWILA WA Plumbing Bathtub or combination bath/shower 0 Bidet 0 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 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 PLUMBING /GAS PIPING PERMIT FIXTURE TYPE AND OUANTITY * *continued on next page ** Permit Number: Issue Date: Permit Expires On: Phone: Phone: Phone: Expiration Date: Uniform Plumbing Code Edition: 2006 2006 Value of Plumbing /Gas Piping: $200.00 Fees Collected: $88.00 International Fuel Gas Code Edition: PGO7 -302 11/09/2007 05/07/2008 Plumbing (cont.) Building sewer and each trailer park sewer 0 Rain water system - per drain (inside bldg) 0 0 Water heater and/or vent 1 0 Industrial waste treatment interceptor, including 0 its trap and vent, except for kitchen type O grease interceptors 0 0 Repair or alteration of water piping and/or water O treatment equipment 0 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 O Gas Piping 0 Gas piping outlets (0 -5) 0 0 Gas piping outlets (6 +) 0 PG07 -302 Printed: 11 -09 -2007 Permit Center Authorized Signature: 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 authorized to sign and obtain this plumbing /gas piping permit. 40 41 Date: t Signature: - t -o' r doc: UPC -10/06 Print Name: iPad City di 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 (1/41 roct"-L--.2— Lu,i1L Permit Number: PG07 -302 Issue Date: 11/09/2007 Permit Expires On: 05/07/2008 Date: 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 -302 Printed: 11 -09 -2007 Parcel No.: 1523049058 Address: Suite No: Tenant: 1: ** *PLUMBING AND GAS PIPING * ** doc: Cond - 10/06 3320 S 132 ST TUICW BROOME RESIDENCE 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: Status: Applied Date: Issue Date: PG07 -302 ISSUED 11/09/2007 11/09/2007 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: 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 -302 Printed: 11 -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: )1 i' Print Name: Pa dM doc: Cond -10/06 Date: 11-0q-07 PG07 -302 Printed: 11 -09 -2007 Site Address: 3 3 °fi(23 S 1 3 S Tenant Name: Po, eAdt 4 (Zbowl Property Owners Name: Po,.,A11 ti c R)+200vN-■ - N(s Mailing Address: 2 2 2 0 S \3a 5 - T L-& K w 1 L 1 � City Name: 'Pa okel (.j (2.,C.>0 kne1 Mailing Address: 23 ad 5 12 r E -Mail Address: Contact Person: E -Mail Address: Contractor Registration Number: Contact Person: E -Mail Address: CITY OF TUKWILL Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us OA Applications On Line\3 -2006 - Plumbing -Gas Piping Permit Application.doc Revised: 4 -2006 bh PlumbinglGas Permit Rio. Project No. For 42 use 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 ** Suite Number: New Tenant: State State State GY 0) ;3 3 King Co Assessor's Tax No.: I SJ- 30R q 0 Floor: .... Yes ❑ ..No (.v r9 9$ 16 B State Zip CONTACT PERSON —Who do we contact when your permit is ready to be issued Day Telephone: =906 c Li 3 3 6 I q T(A\& G-5 &) 9S 16 8 City State Zip Fax Number: PLUMBING / GAS PIPING CONTRACTOR INFORMATION Name: Mailing Address: Zip City Day Telephone: Fax Number: Expiration Date: ARCHITECT OF RECORD - Al! plans must be wet stamped by Architect of iteeorli 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 Record Company Name: Mailing Address: Zip City Day Telephone: Fax Number: Page 1 of 2 Fixture Type: Fixture Type: Qty ;Fix #ure: Type: Qty Fixture Type :. 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 I i 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): $ caC , 0 0 Scope of Work (please provide detailed information): ■C A-C g:Irv\ -- kr - f 0-e ex 1 -}- i tv 5 \' - - A-t e 14 c-)4 Building Use (per Intl Building Code): Occupancy (per Int'1 Building Code): Utility Purveyor: Water: Sewer: 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 O P WNER OR AUTHORIZED AGENT: Signature: _C! t # i d , ° ` i -o-04^-t- Date: \ t , °, d Print Name: Pa cir (.j i✓Y1 T12O Pv Day Telephone(c 4 " 3 6 I cl Mailing Address: 2 3 2O ....5"' 13 c o S T TL1K ( t L Gin q g n-G g City State Zip Date Application Expires: Date Application Accepted: Q:\Applications\Forms - Applications On Linel3 -2006 - Plumbing -Gas Piping Permi Application.doc Revised: 4 -2006 bh Staff Initials: Page 2 of 2 Receipt No.: R07 -02465 Payee: PADDY BROOME 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 Parcel No.: 1523049058 Permit Number: PG07 -302 Address: 3320 S 132 ST TUKW Status: PENDING Suite No: Applied Date: 11/09/2007 Applicant: BROOME RESIDENCE Issue Date: Initials: WER Payment Date: 11/09/2007 04:33 PM User ID: 1655 Balance: $0.00 TRANSACTION LIST: Type Method Description Amount Payment Cash 88.00 Account Code Current Pmts 000/322.100 88.00 Total: $88.00 Payment Amount: $88.00 4925 11/13 9710 TOTAL. 138.00 doc: Receiot -06 Printed: 11 -09 -2007 Proj , ODOA t � Type oflpsection: p f- / N f Address: i 32 32 Date Called: Special Instructions: Date i a /tec): / (( / . rn. Requester: Phone No: INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION R 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3 7 k nspecto Approved per applicable codes. ❑ Corrections required prior to approval. COMMENTS: (1:; r- n'1 p )e-le (Recei • ' o.. ce p /av�„ 'Date: I / ate; INSPECTION FE REQUIRED. PrI to inspection. fee must be 00 Southcenter Blvd.. Suite 100 Call the schedule reinspection. COUNTY OF KING 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) G}�_a:��ys U4 .tw it AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION Nj,' 4(./13%„‘C) i ?2 _ ss. 1 ‘4 coow [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. L3 , 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. \applications -2004 affidavit in lieu of contractor registration APPLICAN Signed and sworn to before me this day of J V , 200 . e N ARY P and for the State of ashington, Residing at ' l__( _ , County. S A .. in . L � iS Name as commissioned: ( C 1 z(11 My commission expires: PERMIT NO.: ©7 L2 PLqci -3o , states as follows: &0-6"4"-t--