HomeMy WebLinkAboutPermit PG06-002 - GRAY RESIDENCEGRAY RESIDENCE
4044 S 128 ST
EXPIRED 10 -23 -06
PG06 -002
Parcel No.:
Address:
Suite No:
Tenant:
Name:
Address:
City t ' Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 - 431 -3665
Web site: ci.tukwila.wa.us
7340600686
4044 5 128 ST TUKW
GRAY RESIDENCE
4044 S 128 ST, TUKWILA WA
Owner:
Name: STEIN DAVID L
Address' 4054 S 128TH ST, TUKWILA WA
Contact Person:
Name: LEROY GRAY
Address' 1760 FERRY AV SW, SEATTLE WA
Value of Plumbing /Gas Piping: $0.00
Fees Collected: $168.00
Plumbing
Bathtub or combination bath /shower
sewer 0
Bidet 0
Clothes washer, domestic 1
Dental unit, cuspidor 0
Dishwasher, domestic, with independent drain
Drinking fountain or water cooler (per head)
0
Food -waste grinder, commercial 0
Floor drain 0
Shower, single head trap
Lavatory 1
Wash fountain 0
Receptor, indirect waste 0
Sinks 2
doe: UPC - Permit
PLUMBING /GAS PIPING PERMIT
Contractor:
Name: OWNER AFFIDAVIT ON FILE - MARCI GRAY
Address' ,
Contractor License No:
Expiration Date:
DESCRIPTION OF WORK:
REFINISH PLUMBING FOR TWO BATHROOMS
1) MAIN FLOOR TUB /SHOWER, SINK, TOILET, WATER, DRYER
2) PLUMBING IS TUB ONLY, ROUGH -IN FOR FUTURE BATHROOM WAISTLINE FOR TOILET,
SINK, TUB /SHOWER UNIT
FIXTURE TYPE AND QUANTITY
Gas Pining
Permit Number:
Issue Date:
Permit Expires On:
Phone:
Phone: 206 660 8667
Phone:
Steven M. Mullet, Mayor
Steve Lancaster, Director
PG06 -002
04/04/2006
10/01/2006
Uniform Plumbing Code Edition: 2003
International Fuel Gas Code Edition: 2003
plumbing (cont.)
1 Building sewer and each trailer park
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
Repair or alteration of water piping and /or water
treatment equipment 1
2 Medical gas piping system serving one to five
inlets /outlets for a specific gas 1
PGO6 -002 Printed: 04-04 -2006
Urinals 1 Gas piping outlets (0 -5) 1
Water Closet 1 Gas piping outlets (6 +) 0
doc: UPC - Permit
City t Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 - 431 -3665
Web site: ci.tukwila.wa.us
* *continued on next page **
Steven M. Mullet, Mayor
Steve Lancaster, Director
PG06 -002 Printed: 04 -04 -2006
Permit Center Authorized Signature:
I hereby certify that I have read an
Print Name:
doe: UPC - Permit
City tk Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Fax: 206 -431 -3665
Web site: cttukwila.wa.us
ikaA49
Steven M. Mullet, Mayor
Steve Lancaster, Director
Permit Number: PG06 -002
Issue Date: 04/04/2006
Permit Expires On: 10/01/2006
Date:
this permit and know the same to be true and correct. All provisions of law and
ordinances governing this work will 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 constru ion or the performance of w rk. I am authorized to sign and obtain this plumbing /gas piping permit.
Signature: Date: "t — — 1 —
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.
PG06 -002 Printed: 04 -04 -2006
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 7340600686
Address' 4044 S 128 ST TUKW
Suite No:
Tenant: GRAY RESIDENCE
doc: Conditions
PERMIT CONDITIONS
* *continued on next page **
Permit Number: PG06 -002
Status: ISSUED
Applied Date: 04/04/2006
Issue Date: 04/04/2006
1: ** *BUILDING DEPARTMENT CONDITIONS * **
2: ** *PLUMBING AND GAS PIPING * **
3: No changes shall be made to applicable plans and specifications unless prior approval is obtained from the Tukwila
Building Division.
4: All permits, inspection records and applicable plans shall be maintained at the job and available to the plumbing
inspector.
5: All plumbing systems shall be installed in compliance with the Uniform Plumbing Code.
6: No portion of any plumbing system shall be concealed until inspected and approved.
7: All plumbing systems shall be tested and approved as required by the Plumbing 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.
8: 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.
9: 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.
10: 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.
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 any other ordinance of the jurisdiction.
PG06 -002 Printed: 04 -04 -2006
Signature:
Print Name:
doc: Conditions
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
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.
Date: —f — —I
PG06 -002 Printed: 04 -04 -2006
Site Address:
Tenant Name:
Property Owners Name I SC& \Go_niV
Mailing Address: e 7 (,(2 ""P QJL iNue S.up Se
City
CONTACT PEItSON —who fiQ WO. con.
&act when your permit is ready.to be issued
[
PLUMBING / GAS music CONTRACTOR INFORMATION
Company Name: se (-F
Mailing Address: S e-- s Orr
Contact Person:
E-Mail Address:
RECPREAli plans must be wenteteped
Company Name:
Mailing Address:
CITY OF TUKWILA
Community Developmen
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
huo://www.ci.tukwila.wa.us
s 0 at
se/F
Contact Person:
E-Mail Address:
'ENGINEER OF ItECORR,10 plans must be wet stamped by Eugmeer of Retard
ONApplicatione \ FonnpApplieations On Line \ 3-2006 - Plumbing-Cu Piping Pernik Applicationdoc
Replied: 4-2006
bh
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-00v
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.: 7 3 q' O GO
Suite Number: -43' Floor: 2-
New Tenant: .... Yes 0 ..No
Day Telephone:
tact of Record
Oti_a(a_
State Zip
Name:
,ei Giz-n-
Mailing Address: --) /7& t a to_r j oe scl) Sep t gifica
City State
E-Mail Address: Fax Number: 2- n -93
Zip
City State
Day Telephone:
Fax Number:
Contractor Registration Number: Expiration Date:
State
State
City
Day Telephone:
Fax Number:
Company Name:
Mailing Address: ey 2 12 ' > A— q51
City
Contact Person: A/e, /At' Day Telephone:
E-Mail Address: Fax Number:
Pa 1 of 2
1?iature Typb:.
Qty
. Fiat ure Type:
Qty
` Fixture Type:
Qty '
.Fixture Type:
Qty
Bathtub or combination
bath/shower
I
Drinking fountain or water
cooler (per head)
Wash fountain
Gas piping outlets
- C;r —
Bidet
Food -waste grinder,
commercial
Receptor, indirect
waste
Hit t
Clothes washer, domestic
/
Floor drain
- Sinks
V—
Dental unit, cuspidor
a--
Shower, single head trap
Urinals
Dishwasher, domestic,
with independent drain
'G
Lavatory
I ++
Water Closet
/
Additional medical gas
inlets/outlets — six or more
'� '
Building sewer or trailer
park sewer
-�
Rain water system — per
drain (inside building)
e-
Water heater and/or
vent
Industrial waste
pretreatment interceptor,
including its trap and vent,
except for kitchen type
grease interceptors"
4
_Repair or alteration of water
piping and/or water treating
equipment
j ig
1-, ,
(Que
t 1�
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):
Building Use (per' Gilding Code): n
Occupancy (per Tnl (ding Code): One_ - . .41 t- gestenni
Water: Utility Purveyor: 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 OWNER , O , RAUTHORIZE GENT:
Signature: Ali \,�
n
(
Print Name: ► //--
Mailing Address: / 7 0 0
Date Application Expires: I
bo�
Date Application Accepted:
7
Q Appliationdronne- Applications On Line 3.2006 - Plumbing -Gae Piping Permit Appliation.doc
Revised - . 4.2006
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City State Zip
Staff Initials:
Page 2 of 2
i
Payee: MARCI GRAY
ACCOUNTLTEM:t2Sn
Description
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
Parcel No.: 7340600686
Address: 4044 5 128 ST TUKW
Suite No:
Applicant: GRAY RESIDENCE
Receipt No.: R06 -00444 Payment Amount: 168.00
Initials: ]EM Payment Date: 04/04/2006 09:35 AM
User ID: 1165 Balance: $0.00
Type Method Description Amount
Payment Cash 168.00
PLUMBING - RES
RECEIPT
Account Code Current Pmts
000/322.100 168.00
Permit Number: PG06 -002
Status: PENDING
Applied Date: 04/04/2006
Issue Date:
Total: 168.00
4180 04/04 9716 TOTAL 168.00
doe: Receipt Printed: 04-04 -2006
Pro WY / Yj c S
(( l�
Type Inspec :
1 A rt - t 4 . 1
Address:
Date Called:
/ fr e1/47 /e -69a 0 —
(1 0 ,i /fn -bow' s ✓ s-e- fJd
Special Instructions:
Date Wan[
' U d �j
7
a:m
Requester:
/
Phone No:
Approved per applicable codes. Corrections
required prior to approval.
COMMENTS:
i) lLe -I 2_ ?Mir — /4u
/ fr e1/47 /e -69a 0 —
(1 0 ,i /fn -bow' s ✓ s-e- fJd
L ic/ -„ ' e /(
R(sn -t..--
le 5 / /r /r
/
n�spe {or: iJw�
I 4v i 7 A Gz
° Dates /
Receipt No.:
INSPECTION RECORD
Retain a copy with permit
INSPECTIO
CITY • F TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
'Date:
8.00 REINSPECTION FrEE REQUIRE Prior to inspection, fee must be
aid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
Project:
Type of Inspecti• n:/
!t. —/ i
A =
Address:
WCW y So, /2.18 -
Date Calle..
Alai. /r J r G/ , `$ ti
Special Instructions:
EAAC
a /
Date Wanted:
a.m.
v
Requester: ,a
h
�� C
Phone N� Z
33 Z
Approved per applicable codes. gCorrections required prior to approval.
COMMENTS) / . _ 44. j »X
S
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Alai. /r J r G/ , `$ ti
vc, 14-4-4"."2, 1.6en-
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3 ! J k— /7-1 i 9(.L, I in ., ch -oe5 —s
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INSPECTION NO.
CITY TUKWILA BUILDING DIVISION �� a
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)4 1-3
INSPECTION RECORD
Retain a copy with permit
P te' ` � Date: 19""" 1��
(((a�h ) i
In $58.00 REINSPECTION FE REQUIRED. Prior to inspectionit fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to sechedure reinspection.
Receipt No.:
'Date:
Project:
TO, i
Type of Inspection:
/ A)
Address:
4/ 0 4/ —5 • /a 8 s'-/
Date ailed: 0
Special Ins (ructions:
Date Wanted:
oK,
C .--4M7 Pr
Requester:
--
Phone No:
_
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
PER NO.
EG r 206)431 ) -36
1/41A per applicable codes. El Corrections required prior to approval.
COMMENTS:
(Inspec
Date
58.00 REINSPECT1 FEE RE'. IRED. Prio o inspection, fee must be
paid at 6300 Southcenter Blvd., ulte 100 all to sechedule reinspection.
eceipt No.: 'Date:
Pr r ib L PS '
II
I R
Type of Inspection:
O
G Y �c t bi Y
Address:
yONN S IZ - I —
Date Called:
Special Instructions:
- --,
Date Want gd Cali m ,
s I2._ — D� p.m.
Requester:
Phone No:
(Receipt No.:
INSPECTION RECORD
Retain a copy with permit
P( -ooz
IN • ` ION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 20 )431.367
PER NO.
Approved per applicable codes. 0 Corrections required prior to approval.
COMMENTS:
a y— - VD P&R
N
Ins ect •
Date d 1
( O
U $58.Qtj REINSPECTION FEE REQUIRED. Prior tl inspection, fee must be
paid 6300 Southcenter Blvd., Suite 100. Cal to sechedule reinspection.
Date:
leroy gray job
plumbing plane ron griffin
main sub floor
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
STATEOF WASHINON3
) ss.
COUNTY OF KING : )
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
[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 re u ement of RCW 18.27.090, I consider the work authorized
under this building permit to be exempt under No., 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.
oo L Anal '
Y \A O � '� �Ys
f EnlAt
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\applications\8 -2004 affidavit in lieu of contractor registration
APPLIC
PERMIT NO.: M.,
states as follows:
Signed and sworn to before me this
day of
Permit Center /Building Division:
206 -431 -3670
Public Works Department:
206 -433 -0179
Planning Division:
206-431-3670
,20
NOTARY W BLIC in and for 'Z State of Washington,
Residing at , County.
Name as commissioned:
My commission expires:
( ; r I La'hcnafa-
5- /5 .4 (0
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
%r'
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. My person who engage'S: Lot .,bctivities herein
regulated as an efl loyee, ; pf ‘ registered
contractor with wages ap his Sole Cbmpehsation;
V 11..E
17. Contractors on higljwjy pr9ikdtstit!ho have been
prequalified as requfQ by 0001'. 3 of the Laws
of 1961, RCW 47.28.6) wktrttte department of
transportation to perforliftti9hway construction,
reconstruction, or maintenance work.