HomeMy WebLinkAboutPermit M08-078 - CAMPBELL & TAYLOR ADDITIONCAMPBELL & TAYLOR
ADDITION
4417 S 136 ST
M08-0 78
Parcel No.:
Address:
Suite No:
Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name: OWNER AFFIDAVIT - PETER TAYLOR
Address: 4417 S 136 ST , TUKWILA WA
Contractor License No:
Value of Mechanical: $2,000.00
Type of Fire Protection:
Furnace: <100K BTU
> 100K BTU
Floor Furnace
Suspended/Wall/Floor Mounted Heater
Appliance Vent
Repair or Addition to Heat/Refrig /Cooling System....
Air Handling Unit <10,000 CFM
>10,000 CFM
Evaporator Cooler
Ventilation Fan connected to single duct
Ventilation System
Hood and Duct
Incinerator: Domestic
Commercial/Industrial
doc: IMC - 10/06
7347600075
4417 S 136 ST TUICW
CitAf 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
CAMPBELL & TAYLOR ADDITION
4417 S 136 ST , TUKVVILA WA
CAMPBELL LESLIE W
TAYLOR PETER , 4417 S 136TH
PETER TAYLOR
4417 S 136 ST , TUKWILA WA
MECHANICAL PERMIT
DESCRIPTION OF WORK:
RENEWAL OF PERMIT M06 -150: MECHANICAL FOR 913 SF 2 -STORY ADDITION
EQUIPMENT TYPE AND QUANTITY
0
0
0
5
0
0
0
0
0
3
0
0
0
0
* * continued on next page **
M08 -078
Permit Number:
Issue Date:
Permit Expires On:
Expiration Date:
Phone:
Phone: 206 937 -2155
Phone: 206 - 973 -2155
M08 -078
03/26/2008
09/22/2008
Fees Collected: $193.88
International Mechanical Code Edition: 2006
Boiler Compressor:
0 -3 HP /100,000 BTU 0
3 -15 HP /500,000 BTU 0
15 -30 HP /1,000,000 BTU.. 0
30 -50 HP /1,750,000 BTU.. 0
50+ HP /1,750,000 BTU 0
Fire Damper 0
Diffuser 0
Thermostat 5
Wood/Gas Stove 0
Water Heater 0
Emergency Generator 0
Other Mechanical Equipment 0
Printed: 03 -26 -2008
Permit Center Authorized Signature:
•
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 Number: M08 -078
Issue Date: 03/26/2008
Permit Expires On: 09/22/2008
Date:' ( U
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 t e performance of work�thorized to sign and obtain this mechanical permit.
Signature: Date:
Print Name: /"e 7e w 0-
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.
doc: IMC -10/06
- 7 — 4
3 -2 6 Z005
M08 -078 Printed: 03 -26 -2008
1: ** *BUILDING DEPARTMENT CONDITIONS * **
City of Tukwila
Parcel No.: 7347600075
Address: 4417 S 136 ST TUKW
Suite No:
Tenant: CAMPBELL & TAYLOR ADDITION
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
Permit Number: M08 - 078
Status: ISSUED
Applied Date: 03/13/2008
Issue Date: 03/26/2008
2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the
Building Official.
3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to
start of any construction. These documents shall be maintained and made available until final inspection approval is
granted.
4: Manufacturers installation instructions shall be available on the job site at the time of inspection.
5: Except for direct -vent appliances that obtain all combustion air directly from the outdoors; fuel -fired appliances
shall not be located in, or obtain combustion air from, any of the following rooms or spaces: Sleeping rooms,
bathrooms, toilet rooms, storage closets, surgical rooms.
6: Equipment and appliances having an ignition source and located in hazardous locations and public garages, PRIVATE
GARAGES, repair garages, automotive motor -fuel dispensing facilities and parking garages shall be elevated such that
the source of ignition is not less than 18 inches above the floor surface on which the equipment or appliance rests.
7: Water heaters shall be anchored or strapped to resist horizontal displacement due to earthquake motion. Strapping shall
be at points within the upper one -third and lower one -third of the water heater's vertical dimension. A minimum
distance of 4- inches shall be maintained above the controls with the strapping.
8: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the Cityof Tukwila
Permit Center.
9: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building
Department (206- 431 - 3670).
10: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of,
any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits
presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila
shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the
Building Official from requiring the correction of errors in the construction documents and other data.
doc: Cond - 10/06
* * continued on next page **
M08 -078 Printed: 03 -26 -2008
•
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:
Print Name:
doc: Cond -10/06
Pe '6 k YJ, 7Wt
Date: r/ -2K
M08 -078 Printed: 03 -26 -2008
CITY OF TUKWIr"
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.citukwila.wa.us
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**
S T CA
Site Address: it / /7 5, / 3 C Yet
Tenant Name:
Property Owners Name: L ES Li E C ton
Mailing Address: ' 7 " 7 / 7 5. 13.'
/27E l{ 7t','ior
Mailing Address: 'Pt /7 S /3, TM S r
Name:
E -Mail Address:
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Contractor Registration Number:
Building Fen�_� N
King Co Assessor's Tax No.: 7.? 00 75 01-20P
Suite Number: Floor:
New Tenant: JJ .... Yes ..No
hell , 7 R -TA y 4Q
k i'v" A 4 W 4 9"
City State Zip
Day Telephone: X 01 7j7 Z/55
l v ' vv; / e qg /d (9
City S tate Zip
Fax Number:
City
Day Telephone:
Fax Number:
State
Zip
Expiration Date:
Company Name: 'erg
Mailing Address: / 7/0 3 7 ►/E Sii5,4 7 E W A Fffi2
City Sta Zi
Contact Person: /II / / / VE «.,5 0,/
E -Mail Address:
t: .
P
Day Telephone: ,2 6 7 DO
Fax Number: 2 -° 4 7Z 6 /00f
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Q:\Applications'Forms- Applications On Line\3 -2006 - Permit Application.doc
Revised: 9 -2006
bh
City
Day Telephone:
Fax Number:
State
Zip
Page 1 of 6
BUILDING PERMIT INFORMATION — 206 - 431 -3670
Valuation of Project (contractor's bid prn,e): $ /0o, oeor, (2 Existing Building Valuation: $ / / ono . 00
Scope of Work (please provide detailed information): A E /?') UV-e / 5 % a Wi 1lt'r e f4 /, o i T' 4' 4 4'1
or Ex; 5T, /,5TQfir WO. FAME .5iMiLE FAM/ ! des r1 )DE4'cc &�NM Ew z
5ToRy w0 F AA41 , "TIOrV 6Vim/ CRAWL 5'PAc E AT 'R OF 4/iy
Peo C„ ' /ON's WE - our ) / ` t= /i /y7c» ( 6 46 4 C \ P EMVI carAA
Will there be new rack storage? ❑.... Yes [�7�No If yes, a separate permit and plan submittal will be required.
:oxide All Building Areas in Sp are Footage B e' o
xist
is' V1
Zito, Floor
Flom
lob
A
tie
ag e
r bed
9756
U7
Remodel
Additioi.
Ex(stint
trttc
l
7
Ta=pe of
Occupancy per
IBC
PLANNING DIVISION: qq
Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) Z3
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): Floor area of principal dwelling: Floor area of accessory dwelling:
*Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard: / Compact: Handicap:
Will there be a change in use? ❑ Yes ❑ No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS: ,,
I:3 Sprinklers ❑ Automatic Fire Alarm El None X Other (specify)5f►'j®! ' ,� g/ f(,y.
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes No
If `yes', attach list of materials and storage locations on a separate 8 -1/2 "x 11 " paper including quantities and Material Safe ata Sheets.
SEPTIC SYSTEM
❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health
Department.
Q:\Appliations\Forms- Applications On Line3 -2006 - Permit Application.doc
Revised: 9 -2006
bh
Page 2 of 6
0
PUBLIC WORKS PERMIT ORMATION -10643370179
Scope of Work (please provide detailed information): /l /y1 ovt / 5 T iQy r WO, P ADM T AAam RP44
$ iQ ' i4/0 " RA/YJ 5 i iVCi. F FA. L R s 79 E/Icx 8oi LO /'Bi reify
v1/D F/i'Ml AIJLJri Wew CvAR CRA -W/. s Police AT l 4.i? OP 4415i: /7
E PAN,O 15 f W , , t'c r44Lo,v6 IFS P'.. ,s't9 v T'Ji ,o OF /401P02/
Call before you Dig: 1- 800 - 424 -5555
Sewer District
❑ ...Tukwila
❑ ...Sewer Use Certificate
Please refer to. Public Works= Bulletin " #1: for fees and sheet.
Water District
❑ ...Tukwila[... Water District # 125
❑ ...Water Availability Provided
Septic System:
❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department.
Sujtttitted with Application (mark boxes which apply):
Civil Plans (Maximum Paper Size — 22" x 34 ")
❑ ...Technical Information Report (Storm Drainage)
❑ ...Bond ❑ .. Insurance ❑ .. Easement(s)
Proposed Activities (mark boxes that apply):
❑ ...Right -of -way Use - Nonprofit for less than 72 hours
❑ ...Right -of -way Use - No Disturbance
❑ ...Construction/Excavation/Fill - Right -of -way
Non Right -of -way
❑ ...Total Cut
❑ ...Total Fill
/P
Q
![�ValVue ❑ .. Renton ❑...Seattle
❑ ... Sewer Availability Provided
cubic yards
cubic yards
❑ ...Sanitary Side Sewer
❑ ...Cap or Remove Utilities
❑ ...Frontage Improvements
❑ ...Traffic Control
❑ ...Backflow Prevention - Fire Protection
Irrigation
Domestic Water
❑ ...Permanent Water Meter Size...
❑ ...Temporary Water Meter Size..
❑ ...Water Only Meter Size
❑ ... Sewer Main Extension Public
❑ ...Water Main Extension Public
11
11
❑•
.. Abandon Septic Tank
.. Curb Cut
. Pavement Cut
❑ .. Looped Fire Line
Q:'Applications\Forms- Applications On Linell -2006 - Permit Application.doc
Revised: 9 -2006
bh
11
WO #
WO ti
WO #
Private
Private
❑ .. Highline
❑ .. Geotechnical Report
❑ .. Maintenance Agreement(s)
❑ .. Right -of -way Use - Profit for less than 72 hours
❑ .. Right -of -way Use — Potential. Disturbance
❑ .. Work in Flood Zone
❑ .. Storm Drainage
❑ ...Renton
❑...Traffic Impact Analysis
❑ ... Hold Harmless — (SAO)
❑ ...Hold Harmless — (ROW)
❑ .. Grease Interceptor
❑ .. Channelization
❑ .. Trench Excavation
❑ .. Utility Undergrounding
❑...Deduct Water Meter Size
FINANCE INFORMATION
Fire Line Size at Property Line
❑ ...Water ❑ ...Sewer
Monthly Service Billing to:
Name:
Mailing Address:
Water Meter Refund/Billing:
Name:
Mailing Address:
Number of Public Fire Hydrant(s)
❑ ...Sewage Treatment
/
Day Telephone:
City
State Zip
Day Telephone:
City
State Zip
Page 3 of 6
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Boiler/Compressor:
Qty
Furnace <100K BTU
Air Handling Unit >10,000
CFM
Fire Damper
0 -3 HP /100,000 BTU
Furnace >100K BTU
Evaporator Cooler
Diffuser
3 -15 HP /500,000 BTU
Floor Furnace
Ventilation Fan Connected
to Single Duct
3
Thermostat
15 -30 HP /1,000,000 BTU
Suspended Floor
Mounted Heater eater
3 --
Ventilation System
Wood /Gas Stove
30 -50 HP /1,750,000 BTU
Appliance Vent
Hood and Duct
Emergency
Generator
50+ HP /1,750,000 BTU
Repair or Addition to
Heat/Refrig /Cooling
System
Incinerator - Domestic
Other Mechanical
Equipment
Air Handling Unit
<10,000 CFM
Incinerator — Comm/Ind
MECHANICAL PERMIT INFORMATION - 206 - 431 -3670
MECHANICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
City State Zip
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
Contractor Registration Number: Expiration Date:
Valuation of Mechanical work (contractor's bid price): $ Z, A/
Scope of Work (please provide detailed information):
Use: Residential: New .... Replacement .... ❑
Commercial: New .... Replacement .... ❑
Fuel Type: Electric
Gas ....0 Other:
Indicate type of mechanical work being installed and the quantity below:
Q:\ Applications \Forms- Applications On Line \3-2006 - Permit Application.doc
Revised: 9 -2006
bh
Page 4 of 6
FixtureType: ; '• :.
Qty
:'Fixture:
.Qty
FixtureType : :
Qty.
F.ixtiire .Type:'"
Bathtub or combination
bath/shower
fountain or water
cooler (per head)
Wash fountain
Gas piping outlets
.Qty'.
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
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
PLUMBING AND GAS -PIP PERMIT INFORIVIATION — 206 -4
PLUMBING AND GAS PIPING CONTRACTOR INFORMATION
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Contractor Registration Number:
Valuation of Plumbing work (contractor's bid price): $ , t ) ' 000
Valuation of Gas Piping work (contractor's bid price): $
Scope of Work (please provide detailed information):
Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below:
Q:'ApplicationsWorns- Applications On Line U-2006 - Permit Application.doc
Revised: 9 -2006
bh
City State Zip
Day Telephone:
Fax Number:
Expiration Date: ;
Building Use (per Intl Building Code):
Occupancy (per Intl Building Code):
Utility Purveyor: Water: Q/`5 y'/q /CF 441 /5 Sewer: \M V('y
Page 5 of 6
PERMIT APPLICATION NOT — Applicable to all permits in this a
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.
Building and Mechanical Permit
The Building Official may grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be
requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition).
Plumbing Permit
The Building Official may grant one extension of time for an additional period not exceeding 180 days. The extension shall be requested
in writing and justifiable cause demonstrated. Section 103.4.3 Uniform 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 OWNS OR AUT A
ORIZED GENT:
Signature: /t..r
e� 0 . ;4-kket
Mailing Address: / 7 5. /3 C >t S T
Print Name:
Date Application Expires:
cetN
Date Application Accepted:
Q:\Applications\Ponns- Applications On Line\3 -2006 - Permit Application. doe
Revised: 9 -2006
bh
Date: Z - 43 2\ ®
Day Telephone: Z0 6 73 ' ,Z /
City State Zip
Staff Initials:
Page 6 of 6
RECEIPT NO: R08 -00744
Initials: JEM Payment Date: 03/13/2008
User ID: 1165
Payee: PETER D TAYLOR
SET ID: S000000979 SET NAME: Tmp set/Initialized Activities
SET TRANSACTIONS:
Set Member Amount
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
D08 -134 582.25
MO8 77.55
PG08 2 0 9 64.00
TOTAL: 723.80
TRANSACTION LIST:
Type Method Description Amount
Payment Check 2348 723.80
TOTAL: 723.80
ACCOUNT ITEM LIST:
Description
SET RECEIPT
Total Payment: 723.80
Account Code Current Pmts
BUILDING - RES 000/322.100 577.75
MAPS /PUBLIC /MAILING 000/341.500 77.55
PLUMBING - RES 000.322.103.00.0 64.00
STATE BUILDING SURCHARGE 000/386.904 4.50
TOTAL: 723.80
Ti ;T-...
Project: f „ , - `
j I C _
Type of Inspection: - f
•.
A ( $1
5;
Date Called:
Special Instructions:
.
Date Wanted:gr\ z.
\
a.m.
4� a p.m.
Requester:
Phone No:
INSPECTION RECORD � ° c. 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. LJ Corrections required prior to approval.
Inspector:
Date: 4 \ Lii\
$58.00 REINSPECTION FEE REQUIRED. Prior o inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection.
Receipt No.:
Date:
•
CITY OF TUKWILA
Department of Community Development
6300 Southcenter Boulevard, Tukwila, WA 98188
Telephone: (206) 431 -367o FAX (206) 431-3665
E -mail: tukplanAci.tukwila.wa.us
STATE OF WASHINGTON)
) ss.
COUNTY OF KING
P - 0 4 eP , " , states as follows:
please print] 7
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
Permit Center /Building Division
206 431 -3670
Public Works Department
206 433 - 0179
Planning Division
206 431 -3670
PERMIT NO: 20i 1794 t N O - oil
ail
1. I have made application for a 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 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 permit to be exempt under No. , and
will therefore not be performed by a registered contractor.
5. I understand that the licensing provision of RCW 19.28.161 through 19.28.271 shall not apply to
persons making electrical installations on their own property or to regularly employed employees
working on the premises of their employer. The proposed electrical work is not for the
construction of a new building for rent, sale or lease.
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 onstruction work.
Owner /Owner's Agent
Signed and sworn to before me this
.�lllday of , . �R .
NOTARY PUBLIC in and for s e State of Washington
Residing at K---( "✓ , County
Name as commissioned: S Lf i/1 d Ock--
My commission expires: