HomeMy WebLinkAboutPermit PG08-045 - SOUTHGATE MOBILE HOME PARK #37SOUTHGATE MOBILE HOME
PARK # 37
14005 42 AV S
PG08-045
Parcel No.: 1523049008
Address:
Suite No:
CitAlbf 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
14005 42 AV S TUKW
PLUMBING /GAS PIPING PERMIT
Permit Number:
Issue Date:
Permit Expires On:
PG08 -045
02/15/2008
08/13/2008
Tenant:
Name: SOUTHGATE MOBILE HOME PARK
Address: 14005 42 AV S #37 , TUKWILA WA
Owner:
Name: STEPPING STONE VENTURES L L
Address: 20303 10TH AVE W , LYNNWOOD WA
Contact Person:
Name: ERIN O'LEARY
Address: 14005 42 AVE S , TUKWILA WA
Contractor:
Name: OWNER AFFIDAVIT - ERIN O'LEARY
Address: 14005 42 AVE S , TUKWILA WA
Contractor License No:
Phone:
Phone: 206- 484 -3840
Phone: 206- 484 -3840
Expiration Date:
DESCRIPTION OF WORK:
HOOK UP UNIT TO WATER & SEWER. WILL NOT BE CHANGING ANY INTERIOR PLUMBING
Value of Plumbing /Gas Piping:
Fees Collected:
$150.00
$126.00
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
Sh ks-
Urinals
Water Closet --
Uniform Plumbing Code Edition: 2006
International Fuel Gas Code Edition: 2006
FIXTURE TYPE AND OUANTITY
Plumbing (cont.)
0 Building sewer and each trailer park sewer 1
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
0 Repair or alteration of water piping and/or water
0 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 1
0 Medical gas piping (6 +) inlets /outlets - 1
0 Gas Piping
0 Gas piping outlets (0 -5) 0
0 Gas piping outlets (6 +) - - -- 0
* *continued on next page **
doc: UPC -10/06
PG08 -045 Printed: 02 -15 -2008
City ofTukwila
Department of Community Development
6300 Southcentet Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206- 431 -3670
Fax: 206-431-3665
Web site: http: / /www.ci:tukwila.wa.us
Permit Number: PG08 -045
Issue Date: 02/15/2008
Permit Expires On: 08/13/2008
Permit Center Authorized Signature:
Date: -Og
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 performanc f work. I am authorized to sign and obtain this plumbing /gas piping permit.
•
Date: I [CR)
Signature:_
Print Name: Z N �•/ Le
This permit shall become null and void if the work is not comm nced 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: UPC -10/06
PG08 -045 Printed: 02 -15 =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
PERMIT CONDITIONS
Parcel No.: 1523049008
Address:
Suite No:
Tenant:
14005 42 AV S TUKW
SOUTHGATE MOBILE HOME PARK
Permit Number:
Status:
Applied Date:
Issue Date:
PG08 -045
ISSUED
02/15/2008
02/15/2008
1: ** *PLUMBING AND GAS PIPING * **
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 erribedded 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.
* *continued on next page **
doc: Cond -10/06
PG08 -045 Printed: 02 -15 -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: hitpr / /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
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
construction or the performance of work.
Signature:
0
Print Name _ 12"-- _N
Date:
ordinances governing
or local laws regulating
doc: Cond -10/06 PG08 -045
Printed: 02 -15 -2008
CITY OF TUKWILlit
Community DeMopme#patment
Permit Center
6300 Seiutheentei. BIvd, Suite 100
Tukwila, WA 98188
littp://www„ei,tiikwila.wa,US
Plumbing/G?Permit No.'
Project No.
(For office use only)
PLUMBING / GAS PIPING PERMIT APPLICATION
Applications andplans mustbe complete in order to be accepted for plan review.
Applications Will not be accepted through the mail or by fax.
**Please Print**
SITE LOCATION
Site Addres-s—: 5 L-/- '-
Tenant Name : So 1741,
Property Owners Nairie:
Mailing AddreSS-:
King CO Assessor's Tax No.: I'S 0, 3Q4 ei 0 o
Suite Number: 3-7 noon _
New Tenant: In .... Yes
Alat%/42j_ itt/ vt5_ L
State
Zip
CONTACT PERSON Who.dOWe contact when your permit is ready to be 'issued
Nati it:
_
Day TelephOfie: LOL tjLL 343qo
Mailing Address:
city
Fax Number:
E-Mail Address:
State
Zip
PLUMBING / GAS PIPING CONTRACTOR INFORMATION
Company Name: cff
MaiIiig Addressl_
Contact Person:
E-Mail Address:
Contractor Registration Number: _
city
Day Telephone:
Fax Number:
State
Zip
Expiration Date:
ARCHITECT OF
Utolins intistbe,wet.:,stanipediv,Architeet ofReeord,
Company Na
Mailing Address:
COritatt
E-Mail Address:
City
Day Telephone:
Fax Number:
State
Zip
ENGINEER'OF
AllvlansriP''xi*6e
•
Cornp y Name:
Mailing A ss:
Contact Person:
E-Mail Address:
Q: \ApidiCaiions Worms,Applications On Line \3-/006 - Plainbing-Gas
REvised:
bh
ngi'efinit Application.doc
city
Day Telephone:
Fax Number:
State
Zip
Page 1 of 2
Valuation of Project (contractor's bid price): $ ( S
Scope of Work (please provide detailed information):
Building Use (per Int'l Building Code):
Occupancy (per Int'l Building Code):
Utility Purveyor: Water:'; 1 ra 5
Sewer:
Val Uv�
Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below:
Fixture Type:
. Qty
- Fixture Type:
Qty
Fixture Typ `, e: -
Qty
- FtxturefType
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
)
L
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
F
1
Medical gas piping system
serving one to five
inlets /outlets for specific gas
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).
1 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 0 - ' OR A , ' I a 1 A "
Signature:
Print Name: I %J
Date: 0.415 Int
Day Telephone:
Mailing Address:
City
State
Zip
IDate Application Accepted:
Date Application Expires:
Staff Initials:
Q:\ApplicationslForms- Applications On Line \3-2006 - Plumbing -Gas Piping Permi Application.doc
Revised' 4-2006
bh
Page 2 of 2
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.: 1523049008 Permit Number: PG08 -045
Address: 14005 42 AV S TUKW Status: PENDING
Suite No: Applied Date: 02/15/2008
Applicant: SOUTHGATE MOBILE HOME PARK Issue Date:
Receipt No.: R08 -00449 Payment Amount: $126.00
Initials: WER Payment Date: 02/15/2008 02:44 PM
User ID: 1655 Balance: $0.00
Payee: STEPPING STAONE VENTURES
TRANSACTION LIST:
Type Method Description
Amount
Payment Check 6776 126.00
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
PLUMBING - NONRES
000.322.103.00.0 126.00
Total: $126.00
8799 02/19 9710 TOTAL 504.40
doc: Receiot -06 Printed: 02 -15 -2008
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
(206)431-36
INSPECTION NO.
Project:
it %%
Type of Inspection:
Lg/ y'')/a'n1`
v
Address:
// /CU,5- z /L9V_$
Date Called:
Special Instructions:
Date Wanted:
/ZJ,4°
a.m.
p.--61.-
Requester:
Phone No
2 0 - 2/Z--/- -7c 5z/0
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
Date... J 0
0 $58.0 EINSPECTION FEE )REQUIRED. (Prior o inspection. fee must be
pal
6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection.
Receipt No.:
Date:
INSPECTION RECORD //
Retain a copy with permit ���u A�'S
PERMIT NO. r/1
6300 Southcenter Blvd., #1 00, Tukwila, WA 98188 (206)431 -370
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
f?i " 7AO, XP
ti
Type .Inspection;
i/ d04°74 N
Addre x
Date Called:
Special Instructions:
Date Wanted: � J�
//
a�mr
Requester:
Phone
- 2149(.._
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
(Inspecto Date:
," 2/27 /0e
. 0 REINSPECTION FE REQUIRE . Prior o inspection. fee must be
id at 6300 Southcenter lvd.. Suit 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: tukplanOci.tukwila.wa.us
Permit Center /Building Division
206 431 -3670
Public Works Department
206 433 -0179
Planning Division
206 431 -3670
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
PERMIT NO: _ "K 0 e"" ) H 5
STATE OF WASHINGTON)
) ss.
COUNTY OF KING
■K 1 O' 1-.. e f R\ ; states as follows:
[please print]
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. 13 , 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 pe construction or
Owner /Owner
Signed and sworn to me this
/i•. `
day of r� FJr�'i 4Ga r� , 20 O tP.
NOTARY PUBLIC in and for the State of Washington
Residing at
County
Name as commissioned: ktu /51-t,eerle
My commission expires: 05 -02 9-/