HomeMy WebLinkAboutPermit PG08-046 - SOUTHGATE MOBILE HOME PARK #31SOUTHGATE MOBILE
HOME PARK
14005 42 AV S
PGO8-046
Parcel No
Address:
Suite No:
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
1523049008
14005 42 AV S TUKW
PLUMBING /GAS PIPING PERMIT
Permit Number:
Issue Date:
Permit Expires On:
PG08 -046
02/15/2008
08/13/2008
Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
Address:
SOUTHGATE MOBILE HOME PARK
14005 42 AVE S #31 , TUKWILA WA
STEPPING STONE VENTURES L L
20303 10TH AVE W , LYNNWOOD WA
ERIN O'LEARY
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:
HOOKING UP MOBILE HOME TO EXISTING WATER & SEWER AND PROPANE
Value of Plumbing /Gas Piping:
Fees Collected:
$375.00
$218.00
Uniform Plumbing Code Edition: 2006
International Fuel Gas Code Edition: 2006
FIXTURE TYPE AND QUANTITY
Plumbing
Bathtub or combination bath/shower 0
Bidet 0
Clothes washer, domestic 0
Dental unit, cuspidor -- 0
Dishwasher, domestic, With independent drain 0
Drinking fountain or water cooler (per head) 0
Food -waste grinder, commercial - - 0
Floor drain 0
Shower, single head trap 0
Lavatory 0
Wash fountain
Receptor, indirect waste 0
Sinks 0
Urinals 0
Water Closet 0
0
Plumbing (cont.)
Building sewer and each trailer park sewer 1
Rain water system - per drain (inside bldg) 0
Water heater and /or vent 0
Industrial waste treatment interceptor, including
its trap and vent, except for kitchen type
grease interceptors 0
Repair or alteration of water piping and/or water
treatment equipment 0
Repair or alteration of drainage or vent piping 0
Medical gas piping system serving (1 -5)
inlets /outlets for a specific gas 1
Medical gas piping (6 +) inlets /outlets 1
Gas Piping
Gas piping outlets (0 -5) 1
Gas piping outlets (6 +) 0
* *continued on next page **
doc: UPC -10/06
PG08 -046 Printed: 02.15 -2008
City ofTukwila
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: PGO8 -046
Issue Date: 02/15/2008
Permit Expires On 08/13/2008
Permit Center Authorized Signature:
� a— Date: � -�s-08
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 rformance • work. am authorized to sign and obtain this plumbing /gas piping permit.
Signature:
Print Name:
Date: c�--( 1S1 O
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` UPC -10/06
PG08 =046 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 -046
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 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.
* *continued on next page **
doc: Cond -10/06
PG08 -046 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.tukroila.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: _ Date. ■= t l 1 S I
Print Name: 1 J V' �eVA 4a■
ordinances governing
or local laws regulating
doc: Cond -10/06 PG08 -046
Printed: 02 -15 -2008
CITY OF TUKWIL,�
Community Developmen apartment
Permit Centel-
6300 Southcen ter Blvd., Suite 100
Tukwila, WA 98188
http °Lwww:ci- tukwila..wa -us
Plumbing/Gas Permit No. TGo g- (yf Ip
Project No.
(Fdr office use only), .
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 Piinf* *
SITE LOCATION
Site Address:
Tenant Name:
s 1-1-4`4 S
King Co Assessor's Tax No.: I 5x04 I Q
Suite Number: 3 ( _ Floor:
New Tenant: 0 .... Yes
Property Owners Name:_
Mailing Address: 03-O 3
State
Zip
CONTACT PERSON - Who do we contact when your permit is ready-to tie issued
Name: '1 0' L e_10 t -
Day Telephone: 10 4 91713 (2 "id
Mailing Address:_
City
Fax Number:
E -Mail Address:
Company Name:
State
Zip
Mailing Address":
Contact Person:_
E -Mail Address:
Contractor Registration Number:
city
Day Telephone:
Fax Number:
Expiration Date:
State
Zip
C. i pany Name:
Mailin Address:
Contact Pers
E -Mail Address:
city
Day Telephone:
Fax Number:
State
Zip
Co • any Name:
Mailing - • dress:_
Contact Person.
= rAllplans must wet stamped' by.Engtneer o
E -Mail Address:
ONAppliwtions\Fonns- -Applications On,
Revised: 4 -2006
bh
eU= 2006 =plumbing -Gas Piping Pennii Application `doc
City
Day Telephone:
Fax Number:
State
Zip
Page 1 oft
Valuation of Project (contractor's bid price): $
Scope of Work (please provide detailed information):
'1> 'PO) p
Building Use (per Intl Building Code):
Occupancy (per Int'l Building Code):
Utility Purveyor: Water: + f c.1'j
Sewer:
Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below:
Fixture Type:
Qty
, Fixture Type;
Qty
Fixture Type: Yp •
' Qty
Fixture Type:
Qty.
Bathtub or combination
bath/shower
Drinking fountain or water
cooler (per head)
Wash fountain
Gas piping outlets
I
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
J
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
j
Repair or alteration
of drainage or vent
piping
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).
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 S ATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING 0 ° ' 0 ; T 0 ' ' ED ENT:
Signature: Date: i 5 (o6
Print Name: .l IQ O � Day Telephone:
Mailing Address: /---€4144 g
City
State
Zip
IDate Application Accepted:
Date Application Expires:
Staff Initials:
Q:\Applications\Porms- Applications On Line \3 -2006 - Plumbing -Gas Piping Penni 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 -046
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 -00450 Payment Amount: $218.00
Initials: WER Payment Date: 02/15/2008 02:53 PM
User ID: 1655 Balance: $0.00
Payee: STEPPING STONE VENTURES
TRANSACTION LIST:
Type Method Description Amount
Payment Check 6776 218.00
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
GAS - NONRES
PLUMBING - NONRES
000.322.103.00.0 92.00
000.322.103.00.0 126.00
Total: $218.00
8799 02/19 9710 T0TAL. 504.00
doc: Receiot -06
Printed: 02 -15 -2008
'C✓
� Z
INSPECTION RECORD P6o 0,4 ork
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION \2-
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Project:
SOt/c {�`q /°'1~d�
' le /4/24,
Type of Insp ctio�:
/4 AA' t, !fir(
�e
Address:
1.{005 4z
/vi, S
Date Called t'7 j/o
Special Instructions:
/
Date Wanted: a.m.
Requester:
Phone 1D / `Z 1- '340
Approved per applicable codes. ❑ Corrections required prior to approval.
COMMENTS:
�n el ,3 e --
Inspector: i.r jU
Date22���Y
JJ $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:
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION ?-
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3 7
f �avaeIC
Project: /. '
Type of Inspection:
Address:
/4'o6W4J3
Date Called:
Special Instructions:
Date Wanted: a.m.
2 - -zg - v (-4'7
Requester:
Phone No:
c. v6- z(6 4/— 301/0
XApproved per applicable codes. Corrections required prior to approval.
COMMENTS:
specto
thvzi
D e:
23
$5•.00 REINSPECTION FEE EQUIR D. Prior o inspection. fee must be
Ad at 6300 Southcenter Bl d., Suite 100. Call the schedule reinspection.
Receipt No.:
Date:
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit /- Q,-10%4.
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION -
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -36
Prgjeet+.
fir /4 /7 h�
Type of nspecti n: .
✓Zo,til- '4, 74-0-1s -6.
A7_ /`7 ,,
Date Called:
Special Instructions:
Date Wanted:
vgD /77/4,)
a ,•
Aldo
Requester:
Phone 66 ?$
--/ e.)
S
Approved per applicable codes. Corrections required prior t� approval.
COMMENTS:
58:00 REINSPECTION FE REQUIRED rior o inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 00. Call the schedule reinspection.
Receipt No.:
Date:
CITY OF TUKWILA
Department of Community Development
6300 Southcenter Boulevard, Tukwila, WA 98188
Telephone: (206) 431 -3670 FAX (206) 431 -3665
E -mail: tukplanaci.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: 6 OS' 0
STATE OF WAS HINGTON)
) ss.
COUNTY OF KING '' )
■1? 1 N V, h-e A g\ / , 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. /3 , 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 m construction -
Owner/Own
.. OSJ�S 'o%%%% % %t�.�'! Signed and sworn to me this
=,�a' a•rA y 15 day of ) 1 Y' /-,4 , 20 c:�F.
Z Vic.. '�'.� p4,
sc,y
wy �,145.i9 ;�.. 45- Nb'r Y PUBLIC in and for the State of Washington
/�f t0 `WAS ;.�'+ Residing at
County
Name as commissioned: kat /7 -e /9- et,'erle
My commission expires: 0 5-0? 9 -/ CD