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HomeMy WebLinkAboutPermit PG08-161 - SMILES AT SOUTHCENTERSMILES AT SOUTHCENTER 15425 53 AV S PGO8-161 Parcel No.: Address: Suite No: Citylif 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 1157200033 15425 53 AV S TUKW PLUMBING /GAS PIPING PERMIT Permit Number: Issue Date: Permit Expires On: PG08 -161 07/01/2008 12/28/2008 Tenant: Name: Address: Owner: Name: Address: SMILES AT SOUTHCENTER 15425 53 AV S , TUKWILA WA QUESTAR PARTNERSHIP PO BOX 98210 , LAKEWOOD WA Contact Person: Name: MARK SUTIN Address: 206 AVE G , SNOHOMISH WA Contractor: Name: THE PLUMBERS Address: 206 AV G , SNOHOMISH WA Contractor License No: PLUMB ** 151JR Phone: Phone: 360 840 -0120 Phone: 360 - 568 -3880 Expiration Date: 01/29/2009 DESCRIPTION OF WORK: PLUMBING, AIR, AND VAC FOR NEW TENANT (DENTAL OFFICE) INCLUDING INSTALLATION OF 1/2 " WILKINS 975 XL REDUCED PRESSURE PRINCIPLE ASSEMBLY (RPPA) FOR IN- PREMISE ISOLATION. REFER TO PERMIT PW08 -038 FOR PREMISE ISOLATION RPPA. Value of Plumbing /Gas Piping: Fees Collected: $36,000.00 $466.00 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 Sinks Urinals Water Closet Uniform Plumbing Code Edition: 2006 International Fuel Gas Code Edition: 2006 FIXTURE TYPE AND QUANTITY Plumbing (cont.) 0 Building sewer and each trailer park sewer 0 0 Rain water system - per drain (inside bldg) 0 1 Water heater and /or vent 1 6 Industrial waste treatment interceptor, including 2 its trap and vent, except for kitchen type 0 grease interceptors 0 0 Repair or alteration of water piping and/or water 1 treatment equipment 0 0 Repair or alteration of drainage or vent piping 0 3 Medical gas piping system serving (1 -5) 0 inlets /outlets for a specific gas 0 2 Medical gas piping (6 +) inlets /outlets 0 4 Gas Piping 0 Gas piping outlets (0 -5) 0 3 Gas piping outlets (6 +) 0 * *continued on next page ** doc: UPC -10/06 PG08 -161 Printed: 07 -01 -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 -161 Issue Date: 07/01/2008 Permit Expires On: 12/28/2008 Permit Center Authorized Signature: Date: 57//01 /0,P— 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 pe�rforny�nc�of worjq. I am authorized to sign and obtain this plumbing /gas piping permit. r Date: / -- / 0c3 Signature: Print Name: 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 -161 Printed: 07 -01 -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 Parcel No.: 1157200033 Address: 15425 53 AV S TUKW Suite No: Tenant: SMILES AT SOUTHCENTER PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: PG08 -161 ISSUED 05/27/2008 07 /01/2008 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: AU 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. 13: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * ** 14: Reduced Pressure Principle Assembly (RPPA) shall be installed per manufacturers specifications. RPPA shall be tested by a certified tester and passing backflow test report submitted to City Utilities Inspector. * *continued on next page ** doc: Cond -10/06 PG08 -161 Printed: 07 -01 -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: M1 1 tK- b, suri6Y doc: Cond -10/06 PG08 -161 Printed: 07 -01 -2008 CITY OF TUKWI Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us Plumbing /Gas Permit No. V - �� 1 Project No f 00 -� 0. (For 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 Print** SITE LOCATION Site Address: /5212.., jztp 4 j//E S'D Tenant Name: 1R t N -(.Y . N Property Owners Name: 1-)7K., Q\l G- U Y g.„ Mailing Address: S 4 M King Co Assessor's Tax No.: Suite Number: New Tenant: - Floor: *- K.... Yes El ..No tk/I L Ci k/i -( State g8iBS Zip CONTACT PERSON -Who do when your permit is ready to be issued Name: M 4 f - S i T 7 O/ Day Telephone: 3 60 - &VO- ®12O Mailing Address: „Q ) (1, 14-1/ f G- N p J- f O P'11.5' Al- City State Zip MS UTI N� �bi1 e�4ST, Fax Number: j -24 4// E -Mail Address: PLUMBING GAS PIPING ,ONTRA,CTOR INFORMATION Company Name: Mailing Address: M TELW-.11 f F - O% ,4V Cr k/ G (Dail, T 14-E '1=-4. liM !3E /2.5) LS 1 -a Contact Person: N'} )1 Ri v 7-7 6/ E -Mail Address: Contractor Registration Number: P L U M 13 / 5/ (.7-1_ Company Name: Mailing Address: 3 23 O2_ c 0 L *y /- IJ t., F-1/ .2E_17 -- City State Zip Contact Person: gp R Day Telephone: V%2._ .2s r/' 3 / 36 E -Mail Address: ` i t' C}4-04r-itP4 1 P2 IFA- trnN- L►N11, A/gt"FaxNumber: '0- -a. Z- 33 / 7 City State Zip Day Telephone: 34,0 g LI) 0 O 1 ?_D Fax Number: ,3 (r, d - Expiration Date: /-e2. / —09 plan must be ret stamped by, Are illtee `p,o £t 1 Lc/ 44f, P jo iV gyp., 592 l et. stamped by Eng Company Name: Mailing Address: Zip Contact Person: E -Mail Address: Q:\Applications\Porms- Applications On Line\3 -2006 - Plumbing -Gas Piping Permit Application.doc Revised: 4 -2006 bh City Day Telephone: Fax Number: State Page 1 of 2 • Valuation of Project (contractor's bid price): $ 3 (oj 0 0 0 Scope of Work (please provide detailed information): 'L l,M f / 1∎1 - '' A-1 VMM C Building Use (per Intl Building Code): b E W7 /-L aL/ A) / C Occupancy (per Int'l Building Code): Utility Purveyor: Water: 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: Qty :Fixture Type: 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 2_ ,2- cl4FLvW "iLEV, Clothes washer, domestic / Floor drain / Sinks Dental unit, cuspidor 4, Shower, single head trap Urinals Dishwasher, domestic, with independent drain 2 Lavatory 3 Water Closet 3 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 (4- A-1 R. ,13-v A C. 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 0 D AG T: Signature: r'' ('� Print Name: R..)L u -7 N Mailing Address: ,2O Date: Day Telephone: 3 toO -WO -p l 2 0 SA 1-- 0M1Slf /,✓4- i514- 9 .290 City State Zip Date Application Accepted: (1,1-101) Date Application Expires: Staff Initials: Q:\Applications\Forms- Applications On Line13 -2006 - Plumbing -Gas Piping Permii 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 Parcel No.: 1157200033 Address: 15425 53 AV S TUKW Suite No: Applicant: SMILES AT SOUTHCENTER RECEIPT Permit Number: PG08 -161 Status: APPROVED Applied Date: 05/27/2008 Issue Date: Receipt No.: R08 -02359 Payment Amount: $366.00 Initials: LAW Payment Date: 07/01/2008 12:15 PM User ID: 1632 Balance: $0.00 Payee: MARK THE PLUMBER INC TRANSACTION LIST: Type Method Descriptio Amount Payment Check 14481 366.00 ACCOUNT ITEM LIST: Description Account Code Current Pmts PLUMBING - NONRES 000.322.103.00.0 366.00 Total: $366.00 4290 07/01 9711 TOTAL 36500 doc: Receiot -06 Printed: 07 -01 -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 Parcel No.: 1157200033 Address: 15425 53 AV S TUKW Suite No: Applicant: SMILES AT SOUTHCENTER RECEIPT Permit Number: PG08 -161 Status: PENDING Applied Date: 05/27/2008 Issue Date: Receipt No.: R08 -01819 Initials: JEM User ID: 1165 Payment Amount: $100.00 Payment Date: 05/27/2008 02:15 PM Balance: $366.00 Payee: MARK THE PLUMBER TRANSACTION LIST: Type Method Descriptio Amount Payment Cash 100.00 ACCOUNT ITEM LIST: Description Account Code Current Pmts PLAN CHECK - NONRES PLUMBING - NONRES 000/345.830 86.00 000.322.103.00.0 14.00 Total: $100.00 2888 05/27 9710 TOTAL 100.00 doc: Receiot -06 Printed: 05 -27 -2008 INSPECTION NO. INSPECTION RECORD Retain a copy with permit CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Project: n \ 01/4...A. Type of Ins ection: f 1--) A. e -k Al G, A b r7 Address: 5425 33 lcl Dam. Special Instructions: Date Wanted: c /0- ?4 —Ja' p.m. Requester: Phone No: 7,0(0- 35i— .5"2`7( ES Approved per applicable codes. ❑ Corrections required prior to approval. COMMENTS: pe_f z,c7 dt,<, Inspector: \ 01/4...A. 'Date `] r ❑ $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: Date: INSPECTION NO. INSPECTION RECORD Retain a copy with permit % dr -(4( PERMIT NO. CITY OF TUKWILA BUILDING DIVISION Iz 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (20p431 -3670 Project: 1 it-. , I . S C(',�.�' -er` Type of,rlspecti : f, ,, ..J C.,, AS Address: r4 Date Called: Special Instructions: / Date Wanted: / 3 //�� '1 — J� .p.m.. p.m. Requester: Phone No: Approved per applicable codes. 0 Corrections required prior to approval. COMMENTS: At.y Date: 1 J G J 1 El $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: Date: INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION IQ- 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 P6 v? - /6 Project: Type of Inspection: Address: _ , e / 511,5 )3- ''L ,f0, D e Called: J , Special Instructions: Date Wanted: cm /0-`1-) Requester: Phone No: 7 -or,0 5-1 --5 ?7I ❑ Approved per applicable codes. Corrections required prior to approval. COMMENTS: kv ' . / 7qM P '4f./ CJ ;'l.) % fv, -- Di- :, ; 1,,1AJ 1:, of . , 2) A< I eit f_ C JA e_ I fr../ Inspec(tor:' Date: : ❑$60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: Date: t 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 -3670 I:4 8?-/4/ ti Project /' Type of Inspection:, 4il Address: /5 ,/2s- -5-3d 414,5- Date Called: Instructions: Date Wanted:,, f 2 f ap.m:, Requester: Phone No: .360 8'4/0 o/2/17 Approved per applicable codes. ElCorrections required prior to approval. COMMENTS: ,C't t t of ✓ o- - 4' e4 1E Inspector:.k164t‘ Date: 1 El $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee, must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule rein'spection. Receipt No.: !Date: • 1 4 BACKFLOW PREVENTION ASSEMBLY TEST REPORT u/MBrN* P6 og-A,/ ACCOUNT # AACRA Backflow Assembly Testing & Service PMB A -11, 621 S.R. 9 N.E., Lake Stevens, WA 98258 Phone: 425-334-4507 Pager: 425 -438 -5316 Fax: 425-334-6526 AACRABA990DM PL30YOUNGLW983PT NAME OF PREMISE PG s i \ Q C7� ; Ci vti�(h G Q, v� r Commercial tit Residential 0 SERVICE ADDRESS 1 5 L I- 5- a• Q 5 crril 1 tiry 11 Ol ZIP ()l i n CONTACT PERSON PHONE( ) LOCATION OF ASSEMBLY m •1 voovn 0 FAX ( ) r c. 0 RPBA L PVBA 0 OTHER PROPER INSTALLATION? YES ttI NO ❑ W 151)-2, i 1-1 SIZE 5 ° DOWNSTREAM PROCESS A i \M K\ DCVA NEW INSTALL EXISTING ❑ REPLACEMENT ❑ OLD SER. # MAKE OF ASSEMBLY \,\) > \\'`x Y15 MODEL `A 1 5 L. SERIAL NO. INITIAL TEST PASSEDM DCVA / RPBA DCVA / RPBA RPBA PVIIA/SVBA CHECK VALVE NO.1 CHECK VALVE NO.2 OPENED AT 3,ko PSID AIR INLET OPENED AT PSID LEAKED ❑ 1 i PSID LEAKED • 1 1 (A A\ PSID #1 CHECK "7.9 PSID AIR GAP OK? 14,1_ DID NOT OPEN • FAILED • NEW PARTS AND REPAIRS OlEAN REPLACE PART CLEAN REPLACE PART CLEAN REPLACE PART CHECK VALVE HELD AT PSID • • • • ■ • • • • • • LEAKED • • • • ❑ • • CLEANED ❑ • • • ❑ • • REPAIRED • TEST AFTER REPAIRS PASSED 0 FAILED • OPENED AT PSID AIR INLET PSID LEAKED • PSID LEAKED ■ PSID #1 CHECK PSID CHK VALVE _ PSID AIR GAP INSPECTION: Required minimum air gap separation provided? Yes No 0 Detector Meter Reading REMARKS: LINE PRESSURE 1 Q 5 PSI TESTERS SIGNATURE: TESTERS NAME PRINTED: CAL. DATE t_ /A / ®% GAUGE # ❑ 03050953 012050050 REPORT TO CONFINED SPACE? lU ') CERT. NO. B -3497 DATE 1 -� ~� C'� Lewis W. Young TESTERS PHONE # ( 425 ) 334 -4507 MAKE Midwest MODEL_ 845_ SERVICE RESTORED? YES1 NO ❑ I certify that this re r_ort inaccurate, and I have used WAC 246- 290-490 approved test methods and test equipment BACKFLOW PREVENTION ASSEMBLY TEST REPORT AACRA Backflow Assembly Testing & Service PMB A -11, 621 S.R. 9 N.E., Lake Stevens, WA 98258 Phone: 425-334-4507 Pager: 425 -438 -5316 Fax: 425-334-6526 AACRABA990DM PL30YOUNGLW983PT ACCOUNT # NAME OF PREMISE 6 r!N, j \ k, S A ,;p V\ \tVN, G F• ,KV4,1r' Commercial Residential 0 SERVICE ADDRESS) 5 Q-- 5 5 Z r 4 V �-, ► CITY i'A h Vi 11 Oi ZIP q g 1% CONTACT PERSON PHONE( ) c FAX ( ) LOCATION OF ASSEMBLY S • 5 j kS. p p ch ti• k i 1,10\ 8� )� "1 ► r k. v OL +u 1� 1-- Yrn cA ; 1 60 X es DOWNSTREAM PROCESS L-. r )- 1 1 tAA 16 Yl DCVA k RPBA 0 PVBA 0 OTHER NEW INSTALL ❑ EXISTING t'l REPLACEMENT ❑ OLD SER. # PROPER INSTALLATION? YES 4 NO ❑ MAKE OF ASSEMBLY \) 1 \k 1 'Y) 5 MODEL Ci S V r) C SERIAL NO. '')%1 518 SIZE l , 0 " INITIAL TEST PASSED 0, DCVA /RPBA DCVA / RPBA RPBA PVBA/SVBA CHECK VALVE NO.1 CLIECK VALVE NO.2 OPENED AT PSID AIR INLET OPENED AT PSID LEAKED • 'D, ' 1 PSID LEAKED • PSID #1 CHECK PSID DID NOT OPEN • AIR GAP OK? FAILED • NEW PARTS AND REPAIRS CLEAN RFPL M PART CLEAN REPLACE PART CLEAN REPLACE PART CHECK VALVE HELD AT PSID • • • • • • • • • • • LEAKED • • • • ■ • • CLEANED ❑ • • • 0 • ❑ REPAIRED • TEST AFTER REPAIRS OPENED AT PSID AIR INLET PSID LEAKED • PSID LEAKED • PSID #1 CHECK PSID CHK VALVE PSID PASSED • FAILED • AIR GAP INSPECTION: Required minimum air gap separation provided? Yes 0 No 0 Detector Meter Reading REMARKS: \ 5 \n v1\ 0 s L -\ 6 's t Ut> v�G h Ve) 'k VA LINE PRESSURE 1 l) PSI CONFINED SPACE? N 0 CERT. NO. B -3497 DATE cl ^ "' TESTERS SIGNATURE: fy.i‘AN\\v,,,,ket\ TESTERS NAME PRINTED: Lewis W. Young TESTERS PHONE # ( 425 ) 334 -4507 CAL. DATE j_ / 9-. / f i GAUGE # ❑ 03050953 1412050050 MAKE Midwest MODEL_ 845_ -� ' l 5 1 Vk SERVICE RESTORED? YES ❑ NO ❑ n s S' V to y)(k REPORT TO I certify that this repgrt is accurate, and I have used WAC 246-290-490 approved test methods and test equipment. • BACKFLOW PREVENTION ASSEMBLY TEST REPORT AACRA Backfow Assembly Testing & Service PMB A-11, 621 S.R. 9 N.E., Lake Stevens, WA 98258 Phone: 425- 334 -4507 Pager. 425 - 438-5316 Fax: 425- 334 -6526 AACRABA990DM PL30YOUNGLW983PT ACCOUNT fi NAME OF PREMISE S an AA, 5 ci ..S% v\ -kli C, aYA44,t- - Commercial Al Residential 0 SERVICE ADDRESS \ 5 N 2- 5 S a r k a 5, CrTf'si6,v4 i\ A zip a1$1vt `b CONTACT PERSON V PHONE HONE ( 1 in FAX ( ) LOCATION OF ASSEMBLY S . 5 I. OC a A r 1 'nel \ of i UA. b 0 tp 1, i Ci t" '. \) A 14V\ v DOWNSTRF,AM PROCESS r 41.`m 1'a_�S IS tX e,N i m n DCVA 0 RPBA PVBA 0 OTHER NEW INSTALLLIBXLSTING ❑ REPLACEMENT ❑ OLD SER. # PROPER INSTALLATION? YES 41 NO ❑ MAKE OF ASSEMBLY ti3S 5 MODEL QC9a1 ill �- V SERIAL NO. A 1 \fp 9 J 5 STS 144" AIR GAP INSPECTION: Required minimum air gap separation provided? Yes tif No 0 Detector Meter Reading REMARKS: LINE PRESSURE 11 i PSI CONFINED SPACE? N 0 TESTERS SIGNATURE: TESTERS NAME PRINTED: Lewis W. Young TESTERS PHONE # ( 425 ) 334 -4507 MAKE Midwest MODEL 845 SERVICE RESTORED? YES NO ❑ CERT. NO. B -3497 DATE %—% Q 2 CAL. DATE 1_ /0% GAUGE # ❑ 03050953 REPORT TO �� b S 12050050 I certify that this report it accmnre, and t have used WAC 246 - 290 -490 approved tat methods caul test equipment DCVA / RPBA DCVA / RPBA RPBA PVBA/SVBA JNT 1AL TEST PASSED CHECK VALVE NO.1; CHECK VALVE NO.2 OPENED AT 9, .1 PSID MR INLET OPENED AT PSID LEAKED • —7 . 1 PSID LEAKED ❑ -1-1 ' % hN' PSID #1 CHECK % h 9 PSID DID NOT OPEN • AIR GAP OK? 00,5 FAILED • PAID PART AND REPAIRS CLEAN RERACE PART CLEAN REPLACE PART €iEAJJ REPLACE PART CHECK VALVE HELD AT PS • • • • • • LEAKED • ❑ • • • • • . • • • ❑ ■ ■ CLEANCLEANED ❑ REPAIRED ❑ ❑ • • • • TEST AFTER REPAIRS OPENED AT PSID AIR INLET PSID LEAKED ■ PSID LEAKED • PSID 71 CHECK PSID CHK VALVE • PSID PASSED • FAILED • AIR GAP INSPECTION: Required minimum air gap separation provided? Yes tif No 0 Detector Meter Reading REMARKS: LINE PRESSURE 11 i PSI CONFINED SPACE? N 0 TESTERS SIGNATURE: TESTERS NAME PRINTED: Lewis W. Young TESTERS PHONE # ( 425 ) 334 -4507 MAKE Midwest MODEL 845 SERVICE RESTORED? YES NO ❑ CERT. NO. B -3497 DATE %—% Q 2 CAL. DATE 1_ /0% GAUGE # ❑ 03050953 REPORT TO �� b S 12050050 I certify that this report it accmnre, and t have used WAC 246 - 290 -490 approved tat methods caul test equipment BACKFLOW PREVENTION ASSEMBLY TEST REPORT AACRA Backflow Assembly Testing & Service PMB A -11, 621 S.R. 9 N.E., Lake Stevens, WA 98258 Phone: 425- 334 -4507 Pager: 425 -438 -5316 Fax: 425- 334 -6526 AACRABA990DM PL30YOUNGLW983PT ACCOUNT # NAME OF PREMISE S ri--1 11 01? s \-S6 G 41t.34 CommerdalI Residential 0 SERVICE ADDRESS +- - 1 S 4,-.c S i- 'Y S CITY —Tvi kVA l 0, ZIP CONTACT PERSON PHONE ( )r FAX ( ) LOCATION OF ASSEMBLY \ 9.v% 1 Svc G (v r n� V) d'1 -P 1- 0 VIA L\ DOWNSTREAM PROCESS T i 4-- V '` G�, DCVA D RPBA 0 PVBA 0 OTHER I) C.0 i NEW INSTALL I EXISTING ❑ REPLACEMENT ❑ OLD SER.1 PROPER INSTALLATION? YES 14 NO ❑ M A K E O F A S S E M B L Y W � t � MODEL? S 7' Gxi MISERIAL NO. 1 A 01% SIZE 51 0 INITIAL mil' PASSED 0 DCVA /RPBA DCVA /RPBA RPBA, OPENED AT PSID PVBA/SVBA, AIR INLET OPENED AT PSID CHECK VALVE NO.1 CHECK VALVE N0.2 CLOSED TIGHT bp LEAKED 0 t \A PSID CLOSED TIGHT of ` LEAKED • PSID #1 CHECK PSID MR GAP OK? DID NOT OPEN • FAILED • PARTS AND REPAIRS CLEAN REPLACE PART CLEAN REPLACE PART CLEAN REPLACE PART CHECK VALVE HELD AT PSID • ■ 0 • • • . • • • 0 LEAKED • • 0 • • • • CLEANED ❑ REPAIRED • • • • • • • TEST AFTER REPAIRS OPENED AT PSID AIR INLET PSID LEAKED • LEAKED • PSID PSID #1 CHECK PSID CHK VALVE PSID PASSED • FAILED • MR GAP INSPECTION: Required min' air gap separation provided? Yes ❑ No 0 Detector Meter Reading REMARKS: LINE PRESSURE i 15 PSI CONFINED SPACE? 4,j, f CERT. NO. B -3497 DATE cr"i ' 'r B g TESTERS SIGNATURE: TESTERS ERS NAME PRINTED: Lewis W. Young TESTERS PHONE # ( 425 ) 334 -4507 MAKE Midwest MODEL 845_ SERVICE RFSI'ORED? YES if NO ❑ CAL. DATE ` / 1- /Q3 REPORT TO GAUGE # ❑ 03050953 t412050050 a s 1 certify that this repot is aecumm, and I have used WAC 246 - 290 -490 approved test methods and test equipment ., OP BACKFLOW PREVENTION ASSEMBLY TEST REPORT AACRA Backflow Assembly Testing & Service PMB A -11, 621 S.R. 9 N.E., Lake Stevens, WA 98258 Phone: 425- 334 -4507 Pager. 425- 438 -5316 Fax: 425- 334 -6526 AACRABA990DM PL30YOUNGLW983PT ACCOUNT 1 NAME OF PREMISE °►k 0%30\ Q �R `Q Commercial Residential D SERVICE ADDRESS t S ti `k 5 -ittV S CITY v !v W a\ up It j k.1 CONTACT PERSON`, PHONE ( ) FAX ( ) LOCATION OF ASSEMBLY vAN , iAl 6 D YV M m 1-1 0 PA. Ce� DOWNSTREAM PROCESS V ∎ \- -a.' `.�,L Y y t9. b v4 $ � 5 S DCVA [ RPBA ❑ PVBA [] OTHER NEW INSTALL tEXLSTING ❑ REPLACEMENT ❑ OLD SER. # PROPER INSTALLATION? YES ki NO ❑ MAKE OF ASSEMBLY NO ith-Vr S MODEL D Q 7 FI `S ®1 SERIAL NO. 3-.K) Q 1 q I SIZE Q t °17 INITIAL TEST PASSED A DCVA /RPBA DCVA / RPBA BA PVBA /MA CHECK VALVE NO.I, CHECK VALVE NO.2 OPENED AT MD AIR INLET OPENED AT PSID CLOSED TIGHT ligkt LEAKED 0 CLOSED TIGHT 0 LEAKED • a- • LI PSID #1 CHECK PSID 1- • 3 PSID AIR GAP OK? DID NOT OPEN • FAILED • NEW PARTS AND REPAIRS CLEAN REPLACE PANT CLEAN REPLACE PART CLEAN REPLACE PART CHECK VALVE HELD AT PSID • • • ❑ • ❑ • • ❑ • • • LEAKED • • • • • • • CLEANED ❑ REPAIRED ❑ • • • • • • TEST AFTER REPAIRS LEAKED ❑ PSID OPENED AT PSID AIR INLET PSID LEAKED • PSID #1 CHECK PSID CHK VALVE PSID PASSED • FAILED • AIR GAP INSPECIION: Required minimum air gap lseparation provided? Yes 0 No ❑ Detector Meter Reading 'cm-0(N $ 3 REMARKS: vv\'� y v 41' 3 114 1\0 b l\ LINE PRESSURE 11 5 PSI CONFINED SPACE? 4..L5 TESTERS SIGNATURE: TESTERS NAME PRINTED: Lewis W. Young TESTERS PHONE 1( 425 ) 334 -4507 CAL. DATE _1_ / 2- / (% GAUGE # ❑ 03050953 1012050050 MAKE_ Midwest MODEL 845_ REPORT TO —.Si' No 5 ; -‘k SERVICE RESTORED? YESki NO ❑ CERT. NO. - -_ B -3497 DATE °1- `1" 1 certify that ibis report it =curate, t td I have used WAC 246 -290 -490 approved met methods and sem equipment 1U /UJ /4UU6 14:40 rR. 443/41L.7UU 1Y111(Ud 1141, • :Miattrapir Inc a Medical Gases • Medical Gas Line Verifications • Analgesia Equipment \AOita I' DENTAL AIR AND VACUUM VERIFICATION *** Mitei • 19 SEPTEMBER 2008 CONTRACTOR: WR HANSEN DATE AND TIME OF TESTING: 18 SEPTEMBER 2008 / 10:00 AM FACILITY: SMILES AT SOUTHCENTER Dr's THUY NGUYEN AND DOREEN M ROSETO DDS 15425 - 53RD AVE SO. TUKWILA WA 98188 SCOPE OF WORK: NEW DENTAL AIR AND VACUUM SYSTEMS I. GENERAL FINDINGS: A. DENTAL AIR AND VACUUM ARE IN COMPLIANCE WITH NFPA 99 (2005ed,) LEVEL 3, DENTAL B. NO CROSSED LINES WERE FOUND IN DENTAL AIR. OR VACUUM IN TESTED AREAS ON THE DAY OF TESTING. C. DENTAL AIR MEETS OXYGEN CONCENTRATION. D. DENTAL v C�M MEETS VACUUM PRESSURE AND REQUIREMENTS. E. DENTAL REQUIREMENTS. F. DENTAL AIR AND VACUUM SYSTEM COMPONENTS O IN AREA TESTED ARE IN COMPLIANCE WITH NFPA 99 ( ) LEVEL G. LINE PRESSURE TEST FOR 24 HOURS: PASS CITY OF TUKWILA: # PG 08 -161 11. DENTAL AIR: A. STATIC LINE PRESSURE: 100 PSIG. B. CONCENTRATION OF OXYGEN: 20.8 % III. DENTAL VACUUM: A. STATIC DENTAL LINE VACUUM: 12" l IgV . IV. PARTICULATE LINE TEST: PASS. SMILES -SC- 09.18.08 2706 164th Street S.W.. Lynnwood, WA 98087 (425) 741 -8807 - 1- 800 - 736-7047 • Fax: (425) 741.2500 Page 1 of 2 WILKINS ZURN comh,iny Model 975XL Reduced Pressure Principle Backflow Prevention Assembl SPECIFICATION SUBMITTAL SHEET FEATURES Sizes: ❑ 1/4" ❑ 3/8" ❑ 1/2" Maximum working water pressure Maximum working water temperature Threaded connections (FNPT) OPTIONS (Suffixes can be combined) 175 psi 180° F ANSI B1.20.1 ❑ - with full port ball valves (standard) ❑ L - less shut -off valves ❑ S - with bronze "Y" type strainer (1/2" only) ❑ TCU - with test cocks up ❑ FT - with integral male 45° flare SAE test fitting ACCESSORIES ❑ Air gap (Model AG) ❑ Repair kit (rubber only) ❑ Thermal expansion tank (Model WXTP) ❑ Soft seated check valve (Model 40) ❑ Shock arrester (Model 1250) ❑ QT -SET Quick Test Fitting Set ❑ Test Cock Lock (Model TCL24) DIMENSIONS & WEIGHTS (do not include pkg.) APPLICATION Designed for installation on potable water lines to protect against both backsiphonage and backpressure of contami- nated water into the potable water supply. The Model 975XL provides protection where a pote tial STANDARDS COMPLIANCE • ASSE® Listed 1013 • IAPMO® Listed • CSA® Certified • Approved by the Founda Control and Hydraulic R Southern Califomia MATERIALS Main valve body Access covers Internals Elastomers Polymers Springs c CODE( pXist,SVR �,. CDDE COMPLIANCE APPROVED JUN 3 0 2006 JUN 2 4 2006 TUKWILA PUBLIC WORKS Cast bronze ASTM B 584 Cast bronze ASTM B 584 Stainless steel, 300 Series Silicone (FDA approved) Buna nitrite (FDA approved) NorylTM, NSF Listed Stainless steel, 300 series Relief Valve discharge port: 1/4" -1/2" - 0.38 sq. in. G A B R EIVED JIM 202006 PERMIT CENTER MODEL SIZE in. mm DIMENSIONS (approximate) WEIGHT in. A mm in. B mm in. C mm D in. mm in. E mm F in. mm G in. mm W /BV lbs. kg LJBV lbs. kg 1/4 8 9 1/2 241 5 3/4 146 1 1/2 38 2 3/4 70 2 51 4 102 N/A N/A 7 3.2 6 2.7 3/8 10 9 1/2 241 5 3/4 146 1 1/2 38 2 3/4 70 2 51 4 102 N/A N/A 7 3.2 6 2.7 1/2 15 10 254 5 3/4 146 1 1/2 38 2 3/4 70 2 51 4 102 13 1/2 343 7 3.2 6 2.7 Page 1 of 2 DOCUMENT #: BF-975XL SM REVISION: 6/06 CORRECTION LTR# V&08 I61 FLOW CHARACTERISTICS MODEL 975XL 1/4 ", 3/8" & 1/2" (STANDARD & METRIC) FLOW RATES (I /s) 0.38 0.57 0.76 a 20 0 15 w N 10 W a 5 0.19 0.95 137 to 103 w 69 S 0) 35 a w FLOW RATES (GPM) O Rated Flow (Established by approval agencies) TYPICAL INSTALLATION Local codes shall govern installation requirements. To be installed in accordance with the manufacturers' instructions and the latest edition of the Uniform Plumbing Code, Un- less otherwise specified, the assembly shall be mounted at a minimum of 12" (305mm) and a maximum of 30" (762mm) above adequate drains with sufficient side clear- ance for testing and maintenance. The installation shall be made so that no part of the unit can be submerged or where relief valve discharge could cause damage. Capacity thru Schedule 40 Pipe Pipe size 5 ft /sec 7.5 ft /sec 1/4" (6mm) 15 ft /sec 1/8" - 1 2 3 1/4" 2 i � 3/8 (9mm) 3/8" 3 . `. 6 9 1/2" 5 7 c 1/2" (15mm) 3/4" 8 12 17 25 1" 13 20 27 40 1 1/4" 23 35 47 70 1 1/2" 32 48 63 95 2" 52 78 105 167 ) 3 6 9 12 1 FLOW RATES (GPM) O Rated Flow (Established by approval agencies) TYPICAL INSTALLATION Local codes shall govern installation requirements. To be installed in accordance with the manufacturers' instructions and the latest edition of the Uniform Plumbing Code, Un- less otherwise specified, the assembly shall be mounted at a minimum of 12" (305mm) and a maximum of 30" (762mm) above adequate drains with sufficient side clear- ance for testing and maintenance. The installation shall be made so that no part of the unit can be submerged or where relief valve discharge could cause damage. Capacity thru Schedule 40 Pipe Pipe size 5 ft /sec 7.5 ft /sec 10 ft /sec 15 ft /sec 1/8" 1 1 2 3 1/4" 2 2 3 5 _ 3/8" 3 _ 4 6 9 1/2" 5 7 9 14 3/4" 8 12 17 25 1" 13 20 27 40 1 1/4" 23 35 47 70 1 1/2" 32 48 63 95 2" 52 78 105 167 DIRECTION OF FLOW. INDOOR INSTALLATION SPECIFICATIONS The Reduced Pressure Principle Backflow Preventer shall be ASSE® Listed 1013, rated to 180° F and supplied with full port ball valves. The main body and access covers shall be bronze (ASTM B 584), the seat ring and all internal polymers shall be NSF® Listed NorylTm and the seat disc elastomers shall be silicone. The checks shall be oriented at a 45° angle upward and accessible for maintenance without removing the relief valve or the entire device from the line. If installed indoors, the installation shall be supplied with an air gap and "y" type strainer. The Reduced Pressure Principle Backflow Preventer shall be a WILKINS Model 975XL. Page 2 of 2 WILKINS a Zum company, 1747 Commerce Way, Paso Robles, CA 93446 Phone:805 /238 -7100 Fax:805/238 -5766 IN CANADA: ZURN INDUSTRIES LIMITED, 3544 Nashua Dr., Mississauga, Ontario L4V 11.2 Phone:905 /405 -8272 Fax:905 /4 ECEIVED Product Support Help Line: 1- 877 - BACKFLOW (1- 877 - 222 -5356) • Website: http: //www.zurn.com JUN 202008 PERMIT CENTEI• June 17, 2008 Jim Haggerton, Mayor epartment of Community Development Jack Pace, Director Mark Sutin 206 Avenue G Snohomish, WA 98290 RE: CORRECTION LETTER #1 Plumbing /Gas Piping Application Number PG08 -161 Smiles at Southcenter —15425 — 53rd Avenue S Dear Mr. Sutin, This letter is to inform you of corrections that must be addressed before your plumbing permit can be approved. All correction requests from each department must be addressed at the same time and reflected on your drawings. I have enclosed comments from the Building and Public Works Departments. Building Department: Allen Johannessen at 206 - 433 -7163 if you have questions regarding the attached comments. Public Works Department: Joanna Spencer at 206 - 431 -2440 if you have questions regarding the attached comments. Please address the attached comments in an itemized format with applicable revised plans, specifications, and /or other documentation. The City requires that two (2) complete sets of revised plans, specifications and /or other documentation be resubmitted with the appropriate revision block. In order to better expedite your resubmittal, a `Revision Submittal Sheet' must accompany every resubmittal. I have enclosed one for your convenience. Corrections /revisions must be made in person and will not be accepted through the mail or by a messenger service. If you have any questions, please contact me at (206) 431 -3670. Sincerely, Brenda Holt Permit Coordinator encl xc: File No. PG08 -161 P:\Pennit Cen ter \Correction Letters\2008\PG08 -161 Correction Ltr #1.DOC wee 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206- 431 -3665 Tukwila Building Division Allen Johannessen, Plan Examiner Building Division Review Memo Date: June 2, 2008 Project Name: Smiles at Southcenter Permit #: PG08 -161 Plan Review: Allen Johannessen, Plans Examiner The Building Division conducted a plan review on the subject permit application. Please address the following comments in an itemized format with revised plans, specifications and /or other applicable documentation. (GENERAL NOTE) PLAN SUBMITTALS: (Min. size 11x17 to maximum size of 24x36; all sheets shall be the same size). (If applicable) Structural Drawings and structural calculations sheets shall be original signed wet stamped, not copied.) 1. The floor plan is confusing in being able to determine the different plumbing lines and where they connect. Please revise floor plan or provide differentiating line markings or color coding that clearly identifies the different types of plumbing lines. Clearly identify the location of vent pipes and where they shall vent to roof. Identify on all cleanouts on the floor plan (2006 UPC 707 & 719). 2. Clarify the drain lines on the isometric drawings to differentiate between drain pipes and vent pipes. Identify all fixtures on all isometric plumbing sheets. Clearly identify all clean outs as they are in reference to the floor plan. Should there be questions concerning the above requirements, contact the Building Division at 206 -431- 3670. No further comments at this time. • • PUBLIC WORKS DEPARTMENT COMMENTS DATE: June 13, 2008 PROJECT: Smiles at Southcenter 15425 53rd Ave S PERMIT NO: PG08 -161 PLAN REVIEWER: Contact Joanna Spencer (206) 431 -2440 if you have any questions regarding the following comments. 1) Please revise per attached mark -up and return it with your revision submittal. P: joanna/comments 1 PGO8 -161 PERMIT COORD COPY PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG08 -161 DATE: 06 -20 -08 PROJECT NAME: SMILES AT SOUTHCENTER SITE ADDRESS: 15425 53 AVE S Original Plan Submittal Response to Incomplete Letter # X Response to Correction Letter # 1 Revision # After Permit Issued DEPARTMENTS: Pl BuildiNi on gric 11Nats d Fire Prevention Structural n Planning Division n ❑ Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 06 -24 -08 Complete Comments: Incomplete Not Applicable n Permit Center Use Only INCOMPLETE LETTER MAILED: Departments determined incomplete: Bldg ❑ LETTER OF COMPLETENESS MAILED: Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES/THURS ROU FING: Please Route Structural Review Required ❑ No further Review Required REVIEWER'S INITIALS: DATE: n APPROVALS OR CORRECTIONS: Approved n Approved with Conditions Notation: REVIEWER'S INITIALS: DUE DATE: 07 -22 -08 Not Approved (attach comments) DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents/routing slip.doc 2 -28 -02 PERMIT COOHD COPY PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG08 -161 DATE: 05 -27 -08 PROJECT NAME: SMILES AT SOUTHCENTER SITE ADDRESS: 15425 53 AV S X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # after Permit Issued DEPARTMENTS: : : ing i v Sion W9rks Structural fI /AAA 414 fl /I -7� DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Fire Prevention Complete Comments: Incomplete n n Planning Division Permit Coordinator DUE DATE: 05 -29-08 Not Applicable n Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES/THURS ROUTING: Please Route V( Structural Review Required ❑ No further Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 06-26-08 Approved Approved with Conditions n Not Approved (attach comments) 117f Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: ''1 Departments issued corrections: Bldg Fire ❑ Ping ❑ PW Staff Initials Documents/routing slip.doc 2 -28 -02 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 REVISION SUBMITTAL Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Date: Plan Check/Permit Number: PG08 -161 ❑ Response to Incomplete Letter # ® Response to Correction Letter # 1 ❑ Revision # after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner Project Name: SMILES AT SOUTHC NTER Project Address: 15425 — 53rd Avenue S Contact Person: Mark Sutin Phone Number: `1470 8 yO• Ql _20 Summary of Revision: g-41 L.4 T'it b VE,Ivr /.l fir- 7-! -1200 QlJrS j-511-- --i= g-o rg_ert x A --NA/b9 S P cElt A_ R ou7 / /�- �I a� . I tE)t3 v 1 2✓H- /y SO/ 1 D xiv (_ .J l 7-I-1 22/1 ge.pt31 •A-7— Sheet Number(s): RECEIVED CITY OF TUKWILA JUN 20 2008 "Cloud" or highlight all areas of revision includin Received at the City of Tukwila Permit Center by: lil----Entered in Permits Plus on or rev, '1 NTER \applications \forms - applications on line\revision submittal Created: 8 -13 -2004 Revised: Look Up a Contractor, Electrician or Plumber License Detail • uigioR kt.a ,epanmerc of or:'and 5i dusfries Page 1 of 3 Topic Index I Contact Info Search Home Safety Claims & InsuranceT Workplace Rightsir Trades & Licensing Find a Law or Rule Get a Form or Publication ® Help Look Up a Contractor, Electrician or Plumber Printer Friendly Version 'General /Specialty Contractor :A business registered as a construction contractor with L &I to perform construction work within the scope :of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment :of account and carry general liability insurance. ' License Information License PLUMB * *151JR Licensee Name PLUMBERS, THE Licensee Type CONSTRUCTION CONTRACTOR UBI 600564790 Verify Workers Comp Premium Status • Ind. Ins. Account Id TRAVELERS CAS & SURETY Business Type INDIVIDUAL Address 1 206 AVE G Address 2 $12,000.00 ' City SNOHOMISH County SNOHOMISH State WA Zip 98290 Phone 3605683880 . Status ACTIVE . Specialty 1 GENERAL ' Specialty 2 UNUSED Effective Date 4/19/1985 Expiration Date 1/29/2009 Suspend Date Separation Date Parent Company Previous License MECON "'20304 Next License Associated License Business Owner Information Name . SUTIN, MARK D 0 , Bond Information Role Effective Date ■NER 04/14/1985 Expiration Date Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date #5 TRAVELERS CAS & SURETY 206085397 02/19/2002 Until Cancelled $12,000.00 12/14/2001 RELIANCE Until https: // fortress. wa. gov /lni/bbip/Detail.aspx ?License =PLUMB * * 151 JR 07/01/2008 TABLE 606.7 ICC / ANSI A-117.1-2003 MAXIMUM REACH DEPTH AND HEIGHT MAXIMUM REACH DEPTH .5 INCH (13mm) 2 INCH (50mm) 5 INCH (125mm) 6 INCH (150mm) 9INCH (230mm) 111NCH (280mm) MAXIMUM REACH HEIGHT 48 INCH (1220mm) 46 INCH (1170mm) 42 INCH (1965mm) 40 INCH (1050mm) 36 INCH (915mm) 34 INCH (865mm) w. S-150th sl `._ S_151st - 5t NOT TO SCALE 5 16011; St- , g- D 4i V f ti--, 5 t 1L, ii 5if W IA VIC NOT TO SCALE TE PLA\ V `- S 150161 St'r: --,' l ' i of SCALE: 1/1 6 " =1 ' -O" 's 1S2rndl'l AP LD\C'S ALOOF' RLA\ rr I DV GENERAL NO ES 1. CONTRACTOR TO VERIFY EXISTING CONDITIONS PRIOR TO COMMENCING WORK AND DETERMINE THE LOCATION OF UTILITIES. NOTIFY THE ARCHITECT OF DISCREPANCIES. 2. CONTRACTOR IS RESPONSIBLE FOR SAFETY PRECAUTIONS, METHODS, TECHNIQUES, SEQUENCES OR PROCEDURES REQUIRED TO PERFORM THE WORK. 3. CONTRACTOR INITIATED CHANGES SHALL BE SUBM TIED IN WRITING FOR APPROVAL PRIOR TO FABRICATION OR CONSTRUCTION. 4. CONTRACT DOCUMENTS DESCRIBE GENERAL AND TYPICAL DETAILS. WHERE CONDITIONS ARE NOT SPECIFICALLY DETAILED BUT ARE OF SIMILAR CHARACTER TO DETAILS SHOWN, USE SIMILAR DETAILS. 5. THIS SET REPRESENTS "THE PERMIT DRAWINGS" AND IS INTENDED TO SHOW MINIMUM REQUIREMENTS. IT IS THE RESPONSIBILITY OF THE CONTRACTOR TO PROVIDE ALL CONSTRUCTION NECESSARY FOR THE COMPLETE INSTALLATION OF ALL OPERATING SYSTEMS, MATERIALS AND FINISHES IN ACCORDANCE WITH MFR.'S RECOMMENDATION. CONTRACTOR SHALL THOROUGHLY REVIEW DRAWINGS, SPECIFICATIONS AND OWNER'S REQUIREMENTS. 6. CONTRACTOR SHALL FIELD VERIFY ALL EXISTING DIMENSIONS PRIOR TO BID. DISCREPANCIES IN DIMENSIONS, DRAWINGS, GRAPHIC REPRESENTATION AND ACTUAL FIELD MEASUREMENTS SHALL BE BROUGHT TO THE IMMEDIATE ATTENTION OF THE DESIGNER. 7. CONSTRUCTION SHALL BE BASED ON THE CITY APPROVED PLANS AND OWNER'S COMMENTS. THE APPROVED PLANS ARE TO REMAIN ON SITE AT ALL TIMES FOR USE BY ALL INVOLVED TRADES AND INSPECTORS. 8. THIS SET OF DRAWINGS SHALL NOT BE COPIED IN WHOLE OR IN PART WITHOUT PRIOR WRITTEN CONSENT FROM THE OWNER. THIS DOCUMENT IS CONSIDERED AS ONE UNIT AND SHALL NOT BE CONSIDERED COMPLETE OR WHOLE IF DOCUMENTS ARE SEPARATED IN ANY vrAN DER. DOCUMENTS SHALL NOT BE SEPARATED FOR THE PURPOSES OF SUBMITTING PROPOSALS OR FOR SEPARATE PHASES OF CONSTRUCTION. 9. THESE DOCUMENTS ARE PREPARED FOR THE USE BY CONTRACTOR AND IN NO WAY, EITHER IN WHOLE OR IN PART CONSTITUTE ANY DIRECTION OR INSTRUCTION TO ANY CONTRACTOR WITH REGARD TO CONSTRUCTION METHODS, MEANS OR TECHNIQUES. 10. CONTRACTOR SHALL BE RESPONSIBLE FOR DEMOLITION WORK INCLUDING, BUT NOT LIMITED TO, SEQUENCE & TEMPORARY SHORING OF ALL EXISTING STRUCTURES & VERIFICATION OF EXISTING UTILITIES & SERVICES. 11. CONTRACTOR SHALL NOTIFY UTILITIES PRIOR TO COMMENCEMENT OF ALL WORK. THE CONTRACTOR IS RESPONSIBLE FOR REPAIRS, SUBJECT TO CITY AND UTILITY INSPECTOR'S FINAL APPROVAL. 12. CONTRACTOR SHALL CLEAN UP ALL PUBLIC RIGHT -OF -WAY AND PRIVATE DRIVEWAYS AFTER EACH WORK DAY. CONSTRUCTION VEHICLES SHALL NOT BLOCK PUBLIC TRAFFIC OR ENTRIES AT ANY TIME. CONTRACTOR SHALL WORK ACCORDING TO CITY'S ALLOWED SCHEDULES ONLY. OL T SCALE: 1/16 " =1' -O" scoP OF v PROV v E\ TS: CONSTRUCT TENANT IMPROVEMENTS FOR A 4,217 S.F. DENTAL OFFICE, INCLUDING INTERIOR PARTITIONS, FINISHES, PLUMBING, ELECTRICAL WIRING AND LIGHTING. TIRE SPRI\KER SYST PLJVBI\G HVAC TO „ \D -I' SIPAPAT V V V =c OD n IFI ICAL -RVIT I A PLA\ DEMOLITION NOTES - TO BE DEMOLISHED TO REMAIN officewraps, inc. LORI SALEBA, DESIGNER CAROLINE TEDJA, DESIGNER 570 KIRKLAND WAY SUITE 201 KIRKLAND, WA 98033 (425) 952 -5393 (425) 952 -5397 FAX Iori ©officewraps.com caroline@officewraps.com ARCHIT ER =CT ROBERT W. CHAMPION ARCHITECT A.L.A. 3802 COLBY AVENUE EVERETT, WA 98201 (425) 259 -3136 (425) 252 -3317 FAX rchampaiaaearthlink.net "'NOTE: BLDG. OW R &N REAL ESTATE, LLC THUY NGUYEN & DOREEN ROSETO 33522 5TH PLACE SW FEDERAL WAY, WA 98023 (206) 390 -9782 CO \TRACTO WR HANSON RICK KUHNS 12510 130TH LN NE KIRKLAND, WA 98034 (425) 821 -6747 LIC #: WRHAN * *251B1 rick©wrhanson.com r-ARATF REQUIRED FOR: al Mechanical rAio Electrical City of BUILDING ER 1 A \ REVISION NUMBER 0 SUBMITTAL ITEM NUMBER �Rr1 1li;ll !De r>`1 '-Ip to thn scr,r'P (_f prior ap rrov9I of Building Division. evic;n= , ;. I r.Tgr,ire :a new plan submit ±al nr:l n rr ?trie w 'r f PROJECT DATA: Sip IT ARISS SMILES © SOUTHCENTER THUY NGUYEN, D.D.S. AND DOREEN M. ROSETO, D.D.S. 1547.5 53RD AVE. S. TUKWILA, WA 98188 -2338 LEGAL DISCHPTO THAT PORTION OF LOT #3 OF BROOKVALE GARDEN TRACTS AS RECORDED IN BOOK OF PLATS, VOLUME 10, PAGE 47.5 RECORDS OF KING COUNTY, WASHINGTON, DESCRIBED AS FOLLOWS: COMMENCING AT THE SOUTHEAST CORNER OF SAID LOT #3; THENCE NORTH 0 °42'00" EAST, A DISTANCE OF 184.20' TO TRUE POINT OF BEGINNING; THENCE CONTINUING NORTH 0 °42'00" EAST A DISTANCE OF 148.27' THENCE NORTH 83 °42'30" WEST A DISTANCE OF 50.15'; THENCE NORTH 88'12'00" WEST A DISTANCE OF 250.05'; THENCE SOUTH 0 °42 WEST A DISTANCE OF 146.80'; THENCE SOUTH 88 °I2'00" EAST A DISTANCE 300.00' TO THE TRUE POINT OF BEGINNING. ALL SITUATED IN THE SOUTHWEST QUARTER OF SECTION 23, TOWNSHIP 23 NORTH, RANGE 4 EST, W.M. KING COUNTY, WASHINGTON. ASSESSOR'S PACEL 115720- 0033 -0 SIT- & LOT COVAC TOTAL SITE AREA: N/A IMPERVIOUS AREA: N/A BUILDING AREA: 10,000 SQFT LOT COVERAGE: N/A TI/ BL LD\C .STATISTICS NUMBER OF STORIES : 1 OCCUPANCY CLASSIFICATION : B- DENTAL OFFICE OCCUPANCY LOAD :42 (4,217 SF / 100 SF = 42 OCCUPANTS) NUMBER OF EXIT PROVIDED : 4 (MAIN) +1 (STORAGE) +1 (MECHANICAL) BUILDING TYPE: V -N SPRINKLERED AREA OF SPACE TO BE REMODELED: 4,217 SQFT CONSTRUCTION VALUE: $ 126,510.00 - -DAR 7_0 STANDARD -41 ACCESSIBLE -2 NG I FOPV A TI O FORV ATO\ LURISDICTION: CITY OF TUKWILA, WA ZONING : RCM SETBACK REQUIREMENTS: N/A BUILDING HEIGHT PERMITTED: N/A PROPOSED BUILDING HEIGHT: N/A TRANSPORTATION MANAGEMENT PLAN NOT REQUIRED CODE COVPLA\C I\f OGV,1TIG BUILDING CODE: 2006 INTERNATIONAL BUILDING CODES 2006 WA STATE ENERGY CODE AMERICAN NATIONAL STANDARD - ANSI A117.1 --2003 DRAWING INDEX: A -1.0 SITE PLAN BUILDING FLOOR PLAN VICINITY MAP PROJECT DATA /CONTACT INFO GENERAL NOTES SHEET INDEX A -2.0 FLOOR PLAN WALL LEGEND DOOR /HARDWARE SCHEDULE DOOR & DOOR FRAME TYPES TYP. INT. WALL SECTIONS A -3.0 RCP / LIGHTING PLAN RCP LEGEND RCP GENERAL NOTES CEILING DETAILS CEILING LEGEND A-4.0 ROOM FINISH SCHEDULE CEILING DETAILS LIGHTING/ ELECTRICAL NOTES TYP. ADA CLEARANCES FOR RESTR00v1 ENERGY CALCULATION JV G REVIEWED FOR CODE COMPLIANCE APPROVED JUN 302D_ RECEIVED - CITY OF TUKWILA MAY 272008 PERMIT CENTER This set of drawings shall not be copied in whole or in part without prior written consent from the owner. This document is considered as one unit and shall not be considered complete of whole if documents are separated in any manner. Documents shall not be separated for the purpose of submitting proposals or for separate phases of construction. and o n@SF:'772 ?s not once. F'Vr Lii LU LLI 0 IA sa 41 tell cil Cl t ex g C/7 0 s l— IO DATE: 01/2412008 REVISIONS BY: : SCALE: AS NOTED SHEET: PERMIT SET A 1.0 OF: 4 w s, - „ Jr. kwila TNG DIVT,I01 A � City of Tt kw-lf E TG'>_ OING DI'v Plar rcviev c pprova! is subject to ci Ion Approval of construction document do the violation of any adopted code 01 on 0 approved `°i ' :, C ;ofy and c nditi :is i By 0 a P1 DOOR SCHEDULE LOCATION DOOR FRAME PIDWE GROUP' REMARKS N0. SIZE TYPE MAIN ENTRANCE 1 1 3/4" x 3' -0" x 7' -0° A N/A LOCKSET DOOR CLOSER, 90 DEGREE STOP HINGE. NOTED AS: "THIS DOOR TO REMAIN UNLOCKED DURING BUSINESS HOURS" MAIN ENTRANCE 2 1 3/4" x 3' -0" x 7' -0" ® N/A ( (T LOCKSET DOOR CLOSER, 90 DEGREE STOP HINGE RR 1 3 1 3/4" x 3' -0 x 7' -0 "O FLUSH PRIVACY LATCHSET DOOR CLOSER, 90 DEGREE STOP HINGE STORAGE 3A 1 3/4" x 2' -0" x 7' -0" (3 FLUSH RECEPTION 4 1 3/4" x 3' -0" x 7' -0" TO FLUSH LOCKSET DOOR CLOSER, FLOOR STOP, FROSTED TEMPERED GLASS CONSULT 5 1 3/4" x 3' -0" x 7' -0" ® FLUSH ® FLUSH © FLUSH U 1 L 1 POCKET POCKET BI -FOLD POCKET DOOR HARDWARE. FROSTED TEMPERED GLASS POCKET DOOR HARDWARE. FROSTED TEMPERED GLASS DI -FOLD DOOR HARDWARE DOCTOR'S OFFICE 6 1 3/4" x 3'--0" x 7' -0" LAN 7 1 3/4" x 3' -0" x 7' -0" STAFF ENTRY 1 8 EXISTING EXISTING EXISTING O EXISTING EXISTING DOOR TO REMAIN DOCTOR'S OFFICE 9 1 3/4" x 3' -0" x 7' -0" 0 FLUSH LATCHSET RR 3 10 1 3/4" x 3'--0" x 7-0" 0 FLUSH 0 POCKET /PRIVACY POCKET DOOR IIARDWARE WITIT PRIVACY LOCKSET RR 2 11 1 3/4" x 3' -0" x 7' -0" C FLUSH PRIVACY FLOOR STOP CLOSET 12 1 3/4" x 3' -0" x 7' -0" C FLUSH , t�'1l LATCHSET WALL STOP OP 4 13 1 3/4" x 3' -0" x 7' -0 " Q FLUSH J� LATCHSE DOOR CLOSER, WALL STOP OP 4 14 1 3/4" x 3' -0" x 7'--0" ® FLUSH ('J LATCHSET DOOR CLOSER, WALL STOP STAFF ENTRY 3 15 1 3/4" x 3' -0" x 7' -0" A N/A LOCKSET DOOR CLOSER, 90 DEGREE STOP HINGE LAB 16 1 3/4" x 3' -0" x 7' -0" 0 FLUSH LATCHSET FLOOR STOP, 90 DEGREE STOP HINGE LOUNGE 17 1 3/4" x 3' -0" x 7' -0 "0 FLUSH LATCHSET DOOR CLOSER, 90 DEGREE STOP HINGE STAFF ENTRY 2 18 REPLACE EXISTING EXISTING EXISTING LOCKSET REPLACE DAMAGED DOOR, NEW HARDWARE SPRINKLER ROOM 19 EXISTING EXISTING EXISTING EXISTING EXISTING DOOR TO REMAIN EGRESS 20 EXISTING EXISTING EXISTING EXISTING EXISTING DOOR TO REMAIN STORAGE 21 1 3/4" x 3' -0" x 7' -0" C( FLUSH 1 LOCKSET WALL STOP DOOR NOTES: FOR APPROVAL. FIDWR TO MATCH EXISTING. WI RIOUT THE USE OF KEY OR ANY SPECIAL KNOWLEDGE OR EFFORT. DEVICES ON DOORS, CABINETS, PLUMBING FIXTURES AND STORAGE FACILITIES PERMIT OPERATION BY WRIST OR ARM PRESSURE AND WHICH DOES NOT REQUIRE LBS. AT EXTERIOR DOORS AND 5.0 LBS. AT INTERIOR DOORS. REQUIREMENTS. RECEIVED STAIN: T.B.U. REFINISHED. CORRECTION JUN 2 0 20008 LT #_ _ _ ,_r._- .s,_" PERMIT CENTER OTHERWISE SPECIFIED. LOCATED ON PUSH SIDE OF DOOR W/ CLOSERS AND WITHOUT HOLD. -OPEN DEVICE. FLOOR. 1. SUBMIT KEYING SCHEDULE AND HARDWARE SAMPLES 2. EXIT DOORS SHALL BE OPERABLE FROM THE INSIDE 3. HANDLES, PULLS, LATCHES, LOCKS AND OTHER OPERATING SHALL HAVE A LEVER OR OTHER SHAPE WHICH WILL TIGHT GRASPING, PINCHING OR TWISTING TO OPERATE. 4. DOOR THRESHOLD SHALL NOT EXCEED 1/2" IN HEIGHT. 5. MAX, DOOR OPENING PRESSURES ARE LIMITED TO 8.5 6. VERIFY ALL DOOR SWINGS, HARDWARE AND KEYING 7. NEW DOORS AND FRAMES: SPECIES: T.B.D. FINISH/ 8. EXISTING DOORS AND FRAMES TO BE CLEANED AND 9. ALL BOOR FRAMES TO BE CUSTOM GRADE. 10. NEW DOOR TRIM TO RE 2 -3/4" X 3/4" WITH EASED EDGE, UNLESS 11. ACCESSIBLE RESTROOM STORAGE WI TACTILE CIIARACTOR FD DE TACTILE CHARACTOR SHALL BE 48 INCH MIN., 60 INCH MAX. ABOVE WALL LEGEND 7 NEW PARTITION WALL - _---- -__ -__ = DEMISING / SOUND WALL. IF EXISTING, FINISH ON TENANT SIDE ONLY I�TdF{>�1u -� •�• M "' HALF WALL 44" A.F.F. (FRONT DESK) °° ° °°°°°°°°°°°°°°°° rNq-„ ° n-° o-v- °'° °°°°°°'° :: p a n 0 ° °vO n OeO ° ° ° 90 ?9C °° °o WALL WITH BACKING ♦ U E fan EXISTING BRICK WALL EXISTING WALL 4'i:i :iS4 :iii' A BENCH • I I U 0 I 1 BENCH O 1 A OP 5 1 1 A L i :r c COAT Pi HOOKS Pe/ i--.-. A A • OP f� • 116 O 4 i r� ///1 /!1 111 /! / /./J -Or AV/i 6 Fi 0 Pi._ COAT HOOKS A or ... o . _, „ I 1 , 1 OP8 1 EM NCl l Q R IIIiiiiiiiiiiiriiii 1 LOCKERS 1 I L — ! 6 STORA GE 1 ay i: , ii::::: _ LOUN NG � P LER mu Oiled COMPRESSOR r it I is :Ti :Ti:'lS% S % %: iris% SS: S: SSiSi iSi: S- S= �- I r:P I Y nY 115 C OP 7 117 COAT HOOKS COAT HOOKS 118 � % O 7 ..i RR -+�' ( A�// A01 4 4.1 INTEriki r v 10 1 0 O MI C- 9 1 Co 9 1 CO 9 v 111111 I♦ WAY 4 0 IG 18 0 0 0 0 0 0 z uJ 1n 120 MODEL 130X STORAGE - ref yH o I DNV I TIC I r 1 T I N 9 _t, 13' -2" U OP4 1 4 STERILIZATION 119 6 /( WORKSTATION 1 I I., ,A / MI 1221E- I I ,... 4 -� LEAD 3I APR:. N HOOKS ig ° a �iiii iiiiii i.iengeif��Piiiiiiiiiiiiiiiii ii RE P. PAN 11 i re PHOTO AREA MODEL BOX ' TTORAGE 121 CD EPH CO Z 1 Q N,.._,, I V 1 I � O !I�QNY: 1 111 I1 M 0 BENCN Q F'11// r/1////1 1 % STORAGE i A 1 �1 is�.a :ii::i- i . V n LCCIRIC L 1 I I IG COAT HOOKS BOOKCASES eoc. OFFICE 108 O BENCN OP L I i n 113 CAT — HOOKS P2 112 COAT HOOKS 2 11" 41 4'1 LAN 7 FOC P011\ CHILDREN'S LIBRARY 02 R1 103 FOCAL POINT f r CONSULT 107 „ zi li D BENCH/ BOOKCASE o;oan�� it UPPER UPPER AGAZINES/ DISPLAY CO AGAZINES/ DISPLAY CUBBIES CUBBIES 2 ' .6 ” L � 7 rn CO 9 1 10 MOO' AOr CHECKOUT I 0 CHECKO_ T � � '' v it Al 1�� 0 o O CHECKOUT 2 CHECKOUT 2 o I a NV ADi COUNTER 0) L? CO • CO m I *x* i, * RECEPTION 101 RECEP. DESK 104 BUSINESS 106 1 6' -O" m * VAMP ArAirAll tea. *0> :* EXISTING 126 19 11 I--- 00H SCALE: 1/4"=1' A\ 11' -6" t!al`IkVP O'4 Vet- SINPL1 E4 V LP14 OW orl N1Th ii a SQA n 9 STAFF ENTRY 2 (EXISTING) 5 ' .6 " STAFF ENTR Y3 COAT HOOKS n 26' -1 1/4" 12' -0" MAP 1.N S5-W i( 8 ' .5 " 6 1 -1 " ► ■ Ar AP air haiSi- i:i. STORAGE 125 k: iSiAM : i:.- is i :SAT i.T: is is ii. 1 20 21 EGRES 6 " 3 1 STO RAG SCALE: 1/4 " =1 O" S I EX TAFF ISTING) ENTRY 12' -8 3/4" (EXISTING) n 7 1_ 4 11 10 -10 n 11 U 4' -11 1/4" 20' -7 1/4" 12'-3 1 /4" Z W �— N 9 N NO SCALE r HD. DIM- STORE FRONT DOOR TEMPERED GLASS NOT TO SCALE NOT TO SCALE Ii SEA ANT (TYP.) DEMISING WALL SOUND WALL ijiiii....n....i.i"i TYP BETWEEN TENANT SPACES HD. DIM- DOOR TYPES 0 SOLID WD. W/ " 1 -LITE TEMPERED GLASS FLUSH DOOR "VICE INDUSTRIES" DOOR PULLS #2 1 3/4" WIRE PULLS CTC C" G 3/4" P 2-1/4" - -- DOOR POCKET DOOR HDWR 5/8" G.w.e. ON 3.5" MET. STUDS 0 18" 0.0. WI RC -1 CHANNEL (16" 0.0.) & SOUND ATTENUATION BLANKET HD. DIM-- -$CHD. DIM- 1 i" SOLID WD. 1 i" HOLLOW WD. FLUSH DOOR FLUSH DOOR TYP. IN T. PARTITIONS INSTALLATION NOTES: CUSTOM WOOD FRAME TYPES NOT TO SCALE 5/6" G.W.B. ON 3.5" MET. STUDS 0 24" O.C. NON —RATED WALL USE DEFLECTION TRACKS 9 TOP OF PAR II TIONS TO STRUCTURAL SUPPORTS ABOVE TYPICAL INTERIOR WALL SECTIONS This set of drawings shall not be copied in whole or in part without prior written consent from the owner. This document is considered as one unit and shall not be considered complete of whole if documents are separated in any manner. Documents shall not be separated for the purpose of submitting proposals or for separate phases of construction. 0 z LU 0 z 0 0 0 LL w H- z w 0 ^°`�' 0 CO CO A 2.0 OF: 4 uJ D Q O 0 w cb 0 F— D 0 0 DATE: 01/24/2008 SHEET: PERMIT SET REVISIONS BY: SCALE: AS NOTED 0 11 34/ 7 e. o E 5 1.2 -i- 4oT 12, ET v iv I E5 CORRECTION TGOE3- I W RECEIVED (JUN 20 2008 PE1M1T CENTE- A - T -- c7 3L S GEwm iNruit•) r-- g C, 7 STE- R.0 06 /--) o 0 T606 1k2( RECEIVED JUN 2 0 2008 PERMIT CENTEF