HomeMy WebLinkAboutPermit PG08-296 - MZIMAMZIMA
12101 TUKWILA
INT RNATIONAL BL
PGO8-296
Parcel No.: 0923049031
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
PLUMBING /GAS PIPING PERMIT
:12101 TUKWILA INTERNATIONAL BL TUKW
Permit Number:
Issue Date:
Permit Expires On:
PG08 -296
12/16/2008
06/14/2009
Tenant:
Name: MZIMA
Address: 12101 TUKWILA INTERNATIONAL BL , TUKWILA WA
Owner:
Name:
Address:
INTERNATIONAL GATEWAY WEST
12201 TUKWILA INTERNATIONAL BLVD , SEATTLE WA
Contact Person:
Name: BEN GEZON
Address: 7717 DETROIT AV SW , SEATTLE WA
Contractor:
Name: MACDONALD /MILLER FAC SOL INC
Address: PO BOX 47983 , SEATTLE, WA
Contractor License No: MACDOFS980RU
Phone:
Phone: 206 768 -4030
Phone: 206 -768 -4180
Expiration Date: 12/31/2008
DESCRIPTION OF WORK:
INSTALL (1) BACKFLOW PREVENTER
Value of Plumbing /Gas Piping:
Fees Collected:
$1,500.00
$92.00
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
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 0
0 Medical gas piping (6 +) inlets /outlets 0
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 -296 Printed: 12 -16 -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 Number: PGO8 -296
Issue Date: 12/16/2008
Permit Expires On: 06/14/2009
Permit Center Authorized Signature
Date: �2�K,[05
I hereby certify that I have read an ex- ed t1 is permit and know the same to be true and correct. All provisions of law and ordinances
governing this work will be compli . wi h, 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 theirformance of work. I am authorized to sign and obtain this plumbing /gas piping permit.
Signature:
Print Name:
r7 iOL4 SG
Date:
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 -296 Printed: 12 -16 -2008
Parcel No.: 0923049031
Address:
Suite No:
Tenant: 1VIZIMA
•
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
12101 TUKWILA INTERNATIONAL BL TUKW
Permit Number:
Status:
Applied Date:
Issue Date:
PG08 -296
ISSUED
12/16/2008
12/16/2008
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 -296 Printed: 12 -16 -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
this work will be c:omplied 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: Lv Y(1/9-1_, -
Print Name: f\-(2(2--:i. \ t'CC9'Ni1 S--e
Date: , 2-1/ I0 csd
ordinances governing
or local laws regulating
doc: Cond -10/06 PG08 -296
Printed: 12 -16 -2008
CITY OF TUKWILA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
httollwvvw.ci.tukwila.wa.us
Building Permit No.
Mechanical Permit No.
Plumbing/Gas Permit No.
Public Works Permit No.
Project No.
(For office use only)
Applications and plans must be complete in order to be accepted for plan review.
Applications will not be accepted through the mail or by fax.
**Please Print**
King Co Assessor's Tax No.: 09-a-3 °"11031
Site Address: I Z 1 0 1 i, k. 1:„1„,„, ¶ J .rD
Tenant Name:
YvN
Property Owners Name: r\c--)C 10
Mailing Address: r\l• ' N S_ztU
City
Suite Number:
New Tenant:
c
Floor:„2.
Yes No
CS"'V
Zip
State
CONTACT PERSON
Name: e- ov,
Day Telephone: ( 2-01-) 2_C-J
Mailing Address: --11 1 1 'De..;h--tirt- SL SzisdkAt wi;
City Zip
State
E-Mail Address: Fax Number:
GENERAL CONTRACTOR INFORMATION -
(Contractor Inforznation for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5) )
Company Name:
Mailing Address:
Contact Person:
E-Mail Address:
Contractor Registration Number:
city
Day Telephone:
Fax Number:
ir<on Date:
State
Zip
ARCHITECT OF RECORD - All plans must be wet stamped by Architect of Record
Company Name:
Mailing Address:
Contact Person:
E-Mail Address:
ENGINEER OF RECORD - All plans must be wet stamped
City
Day Telephone:
Fax Number:
State
Zip
ngineer of Record
Company Name:
Mailing Address:
City
Day Telephone:
----'-'---....F_,.....„...
ax Number:
State
Zip
Contact Person:
E-Mail Address:
Appl icationta(mns-Applications Ort Line \ 1.2006 - Permit Applieittion.t.bc
Revised: 4-2006
bh
Page 1 of 6
PLUMBING AND GAS PIP
G PERMIT INFORMATION 206- 431 -3670
PLUMBING AND GAS PIPING CONTRACTOR INFORMATION
Company Name: ill 0. C t o evc l (,` 111 t 1 k e_r
Mailing Address: —11 -ZE,k"ro t t' 1 Si...) 9110(0
state Zin
Contact Person: -2 C) V1
E -Mail Address:
Contractor Registration Number: fi4 At-Thc , s ?C 3o >zu
Cay
Day Telephone: ( (51=0 -7 t — b3
Fax Number:
Expiration Date:
Valuation of Project (contractor's bid price): $ 1 S 61D
Scope of Work (please provide detailed information): r -, S Tea) i 1 Gt; Sl LS V-) e ✓ 2rVAby
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
�AC�.� /c>
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
Rain water system - per
drain (inside building)
Water heater and/or
vent
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
Additional medical gas
inlets /outlets - six or more
Q; 1Applicaiionstforms• Applications On Lines3 2OU6 - Permit Applisatinn
Revised: 4.200(,
bh
Page 5 of 6
PERMIT APPLICATION NOTES — Applicable to all permits in this application
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.
BUILDINGrT7042.4UTHORIZED AGENT: r -
Signature: . � `- • Js� Date: / z T 140-- () .
Print Name: '-Y)4>2t`IA 1 1 Day Telephone(2 Ojo) -1 b ( — `la 7
Mailing Address: 1-111 Q.�Cro\ ALA-12, S Cn W I(4i t
City State Zip
Date Application Accepted:
\)-1 tcei
Date Application Expires: ( Staff Initials:
Qiv\pplicuoionsV 'arms- Applicniion3 On Unel3.2006 - penni[ Applieation.doc
Revised: 4.2006
hh
Page 6 of 6
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.: 0923049031 Permit Number: PG08 -296
Address: 12101 TUKWILA INTERNATIONAL BL TUKW Status: APPROVED
Suite No: Applied Date: 12/16/2008
Applicant: IVIZIMA Issue Date:
Receipt No.: R08 -03940
Initials: JEM
User ID: 1655
Payment Amount: $92.00
Payment Date: 12/16/2008 01:06 PM
Balance: $0.00
Payee: IVIACDONALD- MILLER FACILITY SOLUTIONS, INC.
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 1976 92.00
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
PLUMBING - NONRES
000.322.103.00.0 92.00
Total: $92.00
0551 12/16 9707 TOTAL 9200
doc: Receipt -06 Printed: 12 -16 -2008
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
X08 -2'
PERMIT NO.
(206)431 -3670
Project:
M �'t o�
Type of Inspection• D
-j /� 6 * p(, -- A, ,
'Address: �--
Date Called:
Special Instructions:
/
Date Wanted: .�..
Requester:
Phone Ia0 J o —,n' /410(
{'Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
eJ
P AC
Inspect r: k)(< i 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:
MacDonald - Miller
FACILITY SOLUTIONS
Backflow Prevention Assembly Test Report
NOTE: COMPLETE REPORT MUST INCLUDE ASSEMBLY ID NUMBER
ASSEMBLY ID: '0€`41
NAME OF PREMISE 4/'2
SERVICE ADDRESS__
CONTACT PERSON
PASSED ANNUAL TEST: YES ti NO L i
COMMERCIAL /RESIDENTIAL 11
CITY / ZIP
GO8- ;29(p
Phone ( ) Fax (
LOCATION OF ASSEMBLY ,°45 efiri- /0.4011, 1 t /u41 Ad7! "0OI4c
DOWNSTREAM PROCESS giciyiifi'FLIe DCVA ❑ RPBA' PVBA ❑
PROPER INSTALLATION?
SERIAL NO. ge`JOOf
NEW INSTALL X EXISTING ❑ REPLACEMENT ❑ OLD SER. #
MAKE OF ASSEMBLY &A.W3 MODEL 0'f '03
OTHER:
YES.K NO 0
SIZE '3/,‘
INITIAL
TEST
PASS>(
FAIL [1
NEW
PARTS AND
REPAIRS
DCVA/RPBA CHECK
DCVARPBA CHECK
RPBA
PVBA SVBA
AIR INLET
OPENED AT
DID NOT OPEN
CHECK VALVE
HELD AT I
LEAKED
--
CLEANED
REPAIRED
VALVE NO. 1
VALVE NO. 2
OPENED AT Z•1_ PSID
#t CHECK 7. / PSID
AIR GAP OK? y 44
/
CLEAN REPLACE PART
I !
LEAKED '
7, / PSID
CLEAN REPLACE PART
LEAKED ; :
7 4'7g" PSID
CLEAN REPLACE PART
�
1 ■
TEST
AFTER
REPAIRS
PASS ❑
FAIL ❑
LEAKED I t
PSID
LEAKED ! I
PSID
OPENED AT __ PSID
111 CHECK PSID
AIR INLET P
CHK VALVE
_
AIR GAP INSPECTION: Required minimum air gap separation provided? Yes( No 0 Detector Meter Reading
REMARKS: LINE PRESSURE /y'O
PSI
TESTERS SIGNATURE: Viltikif.A-Aii.9160"1/4,
TESTERS NAME (PRINT): _fAlt tta .4(9)yNA 4)
REPAIRED BY: -
FINAL TEST BY: -_- 1OR_ -_
CALIBRATION DATE tb/ I?j /j GAUGE #
q
PSID
SID
SID
PSID
CONFINED SPACE? _ '%ti_ °_
CERT. NO._7 &41II. _DATE WC/
Phone 0451 0 ki
DATE
CERT. NO._ LK DATE- -Phi
MODEL 4115../..6___
SERVICE RE WTED? YES.
/ certify that this report is accurate, and / have used WAC 246 - 290 -490 approved test methods and test equipment.
NO 1'1
05 -04 -2009
BEN GEZON
7717 DETROIT AV SW
SEATTLE WA 98106
City of Tukwila
Jim Haggerton, Mayor
Department of Community Development
RE: Permit No. PG08 -296
12101 TUKWILA INTERNATIONAL BL TUKW
Dear Permit Holder:
Jack Pace, Director
In reviewing our current records the above noted permit has not received a final inspection by the City of Tukwila Building Division.
Per the Uniform Plumbing Code and/or International Fuel Gas Code, every permit issued by the Building Division under the
provisions of this code shall expire by limitation and become null and void if the building or work authorized by such permit is not
commenced within 180 days from the date of such permit, or if the building or work authorized by such permit is suspended or
abandoned at any time after the work is commenced for a period of 180 days.
Based on the above, you are hereby advised to:
Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 to schedule for the next or final inspection.
This inspection is intended to determine if substantial work has been accomplished since issuance of the permit or last inspection; or if
the project should be considered abandoned.
If such determination is made, the Plumbing and/or Gas Code does allow the Building Official to approve one extension of time for an
additional period not exceeding 180 days. Extension requests must be in writing and provide satisfactory reasons why circumstances
beyond the applicants control have prevented action from being taken.
In the event you do not call for the above inspection and receive an extension prior to 06/14/2009 , your permit will become null and
void and any fin-ther work on the project will require a new permit and associated fees.
Thank you for your cooperation in this matter.
Sincerely,
Bill Rambo
Permit Technician
xc: Permit File No. PGO8 -296
6300 Southcenter Boulevard_ .Suite #100 • Tukwila_ Wa.chinntnn OR1RR o Phnno• 2n5_4?1_?fi71) • Pa Y. 7fM- 471 -2/iAc
Untitled Page
•
General /Specialty Contractor
A business registered as a construction contractor with Lai 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.
Business and Licensing Information
Name
Phone
Address
Suite /Apt.
City
State
Zip
County
MACDONALD /MILLER FAC
SOL INC
2067684180
PO BOX 47983
SEATTLE
WA
98106
KING
Business Type CORPORATION
Parent
Company
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Previous
License
Next License
Associated
License
Specialty 1
Specialty 2
602254260
ACTIVE
MACDOFS980RU
CONSTRUCTION
CONTRACTOR
12/31/2002
12/31/2010
DIVCOI *988RC
GENERAL
UNUSED
Business Owner Information
Name
Role
Effective Date
Expiration Date
TURLEY, DOUGLAS
CHIEF EXECUTIVE OFFICER
02/13/2008
Bond
Amount
TURLEY, DOUGLAS
CHIEF OPERATING OFFICER
02/13/2008
023006951
SIGMUND, FREDRIC
PRESIDENT
12/31/2002
HACK, RICHARD
SECRETARY
02/13/2008
KOPET,'TYLER
TREASURER
12/31/2002
LOVELY, STEVE C
VICE PRESIDENT
12/31/2002
Bond Information
Bond
Bond
Company
Name
Bond
Account
Number
Effective
Date
Expiration
Date
Cancel
Date
Impaired
Date
Bond
Amount
Received
Date
1
LIBERTY
MUTUAL
INS CO
023006951
12/11/2002
Until
Cancelled
$12,000.00
12/31/2002
Insurance Information
Page 1 of 2
Insurance
Company
Name
Policy Number
Effective
Date
Expiration
Date
Cancel
Date
Impaired
Date
Amount
Received
Date
7
TRAVELERS
INDEMNITY
DTC0526D75131ND0712/31
/200712/31
/2008
$1,000,000.00
12/21 /2007
https: //f ortress.wa. gov /lni/bbip /Detail. aspx ?License= MACDOFS980RU
12/16/2008