HomeMy WebLinkAboutPermit PG09-062 - HAIR CLUB FOR MENHAIR CLU
545 AND
1 1
VE
FOR
PGO9-062
EN
P1KW
Parcel No.:
Address:
Suite No:
Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name: SAGER MECHANICAL INC
Address: 8425 219 ST SE, STE 102 , WOODINVILLE WA
Contractor License No: SAGERMI088NK
DESCRIPTION OF WORK:
ADD (3) SINKS, (1) WATER CLOSET, AND (1) LAVATORY TO EXISTING SPACE. INSTALL
1.5" REDUCED OPRESSURE PRINCIPLE ASSEMBLY (RPPA) WILKINS Model 975XL FOR
IN- PREMISE ISOLATION.
Value of Plumbing /Gas Piping:
Fees Collected:
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 1
Wash fountain
Receptor, indirect waste 0
Sinks 3
Urinals 0
Water Closet 1
doc: UPC -7/07
2623049144
545 ANDOVER PK W TUKW
Cityilk 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
HAIR CLUB FOR MEN
545 ANDOVER PK W , TUKWILA WA
SOUTHCENTER CORPORATE SQUAR
150 CALIFORNIA ST , SAN FRANCISCO CA
DON WYCOFF
8425 219 ST SE #102 , WOODINVILLE WA
$9,018.00
$180.00
PLUMBING /GAS PIPING PERMIT
Uniform Plumbing Code Edition:
International Fuel Gas Code Edition:
FIXTURE TYPE AND QUANTITY
0
Plumbing (cont.)
Building sewer and each trailer park sewer 0
Rain water system - per drain (inside bldg) 0
Water heater and /or vent 0
Industrial waste treatment :nterceptor, 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 spezific gas 0
Medical gas piping (6 +) in ets /outlets 0
Gas Piping
Gas piping outlets (0 -5) 0
Gas piping outlets (6 +) 0
* * continued on next page **
•
Permit Number:
Issue Date:
Permit Expires On:
Phone:
Phone: 425 402 -1930
Phone: 425 402 -1930
Expiration Date: 08/10/2009
PG09 -062
07/16/2009
01/12/2010
2006
2006
PG09 -062 Printed: 07 -16 -2009
Permit Center Authorized Signature:
I hereby certify tha
governing this w
ave read and
be complie
The granting ' -f p 't does not pre
construction • - • rformance of *ork. I
Signature:
City o
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:
Issue Date:
Permit Expires On:
PGO9 -062
07/16/2009
01/12/2010
Date:
trA
ed this • ermit and know the same to be true and correct. All provisions of law and ordinances
whether specified herein or not.
e to gi e authority to violate or cancel the provisions of any other state or local laws regulating
a orized to sign and obtain this plumbing /gas piping permit.
Date: /c
Print Name: ' . � /r—
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 -7/07
PG09 -062 Printed: 07 -16 -2009
Parcel No.: 2623049144
Address:
Suite No:
Tenant:
HAIR CLUB FOR MEN
1: ** *PLUMBING AND GAS PIPING * **
I
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
545 ANDOVER PK W TUKW
PERMIT CONDITIONS
Permit Number:
Status:
Applied Date:
Issue Date:
PG09 -062
ISSUED
06/18/2009
07/16/2009
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.
13: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * **
14: RPPA FOR PREMISE ISOLATION SHALL BE INSTALLED PER MANUFACTURER'S SPECIFICATIONS.
doc: Cond -10/06
* *continued on next page **
PG09 -062 Printed: 07 -16 -2009
City of Tukwila
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 specifies herein or not.
Signature:
Print Name:
doc: Cond -10/06
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
The granting of . - • ermit does not presume • give authority to violate or cancel the provision of any other work or local laws regulating
construction o the p - rformance of work.
1,)/6e,cf
Date: 7/6 d,
PG09 -062 Printed: 07 -16 -2009
SITE LOCATION
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http: //www. ci. tukwila. wa. us
Plumbing/Gas Permit No.
1)&0
Project No.
(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 Address: 45 Andover Park W, Tukwila, Wa
Tenant Name: Hair Club For Men
Property Owners Name: Southcenter Corporate Square
Mailing Address: 575 Andover Park W,
King Co Assessor's Tax No.: 2623049143
Suite Number: 210 Floor: 2
Tukwila
City
New Tenant: ❑ Yes ® .. No
Wa
State
Zip
CONTACT PERSON - Who do we contact when your permit is ready to be issued
Name: Don Wycoff
Mailing Address: 8425 219th St SE #102
E -Mail Address: dwycoff @sagermechanical.com
PLUMBING / GAS PIPING CONTRACTOR INFORMATION
Company Name: Sager Mechanical
Mailing Address: 8425 219th St SE #102
Contact Person: Don Wycoff
E -Mail Address: dwycoff @sagermechanical.com
Contractor Registration Number: sagermi088nk
Contact Person:
E -Mail Address:
Contact Person:
E -Mail Address:
H: Applicatiom\Forms- Applications On Linc\2009 Applications\l -2009 - Plumbing -Gas Piping Permit Application.doc
Revised. 1-2009
bh
Day Telephone: (425) 402 -1930
Woodinville Wa 98072
City
State
Fax Number: (425) 402 -6721
Woodinville
City
Day Telephone:
Fax Number:
Expiration Date:
ARCHITECT OF RECORD — All plans must be wet stamped by Architect of Record
Company Name:
Mailing Address:
City
City
wa 98072
State
(425) 402 -1930
(425) 402 -6721
08/10/2009
State
Zip
Zip
Zip
Day Telephone:
Fax Number:
ENGINEER OF RECORD — All plans must be wet stamped by Engineer of Record
Company Name:
Mailing Address:
State
Zip
Day Telephone:
Fax Number:
Page 1 of 2
Fixture Type:
Qty
Fixture Type:
Qty
Fixture Type:
Qty
Fixture Type:
Qty
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
1
Wash fountain
Receptor, indirect waste
Sinks
3
Urinals
Water Closet
1
Building sewer and each
trailer park sewer
Rain water system — per
drain (inside building)
Water heater and/or vent
Industrial waste treatment
interceptor, including trap
and vent, except for kitchen
type grease interceptors
Each grease trap
(connected to not more
than 4 fixtures - <750
gallon capacity)
Grease interceptor for
commercial kitchen ( >750
gallon capacity)
Repair or alteration of
water piping and/or water
treatment equipment
Repair or alteration of
drainage or vent piping
Medical gas piping
system serving 1 -5
inlets /outlets for a
specific gas
Each additional medical
gas inlets/outlets greater
than 5
Backflow protective
device other than
atmospheric -type vacuum
breakers 2 inch (51 mm)
diameter or smaller
Backflow protective device
other than atmospheric -type
vacuum breakers over 2
inch (51 mm) diameter
Each lawn sprinkler
system on any one meter
including backflow
protection devices
Atmospheric -type vacuum
breakers not included in
lawn sprinkler backflow
protections (1-5)
Atmospheric -type
vacuum breakers not
included in lawn
sprinkler backflow
protections over 5
Gas piping outlets
Valuation of Project (contractor's bid price): $ 9,018
Scope of Work (please provide detailed information): Add three (3) sinks, one (1) water closet, and one (1)
lavatory to existing space
Building Use (per Int'l Building Code):
Occupancy (per Int'I Building Code):
Utility Purveyor: Water: Sewer:
Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below:
PERMIT APPLICATION NOTES -
Value of Construction — In all cases, a value of construction . ount should be entered by the applicant. This figure will be reviewed and is subject
to possible revision by the Permit Center to comply with cu ent fee schedules.
Expiration of Plan : eview — Applications for which no .ermit is issued within 180 days following the date of application shall expire by limitation.
The Building 0 lal m. grant one extension of time or an additional period not to exceed 180 days. The extension shall be requested in writing
and justifiabl ause demo strated. Section 103.4.3 temational Plumbing Code (current edition).
I HE BY CERTIF THAT I HAVE ' A l AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENA OF PERDU' BY THE LAW. O' THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUI I O E ,, OR AUTH 1 RI . AGENT:
Signat
Print Name: Don Wyco
Mailing Address: 8425
Date Application Accepted:
19t t SE #102
oil
• 0
H: Applications\Fonns- Applications On line \2009 App ications\l -2009 - Plumbing -Gas Piping Permit Application.doc
Revised: 1 -2009
bh
City
Date: 06/09/2009
Day Telephone: (425) 402 -1930
Woodinville Wa 98072
State Zip
Date Application Expires:
IA 1A
[17 Staff Initials:
ge 2 of 2
Parcel No.: 2623049144
Address: 545 ANDOVER PK W TUKW
Suite No:
Applicant: HAIR CLUB FOR MEN
Receipt No.: R09 -00917
Initials:
User ID:
Payee:
JEM
1165
ACCOUNT ITEM LIST:
Description
•
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
SAGER MECHANICAL, INC.
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 14797 180.00
Authorization No.
PLAN CHECK - NONRES
PLUMBING - NONRES
RECEIPT
Account Code Current Pmts
000/345.830 36.00
000.322.103.00.0 144.00
Total: $180.00
Permit Number: PG09 -062
Status: PENDING
Applied Date: 06/18/2009
Issue Date:
Payment Amount: $180.00
Payment Date: 06/18/2009 10:38 AM
Balance: $0.00
PAYMENT
RECEIVED
doc: Receiot -06 Printed: 06 -18 -2009
Project:
r e (� Tr � /QA
Type of Inspectio :
11-.A4 � .
Ad rd esss: _
542 4'1 d Li . 1)J7�
Date Called:
Special Instructions:
U 3 �� S v
LAJ r•i _( -A q heft,%-P
Date Wanted: + �. J
Requester:
Phone No:
7o r7cr3 -cl5
INSPECTION RECORD
Retain a copy with permit
INSP.F.6ii0 N NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION ►'�-
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
I=
Approved per applicable codes. ❑ Corrections required prior to approval.
COMMENTS:
OA 1
•
Inspector:,
1 .�. 14 Ada
ri $60. 1 INSPECTION FEE REQUIRED. Prior to inspection, fee mu be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
Projec •
#7;e9// Ch/6 re)/ / -i�/
Type of Inspection: •
/21)/ Ai --iV - i i
Address:
— q 9v/ Piz
Date Called:
A /
Special Instructions: • • b
- 7 (� �i• r
r � , ;
t •
• '' ' � '
/
Date Wanted:
7 - 2D -
rtr
p.m.
Requester
Phone No:
6C- 7l`. T-- 56
6/
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION Y
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
�� aS -ate
Approved per applicable codes. El Corrections required prior to approval.
COMMENTS:
6 e-ft)
8
Date: c.)/
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:
Proj�eSt:
(7/7�6 4-4-A/
h' 9f» 7---a-y-
T e of Inspection: .
Row; h - / .--i,, wf
Address:
.5" 41v A l/a P is t.G1
Date Called:
Special Instructions:
Date Wanted:
7 — / -
Requester:
Phone No:
D30 6- 753- 5s6/
I.
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION IL
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -36T0
❑ Approved per applicable codes.
COMMENTS:
A107 /241.
/ Pc- <
Inspector~:
❑ P
Rec ; pt No.:
0 REINSPECTION
at 6300 Southcenter
E REQ
lvd.,
fI
Corrections required prior to approval. It
JII'R Prior to inspection, fee must be
uite 100. Call to schedule reinspection.
'Date:
Pies -de?
Proj ct: A '
�
Type of I =ction • `,) L /�
A dress:
s45 -P'`�
A
Date Calf•:
7 1 ®q
Special Instructions:
Date Wanted7� 1 �9
Requester:
Phone : --
713 -151e1
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Approved per applicable codes. ❑ Corrections required prior to approval.
COMMENTS:
Inspector:
IDate: I3 /01
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:
INITIAL
TEST
PASSED 14,
DCVA / RPBA
DCVA / RPBA
RPBA.
PVBA/SVBA
CHECK VALVE NO.1
CHECK VALVE NO.2
AT �. .1 PSID
AIR INLET
OPENED AT PSID
CLOSED TIGHT (
LEAKED •
PSID
CLOSED TIGHT
LEAKED •
PSID
I
#1 CHECK 7. PSID
AIR GAP OK? \O S
DID NOT OPEN •
FAILED •
NEW
PARTS
AND
REPAIRS
CLEAN REPLACE PART
CLEAN REPLACE PART
CLEAN REPLACE PART
CHECK VALVE
HELD AT PSID
■ •
•
• •
• •
❑
❑ •
LEAKED ❑
• •
• •
• ■
CLEANED ❑
REPAIRED •
TEST AFTER
REPAIRS
PASSED •
FAILED •
LEAKED •
PSID
OPENED AT PSID
AIR INLET PSID
LEAKED •
PSID
#1 CHECK PSID
CHK VALVE PSID
ACCOUNT #
BACKFLOW PREVENTION ASSEMBLY TEST REPORT
pc7oc( - o (oz.
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 %v,, i Y L \ Nl) Commercial tip Residential 0
SERVICE ADDRESS S 5 P1 Nk4UlaY V%r� l 0 5 CITY w 10. ZIP WIZ
CONTACT PERSON PHONE ( )
LOCATION OF ASSEMBLY Y'(1 Q, CJV__0,`!1 1. C.- \ O m
DOWNSTREAM PROCESS V`T` (N 1U ; S 6`0vk'‘ DCVA 0 RPBA I PVBA 0 OTHER
NEW INSTALL EXISTING ❑ REPLACEMENT ❑ OLD SER. # PROPER INSTALLATION? YES NO ❑
MAKE OF ASSEMBLY W \ � i Y1 S MODEL \ 5 X SERIAL NO. - 31ki ' L SIZE S ry
AIR GAP INSPECTION: Required minimum air gap separation provided? Yes ' No 0 Detector Meter Reading
REMARKS: LINE PRESSURE I ) PSI
CONFINED SPACE? ICI b
FAX(
CERT. NO. B -3497 DATE ) "1-5 — ()1
TES I ERS SIGNATURE:
TESTERS NAME PRINTED: Lewis W. Young TESTERS PHONE # ( 425 ) 334-4507
CAL. DATE \ / , / (Y\ GAUGE #03050953 012050050 MAKE Midwest MODEL 845_
REPORT TO SERVICE RESTORED? YESII NO ❑
I certify that this report is accurate, and I have used WAC 246 -290 -490 approved test methods and test equipment.
MODEL
I t$141"4r
WEIGHT
LESS
WITH
SIZE
A
A UNION
BLESS BALL
C
D
E
F
G
BALL
BALL
BALL VALVES
VALVES
VALVES
VALVES
in.
mm
in.
mm
in
mm
in.
mm
in
mm
in.
mm
in.
mm
in.
mm
in.
mm
lbs
kg
lbs.
kg
3/4
20
12
305
13 3/4
349
7 3/4
197
2 1/8
54
3
76
3 1/2
89
5
127
16 1/8
410
10
4.5
12
5.5
1
25
13
330
14 1/2
368
7 3/4
197
2 1/8
54
3
76
3 1/2
89
5
127
17 3/8
441
10
4.5
14
6.4
1 1/4
32
17
432
18 13/16
478
10 15/16
278
2 3/4
70
3 1/2
89
5
127
6 3/4
171
22 9/16
573
22
10
28
12.7
1 1/2
40
17 3/8
441
19 3/8
492
10 15/16
278
2 3/4
70
3 1/2
89
5
127
6 3/4
171
24 1/16
611
22
10
28
12.7
2
50
18 1/2
470
20 1/2
521
10 15/16
278
2 3/4
70
3 1/2
89
5
127
6 3/4
171
26 1/2
673
22
10
34
15.4
a ZURN,. company
el 97 S
li i Il�'t�
eure Prin Assembly
f� ss . .i 1il i l i, i r .
FEATURES
Sizes: ❑ 3/4" ❑ 1"
Maximum working water pressure
Maximum working water temperature
Hydrostatic test pressure
End connections Threaded
OPTIONS
(Suffixes can be combined)
L -
U -
MS -
P-
S-
BMS -
FDC -
TCU -
V -
SE -
FT -
JUL 1 4 2009
p F ' i F: I; Ar N '41 n,,1 ' T i \, I. SHEET
REr�EIV� w D
CITY o T'U LA
JUL 13 2009
PERMIT CENTER
❑ 1 1/4" ❑ 1 1/2" ❑ 2"
175 PSI
180 °F
350 PSI
ANSI B1.20.1
with full port QT ball valves (standard)
less ball valves
with union ball valves
with integral relief valve monitor switch
for reclaimed water systems
with bronze "Y" type strainer
with battery operated monitor switch
with fire hydrant connection; 2" only
with test cocks up
with union swivel elbows (3/4" & 1 ")
with street elbows
with integral male 45 flare SAE test fitting
ACCESSORIES
❑ Air gap (Model AG)
❑ Repair kit (rubber only)
❑ Thermal expansion tank (Model
❑ Soft seated check valve (Model
❑ Shock arrester (Model 1250)
❑ QT -SET Quick Test Fitting Set
❑ Ball valve handle locks
❑ Test Cock Lock (Model TCL24)
DIMENSIONS & WEIGHTS (do not in lude rety of Tukwila
APPLICATION
Designed for installation on potable water lines to protect
against both backsiphonage and backpressure of contami-
nated water into the potable water supply. Assembly shall
provide protection where a potential health hazard exists.
STANDARDS COMPLIANCE
• ASSE® Listed 1013
• IAPMO® Listed
• UL® Classified (less shut -off valves or with OS &Y valves)
• C -UL® Classified
• CSA® Certified
• AWWA Compliant C511
• ,._Approved by the Foundation for Cross Connection
Control and Hydraulic Research at the University of
Southern California
• NYC MEA 425 -89 -M VOL 3
MATERIALS
Main valve body
Access covers
Fasteners
Elastomers
Polymers
Springs
REVIEWEDFF
CODE COMP] lA q
o XL) APPROVEO-
c
JUL 15 2009
Cast Bronze ASTM B 584
Cast Bronze ASTM B 584
Stainless Steel, 300 Series
Silicone (FDA Approved)
Buna Nitrile (FDA Approved)
NoryITM, NSF Listed
Stainless steel, 300 series
i
• B
G
3/4" - 1"
1 1/4" - 2"
Relief Valve discharge port:
0.63 sq. in.
1.19 sq. in.
DOCUMENT #:
BFI -975XL I.
Page 1 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 1L2 Phone:905 /405 -8272 Fax:905/405 -1292
Product Support Help Line: 1 -87COC M/( -2�2 -p 56) • Website: http: //www.zurn.com
LTR #. 1 If 2
�7V�
Capacity thru Schedule 40 Pipe
Pipe size
5 ft/sec
7.5 ft/sec
10 ft/sec
15 fUsec
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
1 1/4" (32mm)
112"
(40mm_ 2
(50mm)
?
a 20
to
o 15
re
w
a ▪ 5
FLOW CHARACTERISTICS
MODEL 975XL 3/4 ", 1 ", 1 1/4 ", 1 1/2" & 2" (STANDARD & METRIC)
FLOW RATES (I /s)
.26 2.52 3.8 5.0
20
3/4" (20mm) _ 1" (25mm)
20 40
15
10
60 80 5
3.2
50
FLOW RATES (GPM)
0 Rated Flow (Established by approval agencies)
6.3
100
9.5
12.6
150
200
15.8
137
0)
103
w
69 S
to
to
35
250
TYPICAL INSTALLATION
Local codes shall govern installation require-
ments. To be installed in accordance with the
manufacturers' instructions and the latest edition
of the Uniform Plumbing Code. Unless 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 clearance for testing and maintenance. The
installation shall be made so that no part of the
unit can be submerged.
CENTRAL
STATION
ALARM
PANEL
BA TTERY
MONITOR
SWITCH'
AIR GAP
FITTING
FLOOR -/
Page 2 of 2
I I U
4 12 MIN
3D" MAX
T • . p
p e
FLOOR DRAIN
DIRECTION OF FLOW
INDOOR INSTALLATION
('Shown w/ optional BMSI
OPT ONAL
WATER METER
PROTECTIVE
ENCLOSURE
INLET SHUT -OFF
AIR GAP
DRAIN
DIRECTION OF FLOW
OUTDOOR INSTALLATION
12" MIN
30" MAX
WILKINS a Zurn 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 1L2 Phone:905 /405 -8272 Fax:905/405 -1292
Product Support Help Line: 1- 877 - BACKFLOW (1 -877- 222 -5356) • Website: http: //www.zurn.com
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 first and second checks
shall be 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 adapter and integral monitor switch. The Reduced Pressure
Principle Backflow Preventer shall be a WILKINS Model 975XL.
July 13, 2009
Don Wycoff
8425 219 St SE #102
Woodinville, WA 98072
RE: CORRECTION LETTER #2
Plumbing /Gas Piping Permit Application Number PG09 -062
Hair Club for Men — 545 Andover Pk W
Dear Mr. Wycoff,
This letter is to inform you of corrections that must be addressed before your plumbing/gas piping
permit(s) 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 Public Works Departments. At
this time there
Public Works Department: Joanna Spencer at 206 431 -2440 if you have questions regarding the
attached memo.
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,
fer shall
it Technician
Encl
File: PG09 -062
•
W:\Permit Center\Correction Letters \2009\PG09 -062 Correction Letter #2.DOC
0
Jim Haggerton, Mayor
epartment of Community Development Jack Pace, Director
h ?nn Cnrrth,•ontor Rnnlov•rd Cnita itlnn • Tukwila Wachinatnn OR1RR o Phnna• 21h- 431 -3h71) o Fay- 2nh -4 1 -
PUBLIC WORKS DEPARTMENT COMMENTS
www.ci.tukwila.wa.us
Development Guidelines and Design and Construction Standards
DATE: July 9, 2009
0
PROJECT: Hair Club for Man
545 Andover Park West
PERMIT NO: PG09 - 062
PLAN REVIEWER: Contact Joanna Spencer (206) 431 -2440 if you have any questions
regarding the following comments.
1) The proposed 1.5" RPPA Wilkins Model 375 is not an approved devise, only sizes 3 /4 # -1" are
approved. I have attached few pages from the list of approved backflows, so please pick one from
the list and submit backflow cut sheet.
2) Show on your plan location where this backflow is going to be installed, so the City inspector can
easily find it inside the building.
(P: Joanna/Comments 3 PG09 -062)
June 30, 2009
Don Wycoff
8425 219 St SE #102
Woodinville, WA 98072
RE: Letter of Incomplete Application # 1 to Correction Letter #1
Plumbing/Gas Permit Application PG09 -062
Hair Club for Men — 545 Andover Pk W
Dear Mr. Wycoff,
This letter is to inform you that your resubmittal received at the City of Tukwila Permit Center on June
29, 2009 is determined to be incomplete. Before your application can continue the plan review process
the following items from the following department need to be addressed:
Building Department: Dave Larson at 206 431 -3678 if you have any questions concerning the
following comments.
Public Works Department: Joanna Spencer at 206 431 -2440 if you have any questions concerning
the following comments.
Please address the comment above in an itemized format with applicable revised plans, specifications,
and/or other documentation. The City requires that four (4) 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. 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 the Permit Center at (206) 431 -3670.
Sincerely,
fer Mijhall
erm't Technician
Enblo;aures
File: PG09 -062
•
City O, f Tuk9A/8
W:\Permit Center\Incomplete Letters\2009\PG09 -062 Inc Ltr #1 to Corr Ltr #1.DOC
jem
414
Jim Haggerton, Mayor
Department of Community /r evelopment Jack Pace, Director
6300 Southcenter Boulevard, Suite #100 0 Tukwila, Washington 98188 0 Phone: 206 - 431 -3670 0 Fax: 206 - 431 -3665
•
Determination of Completeness Memo
Date: June 30, 2009
Project Name: Hair Club for Men
Permit #: PG09 -062
Plan Review: Dave Larson, Senior Plans Examiner
Tukwila Building Division
I I t II I � l!LI 11
Dave Larson, Senior Plan Examiner
The Building Division has deemed the subject permit application incomplete. To assist the applicant in
expediting the Department plan review process, please forward the following comments.
(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. Refer to item number 1 of the last review memo dated 6- 25 -09. You propose to isolate the building supply
at the meter location. You also need to isolate this tenant from other tenants in the same building due to
medical procedures. Please show the location of this RPBA as well. Please note that the backflow device
for the entire building will be permitted under a separate Public Works permit. The tenant RPBA will be
permitted under this permit.
2. Refer to item 2 on the same review letter. You did not add hot water to the bathroom lavatory. Please add.
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
www.ci.tukwila.wa.us
Development Guidelines and Design and Construction Standards
DATE: June 30, 2009
•
PROJECT: Hair Club for Man
545 Andover Park West
PERMIT NO: PG09 -062
PLAN REVIEWER: Contact Joanna Spencer (206) 431 -2440 if you have any questions regarding
the following comments.
1) Since Hair Club for Men is also performing surgical hair transplant procedures and is treated as a
medical facility, a Reduced Pressure Principle Assembly (RPPA) is required as means of in- premise
cross - control isolation to protect other tenants in this building. On your plan please show location of
RPPA installation and specify size, manufacturer and model number. Submit RPPA cut sheet and
circle the backflow to be installed.
You have submitted only drawings for premise isolation RPPA outside the building, which requires a
separate permit application. See item 2) below.
2) For RPPA in a Hot Box for premise isolation (outside the building) a separate Public Works Type C
Construction Permit is required. It shall also cover:
a) an AMR (compatible to SENSUS) upgrade to the existing irrigation deduct water meter.
b) replacement of the lid on the existing irrigation DCVA box; current one is broken and creates a
hazard.
Please submit the attached Public Works permit application together with construction cost estimate, 4
sets of plans and RPPA cut sheet. Permit fee is $250 plus 5% of construction cost estimate for item 2.
(P: Joanna/Comments 2 PG09 -062)
June 26, 2009
Dear Mr. Wycoff,
Don Wycoff
8425 219 St SE #102
Woodinville, WA 98072
RE: CORRECTION LETTER #1
Plumbing /Gas Piping Permit Application Number PG09 -062
Hair Club for Men — 545 Andover Pk W
This letter is to inform you of corrections that must be addressed before your plumbing /gas piping
permit(s) 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:
Public Works Department:
•
cart' of 7°arcwi
epartment of Community Development Jack Pace, Director
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,
ifer shall
it Technician
encl
File: PG09 -062
W: \Permit Center\ Correction Letters \2009\PG09 -062 Correction Letter #1.DOC
Dave Larson at 206 431 -3678 if you have questions regarding the
attached memo.
Jim Haggerton, Mayor
Joanna Spencer at 206 431 -2440 if you have questions regarding the
attached memo.
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206- 431 -3670 • Fax: 206 - 431 -3665
I
Building Division Review Memo
•
Date: June 25, 2009
Project Name: Hair Club For Men
Permit #: PG09 -062
Plan Review: Dave Larson, Senior Plans Examiner
I 14 ' I 111
Tukwila Building
Dave L ar s o n , Se
Division
( Plan Examiner
I.;
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. Provide a RPBA to isolate this tenant space water system from the other tenants. Please
provide specs, installation details and proposed location.
2. The plan isometric for the water system lacks hot water to the lavatory sink in the toilet
room. Please add.
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
www.ci.tukwila.wa.us
Development Guidelines and Design and Construction Standards
DATE: June 25, 2009
PROJECT:
PERMIT NO:
PLAN REVIEWER:
1) Since Hair Club for Men is also performing surgical hair transplant procedures and is treated as a
medical facility, therefore a Reduced Pressure Principle Assembly (RPPA) is required as means
of in- premise cross - control isolation to protect other tenants in this building. On your plan
please show location of RPPA installation, specify size, manufacturer and model number.
Submit RPPA cut sheet and circle the backflow to be installed.
P: Joanna/Comments 1 PG08 -062
Hair Club for Man
545 Andover Pk West
PG09 -062
Contact Joanna Spencer (206) 431 -2440 if you have any questions
regarding the following comments.
DEPARTMENTS:
Building Division
Aft/(/ 04
PubIicVorks
DETERMINATI(]►N OF COMPLETENESS: (Tues., Thurs.)
Complete
Comments:
APPROVALS OR CORRECTIONS:
Approved ❑ Approved with Conditions
Notation:
REVIEWER'S INITIALS:
Documents/routing slip.doc
2 -28 -02
•PERMIT COORD COPY S
PLAN REVIEW/ROUTING SLIP
ACTIVITY NUMBER: PG09 - 062 DATE: 07 - -
PROJECT NAME: HAIR CLUB FOR MEN
SITE ADDRESS: 545 ANDOVER PK W
Original Plan Submittal
X Response to Correction Letter #
Response to Incomplete Letter #
Revision # After Permit Issued
Fire Prevention
Structural
Incomplete ❑
Planning Division
❑ Permit Coordinator
TUES /THURS R9UTING:
Please Route U Structural Review Required ❑ No further Review Required
REVIEWER'S INITIALS:
DATE:
Not Approved (attach comments)
DATE:
Not Applicable
DUE DATE: 07-14-09
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
DUE DATE: 08-11-09
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
DEPARTMENTS:
Alt
uilding Divisio
Comments:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections:
Documentshouting slip.doc
2 -28 -02
PERMIT CHORD COPY GO
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: PG09 - 062 DATE: 07 - -
PROJECT NAME: HAIR CLUB FOR MEN
SITE ADDRESS: 545 ANDOVER PK W
Original Plan Submittal
X Response to Correction Letter # 1
X Response to Incomplete Letter # 1
Revision # After Permit Issued
Fire Prevention
Structural
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete I Y I
Incomplete n
Planning Division
n Permit Coordinator
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS RO TING:
P ease Route Structural Review Required ❑ No further Review Required n
REVIEWER'S INITIALS:
DATE:
APPROVALS OR CORRECTIONS:
Approved ❑ Approved with Conditions ❑ Not Approved (attach comments)
Notation:
REVIEWER'S INITIALS:
DATE:
Bldg ❑ Fire ❑ Ping ❑ PW 1'1 Staff Initials:
LJ
DUE DATE: 07-07-09
Not Applicable ❑
DUE DATE: 08-0-09
ACTIVITY NUMBER: PG09 - 062 DATE: 06 -29 -09
PROJECT NAME: HAIR CLUB FOR MEN
SITE ADDRESS: 545 ANDOVER PK W
Original Plan Submittal
X Response to Correction Letter # 1
Response to Incomplete Letter #
Revision # After Permit Issued
DEPA TMENTS:
V( IA 010
Building Division
Comments:
TUES /THURS ROUTING:
Please Route
Documentshouting slip.doc
2- 28-112
• PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
Gel
APPROVALS OR CORRECTIONS:
Fire Prevention
Structural
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete Incomplete
n
REVIEWER'S INITIALS: DATE:
Planning Division
Permit Coordinator
DUE DATE: 06-30-09
Not Applicable
Permit Center Use Only
INCOMPLETE LETTER MAILED: " ,J r 1 �,(+ LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg �J Fire ❑ Ping ❑ PWI, Staff Initials:
Structural Review Required No further Review Required
DUE DATE: 07-28-09
Approved U Approved with Conditions I Not Approved (attach comments)
Notation:
REVIEWER'S INITIALS: DATE:
n
LJ
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
ACTIVITY NUMBER: PG09 - 062 DATE: 06 -18 -09
PROJECT NAME: HAIR CLUB FOR MEN
SITE ADDRESS: 545 ANDOVER PK W
X Original Plan Submittal
Response to Correction Letter #
Response to Incomplete Letter #
Revision # After Permit Issued
DEPARTMENTS:
cu•
Building !vision
I C t\
is Works
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
Comments:
•
PLAN REVIEW /Id
Fire Prevention
Structural
Permit Center Use Only
INCOMPLETE LETTER MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES /THURS ROUTING:
Please Route L Structural Review Required n
REVIEWER'S INITIALS:
APPROVALS OR CORRECTIONS:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections:
Documenlshouting slip.doc
2 -28 -02
61 ( M A
Bldg
UTING SLIP
n Permit Coordinator
LETTER OF COMPLETENESS MAILED:
DUE DATE: 06-23-09
Incomplete Not Applicable
No further Review Required
DATE:
Planning Division
Approved n Approved with Conditions Not Approved (attach comments)
Notation:
REVIEWER'S INITIALS: DATE:
LJ
LJ
DUE DATE: 07-21 -09
Fire ❑ Ping ❑ PW Staff Initials:
• 0
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 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: PG09 -062
❑ Response to Incomplete Letter #
® Response to Correction Letter # 2
❑ Revision # after Permit is Issued
❑ Revision requested by a City Building Inspector or Plans Examiner
CITY OF TU LA
JAL 13 2009
PER MIT CENTER
Project Name: Hair Club for Men
Project Address: 545 Andover Pk W
Contact Person: Don Wycoff Phone Number: 425 402 -1930
Summary of Revision:
Provided cut sheet for approved backflow device.
Sheet Number(s):
"Cloud" or highlight all areas of revision including date of revision
Received at the City of Tukwila Permit Center by:
Entered in Permits Plus on o 't 0 I0
\applications \forms- applications on line\revision submittal
Created: 8 -13 -2004
Revised:
Date:
•
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.
1 Response to Incomplete Letter # I
• Response to Correction Letter # 1
❑ Revision # after Permit is Issued
❑ Revision requested by a City Building Inspector or Plans Examiner
Project Name: Hair Club for Men
Project Address: 545 Andover Pk W
Contact Person: ' J U«R Phone Number: 9c 2-€POS7 / t/ 7
Summary of Revision: 04%' l 7Z 1 M14 - 1.//1'/v f 4
/-/al Pie /A.)- 2 ii—tab / //r - ' 1M GO/.s ue S� i
- /SL A- --2-.' -- (,c - )/ eQ(-7 Salad liar « *7
Sheet Number(s):
"Cloud" or highlight all areas of revision including date of revision
Received at the City of Tukwila Permit Center by: " 1
Entered in Permits Plus on VA 10(1 [o'
\appl :cations \forms - applications on line \revision submittal
Created: 8 -13 -2004
Revied:
Plan Check/Permit Number: PG09 -062
RECEIVED
CITY OF TUKWII A
JUL 06 2009
PERMIT CENTER
Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through
the mail, fax, etc.
Date: i/(, f T I t '
•
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
Response to Incomplete Letter #
Response to Correction Letter #
Revision # after Permit is Issued
Plan Check/Permit Number:
❑ Revision requested by a City Building Inspector or Plans Examiner
Project Name:
Project Address:
Contact Person: f/'f
RECEIVED
CITY OP TUKWILA
JUN 2 9 2009
PERMIT CENTER
Phone Number: 2W 201) 2 59 1 1,1
Summary of Revision:
PtiM i" n " 60 bk4-74/1r3ok
fv\rkV\ y4r 1,6 AV- tj&
Sheet Number(s):
"Cloud" or highlight all areas of revision including date of revision
Received at the City of Tukwila Permit Center by:
Entered in Permits Plus on lJ�
\applications\forms - applications on Iine\revision submittal
Created: 8 -13 -2004
Revised:
Kind of Fixture
Fixture Units
No. of Fixtures
Total
Fixture Units
Public
Private
Public
Private
Bathtub and Shower
4
4
Shower, per head
2
2
Dishwasher
2
2
Drinking fountain (each head)
1
.5
Hose bibb (interior)
2.5
2.5
Clotheswasher or laundry tub
4
2
Sink, bar or lavatory
2
1
/
/
Sink, Clinic flushing
8
8
Sink, kitchen
3
2
‘71._1.--
Sink, other (service)
3
1.5
Sink, wash fountain, circle spray
4
3
Urinal, flush valve. 1 GPF
5
2
Urinal, flush valve, >1 GPF
6
2
Urinal, waterless
0
0
Water closet, tank or valve, 1.6 GPF
6
3
/
'1
Water closet, tank or valve, >1.6 GPF
8
4
km King County
Department of Natural Resources and Parks
Wastewater Treatment Division
Non - Residential
Sewer Use Certification
I
• To be completed for all new sewer connections, reconnections or
change of use of existing connections.
• This form does not apply to repairs or replacements of existing
sewer connections within five years of disconnect.
Please Print or Type
e. 1d 1
Property Street Address
pt./ A
City State ZIP
6O CORPS , 9-R &
Owner's Name
Subdivision Name
Subdiv. #
Building Name
(if applicable)
Owner's Phone Number (with Area Code)
Property Contact Phone Number (with Area Code)
Owner's Mailing Address
- S be. P r y k ' J . p �Lc� nfL
A. Fixture Units
Fixture Units x Number of Fixtures = Total Fixture Units
Residential Customer Equivalent (RCE)
20 fixture units equal 1.0 RCE
Total No. of Fixture Units _
20
I certify that the information given is c
deviation will require resubmission
Signature of Owner /Representati
Print Name of Owner /Representative
1058 (Rev. 9/07)
Total Fixture Units 3,
RCE
Lot #
Block #
For King County Only
Account #
No. of RCEs
Monthly Rate
Property Tax ID # 2
Party to be Billed (if different from owner)
City or Sewer District
Date of Connection
Side Sewer Permit #
Please report any demolitions of pre- existing building on this property.
Credit for a demolition may be given under some circumstances.
Demolition of pre- existing building? ❑ Yes ❑ No
Was building on Sanitary Sewer? ❑ Yes ❑ No
Was Sewer connected before 2/1/90? ❑ Yes ❑ No
Sewer disconnect date:
Type of building demolished?
Request to apply demolition credit to multiple buildings? ❑ Yes ❑ No
B. Other Wastewater Flow
(in addition to Fixture Units identified in Section A)
Type of Facility /Process:
Estimated Wastewater Discharge:
Gallons /days
Residential Customer Equivalents (RCE):
187 gallons per day equals 1.0 RCE
Total Discharge (gal /day) _
187
C. Total Residential Customer Equivalents:
(add A & B)
A
B
RCE
Date (o '/o '0 7
01
RCE
Pursuant to King County Code 28.84, all sewer customers who establish a new service which uses metropolitan sewage facilities shall be subject to a capacity charge.
The amount of the charge is established annually by the King County Council at a rate per month per residential customer or residential customer equivalent for a
period of fifteen years. The purpose of the charge is to recover costs of providing sewage treatment capacity for new sewer customers. All future billings can be
prepaid at a discounted amount. All future billings can be prepaid at a discounted amount.
Questions regarding the capacity charge or this form ould be referred to King County's Wastewater Treatment Division at 206.684 -1740.
I understand that the capacity charge levied will be based on this information and any
cted data sr :etermination of a revised capacity charge.
White Kina County Yellow - Local Sewer Aoencv Pink - Sewer Customer . ®,p„, g§
Bond
Bond
Company
Name
Bond
Account
Number
Effective
Date
Expiration
Date
Cancel
Date
Impaired
Date
Bond
Amount
Received
Date
3
TRAVELERS
CAS it
SURETY
104575403
07/19/2005
Until
Cancelled
$6,000.00
08/02/2005
2
OLD
REPUBLIC
SURETY CO
YLI238326
08/12/2001
Until
Cancelled
08/28/2005
$6,000.0007/09/2001
1
OLD
REPUBLIC
INS CO
YLI238326
08/12/199808/12
/2001
$4,000.00
08/12/1998
Name
Role
Effective Date
Expiration Date
SAGER, ROBERT T
PRESIDENT
08/12/1992
Received
Date
SAGER, ANDREW VINCENT
VICE PRESIDENT
08/12/1992
01/10/2008
Savings
Assignment of
Savings
Account
Effective
Date
Release
Date
Assignment
Type
Impaired
Date
Amount
Received
Date
Untitled Page
•
•
General /Specialty Contractor
A business registered as a construction contractor with LI*I to perform construction work
within the scope of its specialty. A General or Specialty construction Contractor must
maintain a surety bond or assignment of account and carry general liability insurance.
Business and Licensing Information
Name
Phone
Address
Suite /Apt.
City
State
Zip
County
Business Type
Parent
Company
SAGER MECHANICAL INC UBI No.
4254021930 Status
8425 219TH ST SE STE
102
WOODINVILLE
WA
98072
KING
Corporation
License No.
License Type
Effective Date
Expiration
Date
Suspend Date
Specialty 1
Specialty 2
602234477
ACTIVE
SAGERMI088NK
CONSTRUCTION
CONTRACTOR
8/12/1992
8/10/2011
PLUMBING
UNUSED
Business Owner Information
Bond Information
Assignment of Savings Information
Page 1 of 2
https: // fortress .wa.gov /lni/bbip/Detail.aspx 07/16/2009
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1) CONTRACTOR 18 TO PROVIDE ELECTRICAL FOR
ALL UNDER CABINET IJGHTING. SEE CASEWORK ELEVATIONS;
TI-7.
2) CONTRACTOR IS TO RE-USE EXISTING ABANDON
ELECTRICAL BOXES AS IS POSSIBLE. INDICATED BY " OFF " .
3) CONTRACTORIS TO DEMO ALL EXISTING
ELECTRICALlCOMMUNICATIONS CUTLETS NOT SHOWN ` ON PLAN
PATCH & REPAIR HOLE TO MATCH SURROUNDING WALT:
'SURFACE.
4) CONTRACTOR IS TO DEMO ALL BLANK FACE PLATES ON
EXISTING OUTLETS, NOT TO BE REUSED. PATCH & REPAIR
HOLE TO MATCH SURROUNDING WALL. SURFACE.
1, CONTRACTOR IS TO VERIFY NEW CORE DRILL.
LOCATIONS AND REQUIRPMENI$ WITH TENANT -
2 INSTALL NEW OUTLETS AT 24' DOWN FROM CEILING GRID.
D CONTRACTOR IS TO PROVIDE & INSTALL DEDICATED 20A
C G FI)WI TH A6 20R RE THE UPS
EQUIPMENT AS SHOWN "r''
CONTRACTOR IS TO PROVIDES IN STALL A BACKUP
B RANCH CIRCU FR OM THE UPS O UTPUT MALE INLET
FLANGE TO THE TENANT PROVIDED MIDMARK LIGHTI
SY8TEMABOVE THE CEILING GRID, SEE TN
C ONTRACTOR IS TO P ROVID E & INSTALL BA CKUP BR
.." CIRCUIT FROM INLET PLU TQ OUTLETS I NDICATED, T O,
INCLUDE RECESSED FLOOR REC EPT A CLE FO R PATI
CHAIR AND 2 WALL MOUNTE D Q UADS . LABEL WAL M OUNT s
I NLE[ PLUG FLANGE'UPS BACKUP POWER" NE OUTLET
PLATES SHOULD BE ORANGE OR GRAY, N 5.15R, AND `
CLEARLY L ABELED "UPS BA CK U P POWER ONLY". PROV '.
a CONNECT STANDARD 3 PRONG EXTENSI COR
FROM EACH DEDICATED UPS INPUT POWER RECE ;
TO THE BACKUP POWER INLET WHERETflE UP WILL BE "
LOCATED FOR USE UNTIL THE UPS IS CONNECTED. VERIF
THAT 'POWERBRANCH `
INCLUDING LIGHTS (SEE KEYNO 4) CHAIR &
RECEPTACLES IS FUNCTIONAL. .
DRAWN BY: ; < `. NSA
Marvin Ste
planning v design
2221 Fifth Avenue, Seattle, Washington 98121 (206) 441 -1449
SOUTHCENTER
CORPORATE SQUARE
BUILDING 1
TUKWILA, WASHINGTON
N0.
REVISIONS /ISSUANCE:
REVISIONS INDICATED THUS ; A
PRICING . SET REVISION
PERMIT SET
DATE
03/28/05
05/10 /08
ELECTRICAL /
COMMUNICATIONS PLAN
REPRODUCTION, ALTERATION OR PUBLICATION' OF THIS
DRAWING, WITHOUT. EXPRESSED PERMISSION BY MS&A, IS
A VIOLATION OF FEDERAL COPYRIGHT LAW. ',COPYRIGHT
BY MS&A 2001
RECEIVED
JUL 0 7 7009
TUKWILA
TUKWILA
PUBLIC WORKS
REEtV
CITY OF TU
JUL (1 2009
PERMIT CENTER
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INCOMPLETE
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