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HomeMy WebLinkAboutPermit PG09-114 - 7-ELEVEN7- ELEVEN 14057 INTERURBAN AV S PGO9-1 14 Parcel No.: 3365900865 Address: Suite No: Cityef 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 14057 INTERURBAN AV S TUKW Tenant: Name: 7- ELEVEN Address: 14057 INTERURBAN AV S , TUKWILA WA Owner: Name: Address: THE SOUTHLAND CORPORATION C/O TAX DEPT , PO BOX 711 Contact Person: Name: PAUL FARROW Address: 2918 SE LIBERTY PL , GRESHAM OR Contractor: Name: LIBERTY PLACE VENTURER LLC Address: 2918 SE LIBERTY PL , GRESHAM OR Contractor License No: LIBERPV967R7 Plumbing Bathtub or combination bath/shower 0 Bidet 0 Clothes washer, domestic 0 Dental unit, cuspidor 0 Dishwasher, domestic, with independent drain 0 Drinking fountain or water cooler (per head) 0 Food -waste grinder, commercial 0 Floor drain 0 Shower, single head trap 0 Lavatory 0 Wash fountain Receptor, indirect waste 0 Sinks 0 Urinals 0 Water Closet 0 doc: UPC -7/07 PLUMBING /GAS PIPING PERMIT DESCRIPTION OF WORK: DISCONNECT 4 SUPPLY LINES - 2 TO SALES FLOOR HAND SINK, 2 TO COFFEE ISLAND. RECONNECT 4 SUPPLY LINES. DISCONNECT AND RECONNECT 1 SLURPEE /SODA FOUNTAIN MACHINE Value of Plumbing /Gas Piping: $200.00 Uniform Plumbing Code Edition: 2006 Fees Collected: $45.00 International Fuel Gas Code Edition: 2006 FIXTURE TYPE AND QUANTITY 0 * * continued on next page ** Permit Number: Issue Date: Permit Expires On: Phone: Phone: 503 - 913 -9249 Phone: 503 - 618 -1053 Expiration Date: 12/27/2010 PG09 -114 09/29/2009 03/28/2010 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 interceptor, including its trap and vent, except for kitchen type grease interceptors 0 Repair or alteration of water piping and/or water treatment equipment 0 Repair or alteration of drainage or vent piping 0 Medical gas piping system serving (1 -5) inlets /outlets for a specific gas 1 Medical gas piping (6 +) inlets /outlets 0 Gas Piping Gas piping outlets (0 -5) 0 Gas piping outlets (6 +) 0 PG09 -114 Printed: 09 -29 -2009 Permit Center Authorized Signature: The granting of thi construction or th Signature: Print Name: doc: UPC -7/07 City orTukwila 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 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. e to give authority to violate or cancel the provisions of any other state or local laws regulating am - orized to sign and obtain this plumbing /gas piping permit. • Permit Number: PG09 -114 Issue Date: 09/29/2009 Permit Expires On: 03/28/2010 Date: 9'0)-- © f Date: 9--P-- 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. PG09 -114 Printed: 09 -29 -2009 Parcel No.: 3365900865 Address: Suite No: Tenant: 7- ELEVEN 14057 INTERURBAN AV S TUKW 1: ** *PLUMBING AND GAS PIPING * ** • 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 Permit Number: Status: Applied Date: Issue Date: PG09 -114 ISSUED 09/29/2009 09/29/2009 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 art 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. doc: Cond -10/06 * * continued on next page ** PG09 -114 Printed: 09 -29 -2009 I hereby certify that I have this work will be complied The granting of this permit construction or the pe Signature: Print Name: doc: Cond -10/06 • • 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 read these conditions and will comply with them as outlined. All provisions of law and ordinances governing with, whether specified herein or not. does not presume to give authority to violate or cancel the provision of any other work or local laws regulating of work Date: PG09 -114 Printed: 09 -29 -2009 Site Address: Mailing Address: CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us 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 . R/057 Jvl .1ei'Urbi2i AL Suite Number: Floor: Tenant Name: 7 — PleA7,4/1 New Tenant: ❑ Yes A.No Property Owners Name: l; vet 1 ('I �� Zip Name: Paul � 1 �W. ��" Mailing Address: 21 I8 5 4.1)4 1 ai Plumbing /Gas Permit No. I L Project No. (For office use only) Contact Person: E -Mail Address: E -Mail Address: 1 c awn PLUMBING / GAS PIPING CONTRACTOR INFORMATION H:Wpplications \Forms - Applications On Line \2009 Applications \1.2009 - Plumbing -Gas Piping Permit Application.doc Revised: 1 -2009 bh King Co Assessor's Tax No.: Tukio la WA CONTACT PERSON - Who do we contact when your permit is ready to be issued Day Telephone: 51)3 ' 3 -924/ A4 is City Fax Number: "3(o 0 -0r3(o5 State 6 State I Zip Company Name: Mailing Address: City State Zip � Contact Person: 4i2_I` / , te� Day Telephone: 3- 9/3 - ` E -Mail Address: L P pi c �Y 7 43r;,„res!s �.� . ham- �_Fax Number: , T.� 3- 4'4 s -7.3 Contractor Registration Number: jJ ^7 L ! 6f efU'G 7e I Expiration Date: /,, 7^ 0 ,2eVa ARCHITECT OF RECORD - All plans must'be wet stamped by Architect of Record. • Company Name: Mailing Address: State Zip City Day Telephone: Fax Number: ENGINEER OF RECORD - All plans must be wet stamped by Engineer of Record Company Name: - - Mailing Address: City Contact Person: Day Telephone: E -Mail Address: - Fax Number: State Zip Page I 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 Wash fountain Receptor, indirect waste Sinks Urinals Water Closet 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 ' PE RIVIIT'APPLICATION NOTES -" Valuation of Project (contractor's bid price): $ Scope of Work (please provide detailed information): Building Use (per Int'l Building Code): Occupancy (per Int'l Building Code): Utility Purveyor: Water: BUILDING ORIZ . D AGENT: Signature: Print Name: Mailing Address: 9 J 2 6E ,Li Date Application Accepted: H:\Applications \Forms - Applications On t.ine12009 Applications \ 1-2009 - Plumbing -Gas Piping Permit Applicationdoc Revised: 1.2009 bh • S it j a Di A' , $ 5*6 -loo( Vao6 Son 2 5vpp\y 1 IMO ! cD;scm ms`s' e4.e„ •. s c'� Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below: leo Sewer: 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. Date: 9 Day Telepho e: 14- _dee 4 ?dam City State Zip Date Application Expires: Staff Initials: Page 2 of 2 Receipt No.: R09 - 01522 Payee: LIBERTY PLACE VENTURER Payment Credit Crd VISA - Authorization No. 051834 ACCOUNT ITEM LIST: Description doc: Receipt - 06 PLUMBING - NONRES 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.: 3365900865 Permit Number: PG09 -114 Address: 14057 INTERURBAN AV S TUKW Status: PENDING Suite No: Applied Date: 09/29/2009 Applicant: 7 - ELEVEN Issue Date: Initials: WER Payment Date: 09/29/2009 10:32 AM User ID: 1655 Balance: $0.00 TRANSACTION LIST: Type Method Descriptio Amount 45.00 Account Code Current Pmts 000.322.103.00.0 45.00 Total: $45.00 Payment Amount: $45.00 PAY' . ENT RECEIVED Printed: 09 -29 -2009 Project: Type of IFspecti n: Address: 140 -( "f - f 6 ,4 , .E Date Called: Special Instructions: / Date Wanted: C �a.m. p.m Requester: Phone ?S /4 a— (3t? INSPECTION NO. INSPECTION RECORD Retain a copy with permit it PERMIT 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: r et .s i tA . A4 p Date: 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: COMMENTS: Type of Inspection: N F wra-L- Address: I40Si ...1,--r4 -te v I.1 r IA /.' A ? t ;r7e,:. : -/1 (-) (o.9 A - . .1( ,., t- ' r- )cr J /Cj b,1-.5 6( bee', SA PO el - 7 - P.i . / e - - IT 5J/ D (. - g f 7 ,A__,1 &j : ( ' S / ---\ A Project: - FL UFt..) Type of Inspection: N F wra-L- Address: I40Si ...1,--r4 -te v I.1 r IA Date Called: Special Instructions: ®3GoT.S i Date Wanted: Requester: Phone No: 42-5,7S0 - I Z ❑ Approved per applicable codes. INSPECTION RECORD Retain a copy with permit CITY OF TUKWILA BUILDING DIVISION -1I PERMIT NO. 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -367 Corrections required prior to approval. ri $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: COMMENTS: r- I 1) e g u ., i 9- AI S k h - 1J A\ A rr o j� 4/ �'"`r� !1'� ` [u ' Fc r TL (.s ` S\t\rL/ ( u f f p -- /-1)1 P_S1 k411 ; SL (e re t-tJ; S 1 C ;�1 �TP /7'� ,� (T 3A( � h 1„ 1 � � b� � I mil. . �in ( /5 [) )' A.ou -e i ?� ( (� f 1 A/ -C (Jot T?) ,4 S , p D-ef rat ( , ? _ v(AJ/ e - ,A4 //0 ( T t�t( (,?•4e, o 1 o ' t — , , f1N n rte/' j A 1�:si. /e r c8 _ S (L r p. e e /ka : /t c * i7A-e' L E t;.S RA1kiloc4 pi;Te- (7, err '-P ef A- t Pr i Ct eriP.N I 6 A c PCP? 0 [,J rej r Projec : T of Inspection: n pc LA , A--1 - A < 'C Address: Date led: / C � Special In tructions: Date Wanted: _ J -c) p.m. Requester: Phone 2 j /3 — 2.41 INSPECTION RECORD Retain a copy with permit INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 300 Southcenter Blvd., #100, Tukwila, WA 98188 Approved per applicable codes. PERMIT NO. (206)431 -36y7 orrections required prior to approval. n$60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee'must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Date: q > u 1 G) Receipt No.: Date: - ...�... _ COMMENTS: Type of Inspection: / i �? LAln e_A ��s 3 ST- 5:c-4( -g 1nom �^ /{J� j i J IIP A r i 10. K1Ll el , S; ZP• ti l 1 : A ' /�U h - r� J:1 ( its f 69. d,, f -- _Af e--C7 � r 17 ,Ar °IIcj 1, i)/J7� o•t d cei7)R Lid( d( b-P l e u . [ " 0 4 A l P - ti a - 111 r . � J � - - (i ,_ ,ti ,l, /--,-,•&• 1 A S(LJi pee ), A7.9. -e . il l • Pro ect: Type of Inspection: r_ Address: ; L4037 fPr�c a to p Date Called: Special Instructions: 0 4 �J prate � p k (-0 �n ok • S 0G 1 >r Date Inted:_ — J p.m. Requester: Phone No: 5 3 _.S 2Lf INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION ( 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3 7 El Approved per applicable codes. P6 oS -iiy Corrections required prior to approval. dri El $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Insp'ctor: Date: ci -3o- o f Receipt No.: Date: k_ Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 1 CBIC PD6415 12/21/2004 Until Cancelled $12,000.00 12/27/2004 Name Role Effective Date Expiration Date FARROW, PAUL PARTNER /MEMBER 12/27/2004 Amount FARROW, SANDRA PARTNER /MEMBER 12/27/2004 bkw53776799 Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date 4 WEST AMERICAN INS CO bkw53776799 12/15/200812/15 /2009 $1,000,000.0012 /23/2008 3 AMERICAN STATES INS CO 02BP3939813012 /15/200512/15/2008 $2,000,000.0012 /10/2007 Untitled Page General /Specialty Contractor A business registered as a construction contractor with LEt1 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 LIBERTY PLACE VENTURER LLC 5036181053 2918 SE LIBERTY PLACE GRESHAM OR 97080 OUT OF STATE Limited Liability Company UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 602457255 ACTIVE LIBERPV967R7 CONSTRUCTION CONTRACTOR 12/27/2004 12/27/2010 GENERAL UNUSED Business Owner Information Bond Information Insurance Information • 0 Page 1 of 2 https://fortress.wa.gov/lni/bbip/Detail.aspx 09/29/2009