HomeMy WebLinkAboutPermit PG09-131 - MIX RESIDENCEMIX RESIDENCE
1442657AVS
PGO9-131
Parcel No.: 3365900570
Address:
Suite No:
Tenant:
Name:
Address:
14426 57 AV S TUKW
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
MIX RESIDENCE
1442657AVS,TUKWILAWA
Owner:
Name: MIX CORY +ELIZABETH +LANNY +KA
Address: 14426 57TH AVE S , TUKVVILA WA
Contact Person:
Name: LARRY MIX
Address: PO BOX 1190 , JEFFERSON OR
Contractor:
Name: H2OLLWY RDNT FL HTG /PLG SR LLC
Address: PO BOX 363 , PRESTON WA
Contractor License No: H2OLLRF950M9
PLUMBING /GAS PIPING PERMIT
Permit Number:
Issue Date:
Permit Expires On:
Phone:
Phone: 514 990 -3987
Phone: 206 854 -3864
Expiration Date: 08/10/2011
DESCRIPTION OF WORK:
INSTALL NEW KITCHEN SINK IN NEW LOCATION. REPLACE TUB, TOILET, AND SINK IN
EXISTING LOCATION. REPLACE ELECTRIC WATER HEATER WITH TANKLESS WATER HEATER.
PG09 -131
11/09/2009
05/08/2010
Value of Plumbing /Gas Piping: $0.00 Uniform Plumbing Code Edition: 2006
Fees Collected: $105.00 International Fuel Gas Code Edition: 2006
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 1
Urinals 0
Water Closet 0
doc: UPC -7/07
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 1
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 0
Medical gas piping (6 +) inlets /outlets 0
Gas Piping
Gas piping outlets (0 -5) 0
Gas piping outlets (6 +) 0
* * continued on next page **
PG09 -131 Printed: 11 -09 -2009
Permit Center Authorized Signature:
I hereby certify that I have read and ex
governing this work will be complied
The granting of this permit does not presume
construction o - orm. c : f work
Signature:
Print Name:
doc: UPC -7/07
City o?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
min
th,
•
aut
ve a
ed
0
Permit Number:
Issue Date:
Permit Expires On:
PG09 -131
11/09/2009
05/08/2010
Date:
d this permit and know the same to be true and correct. All provisions of law and ordinances
hether specified herein or not.
rity to violate or cancel the provisions of any other state or local laws regulating
o -ign and obtain this plumbing /gas piping permit.
Date: /G O
This permit shall become null and void if t 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 -131 Printed: 11 -09 -2009
Parcel No.:
Address:
Suite No:
Tenant:
doc: Cond -10/06
3365900570
14426 57 AV S TUKW
MIX RESIDENCE
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
* *continued on next page **
Permit Number:
Status:
Applied Date:
Issue Date:
PG09 -131
ISSUED
11/09/2009
11/09/2009
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.
PG09 -131 Printed: 11 -09 -2009
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 complied with, whether specified herein or not.
The granting of this permit does not presume to give authority to violate or cancel the provision of any other work
construction or the performance of work.
doc: Cond -10/06 PG09 -131
Date: / - / - CD
ordinances governing
or local laws regulating
Printed: 11 -09 -2009
Site Address: 4 Z
Tenant Name:
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
httpl/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
U1.I\k( V'6 ►Df C k
Property Owners Name: Col Aft; j` F l ► 2 ID vt M + l� , L4'r1
Mailing Address: 2 to - Ave, 3. T.) k
l AIL `Jf I f. f f i c
City
CONTACT PERSON - Who do we contact when your permit is ready to be issued
Name: Z_ c n y 114; Day Telephone: 51 1- 912.- 0) -
Mailing Address: P. a t) 3c . 1 9v j e C-Crus -A a a . 77 35 z 19 t 4 y 0 3 7le_ / 1
City State Zip
•
E -Mail Address: k L / 14 \ X C..c/Ai CCe 54 i/{ ' f Fax Number: 51 / - 7 / - 3 3 0 )
Company Name: G & , i -f - 1 — + ` 1 Pi
Mailing Address: p.0 6a .3 (0 3 he5 on ``
W A f 8 0 c O "' 3? 3
Contact Person: (Ct `4 1-46M0 , LA- , �' C(
E -Mail Address: 1 011 w )
e p�1 UAl 1 �',1 (-A (H iJ e, ; L v A k
Contractor Registration Number: tt Zo C. LR F 4 So 1149
ARCHITECT. OF RECORD - All plans must be wet'stamped by Architect of Record
Contact Person:
E -Mail Address:
H:Wpplications\Forms- Applications On Line \2009 Applieations\1 -2009 - Plumbing -Gas Piping Permit Application.doc
Revised: 1-2009
bh
Plumbing /Gas Permit No.
vnal -
Project No.
(For office use only)
King Co ^ Assessor's Tax No.: �� (r7� ?C " O.57o- 0 1
/i Suite Number: Floor:
New Tenant: ❑ Yes ❑ ..No
8/ 1
State
City State Zip
Day Telephone: ZO (9 i '1 3 0 ( el
Fax Number:
Expiration Date:
State
ao(1
Zip
Company Name:
Mailing Address:
Cit
Day Telephone:
Fax Number:
State Zip
• ENGINEER OF RECORD = All plans must be wet stamped by Engineer of Record
Company Name:
Mailing Address:
Cit
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
Zip
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
Wash fountain
Receptor, indirect waste
Sinks
t
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
PERMIT APPLICATION NOTES .. : - •
Valuation of Project (contractor's bid price): $ 32 00.O l r - - -
Scope of Work (please provide detailed information): l/\ \' '� 4-c .?
1-e,fi . - A
L)- y-<J- s A b e 0 8
Building Use (per Int'I Building Code):
Occupancy (per Int'l Building Code):
Utility Purveyor: Water:
BUILDING
Print Name:
I Date Application Accepted:
•
H:\Applications \Forms - Applications On Line12009 Applications\1-2009 - Plumbing -Gas Piping Permit Application.doc
Revised: 1.2009
bh
•
5
Indicate type of plumbing fixtures and /or gas piping outlets being installed and the quantity below:
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 LA S OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
! • 'i1' .r Ii ;.• r• ZED
Signature: Date: 140%) . 9 20 pi
1 1-6 / r D Cl Day Telephone: ?Olt' 9 J 'T 3P(A 'T
Mailing Address: p 0. 86 3 6 3 1 5 k lr 0 C d— 3 6 3 g Zip
City State
Date Application Expires:
Staff Initials:
Page 2 of 2
Parcel No.: 3365900570
Address: 14426 57 AV S TUKW
Suite No:
Applicant: MIX RESIDENCE
Receipt No.: R09 -01766
Initials:
User ID:
Payee:
doc: Receipt-06
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
RECEIPT
KEVIN HOLLOWAY /HOLLOWAY RADIANT FLOOR HTG
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd MC
Authorization No. 009288
PLUMBING - RES
105.00
•
Account Code Current Pmts
000.322.103.00.00 105.00
Total: $105.00
Permit Number: PG09 -131
Status: PENDING
Applied Date: 11/09/2009
Issue Date:
Payment Amount: $105.00
Payment Date: 11/09/2009 10:34 AM
Balance: $0.00
PAYME' .T
RECEIVED
Printed: 11 -09 -2009
Project:
/ 4),-s -
Type of Inspection:
,vim i 7D6t , h
Address:
iy4/z s7A Us
Date Called:
Special Instructions:
Date Wanted:
2.— �--
/0
,m.
�r
Requester:
Phone No:
INSPECTION RECORD
Retain a copy with permit
it PEt9I0 NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
PERMIT NO.
1
(206)431 -3670
\ gi pproved per applicable codes. ❑ Corrections required prior to approval. r
COMMENTS:
-7 4,71f AA/
naN
s
Dat5
.00 REINSPECTION FE REQUIRO. Prior to inspection, fee must be
d at 6300 Southcenter B1,vd., Suite 100. Call to schedule reinspection.
R eipt No.: 'Date:
-, , _,.
Project:. � ��
�S ,�
Type Qf Inspection:_ P/ im& ,
/ u .! .1--71 I�
Address: �r
2 is
Date Called/
4 _9 ,
Special Instructions:
Date Wanted: I
II I
/
-- ( ---
p.m.
Requester:
Phon No:
Vs-4. ' 38 ,
1
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Approved per applicable codes. El Corrections required prior to approval.
COMMENTS:
I
Inspec r:
h(,(/L/ ,4 (A-/47°
$60.0 ' EINSPECTION FEE REQUI ED. Pr'Gr to inspection, fee must be
p.. at 6300 Southcenter Blvd., Sul 100. all to schedule reinspection.
Rec eipt No.:
INSPECTION RECORD
Retain a copy with permit
Date:
Date:
P6 al —1.3 1
PERMIT NO.
Insurance
Company
Name
Policy
Number
Effective
Date
Expiration
Date
Cancel
Date
Impaired
Date
Amount
Received
Date
4
FARMERS
INS
GROUP
604751034
07/15/200907/15
/2010
$1,000,000.0007
/14/2009
3
CBIC
C115G232007 /15/200807/15/200908
/13/2009
Until
Cancelled
$1,000,000.0007 /14/2008
2
CBIC
C11SG232007/15/200607/15/2008
$1,000,000.0008 /04/2006
1
CBIC
C11SG232007/15/200507/15/2006
$1,000,000.0007 /29/2005
Bond
Bond
Company
Name
Bond
Account
Number
Effective
Date
Expiration
Date
Cancel
Date
Impaired
Date
Bond
Amount
Received
Date
2
CBIC
SI3491
07/15/2009
Until
Cancelled
$12,000.0009/22
/2009
1
CBIC
SG2320
07/15/2005
Until
Cancelled
09/12/2009
$12,000.0007/29
/2005
Name
Role
Effective Date
Expiration Date
HOLLOWAY, KEVIN
PARTNER /MEMBER
07/29/2005
HOLLOWAY, JAMIE
PARTNER /MEMBER
07/29/2005
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
Business Type
Parent
Company
H2OLLWY RDNT FL HTG /PLG
SR LLC
2068543864
PO BOX 363
PRESTON
WA
98050
KING
Limited Liability Company
UBI No.
Status
License No.
License Type
Effective
Date
Expiration
Date
Suspend Date
Specialty 1
Specialty 2
602517938
ACTIVE
H2OLLRF950M9
CONSTRUCTION
CONTRACTOR
7/29/2005
8/10/2011
GENERAL
UNUSED
Business Owner Information
Bond Information
Insurance Information
•
•
https://fortress.wa.gov/lni/bbip/Detail.aspx
Page 1 of 1
11/09/2009