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Home My WebLink AboutPermit PG10-087 - FIBERDYNEFIBERDYNE 17616 WEST VALLEY HY PG1 0-087 City oPI'ukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Inspection Request Line: 206 - 431 -2451 Web site: http: / /www.ci.tukwila.wa.us PLUMBING /GAS PIPING PERMIT Parcel No.: 2523049017 Address: 17616 WEST VALLEY HY TUKW Project Name: FIBERDYNE Permit Number: PG 10 -087 Issue Date: 08/18/2010 Permit Expires On: 02/14/2011 Owner: Name: BROMEL DAVID K Address: 3409 S LAURELHURST DR NE , SEATTLE WA 98105 Contact Person: Name: STEVE LAMBERT Address: 17616 WEST VALLEY HY , TUKWILA WA 98188 Email: SLAMBERT@FIBERDYNEONE.COM Contractor: Name: WALTS GAS PIPING SERVICE Address: 11202 74 AV E , PUYALLUP WA 98373 Contractor License No: WALTSGP970PS Phone: 253 - 970 -3507 Phone: 253 - 841 -2171 Expiration Date: 07/16/2012 DESCRIPTION OF WORK: INSTALL GAS LINE TO 800,000 BTU OVEN Value of Plumbing /Gas Piping: $2,000.00 Uniform Plumbing Code Edition: 2009 Fees Collected: $120.75 International Fuel Gas Code Edition: 2009 Permit Center Authorized Signature: l /liC�c �- �/ Date: O6 d d I hereby certify that I have read and examined this permit and know the same to be true and correct. All provisions of law and ordinances governing this work will be complied with, whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws regulating construction or t - performance of work. I am authorizgd to sign and obtain this plumbing /gas piping permit. Signature: Date: /S/ ?O/C) Print Name: TZ %/ 1 CL k • W 0 (c. G fri 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 -4/10 PG10 -087 Printed: 08 -18 -2010 • • 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.tulcwila.wa.us Parcel No.: 2523049017 Address: Suite No: Tenant: 17616 WEST VALLEY HY TUKW FIBERDYNE PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: PG 10 -087 ISSUED 07/21/2010 08/18/2010 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: 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. 8: 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. 9: 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. 10: 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 PG10 -087 Printed: 08 -18 -2010 • City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206-431-3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us I hereby certify that I have read these conditions and will comply with them as outlined. All provisions of law and ordinances governing this work will be complied with, whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provision of any other work or local laws regulating construction or the performance of work. Signature: / Print Name: ail-(0-)/1 c( 606/c o�� Date: 20/0 doc: Cond -10/06 PG10 -087 Printed: 08 -18 -2010 a[� Site Address: CITY OF TUKWILO Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us Plumbing /Gas Permit N ProjectNo., 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 ** —RIA4 \j.) v��L9 \- ■\ Tenant Name: 'ot.r . 6 Property Owners Name: I ! / Mailing Address: Sj/U 7/ Q 1� -I l 4 Sf- 3r N E rfrttA ' - King Co Assessor's Tax No.: -S L 3 ci4,0 17 Suite Number: Floor: New Tenant: Yes ❑ ..No Se City to State Zip ' CONTACT PERSON - .Who'do.we contact when your permit is ready to be issued Name: S fe v LOu'►'l b e. r Mailing Address: / &OF' S it V E -Mail Address: 614 m Ae -¢ ilK744A, 6.e_rdyPie 46 N. C Day Telephone: (2.5 e) 9U - 350 /3 71.ckwi'/ hi- 'B 13,Y City S ate Zip Fax Number: (•4f2 5) 9 8 8 - 63 y3 PLUMBING / GAS PIPING CONTRACTOR INFORMATI Company Name: Mailing Address: , 01.�� T% 'u�\-, � Pk.) \V� Stpate, 1 Ztp Day Telephone: o �-f l c1 U1 1 Fax Number: Expiration Date: (DfIN nQ \ * CD u\) Gooslx Contact Person: W'\ c 73 E -Mail Address: L> >�"\ ASP \ P\ ('p ''\C)` O Contractor Registration Number: W'?.\L. - --A- G Q O--1 0 kS ARCHITECT OF RECORD All plans must be wet stamped by Architect of Record. Company Name: Mailing Address: ss O c �&/e Contact Person: (&)46 6 E -Mail Address: i ..�iia� city State Zip Day Telephone: t 2c /p) 32 5 -2 5S 3 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 H:Wpplications \Forms - Applications On Line \2009 Applications \1 -2009 - Plumbing -Gas Piping Permit Application.doc Revised: 1 -2009 bh Page 1 of 2 21600 ,00 Valuation of Project (contractor's bid price): $ Scope of Work (please provide detailed information): i ■(_L GA N E. 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: Fixture Type: Qtyr.: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 1 - 0 \.IE-/\/ 200, 00 0 •87-70 'PERMIT APPLICATION NOTES - 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 anadditional period not to exceed 180 days. The extension shall be requested in writing and justifiable cause demonstrated. Section 103.4.3 International Plumbing Code (current edition). I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OW]$E Signature: (` Print Name: ZED AGENT: (r.)Aci rn‘L slc( Mailing Address: 1 (4- {-t.\'N e- Day Telephone: ?City60,A ci Date: -J' 1 Z?, 2 ?to 9gs-73 State Zip Date Application Accepted: 1 D Date Application Expires: � �� i i S Staff Initials: H:\Applications\Forms- Applications On Line \2009 Applications \I -2009 - Plumbing -Gas Piping Permit Application.doc Revised: 1 -2009 bh Page 2 of 2 r • 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.tulcwila.wa.us RECEIPT Parcel No.: 2523049017 Permit Number: PG 10 -087 Address: 17616 WEST VALLEY HY TUKW Status: APPROVED Suite No: Applied Date: 07/21/2010 Applicant: FIBERDYNE Issue Date: Receipt No.: R10 -01621 Initials: User ID: LAW 1632 Payment Amount: $95.75 Payment Date: 08/18/2010 04:29 PM Balance: $0.00 Payee: FIBERDYNE TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd MC Authorization No. 022819 ACCOUNT ITEM LIST: Description 95.75 Account Code Current Pmts GAS - NONRES 000.322.103.00.00 95.75 Total: $95.75 PAYMENT qFr.FivEp doc: Receiot -06 Printed: 08 -18 -2010 City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206-431-3670 Fax: 206 -431 -3665 Web site: http: / /www.ci.tukwila.wa.us Parcel No.: 2523049017 Address: 17616 WEST VALLEY HY TUKW Suite No: Applicant: FIBERDYNE RECEIPT Permit Number: PG 10 -087 Status: PENDING Applied Date: 07/21/2010 Issue Date: Receipt No.: R10 -01377 Initials: User ID: Payee: WER 1655 Payment Amount: $24.15 Payment Date: 07/21/2010 03:12 PM Balance: $96.60 WALT MILEWSKI TRANSACTION LIST: Type Method Descriptio Amount Payment Cash Authorization No. ACCOUNT ITEM LIST: Description 24.15 Account Code Current Pmts PLAN CHECK - NONRES 000.345.830 24.15 Total: $24.15 PAYMENT RECEIVED doc: Receiot -06 Printed: 07 -21 -2010 City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: http: / /www.ci.tukwila.wa.us Parcel No.: 2523049017 Address: 17616 WEST VALLEY HY TUKW Suite No: Applicant: FIBERDYNE RECEIPT Permit Number: PG 10 -087 Status: PENDING Applied Date: 07/21/2010 Issue Date: Receipt No.: R10 -01378 Initials: User ID: Payee: WER 1655 Payment Amount: $.85 Payment Date: 07/21/2010 03:13 PM Balance: $95.75 WALT MILEWSKI TRANSACTION LIST: Type Method Descriptio Amount Payment Cash Authorization No. ACCOUNT ITEM LIST: Description .85 Account Code Current Pmts GAS - NONRES 000.322.103.00.00 .85 Total: $.85 PAYMENT RECEIVED doc: Receiot -06 Printed: 07 -21 -2010 INSPECTION RECORD "Retain a copy with permit IN . NO. PERMIT N0. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Project r 6jer // AI,c Type of Inspection: / ® Fill 645 ! .1+ Q •11C Address: ti(,) l� Y Lt.1). U/1-I( -7 Date Called: Special-Instructions: Date Wanted: 3J-/0 a.m. wnr Requester: Phone No: _ 53 - `I ?D —3's o7 Approved per-applicable codes.- Corrections required prior to approval. OM TS: it wN A (gy 6- 1 SPE ION FEE REQUI D. Prior to n t inspection. fee must be paid at 6 3b0 Southcenter Blvd.`. Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 / //4 -087 Project: - Type of Inspection: r° , I)ff 1N— G45 Adfri?rt?Aeltive s: /76 /4 Af s% ///9// ' Date Called: Special Instructions: Date Wanted: a.m. Requester: Phone No: _ 11025 -ciD --6357/ Approved per applicable codes. Corrections required prior to approval. COM ENTS: INS�I3ECTION FEE REQ IRED. Prior�o next inspection. fee must be P.ai�d t 6300 Southcenter B vd., Suite 1 0. Call to schedule reinspection. '' �; PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG10 -087 PROJECT NAME: FIBERDYNE SITE ADDRESS: 17616 WEST VALLEY HY X Original Plan Submittal Response to Incomplete Letter # DATE: 07 -21 -10 Response to Correction Letter # Revision # After Permit Issued DEPARTT�MWENTS: li ding Divis on Public Works ❑ Fire Prevention Structural n Planning Division n Permit Coordinator n DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Comments: Incomplete DUE DATE: 07 -22 -10 Not Applicable Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES /THURS ROUTING: Please Route Structural Review Required ❑ No further Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved Approved with Conditions Notation: REVIEWER'S INITIALS: DUE DATE: 08-19-10 Not Approved (attach comments) n DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents /routing slip.doc 2 -28 -02 Contractors or Tradespeople enter Friendly Page 1 General /Specialty Contractor A business registered as a construction contractor with L &I to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name Phone Address Suite /Apt. City State Zip County Business Type Parent Company WALTS GAS PIPING SERVICE 2538412171 11202 74Th Ave E Puyallup WA 98373 Pierce Individual UBI No. 602333203 Status Active License No. WALTSGP970PS License Type Construction Contractor Effective Date 10/10/2003 Expiration Date 7/16/2012 Suspend Date Specialty 1 General Specialty 2 Unused Business Owner Information Name Role Effective Date Expiration Date MILEWSKI, WALTER Owner 10/10/2003 Bond Amount Bond Information Page 1 of 2 Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 4 American Contractors Indem CO 100054359 09/15/2008 Until Cancelled $12,000.0009/17 /2008 3 AMERICAN CONTRACTORS INDEM 100025752 05/15/2007 Until Cancelled 08/07/2008 $6,000.0007/02/2007 05/14/2009 2 PLATTE RIVER INS CO 41066215 05/15/2006 Until Cancelled 05/18/2007 $6,000.0006/02/2006 1 CBIC SF2248 10/07/2003 Until Cancelled 04/27/2005 10/12/2005 $6,000.0010/10/2003 Assignment of Savings Information No records found for the previous 6 year period Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date 6 WESTERN HERITAGE INS CO SCP0802089 04/30/2010 04/30/2011 $1,000,000.00 04/30/2010 5 ATLANTIC CAS INS CO L065007236 05/15/2009 05/15/2010 51,000,000.00 05/14/2009 4 PENN -STAR INS PAC561115 05/15/2008 05/15/2009 $1,000,000.0005 /27/2008 3 PENN -STAR INS CO PAC561115 05/15/2006 05/15/2008 $1,000,000.0005 /22/2007 2 CBIC INSSF2248 10/07/2004 10/07/2005 02/07/2005 $900,000.0009/20 /2004 1 CBIC SC2248 10/07/2003 10/07/2004 $300,000.0010/10 /2003 Summons /Complaint Information Cause County Complaint Judgment Status Payment Paid By 05 -2- 18149 -4 THERMAL SUPPLY INC InterPlead: No KING Date: 06 /02/2005 Amount: $6,458.74 Date: Amount: 50.00 Open Date: 10/12/2005 Amount: $4,000.00 Bond https://fortress.wa.gov/lni/bbip/Print.aspx 08/18/2010 at-it VF(lticL N&W NLrT&R f 5E PIPC: /f1AI Ep iww...A..aw...w.Awe. N GW G- A.S a'` G- 1tos6``1prtqL 7t I4'6'` �OO)QOo GAS ° (NEI\ '1'6" ViCrik t �l 6" IOROO t ni PIPE Lay Up Room., Server`s Pantry Storage %•Jk/�MV•iNNh�� W.MIMMA�WAHN.V1N '!�iY- M11�bNHAHjiAiMWIMk#.h Vo~ .......+.rwiwwvw....w..n a D w000irrio 04::=31. a►F L •. _ ....Mwv • a •A•....w..••••••••■ No changes shall be €made to the sc ope of work without prior approval of Tukwila Building Division. NOTE: Revisions will require a new plan submittal and may include additional plan review fees. FILE COPY 08 7 Permit No. Plan review approval is subject to errors and omissions. Approval of construction documents does not authorize I i violation of any adopted code or ordinance. Receipt rif approved Field Copy and conditions is acknowledged: By Date: City Of Tukwila BUILDING DIVISION SEPARATE PERMIT REQUIRED FOR: &Mechanical arElectrical Crumbing ❑ Gas Piping City of Tukwila E DIVISION r EVIEWED FOR DE COMPLIANCE m� '�Vl 1Uu 05 2Q1Q City of Tukwila UILDING DI \I'ISIMI 1 i ?Gtoo87 • . •4401Y..M AIM.WM s.. to, . u. 44 J .4 •.• • 144 ..•.. s. N RECEIVED JUL 212010 PERMIT CENTER