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Home My WebLink AboutPermit PG10-126 - JACOBSEN RESIDENCEJACOBSEN RESIDENCE 12065 44 AV S PG1O-126 City AI/Tukwila 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 Parcel No.: 3347400410 Address: 12065 44 AV S TUKW Project Name: JACOBSEN RESIDENCE PLUMBING /GAS PIPING PERMIT Permit Number: PG10 -126 Issue Date: 09/15/2010 Permit Expires On: 03/14/2011 Owner: Name: JACOBSEN SAMUEL F +BETTY J Address: 12065 44TH AVE S , SEATTLE WA 98178 Contact Person: Name: NAIDA KHAN Address: 1345 GULF RD , POINT ROBERTS WA 98281 Email: NAIDA@NWPERMIT.COM Contractor: Name: WASHINGTON ENERGY SERVICES CO Address: 2800 THORNDYKE AVE W , SEATTLE, WA 98199 Contractor License No: WASHIES9710B Phone: 360 - 945 -2787 Phone: 206 282 -4200 Expiration Date: 09/02/2011 DESCRIPTION OF WORK: REPLACE 40 GALLON WATER HEATER Value of Plumbing /Gas Piping: $1,000.00 Uniform Plumbing Code Edition: 2009 Fees Collected: $47.25 International Fuel Gas Code Edition: 2009 Permit Center Authorized Signature: Date: 9- (s -io 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 the performance of work. I am authorized to sign and obtain this plumbing /gas piping permit. Signature: < ; J ' Date: a e /lJ Print Name: /'D/ 5 7L,; rK 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 -126 Printed: 09 -15 -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.: 3347400410 Address: Suite No: Tenant: 12065 44 AV S TUKW JACOBSEN RESIDENCE PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: PG10 -126 ISSUED 09/15/2010 09/15/2010 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: No water, soil, or waste pipe shall be installed or permitted outside of a building or in an exterior wall unless, adequate provision is made to protect such pipe from freezing. All hot and cold water pipes installed outside the conditioned space shall be insulated to minimum R -3. 8: Plastic and copper piping running through framing members to within one (1) inch of the exposed framing shall be protected by steel nail plates not less than 18 guage. 9: Piping through concrete or masonry walls shall not be subject to any load from building construction. No plumbing piping shall be directly embedded in concrete or masonry. 10: All pipes penetrating floor /ceiling assemblies and fire - resistance rated walls or partitions shall be protected in accordance with the requirements of the building code. 11: Piping in the ground shall be laid on a firm bed for its entire length. Trenches shall be backfilled in thin layers to twelve inches above the top of the piping with clean earth, which shall not contain stones, boulders, cinderfill, frozen earth, or construction debris. 12: The issuance of a permit or approval of plans and specifications shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the Plumbing Code or Fuel Gas Code or any other ordinance of the jurisdiction. * *continued on next page ** doc: Cond -10/06 PG10 -126 Printed: 09 -15 -2010 • • City of Tukwila 3t y 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: 5;r /k Date: doc: Cond -10/06 PG10 -126 Printed: 09 -15 -2010 CITY OF TUKWIL• Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 hi/pi/141m. ci. tuk o'ila. wa. us Building Pen No. Mechanical Permit No. Plumbing /Gas Permit No. ? 610- l Public Works Permit No. Project No. (For office use only) Applications and plans must be complete in order to be accepted for plan review. Applications will not be accepted through the mail or by fax. * *Please Print ** SITE LOCATION Site Address: 12065 44TH AVE S Tenant Name: King Co Assessor's Tax No.: 3347400410 Suite Number: Floor: New Tenant: ❑ Yes ❑..No Property Owners Name: SAM JACOBSEN Mailing Address: 12065 44TH AVE S TUKWILA City WA State 98178 Zip CONTACT PERSON — who do we contact when your permit is ready to be issued Name: Naida Khan /Northwest Permit Inc Day Telephone: 360- 945 -2787 Mailing Address: 1345 GULF RD Point Roberts WA 98281 City E -Mail Address: naida @nwpermit.com State Zip Fax Number: 360- 945 -2091 GENERAL CONTRACTOR INFORMATION — (Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5)) Company Name: Mailing Address: City State Zip Day Telephone: 800- 398 -4463 Fax Number: Expiration Date: Contact Person: E -Mail Address: Contractor Registration Number: ARCHITECT OF RECORD — All plans must be wet stamped by Architect of Record Company Name: Mailing Address: Contact Person: E -Mail Address: City Day Telephone: Fax Number: State Zip ENGINEER OF RECORD — All plans must be wet stamped by Engineer of Record Company Name: Mailing Address: Contact Person: E -Mail Address: Q: Applications\Forms- Applications On Line\3 -2006 - Permit Application.doc Revised: 9 -2006 bh City Day Telephone: Fax Number: State Zip Page 1 of 6 PLUMBING AND GAS PIPIN(SRMIT INFORMATION - 206 - 431.70 PLUMBING AND GAS PIPING CONTRACTOR INFORMATION Company Name: WESCO Mailing Address: 2800 Thorndyke Avenue W Contact Person: NAIDA KHAN Seattle WA 98199 City State Day Telephone: 360- 945 -2787 E -Mail Address: Fax Number: Expiration Date: 09/02/11 Contractor Registration Number: WAS H I ES971 OB Zip Valuation of Plumbing work (contractor's bid price): $ :'� !/ 000 Valuation of Gas Piping work (contractor's bid price): $ Scope of Work (please provide detailed information): REPLACE 40 GALLON GAS WATER HEATER Building Use (per Int'l Building Code): Residential Occupancy (per Intl Building Code): Utility Purveyor: Water: Sewer: Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below: Fixture Type: Qty Fixture Type: Qty Fixture Type: Qty Fixture Type: Qty Bathtub or combination bath /shower Drinking fountain or water cooler (per head) Wash fountain Gas piping outlets Bidet Food -waste grinder, commercial Receptor, indirect waste Clothes washer, domestic Floor drain Sinks Dental unit, cuspidor Shower, single head trap Urinals Dishwasher, domestic, with independent drain Lavatory Water Closet Building sewer or trailer park sewer Rain water system — per drain (inside building) Water heater and /or vent ,) Additional medical gas inlets /outlets — six or more Industrial waste pretreatment interceptor, including its trap and vent, except for kitchen type grease interceptors Repair or alteration of water piping and/or water treating equipment Repair or alteration of drainage or vent piping Medical gas piping system serving one to five inlets /outlets for specific gas Q:\Applications \Forms - Applications On Line\3 -2006 - Permit Application.doc Revised: 9 -2006 bh Page 5 of 6 PERMIT APPLICATION NOTES — Applicable to all permits in this application Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject to possible revision by the Permit Center to comply with current fee schedules. Expiration of Plan Review — Applications for which no permit is issued within 180 days following the date of application shall expire by limitation. Building and Mechanical Permit The Building Official may grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition). Plumbing Permit The Building Official may grant one extension of time for an additional period not exceeding 180 days. The extension shall be requested in writing and justifiable cause demonstrated. Section 103.4.3 Uniform Plumbing Code (current edition). 1 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 1 AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OW R OR AI,f// JTHORI ED A ENT: Signature: 1- Date: �+t� G/ / Si (WO Print Name: Naida Khan /Northwest Permit Inc Day Telephone: 365 -94 -2787 Mailing Address: 1345 Gulf Road Point Roberts WA 98281 City State Zip IDate Application Accepted: Date Application Expires: Staff Initials: Q:\Applications \Forms- Applications On Line' -2006 - Permit Application.doc Revised: 9 -2006 bh Page 6 of 6 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 Parcel No.: 3347400410 Address: 12065 44 AV S TUKW Suite No: Applicant: JACOBSEN RESIDENCE RECEIPT Permit Number: Status: Applied Date: Issue Date: PG10 -126 ISSUED 09/15/2010 09/15/2010 Receipt No.: R10 -01831 Initials: WER User ID: 1655 Payee: Payment Amount: Payment Date: Balance: $47.25 09/15/2010 08:48 AM $0.00 WASHINGTON ENERGY SERVICES TRANSACTION LIST: Type Method Descriptio Amount Payment Check Authorization No. ACCOUNT ITEM LIST: Description 6643 47.25 Account Code Current Pmts PLUMBING - RES 000.322.103.00.00 Total: $47.25 47.25 PAYMENT RECEIVED don- Raraint -nA Printarl. nq -15 -2010 G 0 1 INSPECTION RECORD 6 i--- Retain a. copy with permit P6/0-72 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 Project: . ,,`M46.o1.\) /?c°S Type of Inspection: I_,n/t/- 1 -'/2e "4 .6 • /.. D 65 Address: yc/ f9/ S Date C d� ji Special Instructions: Date Wanted: . a.m.. Requester: Phone No: .2e6 -33/ -7781 Approved per applicable codes. O Corrections required prior to approval. COMMENTS: erk Inspecto( 1 r i ,AA'ct 1j :A Date•) n REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. 02 -01 -2011 City of Tukwila Jim Haggerton, Mayor Department of Community Development Jack Pace, Director NAIDA KHAN 1345 GULF RD POINT ROBERTS WA 98281 RE: Permit No. PG10 -126 12065 44 AV S TUKW Dear Permit Holder: In reviewing our current records, the above noted permit has not received a final inspection by the City of Tukwila Building Division. Per the International Building Code, International Mechanical Code, Uniform Plumbing Code and /or the National Electric Code, every permit issued by the Building Division under the provisions of these codes shall expire by limitation and become null and void if the building or work authorized by such permit has not begun within 180 days from the issuance date of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work has begun for a period of 180 days. Your permit will expire on 03/14/2011. Based on the above, you are hereby advised to: 1) Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 to schedule for the next or final inspection. Each inspection creates a new 180 day period, , provided the inspection shows progress. -or- 2) Submit a written request for permit extension to the Permit Center at least seven (7) days before it is due to expire. Address your extension request to the Building Official and state your reason(s) for the need to extend your permit. The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is determined that your extension request is granted, you will be notified by mail. In the event you do not call for an inspection and /or receive an extension prior to 03/14/2011, your permit will become null and void and any further work on the project will require a new permit and associated fees. Thank you for your cooperation in this matter. Sincerely, Bill Rambo Permit Technician File: Permit File No. PGIO -126 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 Contractors or Tradespeople Printer Friendly Page General /Specialty Contractor A business registered as a construction contractor with Lftl 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 WASHINGTON ENERGY SERVICES CO UBI No. 602320560 Phone 2062824700 Status Active Address 2800 Thorndyke Ave W License No. WASHIES971OB Suite /Apt. License Type Construction Contractor City Seattle Effective Date 9/2/2003 State WA Expiration Date 9/2/2011 Zip 98199 Suspend Date County King Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Business Owner Information Name Role Effective Date Expiration Date OLSON, CRAIG President 09/02/2003 Amount HEAGLE, RANDY Secretary 09/02/2003 000259901 CHRISTIANSON, STEVE Treasurer 09/02/2003 OLSON, VERN Vice President 09/02/2003 Ironshore Specialty Ins Co 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 1 DEVELOPERS SURETY Et INDEM CO 571389C 08/29/2003 Until Cancelled $12,000.00 09/02/2003 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 8 IRONSHORE SPECIALTY INS CO 000259901 05/01 /2010 05/01 /2011 $1,000,000.0004 /30/2010 7 Ironshore Specialty Ins Co 00G4H0905001 05/01/2009 05/01/2010 $1,000,000.0004 /29/2009 6 UNITED SPECIALTY INS AGL0810381 05/01 /2008 05/01 /2009 $1,000,000.0004 /30/2008 5 UNDERWRITERS AT LLOYDS CJ0749013 05/01/2007 05/01/2008 $1,000,000.00 04 /27/2007 4 UNDERWRITERS AT LLOYDS CJ0677036 05/01 /2006 05/01 /2007 $1,000,000.0004 /28/2006 3 UNDERWRITERS AT LLOYDS CJ0583038 05/01/2005 05/01/2006 51,000,000.0004 /27/2005 2 LLOYDS OF LONDON CJ0426061 04/01/2004 05/01/2005 $1,000,000.0004 /13/2004 Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period Warrant Information No unsatisfied warrants on file within prior 6 year period Infractions /Citations Information Infraction / Citation 1 Date 1 RCW Code I Type 1 Status I Violation Amount https://fortress.wa.gov/lni/bbip/Print.aspx 09/15/2010