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Home My WebLink AboutPermit PG10-136 - GROUP HEALTHGROUP HEALTH 12400 EAST MARGINAL WY S PG1O-136 City. oftukwila 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.: 7340600480 Address: 12400 EAST MARGINAL WY S TUKW Project Name: GROUP HEALTH Permit Number: PG10 -136 Issue Date: 10/06/2010 Permit Expires On: 04/04/2011 Owner: Name: ANNE ARUNDEL APARTMENTS LLC Address: 10 W MARKET -1200 MARKET TOWE , INDIANAPOLIS IN 46204 Contact Person: Name: BUD KLOSTERMAN Address: 8706 S 222 ST , KENT WA 98031 Email: BUD @STATEMECH.NET Contractor: Name: STATE MECHANICAL COMPANY Address: 600 INDUSTRY DR 8 , TUKWILA WA 98188 Contractor License No: STATEMC 141 C7 Phone: 206 - 575 -7527 Phone: Expiration Date: 09/01/2011 DESCRIPTION OF WORK: INSTALL ONE TRAP PRIMER TO EXISTING FLOOR DRAIN Value of Plumbing /Gas Piping: $700.00 Fees Collected: $47.25 International Fuel Gas Code Edition: 2009 Uniform Plumbing Code Edition: 2009 Permit Center Authorized Signature: Date: ( 0 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 th_ performance of work. I am aut s orized to sign and obtain this plumbing /gas piping permit. / 6 6 / l Date: "- Signature. Print Name: CJ Q (Gc—G rtr-e -fV'} jJ 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 -136 Printed: 10 -06 -2010 • City of Tukwila ti � 2 De P artment of Community Development y 6300 Southcenter Boulevard, Suite #100 r �� Tukwila, Washington 98188 Phone: 206-431-3670 Fax: 206 - 431 -3665 Web site: http://www.ci tukwi la. wa. us Parcel No.: Address: Suite No: Tenant: PERMIT CONDITIONS 7340600480 12400 EAST MARGINAL WY S TUKW GROUP HEALTH Permit Number: Status: Applied Date: Issue Date: PG10 -136 ISSUED 09/29/2010 10/06/2010 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 -136 Printed: 10 -06 -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 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. Signature: Print Name: oi-rne4lei Date: 76/(o ordinances governing or local laws regulating doc: Cond -10/06 PG10 -136 Printed: 10 -06 -2010 CITY OF TUKWILIII Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http: / /www.ci. tukwila. wa. us Building Permit No. Mechanical Permit No. Plumbing/Gas Permit No. G (- `3 e 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 E (` •• '' King Co Assessor's Tax No.: 1'34 062 (O4 Site Address: 12_ -uu E 100 �RQ '' C liV 4 l; WR y S Suite Number: Floor: c i\ 2 (. c,. Pre_c.t-ku c_ Tenant Name: 6'� J 4 Property Owners Name: Mailing Address: New Tenant: E Yes la.. No City State Zip CONTACT PERSON - who do we contact when your permit is ready to be issued Name: TBUV Los- rcQ.sflA lJ Mailing Address: g70 GQ S Z7 21J jv (St.@ 124- E -Mail Address: Day Telephone: ZO Co — 5-75 - 5 -2.. —7 City l.J€ 9 R0 s1 State Zip Fax Number: GENERAL CONTRACTOR INFORMATION — (Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5)) Company Name: Mailing Address: Contact Person: E -Mail Address: Contractor Registration Number: City Day Telephone: Fax Number: Expiration Date: State Zip ARCHITECT OF RECORD - All plans must be wet stamped by Architect of Record Company Name: Mailing Address: City Contact Person: Day Telephone: E -Mail Address: Fax Number: State Zip ENGINEER OF RECORD - All plans must be wet stamped by Engineer of Record Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: Q:\ApplicationsWorms- Applications On Line\3 -2006 - Permit Application.doc Revised: 9 -2006 bh Page 1 of 6 PLUMBING AND GAS PIPING PERMIT INFORMATION - 206 - 431 -3670 PLUMBING AND GAS PIPING CONTRACTOR INFORMATION Company Name: ' i Pft n/16-044a Mailing Address: g t7 000 S Z2 2)4E' S7- IL & T (Al P gd3I City State Zip Contact Person: Bu'D1 (e_L.0� S 1-62al ( N Day Telephone: 2-06— 57$ - 75 Z 7 E -Mail Address: C) cJ. u @ S Fax Number: 2-c - 575 -75 Z� Contractor Registration Number: ,TAT—C., NI C 1 (j/ - Expiration Date: Valuation of Plumbing work (contractor's bid price): $ %o Valuation of Gas Piping work (contractor's bid price): $ P n Scope of Work (please provide detailed information): �+JSt j-t- ,-(A/ -) dM C P -PRi /l && Td G X I ST ( k1 G, Pc-Oc) Q t7 2A I n1 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: 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 1-11-49-P P(ZUV�EIZ 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: WpplicationsWorms- Applications On tineN3-2006 - 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). 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 1 AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNER OR AUTHORIZED AGENT: Signature: Print Name: EBM Mailing Address: 1 7I . S Z NC) Date: /0/6-7-/ Day Telephone: 2-07- 575 ` 7527 4 City State Zip Date Application Accepted: Date Application Expires: Staff Initials: Q:\ApplicationsWorms- Applications On lined -2006 - Permit Application.doc Revised: 9 -2006 bh Page 6 of 6 • 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.: 7340600480 Permit Number: PG 10 -136 Address: 12400 EAST MARGINAL WY S TUKW Status: PENDING Suite No: Applied Date: 09/29/2010 Applicant: GROUP HEALTH Issue Date: Receipt No.: R10 -01999 Initials: WER User ID: 1655 Payment Amount: $47.25 Payment Date: 10/06/2010 02:50 PM Balance: $0.00 Payee: STATE MECHANICAL CO TRANSACTION LIST: Type Method Descriptio Amount Payment Check 28284 47.25 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts PLUMBING - NONRES 000.322.103.00.00 47.25 Total: $47.25 doc: Receiot -06 Printed: 10 -06 -2010 7__- -- 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 4L ft/D-13(„ Pro ct: Type of Inspe tion: Address: )2110 6) C. /41404/A,41 Date Called: ' -) p � / /—/ Special Instructions: Date Wanted: a-x Requester: Vo: // p b ,. 7i 1, -b4 Approved per applicable codes. Corrections required prior to approval. COMMENTS: (tcrwt P ide /J „v l ri.00 REINSPECTI('N FEE REQUIR D. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: Date: INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. PG(0�d3� CITY OF TUKWILA BUILDING DIVISION , 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 433670 Permit Inspection Request Line (206) 431 -2451 Pro'ect: Id , -- Ty e of Inspection: f�.�� - P�� X13 dress: t 24 a c) ,_-1,, 44A/6 . "4 -L.- Date Called: -- Special Instructions: ) (/ / e C. S1 - �' 0I.`c'` / Date Wanted: r 7 - ( ° a.m. Requester: Phone No /,40 (- --?(E( -6130--C Approved per applicable codes. El Corrections required prior to approval. /( COMMENTS: Insctor: Date: 1 0-- n REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Contractors or Tradespeople Pf ter Friendly Page • 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 STATE MECHANICAL COMPANY 2065757527 600 Industry Dr 8 Tukwila WA 98188 King Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 600611697 Active STATEMC141C7 Construction Contractor 2/27/1986 9/1/2011 Plumbing Unused Other Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status DESIGM'110NQDESIGN MECHANICAL Construction Contractor Boiler /Steam Fit /Proc Piping plumbing 8/18/1989 8/17/1993 Archived RXHCO "'121NARXH COMPANY Construction Contractor Plumbin g Boiler /Steam Fit /Proc Piping 8/1/1988 7/27/1999 Archived GERRICI163B3 GERRIK COMPANY INC Construction Contractor General Unused 1/23/1984 1/9/1991 Archived Business Owner Information Name Role Effective Date Expiration Date PLATZ, GREG D Cancel Date 01/01/1980 Amount DEWITT, RALPH E 21 01/01/1980 GL1650262 Bond Information Page 1 of 1 Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 3 TRAVELERS CAS & SURETY CO 200686359 07/27/2001 Until Cancelled $6,000.00 08/14/2001 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 21 COLONY INS CO GL1650262 06/02/2010 06/02/2011 $1,000,000.0009 /16/2010 20 COLONY INS CO GL1650261 06/02/2008 06/02/2011 $1,000,000.0005 /06/2010 19 FIRST MERCURY INS CO FMFL001801 06/02/2006 06/02/2008 $1,000,000.00 05/09/2007 18 NORTH AMERICAN CAPACITY PNG100046600 06/02/2006 06/02/2007 $1,000,000.00 05/25/2006 17 CO LEXINGTON INS 1143373 A 06/02/2004 06/02/2006 $1,000,000.0005 /19/2005 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 https://fortress.wa.gov/lni/bbip/Print.aspx 10/06/2010