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HomeMy WebLinkAboutPermit PG10-158 - 6840 BUILDING - VACANT SPACEVACANT SPACE 6840 FORT DENT WY PG1O-158 City oilkukwila 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.: 2954900425 Address: 6840 FORT DENT WY TUKW Project Name: VACANT SPACE Permit Number: PG10 -158 Issue Date: 12/03/2010 Permit Expires On: 06/01/2011 Owner: Name: PEPPERWOOD HOLDINGS LLC Address: 2835 82ND AVE SE #300 , MERCER ISLAND WA 98040 Contact Person: Name: RICK MOORE Address: 7501 2 AV S , SEATTLE WA 98108 Email: RICKM @FOXPH.COM Contractor: Name: Address: Contractor License No: Phone: 206 - 767 -3311 Phone: Expiration Date: DESCRIPTION OF WORK: INSTALL WASTE, WATER & VENT FOR A BREAK ROOM KITCHEN SINK. INSTALL A 25 GALLON 120V ELECTRIC WATER HEATER. INSTALL A TRAP PRIMER WITH FUNNEL CUP DRAIN - INDIRECT FORT & P OF NEW WATER HEATER. Value of Plumbing /Gas Piping: $5,700.00 Uniform Plumbing Code Edition: 2009 Fees Collected: $154.88 International Fuel Gas Code Edition: 2009 Permit Center Authorized Signature: Ltxx; Date: I 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 construction or the perf on the back of this p Signature: Print Name: presume to give a ority to violate or cancel the provisions of any other state or local laws regulating I am a tho d to si and obtain this plumbing /gas piping permit and agree to the conditions Date: 4? _3 _ .2oL This permit shall become null and void if the work is not commenced within ldays 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 -158 Printed: 12 -03 -2010 • • PERMIT CONDITIONS Permit No. PG10 -158 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: All new plumbing fixtures installed in new construction and all remodeling involving replacement of plumbing fixtures and fittings in all residential, hotel, motel, school, industrial, commercial use or other occupancies that use significant quantities of water shall comply with Washington States Water Efficiency and Conservation Standards in accordance with RCW 19.27.170 and the 2006 Uniform Plumbing Code Section 402 of Washington State Amendments. 13: 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: UPC -4/10 PG 10 -158 Printed: 12 -03 -2010 CITY OF TUKWILA Department Developm epartment Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us Plumbing/GasQrmit No. l 10 '1 sr Project No. "" "(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 ** SITE LOCATION Site Address: Co 0 �/ j)1�%- Gtl%ty King Co Assessor's Tax No.: )4s q' t' v 6 14) Floor: Suite Number: Tenant Name: New Tenant: ❑ Yes 4.. No Property Owners Name: ,. J /Z Mailing Address: A / d / k City State Zip CONTACT PERSON - Who do we contact when your permit is ready to be issued Name: ,/< /C, /92074-7- �j Mailing Address: /(=7/ �4 E �' E -Mail Address: /S /C/L //'% 6) J /3L COP91 Day Telephone: '2 ' /— 33/1 City n t� State Zip Fax Number: o� t� /� - 4.5-6217/ PLUMBING / GAS PIPING CONTRACTOR INFORMATION Company Name: L K �G%�iyY16'4 ter Mailing Address: �75 O/ � L� L)F S . Contact Person: 7'QL /0/904-C-- E -Mail Address: /C/2/91 ' X'Q'1• Q��J Contractor Registration Number: FOXP'f6 /11.37 Gt%2 - S! City/ Day Telephone: t/;&-- State Zip Fax Number: - r7 6 E - 56 v Expiration Date: ARCHITECT OF RECORD - All plans must be 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 stamped by Engineer of Record Company Name: Mailing Address: City Contact Person: Day Telephone: E -Mail Address: Fax Number: State Zip H:\Applications\Forms- Applications On Line\2010 Applications \7 -2010 - Plumbing -Gas Piping Permit Application.doc Revised: 7 -2010 bh Page 1 of 2 0 Valuation of Project (contractor's bid prig" $ (51709 ` O� Scope of Work (please provide detailed information): //) GC -.A-4 - 57? J ‘1997-47 /20 �! G�Z�� �e 70A.. �;v,5j2 %'W 0 //nL-,2 Gt1 /?/ F2- .01W- - O //)),t) F972- % t- 2 OF AX-z-J 4515W- 110.95-27r S Building Use (per Int'l Building Code): Occupancy (per Int'l 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 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 PERMIT APPLICATION NOTES - Value of Construction — In all cases, ayalue of construction amount should be entered by the applicant. This figure will be reviewed and is subject to possible revision by the Permit Ceder to comply with current fee schedules. Expiration of Plan Review 7 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. BUI NG OWN , ' OR AUTHOR D AGENT: Signatur Print Name: C / C/2 Mailing Address: 1-7‘.67/ ' A 9, & - 5 917 _cJ 9 ? /6,5) City / State Zip Date: // /a9 Day Telephone: o-5� Date Application Accepted: 11-1-7-rd Date Application Expires: H:Wpplications\Forms- Applications On Line\2010 Applications \7 -2010 - Plumbing -Gas Piping Permit Application.doc Revised: 7 -2010 bh Staff Initials: I4fi Page 2 of 2 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.: 2954900425 Address: 6840 FORT DENT WY TUKW Suite No: Applicant: VACANT SPACE RECEIPT Permit Number: PG10 -158 Status: APPROVED Applied Date: 11/17/2010 Issue Date: Receipt No.: R10 -02428 Initials: WER User ID: 1655 Payment Amount: $123.90 Payment Date: 12/03/2010 01:09 PM Balance: $0.00 Payee: FOX PLUMBING & HEATING TRANSACTION LIST: Type Method Descriptio Amount Payment Check 47947 123.90 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts PLUMBING - NONRES 000.322.103.00.00 123.90 Total: $123.90 doc: Receiot -06 Printed: 12 -03 -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.: 2954900425 Address: 6840 FORT DENT WY TUKW Suite No: Applicant: VACANT SPACE RECEIPT Permit Number: PG10 -188 Status: PENDING Applied Date: 11/17/2010 Issue Date: Receipt No.: R10 -02338 Initials: WER User ID: 1655 Payment Amount: $30.98 Payment Date: 11/17/2010 03:59 PM Balance: $123.90 Payee: FOX PLUMBING & HEATING TRANSACTION LIST: Type Method Descriptio Amount Payment Check 47918 30.98 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts PLAN CHECK - NONRES 000.345.830 30.98 Total: $30.98 doe: Receipt -06 Printed: 11 -17 -2010 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 F6t0 -l. Project: Type of Inspection: Address: 0 (314 0 FOR T ►..r1-- U. Date Called: L Special Instructions: Da Wanted: —t,— i \ /�r� •pill. Requester: Phone No: _ a b l, - 355-17 & t Approved per applicable codes. ElCorrections required prior to approval. Date: n R ItISPECTION FEE EQUIR Prior to n xt inspection, fee must be p jd at 6300 Southcenter Blvd uite 100. Da 11 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 Pro ect.: ` j i JPA-Ge Type of Inspection: A , �t g J J G it -t-P-' I °�- Address: Date Iled: Special Instructions: 0.'1.33 - cJ(' - � � 0 � Date Wanted: a.m. i2--f-7-10 (7 Requester: Phone No: f -- � ��� '?8tio rO_ 1 Approved per applicable codes. El Corrections required prior to- approval. COMMENTS: Inspetor: Date: ! 1/0 n REINSP CTION FEE REQOIRED. Priorto next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. • City of f 7'uPwila Jim Haggerton, Mayor Department of Community evelopment Jack Pace, Director November 19, 2010 Rick Moore Fox Plumbing 75012 "1AvS Seattle, WA 98108 RE: Letter of Incomplete Application # 1 Plumbing /Gas Piping Permit Application PG10 -158 Vacant Space — 6840 Fort Dent Wy Dear Mr. Moore, This letter is to inform you that your permit application received at the City of Tukwila Permit Center on November 17, 2010 is determined to be incomplete. Before your application can continue the plan review process the attached /following items from the following department(s) need(s) to be addressed: Public Works Department: Dave McPherson at 206 431 -2448 if you have any questions concerning the attached comment. Please address the comment above in an itemized format with applicable revised plans, specifications, and /or other documentation. The City requires that two (2) sets of revised plans, specifications and /or other documentation be resubmitted with the appropriate revision block. In order to better expedite your resubmittal a Revision Submittal Sheet must accompany every resubmittal. I have enclosed one for your convenience. Revisions must be made in person and will not be accepted through the mail or by a messenger service. If you have any questions, please contact me at the Permit Center at (206) 431 -3670. Bill Rambo Permit Technician Enclosures File: PG10 -158 W:\Permit Center \Incomplete Letters\20I0\PG10 -158 Incomplete Ltr #1.DOC 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 DATE: PROJECT: PERMIT NO: CITY OF TUKWILA PUBLIC WORKS DEPARTMENT / REVIEW COMMENTS www.ci.tukwila.wa.us Development Guidelines and Design and Construction Standards November 18, 2010 Vacant Space 6840 Fort Dent Way PG10 -158 PLAN REVIEWER: Contact David McPherson at (206) 431 -2448, if you have any questions /comments regarding the following comment. dmcpherson(ci.tukwila.wa.us 1. Please provide a completed King County Metro Non - Residential Sewer Use Certificate form, listing only the new plumbing fixtures and not any existing or those being replaced -in -kind. (See enclosed form) 41PERMITCOORDCOPY PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG10 -158 DATE: 11/22/10 PROJECT NAME: VACANT SPACE SITE ADDRESS: 6840 FORT DENT WY Original Plan Submittal X Response to Incomplete Letter # 1 Response to Correction Letter # Revision # after Permit Issued DEPARTMENTS: Building Division NN�►_ %\-;1--1,0 Pudic WA/irks Fire Prevention Structural Planning Division n UPermit Coordinator ❑ DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Ei Comments: Incomplete ❑ DUE DATE: 11/23/10 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: Building Please Route k Structural Review Required ❑ No further Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved ❑ Approved with Conditions Notation: REVIEWER'S INITIALS: DUE DATE: 12/21/10 Not Approved (attach comments) ❑ DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents/routing slip.doc 2 -28 -02 • • K . (4, OCOPY PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG10 -158 DATE: 11 -17 -10 PROJECT NAME: VACANT SPACE SITE ADDRESS: 6840 FORT DENT WY X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # After Permit Issued DEPARTMENTS: fS c * \`9-D Building Division igro ublic 1, orks Fire Prevention Structural Planning Division Permit Coordinator U DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 11-18-10 Complete n Incomplete Not Applicable n Comments: Permit Center Use Only INCOMPLETE LETTER MAILED: I 1-19— — LETTER OF COMPLETENESS - MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW.cStaff Initials: �`^���ir[/� TUES /THURS ROUTING: Please Route Structural Review Required REVIEWER'S INITIALS: ❑ No further Review Required DATE: n APPROVALS OR CORRECTIONS: DUE DATE: 12 -16 -10 Approved n Approved with Conditions n Not Approved (attach comments) n Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents /routing slip.doc 2 -28 -02 S City of Tukwila Steven M. Mullet, Mayor 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 REVISION SUBMITTAL Steve Lancaster, Director Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Plan Check/Permit Number: PG 10-15 8 ® Response to Incomplete Letter # 1 ❑ Response to Correction Letter # ❑ Revision # after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner Project Name: Vacant Space Project Address: 6840 Fort Dent Wy n �F� to NOV 22 2010 PERMIT CENTER Contact Person: igi ME�7 MEW* Phone Number: 2 126'7- 33/ Summary of Revision: Sheet Number(s): "Cloud" or highlight all areas of revision including date of revision Received at the City of Tukwila Permit Center by: [ Entered in Permits Plus on V2--1 1 \applications \forms- applications on line\revision submittal Created: 8 -13 -2004 Revised: IA King County Department of Natural Resources and Parks Wastewater Treatment Division Non - Residential Sewer Use Certification • To be completed for all new sewer connections, reconnections or change of use of existing connections. • This form does not apply to repairs or replacements of existing sewer connections within five years of disconnect. Please Print or Type Pr ert Street Address ' Fr uot City State ZIP t/4:4- 610- 9 &/ F'Y Owner's Name For King County. Only Account # No. of RCEs Monthly Rate Property Tax ID # P` /5 v20 04 Party to be Billed (if different from owner) Subdivision Name Lot # City or Sewer District Subdiv. # Block # Date of Connection Building Name Side Sewer Permit # (if applicable) Please report any demolitions of pre- existing building on this property. Owner's Phone Number (with Area Code) Credit for a demolition may be given under some circumstances. Demolition of pre- existing building? Q Yes rANo ( ) Was building on Sanitary Sewer? Yes . ❑ No Property Contact Phone Number (with Area Code) Was Sewer connected before 2/1/90? 'Yes ❑ No Owner's Mailing Address Sewer disconnect date: Type of building demolished? Request to apply demolition credit to multiple buildings? ❑ Yes ❑ No A. Fixture Units Fixture Units x Number of Fixtures = Total Fixture Units Kind of Fixture Fixture Units No. of Fixtures Total Fixture Units Public Private Public Private Bathtub and Shower 4 4 Shower, per head 2 2 Dishwasher 2 2 Drinking fountain (each head) 1 .5 Hose bibb (interior) 2.5 2.5 Clotheswasher or laundry tub 4 2 Sink, bar or lavatory 2 1 Sink, Clinic flushing 8 8 Sink, kitchen 3 2 3 Sink, other (service) 3 1.5 Sink, wash fountain, circle spray 4 3 Urinal, flush valve, 1 GPF 5 2 Urinal, flush valve, >1 GPF 6 2 Urinal, waterless 0 0 Water closet, tank or valve, 1.6 GPF 6 3 Water closet, tank or valve, >1.6 GPF 8 4 Total Fixture Units Residential Customer Equivalent (RCE) 20 fixture units equal 1.0 RCE Total No. of Fixture Units 20 •25 RCE B. Other Wastewater Flow (in addition to Fixture Units identified in Section A) Type of Facility /Process: Estimated Wastewater Discharge: Gallons /days Residential Customer Equivalents (RCE): 187 gallons per day equals 1.0 RCE Total Discharge (gal /day) _ 187 C. Total Residential Customer EquivaR OEIVED (add A & B) CITY OF TUKWILA NOV 2 2 2010 PERMIT CENTER RCE AcTho �sg Pursuant to King County Code 28.84, all sewer customers who establish a new service which uses metropolitan sewage facilities shall be subject to a capacity charge. The amount of the charge is established annually by the King County Council at a rate per month per residential customer or residential customer equivalent for a period of fifteen years. The purpose of the charge is to recover costs of providing sewage treatment capacity for new sewer customers. All future billings can be prepaid at a discounted amount. All future billings can be prepaid at a discounted amount. Questions regarding the capacity charge or this form should be referred to King County's Wastewater Treatment Division at 206 - 684 -1740. I certify that the information given is correct. I understand that the capacity charge levied will be based on this information and any deviation will require resubmission • - • ed data for deter ination of a revised capacity charge. Signature of Owner /Representative �i� Date %' Print Name of Owner /Representative /` /C /2 /310496.- 1058 (Rev. 9/07) White — Kino County Yellow — Local Sewer Aoencv Pink — Sewer Customer INCOMPLETE LTR# � ®'� Contractors or Tradespeople Peter 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 FOX PLUMBING & HEATING UBI No. 578073402 Phone 2067673311 Status Active Address 7501 2Nd Ave S License No. FOXPLH`163L0 Suite /Apt. License Type Construction Contractor City Seattle Effective Date 6/20/1984 State WA Expiration Date 11/16/2011 Zip 98108 Suspend Date County King Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Other Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status FOXCUI'163L0 FOX CUSTOM INTERIORS Construction Contractor General Unused 6/20/1984 9/1/1999 Archived FOXSPR'161L0 FOX SPEEDY ROOTER Construction Contractor Other (Specify) Plumbing 6/20/1984 5/15/1986 Archived FOXPLI'242NT FOX PLUMBING /HEATING, INC Construction Contractor General Unused 8/30/1976 5/15/1984 Archived FOXPLH "946Q7 FOX PLUMBING & HEATING Construction Contractor General Domestic Pump 11 /27/2006 1/1/2011 Out Of Business Business Owner Information Name Role Effective Date Expiration Date BROWN, DAVID N President 06/20/1984 01/02/2007 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 10 CBIC P00980 09/01/2001 Until Cancelled $12,000.00 08/07/2001 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 30 TRUCK INS EXCHANGE 604760788 09/01/2009 09/01/2011 $2,000,000.00 09/01/2010 29 CONTINENTAL WESTERN INS CO CNP247400228 09/01/2006 09/01/2007 $1,000,000.00 08/29/2006 28 CONTINENTAL WESTERN CNP247400227 09/01/2005 09/01/2006 $1,000,000.00 08/31/2005 27 CONTINENTAL WESTERN INS CO CNP247002 09/01/2004 09/01/2005 $1,000,000.00 09/03/2004 26 CONTINENTAL WESTERN INS CO CNP2474002 09/01/2004 09/01/2005 $1,000,000.00 09/03/2004 Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period https://fortress.wa.gov/lni/bbip/Print.aspx 12/03/2010 / I r (L���( v ICI u Cotiplyryr a Ma )fP t REVISIONS No cP anges shall be made to the scope of work without prior approval of Tukwila Building Division. NOTE: Revisions will require a new plan submittal and may include additional plan review fees. 1 LPret' SEPARATE PERMIT tREOUiRED FOR: Er Mechanical 0 Electrical EPiumbing :Jonas Piping of Tukwila _DIVISION o/u) 1-1-11-)r: cze-57ir TA* /V G- _ A )12--• GO--P Tie PP-01 do I- I 51t-- FILE COPY � /0-8,./y1 ermtt No. 10 ' 1S$ ,____Pianieviewipprcwal4s st to e Approval of construction documents does not author7ze tt,L violation of any as • • ed code or ordinan . Receipt of approved F': �': �; �n�:�ns is I • I ,'r±• By .c i Date: —REVIEWED FOR- PLIA E NC APDDfVED NUV6U2010 City of Tukwila BUILDING nlvi4lnN • • City Of Tukwila BUILDING DIVISION P&o is'S RECEIVED NOV [ 7 2.0 10 PERMIT CENTEF