HomeMy WebLinkAboutPermit PG11-010 - HENDERSON-NISTOR RESIDENCEHENDERSON - NISTOR
RESIDENCE
11828 44 AV S
PG11-01O
City oftukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Inspectio n Request Line: 206 - 431 -2451
Web site: http: / /www.ci.tukwila.wa.us
PLUMBING /GAS PIPING PERMIT
Parcel No.: 3347401000
Address: 11828 44 AV S TUKW
Project Name: HENDERSON - NISTOR RESIDENCE
Permit Number:
Issue Date:
Permit Expires On:
PG11 -010
01/14/2011
07/13/2011
Owner:
Name: CASON PAMELA
Address: 9226 NE 148TH CT #K102 , BOTHELL WA 98011
Contact Person:
Name: COSMINA NISTOR
Address: 602 NE 63 ST , SEATTLE WA 98115
Email: COSIBOSI77 @YAHOO.COM
Phone: 206 - 235 -7542
Contractor:
Name: OWNER AFFIDAVIT - COSMINA NISTOR Phone:
Address:
Contractor License No: Expiration Date:
DESCRIPTION OF WORK:
REPLACE 50 GALLON WATER HEATER
Value of Plumbing /Gas Piping: $800.00 Uniform Plumbing Code Edition: 2009
Fees Collected: $47.25 International Fuel Gas Code Edition: 2009
Permit Center Authorized Signature:
Date:
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 and agree to the conditions
on the back of this pe t.
Signature:
Print Name:
/ :70)Z
CosAt iwPt. ij L 5
Date:
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
PG11 -010 Printed: 01 -14 -2011
• •
PERMIT CONDITIONS
Permit No. PG11 -010
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.
doc: UPC -4/10
PG11 -010 Printed: 01 -14 -2011
CITY OF TUKWI
Community Developmillf Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.ci.tukwila.wa.us
Plumbing/Gaslrmit No. -PG 1 E - 6112
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
. King o Assessor's Tax No.: 3 � 0 ( 0 0 0
Site Address: //82 � p�
'"7 lA - s SQS4 ��-C- Suite Number.
7nlapiP.iv PjdA- /(?j9 /AJ ®. »/S 2
Tenant Name:
Floor:
,,/ New Tenant: Yes ❑..No
Property Owners Name: /,2f}C Ge.L/ 5e) e_ Dc" QUA A) %P//
Zip
Mailing Address:
6 s ,Sow zi Ji
City State
CONTACT PERSON — Who do we contact when your permit is ready to be issued
Name: (1011 //O`/-} �J /S ?dal
(O
Mailing Address: 0-2 /UE �� c 3T er
E -Mail Address: Ca3/ b05/ 770 yakO * G0 /v1
Day Telephone: .2,6235-7-5-7712
A-5q
City
State Zip
Fax Number:
PLUMBING / GAS PIPING CONTRACTOR INFORMATION
Company Name:
Mailing Address:
6z AJE bar Sr
Contact Person: /45,4
E -Mail Address:
Contractor Registration ' er:
G041 c-497/fs
City State Zip
SO-/Son Day Telephone: Z062-1- 7-C2/2_
Fax Number:
Expiration Date:
ARCHITECT OF RECORD - All plans must be stamped by Architect of Record
Company Name:
Mailing Address:
City
Contact Person: Day Telephone:
Fax Number:
State
Zip
E -Mail Address:
ENGINEER OF RECORD - All plans must be stamped by Engineer of Record
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
H:\Applications\Forms- Applications On Line\2010 Applications \7 -2010 - Plumbing -Gas Piping Permit Application.doc
Revised: 7 -2010
bh
City
Day Telephone:
Fax Number:
State
Zip
Page 1 of 2
Valuation of Project (contractor's bid prix $ 437-451D
Scope of Work (please provide detailed information):
tiett/ /row_ /o>% "d 72Z77 =
•
Building Use (per Int'I Building Code):
Occupancy (per Int'l Building Code): it/D/lJ 71- (s T7 /r'Le
c4
tAe- )acct ' Sewer:
Utility Purveyor: Water:
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 -
IDate Application Accepted:
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 LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OW ■ . R OR A - 1 RIZE
Signature: ■ 411
Print Name: (° dS/) 7il/19 /v (/S�� �—
Mailing Address: Ct7 /tie-
01/
Date:
///1
Day Telephone. 2tar ddb 033-
7S Z
City
u 9,a)//—
State
Zip
Date Application Expires:
Staff Initials:
1-1:1ApplicationsWorms- Applications On Line\2010 Applications \7 -2010 - Plumbing -Gas Piping Permit Application. doc
Revised: 7 -2010
bh
Page 2 of 2
1
•
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: htq,..//www.ci.tukwila.wa.us
RECEIPT
Parcel No.: 3347401000 Permit Number: PG 11 -010
Address: 11828 44 AV S TUKW Status: PENDING
Suite No: Applied Date: 01/14/2011
Applicant: HENDERSON - NISTOR RESIDENCE Issue Date:
Receipt No.: R11 -00078
Initials:
User ID:
Payee:
WER
1655
Payment Amount: $47.25
Payment Date: 01/14/2011 09:30 AM
Balance: $0.00
COSMINA NISTOR
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd VISA
Authorization No. 092929
ACCOUNT ITEM LIST:
Description
47.25
Account Code Current Pmts
PLUMBING - RES
000.322.103.00.00 47.25
Total: $47.25
doc: Receipt -06 Printed: 01 -14 -2011
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
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: f
i Jer.9OA/
Type of Inspection:
/p-/Ai4G
s
Address:
//cg 9 4/ f/ d a 5
Date Called: 160)4
•
Special Instructions:
Date Wanted:
Requester:
Phone No:
Approved per applicable codes.
COMMENTS:
ElCorrections required prior to approval. I p,:
• 4:.
penter tokiip re)?
REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
INSPECTION NO.
INSPECTION RECORD �'"
Retain a copy with permit ii -?�
PERMIT NOS.-&
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670
Perrnit Inspection Request Line (206) 431 -2451
Project:
ivekes 'o41,,oths oa
Type of Inspect' n:
1�ps "-Avid-Plat-me 4
Address:
/422 z1r1_ 4!f- s
Dam
Special Instructions: •
Date Wanted.
/-2
i-/ i
yf�
:rill'
Requester:
Phone No:
9e) e --
_
23,5 -7, s
-
• Approved per applicable codes. '
• i
•
Corrections required prior to approval....
COMMENTS:
00 Uc # A
rr A " 1
t -') ,r 1
/fir
!f"
-
titoA jA g r-
(4).- -Temp
M -r
p P.-St-lake
' rspecto . A Atzk
!Date:
a REINSPECTION FEE REQUIRED-Prior to next inspection, fee mustsbe'
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
�.
INSPECTION RECORD
Retain a copy with permit
INSPECTIO NO. PERMIT Nl
CITY OF T4UKWI.LA BUILDING DIVISION
6300 Southcenter BIvd., #100, Tukwila. WA 98188 (206) 431 =3670
Permit Inspection Request Line (206) 431 -2451
P{ t ( �0{O
Project:
Type Ins ect
n:
Address: '
it 44
S'
Date Called:
.
Special Instructions:
'0 6,04_ w ,4fe
•
Date Wanted:
1
—
!'tea;.
/i P.m-
Requester:
Phone N .-
/
:Approved per applicable codes. • Corrections required prior to approval. r
•
COMMENTS:
Date:
1
1
REI E-TION FEE REQUIRED: Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.'
•
CITY OF TUKWILA
Department of Community Development
6300 Southcenter Boulevard, Tukwila, WA 98188
Telephone: (206) 431 -3670 FAX (206) 431 -3665
E- mail: tukplanaci.tukwila.wa.us
Permit Center /Building Division
206 431 -3670
Public Works Department
206 433 -0179
Planning Division
206 431 -3670
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
PERMIT NO: ? G 11- 10 1
STATE OF WASHINGTON)
) ss.
COUNTY OF KING )
x641 //U79 /l115-Rse , states as follows:
[please print name]
1. I have made application for a permit from the City of Tukwila, Washington.
2. I understand that state law requires that all building construction contractors be registered with the
State of Washington. The exceptions to this requirement are stated under Section 18.27.090 of the
Revised Code of Washington, a copy of which is printed on the reverse side of this Affidavit. I have
read or am familiar with RCW 18.27.090.
3. I understand that prior to issuance of a permit for work which is to be done by any contractor, the
City of Tukwila must verify either that the contractor is registered by the State of Washington, or that
one of the exemptions stated under RCW 18.27.090 applies.
4. In order to provide verification to the City of Tukwila of my compliance with this requirement, I
hereby attest that after reading the exemptions from the registration requirem�ly of RCW 18.27.090,
I consider the work authorized under this permit to be exempt under number b and will therefore
not be performed by a registered contractor.
5. I understand that the licensing provision of RCW 19.28.161 through 19.28.271 shall not apply to
persons making electrical installations on their own property or to regularly employed employees
working on the premises of their employer. The proposed electrical work is not for the construction
of a new building for rent, sale or lease.
I understand that I may be waiving certain rights that I might otherwise have under state law in any decision
to engage an unregistered contractor to perform construction work.
/44I LEI ti. 1.
Owner • wner's Agent*
Signed ad sworn to b fore me this
/ /day of
/6044A g7A0C,k-
NOTARY PUBLIC in and for the State of Washington
Residing at ). //7-2)S- County
&'tS'�i/7
Name as commissioned: (D
My commission expires: / 0 l 1 q- 11
18,27.090 Exemptions. The regi,eion provisions of this chapter do not apply tip
1. An authorized representative of the United States
government, the state of Washington, or any incorporated
city, town, county, township, irrigation district, reclamation
district, or other municipal or political corporation or
subdivision of this state;
2. Officers of a court when they are acting within the scope
of their office;
3. Public utilities operating under the regulations of the
utilities and transportation commission in construction,
maintenance, or development work incidental to their own
business;
4. Any construction, repair, or operation incidental to the
discovering or producing of petroleum or gas, or the
drilling, testing, abandoning, or other operation of any
petroleum or gas well or any surface or underground mine
or mineral deposit when performed by an owner or lessee;
5. The sale of any finished products, materials, or articles of
merchandise that are not fabricated into and do not become
a part of a structure under the common law of fixtures;
6. Any construction, alteration, improvement, or repair of
personal property performed by the registered or legal
owner, or by a mobile /manufactured home retail dealer or
manufacturer licensed under chapter 46.70 RCW who shall
warranty service and repairs under chapter 46.70 RCW;
7. Any construction, alteration, improvement, or repair
carried on within the limits and boundaries of any site or
reservation under the legal jurisdiction of the federal
government;
8. Any person who only furnished materials, supplies, or
equipment without fabricating them into, or consuming
them in the performance of, the work of the contractor;
9. Any work or operation on one undertaking or project by
one or more contracts, the aggregate contract price of
which for labor and materials and all other items is less
than five hundred dollars, such work or operations being
considered as of a casual, minor, or inconsequential nature.
The exemption prescribed in this subsection does not apply
in any instance wherein the work or construction is only a
part of a larger or major operation, whether undertaken by
the same or a different contractor, or in which a division of
the operation is made into contracts of amounts less than
five hundred dollars for the purpose of evasion of this
chapter or otherwise. The exemption prescribed in this
subsection does not apply to a person who advertises or
puts out any sign or card or other device which might
indicate to the public that he or she is a contractor, or that
he or she is qualified to engage in the business of
contractor;
10. Any construction or operation incidental to the
construction and repair of irrigation and drainage ditches
of regularly constituted irrigation districts or reclamation
districts; or to farming, dairying, agriculture, viticulture,
horticulture, or stock or poultry raising; or to clearing or
other work upon land in rural districts for fire prevention
purposes; except when any of the above work is performed
by a registered contractor;
11. An owner* who contracts for a project with a registered
contractor, except that this exemption shall not deprive the
owner of the protections of this chapter against registered
and unregistered contractors. The exemption prescribed in
this subsection does not apply to a person who performs
the activities of a contractor for the purpose of leasing or
selling improved property he or she has owned for less than
twelve months;
12." Any person working on his or her own property,
whether occupied by him or her or not, and any person
working on his or her personal residence, whether owned
by him or her or not but this exemption shall not apply to
any person who performs the activities of a contractor on
his or her own property for the purpose of selling,
demolishing, or leasing the property;
13. An owner* who performs maintenance, repair, and
alteration work in or upon his or her own properties, or
who uses his or her own employees to do such work;
14. A licensed architect or civil or professional engineer
acting solely in his or her professional capacity, an
electrician certified under the laws of the state of
Washington, or a plumber certified under the laws of the
state of Washington or licensed by a political subdivision of
the state of Washington while operating within the
boundaries of such political subdivision. The exemption
provided in this subsection is applicable only when the
person certified is operating within the scope of his or her
certification;
15. Any person who engages in the activities herein
regulated as an employee of a registered contractor with
wages as his or her sole compensation or as an employee
with wages as his or her sole compensation;
16. Contractors on highway projects who have been
prequalified as required by RCW 47.28.070, with the
department of transportation to perform highway
construction, reconstruction, or maintenance work;
17. A mobile /manufactured home dealer or manufacturer
who subcontracts the installation, set -up, or repair work to
actively registered contractors. This exemption only applies
to the installation, set -up, or repair of the
mobile /manufactured homes that were manufactured or
sold by the mobile /manufactured home dealer or
manufacturer;
18. An entity who holds a valid electrical'.contractor's
license under chapter 19.28' RCW .that employs a certified
journeyman electrician, a certified residential specialty
electrician, or an electrical trainee meeting the
requirements of chapter,'19.28. RCW to perfortn plumbing
work that is incidentally, directly, and immediately
appropriate to the like -ill -kind replacement of a.household
appliance or other small household utilizatiop;equipment
that requires limited electric, power..and limited waste
and /or water connections. Ail electrical trainee must be
supervised by a certified electrician while performing
plumbing work.
• Per Washington State Department of Labor and Industries, lessee has been
interpreted to be equivalent to owner for the purpose of these exemptions.