HomeMy WebLinkAboutPermit PG11-012 - SHABELLE MINI MARTSHABELLFJ MINIMART
14822 TUKWILA
INTERNATIONAL BL
PG11-012
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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.: 0041000143 Permit Number: PG11 -012
Address: 14822 TUKWILA INTERNATIONAL BL TUKW Issue Date: 05/09/2011
Permit Expires On: 11/05/2011
Project Name: SHABELLE MINI MARKET
Owner:
Name: STEINBERG DOUG
Address: 26415 MILITARY RD S , KENT WA 98032
Contact Person:
Name: FRANK SOURISH
Address: 15405 SE 310 ST , KENT WA 98042
Email: N/A
Contractor:
Name: FRANK FIRE PROTECTION
Address: 15405 SE 310 ST , KENT WA 98042
Contractor License No: FRANICFP928CO
Phone: 206 229 -5245
Phone: 206 229 -5245
Expiration Date: 02/20/2012
DESCRIPTION OF WORK:
GAS PIPING TO RANGE, FRYER, AND GRIDDLE.
Value of Plumbing /Gas Piping: $1,800.00 Uniform Plumbing Code Edition: 2009
Fees Collected: $120.75 International Fuel Gas Code Edition: 2009
Electrical Service Provided by: SEATTLE CITY LIGHT
Permit Center Authorized Signature: i Date: OS /O ///
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 permit.
Signature:
Print Name:
bran SC1V��1�
Date:) + j
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
PG 11 -012 Printed: 05 -09 -2011
• 1
PERMIT CONDITIONS
Permit No. PG11 -012
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
PG 11 -012 Printed: 05 -09 -2011
CITY OF TUKWIII
Community Developm Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.ci.tukwila.wa.us
Plumbing/Gas rmit No. - 1I2,
l
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:
. King Co Assessor's Tax No.:
Suite Number: Floor:
Tenant Name: 5 \Arl h P - Inc ,� pAnv t ,,,4 New Tenant: ❑ Yes
Property Owners Name: -
Mailing Address:
.. No
City
State
Zip
CONTACT PERSON — Who do we contact when your permit is ready to be issued
Name:
Mailing Address:
E -Mail Address:
?
Day Telephone: 2p17 22? 17 y5
1.. IA
City
Fax Number:
vJ A `l50,-( 2
State Zip
PLUMBING / GAS PIPING CONTRACTOR INFORMATION
Company Name:
Mailing Address:
jr- t In/A ?to
Contact Person: r eht k Sr►, (1 r S1
E -Mail Address:
Contractor Registration Number: ) YON F e 92r cc,
City
State Zip
Day Telephone: 9..AC. -729 jZ 4(5-
Fax Number:
Expiration Date: (-32 . 9 6 - 9 ` 1
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:Wpplications\Forms- Applications On Line\2010 Applications \7 -2010 - Plumbing -Gas Piping Permit Application.doc
Revised: 7 -2010
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Page 1 of 2
IDate Application Accepted:
Valuation of Project (contractor's bid prib $ \ rCGo- d u
•
Scope of Work (please provide detailed information): G C� S P, 21, .1 y T1\ F at ��, y ,v ,e)
Building Use (per Int'I 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
.e
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 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 OWNER OR AUTHORIZED AGENT:
Signature: n Date:
Print Name:
[re S ki S%
Mailing Address:
Day Telephone: 2ly 22? X2 y5
)
City
State
Zip
1
lf\N
Date Application Expires:
Staff Initials:
(To:AA_
ge2of2
H:\Applications \Forms - Applications On Line\2010 Applications \7 -2010 - Plumbing -Gas Piping Permit Application.doc
Revised. 7 -2010
bh
•
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.: 0041000143 Permit Number: PG 11 -012
Address: 14822 TUKWILA INTERNATIONAL BL TUKW Status: PENDING
Suite No: Applied Date: 01/19/2011
Applicant: SHABELLE MINI MARKET Issue Date:
Receipt No.: R11 -00101
Payment Amount: $120.75
Initials: JEM Payment Date: 01/19/2011 09:11 AM
User ID: 1165 Balance: $0.00
Payee: FRANK FIRE PROTECTION, LLC
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 1240 120.75
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
GAS - NONRES
PLAN CHECK - NONRES
000.322.103.00.00 96.60
000.345.830 24.15
Total: $120.75
doc: Receiot -06 Printed: 01 -19 -2011
3
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
P6I k -otZ
aC
\ikt-
(206)431 -3670
Project:
Type of Inspection:
Address:
k 9 8 z 2 _I-k
Date Called:
Special Instructions:
Date Wanted.
a.m.
p.m.
Requester:
Phone No:
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
Date: %
Adnri_ g//,
REINSPECTION FEE REQUI ED. Prior o inspection, fee must be
6300 Southcenter Blvd., Sul e 100. Call to sechedule reinspection.
Rec-' 3 o.:
Date:
INSPEOT.at+NO.
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 R (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
Pro ec :
Akike
T e o hspectio
Addre
``
i L ....r. .. n
Date Called:
Special
Date Wanted: :. F r f r if
a.m.
Requester:
Ph-1<9 (0 ' -7 7c? —7
33
❑Approved per applicable codes. 14 Corrections required prior to approval.
COMMENTS:
teff..0 01
1,
3/-3676
n REINSPECTION FEE R QUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspectioh.
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION 12->
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Project:
S NA
Typ 14of Ins ection
e. ^ ...--) CA S
Address:
Date Call : .
Special Instructions:
•
•
Date Wanted:
7 —II, It
acc
Requester:
Phone No:
20L,— 275-5 245
r
'Approved per applicable codes. 0 Corrections required prior to approval.
COMMENTS:
Inspe to r:
5
p
Date:
.00 REINSPECTION ltEE REQUIRED Prior o inspection, fee must be
id at 6300 Southcenter Blvd.. Suite 1 0. Call the schedule reinspection.
Recd pt No.:
Date:
ya3t.4+. :._ ,a.k• • .. a5: •i: ^L•,4 [ .-x lee cA;E: •
FILE COPY
Porn* No. -PC 1 1-0V2-
Plan revtew approval Is Idled is ewom and on salo
Approval of downs* does not authorize
the violates of any adopted code or ordnance. Recto
01 eppnwedI ndlioes ieedmowwtedped:
Doc cr11 •
City Ol"rII la
WILDING ON
i,AS Ml I
SEPARATE E PERMIT
REQUIRED FOR:
eEr Mechanical
Electrical
Plumbing
❑ Gas Piping
City of Tukwila
Bu :LDING DIVISION
C)\(0bell e PCk h'‘
1�1�22 Tip
2an 1117 12-
REVIEWED D FOR
CODE COMPLIANCE
A PralMVED
FEB 0 8 2011
! Cityo T kwiia
BUILDIN IVISION
11 : 11Ay;c ,,: `. ±; l :.1
I 1 I
Ir,.1.11•,41by1 ink tin •purt( 1011 I1 "' ?'.'i•
REVISIONS
No changes 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 I :! r:! s,rx,,)
( f< 1)!M 1 H`:•?•nH}! 1'
I : Dki t ; 5:,o0•)
crtvRSANALA
JAN 19 2011
PERMff MiESd
P1tOt2
r PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: PG11 -012 DATE: 01/19/11
PROJECT NAME: SHABELLE MINI MARKET
SITE ADDRESS: 14822 TUKWILA INTERNATIONAL BL
X Original Plan Submittal
Response to Correction Letter #
Response to Incomplete Letter #
Revision # after Permit Issued
DEPARTMEN S: I
B ng vision
Public Works
Fire Prevention
Planning Division
UStructural n Permit Coordinator
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
Comments:
Incomplete n
DUE DATE: 01/20/11
Not Applicable
n
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TOES /THURS ROUTING:
Please Route Structural Review Required 1 1 No further Review Required ❑
DATE:
REVIEWER'S INITIALS:
APPROVALS OR CORRECTIONS:
DUE DATE: 02/17/11
Approved Approved with Conditions 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:
Document shouting slip.doc
2 -28 -02
Contractors or Tradespeople Peer Friendly Page
•
General /Specialty Contractor
A business registered as a construction contractor with LEI 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
FRANK FIRE PROTECTION LLC
2062295245
15405 Se 310Th St
Kent
WA
98042
King
Limited Liability Company
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
602796546
Active
FRANKFP928C0
Construction Contractor
2/20/2008
2/20/2012
Fire Protect System
Unused
Business Owner Information
Name
Role
Effective Date
Expiration Date
SOURISH, FARHANG A
Partner /Member
02/20/2008
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
1
WESTERN SURETY CO
70452500
02/01/2008
Until Cancelled
$6,000.00
02/20/2008
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
3
Colantic Cas Ins
L0650073363
02/12/2011
02/12/2012
$1,000,000.00
02/09/2011
2
ATLANTIC CAS
INS CO
L065007336
02/12/2010
02/12/2011
$1,000,000.00
02/18/2010
1
ATLANTIC CAS
INS CO
L0650073361
02/12/2008
02/12/2010
$1,000,000.00
01/22/2009
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 05/09/2011