HomeMy WebLinkAboutPermit PG11-036 - BAYVIEW LIMOUSINEThis record contains information which is exempt from public disclosure
pursuant to the Washington State Public Records Act, Chapter 42.56 RCW
as identified on the Digital Records Exemption Log shown below.
PG11 -036
Bayview Limousine
15701 Nelson Place
RECORDS DIGITAL D- ) EXEMPTION LOG
THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION
Page # tode Exemption = 8rlef Explanatory DeSclriptiop �t�tutel ule
The Privacy Act of 1974 evinces Congress'
intent that social security numbers are a private
concern. As such, individuals' social security
Personal Information —
numbers are redacted to protect those
Social Security Numbers
individuals' privacy pursuant to 5 U.S.C. sec.
5 U.S.C. sec.
DR1
Generally — 5 U.S.C. sec.
552(a), and are also exempt from disclosure
552(a); RCW
552(a); RCW
under section 42.56.070(1) of the Washington
42.56.070(1)
42.56.070(1)
State Public Records Act, which exempts under
the PRA records or information exempt or
prohibited from disclosure under any other
statute.
Redactions contain Credit card numbers, debit
card numbers, electronic check numbers, credit
Personal Information —
expiration dates, or bank or other financial
RCW
13
DR2
Financial Information —
account numbers, which are exempt from
42.56.230(5)
RCW 42.56.230(4 5)
disclosure pursuant to RCW 42.56.230(5),
except when disclosure is expressly required by
or governed by other law.
BAYVIEW LIMOUSINE
15701 NELSON PL
EXPIRED
09 -04-11
PG1 1 -036
City otkukwila
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.: 0005800026
Address: 15701 NELSON PL TUKW
Project Name: BAYVIEW LIMOUSINE
PLUMBING /GAS PIPING PERMIT
Permit Number:
Issue Date:
Permit Expires On:
PG 11 -036
03/08/2011
09/04/2011
Owner:
Name: HANSEN GROUP LLC
Address: 14405 25TH AVE SW , BURIEN WA 98166
Contact Person:
Name:
Address:
Email:
ANTHONY BRADLEY
13324 BINGHAM AV E , TACOMA WA 98446
PUGETSOUNDGASPIPING@YAHOO.COM
Contractor:
Name: PUGET SOUND GAS PIPING INC
Address: 13324 BINGHAM AVE E , TACOMA WA 98446
Contractor License No: PUGETSG956MA
Phone: 253 - 224 -7283
Phone: 253 - 539 -4488
Expiration Date: 07/07/2011
DESCRIPTION OF WORK:
NATURAL GAS LINE TO GENERATOR (10 FT)
Value of Plumbing /Gas Piping: $500.00 Uniform Plumbing Code Edition: 2009
Fees Collected: $120.75 International Fuel Gas Code Edition: 2009
Electrical Service Provided by: PUGET SOUND ENERGY
Permit Center Authorized Signature:
I hereby certify that I have read and ex
governing this work will be complied
n
'th,
The granting of this permit does not pres
construction or the performance of work. I a
on the back of this permit.
e
Signature:
Print Name: % I DN j u eV iems(
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.
?�49JL Date:
this permit and know the same to be true and correct. All provisions of law and ordinances
ether specified herein or not.
o give authority to violate or cancel the provisions of any other state or local laws regulating
authorized to sign and obtain this plumbing /gas piping permit and agree to the conditions
Date: VK///
doc: UPC -4/10
PG 11 -036 Printed: 03 -08 -2011
• •
PERMIT CONDITIONS
Permit No. PG11 -036
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: 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.
8: 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.
9: 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.
10: 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 -036 Printed: 03 -08 -2011
CITY OF TUKWILA D
Community Developme Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.ci.tukwila.wa.us
Plumbing/Gasrmit No. VG G l 03 0
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 Co Assessor's Tax No.:
Site Address: I C101 Ne_\ Soh ? k SeA,441e, LOA q if I n
Tenant Name: 3uyvt&),J L,`..-.0z4-44n
Property Owners Name:
Mailing Address: 1 S")0I Ne,150" ?hi
Suite Number: Floor:
New Tenant:
Yes
.. No
city
State
giocky
Zip
CONTACT PERSON — Who do we contact when your permit is ready to be issued
Name: A11 . o.1,1 n
Mailing Address: X3514 BIAyhr,„,, /Le- E
E -Mail Address: 2A3.¢-+ s o.-t not 0‘-s ?' P c-.,kov. cow.
Day Telephone:
/6tLr� rt�
City
Fax Number:
LA
State
Zip
PLUMBING / GAS PIPING CONTRACTOR INFORMATION
Company Name:
Mailing Address:
f l tc t, Sc���` l i
US
1337 1 levjhA ,
Contact Person: Av-ILo^� J
E -Mail Address: aNr+ So_-wt c�tS Q� pl J e co dy,.K-ao ot Fax Number:
Contractor Registration Number: P to (. cT 9561'111 R
/Gs�orr,a
City
Day Telephone: 253 Zu/ 725f3
laid icsiN6
State Zip
Expiration Date:
Tin ///
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
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Page 1 of 2 `�
Valuation of Project (contractor's bid pip: $ 500,c°
Scope of Work (please provide detailed information): &ks
I,
it o
Building Use (per Int'1 Building Code):
Occupancy (per Int'1 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
11
I
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 OW ER OR THORIZED AGENT:
l
Signature:
Print Name: 404-1t17,,1,
Mailing Address: / 332y
8 rtdie5
£�.,,�►,��, A,.
Date: 2,/z.11//
Day Telephone: Z5-3 ZLc/ '72.13
ietGQn1o.
City
State
°1554Ai s
Zip
Date Application Accepted: [ 1
Date Application Expires:
Staff Initials:
H:\Applications\Forms- Applications On Line12010 Applications \7 -2010 - Plumbing -Gas Piping Permit Application.doc
Revised: 7 -2010
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0144_ I
Page 2 of 2
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.: 0005800026
Address: 15701 NELSON PL TUKW
Suite No:
Applicant: BAYVIEW LIMOUSINE
RECEIPT
Permit Number: PG11 -036
Status: APPROVED
Applied Date: 02/28/2011
Issue Date:
Receipt No.: R11 -00448
Initials:
User ID:
JEM
1165
Payment Amount: $96.60
Payment Date: 03/08/2011 04:03 PM
Balance: $0.00
Payee: PUGET SOUND GAS PIPING INC
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 5396 96.60
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
GAS - NONRES
000.322.103.00.00 96.60
Total: $96.60
doc: Receiot -06 Printed: 03 -08 -2011
r •
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.: 0005800026
Address: 15701 NELSON PL TUKW
Suite No:
Applicant: BAYVIEW LIMO
RECEIPT
Permit Number: PG11 -036
Status: PENDING
Applied Date: 02/28/2011
Issue Date:
Receipt No.: R11 -00367
Initials:
User ID:
WER
1655
Payment Amount: $24.15
Payment Date: 02/28/2011 12:27 PM
Balance: $96.60
Payee: PUGET SOUND GAS PIPING INC
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 5389 24.15
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
PLAN CHECK - NONRES
000.345.830 24.15
Total: $24.15
doc: Receipt -06 Printed: 02 -28 -2011
INSPECTION?R.ECORD :fit
+ Retain a covw h.per t ;�
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:
544v, e UJ L,,0
Typ of Inspection:
Kou 44 t-,kJ BAs
Address: J
1 ( I p�
Date Called:
Special Instructions:
Date Wanted -5— t'
!
a.m.
c.-
Requester:
Phone No:
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
I 'specto
ZA/ of
SPECTION FEE REQ RED. Prio to next inspection, fee must be
d at 6300 Southcenter Bt . Suit 100. Call to schedule reinspection.
Date:
REVIEWED FOR
CODE COMPLIANCE
AmB1nm®
mz
City of u ila
BUILDINR IRION
FILE COPY
Permit No.
Plan review approval is subject to errors and omis ors.
Approval of construction documents does not authorize
ordinance. Receipt
of approved Fie d Copy
the violation of any adopted t moons is acknowledged:
By
Date: r�
City Of 'T'iJkkH►Ila
BUILDING DIVISION
Tr-
REVISIONS
No ctiangeishall ho made to the scope
of work without prior approval of
Tukwila Building Division.
NOTE: Revisions will require a new plan submitt I
and may include additional plan review foss.
r,
s
L
JS I
G
^n6 01
q
V
I
r
I
5
SEPARATE PERMIT'
REQUIRED FOR:
VA
Mt: cR hanical
till Electrical
k
11 Plumbing
• Gas Piping
City of Tukwila
BUILDING DIVISION
'
;E WEE)
FFB 28 2011
PG_II__8_3_49
Tr-
REVISIONS
No ctiangeishall ho made to the scope
of work without prior approval of
Tukwila Building Division.
NOTE: Revisions will require a new plan submitt I
and may include additional plan review foss.
08 -01 -2011
City of f Tukwila
Jim Haggerton, Mayor
Department of Community Development Jack Pace, Director
ANTHONY BRADLEY
13324 BINGHAM AV E
TACOMA WA 98446
RE: Permit No. PG11 -036
15701 NELSON PL 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 09/05/2011.
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 09/05/2011, 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,
'*--3-.:)A 4-9cl
Bill Rambo
Permit Technician
File: Permit File No. PG 11 -036
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 -431 -3665
oft 6�wi� Y •
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: PG11 -036
PROJECT NAME: BAYVIEW LIMOUSINE
SITE ADDRESS: 15701 NELSON PL
X Original Plan Submittal
Response to Correction Letter #
DATE: 02 -28 -11
Response to Incomplete Letter #
Revision # After Permit Issued
DEPARTMENTS:
�C/
B iI g sion
Public Works
n11A-
ire Prevention kw
Structural ❑
Planning Division
Permit Coordinator
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
Incomplete
a
DUE DATE: 03-01 -11
Not Applicable
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES/THURS ROUTING:
Please Route
Structural Review Required
No further Review Required
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS:
DUE DATE: 03-29-11
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:
Documents /routing slip.doc
2 -28 -02
Contractors or Tradespeople liter 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 PUGET SOUND GAS PIPING INC UBI No. 602435577
Phone 2535394488 Status Active
Address 13324 Bingham Ave. E License No. PUGETSG956MA
Suite /Apt. License Type Construction Contractor
City Tacoma Effective Date 7/1/2005
State WA Expiration Date 7/7/2011
Zip 98446 Suspend Date
County Pierce Specialty 1 Plumbing
Business Type Corporation Specialty 2 Unused
Parent Company
Other Associated Licenses
License
Name
Type
Specialty 1
Specialty
2
Effective
Date
Expiration
Date
Status
PUGETSG974C7
PUGET SOUND
GAS PIPING
Construction
Contractor
Other
(Specify)
Unused
2/27/2003
2/27/2005
Expired
CLASSGP986JP
CLASS A GAS
PIPING
Construction
Contractor
Other
(Specify)
Unused
4/17/2002
4/17/2004
Out Of
Business
Business Owner Information
Name
Role
Effective Date
Expiration Date
BRADLEY, ANTHONY
President
07/01/2005
Bond Amount
BISCARRET, DOMINIC
Secretary
07/01/2005
919233
ANDERSON, ANDY
Vice President
07/01/2005
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
2
CAPITOL INDEMNITY
CORPORATION
919233
03/02/2006
Until Cancelled
04/06/2010
$6,000.0003/08/2006
03/31/2010
1
ACCREDITED SURETY
Et CAS CO
10034091
02/11/2005
Until Cancelled
02/11/2006
$6,000.0007/01
/2005
Assignment of Savings Information
Savings
Assignment of Savings Account Number
Effective Date
Release Date
Assignment Type
Impaired Date
Amount
Received Date
2
4/27/2010
Until
Released
Bond
$6,000.00
4/27/2010
Insurance Information
Insurance
Company Name
Policy Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Amount
Received Date
8
ATLANTIC CAS
INS CO
L17900228
04/11/2010
04/11/2011
$1,000,000.00
03/31/2010
7
ATLANTIC
CASUALTY INS
CO
L071003336
04/11/2009
04/11/2010
$1,000,000.00
04 /13/2009
6
AMERICAN
STATES INS CO
25CC15518010
04/11/2008
04/11/2009
$1,000,000.00
04 /15/2008
5
FIRST
NATIONAL
INSURANCE CO
OF
25CC15518010
04/11/2007
04/11/2008
$1,000,000.00
04 /13/2007
4
LINCOLN
GENREAL
PUGET7
12/06/2006
12/06/2007
$1,000,000.00
12/06/2006
https://fortress.wa.gov/lni/bbip/Print.aspx
03/08/2011