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HomeMy WebLinkAboutPermit PG11-057 - CONTINENTAL MILLSCONTINENTAL MILLS 18000 ANDOVER PK W PG1 1 -057 City oPi'ukwila • 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.: 3523049018 Address: 18000 ANDOVER PK W TUKW Project Name: CONTINENTAL MILLS Permit Number: PG11 -057 Issue Date: 05/06/2011 Permit Expires On: 11/02/2011 Owner: Name: SEGALE PROPERTIES LLC Address: PO BOX 88028 , TUKWILA WA 98138 Contact Person: Name: ANDREA HOVEY Address: 9322 14 AV S , SEATTLE WA 98108 Email: AHOVEY @PSFMECH.COM Contractor: Name: PSF MECHANICAL, INC. Address: 9322 14TH AVENUE SOUTH , SEATTLE, WA 98108 Contractor License No: PSFMEI *090NZ Phone: 206 - 812 -7670 Phone: 206 764 -9663 Expiration Date: 10/03/2011 DESCRIPTION OF WORK: TENANT IMPROVEMENT OF OFFICE BUILDING. PROVIDING NEW SINKS AND REMODELED 1ST FLOOR RESTROOMS. GAS PIPING FOR NEW ROOFTOP UNIT. Value of Plumbing /Gas Piping: Fees Collected: Electrical Service Provided by: $19,472.00 $481.69 PUGET SOUND ENERGY Permit Center Authorized Signature: Uniform Plumbing Code Edition: 2009 International Fuel Gas Code Edition: 2009 /Aj `j Date: I hereby certify that I have read and examin -d thi fermit 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: II Print Name: A re- L-4ov t: Date: 5/6//( This permit shall become null and void i 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 -057 Printed: 05 -06 -2011 • • PERMIT CONDITIONS Permit No. PG11 -057 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 -057 Printed: 05 -06 -2011 CITY OF TUKI6 Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 htto://Www.ci.tukwila.wa.us Plumbing/Gas Permit No. t t ,- 0 S 7 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 351,3014 -clOtc( OM a Site Address: kJ_ over Pkw W Tenant Name: C ^Q� -� N`� Its / Property Owners Name: St,1In P rb e'er PO 6 oZs LS / LL L g Mailing Address: �X King Co Assessor's Tax No.: Suite Number: Floor: New Tenant: ❑ Yes TA ..No City State eiS113? Zip CONTACT PERSON - Who do we contact when your permit is ready to be issued Name: 4-0.4h-to, 4ove / Mailing Address: Z 1 i r" E -Mail Address: Q.IA-bit ?CC a Day Telephone: Zo( - ¥ 1 Z -fie 7-0 City Fax Number: 706 - State Zip PLUMBING / GAS PIPING CONTRACTOR INFORMATION Company Name: / F me utA w o ,: La,1 , 1 vt Mailing Address: -13Z 2 i'i' AvG 5 Contact Person: A(14) re °. to v2 y E -Mail Address: A k, vY y A PSFM2c.Z.. co-n.. Contractor Registration Number: VW. VIE 1 >k DR 0 NE S4e4.. w I, ckg l �� City State Zip Day Telephone: 7-D6 ' Si Fax Number: 2e6- gl 2 Expiration Date: 1()/3/201 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 Valuation of Project (contractor's bid pri $ I I, q-17. Scope of Work (please provide detailed irmation): I.�„a,,i u rbvt- l 090 crL ‘ou.: Va2v; vutt, 9; $t L 5 a v (e tv∎ o da,1 61L l 41- moor 43i- c►itAS Building Use (per Int'l Building Code): OF,--;cam Occupancy (per Int'1 Building Code): OCC-, Utility Purveyor: Water: c Sewer: PS 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 1 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 �,/�, `"'WW I 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 J 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 ( ` S4�% I - ,TA....., 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 1 AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OW)rrr' OR AIT7:ZED AGENT: Signature: I + Print Name: �r1 f; a'G• F0V F y Mailing Address: Q32.2 Ave .5 Day Telephone: City Date: /7/// 3/! ( zo6 F') Z- - o W k qg�� State Zip Date Application Accepted: Date Application Expires: - %1 Staff Initials: H:\Applications\Forms- Applications On Line\2010 Applications \7 -2010 - Plumbing -Gas Piping Permit Application.doc Revised: 7 -2010 bh 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.: 3523049018 Address: 18000 ANDOVER PK W TUKW Suite No: Applicant: CONTINENTAL MILLS RECEIPT Permit Number: PG11 -057 Status: APPROVED Applied Date: 04/13/2011 Issue Date: Receipt No.: R11 -00913 Initials: User ID: Payee: TLS 1670 Payment Amount: $34.13 Payment Date: 05/06/2011 02:24 PM Balance: $0.00 PSF MECHANICAK INC TRANSACTION LIST: Type Method Descriptio Amount Payment Check 014636 34.13 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts PLAN CHECK - NONRES PLUMBING - NONRES 000.345.830 6.83 000.322.103.00.00 27.30 Total: $34.13 doc: Receiot -06 Printed: 05 -06 -2011 C 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.: 3523049121 Address: 18100 ANDOVER PK W TUKW Suite No: Applicant: CONTINENTAL MILLS RECEIPT Permit Number: PG11 -057 Status: PENDING Applied Date: 04/13/2011 Issue Date: Receipt No.: R11 -00709 Payment Amount: $447.56 Initials: WER Payment Date: 04/13/2011 10:55 AM User ID: 1655 Balance: $0.00 Payee: PSF MECHANICAL TRANSACTION LIST: Type Method Descriptio Amount Payment Check 014622 447.56 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts GAS - NONRES PLAN CHECK - NONRES PLUMBING - NONRES 000.322.103.00.00 000.345.830 000.322.103.00.00 Total: $447.56 96.60 89.51 261.45 doc: Receiot -06 Printed: 04 -13 -2011 INSPECTION RECORD Retain a copy with permit INSPEQTION 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 t�6 iy_o� 7 Project: (DA/T//Vfr4 /. /Y7 /`I- 5 Type of Inspection: Y/ i1/4449,L Address: yet, rf / " ./ ce K !I ,4At/L)M4 ? 7 /! !-i Date Called: Special Instructions: Date Wanted:. 9-- .70— //. a m P.m. Requester: Phone No: _AY25 30 /- :"3129'7 Approved per applicable codes. 0 Corrections required prior to approval. COMMENTS: I I�IVSPECTION FEE REQU d at 6300 Southcenter Bt Date: ED. Prior/o next inspection, fee must be d., Suite 100. Call to schedule reinspection. • tr INSPECTION RECORD Retain a copy with permit ;• INSPECTION NO. PERMIT NO. f06// - ©5 CITY OF TUKWILA BUILDING DIVISION 6300 Soud center Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 • Perrni't .Inspection Request Line (206) 431 -2451 Project: elOA:/ /e/F .k /1 PtLS Type of Inspection: f` /r114 Address: /.01)6.0 . Aft/ad PA( 4. Date Called: Special Instructions: - - Date Wanted:. 2 5 -/ i relo.ni7 Requester: Phone No: st b -'5‘.? - 7d6 • • Approved per applicable codes. ® Corrections required prior to approval. COMMENTS: k' Raw 1,) ,4a / r ∎ S - .?,i, avic o& '114 Arks pecto Date 0 E) SPECTION FEE REQUI ED. Prior (o 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 PO -a2) PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila: WA 98188 v.. (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Project: q Z.-- Typ of Inspection: % j 6 li .:C :Al / Address: 1 f(00 c� ,o' ∎ r l,� Date Called: ..- Special Instructions: Date Wanted:,... r,( . P m. Requester: Phone No: Approved per applicable codes. • 0 Corrections required prior to approval. COMMENTS: Inspe or: ‘44449 ri REI S r ECTION FEE REQUI &ED. Prior next inspection, fee must be paid 6300 Southcenter Blvd., Suite 100. Call to schedule reinspectioh. IDat l� INSPEC ION NO. INSPECTION RECORD Retain a copy with permit CITY OF TUKWILA BUILDING DIV 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 431 -24 51 PERMIT NO. ISION (206) 431 -3670 Project: • Itl(`7 C.lr w1� NOT N._ vvr 0 S TypAof Inspection: !' '- 1(o “- -- a----A/ /� Jim 1 ( Address: I good MOvv'Zt W' Date Called: Special Instructions: • Date Wanted rt l� a.m. Requester: • Phone No: 1 Approved per applicable codes. a Corrections required prior to approval. . • COMMENTS: ? A 4 c) tt,v w 0,.1, .--5 VAA. L LJJ -I h -ir`N a . .- . Inspect r ❑ F 1Date: .. IN PECTION FEE REQUIR - ' . Prior to next inspection. fee. must be id -t 6300 Southcenter Blvd.. Suite 100. Call to schedule. reinspectiob. • I;I a•:• • , 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 / // 9 Project: • . .. �r� �f Cc NZ2 e'A/t4Y� Alfa Type of Inspection: / 4)/ ' A% rn2/»76/Ae Address :. • 1 gem ...t7/1/0/14° A? PK Date Called: GU Special Instructions: 6 X.2 61/ a—o/ Date Wanted:. Requester: Phone No: 0l -7/g - Fes JAppraved per applicable codes. •Corrections required prior to approval. G COMMENTS: i / 0 "i)U ,' 1ii,& Ate? i, /.91X./i/ J.. 0 k 70 _24/.$7,116,-2- ail .12 fligeAA 2. #D 1 C a PECTIQM FEE R�UIRED. Pcf r to Date 5 next inspection. fee must be id at 6300 Southcenter Blvd.. Suite 100. Call 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 Fcu o91 Project: Cl ON-ITT 0E1.MA L ivvia.< Type of Inspection: (91 0 u A.0 vu o/ kr.._ Adziress: - I (00() AA)13 0 ig; V1/4/ Date Called: Special Instructions: Date Wanted: —if Requester: 1,0(0 __3•0 --1-?5701 Phone No: afirt3==k1=Ek613$1116 C'Approved per applicable codes. COMMENTS: EiCorrections required prior to approval. IC r Ins Date: SPECTION FEE REQU D. Prior to next inspection. fee must be ) pa at 6300 Southcenter Blvd., uite 100 Call to schedule reinipection. . . • • PSF Mechanical, Inc. 9322 14th Avenue South Seattle, WA 98108 -5102 T 206.764.9663 F 206.762.8381 psfinechanical.com BACKFLOW PREVENTION ASSEMBLY TEST REPORT ACCOUNT# RETURN NO LATE AN: NAME OF PREMISE elc //v 's69 -C /11./46-1' COMMERCIAL RESIDENTIAL SERVICE ADDRESS /SUDt A .tJoGrat &7I- Pti CITY1 J -tL—' \,Di ZIP CONTACT PERSON PHONE ( ) FAX ( ) LOCATION OF ASSEMBLY V -LZ V/ 4-5-1 DOWNSTREAM PR ESS 1� DCVA❑ RPBA PVBA❑ OTHER NEW INSTALL EXISTING ❑ REPLACEMENT ❑ OLD SER. # PROPER INSTALLATION? YES NO ❑ MAKE OF ASSEMBLY Were-1.5 MODELO6�TSERIAL NOO SIZE 1/2 t7G I- 5 7 INITIAL TEST PASSED FAILED ❑ DCVA /RPBA DCVA / RPBA RPBA PVBA / SVBA HECK VALVE NO. 1 CHECK VALVE NO. 2 OPENED AT3,(iPSID #1 CHECK AT PSID AIR INLET LEAKED ❑ 9'.1.--( PSID LEAKED ❑ ,,vv C.,r, PSID OPENED AT PSID DID NOT OPEN ❑ _ AIR GAP OK? 7 NEW PARTS AND REPAIRS CLEAN REPLACE PART ❑ ❑ CLEAN REPLACE PART ❑ ❑ CLEAN REPLACE PART ❑ ❑ CHECK VALVE HELD AT PSID ❑ ❑ ❑ ❑ ❑ ❑ LEAKED ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ CLEANED ❑ REPAIRED ❑ TEST AFTER REPAIRS PASSED ❑ FAILED ❑ LEAKED ❑ PSID LEAKED ❑ PSID OPENED AT PSID AIR INLET PSID #1 CHECK PSID CHK VALVE PSID AIR GAP INSPECTION: Required minimum air gap separation provided? Yes No LJ DETECTOR METER READING REMARKS' LINE PRESSURE PSI CONFINED SPACE' AI° TESTERS SIGNATURE: '? (L CERT. NO. (26-40410 DATE i 25 TESTERS NAME PRINTED: I cx' Ast, w S TESTERS PHONE #'�I ol') " ^l 2-1 re REPAIRED BY: DATE FINAL TEST BY: CERT. NO DATE CALIBRATION DATE V 1 l // c7 GAUGE # 12- MODEL SERVICE RESTORED? YES NO ❑ 1 certify that this report is accurate, and 1 have used WAC 246 -290 -490 approved test methods and test equipment. • PEW COPV PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG11 -057 PROJECT NAME: CONTINENTAL MILLS SITE ADDRESS: 18000 ANDOVER PK W X Original Plan Submittal Response to Correction Letter # DATE: 04 -13 -11 Response to Incomplete Letter # Revision # After Permit Issued DEPART ENTS: uilding /�i /viissiion Alic Woofs` (I Fire Prevention Structural Planning Division Fl Permit Coordinator to DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Comments: Incomplete n DUE DATE: 04-14-11 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: Please Route 1T1 Structural Review Required REVIEWER'S INITIALS: No further Review Required n DATE: APPROVALS OR CORRECTIONS: Approved n Approved with Conditions Notation: REVIEWER'S INITIALS: DUE DATE: 05 -12 -11 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 La King County Department of Natural Resources and Parks Wastewater Treatment Division AN 1- 057 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 igloo() Aker TV- W Property Street Address �U�(AA,;1rn. � L4-- `9 City State ZIP refle Owner's Name Subdivision Name Lot # Subdiv. # Block # Building Name (if applicable) Owner's Phone Number (with Area Code) Property Contact Phone Number (with Area Code) Owner's Mailing Address �07( 8a 018 —t t,JL1„tO, WA- For King County Use Only Account # No. of RCEs Monthly Rate Property Tax ID # r o -4-- -Lo 1 T! Party to be Billed (if different from owner) City or Sewer District Date of Connection Side Sewer Permit # Please report any demolitions of pre - existing building on this property. Credit for a demolition may be given under some circumstances. Demolition of pre- existing building? ❑ Yes ❑ No Was building on Sanitary Sewer? ❑ Yes ❑ No Was Sewer connected before 2/1/90? ❑ Yes ❑ No 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 Z y Dishwasher 2 2 1 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 8 2.4i 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 -S RCE 30 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 Equivalents: (add A & B) A B RCE RCE 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 of corrected data for determination of a revised capacity charge. Signature of Owner /Representative Date Print Name of Owner /Representative ingsz nv 0/A71 Whim - Vinn r`n„nh. VnIL..., _ 0...,... A Contractors or Tradespeople Printer Friendly Page • • Page 1 of 2 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 P S F MECHANICAL UBI No. 601318369 INC Phone 2067649663 Status Active Address 9322 14Th Ave 5 License No. PSFMEI.090NZ Suite /Apt. License Type Construction Contractor City Seattle Effective Date 8/9/1991 State WA Expiration 10/3/2011 Date Zip 98108 Suspend Date County King Specialty 1 Heating /Vent /Air - Conditioning And Refrig (Hvac /R) Business Type Corporation Specialty 2 Unused Parent Company Other Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status EDENN**225LK NURSERIES NURSERIES Construction Contractor General Unused 6/12/1978 6/1/1986 Archived Business Owner Information Name Role Effective Date Expiration Date BEARDSLEY, WARREN 5 Cancel Date 01/01/1980 Bond Amount CRITCHLOW, JAMES D 4 01 /01/1980 08973126 Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 4 FIDELITY Et DEPOSIT CO OF MD 08973126 08/08/2009 Until Cancelled $6,000.00 07/10/2009 3 HARTFORD FIRE INS CO 52BSBFA6327 08/08/2008 Until Cancelled 08/08/2009 $6,000.00 07/08/2008 2 Co ERALINS 81241859 08/08/2001 08/08/2008 $6,000.0010/01/2001 Assignment of Savings Information No records found for the previous 6 year period Insurance Information Ilnsurancel Company I Policy Number I Effective lExpiration 1CanceIImpaired1 Amount I Received https://fortress.wa.gov/lni/bbip/Print.aspx 05/06/2011