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HomeMy WebLinkAboutPermit PG11-082 - TACO TIMETACO TIME 15037 TUKWILA INTERNATIONAL : L PG1 1 -082 City (ATukwila 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.TukwilaWA.gov PLUMBING /GAS PIPING PERMIT Parcel No.: 0041000493 Permit Number: PG11 -082 Address: 15037 TUKWILA INTERNATIONAL BL TUKW Issue Date: 10/14/2011 Permit Expires On: 04/11/2012 Project Name: TACO TIME Owner: Name: HAWLEY ENTERPRISES INC Address: PO BOX 1002 , ENUMCLAW WA 98022 Contact Person: Name: PAT DIKINSON Address: 2100 196 ST SW #136 , LYNNWOOD WA 98036 Email: INFO @SERVICEPLUMBGINGANDHEATING.NET Contractor: Name: SERVICE PLUMBING & HEATING INC Address: 2100 196TH ST SW , LYNNWOOD WA 98036 Contractor License No: SERVIPH953QD Phone: 425 640 -2121 Phone: (425)640 -2121 Expiration Date: 11/04/2011 DESCRIPTION OF WORK: PROVIDE WASTE, DOMESTIC WATER AND GAS SERVICE TO A FAST FOOD RESTAURANT, SERVICE TO INCLUDE ALL PIPING, GREASE INTERCEPTOR, GAS AND ELECTRIC WATER HEATERS AND ALL REQUIRED ACCESSORIES. VALLEY VIEW SEWER DIST. WATER DIST. 125 Value of Plumbing /Gas Piping: Fees Collected: Electrical Service Provided by: $50,000.00 Uniform Plumbing Code Edition: 2009 $962.06 International Fuel Gas Code Edition: 2009 Permit Center Authorized Signature: (A9A-66( Date: OP(///' 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 - i t. Signature. Print Name: /&a.ell-P/ DS�629-72P Date: /O "'/'1 z of ( 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 -082 Printed: 10 -14 -2011 • • PERMIT CONDITIONS Permit No. PG 11 -082 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 m 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 -082 Printed: 10 -14 -2011 - CIT- ?F- 1VKWJL 4 Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://Www.ci.tukwila.wa.us Building Permit No. Mechanical Permit No. ( 1 t - Plumbing/Gas PennitNo. p& i 1 0 P)_ Public Works Permit No. Project No. (For office use only) • Applications and plans roust 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' bbd /s-e - 1 King Co Assessor's Tax No.: o 1F94 - - oble Site Address: 11' 3 7 Tvrt:w/L 4 IN> s,1Th A/R'!. &AM Suite Number: • Floor. Air yerietverr- e: 7:74-E.47 7-1—..i. or N w / 1N L. Yes ❑ .. No 4444.0....- Property Owners Name: PA1 Is?L,A irr ,L ? >r7¢Q4F7i K ,p- Mailing Address: 2.0/1— Se ii 32.4P/ Jr eh,,, 4,4- .„ City kiepf fee zL State Zip CONTACTPERSON — who do we contact when your permit is ready to be issued Name: f4DWwra( (r. X4tntip27 ita ItInterlx Aiz4 Day Telephone: Mailing Address: PI, Es- a* $ 4441— RGi fah . `✓'t %fpd r 42r 2.7 /- /r7J- Ciry State Zip E-Mail Address: ilk/ r ar '' CAPN'+c- ..Jif: iie1 Fax Number. Z 71 • GENERAL. CONTRACTOR INFORMATION — (Contractor Information for Mechanical (pg 4) for Plwnbing and Gas Piping (pg 5)) Company Mailing Address: City Day Telephone: Fax Number: Contact Person: E-Mail Address: Contractor Registration Number: Expiration Date: Slate ZIP ARCHITECT OF RECORD — All plans must be stamped by Architect of Record Company Name: SAW, E /TS Gomel —7, ion/ 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: V O E L K 7t - i N 6 - 6777e ti 441..44,11-a,_ €'7,16 gds Contact Person: C ih4,4 110 t/Aivt_ac •aF7e., E -Mail Address: 0/ 1 iI , �' 4ve /C 6c /kvc* -e 14401- 9f0s o n:Mpptianfieastram.-Ayptintions on tino12010 Applicatioas7-2010 - Peaeit Applicaion.dae Revise& 72010 bb City Day Telephone: Fax Number. State Zip /2J '1 7- V9* Page 1 of 6 • 4110 BUILDING PERMIT INFORMATION — 206- 431 -3670 Valuation of Project (contractor's bid price): $ 7 OWE 0 0I Existing Building Valuation: $ Scope of Work (please provide detailed information): G0"/iY64.1- ti tw )l' Lt $ F ) f 1Nsrro/ mat .....e tGk_ -acne Rei11u.wi,f 1.#114iA. , VS Cold/ /4-.2_ Da-cp. Will there be new rack storage? ❑ Yes callo If yes, a separate permit and plan submittal will be required. Ff• Provide AU Building Areas in Square Footage Below PLANNING DIVISION: Single family building footprint (arca of ; foundation of all structures, plus any dec t over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide ; following: M. Lot Area (sq ft): Floor area of principal dwelling: w, Floor area of accessory dwelling: *Provide documentation i' t shows that the principal owner lives in one of the dwell gs as his or her primary residence. Number of Parking Stalls Pro r "i ed: Standard: 04 Compact Handicap: Z Will there be a change in Ycs ❑ No if "yes ", explax i At FIRE PROTECTI - ` ZARDO S TE ' IALS: ?,......S • ', ers ❑ . Automatic Fire Alarm ❑ .......None ❑ .......Other (specify) Will there be st. :.:c or use of flammable, combustible or hazardous materials in the building? ❑ Yes No If "yes', tach list of materials and storage locations on a separate 8 -1/2 "x 11" paper including quantities and Material SeyData Sheets. SEPTIC SYSTEM )i4 ID .......0n-site Septic System - For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. 11: ApptieliamlFmne-Appliations On Iine12010 Applies ins\! 2010 - Peewit Applindion.doe Revised: 7 -2010 en Page 2 of 6 _ Existing . • , Interior Remodel Addition to Existing Structure New Tj . of Con - ction per _ / / . IBC •• Typo of - Occupancy per IBC 1st Floor 24! r 1/13 Az_ 2m Floor • • I 3te Floor Floors dull / Basement • Accessory Structure* Attached Garage Detached Garage i. Attached Carport ' ,•' r. Detached Carport Covered Deck 1 'Uncovered Deck % \ _ PLANNING DIVISION: Single family building footprint (arca of ; foundation of all structures, plus any dec t over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide ; following: M. Lot Area (sq ft): Floor area of principal dwelling: w, Floor area of accessory dwelling: *Provide documentation i' t shows that the principal owner lives in one of the dwell gs as his or her primary residence. Number of Parking Stalls Pro r "i ed: Standard: 04 Compact Handicap: Z Will there be a change in Ycs ❑ No if "yes ", explax i At FIRE PROTECTI - ` ZARDO S TE ' IALS: ?,......S • ', ers ❑ . Automatic Fire Alarm ❑ .......None ❑ .......Other (specify) Will there be st. :.:c or use of flammable, combustible or hazardous materials in the building? ❑ Yes No If "yes', tach list of materials and storage locations on a separate 8 -1/2 "x 11" paper including quantities and Material SeyData Sheets. SEPTIC SYSTEM )i4 ID .......0n-site Septic System - For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. 11: ApptieliamlFmne-Appliations On Iine12010 Applies ins\! 2010 - Peewit Applindion.doe Revised: 7 -2010 en Page 2 of 6 *omit A.S.:PIPINGVERMIT INFORMATION PLUMBING AND GAS PIPING CONTRACTORINVO kbE" Company Name: Mailing Address: City •Contatt Person: PM- piclitirtc-AA Day lepbone: E-Mail Addrets: Fax. Nuinber Contradlot Registration Number 6,01V- ()Lk 16-b- &9 Expiration Date: Valuation cif Plumbing work (contractor's bid price): $ .45;006 Valuation of Gas Piping work (contractor's bid price): $ 15teco°4 Scope of Work (please provide detailed inforMation): 'Pronri t,1L Wole-r .avvot Onc5 SAP (Nitt_e4 46 c.e•ki& L.5-1- -Coad Noch+,uegiv1-1-. -10 0.1411L7 oil) ppm?' I 5 reoi5e tin 1-6,0-4001- Ck cThS% e'4-pte tar,,ler R-TS evAcA C'extgt tAnt Gt(z-e.SSePrIP6. Building Use (per Intl Building Code): qu% Occupancy*(per Intl Building Ccide): 2. Utility Purveyor Water 'St rt G- 4L 1 12_S— Sewer \,16‘ \o. VPA) akAler Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below: .:ciituratyPet- . • . Qty Fixture Type:. - * - Qty. -. • tiire.Type: : Qty. . fFixtUre Tyne: .: -- , . cry Bathtub or combination bath/shower Bidet Clothes washer, domestic Dental unit, cuspidor Dishwasher, domestic, with independent drain 1 1 Drinking fountain. or water cooler(per head) Food-waste grinder, commercial Floor Drain (0 Shower, single head trap Lavatory 2. Wash .fountain Receptor, indirect-waste Sinks 6) Urinals 1 Water Closet BuilditigSewer and each trailer park sewer I Rain water system — per drain (inside building) Water heater and/or vent 5 Industrial Waste treaunent interceptor, including trap and, vent, except for.kitehen ,type grease interceptors Each grease trap (connected to not more than 4 fixtures - <750 gallon capacity) Grease inceiteilior- for commercial kitchen (>750 gallon capacity) ( I Repair or 41iOitiloil of- water piping and/or water treatment equipment Repiiii, Or aliendion Of drainage or vent.piping. . Med iCai gat piping system serving 1-5 inlets/ontlets for a specific.es 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 than atmospheric-type vacuum breakers over2 inch (51 mm) diameter Each lawn sprink kr system on any one meter including backflow protection devices Atmospheric-type vacuum breakers not included in lawn sprinkler backflow protections (1-5) 1 _ Atmospheric-typc vacuum breakers not included in lawn sprinkler backflow protections over 5 Gas piping outlets (11 11:1AppliiustonsWorms•Applicatiuoith. Line■20111 Applicaleoree.7-20110 - Permit Appfiralion.duc Revhal: 7-2010 Page 5 of 6 1 PERMIT ' APPLICATION NOTES Applicable to all permits in this application Valve 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. Building and Mechanical Permit The Building Official may grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be requested in writing and justifiable cause demonstrated. Section 105.32 International Building Code (current edition). Plumbing Permit The Building Official may grant one extension of time for an additional period not exceeding 180 days. The extension shall be requested in writing and justifiable cause demonstrated. Section 103.4.3 Uniform 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 O RIZED A ( Signature: Print Name: Mailing 'Address: Cit ,.r 7 A/ IcA ./ 33a p MQp /• Ver ne, hft.9 rt►<.yj Date: Zvi/40p/ Day Telephone: hd-- 2 ].G 4 G „CZ Rth/7 sv,�t 4te,TT 47)c 9 Ciy Slate Zip Date Application Accepted: Date Application Expires: Staff Initials: HAlppaaaowWFams-Applicctoa On linoliOI 0 Appliwlioml7 -20I0 - Permit Applicationda Rewirek 7 -2010 bb Page 6 of 6 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.TukwilaWA.gov RECEIPT Parcel No.: 0041000493 Permit Number: PG11 -082 Address: 15037 TUKWILA INTERNATIONAL BL TUKW Status: APPROVED Suite No: Applied Date: 06/16/2011 Applicant: TACO TIME Issue Date: Receipt No.: R11 -02242 Initials: JEM User ID: 1165 Payment Amount: $769.65 Payment Date: 10/13/2011 10:47 AM Balance: $0.00 Payee: PATRICK C DICKINSON TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 018587 ACCOUNT ITEM LIST: Description 769.65 Account Code Current Pmts GAS - NONRES PLUMBING - NONRES 000.322.103.00.00 110.25 000.322.103.00.00 659.40 Total: $769.65 doc: Receiot -06 Printed: 10 -13 -2011 • 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.TukwilaWA.gov RECEIPT Parcel No.: 0041000493 Permit Number: PG 11 -082 Address: 15037 TUKWILA INTERNATIONAL BL TUKW Status: PENDING Suite No: Applied Date: 06/16/2011 Applicant: TACO TIME Issue Date: Receipt No.: R11 -01230 Payment Amount: $192.41 Initials: WER Payment Date: 06/16/2011 02:28 PM User ID: 1655 Balance: $769.65 Payee: TACO TIME TRANSACTION LIST: Type Method Descriptio Amount Payment Check 601478 192.41 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts PLAN CHECK - NONRES 000.345.830 192.41 Total: $192.41 doc: Receiot -06 Printed: 06 -16 -2011 INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 �, (206) 431-367 Permit Inspection Request Line (206) 431 -2451 Project: _ _7 i -v\E_ Type of Inspection: 1- ,i AL._ Address: Date Called: ,;,,) // L/ F r C (� ✓ S _.�,{/� %/1 G (.'C' Special Instructions: Date Wanted:. j -.._. . 1 _ I m p.m. Requester: Phone No: tai Approved per applicable codes. QCorrections required prior to approval. COMMENTS:: / /f %%-fJa;/fts S.. t.' Y r'/ -,/./ �"*'L � •- L 2fe-v-Iii J g+ /el' VaM 13 0 e3 .K .%'%AA./ ,;,,) // L/ F r C (� ✓ S _.�,{/� %/1 G (.'C' P", "-el" r f. (eyi, 4 ri) /# 1.:,#' %. ,v, Date: SPECTION FEE REQUIRED. Pri6r to next inspection, fee must be aid 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 Project_ f/}� {r i ° —t--.a Type of Inspection: Address: 0 - -- I Date Called: Special Instructions: Date Wanted:.? ,;gym," I_...23""'(._- p.m. Requester: Phone No: ' / Approved per applicable codes. E Corrections required prior to aprov COMMENTS: l U r !: frk .e e C(c._ -L N: 6/ Inspector. Date: 2 3- (L. REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit P61 on_ irt5' c riu au: 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- j( / d// ype f‘lnspecti n: pL 4A)-......„,. .�_ L r? C__ ,,r of_ � y T ' ' e L, Address: 03 i Datq ailed: A F-,' . 'It^ e._ ..s . (0: �4 C; D ,f�-ir c , A f F; f r Special Instructions: yDale Wanted:.: , . ' O. • Requester: Phony No: ,.',n c,3 1 DAppioved per applicable codes. Corrections required prior to approval. COMMENTS: ' TAt ,A0 f-1 aj r 6144-1'r-ivy .s 1... -Elf r& v`'- ,A-t (_,c) p j l .�_ L r? C__ ,,r of_ � y T ' ' e L, i f r,_ i - r' •s p F ,,,:xj r LJ : 1 \ ( C_.i V . fi . 'It^ e._ ..s . (0: �4 C; D ,f�-ir c , A f F; f r e C..- .S ) n! of, 'r , f o A' ftt;tr'( . ( /34),/-- brt d S 1 9( ,,- _ r't tP_. REINSPECTION FEE REQUIRED. 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 IN PE TtO NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION r- 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 #'rolect4. f,i t 6. of Inspection Address: �. (6i 7 1- Date Called: 'I � /Z-Ola' Special Instructwns: ..-reisot oF 4' CNI itr Date Wanted:. a.m. p.m. 1 equeste Phone No: Approved per applicable codes. a Corrections required prior to approval. COM i ENTS: Ac CC P corFtt UFO i007,0 .C.4110.-"A( it-l. . t3 f —r MED 1,1066 V1 14-1 ,o-h-tt4 morttig o -l' tv-? u)t .t.- i i 1 Gf m 4 Ntr(-rccf -" -1 t Wd-TAV AT DN or ' . .�" p ecrm I N1 LT' . 64Getz_ t / T) cW#1, PIV A bat t runoN VFMD i•lecrc- I 19t _ Or K( "4J Date:// .. REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspectlon. INSPECTION RECORD Retain a copy with permit 0. 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:. -- l4 Ty of Ins ection: ©` t' �, A l 6 4:S A, f t LJ A,t i , Address: r2 If so37 Date Called: Special Instructions: fC?`�.. C ..t./t 4.6 R Jics '-r, .a .0 a2( Date Wanted :. _ "tea rr�� ,p r - Requester: Phone No: " 312 -S"'‘, S7 U Approved per applicable codes. Corrections required prior to approval. COMMENTS: e,3 , : d 7 4 -c, l (o &. ,p r - "'ip S - _, - t -61i -tali sir" 4 ,ail( le )e 0 iN ,./- Ni4 e d , 1-- — T7-') _. 1 J • 4 ,'i tp s/ %}} x# J . fj jf�� 7 , , ii / n! rlf f S a . ,A, Y 4. : f d i Ii A_J , OA ,e --,.9Jc AA Li p .4".. L,J / / /=vvAl .rt t •t ,.1 9 ✓4_ •. 2'. t } t , / t Q . s . y1� Y (1 i ",( DoeJ V; r- / j��.jAfl�) j, 1 13y 0 -. REIN$PECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. 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 , Type o hns e/cction� . %� ikt i-) {`. A Address: i (03n '717-2, Date Called: Special Instructions: - .,Ar:,- e Date Wanted: .! ° ( -7 . _ /p.m. a m Requester: Phone No: /ter.. Approved per applicable codes. Corrections required prior to approval. COMMENTS; i-) {`. A :' �'`` ({ 1. ' iZ-r ) f-- NCI S n - .,Ar:,- e `/ . f' -- fl ..�` '1j h 1 Date: 2 REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit ECTION 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 Project: .1-A CLO I WI E__ Type ^o�f Inspection: ! �1 Ra6),k (rat- t,--.• t'.3 fi Address: 1 3-7 Ti P Date Called: Special Instructions: Date Wanted:. 1,2 -. - 27Z-1 1 \ rn " Requester: Phone No: Gt t 2 ..8t'u, P Approved per applicable codes. a Corrections required prior to approval. COMMITS: Ins Dat7.2 _22 PECTION FEE REQUIRE' Prior t next inspection. fee must be d at 6300 Southcenter Blvd.. ' ite 10'. Call to schedule reinspection. INSPECTION 0. INSPECTION RECORD Retain a copy with permit PERMIT NO. ?fit / -oa2 CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Project: 771(,) -7-7114 f' Type of Inspection: / ?rn /ftil -.141 C 4 1.1( CI- if 31/ ,4 r ''‘., - 4 a ✓.N147 z (l .,1(5 G, - ,, ^.. Address: /0.3 7 _1.. TA Date Called: Special Instructions: Date Wanted: . / /- .2 /_ / 1 p:m.; m: Requester: Phone No: �.2 - 9 2 565 5 / Approved per applicable codes. Corrections required prior to approval. COMMENTS: /.)01C/h — : �. ‘e, C — /14prA/ ./ 1.1( CI- if 31/ ,4 r ''‘., - 4 a ✓.N147 z (l .,1(5 G, - ,, ^.. ' 1 ler Date: !/. El PECTION FEE REQUIRED. Pr(or to next inspection, fee must be id at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. p6 03.2_1 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:.. Typ of Inspection: Address: ---, ii 0 rte. Date Called: Si1eciai instructions: s 5-3 Z. 2 -c j i '#' Date Wanted:. 1 1 ° (0 _ a.m. ii ,,,.-p:m; Requester: Phone No: LLk, " 21 2- -S4:)-S7 Approved per applicable codes. Corrections required prior to approval. COMMENTS: Pb A . /)& (41,477W ,4Aviv' '1 , elf f5 SPECTIAN FEE REQUIR . Prior • next inspection. fee must be id at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit Q�r1 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: -FAQ .ati'm Type of Inspection: Q c t 1 -1 LA.} olz r' Address: I c &-7 '"V fit;:. eD Date Called: Special Instructions: (3' • 30 CDC &,{ 3._0, Date Wanted:. IC I l iii (a: tj. p:m. Requester: Phone No: ..2.0( -- ` .:.-- L Approved per applicable codes. E Corrections required prior to approval. COMMENTS: NSPECTION FEE REQUIRED. Prior t rd at 6300 Southcenter Blvd., Suite 10 p. next inspection. fee must be Call to schedule reinspection BACKFLOW PREVENTION ASSEMBLY TEST `I +° 5 DENNIS P McLAUGHLIN STATE CERTIFIED INDEPENDENT OPERATOR ACCOUNT # NAME OF PREMISE CO C SERVICE ADDRESS . L 7< I v T T P m) CONTACT PERSON I I--• 5o N Lra -PHONE LOCATION OF ASSEMBLY r - N r PP GREATER SEATTLE AREA PHONE: (206) 3648631 CELL PHONE: 4206) 418 -0774 FAX: (206) 367 -1837 �) Commercial Residential 0 `-` 1" ZIP FAX ( ) DOWNSTREAM PROCESS 1 DCVRPBA ❑ PVBA ❑ OTHER NEW 1NSTALLEXISTING ❑ REPLACEMENT ❑ OLD SER. # PROPER INSTALLATION? YES 0 t FRFT RTf TED YES MODEL SERIAL NO. -.. /0/7 SIZE MAKE OF ASSEMBLY INITIAL TEST _ PASSED FAILED DCVA /RPBA DCVAIRPBA RPBA - PVBAISVBA CHECK VALVE NO.1.iEC1 VALVE N OPENED AT PSID AIR INLET OPENED AT PSID CLOSED T HT ❑ LEAKED PSID CLOSED TIGHT LEAKED • ` (.9 PSID # 1 CHECK PSID AIR GAP OK? DID NOT OPEN • NEW PARTS AND REPAIRS CLEA3r REPLACE PART CLEAN , REPtJCE PART CLEAN REPLACE Parr CHECK VALVE HELD AT PSID • R • ❑ • LEAKED ❑ • ❑ • • • • ❑ • ❑ ❑ ❑ • ❑ CLEANED • • II REPAIRED • TEST AFTER REPAIRS PASSED, FAILED ❑ CLOSED TIGHT LEAKED • CLOSED TIGHT, LEAKED ❑ V • t, PSID OPENED AT PSID AIR INLET PSID # 1 CHECK PSID CHK VALVE PSID /' PSID AIR GAP OK? AIR GAP INSPECTION: Required MilliMUM air gap separation prwidea? Yes 0 No ❑ Detector Meter Reading 1 ,JDetector Meier # _ / 1/ - 1-!C LINE PRESSURE REMARKS: TESTERS SIGNATURE: TESTERS NAME PRINTED: REPAIRED BY: FINAL TEST BY: frk CALIBRATION DATE If I v ' CONFINED ����� !!�� CERT. NO. 84925 DATE '- B GON ALES TESTERS PHONE # ( 206 ) DATE CERT. NO. . DATE MIDWEST GAUGE # Sfflafflai MODEL 835 SERVICE RESTORED? YESNO ❑ 1 codify this report Is accurate, and l have used WAC 246-290 -490 approved test methods and test equipment. PAC WASHINGTON STATE RECOGNIZED REPORT FORM p(( -oJZ- BACKFLOW PREVENTION ASSEMBLY TEST REPORT DENNIS P McLAUGHLIN STATE CERTIFIED INDEPENDENT OPERATOR ACCOUNT # NAME OF PREMISE 7-77 (l' -77 N SERVICE ADDRESS /'C' 3 7 f I n7? , &- CONTACT PERSON tea ,G6/P, Pi/re —PHONE LOCATION OF ASSEMBLY /N rf1Fi/ /YET /�Tir1� DOWNSTREAM PROCESS r Tre- r1 R-77 � DCVA ❑ RPBA Leg PVBA ❑ OTHER NEW INSTALL ig EXISTING ❑ REPLACEMENT ❑ OLD SER. # PROPER INSTALLATION? YES IdNO ❑ FREEZE PROTECTED YES it NO ❑ MAKE OF ASSEMBLY \ tl TWIT/ MODEL Oe^9I / SERIAL NO. ' . � ` ` 0 SIZE GREATER SEATTLE AREA PHONE: (206) 364-9531 CELL PHONE: (206) 419 -0774 FAX: (206) 367 -1837 Commercial [!7 Residential ❑ CITY % `�%/�" ZIP 2fl /}' r19/, —L FAX INITIAL TEST DCVA /RPBA DCVA /RPBA RPBA PVBA/SVBA CHECK VALVE NO.1 CHECK VALVE NO.2 OPENED AT PSID AIR INLET OPENED AT PSID # 1 CHECK PSID CLOSED TIGHT • LEAKED PSID CLOSED TIGHT • LEAKED • PSID AIR GAP OK? DID NOT OPEN • PASSED • FAILED NEW PARTS AND REPAIRS CLEAN REPLACE PART CLEAN REPLACE PART CLEAN REPLACE PART CHECK VALVE HELD AT PSID • • • • • 4 LEAKED • • • • • • • • • • CLEANED • • • • • • REPAIRED • TEST AFTER REPAIRS PASSED' CLOSED TIGHT' LEAKED • CLOSED TIGHT/V1 LEAKED • OPENED ATi ti PSID AIR INLET PSID # 1 CHECK er.I, PSID CHK VALVE PSID , • PSID PSID FAILED • AIR GAP OK? Ye AIR GAP INSPECTION: Required minimum air gap separdn provided? Yes ❑ No ❑ Detector Meter Reading REMARKS: .# / c , k p- yk 1- L c P. /,.% /cr r. Detector Meter # LINE PRESSURE 77CPSI CONFINED SPACE? TESTERS SIGNATUR 4: ; i4 J���'f���r %yybs /GL CERT. NO. BAT 0205 DATE TESTERS NAME PRINTED: DENNIS),.'111cLAUGHLIN TESTERS PHONE # ( 206) 364-9531 REPAIRED BY: DATE FINAL TEST BY: CERT. NO. DATE ,,/ MIDWEST CALIBRATION DATE 5 / `4 l 1) GAUGE # 06082845 MODEL 835 SERVICE RESTORED? YES NO ❑ I certify that this report is accurate, and I have used WAC 246 - 290 -490 approved test methods and test equipment. WASHINGTON STATE RECOGNIZED REPORT FORM PG11_o6LS f BACKFLOW PREVENTION ASSEMBLY TEST REPORT JJ DENNIS P McLAUGHLIN STATE CERTIFIED NDEPENDENT OPERATOR ACCOUNT # NAME OF PREMISE To) C 0 Q1-! e. SERVICE ADDRESS I tQ 3 7 V 14 W, /41 tn'F CITY T() I) I w IA ZIP 9 CONTACT PERSON 55°C v ' e I% 6&lo g/ PHONE ) FAX ( ) LOCATION OF ASSEMBLY Vic/ (� "t v1:'r' J'42tr h /t3 e 11 ft, r ;, r v() ', ht'u 1ni, 00104, DOWNSTREAM PROCESSCc (h' 644'0 11 DCVA ❑ RPBA(PVBA ❑ OTHER GREATER SEATTLE AREA PHONE: (206) 364-9531 CELL PHONE: (206) 419 -0774 FAX: (206) 367 -1837 Commercial�Residential ❑ NEW.INSTALL EXISTING ❑ REPLACEMENT ❑ OLD SER. # PROPER INSTALLATION? YES NO ❑ j FREEZE PROTECTED YES X NO ❑ MAKE OF ASSEMBLY Vtn i/° J 15 MODEL 0 0 0) U /�l 1 T � SIZE 1G 1/ SERIAL NO. 39 I j -� � INITIAL TEST PASSED DCVA / RPBA DCVA / RPBA RPBA PVBAISVBA CHECK VALVE NO.1. CHECK VALVE NO.2 OPENED AT30 6 PSID AIR INLET OPENED AT PSID CLOSED TIGHT LEAKED • PSID CLOSED TIGHT LEAKED • PSID % # 1 CHECK • o PSID AIR GAP OK ?3& S DID NOT OPEN • . FAILED • NEW PARTS AND REPAIRS CLEAN REPLACE PART CLEAN REPLACE PART CLEAN REPLACE PART CHECK VALVE HELD AT PSID • • • • • • • LEAKED • • • • • • • • • • • • • CLEANED • • R R R • REPAIRED • TEST AFTER REPAIRS PASSED ❑ OPENED AT PSID AIR INLET PSID CLOSED TIGHT • CLOSED TIGHT • LEAKED • LEAKED • # 1 CHECK PSID CHK VALVE PSID PSID PSID FAILED • AIR GAP OK? AIR GAP INSPECTION: Required minimum air gap separation provided? Yes ❑ No ❑ Detector Meter Reading Detector Meter # REMARKS: LINE PRESSURE L/( PSI f ; CONFINED SPACE? a TESTERS SIGNATURE:V CERT. NO. B5703 DATE 1 /13/1 0 TESTERS NAME PRINTED: MA ALLAN L GUY TESTERS PHONE # ( 206) 364-9531 REPAIRED BY: DATE FINAL TEST BY: CERT. NO. DATE MIDWEST CALIBRATION DATE 0 -7 lO 5- 111 GAUGE # 03081577 MODEL 845 SERVICE RESTORED? YES NO ❑ I certify that this report is accurate, and l have used WAC 246 - 290 -490 approved test methods and test equipment. WASHINGTON STATE RECOGNIZED REPORT FORM BACKFLOW PREVENTION ASSEMBLY TEST REPORT DENNIS P McLAUGHLIN -- -STATE CERTIFIED NDEPENDENT OPERATOR ACCOUNT # Ti Ti '^n ,p �. NAME OF PREMISE i f 1 I G `, Commercial ►? Residential ❑ SERVICE ADDRESS 15O i -7 -7( ) (4wi )°i lift 1 �''. y CITY T U kwl / (a ZIP CONTACT PERSON [ It' ' , • F PI V t a ' ij PHONE ( ) FAX ( ) LOCATION OF ASSEMBLY -'t c7 I( V- + (-pi i? r e W ; bi'�� 41 ,; 1 o ri DOWNSTREAM PROCESS - 'JA 1)(fP vvto r DCVA ❑ RPBA '(PVBA ❑ OTHER NEW INSTALL)EXISTING ❑ REPLACEMENT ❑ OLD SER. # PROPER INSTALLATION? YES NO ❑ j� FREEZE PROTECTED YES'( NO ❑ MODEL OOH a 1 SERIAL NO. S g 0) 9 3Z. SIZE )/2 If GREATER SEATTLE AREA PHONE: (206) 364-9531 CELL PHONE: (206) 419 -0774 FAX: (206) 367 -1837 MAKE OF ASSEMBLY !1 UM INITIAL TEST PASSED DCVA1RPBA DCVA IRPBA RPBA 6 PSID PVBAISVBA CHECK VALVE NO.1 CHECK VALVE NO.2 OPENED AT34 AIR INLET OPENED AT PSID CLOSED TIGHT LEAKED • PSID CLOSED TIGHT* LEAKED • PSID c � � # 1 CHECK C:30 PSID DID NOT OPEN AIR GAP OK? l.0 (6) S • �- FAILED • NEW PARTS AND REPAIRS Caw REPLACE PART CLEAN REPLACE PART Caw REPLACE PART CHECK VALVE HELD AT PSID • • • • • • LEAKED • • • • • • • • • • • • • CLEANED REPAIRED • • • • • • • • TEST AFTER REPAIRS CLOSED TIGHT LEAKED • CLOSED TIGHT LEAKED • OPENED AT PSID AIR INLET PSID • • PSID PSID # 1 CHECK PSID CHK VALVE PSID PASSED • AIR GAP OK? FAILED • AIR GAP INSPECTION: Regtrired minimum air gap separation provided? Yes ❑ No ❑ Detector Meter Reading Detector Meter # 11,, REMARKS: LINE PRESSURE too PSI CONFINED SPACE ?T"O �� 4.-4.44-- 7 CERT. NO. B5703 DATE 0� / TESTERS SIGNATURE: ,/ /i e_ / 3�I AAN L 364-9531 TESTERS NAME PRINTED: MAC GUY TESTERS PHONE # (206) 364953 REPAIRED BY: DATE FINAL TEST BY: CERT. NO. DATE MIDWEST CALIBRATION DATE° 7/0 c` /1 I GAUGE # 03081577 MODEL 845 SERVICE RESTORED? YES NO ❑ I certify that this report is accurate, and I have used WAC 246- 290 -490 approved test methods and test equipment WASHINGTON STATE RECOGNIZED REPORT FORM if PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG11 -082 DATE: 06 -16 -11 PROJECT NAME: TACO TIME SITE ADDRESS: 15037 TUKWILA INTERNATIONAL BL X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # After Permit Issued DEPARTMENTS: Akd wilding Division ��p -Ay t Public Works Fire Prevention Structural Planning Division Permit Coordinator n DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Incomplete DUE DATE: 06 -21 -11 Not Applicable a Comments: ':Permit Center'UseOnly INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: TUESITHURS ROUTING: Please Route yj Structural Review Required ❑ No further Review Required REVIEWER'S INITIALS: DATE: n APPROVALS OR CORRECTIONS: DUE DATE: 07-19-11 Approved n Approved with Conditions 0.' 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 Detail • 0 Washington State Department of Labor & Industries Contractors or Tradespeople Detail Return to List > Start a New Search > & Printer friendly Verify Workers' Comp Premium Status Check for Dept. of Revenue Account Page 1 of 2 About 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 SERVICE PLUMBING & HEATING INC Phone No. (425) 640 -2121 Address 2100 196Th St Sw Suite /Apt. Ste 136 City Lynnwood State WA Zip 98036 County Snohomish Business Type Corporation Parent Company UBI No. 4.4 602238671 Status tJ Active License No. SERVIPH953QD License Type Construction Contractor Effective Date 11/4/2005 Expiration Date 11/4/2011 Suspend Date Specialty 1 4.0 General Specialty 2 ,fir Unused ® Other Associated Licenses License Name Type Specialty Specialty Effective Expiration Status 1 2 Date Date WASSER PLUMBING Construction WASSEP *95108 LLC Contractor Construction AKAMAHL955KZ AKAMAI HOMES LLC Contractor MILLENNIUM Construction MILLEBC999CZ BUILDING CO INC Contractor SERVICE PLUMBING & Construction SERVIPH982P2 HEATING Contractor El Business Owner Information al Hide All Plumbing Unused 9/28/2005 9/28/2009 Expired General Unused 5/9/2005 5/9/2009 Expired General Unused 2/9/2001 2/9/2008 Expired Re- General Unused 10/22/2002 10/22/2006 Licensed Name Role Effective Date Expiration Date https: // fortress .wa.gov /lni/bbip/Result.aspx 10/14/2011