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HomeMy WebLinkAboutPermit PG11-109 - WESTFIELD SOUTHCENTER MALL - PANDORA JEWELRYThis 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. PG 11 -109 Pandora Jewelry 516 Southcenter Parkway 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 19 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. PANDORA JEWELRY 516 SOUThCENTER PY PG1 1 -109 City (*Tukwila r 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.: 9202470010 Address: 516 SOUTHCENTER MALL TUKW Project Name: PANDORA JEWELRY Permit Number: PG11 -109 Issue Date: 08/19/2011 Permit Expires On: 02/15/2012 Owner: Name: WESTFIELD PROPERTY TAX DEPT Address: PO BOX 130940 , CARLSBAD CA 92013 Contact Person: Name: STEPHEN WOOD Address: 1124 EASTLAKE AV EAST, STE 201 , SEATTLE WA 98109 Email: stephenw @sabarch.com Contractor: Name: PLUMBING EXPRESS INC Address: PO BOX 2226 , SUMNER WA 98390 Contractor License No: PLUMBEI98600 Phone: 206 957 -6400 X 205 Phone: 253 826 -4621 Expiration Date: 09/20/2012 DESCRIPTION OF WORK: PROVIDE NEW BREAK ROOM SINK AS WELL AS TOILET AND LAVATORY. COLD WATER TO BE PROVIDED FROM EXISTING SPACE. HOT WATER TO BE PROVIDED FROM INSTANTANEOUS ELECTRIC WATER HEATERS. WASTE AND VENT TO TIE INTO EXISTING. Value of Plumbing /Gas Piping: Fees Collected: Electrical Service Provided by: Permit Center Authorized Signature: $8,000.00 Uniform Plumbing Code Edition: 2009 $206.06 International Fuel Gas Code Edition: 2009 Date: Off//9./ 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: Date: (G— \ \ 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 -109 Printed: 08 -19 -2011 • • PERMIT CONDITIONS Permit No. PG 11 -109 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: All new plumbing fixtures installed in new construction and all remodeling involving replacement of plumbing fixtures and fittings in all residential, hotel, motel, school, industrial, commercial use or other occupancies that use significant quantities of water shall comply with Washington States Water Efficiency and Conservation Standards in accordance with RCW 19.27.170 and the 2006 Uniform Plumbing Code Section 402 of Washington State Amendments. 13: 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 -109 Printed: 08 -19 -2011 CITY OF TUKA Community Develfirnent Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 htto://www.ci.tukwila.wa.us Building Pe No. 1-0 Mechanical Permit No. J'kU LQ( Plumbing/Gas Permit No. Public Works Permit No. Project No. (Far office use only) 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: S©.3-cvl C E -cE 2 Myatt Mine: of N 4 o t2- A J t•• King Co Assessor's Tax No.: jia. o Z 14-1 O O 1 0 Suite Number: r? 6,1?) Floor. New Tenant: Yes la. No Property Owners Name: IMF S-t" F .L iD Soy Tb1 LE -Al -kit. LL C, Mailing Address: 2 8 ob Sok3 7K Cer eV'tE 2 SEATTLE \•L 4r 9 o 1 B City State zip CONTACT PERSON - mho cb nemriact.+iioa.3urport itiis><eadytobeissuea Name: c7 'rt. f v(� t\ koo0 Day Telephone: Zo C. ei't 7- (p 14-00 X Z o q" Mailing Address: l L 24- E AST L A rc ,cE d E Al U 1✓ AST SEA Ti. LE 'A f o g 61/431-re tot 1 City Sl g E -Mail Address: S TEPh n1 W. a7 S AL) A/2u -t , Go y^ -1 Fax Number. 1-o G. 9 S 7 (P `E-ori- GENERAL CONTRACTOR INFORMATION - (Cattractor hikoniatim Er Medraical (pg4) Plumli gad Gas Pfgleg (pg5)) Company Name: S H P--41 0 t 2 1-11 421 r•3 � / o ,, Mailing Address: I (p o Dry (y'c R6 r Gj P jo YI ?i � Z Ei � G 7 / City State Zip Cow per: [ 1 kE Goo (^ Day Telephone: R 2--f) 28 Z 79-1-4- E-Mail Address: k Coo He- a 9 Ca- 1-4 1✓ , Ce h Fax Number: ci Z-8 c2 3T Z Contractor Regisf ation Nu ber: (;,fib M C l 7 0 6 i'. Expiration Date: 12 /Z b 1 ARCHITECT OF RECORD - All plasm stbesta redbyArdit artafRecoird Company Name: S Ii .D AT " t✓4 { l 1E CT S Mailing Address: It 24- EAST U E A S T City Contact Person: 5 -CE P K E"-) \4O E -Mail Address: �T� P K Et3 l 1 S A 6 A LC K r•-1 51 I T E. Z.o ( SEATTLE k 4 Q 8/07 State Zip Day Telephone: Z t(o `\ 1 7 64-015 )C t o t Fax Number. Zo G, 1V7- g"44 ENGINEER OF RECORD - All plans mist be shrived by FigineerafIaenard Company Name: Mailing Address: City Contact Person: Day Telephone: E -Mail Address: Fax Number State Zip HAApplicafions Fans- Appllrtians On Lire�l0 App1I ii 17 -afro - Permit Applrtelmdoc Revised 7 -2010 hh Page 1 of 6 BUILDING PERMIT JNFORMATION - 2136431-3370 Valuation of Project (contractor's bid prim $ L50 i cx Q Existing ding Valuation $ IF 4) 11-181700 Scope of Wcuic (please provide wiled inforrr>artion): L W- loo r( f- J€A EL-12-1 S'CoR -rc, . I)ot• ST2JCT%J14 AL, Wock- LLS 1NTeCott I�Ul$k- M�c.trtotN(cAL, ELrc-cn.(c 1 —3?Cor kLE2 k j I-t ALA/LH Wo✓L� To 4t ?Eg- Ctic c5 / q L Will three be new rack storage? ❑ Yes O.. No If yes, a separate pemit and plan submittal will be negrmed. PtwideAR BtilrlirgA>rees in Square Foonge Below L N� crtt4NI CAE. l Si-h 02 IS LP t32� . PLANNING DIVISION: Single family building footprint (area of the • . on of all struchues, plus any decks d er 18 inches and overhangs greater. than 18 Indies) *Far an Accessory dwelline. provide the owing: Lot Area (sq ft): *Provide Number of Paddng Stalls Provi..: - : Standard: Compact: Handicap: Will there be a change in use? ❑ Yes t4' No If "yes ", explain •.. • 1 ICI.drl 1 WI . Floor area of principal dwelling: Floor area of accessory dwelling that the principal owner lives in one of the dwellings as his or her primary residence. PROTECT' t' '41I L MATERIALS: 0 Sprinld: 14 Automatic Fire Alarm ❑ None ❑ Other (specify) Will there be ' c. ..• use of flammable, mrnbust1ble or hazardous materials in the balding? ❑ Yes til No if "yes', atta • , list ofmaterials and storage locations on a separate 8 -1/2"x 11 " paper including quantities and Material Safety Data Sheets SEPTIC SYSTEM ❑ On -site Septic System - For on -site septic system, provide 2 copies of a anent septic design approved by King County Health H:1ApplicatlmnlFams- Applicatla.s On Li e\2010 ApplYmtlmsl7 -2010 - Pandt Applicativ,doc Revise& 7 -2010 bh Page 2 of 6 y. Existing Interior Remodel Addition to Existing Stmchue New T . =.•: - k. ..• . ; «. di pet ' IBC ' ,., Type of Off, per. IBC $Lp c, N 'f . q = 57 8O SF . STc., IJo G K-A4 cis t„1 -Etc <� S4 1A ALL dam'_ - IZ��Ft aLL-cs P rt ni Floors tlau Basement Accessory Sauctine* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck PLANNING DIVISION: Single family building footprint (area of the • . on of all struchues, plus any decks d er 18 inches and overhangs greater. than 18 Indies) *Far an Accessory dwelline. provide the owing: Lot Area (sq ft): *Provide Number of Paddng Stalls Provi..: - : Standard: Compact: Handicap: Will there be a change in use? ❑ Yes t4' No If "yes ", explain •.. • 1 ICI.drl 1 WI . Floor area of principal dwelling: Floor area of accessory dwelling that the principal owner lives in one of the dwellings as his or her primary residence. PROTECT' t' '41I L MATERIALS: 0 Sprinld: 14 Automatic Fire Alarm ❑ None ❑ Other (specify) Will there be ' c. ..• use of flammable, mrnbust1ble or hazardous materials in the balding? ❑ Yes til No if "yes', atta • , list ofmaterials and storage locations on a separate 8 -1/2"x 11 " paper including quantities and Material Safety Data Sheets SEPTIC SYSTEM ❑ On -site Septic System - For on -site septic system, provide 2 copies of a anent septic design approved by King County Health H:1ApplicatlmnlFams- Applicatla.s On Li e\2010 ApplYmtlmsl7 -2010 - Pandt Applicativ,doc Revise& 7 -2010 bh Page 2 of 6 y. Valuation of Project (contractor's bid : $ 8000 Scope of Work (please provide detaile ormation): Provide new break room sink, *employee toilet and ■ lavatory. Cold water to be provided from existing in space. Hot water to be provided from instantaneous electric hot water heaters. Waste and vent to tie in to existing. Building Use (per Int'l Building Code): Occupancy (per Intl 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 batb/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 1.00 Shower, single head trap Lavatory 1.00 Wash fountain Receptor, indirect waste Sinks 1 00 Urinals Water Closet 1 00 Building sewer and each trailer park sewer Rain water system — per drain (inside building) Water heater and/or vent 2 00 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 nun) diameter Each lawn sprinkler system on any one meter including backflow protection devices Atmospheric -type vacuum breakers not included in lawn sprinlder backflow protections (1 -5) Atmospheric -type vacuum breakers not included in lawn sprinlder backflow protections over 5 Gas piping outlets 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 AUTHORIZED AG Signature: : Print Name: S TE. 4'(C Mailing Address: II L4- E- 4 s 7 t- A K A U. lj ,$ Date: •7 ' 2O t zo Day Telephone: "z-•° E' `1 r i 7 - (4 oo x 2 ev- S A tLt ►.J. \le loci City State Zip Date •plicatio Accepted: Date App 1 • ' • - • ire s: H:\Applications \Forms- Applications On Line\2010 Applications \7 -2010 - Plumbing -Gas Piping Permit Applieation.doc Revised: 7 -2010 bh Staff Initials -- ' 1 Page 2 of 2 1 PERMIT APPLICATION NOTES - e ball pencils in dis application • Vaiieef CQrstn tion - In all cases, a value of construction amount nmt should be entered by the applicant. This figure will be reviewed and is subject to possible revision by the Permit Center to comply with anrent fee schedules. Fapi atiarofF' I view - 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 fcw additional periods not exceeding 90 days each The ea tension shall be requested in writing and justiflahle cause demonstrated. Section 105.32 Jnteinaiional Building Code (amrot edition). Plumbing Pemait The Building Official may grant one extension of time for an additional period rot exceeding 180 days. The extension shall be requested in writing and justifiable cause demonstrated. Section 103.4.3 Uniform Plumbing Code (am+eit 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 Signature I DI • - 411-0-7k_ Date: U ` 1144 l Print Name: S T E e e k t-- 140.0D Day Telephme: L20 (p" I `17 f Cn 4- QO X Ze; ` 1 , Mailing Address: j f � C l L &ke, Ave. i w Gl t i b O) � Dili/01k\ Date Application Accepted: Date Application Expires: Q1 I V Staff Initials: iJ HAApyi -APyicatlarn On ure\2010 Appumnans\r -2010 - P n dt Appucatian doc Revised: 7-2010 Page 6 of 6 Parcel No.: Address: Suite No: Applicant: 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 9202470010 516 SOUTHCENTER MALL TUKW PANDORA JEWELRY RECEIPT Permit Number: Status: Applied Date: Issue Date: PG11 -109 ISSUED 07/20/2011 08/19/2011 Receipt No.: R11 -02122 Initials: WER User ID: 1655 Payment Amount: $63.00 Payment Date: 09/28/2011 10:41 AM Balance: $0.00 Payee: SHRADER & MARTINEZ CONSTRUCTION INC TRANSACTION LIST: Type Method Descriptio Amount Payment Check Authorization No. 32214 63.00 ACCOUNT ITEM LIST: Description Account Code Current Pmts PLUMBING - NONRES 000.322.103.00.00 Total: $63.00 63.00 doc: Receiot -06 Printed: 09 -28 -2011 o • 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 ParcelNo.: 9202470010 Permit Number: PG11 -109 Address: 516 SOUTHCENTER MALL TUKW Status: APPROVED Suite No: Applied Date: 07/20/2011 Applicant: PANDORA JEWELRY Issue Date: Receipt No.: R11 -01806 Payment Amount: $164.85 Initials: LAW Payment Date: 08/19/2011 09:55 AM User ID: 1632 Balance: $0.00 Payee: SHRADER & MARTINEZ CONSTRUCTION INC TRANSACTION LIST: Type Method Descriptio Amount Payment Check 31610 164.85 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts PLUMBING - NONRES 000.322.103.00.00 164.85 Total: $164.85 doc: Receiot -06 Printed: 08 -19 -2011 CMT 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 SET RECEIPT RECEIPT NO: R11 -01527 Initials: JEM Payment Date: 07/20/2011 User ID: 1165 Total Payment: 3,084.45 Payee: BEN BRIDGE SET ID: S000001532 SET NAME: Tmp set/Initialized Activities SET TRANSACTIONS: Set Member Amount D11 -240 2,885.20 EL11 -0657 91.93 M11 -104 66.11 PG11 -109 41.21 TOTAL: 2,885.20 TRANSACTION LIST: Type Method Description Amount Payment Check 334464 3,084.45 TOTAL: 3,084.45 ACCOUNT ITEM LIST: Description Account Code Current Pmts BUILDING - NONRES ELECTRICAL PLAN - NONRES PLAN CHECK - NONRES 000.322.100 000.345.832.00.0 000.345.830 TOTAL: 1,660.34 91.93 1,332.18 3,084.45 INSPECTION RECORD Retain a copy with permit • PGA / -9 PERMIT N0. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Project:,. ./z7,4,7 �.�O,t�ar .. A- Type of Inspection: �,/j��/ - /Qi p7/ 4 Address: —S-76, gr.— / 1 .Ic✓l �.f / Date Called` /'` Special instructions: Date Wanted:. 3 ..- / / a. m: Requester: • Phone No Approved per applicable codes. E Corrections required prior to approval. COMMENTS: Inspecto %Y.�!�ifnisDate: /i.2- 3— f / r7 REIN SECTION FEE R �;,. I IRED. 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 P611 -1c09 PERMIT NO. • CITY OF' TUKWILA BUILDING DIVISION �f ` 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 .Permit Inspection•.Request Line (206) 431 -2451 ProPJrA t: • • • r 3tuPdl Type o Inspection: F-. J L— P 1 � "8.'46 Address 5r4: S MA-LL Date Called: Special Instructions: e_ di g 4-e b4r,:r 31 if Date Wanted: /_a.m„ Cl -2//±± " 1— {/ p.m. Requester: Pho4 loo: _As( _ G12- ( 0 Approved per applicable codes. Corrections required prior to approval. COMMENTS: . .('(e Addy i' A e.. ij , A ( f LJ -O VM( 9 f . J • 1-0 / _ % A Ji, . - 2-,7 1 r . %I C- • .- _. r._1 PAT AACf -0 ' A4,42( 7 r q .. e_ di g 4-e b4r,:r 31 if ,..t._.1) ,i_ ._t_o 7 aip --r-,,Av-- r. 4_,( A a • : 6. 6 MIL- :.f(.1 1 lAi rri" vJ47 FD C--- 8'1' • ) • A'6t r .I —(tad' S C - Li JJ4 G A LArcii"Slofi z Ins}>~ector: , Dat@ ct_.�'% • • "INSP.ECT ON NO. INSPECTION RECORD Retain a copy with permit & ;u- (( f PERMIT NO. �. CITY.•OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Ix. (206) 431 -367 Permit.Inspection Request Line (206) 431 -2451 P ect:.., - ...- r of w£ y Type of Inspection: lZvJ 6K Ai Pt0 AA Address: ' { _.:: : S j A4 11"1 -i... Date Called: — Special'Inst`ructions: • • • Date Wanted -'" ( - f ( i J p.m. Requester: Phoq No: Approved per applicable codes. 0-Corrections required prior to approval. COMMENTS: 1t) vO k/ tok Pi A4,1 Date: a REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. ERMIT COORD CORD PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG11 -109 DATE: 09/19/11 PROJECT NAME: PANDORA JEWELRY SITE ADDRESS: 516 SOUTHCENTER MALL Original Plan Submittal Response to Correction Letter # Response to Incomplete Letter # X Revision # 1 after Permit Issued DEPART 4./rf. u ildng Divison ,cYS Public Works' ENTS: ill Fire Prevention Structural Planning Division Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete l'_%1 Comments: Incomplete n DUE DATE: 09/20/11 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 Ep Structural Review Required n REVIEWER'S INITIALS: No further Review Required n DATE: APPROVALS OR CORRECTIONS: DUE DATE: 10 /18 /11 Approved / Approved with Conditions Not Approved (attach comments) 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 •PERMIT CHORD COP. PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG11 -109 DATE: 07/20/11 PROJECT NAME: PANDORA JEWELRY SITE ADDRESS: 516 SOUTHCENTER MALL X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # # after Permit Issued DEPARTMEN S: B it g 'vision, f Public Works 6 Fire Prevention Structural n Planning Division ❑ Permit Coordinator n DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Incomplete n DUE DATE: 07/21/11 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 REVIEWER'S INITIALS: Structural Review Required No further Review Required n DATE: APPROVALS OR CORRECTIONS: DUE DATE: 08 /18 /11 Approved ❑ Approved with Conditions n 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 PROJECT NAME: MO 014411 Ci' 11 \Jlk PERMIT NO: I SITE ADDRESS: I,lJ C--)G Ai1D4 L- ORIGINAL ISSUE DATE: REVISION LOG P o�� 1I I you REVISION NO. DATE RECEIVED STAFF INITIALS ISSUED DATE STAFF INITILS 11 Summary of Revision: � �o��� ��2,� (, � �I.fC1JS ������ � l Prl i Cr &Mt �- W p f P1,1 L1 lyt c- W U1,) Received by: o-k-k--- V\ ; ,lkkar► REVISION NO. DATE RECEIVED STAFF INITIALS ISSUED DATE STAFF INITIALS Summary of Revision: Received by: (please print) REVISION NO. DATE RECEIVED STAFF INITIALS ISSUED DATE STAFF INITIALS Summary of Revision: Received by: (please print) REVISION NO. DATE RECEIVED STAFF INITIALS ISSUED DATE STAFF INITIALS Summary of Revision: Received by: (please print) REVISION NO. DATE RECEIVED STAFF INITIALS ISSUED DATE STAFF INITIALS Summary of Revision: Received by: (please print) REVISION NO. DATE RECEIVED STAFF INITIALS ISSUED DATE STAFF INITIALS Summary of Revision: Received by: (please print) City of Tukwila REVISION SUBMITTAL Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Web site: http: //www.ci.tukwila.wa.us Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fad etc. Date: 1. IQ( • 2c) LI Plan Check/Permit Number: 'PC: 4. L -1 o c- ❑ Response to Incomplete Letter # ❑ Response to Correction Letter # g, Revision # after Permit is Issued Revision requested by a City Building Inspector or Plans Examiner Project Name: "FA f•3 Po R. It �—.) € L( S C t Project Address: ctki ' S of Tv( C_ rJ T T v w; L L 11 C l.J. S T E i€ LP s r H Contact Person: 5TV' 1-(E 13 kt 6 0-0 Phone Number: -zo I c 7 (q- De C x 2n0 ) Tom, Summary of Revision: f ikm ?- o O p.--t tO2tt $ ft- C-K -Roc i Lo 0 so 5E (Ai E2 LJE Go e tv6 Lk] g, C(. c_tei fc. u M 6, ic i o tJ 0 (‘-1 ZLj#PEO To SEP 1 9 21111 rs):144 CENtER Sheet Number(s): ? 2 00 /�p ( `P •G', o "Cloud" or highlight all areas of revision including date of revision Received at the City of Tukwila Permit Center by: 4 Entered in Permits Plus on H:Wpplicatiom\Fmms- Applications On Line \2010 Application,V -2010 - Revision Submittal.doc Created: 8 -13 -2004 Revised: 7 -2010 1 Contractors or Tradespeople Printer Friendly Page • General /Specialty Contractor A business registered as a construction contractor with LW 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 PLUMBING EXPRESS INC 2538264621 Po Box 2226 Sumner WA 98390 Pierce Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 602226682 Active PLUMBEI98600 Construction Contractor 9/20/2002 9/20/2012 Plumbing Unused sated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status PLUMBE`077PR PLUMBING EXPRESS Construction Contractor Plumbing Unused 10/19/1993 10/19/2003 Archived PRECIM`121KB PRECISION MECHANICAL Construction Contractor plumbing Unused 5/2/1988 3/17/1989 Archived PLUMBE`1620QPLUMBING EXPRESS, THE Construction Contractor Plumbing Unused 9/18/1984 9/18/1986 Archived Business Owner Information Name Role Effective Date Expiration Date KILDARE, JOHN THOMAS President 09/20/2002 Amount KILDARE, KRISTI KYLE Vice President 09/20/2002 BKA54313254 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 1 GREAT AMER INS CO OF NY 7902865510010 10/19/2001 Until Cancelled 10/18/2010 $6,000.00 09/20/2002 Assignment of Savings Information Savings Assignment of Savings Account Number Effective Date Release Date Assignment Type Impaired Date Amount Received Date 2 10/26/2010 Until Released Bond $6,000.00 10/26/2010 Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date 9 AMERICAN FIRE & CASUALTY CO BKA54313254 01/01/2011 01/01/2012 $1,000,000.00 11/17/2010 8 AMERICAN FIRE & CASUALTY CO BKA1154313254 01/01/2010 01/01/2011 $1,000,000.00 12/21/2009 7 FEDERATED MUTUAL INS CO 9215213 01/01/2009 01/01/2011 01/01/2010 $1,000,000.00 11/17/2009 6 FEDERATED MUTUAL INS CO 9215213 01/01/2005 01/01/2009 $1,000,000.00 11/30/2007 5 AMERICAN STATES INS CO 01CG393702 09/30/2004 09/30/2005 $1,000,000.00 08/24/2004 Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period https://fortress.wa.gov/lni/bbip/Print.aspx 08/19/2011