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HomeMy WebLinkAboutPermit PG11-117 - WESTFIELD SOUTHCENTER MALL - JAMBA JUICEJAMBA JiJICE 556 SOUTHCENTER MALI. PG11-117 City oilkukwila 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: 566 SOUTHCENTER MALL TUKW Project Name: JAMBA JUICE Permit Number: PG11 -117 Issue Date: 09/09/2011 Permit Expires On: 03/07/2012 Owner: Name: WESTFIELD PROPERTY TAX DEPT Address: PO BOX 130940 , CARLSBAD CA 92013 Contact Person: Name: BRAD DERKACH Address: 3100 E RANDOL MILL RD , ARLINGTON TX 76011 Email: BDRRKACH@PDMSDESIGN.COM Contractor: Name: SERVE -ALL PLUMBING INC Address: 81 WILLIAMS AVE S , RENTON WA 98057 Contractor License No: SERVEPI896KZ Phone: 817 701 -4806 Phone: (206)696 -3702 Expiration Date: 05/09/2013 DESCRIPTION OF WORK: RUN SANITARY AND EXTEND EXISTING WATER LINES TO NEW SINKS. INCLUDES INSTALLATION OF WATTS Series 007 DOUBLE CHECK VALVE BACKFLOW PREVENTER AT THE MAIN WATER SERVICE LINE ENTRANCE AND SCHIER PRODUCTS GREASE INTERCEPTOR/TRAP. Value of Plumbing /Gas Piping: $12,500.00 Uniform Plumbing Code Edition: 2009 Fees Collected: $189.00 International Fuel Gas Code Edition: 2009 Electrical Service Provided by: Permit Center Authorized Signature: j' /' !,G-6-?..e.-e (})ot-i{ Date: eV il/ 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: \IP 0 A - 0 >p,,., P - Date: — q---- i/ This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection. doc: UPC -4/10 PG 11 -117 Printed: 09 -09 -2011 PERMIT CONDITIONS Permit No. PG11 -117 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. 13: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * ** 14: Grease interceptor trap shall be installed per manufacturer's specifications. 15: Proposed backflow(s) shall be installed per manufacturers specifications. 16: Applicant shall maintain the grease trap per attached May 9, 2011 GREASE TRAP MAINTENANCE Program guidelines. 17: Contractor shall coordinate with Public Works Project Inspector Mr. Dave Stuckle at 206 433 -0179; to ensure proper connection of grease waste line to the new grease interceptor /trap. doc: UPC -4/10 PG 11 -117 Printed: 09 -09 -2011 • CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.qov Plumbing /Gas Permit No. f(171,1,- I 11 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: 566 Southcenter Mall Tenant Name: Jamba Juice 20 1-141 —polo Suite Number: 1110 Floor: 1st Property Owners Name: Westfield Southcenter Mall Mailing Address: 2800 Southcenter Mall New Tenant: ® Yes ❑..No Tukwila WA 98188 City State Zip CONTACT PERSON — Who do we contact when your permit is ready to be issued Name: Brad Derkach Mailing Address: 3100 E. Randol Mill Rd. E -Mail Address: BDerkach @pdmsdesign.com Day Telephone: (817) 701 -4806 Arlington TX City State Fax Number: (817) 633 -4153 76011 Zip PLUMBING / GAS PIPING CONTRACTOR INFORMATION Company Name: Mailing Address: Contact Person: E -Mail Address: Contractor Registration Number: City Day Telephone: Fax Number: Expiration Date: State Zip ARCHITECT OF RECORD — All plans must be stamped by Architect of Record Company Name: Michael Black AIA Mailing Address: 3100 E. Randol Mill Rd. Contact Person: Brad Derkach Arlington TX 76011 E -Mail Address: City State Zip Day Telephone: (817) 701 -4806 Fax Number: (817) 633 -4153 ENGINEER OF RECORD —All plans must be stamped by Engineer of Record Company Name: Dan Reeves P.E. Mailing Address: 3100 Randol Mill Rd. Contact Person: Dan Reeves E -Mail Address: DReeves @pdmsdesign.com Arlington TX City State Day Telephone: (817) 633 -4200 Fax Number: (817) 633 -4153 76011 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 price): $ (Z50o • Scope of Work (please provide detailed information): ■cou .5 vJ l?A►ZY.i- r><T o 6X151-to ‘ wj}Teoe !-►N5 TO Building Use (per Int'I 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 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 4 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 PERMIT APPLICATION NOTES - Value of Construction - In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject to possible revision by the Permit Center to comply with current fee schedules. Expiration of Plan Review - Applications for which no permit is issued within 180 days following the date of application shall expire by limitation. The Building Official may grant one extension of time for an additional period not to exceed 180 days. The extension shall be requested in writing and justifiable cause demonstrated. Section 103.4.3 International Plumbing Code (current edition). I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNER OR AUTHORIZED AGENT: Signature: I5 Print Name: ‘.5c1-77- ?OF-5W- Mailing Address:NCO 5U67HC i1l414- aDate Application Accepted: D`blDtLll Date: DUO !/1/ Day Telephone023 -57e -3 8-WCf (501772,c (.)/4 c/nek City State Zip Date Application Expires: 0210i, [2- H:\Applications \Forms- Applicatinns On Line \2010 Applications \7 -2010 - Plumbing -Gras Piping Permit Application.doc Revised: 7 -2010 bh Staff Initials: 6,......-/ 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.TukwilaWA.gov RECEIPT Parcel No.: 9202470010 Permit Number: PG 11 -117 Address: 566 SOUTHCENTER MALL TUKW Status: APPROVED Suite No: Applied Date: 08/01/2011 Applicant: JAMBA JUICE Issue Date: Receipt No.: R11 -01969 Initials: User ID: LAW 1632 Payment Amount: $151.20 Payment Date: 09/09/2011 12:09 PM Balance: $0.00 Payee: SERVE -ALL PLUMBING TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 120824 ACCOUNT ITEM LIST: Description 151.20 Account Code Current Pmts PLUMBING - NONRES 000.322.103.00.00 151.20 Total: $151.20 doc: Receiot -06 Printed: 09 -09 -2011 SET RECEIPT Copy Reprinted on 08 -01 -2011 at 16:52:12 08/01/2011 RECEIPT NO: R11 -01642 Initials: JEM Payment Date: 08/01/2011 User ID: 1165 Total Payment: 198.89 Payee: PRUDENCE SWANN SET ID: S000001539 SET NAME: JAMBA JUICE SET TRANSACTIONS: Set Member EL11 -0711 M11 -109 PG11 -117 TOTAL: Amount 87.63 73.46 37.80 73.46 TRANSACTION LIST: Type Method Description Amount Payment Credit C VISA 198.89 TOTAL: 198.89 ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PLAN - NONRES 000.345.832.00.0 PLAN CHECK - NONRES 000.345.830 87.63 111.26 TOTAL: 198.89 • INSPECTION RECORD Retain a copy with permi :==r INSPECT N 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 , -‹.1. "hob a !hue P Type of Inspection: 1 n/, Address: 5 ( rvi, i, Date Called: Special Instructions: Date Wanted :. //PM/ Requester: Phone No: .11.9 d -450 92_ proved per applicable codes. D Corrections required prior to approval. COMMENTS: P Da //150/ 1-1 I EI PECTION FEE REQUIR D. Prior o next inspection, fee must be at 6300 Southcenter Blv Suit 00. Call to schedule reinspection. f 1� w INSPECTION RECORD Retain a copy with permit PERMIT NO. CITY OF TUKWILA BUILDING DIVISION .! 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 1 Permit Inspection Request Line (206) 431 -2451 'Projeft. "rt... 407r7ST .i/e/te) Type of Inspection: •tf4L— '2/, 4 /A/ Address: SC ...5GY/r4'CvW7FP /?i Date Called: 4 /I Special Instructions: ,eg/A N 4/80. -4 sd _4,y2 g Date Wanted: AO /-2 6/// Requester: ,C0 2,9 0 Phone No: 06 -.2 g8- 737 / - DApproved per applicable codes. Corrections required prior to approval. COMMENTS: g7-mio 717 .140/e AZoisfor 6s2P0/6/20 !an ,frizes / - ,tiscAre41 ri PECTION FEE REQUIRED. Prior to ext inspection. fee must be a} at 6300 Southcenter Blvd.. Suite 10 . Call to schedule reinspection. • • INSPECTION NO. INSPECTION RECORD Retain a copy with permit CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Proje -�kr cr tc Type of Ins ction: 'y" • Addres D Ca led: / Special Instructions: Date Wante_,11 m. Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: 16p-64- ? i efrfil*/,trt!! 'Inspector: (Date: /0 (v // n REINS CtION FEE a UIRED. Prior to next inspection, fee must be paid at 6300 Southcent e r Blvd., Suite 100. Call to schedule reinspection. l — f 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 P0-d7 Projecer r— rt '�, f 'Jj Type ec ot: / 0 Addr j ate ailed: Special Instructions: Date Wanted�7 1; !� my Requester: Phone No: Approved per applicable codes. D Corrections required prior to approval. COMMENTS: ❑ REINSPECTION FEE R QUIRE!). Prior to next inspection. fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. 1 1 s $ f• 1 �/}� V0• INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila: WA 98188 lg.. (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Projec • , AAA CIA tit W- e N. Type of Inspection: _ a th tet -' J Ph( .$ 1n Address: 15 GC, Wi sfN I 1 -II k) a>. �(�. 'l o Date Called: . Special Instructions: • Date Wanted:. a. i V — t,— i ( p.m Requester: Phone No: ..,:n 6, - 7 airs - %a7q Approved per applicable codes. Corrections required prior to approval. COMMENTS: N. -II k) a>. �(�. 'l o -- ($„vi RA 0 F. _'( I v EE • - • P rJGf (0i r t- , L 109 ‘i% S sc s. so f / J i \ 1 FNSPECTION FEE REQUIREDP% rior next inspection. fee must be id at 6300 Southcenter Blvd.. Su e 100. Call to schedule reinspectioh. • 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: • �.014 ne-?,1 I 0 A Type of Inspection: 4Q P.,v<v - c.Jd4 rG Address: 54. "9 Ll Date Called: Special Instructions: ' Date Wanted:. a.m. Requester: Phone No: 0206-7e8 -737/1 'N Approved per applicable codes. ECorrections required prior to approval. Ire COMMENTS: (1.4.44.0.7./ SPECTIO4FEE REQU \JtED. Prior to next inspection. fee must be d at 6300 Southcenter Bl d.. Suite 100. Call to schedule reinspection. IDatb7 "�'- •"'r,y� \ ,�� INSPECTION RECORD Retain a copy with permit 1,0 INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION (206) 431 -3670 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 431 -2451 - )a A ^ +� J t t! V� /d Type of Irysp�o� �t r � A ee.Q I! Date Calked:` f Special Instructions: Date Wanted: i }! =` Reque r: Phone .eO —'5 &I - 8804 ElApproved per applicable codes. Corr ctions required prior to approval. COMMENTS: Inspector: Date: 10 /1—i ❑ REINSPECTION FEE REQUIRED. Prior to next inspection7fee'must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. •. rrom. nrr, r'N 1 1 1 ? ; .Ao 1, l 6.A,T, Mastor . Ion) ?1 0 -9866 WATER PURVEYOR '1 ri m Tukwila ! 0 . C170"rJ1JO0J r . C'J (;AmmAn BACKFLOW PREVENTION ASSEMBLY TEST REPORT Test Procedure: USC 9th Edition -361 I ` 117 ACCOUNTfl ASSF MULY ID /FILE MITI ITV I)I;VICL': Meter it NAME: OF I'RIEMISF. .Iarllha Juice- SOt1thcentek V' Cnmmcrcinl WI Rcsidcntial I_I SERVICE ADDRESS liiO Snuthccnter Mall Tukwila ZIP 98188 CONTACT PERSON Brent nr 1'ritdcncc mom: (360) 544 -8524 LOCA1 JUN U1' ASSEMI)LV Itcltind ioIlinR refrigerator. DOWNSTREAM PROCI'. S I Wller• NEW INSTALL I ✓1 Elvis 1 IN(; 1' REPLACEMENT I I Ar'PIt0vI l) ASSFM1)1.1• YES ICI NO I I MAKE OF ASSF.11lfl Y \V :II IS DCVA IvJ RPBA 1 I'VIIA OTIIER 1 {LMOVEI) U OLD SER.# mom INSTALLATION? YES WI NO MUD1:1, AEI {lAIJ NU. 6RI)54 SIZE .J" INITIAL — n( '\'A / 01.1t:\ n n _ItP11A I I031MA P PVRA /SVRA �;iiirr_,i: V,\[.VI NO2 , A AIR INLET CLOS' :t)'1' :t :I IT • C CI.OSED'1ICHT I ✓l O 111 CHECK SID DID NOT (Ptin LJ AIR CAVOM NEW I CLEAN ! ! •! ..r" !MU ( (:,FAN nl'PIArr PART C CLEAN rlEPLAC( PAST C CIIP.CIC, VAI.VI1. 1 I LEAKED . ' • I 1 11 _ __ CLEANED —I I I 1 I I._J I 1 1 1 C TEST AFTER C CLOSI:II TI(;I I'1' f C CLOSI'o MI IT I R R1' ENERCISED AIR INLET PS1.Il C}uC VALVE 5.1u _ C AIR CAP INSPECTION: PIPE !HAM rTFR DETECTOR. TOR .%7E'1'1':IR REA1'1I V(; SERvICf. AS ff)I INI) Opcn ICI CL,..11 REMARKS: SEPARATION hOV *I Open � Closed PASS1 I FAIL SOVO2: Open ' Closcd LINE I'I {issui f 45 PSI CONFINED SPACE? No TESTERS SIGNATURE: ' '� ' CERT. NO. B4594 DATE 10/24/2011 1'IN'I'I ?NS NAME PRt','ruu 11,,,!u :' C. (:tr!urn•i1. TESTERS PtIONE # _ 4( )210.9866 REPAIRED RV: I,IC NO. DATE FINAL UST By. CERT. NO. DATE CALIBRATION DATF. I _- _u -_I! lu c.:u1G1' n 00;1796 MODEL Nlidwot 845 SERVICE RESTORED YES ✓J ,N(1 I evriiry 11.1A i:r ,n! ;.. ■'rru, :.,.•..,,ui I h v.••usoIng.voe? 246'n1.490.rppeuvC.l f est mcthnda and tecrequip?nent. OCT 2 s 20111 COMMUN,TY RECEIVED 10-28-'11 12:45 FROM- DEVELOPMENT TO- publicworks /dcd P002/003 u�. � - ca-cr�tt 1J. rat rrum. Oct i?8 11 12:3Op Tom Gamman ! r•• I B A T. Mate EIAOKFLOW PREVENTION AS$EMBLY TEST REPORT ~` •' (+2:1) ,In.NARF Test ProcOdure: USC 9th Editio WATER PURVEYOR Tukwila ACCOUNT It LI`I1 7 As11_.N113LY ID /FILE IJ /IITILITY DEVICE u Meter H NAME OF PR F.MoSii, J;unha Juice- Sauthccntcr 1 U • GCIO- .JIJOOJ r • J" J 425- 397 -e-tee p.1 Commeedul ✓ RL•\itlen118) 1 1 SERVICE AI)URESS 680 SOuthccntcr Tukwila z1Y 98188 CONTACT PERSON Brent or Pruticucc LOCATION Or ASSEMBLY On back wall adj. to mop Sink PHONE (360) 544 -8524 DOWNSTREAM PROCESS lee Machine DCVA dl RPt3A PVI3A I .• OTHER Nu:Ve INSTALr. . EXISTING 11 UI.PLACF.M1 N'r REMAYEI) ] OLD SERA APPROVED ASsEMRLY? ¥ -S 11/1 NO Ci PROPER 1N$TALLATION? YES hit NO MAKE OF ASSEMBLY Won't MODEL 007M30T• SERIAL NO. 231582 SIZE .75" INITIAL TN:S'I. PAS`F:1) FAILED) 1 DCVA / I2PHA DCVA / ItPRA RPRA YSID PVR /� ___ I'SI)) 1 ('HFi:K Vn1,VF. NO.1 C}Ir('IC v VF. NC1.2 CLOSED TICHT 1'1 LEAKEI) 11 2.2 Pcr� OPENED AI AIR INLET oPI ?NEI AT.,,,,. CLOSED TICHT .'4 LFn1. °l I) _ 2.2 rsrn NI CHECK pS1A Qfp N(11' OPEN AIIt CAP 01 <'l NEW PARTS AND R I.: PAIRS CLEAN 110I _ACC PAITT I_J n CLEAN REPLACE MAT 1 1 1 CLEAN %EPLACE 1..1 Li PART CHRCK VALVI; FIELD AT PSI 1) 0 I I I.I I 11 (1 LEAKED II I I— _I 11 II CLEANED REPAIRED —I 11 7 . I 1 TEST AN ruR PASSED . FATLFI) 1 1 CLOSED TIGHT 1 LEAK I.:1) PSI'I) CLOSED TIGHT I 1 LEAKED 1 1 I'SLI) RV EXERCISED OPENED AT 1 I L'Sll) AIR INLET PSID PS11) CHK VALVE: tri Ortrc-1: PSID AIR CAE' rNSPECTION: SUI'I'L1' PIPE DIANIE1•I,It DETECTOR METR.0 RI?ADINC LEFT SERvI('IL AS FOUNI) INuL•1liun valve: Open Re Closed 1 I SOVIII Open 'VI Closes 1 I SOV#2: open h/ C.IO.c11 (- RP..MAltKS: SEPARATION EASSI 1 NAIL t INE P RUM) fir. 70 t'S.1 CONFINED SPACE? Na 'ESTI,RS SIGNATURE: .:�.�� :.,. Cli:u'r. NO. 84594 DATE 10/24/2011 TESTERS NAME PRIN•I'IEI) TII.Iniox C. Cornwall TI S'I'I I S PIIONe n (425)210 -9866 kit: AIRED BY: Lie NU. DATE: FINAL TEST BY: CFrt`I'. NO, DATE. CALI1312A1'ION DATE I:•:(I.20I0 GAUGE h JUSI194 MODEL MIdN'est Ras SERVICE RESTORED YE` d1 NO L I ecrtit'y that 1111(. ecport is oCCV r`"Ce and I h.. r i s_c,d A� L 'Z4�t j )I,ry 9Q n rOveLl teal metlindo , nA tot cgwpntent. RECEIVED 10- 28 -'11 12:45 FROM- OCT 2 8 20111 Cr)it MLIIIl1T/ TO- publicworks /dcd P003/003 FILE COPY ES -007 For Non - Health Hazard Applications Job Name Job Location Engineer Approval Contractor Approval Contractor's P.O. No. Representative RECEIVED AUG 2 5 2011 PUBLIC Series 007 Double Check Valve Assemblies Sizes: 1/2" - 3" (15 - 80mm) Series 007 Double Check Valve Assemblies shall be installed at referenced cross - connections to prevent the backflow of pollut- ed water into the potable water supply. Only those cross -con- nections identified by local inspection authorities as non - health hazard shall be allowed the use of an approved double check valve assembly. Check with local authority having jurisdiction regarding vertical orientation, frequency of testing or other installation requirements. The valve shall meet the requirements of ASSE Std. 1015 and AWWA Std. C510. Approved by the Foundation for Cross - Connection Control and Hydraulic Research at the University of Southem California. Features • Ease of maintenance — only one cover • Top entry • Replaceable seats and seat discs • Modular construction • Compact design • Cast bronze body construction — 1/2" - 2" (5 - 1 IEVVED FOR • Fused epoxy coated cast iron body — 2172" - J,,MPLIANCE • Top mounted ball valve test cocks APPROVED 3/4" (20mm) 007M3QT 2" (50mm) 007M1QT HC • Low pressure drop • No special tools required for servicing • 1/2" - 1" (15 - 25mm) have tee handles SEP 0 7 2011 Firs, Specifications City of Tukwila °dt,lE A Double Check Valve Assembly shall be insta !BUILDING DIViio 4,14 roes features a modular design concept which facilitates intenance and assembly by retaining the spring load. 1"i-- aaq�eb�� .... �A E���avOQ'QU. ve-c�coJd V`Cllmn�.w0� o� Check Assembly Second Check Module Assembly noted location. The assembly shall consist of - ing check modules with captured springs and rubber seat discs. The check module seats and seat discs shall be replaceable. Service of all internal components shall be through a single bronze or stainless steel access cover secured with stainless steel bolts. The assembly shall also include two resilient seated isolation valves; four top mounted, resilient seated test cocks. The assembly shall meet the requirements of ASSE Std. 1015 and AWWA Std. C510. Approved by the Foundation for Cross - Connection Control and Hydraulic Research at the University of Southern California. Assembly CORRECTION shall be a Watts Series 007. Now Available WattsBox Insulated Enclosures. For more information, send for literature ES -WB. IMPORTANT INQUIRE WITH GOVERNI FOR LOCAL INSTALLATIO LTR# Watts product specifications in U.S. customary units and metric are approximate and are provided fcr reference only. For precise measurements, please contact Watts Technical Service. Watts reserves the right to change or modify product design, construction, specifications, or materials with- out prior notice and without incurring any obligation to make such changes and modifications on Watts products previously or subsequently sold. V6L% (%1 drrELI) AUG 24 2011 PERMITCENTER WWATFS® Pressure — Temperature W -2" (15 -50mm) Temperature Range: 33 °F -180 °F (0.5 °C - 82 °C). Maximum Working Pressure: 175psi (12.1 bar). 21/2" - 3" (65 - 80mm) Temperature Range: 33°F -110 °F (0.5°C - 43 °C) continuous, 140 °F (60 °C) intermittent. Maximum Working Pressure: 175psi (12.1 bar). Standards ASSE Std. 1015, AWWA Std. C510 IAPMO PS31, CSA B64.5 Approvals ®0®�® ®� t ASSE, AWWA, IAPMO, CSA, UPC • Approved by the Foundation for Cross - Connection Control and Hydraulic Research at the University of Southern California. • Models LF and S are not listed. • UL Classified (LF models only) 3/4" - 2" (20 - 50mm) (except 007M3LF) • UL Classified with OSY gate valves (21/2" and 3" horizontal only.) • Horizontal and vertical "flow up" approval on all sizes Dimensions - Weights Models Sizes: 1/2" - 2" (15 - 50mm) Suffix: S - bronze strainer LF - without shutoff valves LH - locking handle ball valves (open position) SH - stainless steel ball valve handles HC - 21/2° inlet/outlet fire hydrant fittings (2" valve) Prefix: U - Union connections 21/2" - 3" (65 - 80mm) Suffix: NRS - non -rising stem resilient seated gate valves OSY - UUFM outside stem and yoke resilient seated gate valves LF - without shutoff valves QT -FDA - FDA epoxy coated quarter -turn ball valves *Subscript 'S' = strainer model Suffix HC — Fire Hydrant Fittings dimension "A" = 231/2" (594m) MODEL SIZE (ON) in. mm I A M. mm in. B mm in. C mm in. DIMENSIONS D mm in. F mm G in. mm R 10. mm T in. mm WEIGHT lbs. kgs. t• 0070T 12 15 10 254 4% 117 27A6 62 — — 5 127 334 85 25A6 59 21A6 52 4.5 2 t•007M3QT 3/4 20 111/2 282 4 102 31 79 — — 63A6 157 3' /,6 87 2'%s 54 15A6 33 5 2.3 t•007M1QT 1 25 131/4 337 51 130 4 102 — — 71 191 3% 85 1 " ,46 43 1 " ,46 43 12 5.4 tA007M2QT 11/4 32 16% 416 5 127 35/6 84 — — 91 241 5 127 3 76 2 50 15 6.8 t•007M2OT 11 40 163/4 425 47% 124 31/2 89 — — 93/4 248 513/16 148 312 79 211,6 68 15.9 7.2 t•007M10T 2 50 191/2 495 61/4 159 4 102 — — 133/2 340 61 156 37/16 87 21126 68 25.7 11.7 • 0070T -S 1h 15 13 330 6 152 27,46 62 3 76 5 127 334 85 25/,6 59 21A6 52 5.5 2.5 • 007M30T -S 3/4 20 141/2 368 61/2 156 312 79 3 76 63A6 157 37 ,46 87 21/2 54 15A6 33 6.7 3.1 • 007M10T -S 1 25 1715/6 157 73/4 197 4 102 31/4 83 71 191 33% 85 1 " ,46 43 1 "/16 43 14 6.4 • 007M20T -S 11/4 32 211 546 71 ,46 179 35A6 84 31/2 83 9' 241 5 127 3 76 2 50 19 8.6 • 007M20T -S 11/2 40 251,46 637 7'/6 179 31 89 33/4 95 93/4 248 513/16 148 312 79 2" %6 68 19.6 8.9 • 007M10T -S 2 50 271 692 83/4 222 .4 102 4 102 133/2 340 61 156 37A6 87 211A6 68 33.5 15.2 Dimensions - Weights Sizes: 21" — 3" (65 — 80mm) 1" 0007M1QT Union Tailpiece Union Nut Strainer Dimensions 3* 80 10% 267 'S Models only Union Tailpiece Union Nut Sizes: 'h" — 2" (15 — 50mm) MODEL MODEL SIZE (DN) in. mm in. A mm in. DIMENSIONS C mm E, E1 in. mm In. R mm WEIGHT lbs. Vs 20 0070T-FDA 2'% 65 33'% 841 6% 162 91/16 230 83/4 222 155 70 • 007 -NRS 2'% 65 331% 841 93% 238 91/46 230 83/4 222 155 70 A• 007 -0SY 2% 65 33% 841 16% 416 916 230 81 222 158 72 007 -QT -FDA 3 80 341 867 6% 162 91/46 230 83/ 222 155 70 ♦• 007 -NRS 3 80 341 867 10'/4 260 91/46 230 83/4 222 185 84 • 007 -0SY 3 80 34% 867 18% 479 91/46 230 83/4 222 185 84 1" 0007M1QT Union Tailpiece Union Nut Strainer Dimensions 3* 80 10% 267 'S Models only Union Tailpiece Union Nut Sizes: 'h" — 2" (15 — 50mm) MODEL In. SIZE (ON) mm DIMENSIONS A in. mm UO07QT '/e 15 1211/46 326 U0O7M2OT 1/4 20 1313/46 350 00O7M20T 1 25 16% 422 00O7M20T 11 32 203/4 527 00O7M2QT 1'% 40 21% 546 U0O7M1QT 2 50 24% 622 Capacity As complied from documented Foundation for Cross - Connection Control and Hydraulic Research at the University of Southem California lab tests. Typical maximum system flow rate (7.5 feet/sec., 2.3 meters/sec.) UL rated flow bars psi rs 3 12 I? .7 10 G ▪ S 8 .4 6 13 .3 E .1 2 0 0 IA" (15mm) * 0 2 4 6 0 7.6 15.2 22.8 5 7.5 1.5 2.5 pars p9 3'4" (20, •m) 1.5 22 1.2 18 Q .96 14 E .• 69 10 03 • .41 6 .14 2 bats psi a 1.1 16 I? .8 12 C= .7 10 e .5 8 a .1 6 3 4 - .1 2 bars psi 1 14 i? .8 12 0 .7 10 e .5 8 I .4 6 4 .1 2 0 0 Row * 8 10 1 gpm 30.4 38 45. bin 10 fps 3.0 mps D 5 10 15 0 19 38 57 7.5 2.3 1" (25mm) 20 2 76 95 15 4.6 Flow 30 11 35 133 40 152 45 501pm 171 190 Ipm mPs Ott 0 5 0 15 0 19 38 57 5 1.5 11/4" (32mm) 20 25 30 76 95 114 7.5 10 2.3 3.0 Flow * 35 40 45 50 55 60 ppm 133 152 171 190 209 228 Ipm 5 fps 4.6 mps 0 10 20 30 40 50 60 70 80 90 100 1 0 120 gpm 0 38 76 1 4 152 190 228 266 304 342 380 4 8 4561pm 5 7.5 10 15 Ips 1.5 2.3 3.0 4.6 mps Flow WWA1TS® bars psi . .8 12 e.7 10 S 8 g .4 6 w .3 4 a.1 2 M. 0 0 bars .8 rs .7 E.5 e .4 a- 0 Id 12 10 a 6 4 2 0 0 11/2" (40mm) * 0 10 20 30 40 50 60 70 80 90 100 1 0 120 gam 0 38 76 1 4 152 190 228 66 304 342 380 4 8 456 Ipm 5 7.5 10 15 fps 1.5 25 3.0 4.5 mps 2" (50mm) Flow * =bars p9 Q .7 10 ▪ 5 8 .1 6 e3 4 12- 2 0 0 0 0 bars .7 n.5 2.4 7.3 20 d 25 50 75 100 190 285 380 5 7.5 10 1.5 2.3 3.0 0 96 21/2" (65mm) Flow 125 150 475 570 15 4.6 175 665 ** 200 760 Ipn mPs v9 10 8 6 4 2 0 25 95 50 190 3" (80mm) 75 100 125 150 175 285 380 475 570 665 5 7.5 10 1.5 2.3 3.0 Flow * 200 760 225 250 gam 855 950 tel 15 fps 4.6 mps ** 0 25 50 75 100 125 150 175 200 225 250 275 300 325 gpm 0 95 190 265 380 475 570 665 760 855 950 1045 1140 1235 4m 5 7.5 10 Ips 1.5 2.3 3.0 mps Flow M9001 -2008 CERTIFIED A Watts Water Technologies Company ES -007 1103 USA: No. Andover, MA • Tel. (978) 688 -1811 • Fax: (978) 794 -1848 • www.watts.com Canada: Burlington. ONT. • (905) 332 -4090 • Fax: (905) 332 -7068 • www.wattscanada.ca © 2011 Watts • 1 d ©6JG group August 23, 2011 Joanna Spencer Plan Reviewer Public Works Department City of Tukwila Re Permit No: PG11 -117 RE: Jamba Juice #561 Westfield SouthCenter 566 Southcenter Mall Space # 1110 Seattle, WA 98188 The comments below are in response to your review comments date 8/10/11. 1. Added new grease interceptor. A grease trap cut sheet is added on sheet P -101. 2. New grease interceptor location is shown on sheet P -101, P -102, and P -104. Also, its schedule is listed in the plumbing fixture schedule on sheet P -601. 3. Key plan added to sheet P -101. 4. Added Backflow Preventer to Plumbing Supply Plan on sheet P -102. Cut sheet of backflow preventer Watts series 007 is attached with this letter. Should any questions come up during the recheck, please feel free to call. Sincerely, Brad Derkach, LEED AP 1 Project Manager PDMS Design Group 3100 E. Randol Mill Rd. I Arlington, TX 76011 Ph: 817.701.4806 I Fax: 817.633.4153 bderkach @pdmsdesign.com 1 www.pdmsdesign.com CORRECTION -p G 11%-117 RECEIVED AUG 24 2011 PERMIT CENTER • City of f TukWl%cZ Jim Haggerton, Mayor Department of Community Development Jack Pace, Director August 19, 2011 Brad Derkach PDMS Design 3100 E Randol Mill Rd Arlington, TX 76011 RE: Correction Letter #1 Plumbing /Gas Piping Permit Application Number PG11 -117 Jamba Juice — 566 Southcenter Mall Dear Mr. Derkach, This letter is to inform you of corrections that must be addressed before your plumbing/gas piping permit can be approved. All correction requests from each department must be addressed at the same time and reflected on your drawings. I have enclosed comments from the Public Works Department. At this time the Building Department has no corrections. Public Works Department: Joanna Spencer at 206 - 431 -2440 if you have any questions regarding the attached memo. Please address the attached comments in an itemized format with applicable revised plans, specifications, and /or other documentation. The City requires that two (2) sets of revised plans, specifications and /or other documentation be resubmitted with the appropriate revision block. In order to better expedite your resubmittal, a `Revision Submittal Sheet' must accompany every resubmittal. I have enclosed one for your convenience. Corrections /revisions must be made in person and will not be accepted through the mail or by a messenger service. If you have any questions, please contact me at (206) 431 -3670. Sincerely, Bill Rambo Permit Technician encl File: PG11 -117 W:\Permit Center\Correction Letters\2011\PG11 -117 Correction Letter #1.doc 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 PUBLIC WORKS DEPARTMENT COMMENTS DATE: August 10, 2011 PROJECT: Jamba Juice 566 Southcenter Mall PERMIT NO: PG11 -117 PLAN REVIEWER: Contact Joanna Spencer (206) 431 -2440 if you have any questions regarding the following comments. 1) City of Tukwila requires any food preparation facility to tie to sanitary sewer via a grease interceptor. Please contact the Mall Management office and let us know, if Jamba Juice will be connecting to a sewer line that ties into one of the existing outside grease interceptors or to a small internal grease trap provided by the landlord. If the landlord is not providing one it is the tenant responsibility to provide and install a grease interceptor /trap. A grease trap cut sheet needs to be shown on your plan. If you have questions about this requirement please call Mike Cusick, P.E., PublicWorks Senior Sewer Engineer at 206 431 -2441. 2) If Jamba Juice is installing a grease trap /interceptor please show its location on plumbing plan and riser diagram and list it in the Plumbing Fixture Schedule on sheet P -601. 3) Since each permit stands on its own please submit a Mall Key Plan so that the Jamba Juice space can be easily found by our inspector. 4) Plumbing Plans sheet P -102 BACKFLOW PREVENTER note #1 calls for installation of a double check backflow preventer WATTS Series 007. Please show location where it is going to be installed and submit cat sheet for the subject backflow. W:Other /Joanna /PG 11 -117 • 40 PE PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG11 -117 DATE: 08 -24 -11 PROJECT NAME: JAMBA JUICE SITE ADDRESS: 566 SOUTHCENTER MALL Original Plan Submittal X Response to Correction Letter # 1 Response to Incomplete Letter # Revision # After Permit Issued DEPARTMENTS: Building Division Public Works Fire Prevention Structural Planning Division Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Incomplete DUE DATE: 08-25-11 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 n No further Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 09-22 -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 COORS COPS PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG11 -117 PROJECT NAME: JAMBA JUICE DATE: 08/01/11 SITE ADDRESS: 566 SOUTHCENTER MALL X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # after Permit Issued DEPARTMENTS: L g t9-t1 ul din Division Public oo ks 1 -�1 Fire Prevention Structural Planning Division Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Egi Incomplete n DUE DATE: 08/02/11 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 gI Structural Review Required ri No further Review Required ri REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 08/30/11 Approved Approved with Conditions n Not Approved (attach comments) Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: t Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW' Staff Initials: Documents /routing slip.doc 2 -28 -02 • City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite # 100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Web site: http: / /www.TukwilaWA.gov REVISION SUBMITTAL Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Date: 08/23/2011 Plan Check/Permit Number: PG11 -117 Response to Incomplete Letter # ,/ Response to Correction Letter # 1 Revision # after Permit is Issued Revision requested by a City Building Inspector or Plans Examiner Project Name: Jamba Juice #561 Project Address: 566 Southcenter Mall, Space #1110 Contact Person: Brad Derkach Summary of Revision: 1. Grease Trap added. 2. Mall Key Plan added. 3. Backflow Preventer info provided. Ref: attached response letter. Phone Number: (817) 701 -4806 Sheet Number(s): P -001, P -101, P -102, P -104, P -601 "Cloud" or highlight all areas of revision including date of revisit Received at the City of Tukwila Permit Center by: la— Entered in Permits Plus on v')...4 "'J4 RECEIVED CITY OF TUKWILA 'AUG 242011 PERM,fi CEarrepi H1ApplicationslFornta- Applications On Line\20I0 Applicaiions\7 -2010 - Revision SubminaLdoc Revised: May 2011 Contractors or Tradespeople Pr ter 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 SERVE -ALL PLUMBING INC UBI No. 603110702 Phone 2066963702 Status Active Address 81 Williams Ave S License No. SERVEPI896KZ Suite /Apt. License Type Construction Contractor City Renton Effective Date 5/9/2011 State WA Expiration Date 5/9/2013 Zip 98057 Suspend Date County King 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 PLUMBAI943JE PLUMBING AMERICA INC Construction Contractor Plumbing Sanitation System Side Sewer 4/5/2006 4/5/2008 Expired Business Owner Information Name Role Effective Date Expiration Date PARMLEY, DEVEN DWAYNE President 05/09/2011 PARMLEY, DARREN RAY Vice President 05/09/2011 Bond Information Page 1 of 1 Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 1 Great American Ins Co 1696531 05/06/2011 Until Cancelled $6,000.00 05/09/2011 Assignment of Savings Information No records found for the previous 6 year period Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date 1 Contractors Bonding & Insuranc C11519588 05/06/2011 05/05/2012 $300,000.00 05/09/2011 Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period Warrant Information No unsatisfied warrants on file within prior 6 year period https: // fortress .wa.gov /lni/bbip /Print.aspx 09/09/2011