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Permit PG11-126 - JACKSONS STORE NO 631
JACKSONS FOOD STORE 13138 INTERURBAN AV S PG1 1 -126 City ofkukwila • 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.: 0003000108 Address: 13138 INTERURBAN AV S TUKW Project Name: JACKSONS STORE NO 631 Permit Number: PG11 -126 Issue Date: 03/23/2012 Permit Expires On: 09/19/2012 Owner: Name: PACWEST ENERGY LLC Address: 3450 COMMERCIAL CT , MERIDIAN ID 83642 Contact Person: Name: CARYL MATTSON Address: 18215 72 AV S , KENT WA 98032 Email: CMATTSON @BARGHAUSEN.COM Contractor: Name: EVERGREEN ENVIRONMENTAL SERVICES INC Address: 17108 9 AV SE , MILL CREEK WA 98012 Contractor License No: EVERGES061J5 Phone: 425 656 -1063 Phone: 425 -787 -8987 Expiration Date: 01/14/2014 DESCRIPTION OF WORK: PROVIDE FIXTURES AND INSTALL (2) PUBLIC RESTROOMS IN NEW BUILDING INCLUSIVE OF TOILETS, LAVS, AND A URINAL. ALSO PROVIDE MOP SINK, HAND SINKS, THREE- COMPARTMENT SINK, FLOOR SINKS, AND FLOOR DRAINS IN UTILITY ROOM AS NECESSARY. INSTALL 2.5" DDCVA (AMES Series 3000SS) FOR FIRE SPRINKLER INSIDE BUILDING and 1.5" DOMESTIC WATER RPPA (WATTS 009M2QT) FOR PREMISE ISOLATION. Value of Plumbing /Gas Piping: Fees Collected: Electrical Service Provided by: Permit Center Authorized Signature: $0.00 Uniform Plumbing Code Edition: 2009 $888.56 International Fuel Gas Code Edition: 2009 Date: '?5, )_3-1)\ 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: V1301 vltvnU.��, �UteA Date: \-\\(A q\'11-■1_ 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 -126 Printed: 03 -23 -2012 • • PERMIT CONDITIONS Permit No. PG 11 -126 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 m 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: 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. 12: 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. 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. 14: ** *PUBLIC WORKS DEPARTMENT CONDITIONS * ** 15: ZURN grease trap /interceptor shall be installed per manufacturer's specifications and shall be maintained per attached GREASE TRAP MAIIVTENANCE PROGRAM outline dated May 9, 2011. 16: All backflows shall be installed per manufacturer's specifications and tested by a certified tester prior to final permit sign -off. Passing backflow test reports shall be submitted to Public Works inspector. Thereafter all the backflows shall be tested on annual basis at owners expense and backflows test reports shall be submitted to Tukwila Water Department, Minkler Shops, 600 Minkler Blvd, Tukwila, WA 98188, phone (206)433 -1860. 17: ** *FIRE DEPARTMENT CONDITIONS * ** 18: The attached set of building plans have been reviewed by the Fire Prevention Bureau and are acceptable with the following concerns: 19: When subject to vehicular damage, protective guard posts or curbs are required around all gas meters, electrical transformers, sprinkler valves and hydrants. Posts and curbs are to be painted yellow. (City Ordinance #2052) (MAINTAIN A 4 FT. CLEARANCE AROUND THE WIV.) doc: UPC -4/10 PG11 -126 Printed: 03 -23 -2012 20: All valves controlling the watereply for automatic sprinkler systems and watlw switches on all sprinkler systems shall be electrically supervised. (City Ordinance #2050) 21: All exterior components of sprinkler systems should be painted SAFETY RED. This includes: Post indicator valves (PIV), outside stem and yoke (OSY), wall indicator valves (WIV), and Fire Department connection (FDC). (City Ordinance #2050) 22: Contact The Tukwila Fire Prevention Bureau to witness all required inspections and tests. (City Ordinances #2050 and #2051) 23: Any overlooked hazardous condition and/or violation of the adopted Fire or Building Codes does not imply approval of such condition or violation. 24: These plans were reviewed by Inspector 511. If you have any questions, please call Tukwila Fire Prevention Bureau at (206)575 -4407. doc: UPC -4/10 PG 11 -126 Printed: 03 -23 -2012 1 CITY OF TUKWILA Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http: //www. ci. tkwila. wa. us • BCE #14700 Building Permit No. Mechanical Permit No. Plumbing /Gas Permit No. Public Works Permit No Project No. Dll- 2640 tl -n) temp ---912) (For 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: King Co Assessor's Tax No.: 0003000108 13138 Interurban Avenue South (@ 48th Avenue S.) Tenant Name: Jacksons Store No. 631 Property Owners Name: PacWest Energy, LLC Mailing Address: 3450 East Commercial Court Suite Number: Floor: New Tenant: ❑ Yes O..No Meridian, Idaho City 83642 State Zip CONTACT PERSON — who do we contact when your permit is ready to be issued Name: Ms. Caryl Mattson, Design Engineer Consulting Mailing Address: 18215 - 72nd Avenue South, Kent 98032 E -Mail Address: cmattson @barghausen.com Engineers, Inc. Day Telephone: (425) 656 -1063 Kent, Washington city state Fax Number: (425) 251 -8782 98032 Zip GENERAL CONTRACTOR INFORMATION — (Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5)) Company Name: Mailing Address: TBD 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: Mailing Address: Contact Person: E -Mail Address: city Day Telephone: Fax Number: State Zip ENGINEER OF RECORD — All plans must be stamped by Engineer of Record Company Name: Barghausen Consulting Engineers, Inc. Mailing Address: 18215 - 72nd Avenue South Contact Person: E -Mail Address: David Segal, P.E. dsegal @barghausen.com Kent, Washington city State Day Telephone: (425) 251 -6222 Fax Number: (425) 251 -8782 98032 Zip 14700 -F -APPL- BLDG - Convenience Store - 2011- 08- 3.2 .pdf HAApplications\Ponns- Applications On Line\2010 Applications \7 -2010 - Permit Application.doc Revised: 7 -2010 bh Page 1 of 6 BUILDING PERMIT INFORMATI41, 206 - 431 -3670 Valuation of Project (contractor's bid price): $ 239,151.36 Scope of Work (please provide detailed information): Existing Building Valuation: $ 184,506.56 in • . s• = - -fo• • ' •. Construct a new 2,976- square foot building; with a 2,174 - square foot convenience store associated with the retail fuel sales and a 802 - square foot employee Leaming Center. Will there be new rack storage? ❑ Yes m.. No If yes, a separate permit and plan submittal will be required. Provide All Building Areas in Square Footage Below PLANNING DIVISION: Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq fl): Floor area of principal dwelling: Floor area of accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Compact: Handicap: Will there be a change in use? ❑ Yes m No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: 0 Sprinklers ❑ Automatic Fire Alarm ❑ None ❑ Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? Yes ❑ No If 'yes', attach list of materials 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 current septic design approved by King County Health Department. H: Applications\Fonns- Applications On tinet2010 Applications\7 -2010 - Pertnil Application.doc Revised: 7 -2010 bh Page 2 of 6 Existing interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC In Floor 2,976 V -B B & M .2,200 2nd Floor 3`a Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck PLANNING DIVISION: Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq fl): Floor area of principal dwelling: Floor area of accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Compact: Handicap: Will there be a change in use? ❑ Yes m No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: 0 Sprinklers ❑ Automatic Fire Alarm ❑ None ❑ Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? Yes ❑ No If 'yes', attach list of materials 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 current septic design approved by King County Health Department. H: Applications\Fonns- Applications On tinet2010 Applications\7 -2010 - Pertnil Application.doc Revised: 7 -2010 bh Page 2 of 6 • PLUMBING AND GAS PIPING PERMIT INFORMATION — 206 -431 -3670 PLUMBING AND GAS PIPING CONTRACTOR INFORMATION Company Name: TBD Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: Contractor Registration Number: Expiration Date: Valuation of Plumbing work (contractor's bid price): $ 39,000 Valuation of Gas Piping work (contractor's bid price): $ 2,900 Scope of Work (please provide detailed information): Construct new convenience store with two (2) public rest rooms; toilets, lavatories, and urinal. Utility room with mop sink, hand sinks, three compartment sink, floor sinks and floor drains as necessary. Building Use (per Int'1 Building Code): 2009 UPC M Occupancy (per Int'l Building Code): Utility Purveyor: Water: TUKWILA PUBLIC WORKS Sewer: TUKWILA PUBLIC WORKS 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 3 Shower, single head trap Lavatory 2 Wash fountain Receptor, indirect waste Sinks 4 Urinals 1 Water Closet 2 Building sewer and each trailer park sewer Rain water system — per drain (inside building) 6 Water heater and/or vent 3 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 8 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) 1 Atmospheric -type vacuum breakers not included in lawn sprinkler backflow protections over 5 Gas piping outlets 2 H: Applicat ions \Forms- Applications On Line\20I0 Applications \7 -2010 - Permit Application.doc Revised: 7 -2010 bh Page 5 of 6 PERMIT APPLICATION NOTES — Applicable to all permits in this application 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. 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 105.3.2 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 OL UTHORIZED AGENT• Signature: Print Name: Barghausen Consulting Engineers, I Ms. Caryl Mattson, Design Engineer Mailing Address: 18215 - 72nd Avenue South rDate Application Accepted: Date: O� l Day Telephone: (425) 656 -1063 Kent WA 98032 City State Zip 2,29 �t Date Application Expires: H:\Applications\Forms- Applications On Line120I0 Applications17 -2010 - Permit Application.doe Revised: 7 -2010 bh 0 21 0, I wi 2- 1 Staff Initials: S.-�� 1 Page 6 of 6 CillObf 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: R12 -00906 Initials: JEM Payment Date: 03/05/2012 User ID: 1165 Total Payment: 11,325.70 Payee: PACWEST ENERGY LLC SET ID: 1017 SET NAME: JACKSON STORES SET TRANSACTIONS: Set Member Amount D11 -285 652.40 D11 -286 6,892.55 D11 -287 1,798.15 EL11 -0791 505.30 EL11 -0792 212.90 M11 -118 553.55 PG11 -126 710.85 TOTAL: 652.40 TRANSACTION LIST: Type Method Description Amount Payment Check 0007347 11,325.70 TOTAL: 11,325.70 ACCOUNT ITEM LIST: Description Account Code Current Pmts BUILDING - NONRES ELECTRICAL PERMIT - NONR GAS - NONRES MECHANICAL - NONRES PLAN CHECK - NONRES PLUMBING - NONRES PW BASE APPLICATION FEE PW LAND ALT PERMIT FEE PW PERMIT /INSPECTION FEE PW PLAN REVIEW STATE BUILDING SURCHARGE 000.322.100 5,947.70 000.322.101.00.0 718.20 000.322.103.00.0 63.00 000.322.102.00.0 538.85 000.345.830 14.70 000.322.103.00.0 647.85 000.322.100 250.00 000.342.400 89.50 000.342.400 2,992.40 000.345.830 50.00 640.237.114 13.50 TOTAL: 11, 325.70 Ca! of Tukwila. • Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206-431-3665 Web site: hitp: //www. ci. tukwila. wa. us SET RECEIPT Copy Reprinted on 08 -23 -2011 at 14:59:02 08/23/2011 RECEIPT NO: R11 -01842 Initials: JEM User ID: 1165 Payee: BARGHAUSEN CONSULTING ENGINEERS, INC. Payment Date: 08/23/2011 Total Payment: 4,593.29 SET ID: S000001558 SET NAME: JACKSON STORE 631 SET TRANSACTIONS: Set Member Amount D11 -285 193.64 D11 -286 2,756.50 D11 -287 1,165.87 EL11 -0791 126.33 EL11 -0792 53.23 M11 -118 120.01 PG11 -126 177.71 TOTAL: 193.64 TRANSACTION LIST: Type Method Description Amount Payment Check 29585 4,593.29 TOTAL: 4,593.29 ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PLAN - NONRES PLAN CHECK - NONRES PW BASE APPLICATION FEE 000.345.832.00.0 000.345.830 000.322.100 TOTAL: 179.56 4,163.73 250.00 4,593.29 INSPECTION NO. INSPECTION RECORD Retain a copy with permit PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 F (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 4 . Proj t: -9v ‘Z:0 .3 ' Type of Inspection; t iv1-A- k ' Address: 1 3t P)�zt ✓ Date Called: Special Instructions: . Date . anted: . t !-7 r ii' 2.4i : - r. —a:m.. p.m. Requester: Phone No: pproved per applicable codes. Corrections required prior to approval. COMMENTS: 1 R' NSPECTION FEE REQ IRED. Prior t next inspection. fee must be paid at 6300 Southcenter Bilfd.. Suite 100. Call to schedule reinspection. INSPECTION NO. INSPECTION RECORD Retain a copy with permit em-t-zio i'• CITY OF TUKWILA BUILDING QJVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 PERMIT NO. Protest: A CSOA.1 Type r�spestioni ^ Address: -7:-A11-e) 13138 'k^j Date Called: Special Instructions: y� ni(' W Z, l��d J 4 1 Date Wanted r► _ "i I r' r�m. p.m. Requester: Phone No 4 z.1 —SO (1'—q /cc/ ElApproved per applicable codes. • E Corrections required prior to approval. t COMMENTS: ,' p74- 'i 5,.ab; ee..'o LJl?i rc a•� s �,� A fpr F r 1 . .. •• A n REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. • ___...� INSPECTION RECORD P6(1 _ Z, Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION /2_ (206) 431 -367 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 431 -2451 Proj J _ f� oA r Type of rir(i At 6 ` /J O J Addr k L.? e 3... )--co,' . Date Called: Special Instructions: Date Wanted r (_ a p.m. Requester: Phone No: Approved per applicable codes. El Corrections required prior to approval. COMMENTS: 0K- -Ns; 3A a tc.i4DL, Ins i ctor: IDats-_, ri REINSPECTION'FEE REQUIRE n . Prior to next inspection, fee mustrbe paid 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 ,g. (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 • Project:— } �i" Type of Insp t�n / /- Adcliesi / 3 s7,7_47,2/..,,/ 4, D Call Special Instructions: Date Wanted: S -72 -/ . Requester: - ( )' i Phone No: To ElApproved per applicable codes. • orrections required prior to approval. COMMENTS: - q ./sue'/ y /1 d iiReb -D4t ____ O - ( )' i % i r :.) ( To opal ti 1-7)7 -,)( A le- 2 1 ..-"‘ 11 X Dater ? 2 W 1 REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. � RECORD of Li Retain a copy with permit IN PECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 g. (206) 431 -36 0 Permit Inspection Request Line (206) 431 -2451 Project: 'r z ,.4 r S% i�o Ty of Inspection: :7_44 K61,r +i• , . �{u . Address: 1313 • - 'P/ J/5 i�c Dat Called: Special Instructions: Date Wanted:... a.m. Requester: Phone No: ! 5.411. --/100 f Approved per applicable codes. 1 Corrections required prior to approval. COMMENTS: S• 07 r / to ps • b Inspec or: r a._ REINSPECTION FEE REQUIRED. •Priorjto next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspectioh. ( -0- INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF" TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 it. (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 P611,1 Project: C '�� } / Type f Inspection: _ Address: Date Cal(ed: r° 0 D , t Ont Spec al Instructions: Date Wanted -'1(?' a.m. ' p.m. Requester: Phone No: I It • Approved per applicable codes. 11 Corrections required prior to ap COMMENTS: 1 S:7J .S(D e- 4)jJ FAL po REINSPECTION FEE REQUIRED. Pri to next inspection. fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. • • • , - INSPECTION. NQ: • • • INSPECTION RECORD Retain a copy with permit J:7 PERMIT NO. • CITYOF`TUKWILA BUILDING DIVISION ..6300 Southceriter Blvd:,. #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 =2451 • • Praje ' • :f ! '? S Si* e )Jo 43i Type of Inspection: OFF a FuJ Address: j Date Called: 06 fith...1 Special Instructions: . . ' Date Wanted:. a 04 Ill /t3. p.. m, Request is aL Gee/X.-OW CI( Phone No Vas- So&'- 67 700 • :., a Approved per applicable codes. a .. OCorrections required prior to approval. COMMENTS: . i t~ ikle Gi' Aim • 3f ....; ' 14: T., • , Inspector: • y' Ds Date: flo REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be • ..paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. `, INSPECTION NUMBER - ayk.:aY.',.� =..mr� INSPECTION RECORD Pi"— "4. • Retain a copy with permit PC/i - /ate ✓ . { f•� PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206 - 575 -4407 Project: 0-i4c.1! s c_,,,e S Type of I pection: U Address: j 3 i 3 s Suite #: ss91" Contact Person: Special Instructions: Monitor: • Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: %� .-1 ) fZc eGY2Wild /p 1'."4. Z ,4cte Needs Shift Inspection: Sprinklers: Hrs.: ti Fire Alarm: Hood & Duct: • Monitor: • Pre -Fire: Permits: . Occupancy Type: Inspector: fyy; 5-3 Date: g.A7 /jam Hrs.: ti $100.00 REINSPECTION FEE REQUIRED. You will receive fin` invoice from e City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: 1 Zip: Word /Inspection Record Form.Doc T.F.D. Form F.P. 113 ti • File -E Peorecn c7 /v .QOc --L3 &E D E 7 E7F c7o2 3,lckkptow P,eviECEOVED NOV ?2 2011 TUKWILA PUBLIO WQft Series 3000SS ES- A -3000SS A 6V1 E S Double Check Detector Assemblies Sizes: 2'/2" — 12" (65 — 300mm) '" FTLE corn Features • Cam -Check Assembly valve provides low head Toss • Short lay length is ideally suited for retrofit installations • Stainless Steel body is half the weight of competitive designs reducing installation and shipping cost • Stainless steel construction provides long term corrosion protection and maximum strength • Single top access cover with two -bolt grooved style coupling for ease of maintenance • No special tools required for servicing • Compact construction allows for smaller vaults and enclosures • Fumished with 3/4" x 3/4" bronze meter (gpm or cfm) • Detects underground leaks and unauthorized water use • Maybe installed horizontal or vertical "flow up" position Available Models Suffix: LG - Tess shutoff valves OSY - UL/FM outside stem and yoke OSY FxG OSY GxF OSY GxG CFM GPM resilient seated gate valves - flanged inlet gate connection and grooved outlet gate connection - grooved inlet gate connection and flanged outlet gate connec- tion - grooved Inlet gate connection and grooved outlet gate connection - cubic feet per minute - gallons per minute meter Post indicator plate and operating nut available - consult factory FIRE &WATER WORKS Series 3000SS Double Check DetectorAssemblies are designed for use in accordance with water utility non - health hazard containment requirements. It is mandatory to prevent the reverse flowoffire protection system substances, i.e., glycerin wettingagents, stagnant water and water of non - potable quality from being pumped or siphoned into the potable water supply. Specifications A Double Check Detector Assembly shall be installed on fire protection systems when con- nected to a potablewatersupply. Degree of hazard present is determined by the local author- ity having jurisdiction. The main valve body shall be manufactured from 300 Series stainless steel to provide corrosion resistance, 100% lead free through thewater- way. The double check detector assembly consists of two independently operating, spring loaded c heck valves, two UL, FM, OSY resili ent seated gatevalves, and bypass assembly. The bypass assembly consists of a meter (cubic ft. or gallons), a double check including shutoff valves and req ui red test cocks. Each cam-chec k shall be intemally loaded and provide a posi- tive drip tight closure against reverse flow. Cam -check includes a stainless steel cam arm and spring, rubberfaced disc and a replaceable seat. There shall be no brass or bronze parts used withinthecam- checkvalveassembly. Thecheckvalveseatsshall beof moldedthermoplastic construction. The use of seat screws as a retention method is prohibited. All intemal parts shall beaccessiblethroughasinglecoverontheva lveassembly.Thevalvecovershall beheld in place through the use of a single grooved style two -bolt coupling. The bypass line shall be hydraulically sized to accurately measure low flow. The bypass line shall consist of a meter, a small diameter double check assembly with test cocks and isolation valves. The bypass line double check valve shall have two independently operating modular poppet check valves, and top mounted test cocks. The assembly shall be an Ames 3000SS. Materials All intemal metal parts: 300 Series stainless steel, Main valve body: 300 Series stainless steel, Check assembly: Noryle Flange dimension in accordance with AWWA Class D. Noryl® is a registered trademark of General Electric Company. Job Name Contractor Job Location Approval Engineer Contractor's P.O. No. Approval Representative RECEIVED NOV 17 2011 Ames product specifications in U.S. customary units and metric are approximate and are provided far reference only. For precise measurements, please contact Ames Technical Service. Ames reserves the right to change or modify product design. construction, specifications, or materials without prior notice and without incurring any obligation to make such changes and modifications on Ames products previously or subsequently sold. CORRECTION LTR #� www.amesfirewater.com ?&ri (fib Pressure — Temperature Temperature Range: 33 °F —110 °F (0.5 °C — 43 °C) Maximum Working Pressure: 175psi (12 bar) Capacity Flow cu rves as tested by Underwriters Lab o ratory perUL 1469, 1996. ' Rated flow '''UL Tested kPa psi 83 12 69 10 55 8 41 6 28 4 14 2 21 /Y" (65mm) • • 0 2 5 100 1 0 200 250 95 190 380 570 7 0 950 15 4.6 300 350 400 450 5 0 52 pm 1140 1330 1520 1770 1900 199 Ipm his 11Pa 83 12 69 10 psi 3" (80mm) 55 8 41 6 28 4 14 2 w •• 95 198 380 570 76D 950 11 0 1330 1520 15 4.6 kpa 511 4" (100mm) 703 75 83 12 02 9 41 6 21 3 0 0 pm 1710 1900 20902280 1pm 4s MPs •k D 50 100 150 200 250 1300 350 400 450 500 171 380 570 760 950 111 0 1330 1520 1170 1900 5 10 15 1.5 3 4.6 550 600 650 700 750 ppm 2090 2280 2470 26602850 Ipm 1173 Mos Standards ASSE 1048, AWWA C510 -92, CSA B64.5, UL 1469 Approvals UL Classified (OSY only), FM (sizes 21/2" — 10", OSY only) ''11 Approved Y` O 6" (150mm O kPa 103 83 62 41 21 psi 15 12 9 6 3 *4 0 100 2 0 300 4 0 500 600 700 600 900 1000 1100 1200 1300 1400 1500 ppm 380 760 1140 1520 1900 2280 2660 3040 3 20 3800 4180 4560 4940 53 0 5700 ipm 5 10 15 fps 1.5 3 4.6 mps kPa p=; 8" (200mm) 83 12 62 9 41 6 21 3 MP* 103 83 62 41 21 psi 15 12 9 6 3 kPa psi 110 16 97 14 83 12 69 10 55 8 41 6 28 4 14 2 4# 0 250 500 7 0 950 1900 2850 5 1.5 10" (250mm) 1000 1250 1500 3800 4750 5 00 10 3 1750 2000 6650 7600 2250 2500 ppm 8550 9500 fpm 15 Ip1 4.6 mp$ •• 0 2 0 500 750 1000 1250 1500 1750 2000 2250 2500 3000 3500 ppm 950 1900 2850 3800 4750 5700 6650 7600 8550 9500 11400 13300 Ipm 5 10 Ipe 1.5 3 mps 12" (300mm) 0 500 1000 1900 3800 1 00 5700 5 1.5 2000 7600 2500 3000 9500 11400 3500 4000 13300 15200 10 3 4500 ppm 17100 Ipm fps mps SIZE (MD 1n. mm in. A nun in. C (OSY1 mm in. D min DIMENSIONS. G !n. mnl !n L mm is P mm NET WEIGHT w/Gates a kg. NET WEIGHT w/o Gates Ib. kg. 21/2 65 37 965 163/4 416 31/2 89 10 250 22 559 121/2 318 155 70 68 31 3 80 38 965 181/2 479 3314 95 10 250 22 559 13 330 230 104 70 32 4 100 40 1016 223/4 578 41/2 114 10 250 22 559 14% 368 240 109 73 33 6 150 48'/z 1232 301/4 765 51/2 140 15 0 25 50 100 150 200 250 200 350 400 450 502 550 600 95 198 380 570 76D 950 11 0 1330 1520 15 4.6 kpa 511 4" (100mm) 703 75 83 12 02 9 41 6 21 3 0 0 pm 1710 1900 20902280 1pm 4s MPs •k D 50 100 150 200 250 1300 350 400 450 500 171 380 570 760 950 111 0 1330 1520 1170 1900 5 10 15 1.5 3 4.6 550 600 650 700 750 ppm 2090 2280 2470 26602850 Ipm 1173 Mos Standards ASSE 1048, AWWA C510 -92, CSA B64.5, UL 1469 Approvals UL Classified (OSY only), FM (sizes 21/2" — 10", OSY only) ''11 Approved Y` O 6" (150mm O kPa 103 83 62 41 21 psi 15 12 9 6 3 *4 0 100 2 0 300 4 0 500 600 700 600 900 1000 1100 1200 1300 1400 1500 ppm 380 760 1140 1520 1900 2280 2660 3040 3 20 3800 4180 4560 4940 53 0 5700 ipm 5 10 15 fps 1.5 3 4.6 mps kPa p=; 8" (200mm) 83 12 62 9 41 6 21 3 MP* 103 83 62 41 21 psi 15 12 9 6 3 kPa psi 110 16 97 14 83 12 69 10 55 8 41 6 28 4 14 2 4# 0 250 500 7 0 950 1900 2850 5 1.5 10" (250mm) 1000 1250 1500 3800 4750 5 00 10 3 1750 2000 6650 7600 2250 2500 ppm 8550 9500 fpm 15 Ip1 4.6 mp$ •• 0 2 0 500 750 1000 1250 1500 1750 2000 2250 2500 3000 3500 ppm 950 1900 2850 3800 4750 5700 6650 7600 8550 9500 11400 13300 Ipm 5 10 Ipe 1.5 3 mps 12" (300mm) 0 500 1000 1900 3800 1 00 5700 5 1.5 2000 7600 2500 3000 9500 11400 3500 4000 13300 15200 10 3 4500 ppm 17100 Ipm fps mps SIZE (MD 1n. mm in. A nun in. C (OSY1 mm in. D min DIMENSIONS. G !n. mnl !n L mm is P mm NET WEIGHT w/Gates a kg. NET WEIGHT w/o Gates Ib. kg. 21/2 65 37 965 163/4 416 31/2 89 10 250 22 559 121/2 318 155 70 68 31 3 80 38 965 181/2 479 3314 95 10 250 22 559 13 330 230 104 70 32 4 100 40 1016 223/4 578 41/2 114 10 250 22 559 14% 368 240 109 73 33 6 150 48'/z 1232 301/4 765 51/2 140 15 381 271/2 699 151/2 394 390 177 120 54 8 200 52'12 1334 373/4 959 63/4 171 15 381 291/2 749 18'/2 464 572 259 180 82 10 250 55'12 1410 453/4 1162 8 200 15 381 29'h 749 191/2 495 774 351 190 86 12 300 571/2 1461 53' /a 1349 91/3 241 15 381 291/2 749 21 533 1044 474 220 100 A M E S FIRE a WATERWORKS www.amesfirewater.com A Watts Water Technologies Company ES- A- 3000SS 1114 USA: Backflow- Sacramento, CA • Tel. (916) 928-0123 • Fax (916) 928 -9333 Control Valves- Houston, Tx • Tel. (713) 943 -0688 • Fax (713) 944 -9445 Canada: Burlington, ON • Tel. (905) 332 -4090 • Fax (905) 332 -7068 © 2011 Ames Fire & Waterworks 9r2e i'7 P (ZI N\ RLE12 FLIc7t -3 AP AP AP AP kPa psi 34" (10mm) 008PCQT 69 10 55 8 41 6 28 4 14 2 0 0 kPa psi 97 14 83 12 69 10 55 8 41 6 28 4 14 2 0 0 kPa psi 69 10 55 8 41 6 28 4 14 2 0 0 kPa psl 69 10 55 8 41 6 28 4 14 2 0 0 kPa psi 138 20 117 17 96 14 AP 76 11 55 8 35 5 mesi c W AT&R• you c8D S[ u R , Acrc Low ? UEN mR `Typical maximum system flow rat 5et/ .) % FI.PkJ CilAgd 0 05 15 2 2.5 3 3.5 4 45 5 5.5 gpm 0 1.9 3.8 57 76 9.5 114 13.3 15.2 171 19 21 Ipm 3/4" (15mm) 008PCQT FLOW * 0 2 3 4 5 6 7 8 9 10 gpm 0 3 8 7 6 11.4 15.2 19 22.8 27 30 34 38 Ipm FLOW 7.5 fps 2.3 mps 3/4" (20mm) 008PCQT * 0 0 5 10 15 20 25 30 gpm 19 38 57 76 95 114 Ipm FLOW 7.5 fps 23 mps 1" (25mm) 008PCQT * 0 5 10 15 20 25 39 35 40 45 50 pm 0 19 38 57 76 95 114 135 152 171 199 Ipm FLOW 7.5 fps 2.3 mps 1/4" (8mm) 009QT 0 0 kPa psi 138 20 117 17 AP 96 14 76 11 55 8 35 5 0 0 _5 .95 3/4" (10mm) 009QT .50 .9 FLOW .75 2.9 3.8 1.17 gpm 4.5 Ipm .25 .50 .75 95 1.9 2.9 3 8 FLOW 1.25 1.50 25 31 gpm 4.8 5.7 9 5 118 Ipm kPa psl 172 25 138 20 AP 103 15 69 10 35 5 0 0 1h" (15mm) 0090T kPa psi 207 30 165 24 AP 124 18 83 12 41 6 0 0 kPa psi 207 30 172 25 138 20 AP 103 15 69 10 34 5 0 0 kPa psl 172 25 133 20 AP 103 15 69 10 34 5 0 0 25 5 75 10 12.5 15 gpm 3.8 9 5 19 28.5 38 47 5 57 Ipm FLOW 5 75 15 fps 1.5 2. 4.6 mps 3/4" (20mm) 009M3QT * 0 2 6 10 14 0 75 23 38 53 7.5 2.3 1" (25mm) 009M2QT * 18 22 68 84 FLOW 26 3D 34 38 42 46 gpm 99 114 129 144 160 1 5 Ipm hm mps 0 5 10 0 19 3 FLOW 20 30 40 76 114 152 7.5 2.3 11/4" (32mm) 009M2QT * 50 190 60 70 80 gpm 228 266 304 Ipm fps mps 0 10 20 30 40 50 60 70 80 gpm 0 38 6 14 152 190 228 266 304 Ipm FLOW 5 7.5 10 15 tps 1.5 2.3 3.0 4.8 mps kPa 207 20 172 25 , 138 20 AP 103 1 69 10 34 5 0 0 0 psi 13/4" (40mm) 009M211T 10 20 30 40 50 60 70 80 90 100 0 38 76 1 4 152 190 228 266 304 342 380 5 7.5 10 15 1.5 2.3 3.0 4.6 FLOW 110 120 gpm 418 456 Ipm fps mps T1-115 15 THE CHAR-1 sPCclFic To THE VALvE. SP5.GIFIE.D 65 << Flow Charts Series Reduced Pressure Zone Assemblies Sizes: 'A" - 3" (8 - 80mm) DOwype541c. Wattef Redtxeot P s »di'e setgck,clata IteNalivl' 1.5 " saijgwassy auoZ einssead paonpaa 009 QT U009A QT Series 009 Reduced Pressure Zone Assemblies are designed to protect potable water supplies in accordance with national plumbing codes and water authority requirements. This Series can be used in a variety of installations, including the prevention of health hazard cross - connections in piping systems or for contain- ment at the service line entrance. The 009 Series features two in -line, independent check valves, captured springs and replaceable check seats with an intermediate relief valve. Its com- pact modular design facilitates easy maintenance and assembly access. Sizes 1/4" -1 " (8 - 25mm) shutoffs have tee handles. Features • Single access cover and modular check construction for ease of maintenance • Top entry - all internals immediately accessible • Captured springs for safe maintenance • Internal relief valve for reduced installation clearances • Replaceable seats for economical repair • Bronze body construction for durability - 1/4" - 2" (8 - 50mm) • Fused epoxy coated cast iron body - 2'/" and 3" (65 and 80mm) • Ball valve test cocks - screwdriver slotted - 'A' - 2" (8 - 50mm) • Large body passages provide low pressure drop • Compact, space saving design • No special tools required for servicing CORRECTION LTR #_2E___ Materials Sizes 'A" - 2" (8 - 50mm) • Body: Bronze • Check and Relief Valve Discs: Silicone rubber • Check Seats: Replaceable polymer • Relief Valve seat: Removable stainless steel • Cover Bolts: Stainless steel Sizes 2'/211 - 3" (65 - 80mm) • Body: FDA approved epoxy coated cast iron • Seats: Bronze • Relief Valve Seat and Trim: Stainless steel • Test Cocks: Bronze Pressure - Temperature Temperature Range: 1/4" - 2" (8 - 50mm) 33°F - 180'F (0.5C - 82"C) 2h/2" - 3" (65 - 80mm) 33"F - 110°F (0.5°C - 43 °C) continuous, 140'F (60'C) intermittent Maximum Working Pressure: 175psi (12.1 bar) 009M2 QTHC RECEIVED NOV O 1 2011 TUKWILA PUBLIC WORKS Test Cock No. 2 Ball Type Test Cocks Test Cock No. 3 Test Coc r No. 4 2nd Check Module Assembly 1st Check Module Assembly Relief Valve Assembly 1?&U 12(o 34 For additional information, request literature ES-009. Water Outlet R.P. Zone ECE VE OCT 312011 Ti !f R See Flow Charts on p. 65 -66 4 LIGHT COMMERCIAL RECEIVED NUV U 1 2011 TUKWILA MAIO WPM GT2700 Grease Interceptor TAG ®r(Dime•ional Data (inches and 1 mm U are Subject to Manufacturing Tolerances and Change Without Notice F 1 INLET G= WIDTH OF BODY OUTLET INLET GT2700 -4 through GT2700 -50 F G= WIDTH OF BODY GT2700 -75 & GT2700 -100 OUTLET Model Number A/B Inlet/Outlet No-Hub Flow Rate GP.M. [L] Capacity Grease Lbs. [kg] Dimension in Inches C D/E F G _ GT2700 -4 2 [51] 4 [15] 8 [4] 10 [254] 71 /4 [184] 15 7/8 (403] 9 7/8 [251 ] _GT2700 -7 2 [51] 7 [26] 14 [6] 11 1/8 [283] 81/8 [206] 171/4 [438] 11 7/8 [302] GT2700 -10 2 [51] 10 [38] 20 [9] 11 3/4 [298] 81/4 (210] 191/4 [489] 14 (356] _GT2700-15 2 [51 ] 15 [57] 30 (14] 13 3/8 (340] 93/8 [238] 21 1/4 (540] 16 3/4 [425] _ GT2700 -20 3 [76] 20 [76] 40 (18] 15 [381] 11 3/4 [298] 241/8 [613] 171/4 [438] GT2700 -25 3 [76] 25 [94] 50 [23] 17 [432] 121/2 [318] 261/4_18144 19 7/8 [505] GT2700 -35 4 [102] 35 [132] 70 [32] 18 3/4 (476] 141/4 [362] 28 [711] 221/2 [572] _ _ GT 1 I • I .. 11 •.. .(IT: ' :.. _ GT2700 -75 4 (102) 75 [283] 150 [68] 22 3/4 [587) 181/2 [470) 38 [914) 28 5/8 [727) GT2700 -100 4 (102) 100 [379] 200 [91) 27 [685) 23 [584) 42 3/4 [1086) 33 5/8 [854] GT2700 Grease Interceptor Recommended for removing and retaining grease from wastewater in kitchen and restaurant areas where food is prepared. Grease trap is corrosion - resistant coated fabricated steel with no-hub connections, flow diffusing baffle, integral trap, and vented inlet flow control device. OPTIONS - JP2700 6 (152) Extension CORRECTION LTR# 'l•• RECEIVED OCT 312011 ITCENTEER APPROVED Sizes 4 - 50 Sizes 20GP.M.- 50GP.M. ZURN LIGHT COMMERCIAL PLUMBING PRODUCTS • 2040 South Work Street • Falconer, NY 14733 Phone: 1400/90840n • Fax: 710/6&8 -3120 • World Wide Web: wwwaurn.corn le- a lp Rev. A Date: 1/5/05 C.N. No. 84460 Dwg. No. 63802 Product No. GT2700 ASE TRAP MAINTENANCE PROGRAM 3 . MAY 9, 2011 PURPOSE: The intent of this program is to provide maintenance guidelines for food -use businesses utilizing a grease trap in place of a grease interceptor so as to minimize health, safety and environmental concerns. POLICY: All businesses utilizing a grease trap in place of a grease interceptor will be required to contract the services with a grease waste contractor. Each business will have their grease trap maintained (as per the details below) a minimum of every month. Proof of service should be kept on -site as well as copies to the City (directly from the contractor). There shall also be placed on -site a grease trap maintenance log which the contractor will complete upon each monthly service. PROCEDURE: Below is the procedure for grease trap cleaning and recycling to be provided by a required vendor (see sample proposal attached): 1. Removal of all waste from grease traps. 2. Contractor will utilize a portable pumping system when necessary. 3. The grease traps will be backfilled after cleaning to insure proper draining. 4. Contractor will not use any biodegradable or chemicals that might temporarily break up grease but lead to re- coagulating later on. 5. An inspection and service report will be left at each location. 6. Customers will be required to provide a regular cleaning schedule. 7. All customers will be contacted prior to each service. 8. City of Tukwila will be included with a copy of the services by email or fax. (W:PW Eng/Other/Mike Cusick/Grease Trap Maintenance Program) PG(kJ2 f) • City Tukwila • Jim Haggerton, Mayor Department of Community Development Jack Pace, Director January 10, 2012 Caryl J. Mattson Barghausen Consulting Engineers, Inc. 18215 72nd Avenue S Kent, WA 98032 RE: Request for Application Extensions Jacksons Store Number 631 -13138 Interurban Av S Dear Ms. Mattson, This letter is in response to your written request for extensions to Permit Application Numbers D11 -285, D11 -286, D11 -287, M11 -118, PG11 -126, EL11 -0791, and ELI 1 -0792. The Building Official has reviewed your letter and considered your request. It has been determined that the City of Tukwila will extend the permit application expiration dates an additional 90 days, through May 18, 2012. If you should have any questions, please contact our office at (206) 431 -3670. Sincerely, �j enri.fer/JM shall it Tec ician File: Permit No. DI 1 -285 through 287 M11-118, PG11 -126, EL11 -0791, and EL11 -0792 W:\Permit Center\Extension Letters\Applications\2011\EL11 -0972 Application Extension.doc 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 Bill Rambo, Permit Technician City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite 100 Tukwila, Washington 98188 January 5, 2012 RE: Request for Extension of Application Jacksons Store No. 631 13138 Interurban Avenue South, Tukwila, Washington Our Job No. 14700 Dear Bill: CIVIL ENGINEERING, LAND PLANNING, SURVEYING In response to your letters dated January 3, 2012; and on behalf of PacWest Energy, LLC (d.b.a. Jacksons Food Stores, Inc.), we respectfully request the maximum 90 -day extension of our permit application starting from February 19, 2012 for the following permits: 1. D11 -285: 2. D11 -286: 3. D11 -287: 4. PG11 -126: 5. M11 -118: 6. EL11 -0791: 7. ELI 1-0792: Demolition Permit Building Permit — Store Building Permit — Canopy Plumbing Permit — Project Mechanical Permit — Store Electrical Permit — Store Electrical Permit — Canopy We request the extension of these permits at this time to allow us to coordinate the financing and GC selection. We expect the permits to be picked up well within this time frame. Thank you for the notifications of the pending application expiration date. If you have any questions in regard to this extension request, please contact me at 425.656.1063 or by email at cmattson @barghausen.com. CJM /ps 14700C.008 enc: As Noted cc: Jack Davis, Jacksons Food Stores Sincerely, Caryl J. Mattson Design Engineer ve 01114 18215 72ND AVENUE SOUTH KENT, WA 98032 (425) 251 -6222 (425) 251 -8782 FAX BRANCH OFFICES 0 OLYMPIA, WA • CONCORD, CA • TEMECULA, CA www.barghausen.com RECEIVED iellrf OFTUKW LA 1JAN:0.5.2012i PERMIT CENTER City of Tukwila Jim Haggerton, Mayor 2 o Department of Community Development Jack Pace, Director 01 -03 -2012 CARYL MATTSON 18215 72 AV S KENT WA 98032 RE: Permit Application No. PG11 -126 JACKSONS STORE NO 631 13138 INTERURBAN AV S TUKW Dear Permit Applicant: In reviewing our current application files, it appears that your permit applied for on 08/23/2011, has not been issued by the City of Tukwila Permit Center. Per the International Building Code, International Mechanical Code, Uniform Plumbing Code and/or National Electrical Code every permit application not issued within 180 days from the date of application shall expire and become null and void. Your permit application will expire on 02/19/2012. If you still plan to pursue your project, a written request for extension of your application must be submitted to the Permit Center at least seven (7) days before it is due to expire. Address your extension request to the Building Official and state your reason(s) for the need to extend your permit application. If it is determined that an extension is granted, your application will be extended for an addtional 90 days from the expiration date and you will be notified by mail. In the event that we do not receive your written request for extension or request was denied, your permit application will expire, become null and void and your project will require a new permit application, plans and specifications, and associated fees: Thank you for your cooperation in this matter. Sincerely, c Bill Rambo Permit Technician File: Permit File No. PG11 -126 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 • City of f 7'LlkWt%cZ Jim Haggerton, Mayor r4 2 Department of Community Development Jack Pace, Director 2908 November 30, 2011 Caryl Mattson Barghausen Consulting Engineers, Inc. 18215 72 Av S Kent, WA 98032 RE: Correction Letter #4 Plumbing /Gas Piping Permit Application Number PG11 -126 Jackson's Store No 631 -13138 Interurban Av S Dear Ms. Mattson, 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 Fire Department. At this time the Building Department has no comments. Fire Department: Al Metzler at 206 971 -8718 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, '15-40 e'R‘..L.._ Bill Rambo Permit Technician encl File: PG11 -126 W:\Permit Center \ Correction Letters \2011\PGl 1 -126 Correction Letter #4.doc 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 • • Tukwila Fire Prevention Bureau Al Metzler, Fire Project Coordinator Fire Prevention Bureau Review Memo Date: November 29, 2011 Project Name: Jacksons Store # 631 Address: 13138 Interurban Ave S Permit #: PG 11 -126 Plan Reviewer: Al Metzler, Fire Project Coordinator The Fire Prevention Bureau conducted a plan review on the subject permit application. Please address the following comments in an itemized format with revised plans, specifications and/or other applicable documentation. 1. Per conversation with Mr. Pat Taitano of Barghausen Engineering, eliminate the yard PIV from the landscape island and install a Wall PIV on the exterior corner of the sprinkler riser room at a height of 36-48 inches above grade. Should there be questions concerning the above requirements, contact the Fire Prevention Bureau at 206- 971 -8718. No further comments at this time. T_ ABOSSEIN E• NGINEERING, LLC Mechanical - Electrical - Fire Protection - Civil - LEED - CEM DATE: 11/11/2011 Plan Examiner, Position Ms. Joanna Spenser City of Tukwila Department of Community Devleopmetn 6300 Southcenter Blvd. Suite # 100 Tukwila, WA. 98188 Ref.: Jackson Store # 631 13138 Interurban Ave. S. Tukwila WA. Permit # PG 11 -126 Dear: Ms. Spenser Please find below our response to your Plan Review Comments dated 11/04/2011. Comment # 1: Reduced Pressure Backflow Preventer Schedule: The Reduced Pressure Backflow Preventer Schedule is shown on Sht. P02. The note has been revised to reference that sheet. The sheet is included for your reference. Comment # 2: Submit remaining pages of the Watts Reduced Pressure Backflow Preventer: The additional pages listed on the RPBP catalog cut sheet originally submitted are the flow charts for the valves. I have submitted the page the contains the information specific to the valve specified only, page 65. Page 66 that is listed on the original cut sheet is not included because there is no information pertaining to this valve. Comment # 3: Site plan sheet numbers and 4" fire sprinlder main: Site Plan sheet number have been added to all continuation notes. The 4" Fire sprinlder main going into the building has beed added to the plans with cooresponding notes. Civil Site Plan to be provided by the Architect. Comment # 4: Fire Sprinkler water flow calculations: The hydraulic fire sprinkler calculations are provided by the fire sprinkler contractor per local and state codes. The estimated GPM for the Fire Sprinlder System is 275 GPM. The pressure drop for a Ames 4" 3000SS backflow preventer is and the 3" 3000SS are equal at 2 PSIG. Since the pressure drop for both valves are equal a 3" valve was selected for economic reasons.. The flow charts for the Ames 3000SS backflow preventers have been included for your review. I hope this information resolves all permit comments. Please contact me at 425- 462 -9441 if there are any additional questions. Sincerely, Dennis Grovenburg Deans Grovenburg Main Office: 2100 CORRECTION PG11- 1210 112th Ave NE, Suite 201, Bellevue, WA 98004 Phone: 425- 462 -9441 / Fax: 425- 462 -9451 260 Petaluma Blvd N., Suite A, Petaluma, CA 94952 829 2nd Street, Suite 2, Mubilteo, WA 98275 728 Broadway, Suite 2B, Tacoma, WA 98402 www.abossein.com P: \14000s \14700 \consultant\Abossein - MEP\Permit response letter#2.doc Page 1 of 1 RECEIVE NOV 17 2011 TM TER • City of Tukwila Jim Haggerton, Mayor Department of Community Development Jack Pace, Director dk 19Q.. November 4, 2011 Caryl Mattson Barghausen Consulting Engineers, Inc. 18215 72 Av S Kent, WA 98032 RE: Correction Letter #3 Plumbing /Gas Piping Permit Application Number PG11 -126 Jackson's Store No 631 -13138 Interurban Av S Dear Ms. Mattson, 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 comments. 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 -126 W:\Pennit Center \Correction Letters\2011\PGI 1 -126 Correction Letter #3.doc 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 • PUBLIC WORKS DEPARTMENT COMMENTS PROJECT: Jackson Store No. 631 13138 Interurban Ave S PERMIT NO: PG11 -126 PLAN REVIEWER: Contact Joanna Spencer (206) 431 -2440 if you have any questions regarding the following comments. 1) Sheet P -011, 1 of 3, Note 1 below Plumbing Fixture Schedule refers to the schedule for a Reduced Pressure Backflow Prevention Assembly (RPPA), however, it's not reflected in the schedule. Public Works main concern is only the domestic water RPPA for premise isolation and Double Detector Check Valve Assembly (DDCVA) for the fire sprinkler system. 2) Please submit remaining page(s) of the WATTS Reduced Pressure Principle Assembly (RPPA) backflow for domestic water. Only one page was submitted. 3) Sheet P02, 2of 3 Plan Note #1 refers to site plan for continuation. Please include the site plan sheet # in Plan Notes and submit the subject site plan as reference. Please show the location of the 4" fire sprinkler pipe entering the building and provide a callout on the plan and enter the appropriate note plan notes like it's done for the domestic water service (Note 1). 4) Civil site plan shows a 4" proposed fire prevention /sprinkler pipe outside the building, however, sheet P02, 2 of 3 calls for a 3" DDCVA inside the building. Submit fire sprinkler calculations to confirm that a 3" DDCVA is an adequate size backflow. W :Other /Joanna/PG 11 -126c CityofTukwila • Jim Haggerton, Mayor V,� l Department of Community Development Jack Pace, Director October 26, 2011 Caryl Mattson Barghausen Consulting Engineers Inc 18215 72 Av S Kent, WA 98032 RE: Correction Letter #2 Plumbing /Gas Piping Permit Application Number PG11 -126 Jackson's Store No 631 -13138 Interurban Av S Dear Ms. Mattson, 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 comments. 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, Vki enn fer erm t T AP\A hall clan enc File: PG11 -126 W:\Pern it Center \Correction Letters\2011\PG11 -126 Correction Letter #2.doc 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 PUBLIC WORKS DEPARTMENT COMMENTS DATE: October 25, 2011 PROJECT: Jackson Store No. 631 13138 Interurban Ave S PERMIT NO: PG11 -126 PLAN REVIEWER: Contact Joanna Spencer (206) 431 -2440 if you have any questions regarding the following comments. 1) Please submit a cut sheet/specification of proposed ZURN grease interceptor. 2) Please address missing information for premise isolation Reduced Pressure Principle Assembly (RPPA) and fire sprinkler protection Detector Double Check Valve Assembly (DDCVA) per attached markup. W:Other /Joanna /PG11 -126a • City of Tukwila • Jim Haggerton, Mayor Department of Community Development Jack Pace, Director September 20, 2011 Caryl Mattson Barghausen Consulting Engineers Inc 18215 72 Av S Kent, WA 98032 RE: Correction Letter #1 Plumbing /Gas Piping Permit Application Number PG11 -126 Jackson's Store No 631 -13138 Interurban Av S Dear Ms. Mattson, 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 Building and Public Works Departments. Building Department: Dave Larson at 206 431 -3678 if you have any questions regarding the attached memo. 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 -126 W:\Permit Center \Correction Letters \2011 \PG11-126 Correction Letter #1.doc 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 Tukwila Building Division Dave Larson, Senior Plan Examiner Building Division Review Memo Date: August 31, 2011 Project Name: Jacksons Store No. 631 Permit #: PG11 -126 Plan Review: Dave Larson, Senior Plans Examiner The Building Division conducted a plan review on the subject permit application. Please address the following comments in an itemized format with revised plans, specifications and/or other applicable documentation. 1. A grease interceptor is required for the triple sink assuming it will be used to clean greasy pots and pans. Other fixtures such as mop sinks and floor drains may need to connect to the grease interceptor as well if past history has shown a need. Please provide make, model and capacity calculations for the grease interceptor proposed and provide circumstances that would eliminate the need for other fixtures to connect to the grease interceptor. Show the grease interceptor on the plans and include drainage and venting details. 2. There is a 2 inch capped stub and '/s inch cold water stub shown at the center food counter. What fixture(s) will these serve in the future? It is not clear if the vent runs overhead or under the slab. Please show a loop vent or island vent if it is applicable or confirm that vent will run overhead. 3. Please provide the BTU demand of the rooftop equipment, the lengths of gas piping segments and the table out of the 2009 IFGC used to size the piping system or other method used. (GENERAL NOTE) PLAN SUBMITTALS: (Min. size 11x17 to maximum size of 24x36; all sheets shall be the same size). (If applicable) Structural Drawings and structural calculations sheets shall be original signed wet stamped, not copied.) Should there be questions concerning the above requirements, contact the Building Division at 206 -431- 3670. No further comments at this time. 0 • PUBLIC WORKS DEPARTMENT COMMENTS DATE: September 19, 2011 PROJECT: Jackson Store No. 631 13138 Interurban Ave S PERMIT NO: PG11 -126 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 or food vending facility to tie to sanitary sewer via a grease interceptor. A grease trap /interceptor, minimum size 50 gal shall be installed under the three compartment sink. Please show it on your plan, specify the manufacturer /model number, add it to your Plumbing Fixture Schedule on sheet P01 and provide the cut sheet of the one to be installed. Please cloud the revision and enter it in the revision block. Any questions regarding this requirement shall be directed to Mr. Mike Cusick, P.E., Public Works Senior Sewer Engineer at (206)431 -2441. 2) Applicant shall submit the attached Non - Residential Sewer Use Certification form which shall be executed and signed by the Owner /representative. W:Other /Joanna /PG11 -126 STRAP, MAINTENANCEPROG PURPOSE: AMA The intent of this program is to provide maintenance guidelines for food -use businesses utilizing a grease trap in place of a grease interceptor so as to minimize health, safety and environmental concerns. POLICY: All businesses utilizing a grease trap in place of a grease interceptor will be required to contract the services with a grease waste contractor. Each business will have their grease trap maintained (as per the details below) a minimum of every month. Proof of service should be kept on -site as well as copies to the City (directly from the contractor). There shall also be placed on -site a grease trap maintenance log which the contractor will complete upon each monthly service. PROCEDURE: Below is the procedure for grease trap cleaning and recycling to be provided by a required vendor (see sample proposal attached): 1. Removal of all waste from grease traps. 2. Contractor will utilize a portable pumping system when necessary. 3. The grease traps will be backfilled after cleaning to insure proper draining. 4. Contractor will not use any biodegradable or chemicals that might temporarily break up grease but lead to re- coagulating later on. 5. An inspection and service report will be left at each location. 6. Customers will be required to provide a regular cleaning schedule. 7. All customers will be contacted prior to each service. 8. City of Tukwila will be included with a copy of the services by email or fax. (W:PW Eng/Other/Mike Cusick/Grease Trap Maintenance Program) PERMANENT FILE COPY 136 I k 124 OP I • PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG11 -126 DATE: 12 -29 -11 PROJECT NAME: JACKSONS STORE NO 631 SITE ADDRESS: 13138 INTERURBAN AV S Original Plan Submittal Response to Incomplete Letter # X Response to Correction Letter # 4 Revision # After Permit Issued DEPARTMENTS: Building Division Public Works ftw, j f •O4 i2 Fire Prevention IN Structural Planning Division n Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Incomplete DUE DATE: 01 -03-12 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 n Structural Review Required ❑ No further Review Required ❑ REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved n Approved with Conditions Notation: REVIEWER'S INITIALS: DATE: DUE DATE: 01 -31 -12 Not Approved (attach comments) n Perniit:Center Use Only : ' • • CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents /routing slip.doc 2 -28-02 • PLAN KEVI W /ROUTING SLIP ACTIVITY NUMBER: PG11 -126 DATE: 11 -17 -11 PROJECT NAME: JACKSONS STORE NO 631 SITE ADDRESS: 13138 INTERURBAN AV S Original Plan Submittal X Response to Correction Letter # 3 Response to Incomplete Letter # Revision # After Permit Issued DEPARTMENTS: Building Division � s 4--(A ub is orks ev I-ce" Fire revention Structural Planning Division ❑ Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 11-22-11 Complete Incomplete 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 REVIEWER'S INITIALS: ❑ No further Review Required DATE: n APPROVALS OR CORRECTIONS: Approved n Approved with Conditions Notation: n DUE DATE: 12 -20 -11 Not Approved (attach comments) 3R- REVIEWER'S INITIALS: DATE: Departments issued corrections: Documents/routing slip.doc 2 -28 -02 PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG11 -126 DATE: 10 -31 -11 PROJECT NAME: JACKSONS STORE NO 631 SITE ADDRESS: 13138 INTERURBAN AV S Original Plan Submittal X Response to Correction Letter # 2 Response to Incomplete Letter # Revision # After Permit Issued DEPARTMENTS: Building pivisi e Public ew Works Fire Prevention Structural Planning Division ❑ Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 11 -01-11 Complete Comments: Incomplete 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 Structural Review Required ❑ No further Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 11 -29 -11 Approved n Approved with Conditions I I Not Approved (attach comments) Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: (t--L4-11 Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW Staff Initials: Documents/routing slip.doc 2 -28-02 *PERMIT COORD COPS PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG11 -126 DATE: 10 /4/11 PROJECT NAME: JACKSONS STORE NO. 631 SITE ADDRESS: 13138 INTERURBAN AV S Original Plan Submittal X Response to Correction Letter # 1 Response to Incomplete Letter # Revision # after Permit Issued DEPARTMENTS: B i�ding'Dis on vV Y( Public Works Fire Prevention Structural Planning Division nPermit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Comments: Incomplete n DUE DATE: 10/20/11 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 Structural Review Required No further Review Required ❑ REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 11/17/11 Approved Approved with Conditions Not Approved (attach comments) El Notation: REVIEWER'S INITIALS: DATE: Permit Center••Use Only ; CORRECTION LETTER MAILED: I"1I (Iy Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW Staff Initials: Documents /routing slip.doc 2 -28 -02 HERMIT COORD COP'+f PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG11 -126 DATE: 08/23/11 PROJECT NAME: JACKSONS STORE NO. 631 SITE ADDRESS: 13138 INTERURBAN AV S X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # after Permit Issued DEPARTMENTS: Q�,1 ui ding Divisio- �S (\� Q Public Wo$rks Fire Prevention Structural Planning Division ❑ Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Incomplete DUE DATE: 08/25/11 Not Applicable n Comments: Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES/THURS ROUTING: Please Route Structural Review Required No further Review Required n REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved Notation: REVIEWER'S INITIALS: Approved with Conditions DUE DATE: 09/22/11 Not Approved (attach comments) It DATE: Permit Center Use Only CORRECTION LETTER MAILED: 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: 12/29/2011 Plan Check/Permit Number: PG11 -126 Response to Incomplete Letter # Response to Correction Letter # 4 Revision # after Permit is Issued Revision requested by a City Building Inspector or Plans Examiner Project Name: Jacksons Food Stores #631 Project Address: 13138 Interurban Avenue South, Tukwila, WA 98168 Contact Person: Ms. Caryl Mattson Phone Number: (425) 6564063 Summary of Revision: Fire Prevention Bureau Review 1) the yard PIV has been removed from the landscape island along 48th. A WIV has been installed on the corner of the sprinkler riser room at a height of 36 -48 inches above grade. The actual height dimension is shown on the architectural elevations under permit number D11 -286. Sheet Number(s): C 1 6.2 D ou.4 C} M ou,Cs "Cloud" or highlight all areas of revision including date of revisjon Received at the City of Tukwila Permit Center by: ©— Entered in Permits Plus on 2L-4 1 I NEt:EIVED COY OF TUKWILA 'DEC 2 9 2011 PERMIT CENTER H:\Applications \Forms - Applications On Line\2010 Applications \7 -2010 - Revision Submittal.doc Revised: May 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.ci.tukwila.wa.us Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Date: 11-15-11 Plan Check/Permit Number: PG 11 -126 ❑ Response to Incomplete Letter # • Response to Correction Letter # 3 ❑ Revision # after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner Project Name: Jacksons Store No 631 Project Address: 13138 Interurban Av S Contact Person: i/75. C.HRYLil%fo-sNf Phone Number: ��S' 56 —/0 &3 Summary of Revision: fqe 17o ,2ded .7Lo ar e r /e ms 3 Bee d , loon& /e -e/r ,, de..1) d-isul 27`: lam, haive add e/ed iL, -mil /e t tthe-s 41/41 -cry s er f esin2Oivs, Q LL`ie, O B� '�✓ Kfld-c-z- zoJLCh A4.6. 7-he onS sheed; a./1-71-cA/4 && / zi1/2 % / p/a, - a s e at, Sheet Number(s): P01, PO 2 4 keel/le/ice., s/'t C 5.O j CUI SAee9 "Cloud" or highlight all areas of revision including date of revis'o Received at the City of Tukwila Permit Center by: ��� RECENBo ern, OF TUKWILA NOV 17 2011 Entered in Permits Plus on 1147- 1,1 PERMIT CENTER \applications\forms- applications on line\revision submittal Created: 8 -13 -2004 Revised: • City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206- 431 -3670 Fax: 206 - 431 -3665 Web site: http://www.ci.tukwila.wa.us Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Date: J -3/ - 20 // Plan Check/Permit Number: PG 1 1 -126 ❑ Response to Incomplete Letter # ® Response to Correction Letter # 2 111 Revision # after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner Project Name: Jacksons Store No 631 Project Address: 13138 Interurban Av S Contact Person: /NS. (14R,L mA776&Al Phone Number: 4z' - l0 5Co - /067 3 Summary of Revision: RerSpaltSg 7122 1) : A- &a-/- M 'e1 / & prp sea' 2aRAI gr e irl iorcepter is a ffachea, fare S& 1-0 2,) % suf s4 i For & RPPH # 1)4 =6144 a J 2 copes ear.A. /Voles `ia4ry° r2 added -iV 12, 02- as cl i a 6M4;na./ /;'?- anion, 71 e. b1 C VA 0a42 ad/hed o fold") -6,j ,fed ki;epd pla#1 i also a.�fiz flied Sheet Number(s): Po 2 "Cloud" or highlight all areas of revision including�i ZPof revi io Received at the City of Tukwila Permit Center by: IV-D-4( Entered in Permits Plus on fitiCEIVED i�K OCT 2 8 2011 PERMIT CENTER \ applications \forms - applications on line \revision submittal Created: 8 -13 -2004 Revised: • 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.TukwilaWA.gov Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Date: 10/14/2011 Plan Check/Permit Number: PG11 -126 Response to Incomplete Letter # Response to Correction Letter # 1 Revision # after Permit is Issued Revision requested by a City Building Inspector or Plans Examiner rTheltA OCT 17 2011 Project Name: Jacksons Food Stores #631 r''ERAdRCENT,f R Project Address: 13138 Interurban Avenue South, Tukwila, WA 98168 Contact Person: Ms. Caryl Mattson Phone Number: (425) 6564063 Summary of Revision: Building Responses: 1) A grease trap was added for the three compartment sink. For sizing criteria, model number, capacity and installation requirements, see sheet P01. Circumstances for eliminating other fixtures from grease trap: A. The service sink should not connect into the grease trap. This is a small grease trap with minimal water and grease storage, adding the service sink with high soap content will break down the grease /oils in the trap and introduce them into the waste system. B. There are no floor drains in the area of the 3 compartment sink or grease trap. All drains are floor sinks that receive indirect waste from fixtures or backflow preventors. 2) The capped waste line below the island counter is to serve a future beverage type machine via either a floor sink or hub drain. This type of connection does not require island sink venting. The vent line shown to the waste line is below grade. It runs over to the wall then rises up in the wall space to connect to the above ceiling vent pipping system. 3) A gas diagram has been added showing the required information, see sheet P02. Public Works Responses: 1) Grease trap has been added. 2) NRSU Certification form is attached (this is the identical form that was requested for permit D 11 -286). Sheet Number(s): P1.0, P02 & P03 (2 each) "Cloud" or highlight all areas of revision including date of revision Received at the City of Tukwila Permit Cen er by: Entered in Permits Plus on to i H:Wpplications \Forms-Applications On Line\2010 Applications \7 -2010 - Revision Submittal.doc Revised: May 2011 King County Department of Natural Resources and Parks Wastewater Treatment Division Non- Residential Sewer Use Certification • To be completed for all new sewer connections, reconnections or change of use of existing connections. • This form does not apply to repairs or replacements of existing sewer connections within five years of disconnect. Please Print or Type 13/3S /N Ri3Ai' AVE S Property Street Address p14/11.44 a/9- cliykiL ity State ZIP P )667- FVEXc y / Owner's Name �r j `� Subdivision Name6/ �� 6Alf ok Lot #. 8 Subdiv. # Block # Building Name -{ AGK.o1.1 S -toleg 1(-i3 / (if applicable) (20 ) i 9c3,70 (SaGen dV Y) Owner's Phone Number (with Area Code) )4,&-09/c) Property Contact Phone Number (with Area Code) Owner's Mailing Address WS gc i'n /2)//9-N, /n 8=642- A. Fixture Units Fixture Units x Number of Fixtures = Total Fixture Units Kind of Fixture Fixture Units No. of Fixtures Total Fixture Units Public Private Public Private Bathtub and Shower 4 4 Shower, per head 2 2 Dishwasher 2 2 Drinking fountain (each head) 1 .5 Hose bibb (interior) 2.5 2.5 Clotheswasher or laundry tub 4 2 C&, Sink, bar or lavatory 2 1 3 Sink, Clinic flushing 8 8 Sink, kitchen 3 2 Sink, other (service) 3 1.5 I 3 Sink, wash fountain, circle spray 4 3 Urinal, flush valve, 1 GPF 5 2 i .5 Urinal, flush valve, >1 GPF 6 2 Urinal, waterless 0 0 Water closet, tank or valve, 1.6 GPF 6 3 2 i 2 Water closet, tank or valve, >1.6 GPF 8 4 Total Fixture Units 191 Residential Customer Equivalent (RCE) 20 fixture units equal 1.0 RCE Total No. of Fixture Units 20 /.6 RCE For King County list Only Account # No. of RCEs Monthly Rate Property Tax ID # 1)60.36,00/c Party to be Billed (if different from owner) /4Tr/v AioR /6 1L4 • /B3c) __PAC G T£ V C/ 44-C, City or Sewer District G/ ry r %LLj�Gf>iL Date of Connection -773 � % /f' ? //) Side Sewer Permit # / / /---/ 242 Please report any demolitions of pre - existing building on this property. Credit for a demolition may be given under some circumstances. Demolition of pre- existing building? , Yes ❑ No Was building on Sanitary Sewer? ,Yes ❑ No Was Sewer connected before 2/1/90? %j'es ❑ No Sewer disconnect date: ]2/� Type of building demolished? Gi/VVIEI /�_,/t�[E rS ` Request to apply demolition credit to multiple buildings? %Yes ❑ Nou'' B. Other Wastewater Flow (in addition to Fixture Units identified in Section A) Type of Facility /Process: CORRECf ION Estimated Wastewater Discharge R# ' Gallons /days Residential Customer Equivalents (RCE): 187 gallons per day equals 1.0 RCE Total Discharge (gal /day) _ 187 C. Total Residential Customer Equivalents: (add A & B) CITY OF T Wp UKvviLA nrr 1 7 2011 PERMIT CENTER RCE A B RCE ?&LH2J Pursuant to King County Code 28.84, all sewer customers who establish a new service which uses metropolitan sewage facilities shall be subject to a capacity charge. The amount of the charge is established annually by the King County Council at a rate per month per residential customer or residential customer equivalent for a period of fifteen years. The purpose of the charge is to recover costs of providing sewage treatment capacity for new sewer customers. All future billings can be prepaid at a discounted amount. All future billings can be prepaid at a discounted amount. Questions regarding the capacity charge or this form should be referred to King County's Wastewater Treatment Division at 206 - 684 -1740. I certify that the information given is correct. I understand that the capacity charge levied will be based on this information and any deviation will require resubmission of corrected data for determination of a revised capacity charge. Signature of Own Representativ l i9/2L C.r - -:7 -'1 Date 9.-39 - Print Name of Ow epresentat //�.9 L 7" /21/ r7S' )A � y 1058 (Rev. 9/07) White — Kina Countv Yellow — Local Sewer Aaencv Pink — Sewer Customer . 6 E 9 Contractors or Tradespeople Peer 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 EVERGREEN ENVRNMENTAL SVCS INC UBI No. 601540547 Phone 4253553028 Status Active Address 17108 9Th Ave Se License No. EVERGES061J5 Suite /Apt. License Type Construction Contractor City Mill Creek Effective Date 4/25/1994 State WA Expiration Date 1/14/2014 Zip 98012 Suspend Date County Snohomish Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Other Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status NORTHTE083MLTANK NORTHWEST /ENVIR SVCS INC Construction Contractor Tanks /Tank Renovation Demolition 7 /13/1992 4/5/1994 Archived NORTHTT099JS NORTHWEST TANK TESTING Construction Contractor Tanks /Tank Renovation Demolition 4/10/1991 4/5/1992 Archived EVERGCS961N5 EVERGREEN CRANE SERVICES INC Construction Contractor General Unused 8/31/2004 8/31/2006 Out Of Business Business Owner Information Name Role Effective Date Expiration Date HINES, JOHN President 04/25/1994 Amount 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 4 DEVELOPERS SURETY & INDEM CO 856831C 12/15/2001 Until Cancelled $12,000.00 01/14/2002 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 15 EVEREST INDEMNITY INS CO EF4ML00098091 12/15/2008 12/15/2012 $2,000,000.00 12/14/2011 14 EVEREST INDEMNITY INS CO 4000007192071 12/15/2007 12/15/2008 $2,000,000.00 12/11/2007 13 HUDSON SECIALTYINS CO FEC6110300 12/15/2006 12/15/2007 $2,000,000.0012 /14/2006 12 EVEREST INDEMNITY INS CO 40000016780 61 12/15/2005 12/15/2007 $2,000,000.0012 /04/2006 Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period https://fortress.wa.gov/lni/bbip/Print.aspx 03/23/2012