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Home My WebLink AboutPermit PG11-160 - MACAU CASINOMACAU CASINO 5700 SOUTHCENTER BL PG1 1 -160 Parcel No.: Address: 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 1157200353 5700 SOUTHCENTER BL TUKW Project Name: MACAU CASINO Permit Number: Issue Date: Permit Expires On: PG11 -160 11/04/2011 05/02/2012 Owner: Name: Address: Contact Person: Name: Address: Email: Contractor: Name: Address: Contractor RASH & ASSOCIATES #47 PO BOX 260888 , PLANO TX 75026 JIM TRIPPLE 229 172 PL SW , BELLEVUE WA 98012 TONYV @EVERGREENHVAC. C OM EVERGREEN REFRIGERATION LLC 727 S KENYON ST , SEATTLE WA 98108 License No: EVERGRL954R2 Phone: 206 - 819 -4408 Phone: 206 763 -1744 Expiration Date: 01/06/2012 DESCRIPTION OF WORK: RUN GAS PIPING FROM EXISTING GAS METER TO ONE (1) ROOFTOP UNIT. 11 -22 -11 REVISION #1 RECEIVED FROM DOUG POESCHEL. REVISION IS FOR REPAIR OF THE MAIN WATER LINE INSIDE THE BUILDING. WER Value of Plumbing /Gas Piping: Fees Collected: Electrical Service Provided by: Permit Center Authorized Signature: $2,456.00 $168.00 Uniform Plumbing Code Edition: 2009 International Fuel Gas Code Edition: 2009 Date: i' 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 c truc ' • or the performance of work. am authorized to sign and obtain this plumbing /gas piping permit and agree to the conditions o the back • this permit. Signature: Print Name: Date: This permit shall become n void if the work is not commenced thin 180 days from the date of issuance, or if the work is suspended or abandoned for a period of :: days from the last inspection. doc: UPC -4/10 PG11 -160 Printed: 11 -22 -2011 PERMIT CONDITIONS Permit No. PG 1 I -160 1: ** *PLUMBING AND GAS PIPING * ** 0 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: 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. 8: 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. 9: The issuance of a permit or approval of plans and specifications shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the Plumbing Code or Fuel Gas Code or any other ordinance of the jurisdiction. doc: UPC -4/10 PG 11 -160 Printed: 11 -22 -2011 City oftukwila 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.: 1157200353 Address: 5700 SOUTHCENTER BL TUKW Project Name: MACAU CASINO Permit Number: PG11 -160 Issue Date: 11/04/2011 Permit Expires On: 05/02/2012 Owner: Name: RASH & ASSOCIATES #47 Address: PO BOX 260888 , PLANO TX 75026 Contact Person: Name: JIM TRIPPLE Address: 229 172 PL SW , BELLEVUE WA 98012 Email: TONYV @EVERGREENHVAC.COM Contractor: Name: EVERGREEN REFRIGERATION LLC Address: 727 S KENYON ST , SEATTLE WA 98108 Contractor License No: EVERGRL954R2 Phone: 206 - 819 -4408 Phone: 206 763 -1744 Expiration Date: 01/06/2012 DESCRIPTION OF WORK: RUN GAS PIPING FROM EXISTING GAS METER TO ONE (1) ROOFTOP UNIT. Value of Plumbing /Gas Piping: Fees Collected: Electrical Service Provided by: Permit Center Authorized Signature: $2,456.00 Uniform Plumbing Code Edition: 2009 $120.75 International Fuel Gas Code Edition: 2009 Date: l — 1-4'r 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 construc ' • • or the performance of work. I am authorize • o sign and obtain this plumbing /gas piping permit and agree to the conditions on the • ack of • 's permit. Signature: Print Name: n li- Date: / Hi---// This permit shall become null and v the work is not commenced within 180 days from the date of issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection. doc: UPC -4/10 PG11 -160 Printed: 11 -04 -2011 • o PERMIT CONDI-TIONS Permit No. PG11 -160 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: 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. 8: 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. 9: The issuance of a permit or approval of plans and specifications shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the Plumbing Code or Fuel Gas Code or any other ordinance of the jurisdiction. doc: UPC -4/10 PG 11 -160 Printed: 11 -04 -2011 CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 httal/www.TukwilaWA.C1OV Plumbing/Gas Permit No. Project No. 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 Site Address: 5700 Southcenter Blvd. Tenant Name: Macau Casino King Co Assessor's Tax No.: 1157200353 Suite Number: New Tenant: Property Owners Name: Rash and Associates Mailing Address: PO BOX 260888 Floor: m Yes ID ..No 75026 Zip Plano TX City State CONTACT PERSON — Who do we contact when your permit is ready to be issued Name: Jim Tripple Mailing Address: 229 172nd Place SW E -Mail Address: tonyv @evergreenhvac.com Day Telephone: Bellevue (206) 819 -4408 WA City State Fax Number: (425) 361 -2051 98012 Zip PLUMBING / GAS PIPING CONTRACTOR INFORMATION Company Name: Evergreen Refrigeration Mailing Address: 727 S. Kenyon St. Seattle WA 98108 Contact Person: Tony Vogt E -Mail Address: tonyv @evergreenhvac.com Contractor Registration Number: EVERGRL954R2 City State Day Telephone: (206) 763 -1744 Fax Number: (206) 763 -2389 Expiration Date: 01/06/2012 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: Mailing Address: City Contact Person: Day Telephone: E -Mail Address: Fax Number: State Zip H:\Applications \Forms- Applications On Line \2010 Applications \7 -2010 - Plumbing -Gas Piping Permit Application doc Revised: 7 -2010 bh Page 1 of 2 Valuation of Project (contractor's bid pt ): $ 2456 Scope of Work (please provide detailed information): Run gas from existing gas meter to one (1) rooftop unit. Building Use (per Int'l Building Code): • - Occupancy (per Int'l 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 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 1.ei 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 QR UTUORIZED A Signature: ` �►�:kg k Date: I� - 2� — ZO Print Name: Tony Vogt Day Telephone: 206- 763 -1744 Mailing Address: 727 S. Kenyon St Seattle WA 98108 City State Date Application Accepted: f Date Application Expires: H:\ Applications \Forms - Applications On Line\2010 Applications \7 -2010 - Plumbing -Gas Piping Permit Application.doc Revised. 7 -2010 bh Zip Staff Initials: bt,e Page 2 of 2 Parcel No.: Address: Suite No: Applicant: • City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: http: / /www.TukwilaWA.gov 1157200353 5700 SOUTHCENTER BL TUKW MACAU CASINO RECEIPT Permit Number: Status: Applied Date: Issue Date: PG11 -160 ISSUED 10/20/2011 11/04/2011 Receipt No.: R11 -02551 Initials: User ID: WER 1655 Payment Amount: $47.25 Payment Date: Balance: 11/22/2011 02:42 PM $0.00 Payee: DOUG POESCHEL TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 623284 ACCOUNT ITEM LIST: Description 47.25 Account Code Current Pmts PLUMBING - NONRES 000.322.103.00.00 Total: $47.25 47.25 doc: Receiot -06 Printed: 11 -22 -2011 City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: http: / /www.TukwilaWA.gov Parcel No.: 1157200353 Address: 5700 SOUTHCENTER BL TUKW Suite No: Applicant: MACAU CASSINO RECEIPT Permit Number: PG11 -160 Status: PENDING Applied Date: 10/20/2011 Issue Date: Receipt No.: RI 1 -02309 Initials: User ID: Payee: WER 1655 Payment Amount: $120.75 Payment Date: 10/20/2011 04:20 PM Balance: $0.00 EVERGREEN REFRIGERATION LLC TRANSACTION LIST: Type Method Descriptio Amount Payment Check 005073 120.75 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts GAS - NONRES PLAN CHECK - NONRES 000.322.103.00.00 96.60 000.345.830 24.15 Total: $120.75 doc: Receipt -06 Printed: 10 -20 -2011 INSP:CTION NO. INSPECTION RECORD Retain a copy with permit PO( --- 16 PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 ik (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Project: 1M K NJ OAS-IMO Type of Inspection: p, 1�:J U _Lid c F #AL Aat Address: . 510d St... aiviae Date Called: Special Instructions: Date Wanted:. j 1 —.3%)' (lj ",a.n P.m. Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. 2 COMMENTS: ff 6) INK //1/i f(lewp /Ole,/%1�44/ ______ / - PECTION FEE REQUIRED. P !or to next inspection. fee must be • p. i • at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INSPECTION NO. INSPECTION RECORD Retain a copy with permit PGr (- I (0 PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 a. (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Prod t: J kkA-u (As. /1-43 Type of Inspection: RD u ‘ f4- av P6/ti...? Address: -5-7Ja se. 6(1/4/fing Date Caltd�tAix( if:,(Ur' ' 1 c j S:• Special Instructions: • Date Wanted:. m., %i'1.i—t' f p:m. Requester: / X g n - c „_L. P... ! v f 1 6.4 ''_.1- f/.IC - - Phone No: J Approved per applicable codes. >orrections required prior to approvai.� COMMENTS: `. 0 k' ,J �S Nit-t (} I JJ C-. el- ..--. I)/ e :_C •-/ re-- : s () ' 1 c j S:• r' --r:AsM( A4 .3i,e s`)P,a/ 0 Z a c ' ctl i . / X g n - c „_L. P... ! v f 1 6.4 ''_.1- f/.IC - - AI / P A At c, A Inspec r: Date: t ` _ 2' 3— ( REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. L. INSPECTION RECORD --_"' Retain a copy with permit 'INSPECTION NO. • PERMIT NO. CITY.OF TUKWILA BUILDING DIVISION 6300 Southcenter BIvd., #100, Tukwila. WA 98188 r (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Pro'ect Type of Inspnectiion: (— , 4 -.._ . • Address: - . S7 - _Sc. Date Date Called: oc.-) .S I - -; ,1z. ! A p, ,),J Ai --- Special IristructiOns: - • • . ...."# ... - Date Wanted:. t /— ?1 — {1 a.m. (P ' Requester: ,,........, Phone No: - - . Approved per applicable codes. Corrections required prior to approval. COMMENTS: �. ---_-- -.._ . • :, . • l oc.-) .S I - -; ,1z. ! A p, ,),J Ai --- v, ....... _..... ..,--\.. ,,........, . \ . . - 4(iJf.1 !) _,F U , S •' .. -. 7 -.a ! rf J�u..f e •�. A -1 P I of c.0 -re" pit! `e /Q5- A - G . I _ • InspeEtor. . • REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. • s • . • 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: MADAll Typc.ziQnspection: ROI ( 6 H --TV Addresit:040 4,61,4404.4e4 sl jMte Called: - Special Instructions: • • • • ' - Date Wanted: . I I I 1 i l l I I ( A Requester: Phone No: Approved per applicable codes. • - Corrections required prior to approval. COMMENTS: 4I • ID7tr:/ ri INSPECTION FEE REQUIRED. rior to next inspection. fee must be L-1 • id at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. • mi3� z City of Tukwila Jim Haggerton, Mayor Department of Community Development Jack Pace, Director October 26, 2011 Jim Tripple 229 172 P1 SW Bellevue, WA 98012 RE: Correction Letter #1 Plumbing /Gas Piping Permit Application Number PG11 -160 Macau Casino — 5700 Southcenter BI Dear Mr. Tripple, This letter is to inform you of corrections that must be addressed before your mechanical 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 Department. The Public Works Department has no comments at this time. Building Department: Dave Larson at 206 431 -3678 if you have 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 -160 W:\Pennit Center\Correction Letters\2011\PG11 -160 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: October 26, 2011 Project Name: Macau Casino Permit #: PG11 -160 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. (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.) 1. Please provide a gas piping plan that lists the BTU's of all new and existing equipment on the system. 2. Provide a line drawing showing the size and length of piping from all new equipment back to the meter. Should there be questions concerning the above requirements, contact the Building Division at 206 -431- 3670. No further comments at this time. !PERMIT COORD COPY. PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG 11 -160 DATE: 10/31/11 PROJECT NAME: MACAU CASINO SITE ADDRESS: 5700 SOUTHCENTER BL Original Plan Submittal X Response to Correction Letter # 1 Response to Incomplete Letter # Revision # after Permit Issued DEPARTMENTS: Building Division Public Works �vl Fire Prevention Structural Planning Division ❑ Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Incomplete n DUE DATE: 11 /01 /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 ki Structural Review Required n No further Review Required n REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 11 /29 /11 Approved n Approved with Conditions Not Approved (attach comments) n Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only • • CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents /routing slip.doc 2 -28 -02 �., ,'Y� i • 4 fd PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG11 -160 PROJECT NAME: MACAU CASINO SITE ADDRESS: 5700 SOUTHCENTER BL X Original Plan Submittal Response to Incomplete Letter # DATE: 10 -20 -11 Response to Correction Letter # Revision # After Permit Issued DEPA THE TS: �e� IIY1t :4\ V B Odin Division rig Public Works ❑ Fire Prevention Structural Planning Division Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 10-25-11 Complete t Incomplete ❑ Comments: 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: Approved DUE DATE: 11 -22 -11 Approved with Conditions ❑ Not Approved (attach comments) Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only r� CORRECTION LETTER MAILED: 10 '21` � f Departments issued corrections: Bldg Fire ❑ Ping ❑ PW ❑ Staff Initials: ��, Documents /routing slip.doc 2 -28 -02 Cityt Tukwila REVISION SUBMITTAL Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Web site: htV/Iwww,citulcwilawa.us Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Date: / ('' 2 g 1/ Plan Check/Permit Number: ❑ Response to Incomplete Letter # ❑ Response to Correction Letter # ❑ Revision # after Permit is Issued Er Revision requested by a City Building Inspector or Plans Examiner Project Name: k A t C Project Address: Contact Person: Phone Number: - U (nom ,3)-,74 4 —37 c7 / Summary of Revision: RECEIVED CITY OF TunWILA NOV 2 2 2011 aERMIT CENTER Sheet Number(s): "Cloud" or highlight all areas of revision including date of rev Received at the City of Tukwila Permit Center by: Q--Entered in Permits Plus on (l `012'1 ( H:V►pplinHorolpmms- Applications On LineV010 Appliations7 -2010 - Revision Sobmittal.doe Crated: 8-13 -2004 Revised: 7 -2010 City Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Web site: http: / /www.ci.tukwila.wa.us REVISION SUBMITTAL Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Date: i 0) 5 J /20 l ( Plan Check/Permit Number: — 1 % n ❑ Response to Incomplete Letter # (a Response to Correction Letter # ❑ Revision # ` after Permit is Issued 1. . ❑ Revision requested by a City Building Inspector or Plans Examiner Project Name: et C AA/ ,c) Project Address: S'7 a 0 Sv u At L,e,t, 4er R 1 v �( Contact Person: a,nt. LyAAA Summary of Revision: \ Ya.0 -lc, 4O. Iror.A-t.r` Phone Number: 246 3 r7 Zy 7 7 f;S Sheet Number(s): "Cloud" or highlight all areas of revision including date of revision Received at the City of Tukwila Pernt Center by: 4 Entered in Permits Plus on H: ApplimiomWamrApplicetions On LineV010 Appliation:M -2010 - Revision Subn,W.doc Created: 8-13-2004 Revised: 7 -2010 Contractors or Tradespeople P.er 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 REFRIGERATION LLC UBI No. 602512953 Phone 2067631744 Status Active Address 727 S Kenyon St License No. EVERGRL954R2 Suite /Apt. License Type Construction Contractor City Seattle Effective Date 1/6/2006 State WA Expiration Date 1/6/2012 Zip 98108 Suspend Date County King Specialty 1 General Business Type Limited Liability Company Specialty 2 Unused Parent Company Other Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status EVERGHH910J0 EVERGREEN HOME HEATING & ENGY Construction Contractor General Unused 4/20/2009 4/20/2013 Active EVERGI.201D7 EVERGREEN REFRIGERATION INC Construction Contractor General Unused 3/27/1980 7/31/2006 Re- Licensed Business Owner Information Name Role Effective Date Expiration Date EVERGREEN REFRIGERATION LLC Partner /Member 12/22/2005 Amount PATTON, DAVID Partner /Member 01/06/2006 BAW54192293 PATTON, RODGER Partner /Member 01/06/2006 PATTON, MATTHEW Partner /Member 01/06/2006 Continental Western Ins Co 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 TRAVELERS CAS & SURETY CO 104667361 01/01/2006 Until Cancelled $12,000.00 01/03/2006 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 3 AMERICAN FIRE AND CASUALTY COM BAW54192293 07/31/2010 07/31/2012 $1,000,000.00 07/27/2011 2 Continental Western Ins Co CWP2640663 07/31/2006 07/31/2010 $1,000,000.00 03/23/2009 1 ALASKA NATIONAL INSURANCE CO 05GLS31381 07/31/2005 07/31/2006 $1,000,000.00 01/03/2006 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 11/04/2011