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Home My WebLink AboutPermit M10-156 - PACIFIC NW PERIODONTICSPACIFIC NW PERIODONTICS 411 STRANDER BL SUITE 107 M10 -156 City o Tukwila 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.ci.tukwila.wa.us MECHANICAL PERMIT Parcel No.: 0223200052 Address: 411 STRANDER BL TUKW Project Name: PACIFIC NW PERIODONTICS Permit Number: M10 -156 Issue Date: 11/19/2010 Permit Expires On: 05/18/2011 Owner: Name: MEDICAL CENTERS CO LLC Address: 411 STRANDER BLVD STE 107 , TUKWILA WA 98188 Contact Person: Name: ARNIE HAUGEN Address: 500 EAST MAIN ST , MONROE WA 98272 Email: ARNIE @GASHEATING.COM Contractor: Name: G & S HEATING COOLING /ELEC INC Address: 500 EAST MAIN ST , MONROE WA 98272 Contractor License No: GSHEAC *939RK Phone: 425 471 -2487 Phone: 360 - 794 -7306 Expiration Date: 07/18/2011 DESCRIPTION OF WORK: INSTALL (3) EXHAUST FANS Value of Mechanical: $1,940.00 Fees Collected: $209.63 Type of Fire Protection: UNKNOWN International Mechanical Code Edition: 2009 Permit Center Authorized Signature: oit Date: 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 mechanical permit and agree to the conditions on the back of this permit. Signature: Print Name: Date: % 1— [0 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: IMC -4/10 M10-156 Printed: 11 -19 -2010 PERMIT CONDITIONS Permit No. M10-156 1: ** *BUILDING DEPARTMENT CONDITIONS * ** 2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the Building Official. 3: All mechanical work shall be inspected and approved under a separate permit issued by the City of Tukwila Permit Center (206/431- 3670). 4: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to start of any construction. These documents shall be maintained and made available until final inspection approval is granted. 5: All construction shall be done in conformance with the approved plans and the requirements of the International Building Code or International Residential Code, International Mechanical Code, Washington State Energy Code. 6: Manufacturers installation instructions shall be available on the job site at the time of inspection. 7: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building Department (206- 431- 3670). 8: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the Building Official from requiring the correction of errors in the construction documents and other data. doc: IMC -4/10 M10 -156 Printed: 11 -19 -2010 CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 htto://www.citukwila.wa. us Mechanical Permit No. No. �lD -loo Plo�t� (For office use only) MECHANICAL PERMIT APPLICATION nw� 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 `, �I' King Co Assessor's Tax No.: �22w - wc� Site Address: T / )an N 3W Suite Number: , j-v Floor: rL r Tenant Name: P '4< t4i c -JV4 P -',,jo 4d» ,': New Tenant: ��rr�� -- J _ ❑ Yes � ..No Property Owners Name: U AIY`r`+� r� r�T' Mailing Address: T �) %� '4'. —1/A14.74:-1 ) aN 2-G i tf's- State Zip City CONTACT PERSON Who do we contact when your permit is ready to be issued Name: Mailing Address: _,SM3:J E -Mail Address: Q. Y' 3\ Day Telephone: ` City State Zip Fax Number:3 h� v 'y - MECHANICAL CONTRACTOR INFORMATION Company Name: Mailing Address: Contact Person: Y13'1C I'1- 7 E -Mail Address: tt " pp Contractor Registration Number: C..� � Ci ' I � d\ is City State Zip Day Telephone: 5 _ q7 J 91-7 Fax Number: 3ht `� 4 Expiration Date: 1 ` ($' ,/ I ARCHITECT OF RECORD All plans must be wet stamped by Architect of Record Company Name: Mailing Address: City Contact Person: Day Telephone: E -Mail Address: Fax Number: State Zip ENGINEER OF RECORD - All plans must be wet stamped by Engineer of Record Company Name: Mailing Address: City Day Telephone: E -Mail Address: Fax Number: Contact Person: State Zip H:\Applications\Forms- Applications On Line\2009 Applications \1 -2009 - Mechanical Permit Application.doc Revised'. 1 -2009 bh Page 1 of 2 Valuation of Project (contractor's bid price): $ 1.119v– Scope of Work (please provide detailed information): �vt,SL-0773 Use: Residential: New ❑ Replacement ❑ Commercial: New Ea Replacement Fuel Type: Electric ❑ Gas ❑ Other: Indicate type of mechanical work being installed and the quantity below: Unit Type: Qty Unit Type: Qty Unit Type: Qty Boiler /Compressor: Qty Furnace <100K BTU Air Handling Unit >10,000 CFM Fire Damper 0 -3 HP /100,000 BTU Furnace >100K BTU Evaporator Cooler Diffuser 3 -15 HP /500,000 BTU Floor Furnace Ventilation Fan Connected to Single Duct 3 Thermostat 15 -30 HP /1,000,000 BTU Suspended/Wall/Floor Mounted Heater Ventilation System Wood/Gas Stove 30 -50 HP /1,750,000 BTU Appliance Vent Hood and Duct Emergency Generator 50+ HP /1,750,000 BTU Repair or addition to Heat/Refrig /Cooling System Incinerator – Domestic Other Mechanical Equipment Air Handling Unit <10,000 CFM Incinerator – Comm /Ind 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 additional periods not to exceed 90 days each. The extension shall be requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building 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 OWN R OR AUTHORI ED AGENT: Signature: Q Print Name: t J `C 41 Mailing Address: t' Date: 1 �f C-(' Day Telephone: —St"? I 91.7 1- (-a City State Zip Date Application Accepted: i t 1 rJ I Date Application Expires: o f� I Staff Initials: Acyt,‘, H:Wpplications\Forms- Applications On Line\2009 Applications \t -2009 - Mechanical Permit Application.doc Revised: 1 -2009 bh e2of2 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 Parcel No.: 0223200052 Address: 411 STRANDER BL TUKW Suite No: Applicant: PACIFIC NW PERIODONTICS RECEIPT Permit Number: M10 -156 Status: PENDING Applied Date: 11/09/2010 Issue Date: Receipt No.: R10 -02259 Initials: User ID: Payee: JEM 1165 Payment Amount: $209.63 Payment Date: 11/09/2010 11:18 AM Balance: $0.00 G & S GAS HEATING, COOLING & ELECTRIC, INC TRANSACTION LIST: Type Method Descriptio Amount Payment Check 5715 209.63 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts MECHANICAL - NONRES PLAN CHECK - NONRES 000.322.102.00.00 167.70 000.345.830 41.93 Total: $209.63 doc: Receipt -06 Printed: 11 -09 -2010 INSPECTION RECORD CITY OF TUKWILA BUILDING DIVISION - 6300 Southcenter•Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 • fib d -/'S6 Project: > Project: A/ AR /o Dd.'?'e Type of Inspection: ,Zi fvh*I_. 4 Address: 4/// —s.'74 4-.ci.De'iz Date Called: , . -4I i� --L1V . Special Instructions: _ • - _ -Phone . pate Wanted: . —. .ice —'!/ _ C,Itni\ Requester: No: ,a r"4 ---4,41 :2373 . Approved per applicable codes. a. r. ElCorrections required prior t� approval. COMMENTS: Per • I•• if IDat_4I ri REINSPCTION FEE REQUIRED. Prior to next inspection; fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.. • ..' . • INSPECTION RECORD a copy with permit INSPECTION NO. PERMIT N04 CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter BLVd., #100, Tukwila. WA 981881; (206) 431 -3670 Permit Inspection Request Line (2 6) 431 -2451 Projg, pi r kiti Type pf Inpecti t�`) 1 �� 'Address: 4 Date Called: : . , s fir. S`r `F i Special Instructions: ; `•, +•.,. • Date Wanted: ✓ �. p.m. RequeAster: Phone No /: Approved per applicable codes.. Corrections required prior to approval: /' COMMENTS: - ` ! "_ya nib `MTJ F / —MI_ AzAe iN F TAD Be 03-0 : . , s fir. S`r `F i Dr- A _P,474- . _ .e - ,1 .P. ri M i `.. ( n + i EA,Ir-Z / �41, 108 [ .'' m t+ ;- ■- --- LI d7„.6,3,.._ `0.'\ LS _5 c-ke-toLA-4 n • ector: A Date: • A- • •. n REINSPECTION'FEE REQUIRED: nor to next inspection. fee must be paid at 6300 Southcenter Blvd.. S ite 100. Call to schedule reinspection. • -- t c=-4_ ro* SEPARATE PERMIT REQUIRED FOR: o Methanica1 ErBectricat &Plumbing (?Was Piping City of Tukwila BUILDING DIVISION FILE COPY Permft No....„Mla110 Plan review approval is subject to errors and omissions. Approval of construction documents does not authorize rIK violation of any adopted code or ordinance. Receipt approved Field Copy and conditions is acknowledged: By Date: 11— 11-10. City Of Tirkwila BUILDING DIVISION REVISIONS No changes shall be made to the scope of work without prior approval of Tukwila Building Division 1.011 t.,:qurr, r- '' )) 54r‘..,t, v--t) kJW ?-/-j A/Gri)k r-e -F- ,pa<d. REVIEWED FOR CODE COMPLIANCE Appanven Iv wi I. 6 2010 I-- City ot Tukwila BUILDING nansinN CnyliETAIDmiA NOV 09 2010 PERMIT CENTER •)■A 1 50 PERMIT(OORDCOR PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: M10 -156 DATE: 11/09/10 PROJECT NAME: PACIFIC NW PERIODONTICS SITE ADDRESS: 411 STRANDER BL, STE 302 X Original Plan Submittal Response to Correction Letter # Response to Incomplete Letter # Revision # after Permit Issued DEPARTMENTS: ll AAA ullding ivision IN Public Works n 4 Prevention ' A- ® b Structural ❑ Planning Division Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 11/16/10 Complete ISC 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: Building Please Route K. Structural Review Required n No further Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved ❑ Approved with Conditions Notation: REVIEWER'S INITIALS: DUE DATE: 12/09/10 Not Approved (attach comments) n DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents/routing slip.doc 2 -28 -02 Contractors or Tradespeople Pr ter Friendly Page General /Specialty Contractor A business registered as a construction contractor with L &I to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name G e S HEATING COOLING /ELEC INC UBI No. 600407222 Phone 3607947306 Status Active Address 500 E Main St License No. GSHEAC *939RK Suite /Apt. License Type Construction Contractor City Monroe Effective Date 12/12/2007 State WA Zip 98272 County Snohomish Business Type Corporation Parent Company Expiration Date 7/18/2011 Suspend Date Specialty 1 General Specialty 2 Unused ther Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status GSHEAI'191P6 G a S HEATING CO INC Construction Contractor Metal Fabrication Unused 10/26/1981 10/26/1982 Archived GSHEASM233LM G & 5 HEATING/SHEET METAL Construction Contractor Air Heat,Ventilation,Evaporat Unused 6/14/1977 6/14/1982 Archived GSHEAC *930MJ G a S HEATING a COOLING INC Construction Contractor General Unused 7/11/2007 7/18/2009 Inactive GSHEACI147JD G a S HEATING CO INC Construction Contractor General Unused 4/4/1986 7/18/2007 Inactive Business Owner Information Name Role Effective Date Expiration Date THOMPSON, ROGER W President 12/12/2007 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 6 CBIC SA1718 04/04/2002 Until Cancelled $12,000.00 02/11/2002 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 24 American Fire a Casualty BKA54089070 07/16/2010 07/16/2011 $1,000,000.0006 /04/2010 23 American Fire e Casualty Co BKA54089070 07/15/2009 07/15/2010 $1,000,000.0007 /14/2009 22 MID-CENTURY INS CO 604662808 07/16/2009 07/16/2010 $2,000,000.00 06/16/2009 21 MID CENTURY 602247228 07/16/2008 07/16/2009 $2,000,000.00 07/10/2008 20 OHIO CAS INS 0C12397B 07/16/2007 07/16/2008 $1,000,000.00 12/12/2007 19 TRUCK INS EXCHANGE 602247228 07/16/2004 07/16/2008 $1,000,000.00 07/11/2007 Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period https://fortress.wa.gov/lni/bbip/Print.aspx 11/19/2010