HomeMy WebLinkAboutPermit M12-112 - BERGE RESIDENCEBERGE RESIDENCE
4019 S 148 ST
M12 -112
City olkukwila
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
MECHANICAL PERMIT
Parcel No.: 0041000169
Address: 4019 S 148 ST TUKW
Project Name: BERGE RESIDENCE
Permit Number: M12 -112
Issue Date: 07/19/2012
Permit Expires On: 01/15/2013
Owner:
Name: BERGE MICHAEL A
Address: 4019 S 148TH ST , SEATTLE WA 98188
Contact Person:
Name: ERIK SORENSEN
Address: 13407 SE 339 ST , AUBURN WA 98092
Email: MOUNTAINVALLEYHEATING @COMCAST.NET
Contractor:
Name: MOUNTAIN VALLEY HTG & A/C
Address: 13407 SE 339 ST , AUBURN WA 98092
Contractor License No: MOUNTVH970N2
Phone: 206 - 391 -9700
Phone: 425 - 226 -0080
Expiration Date: 03/05/2014
DESCRIPTION OF WORK:
INSTALL MITSUBISHI MINI SPLIT DUCTLESS HEAT PUMP. UP TO 3 TON SYSTEM. OUTDOOR
UNIT #MXZ- 4B36NA, LIVING ROOM INDOOR #MSZ- GE12NA, BEDROOMS MSZ- GEO6NA, FAMILY
ROOM # MSZ- GE15NA
Value of Mechanical: $10,678.00 Fees Collected: $254.65
Type of Fire Protection: UNKNOWN International Mechanical Code Edition: 2009
Electrical Service Provided by:
Permit Center Authorized Signature: 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 perf ance 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:
Datef // . / 2
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
M12-112 Printed: 07 -19 -2012
• •
PERMIT CONDITIONS
Permit No. M12 -112
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 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.
4: Manufacturers installation instructions shall be available on the job site at the time of inspection.
5: Except for direct -vent appliances that obtain all combustion air directly from the outdoors; fuel -fired appliances
shall not be located in, or obtain combustion air from, any of the following rooms or spaces: Sleeping rooms,
bathrooms, toilet rooms, storage closets, surgical rooms.
6: Equipment and appliances having an ignition source and located in hazardous locations and public garages, PRIVATE
GARAGES, repair garages, automotive motor -fuel dispensing facilities and parking garages shall be elevated such that
the source of ignition is not less than 18 inches above the floor surface on which the equipment or appliance rests.
7: Water heaters shall be anchored or strapped to resist horizontal displacement due to earthquake motion. Strapping shall
be at points within the upper one -third and lower one -third of the water heater's vertical dimension. A minimum
distance of 4- inches shall be maintained above the controls with the strapping.
8: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the City of Tukwila
Building Department (206- 431 - 3670).
9: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building
Department (206- 431 - 3670).
10: 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
M12 -112 Printed: 07 -19 -2012
CITY OF TUKWI
Community Developm epartment
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http: / /www.TukwilaWA.gov
Mechapical t'No
Project No �.•.
Date Apphcatiion Accepted
Date Appltcation;Exptres
For of ce. Use only) n
MECHANICAL 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,LOCATI(
4/0
King Co Assessor's Tax No.: 0O{ '- 1000 1 t
Site Address: %cf / T s� TV LAO; 16`. 16 U Suite Number:
AA ecr Owu s
Tenant Name:
PROPERTY- .OWNER�°
a -, �:`;: x • '': °t,
Name: /Pt/ k-e /
2✓
Phone: w 6 S ((_ c/?...O D Fax:
Email: /tit) V14 -runt l2 //t '74 -i,,,' Q 4-4t-«u
Address: g o / 9 l S ,
/
2511.A �.�...
City: % J., uj , 1,
State: um
Zip: .94 :7?
CON`I'AC,T.PERSON „ :pelrsOii,Cce_ii. mgda
{
communication ..': .. "• $,:s #a- ? * =/ � .....
J�
Name: FKL ,VCS U... - /lty 11A,c
Address: I J
City: State: Zip:
Phone: w 6 S ((_ c/?...O D Fax:
Email: /tit) V14 -runt l2 //t '74 -i,,,' Q 4-4t-«u
J
Floor:
New Tenant: ❑ Yes ❑.. No
rMECH0TCWON'TRA0010IVFORIVIATION•••„
Company Name: /tow I L lit I I �l N{ F
c
Address: / 3070 7. 33.7 . %5q. J
City: /1 / v/ik State: aix Zip:91 6
--- 2
Phone: 442S-- 2,26 -00b0 Fax: 4/2,c-22.,‘, -a* o
Contr Reg No.: /) f OliA77V b/ Q f Txp Date: 3 ;/1 Li
Tukwila Business License No.:
' w . ..i V., >ruw.:. rung oil�wsro •wYFrv,n.w.,M,..
Valuation of project (contractor's bid price): $ / 0 J to /� g // 1 ( /
/D�escribbe the scope of work in detail: �k. S /// PI 7S v 119 / S k ‘) /Vt i k , • /r �d l ici e-&S ? *044 fin')
(/ �7j S 7?!G� S/�S felt, , //ijGdr vti. ( 7� r� . / %;° i 4'°''�(�2 - �3 Jtrj�V
G /I,/ ✓onket //t Soo✓ - A(S 2.- '167Z%U/1 tr/ ./a.4-S
7
dooms MS.-?: - 4,E /S -i(/A
,41S - 6l'"O6A/A,
Use: Residential: New
Commercial: New
AIL
Replacement
Replacement
Fuel Type: Electric.... Gas ❑ Other:
H:Wpplications\Forms- Applications On Line \2011 Applications\Mechanical Permit Application Revised 8- 9- 11.docx
Revised: August 2011
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❑
❑
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Page 1 of 2
Indicate type of mechanical work being illtled and the quantity below:
Unit Type : •
.- . ,
'Qty ,
..
Furnace <100k btu
Furnace >100k btu
Floor furnace
Suspended/wall/floor
mounted heater
Appliance vent
Repair or addition to
heat/refrig/cooling
system
--,...
Air handling unit
(2)
<10,000 cfm
YAOPLIC-
. ,. Unit Type
''Qty..
Air handling unit
>10,000 cfm
Evaporator cooler
Ventilation fan
connected to single duct
Ventilation system
Hood and duct
--,...
Incinerator - domestic
(2)
Incinerator -
comm/industrial
, - Unit Type. ,
Qty
Fire damper
Diffuser
Thermostat
Wood/gas stove
Emergency generator
Other mechanical
--,...
equipment
(2)
.. Boiler/Compressor -: '
• .Qty
0-3 hp/100,000 btu
3-15 hp/500,000 btu
15-30 hp/1,000,000 btu
30-50 hp/1,750,000 btu
50+ hp/1,750,000 btu
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.
BUILDI OWNEI-Oft-ALLIaORIZEIiY AGE
Signature:
Print Name:
Date:
Day Telephone: -3 7-dt-2
Mailing Address: /3471V) c:::Cr- 5-7L vtiv0 &2 7 2
1-1: \Applications Worms-Applications On Line \ 2011 ApplicationsWechanical Permit Application Revised 8-9-11.docx
Revised: August 2011
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City State Zip
Page 2 of 2
•
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -43 1 -3670
Fax: 206 - 431 -3665
Web site: http://www.TukwilaWA.gov
Parcel No.: 0041000169
Address: 4019 S 148 ST TUKW
Suite No:
Applicant: BERGE RESIDENCE
RECEIPT
Permit Number: M12 -112
Status: PENDING
Applied Date: 07/19/2012
Issue Date:
Receipt No.: R12 -02165
Initials:
User ID:
Payee:
WER
1655
Payment Amount: $254.65
Payment Date: 07/19/2012 10:18 AM
Balance: $0.00
ERIK SORENSEN
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd MC
Authorization No. 02402S
ACCOUNT ITEM LIST:
Description
254.65
Account Code Current Pmts
MECHANICAL - RES
000.322.102.00.00 254.65
Total: $254.65
doc: Receiot -06 Printed: 07 -19 -2012
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
y
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
I''iiZ I 1 Z
Project:
Type of Inspection:
Address:
q o'r t 6
4 "t 8
Date Called:
_
Special Instructions:
Date Wanted:. (a.m:
7-2-S- :2 +.P.�.
Requester:
Phone No:
,366,--21-1G-(c,Gsty
Approved per applicable codes.
ElCorrections required prior to approval.
COMMENTS:
. cRa\( - D q _ ADP/e6V67,
"W"I;Ui ►-[ UOwlNc 1 J k/4 /
1
tor:
PAULI r
INSPECTION FEE REIIUIRED. Pr).or to next inspection. fee must be
aid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Da
Contractors or Tradespeople liter 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 MOUNTAIN VALLEY HTG &
A/C INC
UBI No. 602302062
Phone 4252260080 Status Active
Address 13407 Se 339Th Street License No. MOUNTVH970N2
Suite /Apt. License Type Construction Contractor
City Auburn Effective Date 3/5/2004
State WA Expiration 3/5/2014
Date
Zip 98092 Suspend Date
County King
Business Type Corporation
Parent
Company
Specialty 1
Heating /Vent /Air - Conditioning And Refrig
(Hvac /R)
Specialty 2 Unused
Other Associated Licenses
License
Name
Type
Specialty 1
Specialty 2
Effective
Date
Expiration
Date
Status
MOUNTVH976C8
MOUNTAIN
VALLEY
HEATING
Construction
Contractor
Air
Conditioning
Metal
Fabrication
2/28/2003
2/28/2005
Archived
Business Owner Information
Name
Role
Effective Date
Expiration Date
SORENSEN, ERIK J
President
03/05/2004
Amount
WILLIAMS, ANNE E
Secretary
03/05/2004
01- CG- 305482-
0
WILLIAMS, ANNE E
Treasurer
03/05/2004
WILLIAMS, ANNE E
Vice President
03/05/2004
American
States
Insurance Co
Bond Information
Page 1 of 2
Bond
Bond Company Name
Bond Account Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Bond Amount
Received Date
1
DEVELOPERS SURETY
& INDEM CO
570065C
07/30/2003
Until Cancelled
$6,000.00
08/22/2003
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
7
American
States
Insurance Co
01- CG- 305482-
0
02/28/2012
02/28/2013
$1,000,000.0002
/10/2012
6
American
States
Insurance Co
01CG3054828
02/28/2011
02/28/2012
$1,000,000.0002
/09/2011
5
AMERICAN
STATES INS CO
01CG3054828
02/28/2010
02/28/2011
$1,000,000.0002
/24/2010
4
FIRST
NATIONAL INS
CO OF AMERI
010E9729979
02/28/2009
02/28/2010
$1,000,000.0002
/17/2009
3
FIRST
NATIONAL INS
CO OF AM
01CG3054826
02/28/2007
02/28/2009
$500,000.0002/01
/2008
https: // fortress .wa.gov /lni /bbip /Print.aspx
07/19/2012