HomeMy WebLinkAboutPermit M12-185 - BAILEY RESIDENCEThis record contains information which is exempt from public disclosure
pursuant to the Washington State Public Records Act, Chapter 42.56 RCW
as identified on the Digital Records Exemption Log shown below.
M12-185
Bailey Residence
4430 South 139th Street
RECORDS DIGITAL D- ) EXEMPTION LOG
THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION
F,age # Code
Exemption � � �� Brief Explsnatoty Description, Statute /Rule
The Privacy Act of 1974 evinces Congress' intent that
Personal Information —
social security numbers are a private concern. As
such, individuals' social security numbers are
Social Security Numbers
redacted to protect those individuals' privacy pursuant
5 U.S.C. sec.
DR1
Generally — 5 U.S.C. sec.
to 5 U.S.C. sec. 552(a), and are also exempt from
552(a); RCW
552(a); RCW
disclosure under section 42.56.070(1) of the
42.56.070(1)
42.56.070(1)
Washington State Public Records Act, which exempts
under the PRA records or information exempt or
prohibited from disclosure under any other statute.
Redactions contain Credit card numbers, debit card
Personal Information —
numbers, electronic check numbers, credit expiration
9
DR2
Financial Information —
dates, or bank or other financial account numbers,
RCW
RCW 42.56.230(4 5)
which are exempt from disclosure pursuant to RCW
42.56.230(5)
42.56.230(5), except when disclosure is expressly
required by or governed by other law.
BAILEY RESIDENCE
4430 S 139 ST
M12 -185
City oiPI'ukwila
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.: 7347600295
Address: 4430 S 139 ST TUICW
Project Name: BAILY RESIDENCE
Permit Number:
Issue Date:
Permit Expires On:
M12 -185
11/26/2012
05/25/2013
Owner:
Name: BAILEY DAVID A
Address: 4430 SO 139TH ST , SEATTLE WA 98168
Contact Person:
Name:
Address:
Email:
Contractor:
Name:
Address:
Contractor
DEBRA COONS
12462 DES MOINES MEMORIAL DR , SEATTLE WA 98168
GLENDALE HEATING & A/C
12462 DES MOINES WY S , SEATTLE, WA 98168
License No: GLENDHA053Q2
Phone: 206 - 660 -2681
Phone: 206 - 243 -7700
Expiration Date: 11/02/2013
DESCRIPTION OF WORK:
REPLACE EXHISTING GAS FURNACE WITH SAME
Value of Mechanical: $3,962.81
Type of Fire Protection: UNKNOWN
Electrical Service Provided by:
Permit Center Authorized Signature: 7
Fees Collected:
$186.50
International Mechanical Code Edition: 2009
Date: / (
I hereby certify that I have read and examined thi' 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:
Dcw. t (-7zz9,1
Date: 2( A/61. . /
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
M12-185 Printed: 11 -26 -2012
PERMIT CONDITIONS
Permit No. M12-185
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
M12-185 Printed: 11 -26 -2012
CITY OF TUKv✓ILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
htto://www.ci.tukwila.wa.us
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 Address:
Tenant Name:
Property Owners Name:
Mailing Address: 1--` 1J
Name:
SD I�jq t;
King Co Assessor's Tax No.:
Suite Number:
New Tenant:
3 3 OVi9 O 7-16.
Floor:
❑ Yes ❑ ..No
Mailing Address: ) ) L U ` ) _ 1)* Pr/n' ra Y tik)
E -Mail Address:
City
Fax Number:
tote Zip
)/ a 5
Company Name:1�107(I
Mailing Address:
City State Zip
Contact Person: b r9 G)0 0.7 Day Telephone: abID V cb?j - 7 b'
E -Mail Address: t t Fax Number: - ,'L) 5 - Cn3L'r
Expiration Date: 11 ` D ,Z ") 1--
Contractor Registration Number: ( LE NN-1l 63
Company Name:
Mailing Address:
City State
Day Telephone:
Fax Number:
Contact Person:
E -Mail Address:
Zip
Company Name:
Mailing Address:
City ✓ State Zip
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
FI:\Applications\Forns- Applications On Line\2010 Applications \7 -2010 - Mechanical Permit Application.doc
Revised: 7 -2010
bh
Page 1 of 2
Valuation of project (contractor's bid price): $
Scope of work (please provide detailed information):
p% : y4 initt J�
Use: Residential: New ❑ Replacement
Commercial: New ❑ Replacement
Fuel Type: Electric ❑
Gas Other:
Indicate type of mechanical work being installed and the quant'ty below:
Unit ®t a b l r # � ;
t��+. `
; t} p. , A
`(� 6
c
IJhit T ®• yy x4 J Y
Nom+ j;
o1 ! 3 B ' r0 � 0
s+
furnace <100k btu
I
air handling unit
>10,000 cfm
fire damper
0 -3 hp /100,000 btu
Y
furnace >100k btu
evaporator cooler
diffuser
3-15 hp /500,000 btu
floor furnace
ventilation fan connected
to single duct
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
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 OWNER
Signature:
Print Name:
Mailing Address:
R AUTHORIZED A
AltilA A
Date Application Accepted:
‘-7 Da Telephone:
al;' II `L i ;
City
.1i.411i
Date: HO 1 M 2
0
State
Zip
1
Date Application Expires:
Staff Initial
H1Applications\Fotms- Applications On Line\2010 Applications \7 -2010 - Mechanical Permit Application.doc
Revised: 7 -2010
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Page 2 of 2
6
�.`NI�A �w�Q City of Tukwila
a `Y o
I90a
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.: 7347600295
Address: 4430 S 139 ST TUICW
Suite No:
Applicant: BAILY RESIDENCE
RECEIPT
Permit Number: M12 -185
Status: PENDING
Applied Date: 11/26/2012
Issue Date:
Receipt No.: R12 -03183 Payment Amount: $186.50
Initials: TLS Payment Date: 11/26/2012 01:53 PM
User ID: 1670 Balance: $0.00
Payee: GLENDALE HEATING AND AIR CONDITIONING
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 67151 186.50
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
MECHANICAL - RES
000.322.102.00.00 186.50
Total: $186.50
doc: Receipt -06 Printed: 11 -26 -2012
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 ` _ (206) 43.1 -367
Permit Inspection Request Line (206) 431 -2451 r
Project:
(-2,A-c...0.--k z Ps
Type of Inspection:
E% Al,_
Address:
1-1 -A 3 G S 1 3G Y
Date Called:
Special Instructions:
Date Wanted:.
1 1 (-7D0
)-7
a.m.
'' plit
Requester:
Phone No:
® Approved per applicable codes.
ElCorrections required prior to approval. ,
COMMENTS:
fill r ET" G2;' - O t
•
Inspector:
Datei:
REINSPECTION FEE REQUIRED. Prior to next inspection, fee must Abe`
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection:,
•
Contractors or Tradespeople P, rater Friendly Page
General /Specialty Contractor
A business registered as a construction contractor with Lftl 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
Phone
Address
Suite /Apt.
City
State
Zip
County
Business Type
Parent Company
GLENDALE HEATING 8 A/C INC
2062437700
12462 Des Moines Memorial Dr
Seattle
WA
981682266
King
Corporation
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
600003167
Active
GLENDHA053Q2
Construction Contractor
11/22/1995
11/2/2013
General
Unused
Other Associated Licenses
License
Name
Type
Specialty 1
Specialty 2
Effective
Date
Expiration
Date
Status
GLENDHO110PU
GLENDALE
HEATING
ft OIL CO
INC
Construction
Contractor
General
Unused
10/31/198911/2/1995
01/01/1980
Archived
GLENDO'237DM
GLENDALE
OIL CO
INC
Construction
Contractor
Boiler /Steam
Fit /Prot
Piping
Air
Heat,Ventilation,Evaporat
3/14/1977
11/2/1989
Archived
Business Owner Information
Name
Role
Effective Date
Expiration Date
HOEFER, GERALD ARTHUR
President
11/22/1995
Received Date
FULTON, DAVID CURTIS
Secretary
11/22/1995
Until
Released
ATWOOD, STANLEY
Agent
01/01/1980
06/26/2012
HOEFER, ARTHUR
Treasurer
01/01/1980
09/30/2011
Bond Information No records found for the previous 6 year period
Assignment of Savings Information
Page 1 of 2
Savings
Assignment of Savings Account Number
Effective Date
Release Date
Assignment Type
Impaired Date
Amount
Received Date
3
3/11/1977
1/20/2009
Bond
0715288
$1,000.00
1/20/2009
Insurance Information
Insurance
Company Name
Policy Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Amount
Received Date
12
Continental
Western Ins Co
CDP2976203
11/02/2012
11/02/2013
$1,000,000.00
10/31/2012
11
WESCO
INSURANCE
COMPANY
WPP101953800
11/02/2010
11/02/2013
$1,000,000.00
10/17/2012
10
FEDERATED
MUTUAL INS CO
0715288
11/02/2004
11/02/2011
11/23/2010
$1,000,000.00
09/27/2010
Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period
https://fortress.wa.gov/lni/bbip/Print.aspx
11/26/2012