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Home My WebLink AboutPermit PG12-040 - HILSEN 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. PG 12 -040 Hilsen Residence 1522540th Avenue South 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 10 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. HILSEN RESIDENCE 15225 40 AV S PG1 2-040 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.TukwilaWA.gov Parcel No.: 0043000168 Address: 15225 40 AV S TUKW Project Name: HILSON RESIDENCE PLUMBING /GAS PIPING PERMIT Permit Number: Issue Date: Permit Expires On: PG12 -040 03/07/2012 09/03/2012 Owner: Name: Address: Contact Person: Name: Address: Email: Contractor: Name: Address: Contractor HILSEN MARILYN J +KENNETH E 15225 40TH AVE S , SEATTLE WA 98188 Yiti- {REIGER 13324 BINGHAM AV E , TACOMA WA 98446 MOOSEKREIGER @YAHOO.COM PUGET SOUND GAS PIPING INC 13324 BINGHAM AVE E , TACOMA WA 98446 License No: PUGETSG956MA Phone: 253 - 224 -7283 Phone: 253- 539 -4488 Expiration Date: 07/27/2013 DESCRIPTION OF WORK: TAPPING INTO LINE FROM RANGE. RUNNING 20 FT TO OUTSIDE. COME UP TO EMG SHUTOFF THEN OVER IN TO FIRE BOX Value of Plumbing /Gas Piping: $300.00 Uniform Plumbing Code Edition: 2009 Fees Collected: $96.60 International Fuel Gas 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 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. Date: 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 PG12 -040 Printed: 03 -07 -2012 • • PERMIT CONDITIONS Permit No. PG 12 -040 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 in 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: 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. 12: 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 PG12 -040 Printed: 03 -07 -2012 CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov • "A) Plumbing/Gas Permit No. G 1) Q if 6 Project No. Date Application Accepted: Date Application Expires: (For office use only) 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: I�Z-ZS -/ 0 Tenant Name: King Co Assessor's Tax No.: d y3 O ®O /(2 6 Suite Number: Floor: New Tenant: ❑ Yes PROPERTY OWNER / Name: / ca " tii J t 4_, 1/C 4,w,.�'%� Address: City:'"?) ii4L.LIP State: �/L�o4 Zip:fr373 Name: atcaL yy) /4. 7. L s Tukwila Business License No.: (mss _ 0 ?? 7,17 Address: A -2:70. 2 YJ%z: C City. /1i e�✓1. - State: ii../9- Zip. 9 6_3(y CONTACT PERSON - person receiving all project communication / Name: / ca " tii J t 4_, 1/C 4,w,.�'%� Address: City:'"?) ii4L.LIP State: �/L�o4 Zip:fr373 Phone ?C ?, .6`75,.-Ll6 3 Fax: EmaiMbO.se 473 Cr+t &A AO. cow. PLUMBING CONTRACTOR INFORMATION Company Name: Fk. air SuN1D 6 S 1;,� ` Address: `3-32 3 Ave_ C l 5� 1 ..a�L,�a+�I l`t City ` �tt State: Zip .1 y, !4/ '7 b Phone``: Za4. 7z2 3 Fax: N )4 Contr Reg No.:. ' e�, .e� T pSL Exp Date: 7////20 13 Tukwila Business License No.: (mss _ 0 ?? 7,17 Valuation of Project (contractor's bid price): $ 300 Scope of Work (please provide detailed information): TiA.? 'A y.i'(o (,.fir �l2,ort1 ''rO OL T5z & , cam V P L744 swr , w e FF "Mew o tYe `tp �T�t Building Use (per Int'l Building Code): Occupancy (per Int'I Building Code): Utility Purveyor: Water: Sewer: H:Wpplications\Forms- Applications On Line\2011 Applications\Plumbing Permit Application Revised 8- 9- 11.doac Revised: August 2011 bh Page 1 of 2 Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below: Fixture Type Qty Bathtub or combination bath/shower Dishwasher, domestic with independent drain Shower, single head trap Sinks Rain water system — per drain (inside building) Grease interceptor for commercial kitchen ( >750 gallon capacity) Each additional medical gas inlets /outlets greater than 5 Atmospheric -type vacuum breakers not included in lawn sprinkler backflow protections (1 -5) 1 Fixture Type Qty Bidet Drinking fountain or water cooler (per head) Lavatory Urinal Water heater and /or vent Repair or alteration of water piping and/or water treatment equipment Backflow protective device other than atmospheric - type vacuum breakers 2 inch (51 mm) diameter or smaller Atmospheric -type vacuum breakers not included in lawn sprinkler backflow protections over 5 1 Fixture Type Qty Clothes washer, domestic Food -waste grinder, commercial Wash fountain Water closet Industrial waste treatment interceptor, including trap and vent, except for kitchen type grease interceptors Repair or alteration of drainage or vent piping Backflow protective device other than atmospheric -type vacuum breakers over 2 inch (51 mm) diameter Gas piping outlets 1 Fixture Type Qty Dental unit, cuspidor Floor drain Receptor, indirect waste Building sewer and each trailer park sewer Each grease trap (connected to not more than 4 fixtures - <750 gallon capacity Medical gas piping system serving I -5 inlets /outlets for a specific gas Each lawn sprinkler system on any one meter including backflow protection devices 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 R UTHVR1ZED AGENT: Signature: ✓ /'/ l Print Name: / Mailing Address: Date: 3 -7- / Z • )2_r L/ " Day Telephone: " 6 7 ?5 i b 3 Qe City State Zip cs&z, ( ZS �% C ?: t ?v ` ii--LC (f H: Applications'Forms- Applications On Line \2011 Applications\Plumbing Permit Application Revised 8 -9 -1 I.doex Revised: August 2011 bh Page 2 of 2 • 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 RECEIPT Parcel No.: 0043000168 Permit Number: PG 12 -040 Address: 15225 40 AV S TUKW Status: PENDING Suite No: Applied Date: 03/07/2012 Applicant: HILSON RESIDENCE Issue Date: Receipt No.: R12 -00951 Initials: WER User ID: 1655 Payment Amount: $96.60 Payment Date: 03/07/2012 11:31 AM Balance: $0.00 fea.. Payee: ITT KREIGER TRANSACTION LIST: Type Method Descriptio Amount Payment Cash Authorization No. ACCOUNT ITEM LIST: Description 96.60 Account Code Current Pmts GAS - RES 000.322.103.00.00 96.60 Total: $96.60 City of Tukwila 6200 Southcenter Blvd, Tukwila, WA 1 Finance Department 1206701 -1 03/07/2012 BR1 T103 Wed Mar07,2012 11:36AM Trans #30 -30 30 $264.30 DCDGEN - DCD Permits Plus - General Fund Secondary ID: MIKE KREIGER 1 ITEM(S): TOTAL: $264.30 MasterCard PAID $264.30 www.tukwilawa.gov 206 -433 -1835 ioc: Receipt -06 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 12. Project: Mil5CA/ A7ie Type of Inspection: /A.M e Address :, / 225 4/0 Av S Date Called: Special Instructions: rim/ . /hi- 44,-4, C7 553.260_.2z-3-.67g-Gig Date Wanted:. a.m. Requester: Phone No: 3 Approved per applicable codes. Corrections required prior to approval. COMMENTS: Inscectar' Date: JQ.I. R INSPECTION 'FEE REQiUIRED. Prior o next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. .. -, k'.s'�'.'^r' . -..s- 4 INSPECTION NO. INSPECTION RECORD Retain a copy with permit P6/,2 --O410 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: ,�/ /. L ....54-1 41--7.5 Type of Inspection /,. /..1 '-L /C /1— / Address: / . ' 5 2 2 : 6 4 / 0 / 9 v S Date Called: Special Instructions: - Date Wanted:. ._i - /2 - /2 a.m. (rfm Requester: Phone No: / .2 7-G7�f -b /' 3 Approved per applicable codes. Corrections required prior to approval. COMMENTS: era 1 Date: ,'REINSPECTION. FEE RE UIRED. Pr r to next inspection. fee must be ':.paid at 6300 Southcenter blvd.. Suite 100. Call to schedule reinspection. 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 Phone Address Suite /Apt. City State Zip County Business Type Parent Company PUGET SOUND GAS PIPING INC 2535394488 13324 Bingham Ave. E Tacoma WA 98446 Pierce Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 602435577 Active PUGETSG956MA Construction Contractor 7/1/2005 7/27/2013 Plumbing Unused ther Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status PUGETSG974C7 PUGET SOUND GAS PIPING Construction Contractor Other (Specify) Unused 2/27/2003 2/27/2005 Archived CLASSGP986JP CLASS A GAS PIPING Construction Contractor Other (Specify) Unused 4/17/2002 4/17/2004 Archived Business Owner Information Name Role Effective Date Expiration Date BRADLEY, ANTHONY President 07/01/2005 Amount BISCARRET, DOMINIC Secretary 07/01/2005 L1790002281 ANDERSON, ANDY Vice President 07/01/2005 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 2 CAPITOL INDEMNITY CORPORATION 919233 03/02/2006 Until Cancelled 04/06/2010 $6,000.00 03/08/2006 Assignment of Savings Information Savings 2 Assignment of Savings Account Number Effective Date 4/27/2010 Release Date Assignment Type Impaired Date Amount Received Date Until Released Bond $6,000.00 4/27/2010 Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date 9 Co Atlantic Cas Ins L1790002281 04/11/2011 04/11/2012 $1,000,000.00 04/11/2011 8 ATLANTIC CAS INS CO L17900228 04/11/2010 04/11/2011 $1,000,000.00 03/31/2010 7 ATLANTIC CASUALTY INS CO L071003336 04/11/2009 04/11/2010 $1,000,000.00 04/13/2009 6 AMERICAN STATES INS CO 25CC15518010 04/11/2008 04/11/2009 $1,000,000.00 04/15/2008 5 FIRST NATIONAL INSURANCE CO OF 25CC15518010 04/11/2007 04/11/2008 $1,000,000.00 04/13/2007 4 LINCOLN GENREAL PUGET7 12/06/2006 12/06/2007 $1,000,000.00 12/06/2006 https://fortress.wa.gov/lni/bbip/Print.aspx 03/07/2012