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Permit PG12-132 - SHEGER ARADA
This 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 -132 Sheger Arada 14645 Tukwila International Boulevard 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 34 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. SHEGER ARADA 14645 TUKWILA INTERNATIONAL BL PG12 -132 Parcel No.: Address: City AI'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 PLUMBING /GAS PIPING PERMIT 0040000865 14645 TUKWILA INTERNATIONAL BL TUKW Project Name: SHEGER ARADA Permit Number: PG12 -132 Issue Date: 10/15/2012 Permit Expires On: 04/13/2013 Owner: Name: Address: Contact Person: Name: Address: Email: Contractor: Name: Address: Contractor OBRIEN TIMOTHY M 14217 59TH AVE S , TUKWILA WA 98188 DOUG HARRIS PO BOX 47013 , SEATTLE WA 98146 DOUG @BANDJPLUMBING.NET B & J PLUMBING INC PO BOX 47013 , SEATTLE WA 98146 License No: BJPLU * *234B6 Phone: 206 293 -6033 Phone: 206 658 -1031 Expiration Date: 07/22/2013 DESCRIPTION OF WORK: ROUGH PLUMB WASTE FOR THREE COMPARTMENT SINK. SINK TO GO INTO GREASE INTERCEPTOR AND ROUGH PLUMB FOR HAND SINK. TRIM OUT THREE COMPARTMENT SINK AS WELL AS HAND SINK. Value of Plumbing /Gas Piping: Fees Collected: Electrical Service Provided by: Permit Center Authorized Signature: $2,500.00 $156.19 Uniform Plumbing Code Edition: 2009 International Fuel Gas Code Edition: 2009 Date: 10 —/ — 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. Signature: Print Name: Date: (0//j --/ / 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 -132 Printed: 10 -15 -2012 • • PERMIT CONDITIONS Permit No. PG 12 -132 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: All new plumbing fixtures installed in new construction and all remodeling involving replacement of plumbing fixtures and fittings in all residential, hotel, motel, school, industrial, commercial use or other occupancies that use significant quantities of water shall comply with Washington States Water Efficiency and Conservation Standards in accordance with RCW 19.27.170 and the 2006 Uniform Plumbing Code Section 402 of Washington State Amendments. 13: 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 -132 Printed: 10 -15 -2012 CITY OF TUKWI A Community Develop Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http: / /www.TukwilaWA.gov 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 Address: ILI14,y5 ri tetera'IIIo1iet' FPO/ Tenant Name: Al�iD,/ Fit L�Ir51"fit ( i, P/1l A o� V t King Co Assessor's Tax No.: cO '{OOt t/ UI(1C PROPERTY OWNER Name: ANDY rt/tti°ll6.0STLA Address: I4I0 LIS TNia'fvGt' i'oviA( Biv i. City: , i t - (a State: via Zip: p 4` I _s CONTACT:: PERSON ,;person receiving all project con munication - Name: Po (AC-7 �i-, rr i S Address: To Box. 14703 City: C aoki ' „e State: ,� .) A Zip: Gigc` Li Phone: zO� Zg13 603 Fax: 7/1f _ 7/_7o on / 22 Email: 12�%(i�,G ?0. EA- WPTL ?V ?icon Suite Number: Floor: New Tenant: ❑ Yes E 1.. No 'PLUMBING:CONTRACTOR'INFORMATION Company Name: AND o- p i to vsn 12 hCi Address: To Box 4 70 ( 3 City: SEAIT I E- State: w A Zip: c (9 b Phone: 204, 65 $ I031 Fax: 206 - 767-0$r1'!o Contr Reg No.: BPLU eexp Date: Tukwila Business License No.: a,tc� D/1792„1 t Valuation of Project (contractor's bid price): $ Z500 'Plumb �`, 1 Scope of Work (please provide detailed information): ROW I� L.'4 �� 7 br ti r�10 zonforT1'otni 51141: +0 67v ivif0 Circa , hiti-eaerfor and gDUy/1 plumb for hclhc iik, 7Ffvh our Three towieer1- ki 7 -irn owl- hard crivi k Building Use (per Int'l Building Code): Occupancy (per Int'l Building Code): Utility Purveyor: Water: Sewer: H:\Applications\Forms- Applications On Line \2011 Applications\Plumbing Permit Application Revised 8 -9 -1 I.docx Revised: August 2011 bh Page 1 of 2 Indicate type of plumbing fixtures and/ors.piping outlets being installed and the quantity elow: Fixture Type r Qty' Bathtub or combination bath/shower Dishwasher, domestic with independent drain Shower, single head trap Sinks 1, 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) 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 Fixture Type .'° 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 f' 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 1 -5 inlets /outlets for a specific gas ' Each lawn sprinkler system on any one meter including backflow protection devices 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 OWNE OR AUTHORIZED AGENT: _ G� Signature: 0 � Date: 374 -e- / f 1 Print Name: Ci rtIO 1 C(L.v t✓{ Day Telephone: 00 Z f3 033 Mailing Address: TO BOX y 70I3 L A. /"i f° City State Zip H:Wpplications\Forms- Applications On Line \2011 Applications\Plumbing Permit Application Revised 8 -9 -1 l.docx 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 ParcelNo.: 0040000865 Permit Number: PG12 -132 Address: 14645 TUKWILA INTERNATIONAL BL TUICW Status: APPROVED Suite No: Applied Date: 06/19/2012 Applicant: SHEGER ARADA Issue Date: Receipt No.: R12 -02859 Payment Amount: $124.95 Initials: WER Payment Date: 10/15/2012 01:29 PM User ID: 1655 Balance: $0.00 Payee: ANDY MENGISTU TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd MC Authorization No. 219916 ACCOUNT ITEM LIST: Description 124.95 Account Code Current Pmts PLUMBING - NONRES 000.322.103.00.00 124.95 Total: $124.95 doc: Receipt -06 Printed: 10 -15 -2012 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.Tukw ila WA.:;ov RECEIPT Parcel No.: 0040000865 Permit Number: PG12 -132 Address: 14645 TUKWILA INTERNATIONAL BL TUKW Status: PENDING Suite No: Applied Date: 06/19/2012 Applicant: SEGER ARAOA Issue Date: Receipt No.: R12 -01911 Payment Amount: $31.24 Initials: JEM Payment Date: 06/19/2012 11:31 AM User ID: 1165 Balance: $124.95 Payee: GREGORY K CLEAVER JR TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 694007 ACCOUNT ITEM LIST: Description 31.24 Account Code Current Pmts PLAN CHECK - NONRES 000.345.830 31.24 Total: $31.24 doc: Receiot -06 Printed: 06 -19 -2012 INSPECTION RECORD Retain a.copy with permit INSPECTION NO. PERMIT NO: CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd!, #100, Tukwila. WA 98188 ,i (206).431 -3670 Permit Inspection Request Line (206) 431 -2451 Prole t: hPCam - A- -` Type o.lnspectiont _ tsJ DI <i. , Address: t4 (al -. ._...� -i Date Called: Special Instructions: -.. Date Wanted 1 —7 ' 3�r`rm: a.m. Requester: I _. P11,97 Note ..... 4 .... Approved per applicable codes. Il Corrections required prior to approval.. COMMENTS: Pt°rr�'ir°� t.��l� ic'1 1, CAI tri Inspect r:, Date: n RE1NSPECTION FEE REQUIRED. Prior.fo next inspection; fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection..;. 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: • G NE 1 �4 a A�. IIkR4I Type of Inspection: C2 8ti«,+4 NI Address: I Li %Z-IS i 1. Date Called: i Special Instructions: Date Wanted:. t©— %`_t_‘Z a.: P.m. Requester: Phone No: cy_,- 2.G3 "Ca e3 2, ©Approved per applicable codes. Corrections required prior to approval. COMMENTS: tU.M.i c.i +4 - NM i q- AL k"- — r� 1a•-•-e C. Inspector: Date: r o —: 4- i> REINSPECTION FEE REQUIR D. Prior to net inspection, fee must be paid at 6300 Southcenter Blvd Suite 100. Call to schedule reinspection. I t. REVIEWED FOR CODE COMPLIANCE APPROVED OCT 1 2 2012 City of FuIwila BUILDING ISION FELE' COPY Permit No. Plan review app t.pproval of const th violation of any adopt of cpproved Field Copy an rg and omission. 1:9 ordlnanceliteceipt ns is acKnowledged: By No changes s lie MEW of work rgittiptit prier 1 of It ukwila Buildirbg in. WOTE: Revisions will re:40re a new plan submittal ad may include additonal plan review fees. ••■ RECEIVED CITY OF TUKWILA SEP 1 1 2012 PERMIT CENTER 1 5-- City Of Tukwila BUILDING DIVISION RE, "01 ApoToor STERED ECT AVID A SIRCOLOUMB 41071q STATE OF WASHINGTON SHEGER ARAOA. GROCERY STORE CORRECTiON 14645 INTERNATIONAL BLVD TUKWILA WASHINGTON 98168 S. I DUSTING STORAGE EXISTING MECHANICAL ROOM EXISTING •RESTROOMS EXISTINg. •DELL rt EXISTING . CORRIDOR DISPLAY CASE SHELVES 'EXISTING SALES AREA DUSTING. SUPPORT KrrCHEN 64ELES 1ST FLOOR •PlAN SCALE VS' alt-0' 0 4 8' 1 MNIMOINISMNI EQUIPMENT'LIST 1.3 COMPARTMENT SINK 2. GREASE INTERCEPTOR • Project Description Remodel existing Support Kitchen for new equipment The new equipment to be installed is as follows : a). Three compartment sink b). New gas range and hood c). New grease interceptor (All items listed above frill be permitted by contractor). REVIEWED FOR CODE COMPLIANCE APPROVED OCT 1 2 2012 City of Tukwila BUILDING DIVISION .Project Notes Per TV kwiia BuiId ing Division 1. See floor plan as shown for existing tenant space conditions and new equipment placement locations, for existing kitchen. 2 The existing use of this -facility is a Grocery Store. There is no changes of the existing tenant space, other then new equipment listed in item #1. (Plumbing and Mechanical contractors will be responsible for equipment Fnstllatlonpem7fts 3 . The function of the three compartment sink, is the request of the Health Department standard for the remodel of the existing kitchen, that will support the existing Deli services as will as the new range and hood. 4, The mechanical and plumbing contractors have not been selected at this time, but will be responsible for material needed for this project per the request of the Tulcwila Building Department ,40 Project Data Owner Sheger Araoa Site Address : 14645 International BLVD, Tukwila Washington, 98168 Parcel No 0040000865 Occupancy Classification: Mercantile Group M Type of Construction: Type V-B Contact Person: Curtis Boozer 403826th Avenue West Seatt)e, WA 98199 curtboozer@comcastnet RECEIVLD CITY OF TUKWILA SEP 1 1 2012 PERMIT CENTER • 8357 57 SHEGER ARAQA GROCERY STORE 14645 INTERNATIONAL BLVD TUKWILA WASHINGTON 98168 •0311 A :?A11:717:i °:GC:U;9? al 1 A.1 1/ 2_- W4 r P c P' n1. c 0 p St' el L 1 Pz4co., REVIEWED FOR CODE COMPLIANCE APPROVED OCT 12 2012 CORRECTION LTR# Z ?6P t37- ECEIVED CITY OF TUKWILA OCT 0 2 2012 PERMIT CENTER M,o ot le_ low in eio+or Y ;RoAO?(s) YS- X435 ep�w E S4pPor lc 4ctc,l fiaA4 '; A 1( CD �c n fi SenL_. LA) 4, kr i0 P Z, g' '/Z � a ' d- REVIEWED FOR CODE COMPLIANCE APPROVED OCT 12 2012 City of Tukwila BUILDING DIVISION CORRECTION LT R# % 1 31 RECEIVED CITY OF TUKWILA OCT 0 2 2012 PERMIT CENTER tl /6tr4.'ot L • frx.Y'e.n T f� lc Apr � gins v- /� fend i 1zdrao No ctecl n 04 - (7 &t f- `!2 Sot let 44,14 sg.wc‘rcn z 1 ; FIPo r. CORRECTION LTR # ow** REVIEWED FOR CODE COMPLIANCE APPROVED OCT 12 2012 City of Tukwila BUILDING DIVISION e. VGE 13 RECEIVED CITY OF TUKWILA OCT 0 2 2012 PERMIT CENTER 111111 1 1 'C I I t,j A iv by 111 riA 15,74 I fricria ire4 Aar y REVIEWED FOR -CODE- 1 0 elelce, 515 I 4.5i --ti 5- :;c7,4-■ le yr, 41 14 .=‘. - i 0 / bil 4-) eg APPROVED 77,. 4i,-.),/iii LAA ciYi6)Y OCT 1 2 2012 Citz____ ',I,' 1 , ....ce.... —CI BUILDING I . AA, "14 ila D SION _ _4,asT —t9 it • w 1 ill .. ... .___ 1 .--) _ _.........., trt ee,, ( 4- L., D e..f Air 1- rvi. .e.- itt + 1 1 I14 ext i 1-k- 1.,.) e..e D .?e-v'itlet I 11- Ne„e ., 'ru ,e-e—tte ''rc, ce..- fi4Awd.) z,..„...;),415--re S 0 -.,' A ( ID aYno ili."1 e by exrra i.--)c if k-- i fAS recro r 1rt as t_t_-___ bc) _k-, ex"rrf- ,.. t ;- 5 1 t — r-egIS,e.... i VI Atre,r,7•"5k4 p,e. 04 C 7 . "'All AT Et iOtIAIT i, t via sit. tut ci 6) A ,,,,ey .c 0 ,.- 1,1,4 0 EA ,.. el. ac..., )zim AEtez1ca Ida- INCOMPLETE _ III Plu bing --ii LTR# I . CllY LA ' JUL 0 6 12 20 ______ ... _ . _ s DIVISION PERMIT CENTER _ BU11.1NiN • kAsiricss Nawie_ : 511c0Jer Arcaoq AVVCCSS . I4b4S ivfcrnaT,onal B1vp Tti k tA) Wei y $ i &9 Nand 5►yk • Th rte Co m pa rr rntvt S j' Crease TNTercettor 1 RECOMMENDED PROCEDURES FOR DESIGN, CONSTRUCTION AND INSTALLATION OF COMMERCIAL KITCHEN GREASE INTERCEPTORS manufacturer's production run shall be water tested. One sample shall be tested for each size interceptor manufactured. Sample interceptors shall be assembled per manufacturer's instructions, set level, and water raised to the flow -line of the outlet fitting. Interceptors shall show no leakage from section seams, pinholes, or other imperfections. Any leakage is cause for rejection. When leakage occurs, additional water testing shall be done of, new samples after corrective measures in production or installation have been completed. Test reports shall show total number of interceptors tested, number passing, number failing, location, and cause of leakage. When leakage occurs, corrective measures taken shall be reported. H 105.8.0 Marking and Identification. H 105.8.1 Grease interceptors shall be permanently and legibly marked with the following: (1) Manufacturer's name or trademark; (2) Model number; (3) Listing mark of a listing agency; and (4) Any other marking required by law. H 106.0 Sizing Criteria. H 106.1 Parameters. The parameters.+ 4 ir' `E "44k, hydraulic grease interceptor for one or more fixtures a hydraulic loading and grease,storag . - _ Appendix H H 106.2 Sizing Formula. lie size of the interceptor shall be determined by using the method outlined in Table H -1. H 107.0 Effluent Sampling. An effluent sampling box on grease interceptors may be required by the Authority Having Jurisdiction. H 108.0 Abandoned Grease Interceptors. Abandoned grease interceptors shall be pumped and filled as required for abandoned sewers and sewage disposal facilities in Section 722.0. TABLE H -1 Sizing of Grease Interceptors 1 REVIEWED FOR CODE COMPLIANCE APPROVED OCT 12 2012 City of Tukwila BUILDING DIVISION Number of meals Waste flow per peak hour' It, x ratez z 3 4 Meals Served at Peak Hour t 0 Waste Flow Rate a. With dishwasher b. Without dishwasher Single service kitchen d. Food waste disposer Retention Times Commercial kitchen waste Dishwasher Single service kitchen Single serving Storage Factors Retention x time3 x 1.5 factor' nee ( Storage Interceptor size 3 em = (liquid capacity) 6 gallon (22.7 L) flow 5 gallon (18.9 L) flow 2 gallon (7.6 L) flow 1 gallon (3.8 L) flow 2.5 hours RECEIVED CITY OF TUKWILA Fully equipped commercial kitchen 8 hour operation: 1 16 hour operation: 2 24 hour operation: Single Service Kitchen CORRECTION LTR# OCT 0 2 2012 IT CENTER PGia- 13 2 291 111 rn, 1015:0 — 1017.1 1015.0 food Waste Disposal and Dishwasher Prohibited. Unless specifically required or permitted by the Authority Having Jurisdiction, no food waste disposal unit or dishwasher shall be connected to or discharge into any grease trap. TABLE 10 -2 Grease Traps Total Number of Fixtures Connected Required Rate of Flow per Minute, Gallons Grease Retention Capacity, Pounds 1 "kit ° 20' 40 t 2 25 50 3 . 35 70 4 50 100 Total Number of Fixtures Connected TABLE 10 -2 Grease Traps (Metric) Required, Rate of Grease.: Retention Flow per Minute, Capacity, Liters kg 1 2 3 4 76 95 132 189 18 22 31 45 Note: For installations with more than four (4) fixtures, the Authority Havirig Jurisdiction may permit the Use of larger grease traps designed not to exceed the parameter's of Section 1014.4, but not to exceed seventy -five (75) GPM (284 liters per minute). 1016.0. Sand Interceptors. 1016.1 Where,Required. 1016.1.1 Whenever the discharge of a fixture or drain may contain solids or semi -solids heavier than water that would be harmful to a drainage system or cause a stoppage within the system, the discharge shall be through a sand interceptor. Multiple floor drains may discharge into one sand interceptor. 1016:1.2 Sand interceptors are required whenever the Authority Having Jurisdiction deems it advisable to have a sand interceptor to protect the drainage system. 1016.2 Construction and Size. Sand interceptors shall be built of brick or concrete, 130 CORRECTION LTR# UNIFORM PLUMBING CODE prefabricated coated steel, or other watertight material. The interceptor shall have an interior baffle for:full separation of the interceptor into two (2) sections. The outlet pipe shall be the same size as the inlet size of the oil interceptor, the minimum being three (3) inches (80 mm), and the baffle shall have two (2) openings of the same diameter as the outlet pipe and at the same invert as the outlet pipe. "These openings shall be staggered so that there cannot be a straight line flow between any inlet pipe and the outlet pipe. The invert of the inlet pipe shall be no lower than the invert of the outlet pipe. The sand interceptor shall have a minimum dimension of two (2) feet square (0.2 m2) for the net free opening of the inlet section and a minimum depth under the invert of the outlet pipe of two (2) feet (610 mm). For each five (5) gallons (18.9 L) per minute flow or fraction thereof over twenty (20) gallons (75.7 L) per minute, the area of the sand interceptor inlet section is to be increased by one (1) square foot (0.09 m2). The outlet, section shall at all times have a minimum area of fifty (50) percent of the inlet section. The outlet section shall be covered by a solid removable cover, set flush with the finished floor, and the inlet section shall have . an open grating set flush with the finished floor and suitable for the traffic in the area in which it is located. 1016.3 Separate Use Sand and similar interceptors for every solid shall be so designed and located as to be readily accessible for cleaning, shall have a water seal of not less' than six inches (152-mm), arid shall be vented. 1016.4 RESERVED 1017.0 Oil and Flammable Liquid Interceptors. 1017.1 Interceptors Required. All repair garages and gasoline stations with grease racks or grease pits, and all factories which' have oily, flammable, or both 'types of wastes as a result of manufacturing, storage, maintenance, repair, or testing processes, shall be provided with an oil or flammable liquid interceptor which shall be connected to all necessary floor drains. The separation or vapor compartment shall be independently vented to the outer air: If two (2) or more separation or vapor compartments are used, each shall be vented to the outer air or may connect to a header which is installed at a minimum of six (6) inches (152 mm) above" the spill line of ` the lowest floor drain and vented independe 6%1V E D outer air. The minimum size of a fl vent shall not be less than two (2) OCT 0 2 2012 PERMIT CENTER Waft- 13Z A • �1v`t %.t!.S'%1Lr4�i'ci ;.'�`�:t:A•�k'sS.C'S. "l�a&'WYw Components for: / Composants pour: / Componentes de: 35GPM - 50GPM 3935A03 35GPM (2.2 LPS • USeg) 3" (76mm) connection/ raccordement / conexi6n 3935A04 35GPM (2.2 LPS • USeg) 4" (110 mm) connection / raccordement / conexi6n 3950A03 50 GPM (3.2 LPS • USeg) 3" (76 mm) connection / raccordement / conexi6n 3950A04 50 GPM (3.2 LP5 • L /Seg) 4" (76 mm) connection / raccordement / conexi6n x IE,, • 01:01 " . , OJ r1#0.4 s.g.t l r ,) • +(i l 3 uC6 '; hv v i ?}yI P� rt N o• t itiiiiroid e ap ; tc ' ' 1 �L eWl!�, ' . ' .,� , 1A - Latches (left) - Attaches (gauche) - Latches (left) #3935A -61H2 1B - Latches (right) • Attaches (droite) - Pestillos (lado derecho) #3935A -6RH2 2 - Reinforced polypropylene cover . - Couverde en polypropylene renforce de nylon - Cubierta de polipropileno reforzado #3935A -2 3 - Rubber gasket - Joint en neoprene -Junta de hule #3935A -5 4 - Removable polypropylene baffles - Chicanes amovibies en polypropylene - Deflectores de polipropileno desmontables 35 GPM: #3920A03 -3 50 GPM: #3950A03 -3 5 - Diffuser Baffle 35/50 GPM UNITS ONLY . - Chicane diffuseuse 35/50 GPM SEULEMENT - Deflector difusor 35/50 GPM SOLAMENTE #3935A03 -4 .... __. #39 ,;CLEWED F CS e E COMPLY APPRAUgr 6 -One -piece tank - Reservoir en une piece - Tanque de una sola pieza Components for: / Composants pour: / 15GPM - 20GPM - 25GPM )R NCE 3915A02 15GPM (0.94 LPS / Us/ USeg 3�92.QA02 20GPM, (02,0-asosikidge-go SEP 1 12012 3925A02 25 GPM (1.6 LPS / Us / USeg) PERMIT CENTER 3925A03 25 GPM (1.6 LPS / Us / USeg) 'ITEM Noinbre Ntime�t , ro I Description/ Description � � r :iX1, A ;�;Y'r.r, "�,t��SY �";•?:^Yiy '"f�. t � ti� Part No:,, Numoro; de,la' pi ce`; NGmero de i te' � +'•r -C 1 - Latches - Attaches - Pestillos #3920A -9 s • -'reinforced polyypropy,Iene cover Couverde polypropylene renforce de nylon, Cubierta de polipropileno reforzado #3920A 2 ` : it 3 - Rubber gasket - Joint en neoprene - Junta de hule #3920A -5 4 - Removable polypropylene baffles - Chicanes amovibies en polypropylene - Deflectoret,de polipropileno desmontables #3920A03 -3 5 - One -piece tank - Reservoir en une piece - Tanque de una sola.pieza #3920A03 -1 CORAECYIQN -13- LTR# - of 0 City of Tukwila Department o Community Development 1908 September 20, 2012 Doug Harris B and J Plumbing PO Box 47013 Seattle, WA 98146 RE: Correction Letter #2 Plumbing /Gas Piping Permit Application Number PG12 -132 Sheger Araoa —14645 Tukwila International BI Dear Mr. Harris, Jim Haggerton, Mayor Jack Pace, Director 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: Allen Johannessen at 206 433 -7163 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, VA enrifer, Ma . hall it ech 'cian enc File: PG12 -132 W:\Perrnit Center \Correction Letters \2012\PG12 -132 Correction Letter #2.doc 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 Tukwila Building Division Allen Johannessen, Plan Examiner Building Division Review Memo Date: September 19, 2012 Project Name: Sheger Araoa Permit #: PG12 -132 Plan Review: Allen Johannessen, 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. Since the last plan submitted the new plan now shows a new range and hood installation. The information from previous request has not been clear indicating what the use is for this new equipment and space. Example: what food is being prepared with the new range and other apparent food preparation equipment? How is this space being used? How is it being served to the public? Please be specific. 2. Installation of a range and hood in a commercial establishment shall require a type I hood. A separate mechanical permit is required with mechanical specifications for a listed type I hood. Plans and specifications for type I hood shall be provided by a design professional. A separate plumbing/gas permit is also required for the gas to the range. 3. (Previous request) Provide the calculations to show how sizing was accomplished for the size grease interceptor proposed. Size of the sinks has not been provided. The sizing shall be calculated by the size and volume of the sinks emptying into the interceptor per the requirements of the 2009 Uniform Plumbing code. A design professional may be required as indicated previously. (UPC Table 10 -2, 1014.3.6, Table 10 -3 & Table 7 -5) 4. Each fixture discharging into a grease interceptor shall be individually trapped and vented in an approved manner. Show a vent for the three compartment sink before emptying into the grease interceptor. (UPC 1014.1.1) 5. In addition to item 4), revise the isometric design that clearly shows the correct plumbing layout for drain waste and vent as well as water supply for hot and cold. (Previous request) 6. The plan shows the public restrooms next to the food preparation area. Toilet rooms shall not open directly into a room used for the preparation of food for service to the public. The area for food preparation shall be required to be separated by a partition and access door. Provide details for this plan revision. (IBC 2902.2.1.1) Should there be questions concerning the above requirements, contact the Building Division at 206- 431 -3670. No further comments at this time. July 12, 2012 City of Tukwila Jim Haggerton, Mayor Department of Community Development Jack Pace, Director Doug Harris B and J Plumbing PO Box 47013 Seattle, WA 98146 RE: Correction Letter #1 Plumbing /Gas Piping Permit Application Number PG12 -132 Sheger Araoa — 14645 Tukwila International BI Dear Mr. Harris, 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: Allen Johannessen at 206 433 -7163 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: PG12 -132 W:\Pennit Center \Correction Letters\2012 \PG12 -132 Correction Letter #1.doc 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206- 431 -3670 • Fax: 206 - 431 -3665 Tukwila Building Division Allen Johannessen, Plan Examiner Building Division Review Memo Date: July 12, 2012 Project Name: Sheger Araoa Permit #: PG12 -132 Plan Review: Allen Johannessen, 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. Item 1) of the previous completeness memo by Dave Larson requested a floor plan of the entire tenant space. Provide a complete floor plan of the entire tenant space to scale. Within that tenant space show this room or area where the sinks and fixtures shall be installed. Show other rooms for clarification and identify by naming the use of each space or room. 2. Item 2) requested what the use is for this tenant space. Provide that information describing the previous use and the new use for this tenant space. This information shall be on the plans in addition to information indicated in item 1). _ 3. Item 3) we still need to know the function of the three compartment sink. Please clearly provide all that information requested from the previous memo. 4. The drawing provided will not meet the plumbing code. Provide clear isometric and plan view drawings done by a design professional or a licensed plumber to show the correct method for plumbing the sinks and grease interceptor. Plumbing plans shall also include hot and cold supply lines and their point of connection to supply the new fixtures and shall show where the water heater is located for supplying hot water to the sinks. Should there be questions concerning the above requirements, contact the Building Division at 206- 431 -3670. No further comments at this time. • City of Tukwila Jim Haggerton, Mayor Department of Community Development Jack Pace, Director June 21, 2012 Doug Harris PO Box 47013 Seattle, WA 98146 RE: Letter of Incomplete Application # 1 Plumbing /Gas Piping Permit Application PG12 -132 Sheger Araoa —14645 Tukwila International BI Dear Mr. Harris, This letter is to inform you that your permit application received at the City of Tukwila Permit Center on June 19, 2012 is determined to be incomplete. Before your application can continue the plan review process, the attached /following items from the following department(s) need(s) to be addressed: Building Department: Dave Larson at 206 431 -3678 if you have any questions concerning the attached comments. Please address the comment above 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. 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 the Permit Center at (206) 431 -3670. Sincerely, fer Marshall t Technician Enclosures File: PGI2 -132 W:\Permit Center \Incomplete Letters\2012\PG12 -132 Incomplete Ltr #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 Determination of Completeness Memo Date: June 21, 2012 Project Name: Sheger Araoa Permit #: PG12 -132 Plan Review: Dave Larson, Senior Plans Examiner The Building Division has deemed the subject permit application incomplete. To assist the applicant in expediting the Department plan review process, please forward the following comments. (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 floor plan of the entire tenant space and show where the new fixtures will be located. 2. Please describe the use of the tenant space, grocery store, meat market, restaurant, fast food etc. The last tenant use was a market. Is this use changing or staying the same? 3. Please describe the function of the three compartment sink. Will it be used for food preparation? Please note that you may need approval from the King County Health Department and if so we will need a copy of their approval before we can issue a permit. 4. The isometric drawing does not show the triple sink. Please add. 5. Please provide the manufacturers spec sheets and sizing calcs for the grease interceptor. Please add an elevation view of the drain system to show how the fixtures will be connected to the grease interceptor and for clarity, show the installation of the grease interceptor as being on top of the floor or recessed into the floor. Should there be questions concerning the above requirements, contact the Building Division at 206 -431- 3670. No further comments at this time. • M` PER. CO D 4Y PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG12 -132 DATE: 10 -02 -12 PROJECT NAME: SHEGER ARADA SITE ADDRESS: 14645 TUKWILA INTERNATIONAL BL Original Plan Submittal Response to Incomplete Letter # X Response to Correction Letter # 2 Revision # After Permit Issued DEPARTMENTS: ui V W BLiifdin Division Public Works n Fire Prevention Structural Planning Division Permit Coordinator . IN DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 10 -04-12 Complete Incomplete Not Applicable Comments: Permit Center Use Only INCOMPLETE LETTER MAILED: Departments determined incomplete: Bldg 0 Fire 0 Ping PW 0 Staff Initials: LETTER OF COMPLETENESS MAILED: TUES/THURS ROUTING: Please Route Structural Review Required ❑ No further Review Required ❑ REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved Approved with Conditions Notation: REVIEWER'S INITIALS: DATE: DUE DATE: 11 -01 -12 Not Approved (attach comments) n Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents/routing slip.doc 2 -28 -02 1PERMIT COORD COP* PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG12-132 DATE: 09/11/12 PROJECT NAME: SHERGER ARADA SITE ADDRESS: 14345 TUKWILA INTERNATIONAL BL Original Plan` Submittal Response to Correction Letter #_ Response to Incomplete Letter # Revision # after Permit Issued DEPART ENTS B I ding ision Public Works Fire Prevention Structural Planning Division Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 09/13/12 Complete X Incomplete ❑ 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 .L-4 Structural Review Required ❑ No further Review Required ❑ REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 10/11/12 Approved El Approved with Condition r Not Approved (attach comments) Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: ol 114 It Departments issued corrections: Bldg 141, Fire ❑ Ping ❑ PW ❑ Staff Initials: `PERMIT COORD COPS PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG12 -132 DATE: 07/06/12 PROJECT NAME: SHEGER ARAOA SITE ADDRESS: 14645 TUKWILA INTERNATIONAL BL Original Plan Submittal X Response to Incomplete Letter # 1 Response to Correction Letter # Revision # after Permit Issued DEPA THE TS: ituilding Division Public Works Fire Prevention Structural Planning Division Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Incomplete DUE DATE: 07/10/12 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 Structural Review Required No further Review Required n REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 08/07/12 Approved Approved with Conditions Not Approved (attach comments) Notation: 7� REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg- Fire ❑ Ping ❑ PW ❑ Staff Initials: •a'ERMIT COORD COP. PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG12 -132 PROJECT NAME: SHEGER ARAOA DATE: 06/19/12 SITE ADDRESS: 14645 TUKWILA INTERNATIONAL BL X Original Plan Submittal Response to Correction Letter # Response to Incomplete Letter # Revision # after Permit Issued DEPARTMENTS: 6ui ding D�!/ ision P c Work tiIk Pubi Fire Prevention Structural Planning Division Permit Coordinator n DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Incomplete IX DUE DATE: 06/21/12 Not Applicable Comments: Permit Center Use Only INCOMPLETE LETTER MAILED: Departments determined incomplete: Bldg 1:/ Fire ❑ Ping ❑ PW ❑ Staff Initials: LETTER OF COMPLETENESS MAILED: TUES/THURS ROUTING: Please Route Structural Review Required n No further Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved Notation: REVIEWER'S INITIALS: Approved with Conditions DUE DATE: 07/19/12 Not Approved (attach comments) DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: 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 Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the- mail,. fax, etc. Date: W-2---\ Plan Check/Permit Number: PG 12 -132 ❑ Response to Incomplete Letter # ® Response to Correction Letter # 2 ❑ Revision # after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner Project Name: Sheger Arada Project Address: 14645 Tukwila International Bl Contact Person: Phone Number: Summary of Revision: S! 'i CL ($ r7,5w JC-4 Acv- j 5.es-k _ /irA t.V t rJ' cJ te.f> + S� ae ? OS 6r-<as ce, iLcr c, r c t.t 1( -� f Sheet Number(s): "Cloud" or highlight all areas of revision including date of revision Received at the City of Tukwila Permit Center by: 1-----Entered in Permits Plus on j, 0 � 1 Z- RECENED OflV OE TUKWIU OCT 0220 M%Y MITER \applications\forms- applications on Iine\revision submittal Created: 8 -13 -2004 Revised: CityllIf Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Web site: http: / /www.TukwilaWA.gov 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/ t'a_. NtSireViiigt-tolhl Plan Check/Permit Number: NrResponse to Correction Letter # 1 ❑ Revision # after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner Project Name: 5A,. V /9 rot oem /4/-/ Project Address: / ¢ , �� %/� Contact Person: Co, o ?cv. Summary of Revision: Phone Number: Z' / ponce 7 i4 /h rrec'efi s' Od a4w/( Zll7) . 519.1e am? r 3 �m C/111 W71ii 1 /z a-(eri RECEIVED KWRA 20121 PERMIT CorTI:R Sheet Number(s): 5. / "Cloud" or highlight all areas of revision including date of revision Received at the City of Tukwila Permit Center by: "'C Entered in Permits Plus on �� H:Wpplications\Forms- Applications On Line\2010 Applications \7 -2010 - Revision Submittal.doc Revised: May 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.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: Plan Check/Permit Number: PG 12 -132 ® Response to Incomplete Letter # 1 ❑ Response to Correction Letter # ❑ Revision # after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner Project Name: Sheger Araoa REC rukvitA JUC 06?012 WEHMtr0E10E4 Project Address: 14645 Tukwila International B1 Contact Person: DDh'1 a 5 H At/6 s Summary of Revision: Phone Number: 7 Co ? -- rc c.A,9 6- ••°' .-S 1 l * � `t Sheet Number(s): "Cloud" or highlight all areas of revision including date of revision Received at the City of Tukwila Permit Center by: Entered in Permits Plus on L(AA \applications \forms - applications on Tine \revision submittal Created: 8 -13 -2004 Revised: Contractors or Tradespeople P 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 B & J PLUMBING INC UBI No. 600060826 Phone 2066581031 Status Active Address Po Box 47013 License No. BJPLU'•234B6 Suite /Apt. License Type Construction Contractor City Seattle Effective Date 1/26/1977 State WA Expiration Date 7/22/2013 Zip 98146 Suspend Date County King Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Business Owner Information Name Role Effective Date Expiration Date HARRIS, BUCKLEY D Impaired Date 01/01/1980 Received Date HARRIS, JANET S 1/24/1977 2/8/1979 Bond 24 NATIONWIDE MUTUAL INS CO ACP7511687621 Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date 28 American Fire & Casualty Co BKA55239459 08/02/2012 08/02/2013 $1,000,000.00 09/25/2012 27 NATIONWIDE MUTUAL INS CO ACP7561687621 10/25/2010 10/25/2012 09/25/2012 $1,000,000.00 09/20/2011 26 NATIONWIDE MUTUAL INS CO ACP7541687621 10/25/2008 10/25/2010 $1,000,000.0009 /22/2009 25 NATIONWIDE MUTUAL INS CO ACP7521687621 10/25/2006 10/25/2008 $1,000,000.00 10/01/2007 24 NATIONWIDE MUTUAL INS CO ACP7511687621 10/25/2005 10/25/2006 $1,000,000.00 10/12/2005 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 Infractions /Citations Information Infraction / Citation 1 Date 1 RCW Code 1 Type 1 Status 1 Violation Amount https:// fortress .wa.gov /lni/bbip /Print.aspx 10/15/2012