HomeMy WebLinkAboutPermit PG12-153 - FORHAN RESIDENCEFORHAN RESIDENCE
14003 MACADAM RD S
PG12 -153
City olIP'I'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
Parcel No.: 1523049062
Address: 14003 MACADAM RD S TUKW
Project Name: FORHAN RESIDENCE
Permit Number: PG12 -153
Issue Date: 08/10/2012
Permit Expires On: 02/06/2013
Owner:
Name: FORHAN TIMOTHY W +ALICE F
Address: 14003 MACADAM RD S , SEATTLE WA 98168
Contact Person:
Name: COREY ALEXANDER
Address: 13330 STONE AV NE , SEATTLE WA 98133
Email:
Phone: 425 516 -4388
Contractor:
Name: INFRASOURCE CONSTRUCTION LLC Phone: 630 - 613 -3518
Address: 1200 ROOSEVELT RD, STE 400 , GLEN ELLYN IL 60137
Contractor License No: INFRACL899CZ Expiration Date: 02/14/2013
DESCRIPTION OF WORK:
RELOCATION OF GAS METER
Value of Plumbing /Gas Piping:
Fees Collected:
Electrical Service Provided by:
Permit Center Authorized Signature:
$1,000.00
$96.60
I hereby certify that I have read and e
governing this work will be complied
Uniform Plumbing Code Edition: 2009
International Fuel Gas Code Edition: 2009
Date:
IZ
this permit and know the same to be true and correct. All provisions of law and ordinances
her specified herein or not.
The granting of this permit does not pres
construction or the perform ance of work. I
on the back of this pe
Signature:
Print Name:
to give authority to violate or cancel the provisions of any other state or local laws regulating
uthorized to sign and obtain this plumbing /gas piping permit and agree to the conditions
Date: E
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 -153 Printed: 08 -10 -2012
PERMIT CONDITIONS
Permit No. PG 12 -153
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 -153 Printed: 08 -10 -2012
CITY OF TUKWIIII
Community Developmen epartment
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
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: NoZ3 r %X4 /7/9'/W /2 S
Tenant Name: 7 /V2 fd /L//A1/tl
King Co Assessor's Tax No.: ts-2 7L1 "—� V�-F' �•
Suite Number: Floor:
New Tenant: ❑ Yes EL. No
i' PROPERTY OWNER . ;'
`
Address: /33 s��6,--- /
Name: �
Q72.,1f/elrr--0.1
Address: 1 /003 /'r°/ne
o! /
/L D 3
City: V,L (f,
State:
Zip:
,CONTACT PERSON person-recervIngall project
communication.`... -.. - �...% ? >. ,
Name: �, —/� L;'7L
Address: /33 s��6,--- /
,/'
City: State: U/.
Zip f
Phone:
_ i 38 ax.
q s',,
Email:
PLUMBING Cot*.i* ,CTOR INFORMATION ., ,, a
Company Name:`. jZ�5 /eeei�
Address: 3330 siZ�'v r /9.4/`C_ /1I'
City: State: 4.4# Zip: 74,„,e22
Phone: r2 f,s76 y70 Fax:
Contr Reg No NFIv aa9 xp Date: 1414 11(
Tukwila Business License No.: Q,y _ mil 2S
Valuation of Project (contractor's bid price): $ /Ot
Scope of Work (please provide detailed information):
/ZEFG 6 c /fib &7 6 K% 6-r n.5 476 4/
Building Use (per Int'l Building Code):
Occupancy (per Int'l Building Code):
Utility Purveyor: Water:
H:\Applications\Forms- Applications On Line\201I Applications\Plumbing Permit Application Revised 8- 9- 11.docx
Revised: August 2011
bh
Sewer:
Page 1 of 2
Indicate type of plumbing fixtures and/or g iping outlets being installed and the quantity low:
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)
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.
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
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
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 OW/�� OR AUTHO
Signature-
Date: 8 ` - r z
Print Name: Day Telephone: Y -2--1051/4/6 Via
Mailing Address: /2 a <S'/ c ,1i 6171- 2r1_-?
City
H:Wpplications\Forms- Applications On Line\201 I Applications\Plumbing Permit Application Revised 8- 9- 11.docx
Revised: August2011
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State Zip
Page 2 of 2
CAI of Tukwila.
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206-431-3665
Web site: hap: //www. ci. tukwila. wa. us
SET RECEIPT
RECEIPT NO: R12 -02332
Initials: JEM
Payment Date: 08/10/2012
User ID: 1165 Total Payment: 193.20
Payee: COREY ALEXANDER, PSE INFROASOURCE LLC
SET ID: 0810 SET NAME: INFRASOURCE
SET TRANSACTIONS:
Set Member Amount
PG12 -153
PG12 -154
TOTAL:
96.60
96.60
96.60
TRANSACTION LIST:
Type Method Description Amount
Payment Credit C VISA 193.20
TOTAL: 193.20
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
GAS - RES
000.322.103.00.0 193.20
TOTAL: 193.20
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:
scio r AA./
Type of Inspects n :;
A
, .
.
Address:
1400 M (AZ A- '
Date Call d:
;
`.
r1
Special Instructions:
Date Wanted:.
; :
• `
(d.m.
Requester:
Phone No:
l!
Approved per applicable codes. Corrections required prior approval.:
COMMENTS:
o.ikA k4 Dt
Inspect6r:`` � �.J�f•/
U REINSPECTION FEE REQUIRED. Prior to next Inspection fee mustbe
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection; -.
Contractors or Tradespeople Printer 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
INFRASOURCE CONSTRUCTION LLC
6306133518
1200 Roosevelt Rd Ste 400
Glen Ellyn
IL
60137
Out Of State
Limited Liability Company
QUANTA SERVICES INC
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
602477130
Active
INFRACL899CZ
Construction Contractor
2/14/2011
2/14/2013
General
Unused
Business Owner Information
Name
Role
Effective Date
Expiration Date
ERNST, CHRISTINE A
Partner /Member
02/07/2011
Amount
MCARTHY, MICHAEL J
Partner /Member
02/14/2011
MWZY59816
Bond Information
Page 1 of 1
Bond
Bond Company Name
Bond Account Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Bond Amount
Received Date
1
Federal Ins Co
82201463
01/12/2011
Until Cancelled
$12,000.00
02/07/2011
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
3
Old Republic
Ins Co
MWZY59816
08/01 /2012
08/01 /2013
$5,000,000.00
07/23/2012
2
OW Republic
Ins Co
mwzy59308
08/01/2011
08/01/2012
$1,000,000.00
07 /19/2011
1
Old Republic
Surety Co
MWZY58873
08/01 /2010
08/01 /2011
$5,000,000.00
02/07/2011
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
https: // fortress .wa.gov /lni/bbip/Print.aspx 08/10/2012