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HomeMy WebLinkAboutPermit PG12-170 - DILETTANTE MOCHA CAFEDILETTANTE MOCHA CAFE 2800 SOUTHCENTER MALL K -2628 PG12 -170 Parcel No.: Address: City oiitukwila 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 9202470010 2800 SOUTHCENTER MALL TUICW Project Name: DILETTANTE MOCHA CAFE Permit Number: Issue Date: Permit Expires On: PG12 -170 09/27/2012 03/26/2013 Owner: Name: Address: Contact Person: Name: Address: Email: Contractor: Name: Address: WESTFIELD PROPERTY TAX DEPT PO BOX 130940 , CARLSBAD CA 92013 MARK YURAZYK 36217 SE ISLEY ST , SNOQUALMIE WA 98065 MARK @NORTHCOASTPLUMBING.NET NORTH COAST PLUMBING INC 9909 RAINIER AV S , SEATTLE WA 98118 Contractor License No: NORTHCP930KA Phone: 206 420 -4600 Phone: 206 420 -4600 Expiration Date: 05/01/2013 DESCRIPTION OF WORK: INSTALL AND COMPLETE PLUMBING FOR (2) SINKS, (1) HWT, (3) FLOOR SINKS, AND (1) ESPRESSO Value of Plumbing /Gas Piping: Fees Collected: Electrical Service Provided by: Permit Center Authorized Signature: $6,800.00 Uniform Plumbing Code Edition: 2009 $206.06 International Fuel Gas Code Edition: 2009 I hereby certify that I have read and e governing this work will be complied Date: D k l,1 4 �' ed this permit and know the same to be true and correct. All provisions of law and ordinances hether specified herein or not. e to give authority to violate or cancel the provisions of any other state or local laws regulating I am authorized to sign and obtain this plumbing /gas piping permit and agree to the conditions The granting of this permit does not pres construction or the performance of work. on the back of this permit. Signature: Print Name: i u (GZ 1( y 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. Date: �d /7 7/1? 1? doc: UPC -4/10 PG12 -170 Printed: 09 -27 -2012 PERMIT CONDITIONS Permit No. PG12 -170 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 PG 12 -170 Printed: 09 -27 -2012 CITY OF TUKOPLA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov • Plumbing/Gas Permit No. ti 0 Project No. Date Application Accepted: Date Application Expires: 02) tiAt3 (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 k - 21,e 2t p King Co Assessor's Tax No.: 92.02.41o° t a Site Address: z. pt0 5 ptit �' Q-��v a� Suite Number: Floor: Z ` l Tenant Name: � \ Q_-�-�un�e MozAqt New Tenant: Yes ❑ ..No "v)∎Z -2�Z PROPERTY OWNER Name: sr.1 Ce.,A c, 1411 ' uj4 p, Address: q•Z2 S so esz.. Ka` State: U J 4 ZiprtE' 252, City :..) \J` CONTACT PERSON — person receiving all project communication Name: ,{ e Address: 3 6,217 S -cr- L L / ST City: c,,, �1 State: JA Zip: s-- Phonee:20G q3 /'6/ _It Fa( goo t( Email:OA 14 PIA (`l (-tit COCL I(i!/1'E4 /,44 -14 PLUMBING CONTRACTOR INFORMATION Company Name: .41AL SGT eam_r pi. V 0411124E7 Address: •562. \7 Sc sL i' S T City: S+n i wd'c State: w4 ZIp. J-- Phone: 6 l ao 4600 Fax: 20G Lao 460 Contr Reg No.: uixoKikxp Date: -/3a Tukwila Business License No.: a4 Ur')/loll Aa 01 Valuation of Project (contractor's bid price): $ 6 go©° CO Scope of Work (please provide detailed information): dtS // c vvin/ /C p"4 l)1 , ESNZSSO Building Use (per Int'I Building Code): MVP<1L PeT L Occupancy (per Int'I Building Code): Utility Purveyor: Water: 1161( L1 Sewer 1k 4,L/k H:Wpplications\Forms- Applications On Line12011 Applications\Plumbing Permit Application Revised 8- 9- 11.docx 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 3 Sinks Rain water system — per drain (inside building) l 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 3 Urinal Water heater and/or vent l 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 3 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 3 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 12,5p(dSo §.PERMITAPPLICATION 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 103.43 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 OWNE1bt QR A ORIZED AGENT: Signature: Date: 12/ I 3 hz Print Name: 1C Day Telephone: 2) 6 9 3 ! " V « 7 Mailing Address: ) 2 ( 7 .4..s I T1 Sy ` 0,e -�q O6r State Zip H:Wpplicmions\Forns- Applications On Lme 2011 ApphcauonsWPlumbmg Pernut Application Revised 8- 9- 11.docc 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.: 9202470010 Permit Number: PG 12 -1 TO Address: 2800 SOUTHCENTER MALL TUKW Status: PENDING Suite No: Applied Date: 09/13/2012 Applicant: DELETTANTE MOCHA CAFE Issue Date: Receipt No.: R12 -02600 Payment Amount: $206.06 Initials: JEM Payment Date: 09/13/2012 12:03 PM User ID: 1165 Balance: $0.00 Payee: NORTH COAST PLUMBING INC TRANSACTION LIST: Type Method Descriptio Amount Payment Check 1797 206.06 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts PLAN CHECK - NONRES PLUMBING - NONRES 000.345.830 41.21 000.322.103.00.00 164.85 Total: $206.06 doc: Receipt-06 Printed: 09 -13 -2012 �t3 INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. SP- CITY OF TUKWILA BUILDING DIVISION' P630_, 176 6300 Southcenter Blvd., #100, Tukwila. WA 98188 ,(206).431 -3670 Permit Inspection Request Line (206) 431 -2451 Proje t: 0 Type o Inspection:' Ad Us 0 r MAT t 1 J (! Date Called: Special Instructions: Date Wanted:. f m Requester: Phone No Approved per applicable codes: „ ,E EiCorrections required prior to approval: COMMENTS: A I I 1 Inspector: II Date: n REINSPECTION FEE REQUIRED. Prior to next inspection, fee_must paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reiiispection:, "' INSPECTION RECORD Retain a copy with permit INSPECTION M1iO. 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: 1Thr L_--r-r RoSTC. Moc.oA Type of Inspection: , r1t,)AL _ 'P1um,t -) Address: P- c c7 so ttsJ r PM Pt IL Date Called: Special Instructions: a Date Wanted:. ,I 1( 12 f tz a4m :p.m:, Requester: Phone No: JApproved per applicable codes. Corrections required prior!tplapproval. P(1,4 COMMENTS: Inspector: n REINSPECTION FEE REQUIRED rior to 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 L 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Project: ,L)_?•!., €.. rne,A/Tf /mom Type of Inspection: (7,9,-;:c A.. /!4L- !?l4•l! .<. Address: c O© ,5D_CFn' .e /n4 // Date Called: /(„., )6.t Special Instructions: (.0405r1---- ° t`.-r� l/ d c e.J s� Up Date Wanted - /V- 1 -. /,7 . a.m . p.m: Requester: Phone o: ElApproved per applicable codes. Corrections required prior to approval. COMMENTS: o f•" .�Pl�cD/ �S`S_.7�]i tit /A`Z ��•'�k-�' IC L).Utor 1A. Inspector: nn, / %Y Date: n REINSPECTION FEE REQUIRED. Prior to next inspection.: fee must be, paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit INSPE TION NO. PERMIT NO..? CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 p (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 PG 12-170 Pro ect: ID l t- cc.•T1- ft, OTC- ' piAcx ri Type of Inspection: ‘ Rtr216, tit --S s� relic ,na.b Address: eCC: 5OC'rai PAi1k Date Calle .: e f -- or )LI . (Mr Special Instructions: `- J� > O (o 3357 -0 ( Date Wanted:. a.m. 10 lif I i 7. p.m. Requester: Phone No: 2C.,_Ci 3t — in 1-71 Approved per applicable codes. Corrections required prior to approval. COMMENTS: r A ic to ' A p A-) ----a- k--- TO J\ 6001 () ic. /*iJ iI i.. 74.1) 7V J rh W !/V t" , 10F o m i /l rt - A '/P / A7-- Inspectvor: Date:1 0 �-- n REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be 'i paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. t,�._....- ,.,.., «..._,..., Trqo changes shall ,, a . be made to the scope cf "!C; is without Ntior approval of Tukwila Building Division. ._. 7: visions will require a new plan submittal L: t'`' nr'! ill r#Ci Tonal �� `..C�'JR Plan revier1 fiefs. j ICE - MACHINE NEW KARNDEAN INTERNATIONAL WOODPLANK WP318 CARBO GLUED OVER 6MM CORK UNDERLAYMENT FLOATING OVER EXISTING 'TILE FLOOR 11' -5" LOUNGE AREA FREE STANDING (3) COMPARTMENT SINK W/ MOP SINK 3 "—,y B TILE FLOORING \EXIST. O REMAIN i REVISIONS FILE COPY Permit Wo. r70 3" MIN. 3'/4' SWINGING ACCESS GATE ,. IP21111 ®� I I L ' N I _N ©,L j FAlk _J L__ L » o o NV \ \ M COUN • 0 ») 1' 3" \ I 3 TOP OF ., COUNTER '& F.F. -3Yi ") F.F. (3' -2 LOW COUNTER ;1 \ TI -1 6 _i SOFA i ® F.F. ®j + (3' -2 ») r�l 1' -3" R \ I ° k 1 L." 1 1 I I I ■ 11, .1 .1 N HIGH COUNTER ® F.F. + (4' -0 ») O"CONDIMENT O , 1'_o "- , COUNTER PLANTER BOX X 3' -4" q X FOOD CABINETS /COUNTER (PRE - MANUFACTURED, FREE S 5' -0" 2' -6" tJ 6' -11" 1' -0" Z SALES AREA/ COFFEE PICK STANDING) REGISTER COUNTER UP COUNTER 0 F.F. + (2' -10 ") * PILON SIGN /GRAPHICS AND OTHER SIGN/ GRAPHIC SPECIFICATIONS TO BE PROVIDED AS A SEPARATE SUBMITTAL FOR WESTFIELD DESIGN REVIEW ke; FLOOR PLAN Y4" =1' -0» FOOD CABINETS 4' -3Yi "— 8' -4" �-'� 2' -6" SALES AREA/ REGISTER 6' -11" PICK -UP COUNTER N TOO North Coast Wumbing Incorporated 36217 SE Islay Street Snoqualmie,WA 98065 RTH CO AST EAST ELEVATION F.F. TYPICAL BASE WHERE SHOWN, 0.5 "X8" CORIAN B "PLANTINUM" BASE CONDIMENT COUNTER r 0" - TEMPERED * * GLAZING, TYP. 5- 0 "X1' -5" SIGNAGE TO BE SUBMITTED SEPARATLY TO LANDLORD FOR APPROVAL \4 3" ri rr iew approval is subject to errors and omissions. ppt r; of construction documents does not authore t! i . ioir ion of any adopted code or ordinance. Receipt of ;approved Field Copy and conditions is acknowtedg2d: By FLOOR PLAN NOTES:pate: 27/7" 1. 2. 3. 4. 5. 6. PLUMBING AND ELECTRICAL SYSTEMS TO BE BIDDER GN r U INaa AND ELECTRICAL SYSTEMS (INCLUDING LIGHTING FIX-FIRM `�" OWNER REQUIREMENTS. ENERGY CALCULATIONS OF TUKWILA SHALL BE PROVIDED BY THE ELECTI CAL t�' CT SHOWING N COMPLIANCE W/ THE CURRENT WASHINGTON STATE ENERGY CODE OR AS REQUIRED BY THE CITY OF TUKWILA. ALL FINISHES (INTERIOR` AND EXTERIOR), DOOR TYPES, TRIM, ETC.; PER TENANT /OWNER REQUIREMENTS. UNDER SLAB SEWER & WATER PER TENANT /OWNER REQUIREMENTS, VERIFY W/ OWNER PRIOR TO SLAB PENETRATION. PROVIDE PORTABLE FIRE EXTINGUISHERS (2A:108: C OR BETTER); (1) FOR EVERY 3,000 SF OF TENANT /BUILDING FLOOR AREA OR 75 OF TRAVEL DISTANCE. LOCATE EXTINGUISHERS AT EXIT DOORS OR IN PATHS OF EXIT TRAVEL IN CLEAR ACCESSIBLE LOCATIONS, NO HIGHER THAN 5 FEET ABOVE THE FINISHED FLOOR. HANDLES, PULLS, LATCHES, LOCKS, AND OTHER OPERATING DEVICES ON DOORS, WINDOWS, CABINETS, PLUMBING FIXTURES, AND STORAGE FACILITIES, SHALL HAVE A LEVER OR OTHER SHAPE WHICH WILL PERMIT OPERATION BY WRIST OR ARM PRESSURE AND WHICH DOES NOT REQUIRE TIGHT GRASPING, PINCHING OR TISIING TO OPERATE (IBC SEC. 1109.12 & ICC /ANSI A117.1). OUTLETS, SWITCHES, PHONE JACKS, COMPUTER CABLES, ETC., TO BE COORDINATED W/ TENANT /OWNER. MOUNT 15" MIN ABOVE FLOOR. e,• * * TYPICAL GLAZING TO BE BUTT JOINTED W/ RECESSED EXTRUSION CHANNELS cmrR�� SEP 13 2012 PERMIT CENTER Q-°11() 11. 11 SEPARATE PERMIT REQUIRED FOR: CifMethantat C!'Etectric at ❑ Plumbing Mean Piping City Df Tukwila CU!I_DING DIVISION POE Engineering, Inc. CIVIL & STRUCTURAL ENGINEERING /CONSULTING 1314 8TH STREET N.E, SUITE 201 AUBURN, WASHINGTON 98002 (253) 833 -4052 / FAX (253) 833 -4053 JOB IRE DILETTANTE MOCHA CAFE'S WESTFIELD SOUTHCENTER MALL 9225 SOU1HCENTER MALL 1UKWM, WA. DA1E JUNE 2012 DRAM BY GM0 DESIGN BY AFP. SET IME CAFE SPACE / FLOOR PLAN REVIEV ED FOR :ODE COMPLIANCE APPROVED SEP 18 2012 City of Tukwila BUILDING DIVISION ace Na 12-023 SHIE Na TI -1 OF 3 70 -5 2 vTie S' r-X vrR SEE A-3 - 41' ex- \ z" 343:40 2r, 2' REVIEWED FOR a ODE COMPLIANCE • APPROVED SEP 18 2012 City of Tukwila BUILDING DIVISION enVOKNA SEP 13 2012 PERMIT CENTER RTH CO AST North Coast Plumbing incorporated 36217 SE Isiey Street Snoqualmle,WA96065 yj 71 _ zl z Z 4 "RWL DN 6 "RWL DN l RETAIL 6 "RWL UP REVIEWED FOR CODE COMPLIANCE APPROVED SEP 18 2012 633 Sm,Neent> Parkway Tukwila, WA.. 96186 -2888 206.2480423 WESTFIELD DESIGN & CONSTRUCTION 11601 Wilshire Boulevard, 11th Floor Los Angeles, California 90025 -1748 Telephone 310 478 4456 Facsimile 310 478 4468 1195 GRAYING R AN NSTRUNTNT OF SRAM. 5 THE PROPERTY OF THE ARCHITECT AM NAY NOT BE REPRODUCED YSTHOUT 11E ARCHITECTS PERNISSICP1 AND MESS NE REPRODUCTION CARRES THE ARCHITECTS NAME NJ. DESQ1 NO 00ER 16.566.11161 9106! ON THE °RAYeMC ARE FOR USE ON THE SPECKED PREIECT ONLY AND SHALL NOT BE USED 01601 600 61HOUT MITTEN PERMISSION FR01I THE ARCHITECT Registration No. City of Tukwila BUILDING DIVISION Consultants C D. i E NrG 1 N E E R "S; WIT SEP 13 2012 PERMIT CNl'ER 4200 - 194th St SW, Suite 200 Lynnwood, WA 98036 T 425.672.1071 F 425.778.8769 www.CDiENGINEERS.com Approvals /Phase: BULLETIN 4 RTH CO AST North Coast Plumbing (naorporated 36217 SE Islay Street Snoqualmie,WA98065 06/12/2007 Key Plan: 1 1111111; '_ oPURE 0111105011111 Nirr �Imp fit �tLJcl.er�' KEY NOTES: 0 3" VENT FOR FUTURE TENANT CONNEC110N. 0 2 "G CAPPED SERVICE STUB INTO FOOD COURT TENANT CEILING SPACE. PROVIDE LOCKABLE SHUT -OFF VALVE IN UTILITY CORRIDOR AND SPACE FOR REGULATOR. R2" GAS (2 PSI) UP. ® 4 "VTR UP. O 4 "W DOWN. © 6 °W DOWN. PROVIDE POINT OF CONNECTION FOR THEATER LOW AS POSSIBLE IN CEILING. 0 4" VENT DOWN. ® Y4"CW FROM BELOW. CONNECT TO COMMON MALL SERVICE ON LEVEL 1. -3" No. Revision 111.° W1 e e; 0 2 °CW SERVICE FROM METER LOCATION IN UTIUTY CORRIDOR. - - - 10 WG FROM BELOW IN EXTERIOR WALL AND STUB -OUT TO EXTERIOR FOR FUTURE FIREPLACE. 11 PROVIDE 34° GAS PIPING, LOW PRESSURE, 80 CFH, DOWN IN COLUMN WALL CHASE TO FIREPI.ACF WITH r. AR rnrlc Date ADDENDUM E 8/7/06 PLAN CHECK REVISIONS 8/21/06 ADDENDUM I 9/26/06 ADDENDUM J 2/5/07 BULLETIN 2 3/30/07 BULLETIN 3 5/1/07 BULLETIN 4 6/12/07 A A 0 A "'PERMIT COORD COP PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: PG12 -170 DATE: 09/13/12 PROJECT NAME: DILETTANTE MOCHA CAFE SITE ADDRESS: 2800 SOUTHCENTER MALL, K -2628 X Original Plan Submittal Response to Incomplete Letter #_ Response to Correction Letter # Revision # after Permit Issued DEPARTMENTS: 4._\ Wi BBui din Division *Dc WOfKS Fire Prevention Structural Planning Division ❑ Permit Coordinator ❑ DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Incomplete ❑ DUE DATE: 09/18/12 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 ❑ REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 10/16/12 Approved ❑ Approved with Conditions Not Approved (attach comments) ❑ Notation: REVIEWER'S INITIALS: DATE: Permit Center, Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Contractors or Tradespeople Priier 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 NORTH COAST PLUMBING INC UBI No. 602708839 Phone 2064204600 Status Active Address 36217 Se Isley St License No. NORTHCP930KA Suite /Apt. License Type Construction Contractor City Snoqualmie Effective Date 5/1/2007 State WA Expiration Date 5/1/2013 Zip 98065 Suspend Date County King Specialty 1 Plumbing Business Type Corporation Specialty 2 Unused Parent Company Business Owner Information Name Role Effective Date Expiration Date YURCZYK, MARK CHRISTOPHER President 05/01/2007 Amount YURCZYK, FARNAZ D Secretary 05/01/2007 01C113370140 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 AMERICAN CONTRACTORS INDEM CO 100022456 04/23/2007 Until Cancelled $6,000.00 05/01/2007 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 6 American States Insurance Co 01C113370140 02/19/2012 02/19/2013 $1,000,000.00 01/10/2012 5 American States Insurance Co 01c113370140 02/19/2012 02/19/2013 02/27/2012 $300,000.00 01/10/2012 4 American States Insurance Co 01C113370130 02/19/2011 02/19/2012 $1,000,000.00 03/01/2011 3 AMERICAN STATES INS CO 01c113370110 02/19/2009 02/19/2011 $1,000,000.00 02 /24/2010 2 LINCOLN GEN INS CO 15146401 04/30/2008 04 /30/2009 $1,000,000.00 04 /30/2008 1 CAPITOL SPECIALTY INS CORP CS00342874 04/30/2007 04/30/2008 $1,000,000.00 05/01/2007 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 No records found for the previous 6 year period https://fortress.wa.gov/lni/bbip/Print.aspx 09/27/2012