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Home My WebLink AboutPermit PG12-205 - PALMERSHEIM RESIDENCEPALMERSHEIM RESIDENCE 4004 S 160 ST PG1 2-205 City 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 PLUMBING /GAS PIPING PERMIT Parcel No.: 8108600641 Address: 4004 S 160 ST TUKW Project Name: PALMERSHEIM RESIDENCE Permit Number: Issue Date: Permit Expires On: PG12 -205 11/26/2012 05/25/2013 Owner: Name: PALMERSHEIM THOMAS P Address: 4004 S 160TH ST , SEATTLE WA 98188 Contact Person: Name: DENNIS ASHMORE Address: 6925 216 ST SW #C , LYNNWOOD WA 98036 Email: Contractor: Name: KING'S HEATING INC Address: 2317 N 179 , SEATTLE WA 98133 -5151 Contractor License No: KINGSHI044JA Phone: 425 275 -5153 Phone: 206 361 -1380 Expiration Date: 03/07 /2014 DESCRIPTION OF WORK: Value of P Fees Colle d: Electrical Service Provided by: 4 vi(, >ing /G s Piping: Permit Center Authorized Signature: I hereby certify that I have read an governing this work will be compli $200.00 Uniform Plumbing Code Edition: 2009 $96.60 International Fuel Gas Code Edition: 2009 Date: ex • ed this permit and know the same to be true and correct. All provisions of law and ordinances with whether specified herein or not. The granting of this permit does not pr construction or the performance of work. on the back of this permit. Signatur Print Name: 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 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. doe: UPC -4/10 PG12 -205 Printed: 11 -26 -2012 PERMIT CONDITIONS Permit No. PG12-205 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 PG12-205 Printed: 11 -26 -2012 CITY OF TUKUA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http: / /www.Tukwi la W A.gov • Plumbing /Gas Permit No. 19(21E7 Project No. 2-4 � �n Date Application Accepted: I L 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 King Co Assessor's Tax No.: 8108600641 Site Address: 4004 S 160th St Suite Number: Floor: Tenant Name: New Tenant: ❑ Yes ❑ ..No PROPERTY OWNER Name: Address: 6925 216th St SW #C Name: Tom Palmersheim Address: Contr Reg No.: KINGSHI044JA Exp Date: 03/10/2014 Address: 4004 S 160th St City: State: City: Tukwila State: WA Zip: 98188 CONTACT PERSON — person receiving all project communication Name: Address: 6925 216th St SW #C City: Lynnwood State: WA Zip 98036 Address: Contr Reg No.: KINGSHI044JA Exp Date: 03/10/2014 Tukwila Business License No.: (I I I (I City: State: Zip: Phone: Fax: Email: PLUMBING CONTRACTOR INFORMATION Company Name: Kings Heating, Inc. Address: 6925 216th St SW #C City: Lynnwood State: WA Zip 98036 Phone: (425) 275 -5153 Fax: (425) 275 -5154 Contr Reg No.: KINGSHI044JA Exp Date: 03/10/2014 Tukwila Business License No.: (I I I (I I Valuation of Project (contractor's bid price): $ 200 Scope of Work (please provide detailed information): Run gas pipe Building Use (per Int'l Building Code): single family Occupancy (per Int'l Building Code): Utility Purveyor: Water: Sewer: H:WpplicationsTorms- Applications On Line12011 Applications\Plumbing Permit Application Revised 8- 9- 11.docx Revisal: 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 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. BUILDINGAWNER t R AUTHO ' .• t AGENT: Signature: Print Name: -SA(/'no Mailing Address: 72 ) 'Z�� ST- w - 1iMr G 1[\ Applications\ Forms- Applications On LiffiVA11 Applications\Plumbing Permit Application Revised 11-9- 11.doac Revised: August 2011 bh Date: / Day Telephone: 1/475; Z 7S` -$(5' 3 Ch�..rvuoa� City state Zip Page 2 of 2 1 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.: 8108600641 Permit Number: PG12 -205 Address: 4004 S 160 ST TUKW Status: PENDING Suite No: Applied Date: 11/26/2012 Applicant: PALMERSHEIM RESIDENCE Issue Date: Receipt No.: R12 -03177 Initials: User ID: Payee: JEM 1165 Payment Amount: $96.60 Payment Date: 11/26/2012 09:18 AM Balance: $0.00 KINGS HEATING & AIR CONDITIONING TRANSACTION LIST: Type Method Descriptio Amount Payment Check 15901 96.60 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts GAS - RES 000.322.103.00.00 96.60 Total: $96.60 (Inc: RarPint -OR Printarl• 11-2R-2017 INSPECTION RECORD P6(2_ Retain a copy with permit 24 INSPECT O. PERMIT NO. I CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 4.._. (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Project)M' Type of Inspecti a r kpprv• e c,`" .f! Address: -4044 Vl. 1 6 (> —37— Date Calledt H PJ A--C_. 6 AS - Special Instructions: t { ^ Date Wanted- . 2- - to -- / � r r p.m. Requester: 7______,_..\ ( r _ J�.Z !z. l p r� ! l Approved per applicable codes. EJCorrections required prior to approval. !3 COMMENTS: r kpprv• e c,`" .f! AI /0 -Cf Lk; 6,bLf adp 7______,_..\ ( r _ ,, Insp eCtor: 0 N1 Dater✓ • n REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Contractors or Tradespeople Filter Friendly Page • General /Specialty Contractor A business registered as a construction contractor with Lftl to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name Phone Address Suite /Apt. City State Zip County Business Type Parent Company KINGS HEATING INC 4252755153 6925 216Th St Sw C Lynnwood WA 98036 Snohomish Corporation UBI No. Status License No. License Type Effective Date 601682595 Active KINGSHI044JA Construction Contractor 4/1/1996 Expiration Date 3/10/2014 Suspend Date Specialty 1 General Specialty 2 Unused Business Owner Information Name Role Effective Date Expiration Date POLLARD, GARY B Cancel Date 01/01/1980 Bond Amount POLLARD, ERIN K 6 01/01/1980 SA1782 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 6 CBIC SA1782 03/07/2002 Until Cancelled $12,000.0003/05 /2002 5 CBIC SI3737 08/12/2009 Until Cancelled 12/11/2009 $12,000.0007/31 /2009 4 FEDERATED MUTUAL INS CO 2062524 05/25/2009 Until Cancelled 08/13/2009 $12,000.0005/04 /2009 3 CBIC SA1782 03/07/2002 Until Cancelled $12,000.0003/05 /2002 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 10 American Fire a Casualty Co BKA54735100 04/01/2012 04/01/2013 $1,000,000.0003 /28/2012 9 Federated Mutual Ins Co 9807890 04/01/2009 04/01/2012 $1,000,000.0003 /01/2011 8 FEDERATED MUTUAL INS 9807890 04/01/2008 04/01/2009 $1,000,000.0003 /04/2008 7 NATIONWIDE MUTUAL INS CO ACPACT0753151764004 /01/2007 04/01/2008 $1,000,000.0003 /30/2007 6 NATIONWIDE MUTUAL INS CO ACPACT07521517640 04/01/2006 04/01/2007 $1,000,000.0003 /29/2006 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 11/26/2012