HomeMy WebLinkAboutPermit PG12-221 - MADRONA SPECIALTY FOODSMADRONA
SPECIALTY FOODS
18475 OLYMPIC AV S
PG12 -221
City oftukwila
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.: 7888900111
Address: 18475 OLYMPIC AV S TUKW
Project Name: MADRONA SPECIALTY FOODS
Permit Number: PG12 -221
Issue Date: 12/27/2012
Permit Expires On: 06/25/2013
Owner:
Name: RRP LA PANZANELLA LLC
Address: 1808 PARKSIDE DR E , SEATTLE WA 98112
Contact Person:
Name: JEFF GREEN Phone: 253 405 -7586
Address: PO BOX 73399 , PUYALLUP WA 98373
Email:
Contractor:
Name: NORTHWEST CASCADE INC
Address: PO BOX 73399 , PUYALLUP, WA 98373
Contractor License No: NORTHCI148BG
Phone: 253 - 848 -2371
Expiration Date: 10/01/2013
DESCRIPTION OF WORK:
ADD A FLOOR DRAIN CENTERED IN ROOM AND A FLOOR SINK TO ACCOMMODATE A WASH LINE.
Value of Plumbing /Gas Piping:
Fees Collected:
Electrical Service Provided by:
Permit Center Authorized Signature:
$1,000.00
$154.88
Uniform Plumbing Code Edition: 2009
International Fuel Gas Code Edition: 2009
Date:
I hereby certify that I have read and examined this permit and know the same to be true and correct. All provisions of law and ordinances
governing this work will be complied with, whether specified herein or not.
The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws regulating
construction or the performance of work. I may, authorized to sign and obtain this plumbing /gas piping permit and agree to the conditions
on the back of this permit.
Signature'
Date:
This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is suspended
or abandoned for a period of 180 days from the last inspection.
(Inn. 11P( -4/10
P(112 -771 Printarl• 17 -77 -7017
PERMIT CONDITIONS
Permit No. PG 12 -221
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.
rinc• 11PC -4/111
P(17 -791 PrintRel• 17 -77 -9(119
CITY OF TUKW'
Community Developm� epartment
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http: / /www.TukwilaWA.gov
PiumbingiGa
Project NO.:
Date Application Accepted:
Date Application Expires.
(For ofce. use_onlv),
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: /Y%.�5-'4J7j3 /G
King Co Assessor's Tax No.: It 1 D LV � D ( [ I
Suite Number: Floor:
Tenant Name: /1/-111=,.. / ,���y�jy %'2 ,S New Tenant: ❑ Yes [ N
PROPERTY OWNER
Company Name: - /•
N / x� 7/_.
/
Name:
?MillatMA V(/
State: e � Zip:�37� U j./11�/ 7 j
Address:
j t, Oa p f,VuO i t or
Tukwila Business License No.:
'._5 -D992 1
City:
6)efki\u State: WK.
Zip: Otto,
CONTACT'PERSON -''person receiving all project
comitiunl cation _ . _
Company Name: - /•
N / x� 7/_.
/
Address: //-), �
�C,/ a 7
zCity`
State: e � Zip:�37� U j./11�/ 7 j
Name: -
Address:
Tukwila Business License No.:
'._5 -D992 1
City:
State:
Zip:
Phone: /x-75
'
Fax:
Email:
PLUMBIN G CONTRACTOR
Company Name: - /•
N / x� 7/_.
/
Address: //-), �
�C,/ a 7
zCity`
State: e � Zip:�37� U j./11�/ 7 j
Phone Fax:
Contr Reg No.: / Exp Date:
t /1z77'�/l' /,rj�'t7� /e7 /3.
Tukwila Business License No.:
'._5 -D992 1
Valuation of Project (contractor's bid price): $ /V
Scope of Work (please provide detailed information): Ti, 4•c/ /.r/
.rte / - ii✓-
Building Use (per Int'l Building Code):
Occupancy (per Int'l Building Code):
Utility Purveyor: Water 'TT - o, /K is i Sewer: K-777 O
H:\Applications \Forms - Applications On Line \2011 Applications\Plumbing Permit Application Revised 8- 9- 11.docx
Revised: August 2011
bh
Page 1 of 2
Indicate type of plumbing fixtures and /o
Fixture Type
Qty
Bathtub or combination
bath/shower
Dishwasher, domestic with
independent drain
i
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)
piping outlets being installed and the quantit'""'"alow:
Fixture Type
Qty
Bidet
Drinking fountain or water
cooler (per head)
i
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
i
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
i
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 THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OW OR AUT RJ b AGENT:
Signature: ( / ice j7 Date:
Print Name:
Mailing Address:
Day Telephone•;;
H. \ Applications \Forms-Applications On Line\201 I Applications\Plumbing Permit Application Revised 8 -9 -11 docx
Revised: August 201 I
bh
City
ate Zip
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
Parcel No.: 7888900111
Address: 18475 OLYMPIC AV S TUKW
Suite No:
Applicant: MADRONA SPECIALTY FOODS
RECEIPT
Permit Number: PG12 -221
Status: PENDING
Applied Date: 12/26/2012
Issue Date:
Receipt No.: R12 -03374
Initials: JEM
User ID: 1165
Payment Amount: $154.88
Payment Date: 12/26/2012 11:26 AM
Balance: $0.00
Payee: NORTHWEST CASCADE INC
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 3366 154.88
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
PLAN CHECK - NONRES
PLUMBING - NONRES
000.345.830 30.98
000.322.103.00.00 123.90
Total: $154.88
rinn. RArAint -OR Printert• 12 -2R -7017
tft
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 pp_ (206) 431-3670
Permit Inspection Request Line (206) 431-2451 1-
PG
Project: ■ .- I
iikAA-A r a.ki A. spee-A 1-04--,-
Type.ofilnspectiL on:
t--, 0 A Plc) /4161-A6,
Address:
1 X4r)-S 0 .1-‘11,C..,
Date e : •_A_r
cato i i 1
u TT— ---4-77Y
Special Instructions: .
0 (P C1-°1-7 - 0 i
'et 0,64,/ A:/\ ROar -014.11.(1_2.5
Date Wan ed: ,. t....a.m,,
1 - :1>-: P.m.
2 I
Requester Requester:
Phone ND' 2_ ...
3. —xt 0.. :7,7? S•gfc,
Approved per applicable codes.
COMMENTS:
ElCorrections required prior to approval:
•
•
Inspecdr: ..
-
Date" ?
\
REINSPECTION FEE REQUIRED. Prior to next inspection, fee_ must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
- - .
•
--4=1
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO. ;c
CITY OF TUKWILA BUILDING DIVISION_ .;
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (20.6).43-1 =3670
Permit Inspection Request Line (206) 431 -2451
Project:
ty _
Type of Inspection:
Address•
l 7 S- O
p L.
Date Called:
,'
Special Instructions: /
O �Q36_ 0(
/
e
Date Wanted:. 7 -'
�G--C^ lfL,p.m.
Requester:
Pho7Ns3 �4 5.... -7 S?
2 Approved per applicable codes.
ElCorrections required prior to approval. - l
COMMENTS:
‘6)-v-s or.fkikefi-
Y
Inspector:
Date: Z
REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection:
.�......,�___�.__...__. -. s._�3':sa�x- fir.- wn::,-
SEPARATE PERMIT
REQUIRED FOR:
FELE COPY
Parma k. P6 11° 714,1
Pl^^ r^v approval is subject to errors and omissions.
1:. oi '.+on.-.',truction documents does not authr A9
tt, _.aticn ::4 L ,y adopted code o en 'nance . Rscc'pt
at LiJdrover Field Copy an , r. ! i, is ackmowledga :
.411111110,01(% .....,-_,.....61/
Are/
/rte 4W/
9rs
I.
mechanical
!� Electrical
❑ Plumbing
as Piping
J Tukwila
'1G DIVISION
s
r
Cray O' Tukwilb
OIVILION
r1 V7
Vr\
40 4- , e Int-o
XiS' -enema
Su6;6c(-- fc,'-e
/
rb s ev,') j( /
D -,)L R9419(e.
w it- c /49-40, ki3 /S 1d
3" Poor
-Fe rr1,
Pr ,,i r
!S�
f 3 . ,boo r
6/0
3" Pioor
REVISIONS
No changes shall be made to the scope
of work without prior approval of
u'swila Building Division.
l `" : F +s c c will require a new plan submittEI
r�at ins' +�de a�ditier�ul piar`reviewi s.
REVIEWED FOR
CODE COMPLIANCE
APPROVED
DEC 2 7 2012
bL
City of Tukwila
BUILDING DIVISION
RECEIVED .
CITY OF TUKVt I A
DEC 2 6 2012
PERMIT CENTER
P&12-22I
• •
Dave Larson
From: Michael Cusick
Sent: Thursday, December 27, 2012 2:39 PM
To: 'Marty Kramer'
Cc: Jeff Green; Bob Benedicto; Dave Larson
Subject: RE: LEtter
Marty,
The City of Tukwila will allow you to connect your proposed dishwasher to your existing 1500 gallon grease
interceptor. The approval is based on the pans will be only washed once a month with a limited flow of Tess than 100
gallons. Please contact me if you have any questions.
Mike Cusick, PE
City of Tukwila
206 431 2441
From: Marty Kramer jmailto:marty@madronafoods.com]
Sent: Thursday, December 27, 2012 2:01 PM
To: Michael Cusick
Cc: Jeff Green
Subject: LEtter
Thanks again for meeting with me today. Attached is the letter we discussed and the MSDS for the
soap to me used.
If you have any questions please don't hesitate to call me.
Marty Kramer
Plant Manager
Madrona Specialty Foods, LLC
18475 Olympic Ave 5
Tukwila, WA 98188
C. 253 208 -2890
Ph. 206- 745 -3687
Fx. 206-673-2635
1
• •
Marty Kramer
Madrona Specialty Foods
18475 Olympic Ave. South
Tukwila, WA 98188
December 27, 2012
Mr. Michael P. Cusick, P.E.
Utilities Engineer
Public Works Department
6300 Southcenter Boulevard
Tukwila, WA 38188
Dear Mr. Cusick
Subject: Tray washer INSTALLATION
The purpose of this letter is to request permission to discharge tray washing water from
a tray washer into our on -site grease trap. As you saw we are in the middle of the
contraction and would like to finish the floor and tray washer installation prior to our start
up January 2, 2013.
It is the intention of our company to install a small tray washer on the premises of 18475
Olympic Ave. South, Tukwila Washington for the purpose of washing cookie trays. The
number and frequency of this type of operation will be approximately 100 — 200 trays
per month. With this number of trays a cycle of the tray washing unit is10 trays for 90
seconds using 1.78 gallons of water per cycle, washing and rinsing, for a total of 17.8 -
35.6 gallons of water. The discharge will be into our on -site 1,500 gallon three
compartment grease trap.
Also attached to this correspondence is the MSDS of the soap that will be used in this
operation.
The installation of this tray washer will enhance our competitive position in the
marketplace helping us to sustain our locally owned and operated business in Tukwila. I
am asking for your help in the facilitation for the approval of this project.
Sincerely
M rty ramer
Plant Manager
Zep Inc.
1310 Seaboard Industrial Blvd.
Atlanta, GA 30318
1- 877 -I- BUY -ZEP (428 -9937)
Supci oiSoforicns www.zep.com
Printing date: 12/22/08
Section 1. Chemical Product and Company Identification
Product name
Product use
Product code
Date of issue
SMS HW DETERGENT (ProVisions)
Alkaline Detergent.
2605
11/25/08 Supersedes
Emergency Telephone Numbers
For MSDS Information:
Compliance Services 1- 877 -I- BUY -ZEP (428 -9937)
For Medical Emergency
(877) 541 -2016 Toll Free - All Calls Recorded
For Transportation Emergency
CHEMTREC: (800) 424 -9300 - All Calls Recorded
In the District of Columbia (202) 483 -7616
Prepared By
Compliance Services
1420 Seaboard Industrial Blvd.
Atlanta, GA 30318
Section 2. Hazards Identification
Emergency overview
DANGER!
CAUSES EYE, SKIN AND MUCOUS MEMBRANE BURNS.
HARMFUL IF SWALLOWED.
'Hazard Determination System (HOS): Health, Flammability, Reactivity
0
NOTE: MSDS data pertains to the product as delivered in the original shipping container(s). Risk of adverse effects are lessened by following all
prescribed safety precautions, Including the use of proper personal protective equipment.
Acute Effects Routes of Entry Eye contact. Inhalation. Ingestion.
Eyes Causes eye bums. Direct contact with the eyes can cause irreversible damage, including
blindness.
Skin Causes skin burns. The amount of tissue damage depends on length of contact.
Inhalation Liquid, spray or mist may produce tissue damage, particularly to mucous membranes of eyes,
mouth and respiratory tract.
May be harmful if swallowed. May cause bums to mouth, throat and stomach.
Ingestion
Chronic effects No known chronic effects from exposure.
Carcinogenicity Ingredients: Not listed as carcinogen by OSHA, NTP or IARC.
Additional Information: See Toxicological Information (Section 11)
Section 3. Composition /Information on Ingredients
Name of Hazardous Ingredients
SODIUM METASILICATE; silicic acid (H2- Si -03) disodium salt; water glass
SODIUM TRIPOLYPHOSPHATE
CAS number % by Weight
6834 -92 -0 5 - 15
7758 -29 -4 <5
Section 4. First Aid Measures
Eye Contact
Immediately flush eyes with plenty of water, occasionally lifting the upper and lower eyelids. Check for and
remove any contact lenses. Continue to rinse for at least 10 minutes. Get medical attention immediately.
Skin Contact In case of contact, immediately flush skin with plenty of water for at least 15 minutes while removing
contaminated clothing and shoes. Wash clothing before reuse. Get medical attention.
Inhalation Move exposed person to fresh air. If irritation persists, get medical attention.
Ingestion Wash out mouth with water. Do not induce vomiting unless directed to do so by medical personnel. If material
has been swallowed and the exposed person is conscious, give small quantities of water to drink. Never give
anything by mouth to an unconscious person. Get medical attention immediately.
Page: 113
Product code 2605
Section 5. Fire Fighting Measures
Material Safety Data Sheet Product Name SMS HW DETERGENT (ProVisions) I
National Fire Protection Association (U.S.
Flash Point None.
Flammable Limits Not applicable.
Flammability Non - combustible.
Fire hazard No specific hazard.
Fire- Fighting Use an extinguishing agent suitable for the surrounding fire. Fire - fighters should wear
Procedures appropriate protective equipment.
Section 6. Accidental Release Measures
Spill Clean up Put on appropriate personal protective equipment (see section 8). Stop leak if without risk. Dilute with water and
mop up if water - soluble or absorb with an inert dry material and place in an appropriate waste disposal container.
Dispose of via a licensed waste disposal contractor.
Section 7. Handling and Storage
Handling
Put on appropriate personal protective equipment (see section 8). Avoid contact with eyes, skin and clothing. Avoid
breathing vapors, spray or mists. Use only with adequate ventilation. Do not ingest. Do not reuse container.
Storage Store in original container protected from direct sunlight in a dry, cool and well - ventilated area, away from incompatible
materials (see section 10) and food and drink. Keep container tightly closed and sealed until ready for use. Keep out of
the reach of children.
Section 8. Exposure Controls/Personal Protection
Product name Exposure limits
SODIUM METASILICATE; silicic acid (H2- Si -03) disodium salt; Supplier Suggested (United States).
water glass CEIL: 2 mg/m' Form:
SODIUM TRIPOLYPHOSPHATE ACGIH TLV / OSHA PEL (United States).
TWA: 5 mg /m' 8 hour(s).
Personal Protective Equipment (PPE)
Eyes Splash goggles.
Body Wear appropriate protective clothing to prevent skin contact.
Chemical- resistant gloves (Nitrile, Neoprene, Rubber gloves.)
Chemical- resistant apron.
Respiratory Use with adequate ventilation. A respirator is not needed under normal and
intended conditions of product use.
Section 9. Physical and Chemical Properties
Physical State Liquid.
pH
Boiling Point
12.5 - 13.0
104.4 °C (220 °F)
Specific Gravity 1.13
Solubility Soluble in water in any proportion.
Section 10. Stability and Reactivity
Stability and Reactivity
Incompatibility
Hazardous Polymerization
Color Clear. Red / Orange.
Odor Odorless.
Vapor Pressure Not determined.
Vapor Density Not determined.
Evaporation Rate 1 (Water= 1)
VOC (Consumer) 0 (g /1).
The product is stable.
Reactive or incompatible with the following materials: oxidizing materials and acids.
Will not occur.
Hazardous Decomposition Products carbon oxides (CO, CO2), phosphorus oxides
Section 11. Toxicological Information
Acute Toxicity
Product/ingredient name
Sodium Metasilicate
Sodium Tripolyphosphate
Result
LD50 Oral
LD50 Oral
LD50 Dermal
LD50 Oral
Species Dose
Rat 1153 mg/kg
Mouse 770 mg/kg
Rabbit >7940 mg/kg
Rat 5400 mg/kg
Page: 2/3
Exposure
Product code 2605 Material Safety Data Sheet Product Name SMS HW DETERGENT (ProVisions)
Section 12. Ecological Information
Environmental Effects No applicable toxicity data
Aquatic Ecotoxicity
Not available.
Section 13. Disposal Considerations
Waste Information
Waste must be disposed of in accordance with federal, state and local environmental control regulations. Consult your local or
regional authorities for additional information.
Waste Stream Code: D002
Classification: - (Hazardous waste.)
Origin: - (RCRA waste.)
Section 14. Transport Information
Regulatory information UN number
Proper shipping name
Classes
PG* Label
DOT Classification
3266
Corrosive liquid, basic,
inorganic, n.o.s. (Sodium
Metasilicate)
8
111
IMDG Class
Not available.
Not available.
Not available.
-
NOTE: DOT classification applies to most package sizes. For specific container size classifications or for size exceptions, refer to
the Bill of Lading with your shipment.
PG* : Packing group
Section 15. Regulatory Information
U.S. Federal Regulations
SARA 313 toxic chemical notification and release reporting:
No products were found.
Clean Water Act (CWA) 307: No products were found.
Clean Water Act (CWA) 311: No products were found.
Clean Air Act (CAA) 112 regulated toxic substances: No products were found.
All Components of this product are listed or exempt from listing on TSCA Inventory.
State Regulations
California Prop 65
No products were found.
Section 16. Other Information
To the best of our knowledge, the information contained herein is accurate. However, neither the above named supplier nor any of its subsidiaries assumes any
liability whatsoever for the accuracy or completeness of the information contained herein.
Final determination of suitability of any material is the sole responsibility of the user. All materials may present unknown hazards and should be used with caution.
Although certain hazards are described herein, we cannot guarantee that these are the only hazards that exist.
*NOTE: Hazard Detemtination System (HDS) ratings are based on a 0-4 rating scale. with 0 representing minimal hazards or risks, and 4 representing significant hazards or risks
Although these ratings are not required on MSDSs under 29 CFR 1910.1200, the preparer may choose to provide them. HDS ratings are to be used with a fullv implemented program to
relav the meanings of this scale.
T CQ*D COPY
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: PG12 -221 DATE: 12 -26 -12
PROJECT NAME: MADRONA SPECIALTY FOODS
SITE ADDRESS: 18475 OLYMPIC AV S
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter #
Revision # After Permit Issued
DEPARTMENTS: kir-4k
Building ivision
Public Works ❑
Fire Prevention
Structural
Planning Division
❑ Permit Coordinator
n
DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 12 -27 -12
Complete
Incomplete
Fl
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 .ESt— Structural Review Required ❑ No further Review Required ❑
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS: DUE DATE: 01 -24 -13
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:
Documents /routing slip.doc
2 -28 -02
Contractors or Tradespeople Pryer Friendly Page
General /Specialty Contractor
A business registered as a construction contractor with Lai 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 NORTHWEST CASCADE INC UBI No. 278049149
Phone 2538482371 Status Active
Address Po Box 73399 License No. NORTHCI148BG
Suite /Apt. License Type Construction Contractor
City Puyallup Effective Date 1/7/1986
State WA Expiration Date 10/1/2013
Zip 983730399 Suspend Date
County Pierce Specialty 1 General
Business Type Corporation Specialty 2 Unused
Parent Company
Other Associated Licenses
License
Name
Type
Specialty 1
Specialty
2
Effective
Date
Expiration
Date
Status
UTILICM960KQ
UTILITY CONST MGMT CO
LLC
Construction
Contractor
General
Unused
5/18/2004
5/18/2014
Active
TTSNOCI022J4
T T S NORTHWEST CO
INC
Construction
Contractor
Sanitation
System
Side Sewer
Other
(Specify)
4/24/1998
4/18/2005
Archived
TRENCTI06066
TRENCHLESS
TECHNOLOGIES INC
Construction
Contractor
General
Unused
1/26/1994
12/27/1997
Archived
TRSNOII072M9
T R S NORTHWEST INC II
Construction
Contractor
General
Unused
7/29/1993
7/27/1996
Archived
TRSNOI'077BN
T R S NORTHWEST INC
Construction
Contractor
General
Unused
1/15/1993
1/14/1994
Archived
AMKRENI088NEAMKRETE
NORTHWEST
INC
Construction
Contractor
Other
(Specify)
Unused
8/5/1992
7/27/1994
Archived
JCENTI'159PG
J C ENTERPRISES INC
Construction
Contractor
Other
(Specify)
Unused
10/7/1985
9/13/1995
Archived
JCDRIC *201R9
J C DRILLING & CONTR
CO INC
Construction
Contractor
Other
(Specify)
Unused
12/29/1980
12/22/1985
Archived
JCDRIC *274M0
J C
DRILLING /CONTRACTING
CO
Construction
Contractor
Other
(Specify)
Unused
7/20/1973
4/14/1981
Archived
DYADC "297JN
DYAD CONSTRUCTION
INC
Construction
Contractor
General
Unused
4/15/1971
7/28/2001
Archived
CASCASS321K0
CASCADE SEPTIC SERVICE
INC
Construction
Contractor
General
Unused
5/20/1968
10/1/1986
Archived
Business Owner Information
Name
Role
Effective Date
Expiration Date
BARGER, STEPHEN R
President
01/07/1986
Bond Amount
WINGARD, WILLIAM B JR
Secretary
01/07/1986
09090648
PERRY, MARK R
Vice President
01/07/1986
01/01/1990
Bond Information
Page 1 of 2
Bond
Bond Company Name
Bond Account Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Bond Amount
Received Date
6
Fidelity Et Deposit Co
of MD
09090648
10/01/2012
Until Cancelled
$12,000.00
09/17/2012
5
SAFECO INS CO OF
AMERICA
6432025
10/01/2006
Until Cancelled
10/01/2012
$12,000.00
08/11/2006
https://fortress.wa.gov/lni/bbip/Print.aspx
12/27/2012