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Home My WebLink AboutPermit PG13-106 - TAZELAAL RESIDENCE - ALTERATIONTAZELAAL RESIDENCE 12624 34 AVE S EXPIRED 02/05/14 PG13-106 City ofilkukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206-43 1-3670 Inspection Request Line: 206-431-2451 Web site: http://www.TukwilaWA.gov Parcel No.: 7340600621 Address: 12624 34 AV S TUKW Project Name: TAZELAAL RESIDENCE PLUMBING/GAS PIPING PERMIT Permit Number: PG13-106 Issue Date: 07/31/2013 Permit Expires On: 01/27/2014 Owner: Name: TAZELAAL ANNEMARIELU Address: PO BOX 68603 , SEATTLE WA 98168 Contact Person: Name: SHEA SEGELSTROM Address: 5225 LAKE ALICE RD , FALL CITY WA 98024 Email: SHEA@BELBROOKPLUMBING.COM Contractor: Name: BELBROOK PLUMBING Address: 13127 444 AV SE , NORTH BEND WA 98045 Contractor License No: BELBRP*905DH Phone: 206-383-4862 Phone: 206-383-4862 Expiration Date: 03/08/2014 DESCRIPTION OF WORK: CHANGE OU T PLUMBING FIXTURES UPSTAIRS, ADD NEW BATH IN BASEMENT TO EXISTING GRINDER PUMP IN BASEMENT, DELETE OLD EXISTING SHOWER Value of Plumbing/Gas Piping: Fees Collected: Electrical Service Provided by: Permit Center Authorized Signature: $3,500.00 Uniform Plumbing Code Edition: 2009 $125.50 International Fuel Gas Code Edition: 2009 ' Date: ! — 31 y 11 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 . ork. I am authorized to sign and obtain this plumbing/gas piping permit and agree to the conditions on the back this permit. / s, ��• , Signature: Date: 7-3 / - Print Name: 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. o1l) a na Printari• n7_31_9M3 PERMIT CONDITIONS Permit No. PG 13-106 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 PG 13-106 Printed: 07-31-2013 CITY OF TUKWai Community Developmarepartment Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http:/iwww.TukwilaWA.gov Plumbing/G•ermit No. Project No. Date Apphcatton Accepted: Date Application Expires. r (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 P-67(1-/ �/1/1L /+'U/J King Co Assessor's Tax No.: '734/G16OKP/ 1 Site Address: 3te 5 Tenant Name: Suite Number: PROPERTY O�,ffWNER Name: oe 3k e? SV-2 Address: 5 ?5-. Areit AXCE €__9 Name: Potig iide t '1-A-2 eGiebge_ Phone: Fax: Email: ••1{QYJ 0 Q> Lbe_c.0\c- PLu,4bi J ,'6/2' Address: o(2y 3747i Irk City: 1%�GC._ Gig- City) C e-unL✓-- State P Zip: qgaB CONTACT PERSON - person; receiving all project communication , _ Name: oe 3k e? SV-2 Address: 5 ?5-. Areit AXCE €__9 City: State: a- Zip:T36,261 1).-.141..Z.-�y'�`'1 I Phone: Fax: Email: ••1{QYJ 0 Q> Lbe_c.0\c- PLu,4bi J ,'6/2' Floor: New Tenant: ❑ Yes ❑.. No PLUMBING CONTRACTOR INFORMATION Company Name Address: ��,2S / /frcir Q p City: 1%�GC._ Gig- State: Zip: , �'"24 Phone: �'- 33- �d�.`Z Fax: Contr Reg No.: Exp Date: Tukwila Business License No.: .��,•�- cc Valuation of Project (contractor's bid price): $ Scope of Work (please provide detailed information): G10-,4.4fg.04->r °Fsrte_..4 Sr UPS're5 PSD .dg. cJ ear —TO Cb,1 ,t) ‘134seir M^K.tPT— ® L� ,^ r C j -� xV_ v G S? w�ce—.._ Building Use (per Int'I Building Code): Occupancy (per Intl Building Code): Utility Purveyor: Water: Sewer: H:\Applicauons\Forms-Applications On Line \2011 Applications\Plumbing Permit Application Revised 8-9-1 t.docx Revised: August 2011 bh Page 1 of 2 Indicate type of plumbing fixtures and/ollpiping outlets being installed and the quantitlow: Fixture Type Qty. Bathtub or combination bath/shower Dishwasher, domestic with independent drain • Shower, single head trap 4,, Sinks 31. 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 4,, Urinal l 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 l 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 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 1 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 Signature: OUT 1 RIZED AGENT: Print Name: Mailing Address: Date: 9// 4-6 t3 S.<&‘1_5172..0 Day Telephone: H:Wpplications\Forms-Applications On Line\2011 Applications\Plumbing Permit Application Revised 8-9-11.docx Revised: August 2011 bh City State Zip Page 2 of 2 r 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.ov Parcel No.: 7340600621 Address: 12624 34 AV S TUKW Suite No: Applicant: TAZELAAL RESIDENCE RECEIPT Permit Number: PG13-106 Status: PENDING Applied Date: 07/31/2013 Issue Date: Receipt No.: R13-02251 Initials: User ID: WER 1655 Payment Amount: $125.50 Payment Date: 07/31/2013 01:10 PM Balance: $0.00 Payee: LENA SEGELSTROM TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd MC Authorization No. 001016 ACCOUNT ITEM LIST: Description 125.50 Account Code Current Pmts PLUMBING - RES 000.322.103.00.00 125.50 Total: $125.50 .r....• oe...;... nc Prinforl• fl7-41_9113 INSPECTION RECORDIL Retain a copy with permit INSPEk ION 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: A l.. ( 1 >�ZE lr�i TY? �-V.o of Inspection:—�— Address: 12(o211 3 y__4v 5 Date Called: Special Instructions: Date Wanted: 0— 9 - (2, a m. p.m. Requester: Phone No: ao(:)— 3S 3-H B6 Z Approved per applicable codes. O Corrections required prior to approval... COMMENTS: nspect n Dat EIN • PECTION FEE REQUI D. Prior to next inspection, fee must be paid =t 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit INSP TION NO. CITY OF TUKWILA BUILDING' -`13- IVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 „ -(206) 431-3670 Permit Inspection Request Line (206) 431-2451 PERMIT NO. Prs �ec.t�:� I 2-E.L6 A L 2c.S Ty a of Inspection: t-ox,v, N' — 2� Address: Date Called: Special Instructions: Date Wanted: ' a Requester: Phone PXDG-3C7—i'l V (07 Approved per applicable codes. Corrections required 'prior to approval. �p COMMENTS: <e (i)c,- 41>cYQ t f geSTs. -- t) T;- itipadki -f- V3,0 1 ..,--)r/ ____N EINSPECTION FEE REQU RED. Prior to ne t inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Cali to schedule reinspection. INSP CTION NO. INSPECTION RECORD Retain a copy with permit PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-367 Permit Inspection Request Line (206) 431-2451 Prro gct: Res Type of Inspection: Gr O v NO vll0 fk:—.. ! AZFLAA-l_._ Address: 'Vo2 34 AUL" Date Called: Special Instructions: Date Wanted: L....13 �!j, p.m. Requester: Phone No: �y �� /-r� 20 Co — 3,E3 --�'t - Approved per applicable codes. LJ Corrections required prior to approval. COMMENTS: S * y /N,. r ...•"------.. Date:C, 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 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 P(3-(oc Pro„ jot: t A--1__E-,(A-Al 0--r-r.„5G Type of Inspection:/I r o u itA v1/4(6,r K____ Address: (U 3/ AuL Date Called: -K/N '`- 0 c.,.I , F (r t,JAs --re Special In tructions: V - 0 ('5 3 V� ( 'n Date Wanted: —�� p.m. Reque;tear: r e-47 f Phone No. -3 Fr 3 I -b t.r. DApproved per applicable codes. Corrections required prior to approval. COMMENTS: -K/N '`- 0 c.,.I , F (r t,JAs --re -- Ie.Ak e ---- /ee_ --Sci, ,ad -e tAilve_A. 0 lee_ r e-47 f , r"/ ,7 Insp ctor: Date: REINSPECTION FEE REQUIRED! Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. 1/2/2014 City of Tukwila Department of Community Development SHEA SEGELSTROM 5225 LAKE ALICE RD FALL CITY, WA 98024 RE: Permit No. PG13-106 TAZELAAL RESIDENCE 12624 34 AV S Dear Permit Holder: Jim Haggerton, Mayor Jack Pace, Director In reviewing our current records, the above noted permit has not received a final inspection by the City of Tukwila Building Division. Per the International Building Code, International Mechanical Code, Uniform Plumbing Code and/or the National Electric Code, every permit issued by the Building Division under the provisions of these codes shall expire by limitation and become null and void if the building or work authorized by such permit has not begun within 180 days from the issuance date of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work has begun for a period of 180 days. Your permit will expire on 2/5/2014. Based on the above, you are hereby advised to: 1) Call the City of Tukwila Inspection Request Line at 206-431-2451 to schedule for the next or final inspection. Each inspection creates a new 180 day period, provided the inspection shows progress. -or- 2) Submit a written request for permit extension to the Permit Center at least seven(7) days before it is due to expire. Address your extension request to the Building Official and state your reason(s) for the need to extend your permit. The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is determined that your extension request is granted, you will be notified by mail. In the event you do not call for an inspection and/or receive an extension prior to 2/5/2014, your permit will become null and void and any further work on the project will require a new permit and associated fees. Thank you for your cooperation in this matter. Sincerely, er Marshall Technician File No: PG13-106 6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 Contractors or Tradespeople Pr er 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 BELBROOK PLUMBING UBI No. 602953860 Phone 2063834862 Status Active Address 13127 444Th Ave Se License No. BELBRP*905DH Suite/Apt. License Type Construction Contractor City North Bend Effective Date 3/8/2010 State WA Expiration Date 3/8/2014 Zip 98045 Suspend Date County King Specialty 1 Plumbing Business Type Individual Specialty 2 Unused Parent Company Business Owner Information Name Role Effective Date Expiration Date SEGELSTROM, SHEA RYAN Owner 03/08/2010 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 3 Navigators Ins Co 46BCO23689 02/21/2012 Until Cancelled $6,000.0005/10/2012 02/21/2013 2 American Contractors Indem CO 100155328 02/23/2011 Until Cancelled 04/22/2012 $6,000.0002/23/2011 02/22/2012 1 PLATTE RIVER INS CO 41194439 02/23/2010 Until Cancelled 03/14/2011 $6,000.0003/08/2010 11/02/2011 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 Security National Insurance NA104916301 02/21/2013 02/21/2014 $1,000,000.00 02/21/2013 2 Security National Insurance NA101747300 02/21/2012 02/21/2013 $1,000,000.00 02/22/2012 1 TRUCK INS EXCHANGE 604777299 11/09/2009 11/09/2012 02/22/2012 $1,000,000.00 11/02/2011 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 Infractions/Citations Information No records found for the previous 6 year period https://fortress.wa.gov/lni/bbip/Print.aspx 07/31/2013