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HomeMy WebLinkAboutPermit D14-0340 - COCA COLA - KIOSKCOCA COLA KIOSK 2600 SOUTHCENTER MALL FC-16 D14-0340 City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206-431-3670 Inspection Request Line: 206-438-9350 Web site: http://www.TukwilaWA.gov Parcel No: 9202470010 Address: DEVELOPMENT PERMIT Permit Number: D14-0340 2600 SOUTHCENTER MALL FC16 Issue Date: 11/12/2014 Permit Expires On: 5/11/2015 Project Name: COCA COLA KIOSK Owner: Name: WESTFIELD PROPERTY TAX DEPT Address: PO BOX 130940 , CARLSBAD, CA, 92013 Contact Person: Name: STARR DELACRUZ Phone: (310) 606-2078 Address: 2413 PACIFIC COAST HWY #202 , LOMATA, CA, 90717 Contractor: Name: GIBSON GUY D Phone: (503) 720-7558 Address: 12369 S NEW ERA RD , OREGON CITY, OR, 97045 License No: DIRTYW*916B1 Expiration Date: Lender: Name: Address: II I DESCRIPTION OF WORK: INSTALLATION OF PRE-FABARICATED COCA COLA KIOSK. EXISTING ELECTRICAL OUTLETS TO REMAIN FOR REUSE. Project Valuation: $40,000.00 Type of Fire Protection: Sprinklers: YES Fire Alarm: Type of Construction: IIB Fees Collected: $1,415.34 Occupancy per IBC: B Electrical Service Provided by: TUKWILA FIRE SERVICE Water District: TUKWILA Sewer District: TUKWILA SEWER SERVICE Current Codes adopted by the City of Tukwila: International Building Code Edition: International Residential Code Edition: International Mechanical Code Edition: Uniform Plumbing Code Edition: 2012 International Fuel Gas Code: 2012 WA Cities Electrical Code: 2012 WA State Energy Code: 2012 2012 2014 2012 Public Works Activities: Channelization/Striping: Curb Cut/Access/Sidewalk: Fire Loop Hydrant: Flood Control Zone: Hauling/Oversize Load: Land Altering: Landscape Irrigation: Sanitary Side Sewer: Sewer Main Extension: Storm Drainage: Street Use: Water Main Extension: Water Meter: Volumes: Cut: 0 Fill: 0 Number: 0 No Permit Center Authorized Signature: �r�//(/ fiyy Date: !//(� I/y I hearby 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 am authorized to sign and obtain this development permit and agree to the conditio...ttt -d to this permit. Signature: Print Name: Dater/-7 2 --`/ This permit shall become null and void if the work is not commenced within 180 days for the date of issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection. PERMIT CONDITIONS: 1: ***BUILDING PERMIT CONDITIONS*** 2: Work shall be installed in accordance with the approved construction documents, and any changes made during construction that are not in accordance with the approved construction documents shall be resubmitted for approval. 3: All permits, inspection record card and approved construction documents shall be kept at the site of work and shall be open to inspection by the Building Inspector until final inspection approval is granted. 4: When special inspection is required, either the owner or the registered design professional in responsible charge, shall employ a special inspection agency and notify the Building Official of the appointment prior to the first building inspection. The special inspector shall furnish inspection reports to the Building Official in a timely manner. 5: A final report documenting required special inspections and correction of any discrepancies noted in the inspections shall be submitted to the Building Official. The final inspection report shall be prepared by the approved special inspection agency and shall be submitted to the Building Official prior to and as a condition of final inspection approval. 6: All construction shall be done in conformance with the Washington State Building Code and the Washington State Energy Code. 7: Fire retardant treated wood shall have a flame spread of not greater than 25. All materials shall bear identification showing the fire performance rating thereof. Such identification shall be issued by an approved agency having a service for inspection at the factory. 8: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Permit Center. 9: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the Building Official from requiring the correction of errors in the construction documents and other data. 11: The attached set of building plans have been reviewed by the Fire Prevention Bureau and are acceptable with the following concerns: 12: Post address of FC-16 on kiosk per approved Westfield standards. 10: Contact The Tukwila Fire Prevention Bureau to witness all required inspections and tests. (City Ordinances #2436 and #2437) 13: Any overlooked hazardous condition and/or violation of the adopted Fire or Building Codes does not imply approval of such condition or violation. 14: These plans were reviewed by Inspector 511. If you have any questions, please call Tukwila Fire Prevention Bureau at (206)575-4407. PERMIT INSPECTIONS REQUIRED Permit Inspection Line: (206) 438-9350 1700 BUILDING FINAL** 1400 FIRE FINAL 4046 SI-EPDXY/EXP CONC Tenant Name: CITY OF TUKWILA Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.Tukwil a W A. eov Building Permit No. D (4 03410 Project No. Date Application Accepted: io(ar/i Date Application Expires: (For office use only) CONSTRUCTION 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.:} a Ue9`q 1 06i 0 Site Address: ° NOD SO L- r 1✓1 Mc�Cn. Suite Number: I oar7 Floor: 9 of,P, Coca CD\G C6. os K/ PROPERTY OWNER Name: Weid Address:(a,u��mel.(�P - siysee4- 4f. C3 t) City: Sao Fro, ut n (�(p State: C Zip _ /(4/03 CONTACT PERSON — person receiving all project communication Name: 5 De Lek �� t '_l Address9"l i "2, 1 Q� a 1 Argo 000 y. ^�2 City: ) ^� State: /nZiP:9 b ill 31 Phone: V 40ma ' �x. £i(/Di 0 JtIJ ut,a0 1 Email: e rr Q.rM i�C, l.�tnoCf•CDM GENERAL CONTRACTOR INFORMATION Too Company Name: Address: City: State: Zip: Phone: Fax: Contr Reg No.: Exp Date: Tukwila Business License No.: New Tenant: Yes ❑ .. No ARCHITECT OF RECORD Company Name: l7p I "S D e 0r �*,n. Architect Name: Mlr 1� 614 V' r J'` lJ 1 S. c Ot r hi ' }��f *a Address: gaka,1 __ ll �� ll f�(� v City: yL,n�1I State: -T� 7/„01 �11?�� ��1.7—_7 Phone: l 1 '^ /jZip: 0 )...4 �� Fax: �� 0'' l.0410fAoi 1 Email: r IrOW F V/e— 0 DJ, i'vl 1164,-n I t o/ ENGINEER OF RECORD IV 1(x Company Name: Engineer Name: Address: City: State: Zip: Phone: Fax: Email: LENDER/BOND ISSUED (required for projects $5,000 or greater per RCW 19.27.095) Name: Address: City: State: Zip: H:\Applications\Porno-Applications On Line\201 I Applications\Permit Application Revised - 8-9-1 I.docx Revised: August 2011 bh Page I of 4 BUILDING PERMIT INFORMATION — 206-431-3670 Valuation of Project (contractor's bid price): $ 01 ODO Existing Building Valuation: $ Describe the scope eeof work (please provide detailed information): t 1� --�'n s� AVil� _ a c"e - r-rx �✓i (air/ Coca ed let l bSK , 1ieerf-hca-e o +S - vumu, n - ‘r-ef u s-e-_ Will there be new rack storage? ❑ Yes No If yes, a separate permit and plan submittal will be required. Provide All Building Areas in Square Footage Below Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC 1n Floor ViAlc1B i ��,S 2ndFloor 3'd Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck PLANNING DIVISION: Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq ft): Floor area of principal dwelling: Floor area of accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Compact: Handicap: Will there be a change in use? ❑ Yes No if "yes", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ Sprinklers ❑ Automatic Fire Alarm None ❑ Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes ❑ No If `yes', attach list of materials and storage locations on a separate 8-1/2" x 11 "paper including quantities and Material Safety Data Sheets. SEPTIC SYSTEM ❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. lL'lI SJ H:\Applications\Forms-Applications On Line\201 I Applications\Permit Application Revised - 8-9-1 I .docx Revised: August 2011 bh Page 2 of 4 PUBLIC WORKS PERMIT INFORiviATION — 206-433-0179 Scope of Work (please provide detailed information): K��J� PN-Q— \W) CC.r(k COCCk &$Q Ca11 before you Dig: 811 Please refer to Public Works Bulletin #1 for fees and estimate sheet. ❑er District .Tukwila ❑...Water District #125 ❑ .. Highline ❑ ...Water Availability Provided e r District ...Tukwila 0...Valley View 0 .. Renton 0 ...Sewer Use Certificate 0...Sewer Availability Provided ❑ .. Renton ❑ .. Seattle Septic System: ❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. Submitted with Application (mark boxes which apply): ❑ ...Civil Plans (Maximum Paper Size — 22" x 34") ❑ ...Technical Information Report (Storm Drainage) 0 ...Bond ❑ .. Insurance 0 .. Easement(s) Proposed Activities (mark boxes that apply): ❑ ...Right-of-way Use - Nonprofit for less than 72 hours ❑ ...Right-of-way Use - No Disturbance ❑ ...Construction/Excavation/Fill - Right-of-way ❑ Non Right-of-way 0 ❑ ...Total Cut ❑ ...Total Fill cubic yards cubic yards ❑ ...Sanitary Side Sewer ❑ ...Cap or Remove Utilities 0 ...Frontage Improvements ❑ ...Traffic Control ❑ ...Backflow Prevention - Fire Protection Irrigation Domestic Water ❑ .. Geotechnical Report ❑ .. Maintenance Agreement(s) ❑ ...Traffic Impact Analysis ❑ ...Hold Harmless — (SAO) ❑ ...Hold Harmless — (ROW) ❑ .. Right-of-way Use - Profit for less than 72 hours ❑ .. Right-of-way Use — Potential Disturbance ❑ .. Work in Flood Zone ❑ .. Storm Drainage ❑ .. Abandon Septic Tank ❑ .. Curb Cut 0 .. Pavement Cut ❑ .. Looped Fire Line 0 ...Permanent Water Meter Size... WO # ❑ ...Temporary Water Meter Size .. WO # ❑ .. Grease Interceptor ❑ .. Channelization ❑ .. Trench Excavation ❑ .. Utility Undergrounding 0 ...Water Only Meter Size WO # 0 ...Deduct Water Meter Size ❑ ...Sewer Main Extension Public 0 Private 0 ❑ ...Water Main Extension Public ❑ Private ❑ 91 FINANCE INFORMATION Fire Line Size at Property Line Number of Public Fire Hydrant(s) 0 ...Water 0 ...Sewer Monthly Service Billing to: Name: 0 ...Sewage Treatment Day Telephone: Mailing Address: Water Meter Refund/Billing: Name: Mailing Address: City State Zip Day Telephone: City State Zip H:\Applications\Forms-Applications On Line\2011 Applications \Permit Application Revised - 8-9-11.docx Revised: August 2011 bh Page 3 of 4 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 or more extensions of time for additional periods not exceeding 90 days each. The extension shall be requested in writing and justifiable cause demonstrated. Section 105.3.2 International Building 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 OWN OR UTHORIZED AGENT: Signature. Print Name: i2 �2-- ( La vT ut b Mailing Address: c-2L4 f P% 4 Date: 1b a ? JI Day Telephone: t 3t - (a0 Co. D %p xi /0 (OD-- Alt �C)717 City State Zip H:Applications\ Forms -Applications On Line\201 I Applications\Permit Application Revised - 8-9-11 .dots Revised: August 2011 bh Page 4 of 4 Cash Register Receipt City of Tukwila DESCRIPTIONS I ACCOUNT I QUANTITY PermitTRAK I PAID $875.90 D14-0340 Address: 2800 SOUTHCENTER MALL Apn: 3597000150 $875.90 DEVELOPMENT $834.40 PERMIT FEE R000.322.100.00.00 0.00 $829.90 WASHINGTON STATE SURCHARGE B640.237.114 0.00 $4.50 TECHNOLOGY FEE $41.50 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R3525 R000.322.900.04.00 0.00 $41.50 $875.90 Date Paid: Monday, November 10, 2014 Paid By: MICHAEL EARLY Pay Method: CREDIT CARD 004969 Printed: Monday, November 10, 2014 3:10 PM 1 of 1 CL--/ Ll WSYSTEMS DESCRIPTIONS Cash Register Receipt City of Tukwila ACCOUNT ( QUANTITY PAID PermitTRAK $539.44 D14-0340 Address: 2800 SOUTHCENTER MALL Apn: 3597000150 $539.44 DEVELOPMENT $539.44 PLAN CHECK FEE TOTAL FEES PAID BY RECEIPT: R3410 R000.345.830.00.00 0.00 $539.44 $539.44 Date Paid: Tuesday, October 28, 2014 Paid By: PERMITS DIRECT Pay Method: CHECK 2700 Printed: Tuesday, October 28, 2014 10:20 AM 1 of 1 CSYSTEMS INSPECTION RECORD Retain a copy with permit PECTIN NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd.., #100, Tukwila. WA 98188 (206) 431,-3670 Permit Inspection Request Line (206) 438-9350 Project; Type of:inspection: Date Called: Special Instructions: i'tequester Phone No: J'Approved per applicable codes. Corrections required prior to approval. COMMENTS: EINSPECTION FEE REQUIRE [paid at 6300 Southcenter Blvd.. D. Prior to nkxt inspection. fee must be Suite tall. all to schedule reinspection. MAYES TESTING ENGINEERS, INC. Project No. T14260 Project Coke Kiosk Address 2800 Southcenter Mall, Tukwila, WA Permit No. D14-0340 Bldg Dept. City of Tukwila Contractor Dirty Work Record No. 001 Date 11-19-14 Weather Indoors Inspection Proprietary Anchors Seattle Office 20225 Cedar Valley Road Site 110 Lynnwood, WA 98036 ph425.742.9360 fax425.745.1737 Tacoma Office 10029 S. Tacoma Way SiiteE2 Tacoma, WA98499 ph 253.584.3720 fax253.584.3707 PodEndOfice 7911 NE 33rd Drive Site 193 Portland, OR 97211 ph 503281.7515 fax 533281.7579 Observed installation of Hilti Kwik Bolt TZ-CS 3/8 x 5" wedge anchors installed into the Food Court floor on Level 2, to anchor pieces of the Coke Kiosk to the floor. Holes were drilled to a depth that will allow for the anchors to seat and still have the required embedment, cleaned and then the anchors installed and torque per the manufacturer's instructions. Work was found to be acceptable per the plans. To the best of our knowledge, all items inspected today are in conformance with approved plans and specifications. Inspector: Tom Robinson Reviewed By:,(e? Dennis Sanborn Senior Project Manager RECEIVED CITY OF TUKWILA DEC 0 9 2014 PERMIT CENTER Information in this report applies only to the actual items inspected or tested and shall not be reproduced except in full, without the approval of Mayes Testing Engineers, Inc. Page 1 of 1 Page 1 of 1 MAYES TESTING ENGINEERS, INC 20225 Cedar Valley Road, Suite 110 Ph Lynnwood, WA 98036 Fax 10029 S. Tacoma Way, Suite E-2 Ph Tacoma, WA 98499 Fax 7911 NE 33r' Drive, Suite 190 Portland, OR 97211 Inspector: Tom Robinson Time: to Inspector: Time: 425.742.9360 425.745.1737 253.584.3720 253.584.3707 Ph 503.281.7515 Fax 503.281.7579 Hours: Inspector: Time: to Hours: SUMMARY: to Hours: Field Copy / Subject to Reviei Project No.: T14260 Date: November 19, 2014 Project: Southcenter Coke Kiosk Permit No.: D14-0340 Weather: Inside Project Address: Owner: 2800 Southcenter Mall Engineer: PDMS Design Group Architect: Michael R Black Contractor: DirtyWork Type of Inspection: Wedge Anchors Samples: N/A Inspector Robinson on site to observe installation of Hilti Kwik Bolt TZ-cs 3/8"x 5" wedge anchors, installed into the Food Court floor on level 2, to anchor pieces of the Coke Kiosk to the Floor. Holes were drilled to a depth that will allow for the anchors to seat and still have the required embedment, cleaned, then the anchors installed and torque per the manufacturer's instructions. Work was found to be acceptable per the plans. Thomas B Robinson To the best of our knowledge, all items inspected today are in conformance with approved plans and specifications. ® Yes ❑ No ['Preliminary Inspection NONCONFORMING CONDITIONS/CORRECTIVE ACTIONS TAKEN: MTE 1000-2C, Rev 2, 4/1/07 PERMIT COORD COPY PLAN REVIEW/ROUTING SLIP PERMIT NUMBER: D14-0340 DATE: 10/28/14 PROJECT NAME: COCA COLA KIOSK FC--1 ,o• SITE ADDRESS: ►i , ! ! SOUTHCENTER MALL - C X Original Plan Submittal Revision # before Permit Issued Response to Correction Letter # Revision # after Permit Issued DEPARTMENTS: Building Division Public WorKs fl Atoc U- Lk9 01- N Fire Prevention Planning Division Structural Permit Coordinator IR PRELIMINARY REVIEW: Not Applicable ❑ (no approval/review required) DATE: 10/30/14 Structural Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 11/27/14 Approved Corrections Required Approved with Conditions Denied (corrections entered in Reviews) (ie: Zoning Issues) Notation: 1 s I.3 REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: 12/18/2013 DIRTY WORK Page 1 of 2 411111114 Washington State Department of Labor & Industries DIRTY WORK Owner or tradesperson GIBSON, GUY DALE Principals GIBSON, GUY DALE, OWNER WA UBI No. 602 374 732 12369 S NEW ERA RD OREGON CITY, OR97045 503-720-7558 Business type Individual License Verify the contractor's active registration / license / certification (depending on trade) and any past violations. Construction Contractor License specialties GENERAL License no. DIRTYW*916B1 Effective — expiration 01/21/2009— 01/31/2015 Bond Wesco Insurance Co Bond account no. 46wb011167 Active. Meets current requirements. $12,000.00 Received by L&1 Effective date 12/06/2012 01 /21 /2013 Expiration date Until Canceled American Contractors Indem CO Bond account no. 100061348 $12,000.00 Received by L&I Effective date 01/21/2009 01/21/2009 Expiration date Until Canceled Bond history Insurance Security National Insurance $1,000,000.00 Policy no. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602374732&LIC=DIRTYW*916B1&SAW= 11/12/2014 DIRTY WORK NA104222602 Page 2 of 2 Received by L&I Effective date 01/21/2014 01/21/2014 Expiration date 01/21/2015 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period, but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp Workplace safety and health No inspections during the previous 6 year period. © Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington. Access WasltingtornK` 4:..fia.ruaient k'c4 thb• https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602374732&LIC=DIRTYW*916B1&SAW= 11/12/2014