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Home My WebLink AboutPermit PG14-0087 - PACIFIC DENTAL - GAS PIPING TO ROOFTOP UNITPACIFIC DENTAL 17420 SOUThCENTER PKWY PG1 4- 0087 Parcel No: Address: 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 PLUMBING/GAS PIPING PERMIT 2623049110 17420 SOUTHCENTER PKWY Project Name: PACIFIC DENTAL Permit Number: PG14-0087 Issue Date: 5/30/2014 Permit Expires On: 11/26/2014 Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: Address: License No: Lender: Name: Address: KIR TUKWILA 050 LLC 3333 NEW HYDE PARK RD #100 PO C/0 KIMCO REALTY CORP, NEW HYDE PK, WA, 11042 ALEX BURKHART 727 S KENYON ST , SEATTLE, WA, 98108 EVERGREEN REFRIGERATION LLC 727 S KENYON ST , SEATTLE, WA, 98108 EVERGRL954R2 Phone: (206) 763-1744 Phone: (206) 763-1744 Expiration Date: 1/6/2016 DESCRIPTION OF WORK: GAS PIPING TO (1) ROOFTOP UNIT Valuation of Work: $1,500.00 Water District: HIGHLINE,TUKWILA Sewer District: TUKWILA SEWER SERVICE Fees Collected: $102.38 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 2012 2012 2012 International Fuel Gas Code: WA Cities Electrical Code: WA State Energy Code: 2012 2012 2012 Permit Center Authorized Signature: Date: 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 conditions attached to this permit. Signature: Date: 5/WM Print Name: ! "" 1)L,V 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: 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. 2: ***PLUMBING/GAS PIPING PERMIT CONDITIONS*** 3: No changes shall be made to applicable plans and specifications unless prior approval is obtained from the Tukwila Building Division. 4: All permits, inspection records and applicable plans shall be maintained at the job and available to the plumbing inspector. 5: All plumbing and gas piping systems shall be installed in compliance with the Uniform Plumbing Code and the Fuel Gas Code. 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: 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. 8: 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. 9: 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. 10: 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. PERMIT INSPECTIONS REQUIRED Permit Inspection Line: (206) 438-9350 2000 GAS PIPING FINAL 9002 ROUGH -IN GAS PIPING CITY OF TUKWJ Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Plumbing/Gas Permit No. P(l4-ocsi Project No. rry� Date Application Accepted: OS- 2)0 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.: Site Address: \ 74 % $0 thli`c P Suite Number: Tenant Name: ri c,i* - PROPERTY OWNER Name:K�� , i tiYW1Dfr � c. Address:. �40. ��. ,5D2U City: Nr�ew L k ptt-l2 "" State: ^ f y Zip: l 1 6L2 CONTACT PERSON - person receiving all project communication Name: /64 Address: -721 saki, kei" Gan 5+ , City: S State: Zip: q 0 7 Phone: 206 -216-5— l-iq Fax: %6---75--23gG( Email: aile_x.6eev,vhvi �cai„.1 Floor: New Tenant: ❑ Yes ❑..No PLUMBING CONTRACTOR INFORMATION Company Name: �L )i^{,h f 7 Address: `(Z� 5uv in S4—,, City: • Si'te.. State: L/A, Zip: / gi A Phone: ii)6 _ ").6-3 _ l i `f ] Fax: 6 -- 3 — 238`1 Contr Reg No.: erz.612,14 S q y2Ixp Date: 1 /4- Az Tukwila Business License No.: SUS _0g el28 7 7 Valuation of Project (contractor's bid price): $itr 1 "ob. Scope of Work (please provide detailed information): Psib Dry- CI) rwf pis , Building Use (per Int'l Building Code): Occupancy (per Int'1 Building Code): Utility Purveyor: Water Sewer H:Wpplications\Fonns-Applications On Line\2011 Applications\Plumbing Pennit 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 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) 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 sprinlder backflow protections over 5 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. BUILDING OWNER,,OR AUTHORIZED AGENT: Signature: Gl''t— Print Name: i4 - Mailing Address: soN'h l t-ya,, Date: 5 i)DA Day Telephone: 2a-6 — Z 6 3 1744 >3 WI City State Zip H:Wpplications\Forns-Applications On Line\2011 Applicatious\Plumbing Permit Application Revised 8-9-11.docx Revised: August 2011 bh Page 2 of 2 Cash Register Receipt City of Tukwila DESCRIPTIONS I ACCOUNT PermitTRAK QUANTITY I PAID $102.38 PG14-0087 Address: 17420 SOUTHCENTER PKWY Apn: 2623049110 $102.38' GAS $97.50 PERMIT ISSUANCE BASE FEE R000.322.100.00.00 0.00 $32.50 PERMIT FEE R000.322.100.00.00 0.00 $65.00 TECHNOLOGY FEE $4.88 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R2239 R000.322.900.04.00 0.00 $4.88 $102.38 Date Paid: Friday, May 30, 2014 Paid By: EVERGREEN REFRIGERATION LLC Pay Method: CHECK 006373 Printed: Friday, May 30, 2014 11:37 AM 1 of 1 SYSTEMS INSPECTION RECORD Retain a copy with permit�o(k�'60.57 ),,c_ IN 'ECTION NO. PERMIT N0. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 431-2451 Project: VA0ir: E ,' 57L Type of Inspection: J= iiv /iC..- Address: Date Called: Special Instructions: P tJ'i CAS �`' Date Wanted: / _ 22- ` ( a:rrt: a:n i Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: r l ytitJ/FJram'—'/�1i~f�-- Insp ctbr: ii, REINSPECTION FEE REQUIRED. 3rior to next inspection. fee must be IP paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. Da`a z2 / `__ 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 Projec u ' , 4 /,/'}� /ei i Type o�^(nspectio Address: i 7-2O s, 14c4/ Date Called: Special Instructions: /// Date Wanted? 2 / C/ .r �! ap-m. Requester "'- Phone No:7 [igApproved per applicable codes. Corrections required prior to approval. COMMENTS: Inspectorb VAA4enn A Date: /_.. Z 1 (/ REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. EVERGREEN REFRIGERATION I T Page 1 of 3 0 Washington State Department of Labor & Industries EVERGREEN REFRIGERATION LLC Owner or tradesperson PATTON, RODGER Principals PATTON, RODGER, PARTNER/MEMBER PATTON, MATTHEW, PARTNER/MEMBER Patton, Adam, PARTNER/MEMBER Patton, Douglas, PARTNER/MEMBER EVERGREEN REFRIGERATION LLC, PARTNER/MEMBER PATTON, DAVID, PARTNER/MEMBER (End: 01/21/2014) Doing business as EVERGREEN REFRIGERATION LLC WA UBI No. 602 512 953 727 S KENYON ST SEATTLE, WA 98108 206-763-1744 KING County Business type Limited Liability Company License Verify the contractor's active registration / license / certification (depending on trade) and any past violations. Construction Contractor License specialties GENERAL License no. EVERGRL954R2 Effective — expiration 01/06/2006— 01/06/2016 Bond Merchants Bonding Co (Mutual) Bond account no. WA15097 Active. Meets current requirements. $12,000.00 Received by L&I Effective date 12/15/2011 01 /01 /2012 Bond history Insurance AMERICAN FIRE AND CASUALTY COM $1,000,000.00 Policy no. BAW54192293 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602512953&LIC=EVERGRL954R2&SAW= 05/30/2014