HomeMy WebLinkAboutPermit M15-0128 - BILLINGSLEY RESIDENCE - GAS FURNACE REPLACEMENTBILLINGSLEY RESIDENCE
14731 S9 AVE S
EXPIRED
04/02/16
M15-0128
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.eov
8687800139
14731 59TH AVE S
MECHANICAL OTC PERMIT
Project Name: BILLINGSLEY RESIDENCE
Permit Number:
Issue Date:
Permit Expires On:
M15-0128
10/5/2015
4/2/2016
Owner:
Name:
Address:
Contact Person:
Name:
BILLINGSLEY BYRON+TERESA
14731 59TH AVE S , TUKWILA, WA,
98168
KATRINA SIMONSON
Address: 1813185 ST E , BONNEY LAKE, WA,
98391
Contractor:
Name: GREEN CITY HTG & A/C INC
Address: 18131 85 ST E , BONNEY LAKE, WA,
98391
License No: GREENCH866B2
Lender:
Name:
Address:
1//
Phone: (206) 227-6616
Phone: (206) 227-6616
Expiration Date: 1/22/2016
DESCRIPTION OF WORK:
REPLACE GAS FURNACE, LENNOX 70,000 BTU'S
Valuation of Work: $6,000.00
Type of Work: REPLACEMENT
Fuel type: GAS
Fees Collected: $219.71
Electrical Service Provided by: PUGET SOUND ENERGY
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:
International Fuel Gas Code:
Permit Center Authorized Signature:
2012
2012
2012
2012
2012
National Electrical Code:
WA Cities Electrical Code:
WAC 296-46B:
WA State Energy Code:
LoA
2014
2014
2014
2012
Date: I���
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 p
state or local laws reg
development • ermit an
Signature:
Print Name:
lating c
agr
es not presume to give authority to violate or cancel the provisions of any other
erformance of work. I am authorized to sign and obtain this
tached to this permit.
ion or th
the conditions a
Date:
This permit shall become null . d oid 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: ***MECHANICAL PERMIT CONDITIONS***
2: All mechanical work shall be inspected and approved under a separate permit issued by the City of Tukwila
Permit Center (206/431-3670).
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: Manufacturers installation instructions shall be available on the job site at the time of inspection.
5: Except for direct -vent appliances that obtain all combustion air directly from the outdoors; fuel -fired
appliances shall not be located in, or obtain combustion air from, any of the following rooms or spaces:
Sleeping rooms, bathrooms, toilet rooms, storage closets, surgical rooms.
6: Equipment and appliances having an ignition source and located in hazardous locations and public garages,
PRIVATE GARAGES, repair garages, automotive motor -fuel dispensing facilities and parking garages shall be
elevated such that the source of ignition is not less than 18 inches above the floor surface on which the
equipment or appliance rests.
7: Type 1 Hoods, the required grease duct leakage test and (light test shall be performed by a special
inspection and testing agency in accordance with I.M.C. Chapter 5.
PERMIT INSPECTIONS REQUIRED
Permit Inspection Line: (206) 438-9350
1800 MECHANICAL FINAL
0701 ROUGH -IN MECHANICAL
CITY OF TUKWl
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
Mechanical Permit No. V (S' V 12-g
Project No.
Date Application Accepted:
Date Application Expires:
(For office use only)
MECHANICAL 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
Site Address: 41. ► 5 G A V e- 5.
King Co Assessor's Tax No.: O (n 81 g O0 I 3q
Suite Number:
Floor:
Tenant Name: M eUQG'i1 11 1 r\BS► e y New Tenant: ❑ Yes ZP.No
PROPERTY OWNER
Name:
meOr G...r ?;\\tr\aS1C'\r
Address: IL 2 1 - 5°1"t` S •
City: t u, V. L.01 \ O. State:1.0 A
Zip: Qs. (lfl$
CONTACT PERSON - person receiving all project
communication
Name440 0..,
Address•
� - k C.tc.-E•o (2 -
City: State:
Zip:
Phone: ZOlo • 2.27 - t-oU 6 Fax:
Email:
0 rc cr\c t by ac. P a
c.A , 1. c e rv\_,.
MECHANICAL CONTRACTOR INFORMATION
Company Name:rcer\ c1- Hy pc
Address: Ig ►.I . cg5-b S..r. E
Cityht'C\j i Q 1! e State: W A Zipgg3G
Phone:2010 . 22'1- to 6 t lv Fax:
Contr Reg No.: Exp Date:
REFNCi-1861067- 1 /22/1to
Tukwila Business License No •
'PUS oci9 to 399
Valuation of project (contractor's bid price): $ A1° t O CIDC_X7
Describe the scope of work in detail:
Use: Residential: New
Commercial: New
Fuel Type: Electric ❑
Gas
LQrrC - -10 I - %.1-VS C .
Replacement
Replacement ❑
Other:
H:\Applications\Forms-Applications On Linc\2011 Applications\Mechanical Permit Application Revised 8-9-11.docx
Revised: August 2011
bh
Page 1 of 2
Indicate type of mechanical work being installed and the quantity below:
Unit Type
Qty
Furnace <100k btu
1
Furnace > 100k btu
`l
Floor furnace
Suspended/wall/floor
mounted heater
Appliance vent
Repair or addition to
heat/refrig/cooling
system
Air handling unit
<10,000 cfm
Unit Type
Qty
Air handling unit
>10,000 cfm
Evaporator cooler
Ventilation fan
connected to single duct
Ventilation system
Hood and duct
Incinerator — domestic
Incinerator —
comm/industrial
Unit Type
Qty
Fire damper
Diffuser
Thermostat
Wood/gas stove
Emergency generator
Other mechanical
e�
equipment
¢,
.U6143 1
-u\- r0.C.e d. 4 G11 IC \c ss loci-tr kca-k r.
Gas pi p ‘ kin ± b o-4-11 m
Boiler/Compressor
Qty
0-3 hp/100,000 btu
3-15 hp/500,000 btu
15-30 hp/1,000,000 btu
30-50 hp/1,750,000 btu
50+ hp/l ,750,000 btu
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 additional periods not to exceed 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 OW
Signa
Print Nam
R AUTHORIZED AGENT:
Date: g a2 I // 5"
t v• C4 vv or S oh Day Telephone: Z O Ia - Z Zi - (p (p / (o
Mailing Address: CI y $ - 111d .&s
�, wtla w 98!f8
City State Zip
•
H:\Applications\Forms-Applications On Line\2011 Applications\Mc hanical Permit Application Revised 8-9-11.docx
Rcviscd: August 2011
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Page 2 of 2
Cash Register Receipt
City of Tukwila
Receipt Number
R6336
DESCRIPTIONS ACCOUNT QUANTITY PAID
PermitTRAK $439.16
M15-0128 Address: 14731 59TH AVE 5 Apn: 8687800139 $219.71
MECHANICAL $209.25
PERMIT FEE
R000.322.100.00.00
0.00
$176.75
PERMIT ISSUANCE BASE FEE
R000.322.100.00.00
0.00
$32.50
TECHNOLOGY FEE $10.46
TECHNOLOGY FEE
R000.322.900.04.00
0.00
$10.46
PG15-0119 Address: 14731 59TH AVE 5 Apn: 8687800139 $219.45
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
PLUMBING $111.50
PERMIT ISSUANCE BASE FEE
R000.322.100.00.00
0.00
$32.50
PERMIT FEE
R000.322.100.00.00
0.00
$79.00
TECHNOLOGY FEE $10.45
TECHNOLOGY FEE
TOTAL FEES PAID BY RECEIPT: R6336
R000.322.900.04.00
0.00 $10.45
$439.16
Date Paid: Monday, October 05, 2015
Paid By: GREEN CITY HTG & A/C INC
Pay Method: CHECK 5939
Printed: Monday, October 05, 2015 11:39 AM 1 of 1
CiriSYSTEMS
City of Tukwila
Department of Community Development
3/1/2016
KATRINA SIMONSON
18131 85 ST E
BONNEY LAKE, WA 98391
RE: Permit No. M15-0128
BILLINGSLEY RESIDENCE
14731 59 AVE S
Dear Permit Holder:
Allan Ekberg, 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 4/2/2016.
Based on the above, you are hereby advised to:
1) Call the City of Tukwila Inspection Request Line at 206-438-9350 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 4/2/2016, 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,
q,a)
Bill Rambo
Permit Technician
File No: M15-0128
6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665
Green City HTG & A/C INC
Page 1 of 3
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0 Washington State Department of
Labor & Industries
Green City HTG & A/C INC
Owner or tradesperson
Principals
Simonson„ Jeffrey Orvold, PRESIDENT
Simonson, Katrina Marie, SECRETARY
Doing business as
Green City HTG & A/C INC
WA UBI No.
603 363 739
18131 85th St E
BONNEY LAKE, WA98391
206-227-6616
PIERCE County
Business type
Corporation
License
Verify the contractor's active registration / license / certification (depending on trade) and any past violations.
Construction Contractor
License specialties
Heating/Vent/Air-Conditioning and Refrig
(HVAC/R)
License no.
GREENCH866B2
Effective — expiration
01/22/2014— 01/22/2016
Bond
................
American Contractors Indem CO
Bond account no.
100180935
Active.
Meets current requirements.
$6,000.00
Received by L&I Effective date
01/22/2014 01/22/2014
Expiration date
Until Canceled
Insurance
.........................
Developers Surety & Indem Co
Policy no.
BIS00012057-04
$1,000,000.00
Received by L&I Effective date
11/24/2014 11/18/2014
Expiration date
11/18/2015
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.
https://secure.lni.wa.gov/verify/Detail.aspx?UBI=603363739&LIC=GREENCH866B2&SAW= 10/5/2015