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Home My WebLink AboutPermit D17-0010 - T-MOBILE - ROOFTOP CELL SITE MODIFICATIONT-MOBILE 130 ANDOVER PARK E fl17-O010 Parcel No: Address: City of Tukwila 0 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 DEVELOPMENT PERMIT 0223100040 Permit Number: D17-0010 130 ANDOVER PARK E BLDG 1 Project Name: T -MOBILE Issue Date: 1/13/2017 Permit Expires On: 7/12/2017 Owner: Name: PUGET SOUND BLOOD CENTER Address: Contact Person: Name: Address: Contractor: Name: Address: 921 TERRY AVENUE DIRECTOR OF ADMINISTRATION, SEATTLE, WA, 98104 VINH DINH 617 8TH AVE S , SEATTLE, WA, 98104 BROKEN ARROW COMMNCTNS 8316 CORONA LP NE , ALBUQUERQUE, NM, 87113 License No: BROKEAC854QL Lender: Name: T -MOBILE Address: 19807 NORTH CREEK PARKWAY N , BOTHELL, WA, 98011 Phone: (206) 295-5926 Phone: (505) 877-2100 Expiration Date: 12/1/2017 DESCRIPTION OF WORK: MODIFICATION TO ROOFTOP FOR CELL SITE EXPIRED PERMIT D16-0028 Project Valuation: $20,000.00 Type of Fire Protection: Sprinklers: Fire Alarm: Type of Construction: Electrical Service Provided by: TUKWILA Fees Collected: $521.01 Occupancy per IBC: Water District: TUKWILA Sewer District: TUKWILA 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: 2015 2015 2015 2015 2015 National Electrical Code: WA Cities Electrical Code: WAC 296-46B: WA State Energy Code: 2014 2014 2014 2015 Public Works Activities: Channelization/Striping: Curb Cut/Access/Sidewalk: Fire Loop Hydrant: Flood Control Zone: Hauling/Oversize Load: Land Altering: Volumes: Cut: 0 Fill: 0 Landscape Irrigation: Sanitary Side Sewer: Number: 0 Sewer Main Extension: Storm Drainage: Street Use: Water Main Extension: Water Meter: No �A Permit Center Authorized Signature: I42i'l4L1YJ/ Date: I : 11 1 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 a agree to the conditions attached to this permit. Signature: Print Name: Date: 11 /3//7 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: Readily accessible access to roof mounted equipment is required. 5: All construction shall be done in conformance with the Washington State Building Code and the Washington State Energy Code. 6: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of this requirement. 7: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Permit Center. 8: 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. 9: Contact The Tukwila Fire Prevention Bureau to witness all required inspections and tests. (City Ordinances #2436 and #2437) 10: Any overlooked hazardous condition and/or violation of the adopted Fire or Building Codes does not imply approval of such condition or violation. 11: Ensure that the emergency power shut-off switch de -energizes both primary and secondary power and is clearly labeled with a readily visible sign of contrasting background. PERMIT INSPECTIONS REQUIRED Permit Inspection Line: (206) 438-9350 1700 BUILDING FINAL** 1400 FIRE FINAL CITY OF TUKWILA Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Building Permit No. Project No. Date Application Accepted: 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 Site Address: King Co Assessor's Tax No.: 0223100040 130 ANDOVER PARK E, TUKWILA, 98188 Tenant Name: T -Mobile PROPERTY OWNER Name: Vinh Dinh Name: Park East Building Inc. City: Seattle State: WA Zip: 98104 Address: 1501 N 200TH ST Email: vinh.dinh@md7.com City: SHORELINE State: WA Zip: 98133 CONTACT PERSON — person receiving all project communication Name: Vinh Dinh Address: 617 8th Ave. S City: Seattle State: WA Zip: 98104 Phone: (206) 295-5926 Fax: Email: vinh.dinh@md7.com GENERAL CONTRACTOR INFORMATION Company Name: Company Name: PM Design Address: 19807 North Creek Parkway N Architect Name: Maurissa Muha Address: '�" rc, 6� `fin dus-it- ( ti • ..iik-C City: --1.--,, i,r.vJ 1 F l S4ate: �. Zip: °�1 Phone: 20.6 q 20ax: Email: mmuha@pmdginc.com Contr Reg No.: ,---lo C ,x&Date: 12/1)1.� Tukwila Business License No.: l H:WpplicationsWorms-Applications On Line \2011 Applications\Permit Application Revised - 8-9-11.doac Revised: August 2011 bh n1 Suite Number: Floor: New Tenant: 0 Yes m ..No ARCHITECT OF RECORD Name: T -Mobile Company Name: PM Design Address: 19807 North Creek Parkway N Architect Name: Maurissa Muha City: Bothell State: WA Address: 7200 South Alton Way, B-270 City: Centennial State: CO Zip: 80112 Phone: (303) 223-4864 Fax: 778-5536 Email: mmuha@pmdginc.com ENGINEER OF RECORD Name: T -Mobile Company Name: CG Engineering Address: 19807 North Creek Parkway N Engineer Name: Joseph G Galusha City: Bothell State: WA Address: 250 4th Ave. S, Ste 200 City: Edmonds State: WA Zip: 98020 Phone: (425) 778-8500 Fax: (425) 778-5536 Email: LENDER/BOND ISSUED (required for projects $5,000 or greater per RCW 19.27.095) Name: T -Mobile Address: 19807 North Creek Parkway N City: Bothell State: WA Zip: 98011 Page 1 of 4 BUILDING PERMIT INFORMATI(1 — 206-431-3670 Valuation of Project (contractor's bid price): $ 20,000 Describe the scope of work (please provide detailed information): Existing Building Valuation: $ Final inspection for permit! cr #D16-0028. Mocick ca:rcam, Avdovivw. ll Will there be new rack storage? ❑ Yes a ttii--tAY S, -l- LtS Sec ir4r aoP4, Z.. No If yes, a separate permit and plan submittal will be required. Provide All Building Areas in Square Footage Below 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? 0 Yes 0 No If "yes", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ Sprinklers 0 Automatic Fire Alarm 0 None ❑ Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? 0 Yes 0 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. H:\ApplicationsTonns-Applications On Line \2011 Applications\Permit Application Revised - 8-9.11.docx Revised: August 2011 bh Page 2 of 4 Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC 1st Floor 2"11 Floor 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? 0 Yes 0 No If "yes", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ Sprinklers 0 Automatic Fire Alarm 0 None ❑ Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? 0 Yes 0 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. H:\ApplicationsTonns-Applications On Line \2011 Applications\Permit Application Revised - 8-9.11.docx Revised: August 2011 bh Page 2 of 4 PUBLIC WORKS PERMIT INFPRMATION — 206-433-0179 Scope of Work (please provide detailed information): Call before you Dig: 811 Please refer to Public Works Bulletin #1 for fees and estimate sheet. Water District ❑ ...Tukwila ❑ ...Water District #125 ❑ ...Water Availability Provided Sewer District ❑ ...Tukwila 0 ...Sewer Use Certificate 0 .. Highline ❑...Valley View 0 .. Renton ❑...Sewer Availability Provided ❑ .. Renton ❑ .. Seattle Septic System: O 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): 0 ...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 0 Non Right-of-way 0 ❑ ...Total Cut ❑ ...Total Fill cubic yards cubic yards ❑ .. 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 ❑ ...Sanitary Side Sewer 0 .. Abandon Septic Tank ❑ .. Grease Interceptor ❑ ...Cap or Remove Utilities 0 .. Curb Cut 0 .. Channelization 0 ...Frontage Improvements 0 .. Pavement Cut ❑ .. Trench Excavation ❑ ...Traffic Control 0 .. Looped Fire Line 0 .. Utility Undergrounding ❑ ...Backflow Prevention Fire Protection Irrigation Domestic Water ❑ ...Permanent Water Meter Size... WO # ❑ ...Temporary Water Meter Size.. WO # ❑ ...Water Only Meter Size WO # ❑...Deduct Water Meter Size ❑ ...Sewer Main Extension Public 0 Private ❑ ❑ ...Water Main Extension Public 0 Private 0 FINANCE INFORMATION Fire Line Size at Property Line Number of Public Fire Hydrant(s) ❑ ...Water 0 ...Sewer 0 ...Sewage Treatment Monthly Service Billing to: Name: Day Telephone: Mailing Address: Water Meter Refund/Billing: Name: Mailing Address: City State Zip Day Telephone: City State Zip H:Vtpplications\Forms-Applications On Line \2011 ApplicationsWennit 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 OWNER R A HOP ZEA(FENT: Signature: Date: 01/4/2017 Print Name: Vinh Dinh Day Telephone: (206) 295-5926 Mailing Address: 9725 3rd Ave. NE, Suite 410 H:WpplicationsWorms-Applications On Line 12011 Applications\Permit Application Revised - 8-9.11.docx Revised: August 2011 bh Seattle WA 98115 City State Zip Page 4 of 4 Cash Register Receipt City of Tukwila DESCRIPTIONS I ACCOUNT I QUANTITY I PermitTRAK PAID $521.01 D17-0010 Address: 130 ANDOVER PARK E BLDG 1 Apn: 0223100040 $521.01 DEVELOPMENT $496.41 PERMIT FEE R000.322.100.00.00 0.00 $491.91 WASHINGTON STATE SURCHARGE B640.237.114 0.00 $4.50 TECHNOLOGY FEE $24.60 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R10429 R000.322.900.04.00 0.00 $24.60 $521.01 Date Paid: Friday, January 13, 2017 Paid By: T -MOBILE Pay Method: CHECK 3449257 Printed: Friday, January 13, 2017 2:33 PM 1 of 1 CirlaWSYSTEMS 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) 438-9350 jet ?--ooICS Project: T/1146V Z— ' Type of inspection: eV/LP/A6 f/ i'tL Address: /30 D 4 ' eek Is, Date Called: Special Instructions:/ Date �, Wanted: 3-30-17 �rn; p.m. Requester: Phone No: NApproved per applicable codes. Corrections required prior to approval. COMMENTS: Inspector: Date /7 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) 438-9350 bI 7-D010 Project: 7=/Jfo5/LA" Type of inspection: 88/Bt.-D//Y - f)NN4 L /(/i Address: /3t ADO44ie /%/< E. Date Called: /UGS SpecialInstructions:.L.P67 ` / OP/fifrCyy'7,0/✓ PD ROOrTAP (/)/- 1":11i/ ./1L4.- S/TE.) 4A/ORAW 1:474–R-2 511/ Date Wanted: �.-4./7 a.m. p.m. Requester: Phone No: ,..53-6.77-1907? Approved per applicable codes. Corrections required prior to approval. COMMENTS: /(/i ,C S 1�Oj@ // Y s picerio 1" /UGS 44/3-w.e, Rfit144' //l' n8iW f.- ,7� Inspector: Date: REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedute reinspection. BROKEN ARROW COMMNCTNO1C Mame Espanol Contact Safety & Health Claims & Insurance 0 Washington State Department of Labor & Industries Search L&I Page 1 of 2 A -Z Index Flelp My LH Workplace Rights Trades & Licensing BROKEN ARROW COMMNCTNS INC Owner or tradesperson Principals CALHOUN, RYAN P, PRESIDENT DENTON, ROBERT N, SECRETARY Doing business as BROKEN ARROW COMMNCTNS INC WA UBI No. 602 667 807 8316 CORONA LP NE ALBUQUERQUE, NM 87113 505-877-2100 Business type Corporation Governing persons ROBERT DENTON RYAN CALHOUN; License Verify the contractor's active registration / license / certification (depending on trade) and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. BROKEAC854QL Effective — expiration 12/01/2015-12/01/2017 Bond ................. Western Surety Co Bond account no. 929623895 $12,000.00 Received by L&I Effective date 11/09/2015 10/29/2015 Expiration date Until Canceled Insurance ... ..................... Old Republic Ins Co $1,000,000.00 Policy no. AICG08501602 Received by L&I Effective date 08/09/2016 08/15/2016 Expiration date 08/15/2017 Insurance history Savings No savings accounts during the previous 6 year period. Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602667807&LIC=BROKEAC854QL&SAW= 1/13/2017