HomeMy WebLinkAboutPP - 13945 53RD AVE S - UNKNOWN - PERMITS AND PLANS13945 53RD AVE S
ASSOCIATED PERMITS
17-5-160 D17-0096
INSPECTION NUMBER
- �3 i
CITY OF TUKWILA FIRE DEPARTMENT
206-575-4407
INSPECTION RECORD
Retain a copy with permit
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PERMIT NUMBERS
Project:
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of Inspection:
Address:
Suite #: /i, YrZ+O
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Contact Person:
Special Instructions:
Occupancy Type:
Phone No.:
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
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Needs Shift Inspection:
Sprinklers:
Fire Alarm:
Hood & Duct:
Monitor:
Pre -Fire:
Permits:
Occupancy Type:
Inspector: /)52,____ Mf 5.5
Date: 104h 7
Hrs.: r, 6
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$100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from
the City of Tukwila Finance Department. Call to schedule a reinspection.
Billing Address
Attn:
Company Name:
Address:
City:
State:
Zip:
Word/Inspection Record Form.Doc
3/14/14
T.F.D. Form F.P. 113
INSPECTION NUMBER
INSPECTION RECORD
Retain a copy with permit
PERMIT NUMBERS
CITY OF TUKWILA FIRE DEPARTMENT
206-575-4407
Project
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Type of Inspection;,
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Address:�
Suite #: 139�'
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Contact Person:
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Special Instructions:
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Phone No.:
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
Sprinklers:
Fire Alarm:
Hood & Duct:
Monitor:
Pre -Fire:
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Needs Shift Inspection:
Sprinklers:
Fire Alarm:
Hood & Duct:
Monitor:
Pre -Fire:
Permits:
Occupancy Type:
Inspector:
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Date: / J23 h X
Hrs.:
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$100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from
the City of Tukwila Finance Department. Call to schedule a reinspection.
Billing Address
Attn:
Company Name:
Address:
City:
State:
Zip.
Word/Inspection Record Form.Doc
3/14/14
T.F.D. Form F.P. 113
INSPECTION NUMBER
INSPECTION RECORD
Retain a copy with permit
P17---610%
PERMIT NUMBERS
CITY OF TUKWILA FIRE DEPARTMENT
206-575-4407
Project: % {ov
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Type of �7'vectiQn:
Address:
Monitor:
Contact Person:
/
Suite #: (,�9
4vE
Special Instructions:
Phone No.:
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
Sprinklers:
Fire Alarm:
Hood & Duct:
Monitor:
Pre -Fire:
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Needs Shift Inspection:
Sprinklers:
Fire Alarm:
Hood & Duct:
Monitor:
Pre -Fire:
Permits:
Occupancy Type:
Inspector:
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Date: 123/i
Hrs.:
f
$100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from
the City of Tukwila Finance Department. Call to schedule a reinspection.
Billing Address
Attn:
Company Name:
Address:
City:
State:
Zip:
Word/Inspection Record Form.Doc
3/14/14
T.F.D. Form F.P. 113
SITE LOCATION
CITY OF TUKWILA
FIRE MARSHAL'S OFFICE
206-575-4407
FIRE PROTECTION SYSTEMS PERMIT APPLICATION
Applications and plans must be complete in order to be accepted for plan review.
**PLEASE PRINT**
King Co. Assessor's Tax No.: 167040-0089-03
Site Address: 13945 53rd AvelK5Suite Number: Floor:
Tenant Name: New Tenant? ❑ - Yes ❑ - No
Property Owner's Name: Cary Lang Construction
Mailing Address: 29815 24th Ave SW
Federal Way
City
WA 98023
State Zip
CONTACT PERSON -if there are questions about the submittal.
Name: Jake Box DayTelephone: p hone:
(307) X51-1701
Company Name: Glacier Fire Protection, LLC
Mailing Address:
E-mail Address:jakeb@glacierfp.com
PO Box 7980
Bonney Lake
City
Fax Number: WA
WA 98391
State Zip
Contractor's City of Tukwila
NICET III number: Business License number: BUS -0998044
Total number of new/relocated devices or sprinkler heads:
Valuation of Project (contractor's bid price): $
Scope of Work (please provide detailed information): Install new NFPA 13D Fire Sprinkler System in new
single family residence
31_ o
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 Fire Marshal to comply with current fee schedules.
Expiration of Plan Review -Every permit issued shall become invalid unless the work on the site authorized by such permit
is commenced within 180 days after its issuance, or if the work authorized on the site by such permit is suspended or
abandoned for a period of 180 days after the time the work is commenced. The Fire Marshal is authorized to grant, in
writing, one or more extensions of time, for periods not more than 180 days each. The extension shall be requested in writing
and justifiable cause demonstrated.
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 OR WASHINGTON, AND I AM AUTHORIZED TO APPLY
FOR THIS PERMIT.
BUILDING OWNER OR AUTHORIZED AGENT:
Jake Box em signed ci; Fire � W. 8/24/2017
Signature: om.:2o,,.oa.�413.05.09 �o Date:
Print Name: Jake Box Day Telephone: (307) 251-1701
Plan Permit App.doc
8/22/14 TFD FP Form 8