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Home My WebLink AboutPermit EL12-0976 - H & R BLOCKThis record contains information which is exempt from public disclosure pursuant to the Washington State Public Records Act, Chapter 42.56 RCW as identified on the Digital Records Exemption Log shown below. EL12 -0976 H & R Block 652 Strander Boulevard RECORDS DIGITAL D- ) EXEMPTION LOG THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION F,age # Code Exemption � � �� Brief Explsnatoty Description, Statute /Rule The Privacy Act of 1974 evinces Congress' intent that Personal Information — social security numbers are a private concern. As such, individuals' social security numbers are Social Security Numbers redacted to protect those individuals' privacy pursuant 5 U.S.C. sec. DR1 Generally — 5 U.S.C. sec. to 5 U.S.C. sec. 552(a), and are also exempt from 552(a); RCW 552(a); RCW disclosure under section 42.56.070(1) of the 42.56.070(1) 42.56.070(1) Washington State Public Records Act, which exempts under the PRA records or information exempt or prohibited from disclosure under any other statute. Redactions contain Credit card numbers, debit card Personal Information — numbers, electronic check numbers, credit expiration 11 DR2 Financial Information — dates, or bank or other financial account numbers, RCW RCW 42.56.230(4 5) which are exempt from disclosure pursuant to RCW 42.56.230(5) 42.56.230(5), except when disclosure is expressly required by or governed by other law. H & R BLOCK 652 STRANDER BL EXPIRED 10-25-13 EL12-0976 Parcel No.: Address: City ofitukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: http: / /www.TukwilaWA.gov 0005800037 652 STRANDER BL TUKW Project Name: H & R BLOCK ELECTRICAL PERMIT Permit Number: Issue Date: Permit Expires On: EL12 -0976 10/31/2012 04/29/2013 Owner: Name: Address: Contact Person: Name: Address: BC PARTNERS LLC C/O MK PROPERTY SVC LLC , PO BOX 997 98065 CLIFF MIHM 5209 122 ST E , TACOMA WA, 98446 Contractor: Name: CULBERTSON SIGN SERVICE LLC Address: 5209 122ND ST E , TACOMA 98446 Contractor License No: CULBESS984MU Phone: 253 538 -0752 Phone: 800 925 -6011 Expiration Date: 08/30/2014 DESCRIPTION OF WORK: HOOK UP SIGN TO EXISTING ELECTRICAL CIRCUIT Value of Electrical: NRES: $180.00 RES: $0.00 Type of Fire Protection: UNKNOWN Electrical service provided by: PUGET SOUND ENERGY � Permit Center Authorized Signature: I hereby certify that I have read and governing this work will be complie Fees Collected: National Electrical Code Edition: $63.00 2008 Date: lOM I� ed this permit and know the same to be true and correct. All provisions of law and ordinances whether specified herein or not. The granting of this permit does not pr e 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 electrical permit. Signature: *Am Date: Print Name: C y\ _ -vl/l t H vY\ This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection. doc: EL -4/10 EL12 -0976 Printed: 10 -31 -2012 PERMIT CONDITIONS • Permit No. EL12 -0976 * *ELECTRICAL ** 1: A copy of the electrical work permit shall be posted or otherwise made readily accessible to the Electrical Inspector at each work site. 2: Approved plans shall be maintained at the construction site and shall be readily available to the Electrical Inspector. 3: All electrical work shall be in accordance with NFPA 70 - NEC, and requirements for electrical installations, Chapter 296 -46B WAC. 4: When any portion of the electrical installation is to be hidden from view by permanent placement of parts of the building, such equipment shall not be concealed until it has been inspected and approved by the Electrical Inspector. 5: The issuance of an electrical work permit shall not be construed to be a permit for, or an approval of, any violation of the provisions of the electrical code or other ordinances of the jurisdiction. Permits or related documentation that presumes to grant this authority are therefore not valid. 6: Any change in the scope of work described by the electrical work permit shall require additional work permits. Where approved plans have been issued, revisions to the plans and additional review may be required. doc: EL -4/10 EL12 -0976 Printed: 10 -31 -2012 CITY OF TO( L Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 htto://www.ci.tukwila.wa.us Electrical Permit No. L\QC 11-( Project No. (For office use only) ELECTRICAL 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.: 0005-8.000.37 Site Address: 652, 4TQloo..S -Z `j�1..�i17.i"rC?r>JILA \ jk. Tenant Name: ( 4g 1'L.004 Property Owners Name: Mailing Address: Suite Number: New Tenant: Floor: Yes ❑..No City State Zip CONTACT PERSON - Who do we contact when your permit is ready to be issued Name: CLEF moon Mailing Address: CZOCC ( 4T C E -Mail Address: CLI it 1 0 M I H ('V\ @ (-VA A-IL. 0 VIA Day Telephone: (Z573) f -075 2- T( -Com A 1k/A ?S.141( City State Zip Fax Number: (23)g- - 077 g' ELECTRICAL CONTRACTOR INFORMATION Company Name: W IZQC130...) 61(.10 c, c=r<VI CE.: Mailing Address: S% O-1 (L 2 ST: Contact Person: eurr im NYI'1 TACOMA E -Mail Address: C LITE, ("M I I-I 1aw C-knA■ L_e co w\ Contractor Registration Number: CULTS c'H mt.) City Day Telephone: (2 S3 .'i?, // g -07 S 2- Fax Number: ( 2 c3 5'3g ^ d `7 7 g Expiration Date: V ?&(o State Zip Valuation of Project (contractor's bid price): $ 1 SO Scope of Work (please provide detailed information): (- ((j&(( OP 5(C'f4J 17) f ST(k.96 (--E T (C(4 Will service be altered? ❑ Yes [ "No Adding more than 50 amps? ❑ Yes [ No Type of Use: Type of work: ❑ New ❑ Addition ❑ Service Change ❑ Remodel [l/ Tenant Improvement dLow Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service Property Served by: IA' Puget Sound Energy ❑ Seattle City Light H:\Applications \Forms - Applications On Line\2010 Applications \7 -2010 - Electrical Permit Application.doc bh Page 1 of 2 RESIDENTIAL NEW RESIDENTIAL SERVICE ❑ New single family dwellings $152.85 (including an attached garage) ❑ Garages, pools, spas and outbuildings $81.90 ea ❑ Low voltage systems (alarm, furnace thermostat) $59.85 ea RESIDENTIAL REMODEL AND SERVICE CHANGES ❑ Service change or alteration $81.90 (no added/altered circuits) ❑ Service change with added /altered circuits $81.90 number of added circuits $11.55 ea ❑ Circuits added/altered without service change $54.60 (up to 5 circuits) ❑ Circuits added/altered without service change $54.60 (6 or more circuits) $7.65 ea ❑ Meter /mast repair $68.25 ❑ Low voltage systems $59.85 (alarm, furnace thermostat) MULTI - FAMILY AND COMMERCIAL Fees are based on the valuation of the electrical contract. MISCELLANEOUS FEES ❑ Temporary service (residential) $63.00 ❑ Temporary service (generator) $78.75 ❑ Manufactured/mobile home service $84.00 (excluding garage or outbuilding) ❑ Carnivals $78.75 Number of concessions $10.50 ea 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 90 days. 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 OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNER OR ELEC iICAL CONTRACTOR: Signature: Print Name: Mailing Address: Sri tv0 lnn y\A I El W\ Date: /e /i /z % Z. Day Telephone: (0 -53 535-07 52, P_: iu A • Date Application Accepted: City State ,r Zip Date Application Expires: Staff Initials: H:\Applications \Forms - Applications On Line\2010 Applications \7 -2010 - Electrical Permit Application.doc bh Page 2 of 2 1 City of Tu lar Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 -431 -3665 Web site: hag,: Mvww. ci. Tukwila. wa. us SET RECEIPT • Copy Reprinted on 10 -31 -2012 at 11:04:37 10/31/2012 RECEIPT NO: R12 -02858 Initials: JEM User ID: 1165 Payee: CULBERTSON SIGNS SERVICE, LLC Payment Date: 10/15/2012 Total Payment: 507.00 SET ID: S000001809 SET NAME: Temporary Set SET TRANSACTIONS: Set Member EL12 -0976 S12 -075 S12 -076 TOTAL: Amount 63.00 222.00 222.00 63.00 TRANSACTION LIST: Type Method Description Amount Payment Check 12388 507.00 TOTAL: 507.00 ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.0 SIGN PERMIT 000.322.100 63.00 444.00 TOTAL: 507.00 09 -03 -2013 CLIFF MIHM 5209 122 ST E TACOMA WA 98446 • City of Tukwila Jim Hag erton. Mayor Department of Community Development Jack- Pace, Director RE: Permit No. EL12 -0976 H & R BLOCK 652 STRANDER BL TUKW Dear Permit Holder: 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 10/25/2013. Based on the above, you are hereby advised to: 1) Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 to schedule for the next or fmal 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 10/25/2013, 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, Bill Rambo Permit Technician File: Permit File No. EL12 -0976 6300 Southcenier Boulevard, Suite 14100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 y.. City of Tukwila April 3, 2013 Jim Haggerton, Mayor Department of Community Development Jack Pace, Director Cliff Mihm Culberton Sign Service 5209 122 Street E Tacoma, WA 98446 -4905 RE: Request for Extension Electrical Permit Number EL12 -0976 H & R Block — 652 Strander Bl Dear Mr. Mihm, This letter is in response to your written request for an extension to Permit Number EL12 -0976. The Building Official has reviewed your letter and considered your request to extend the above referenced permit. The City of Tukwila Building Division will be extending your permit an additional 180 days from the date of expiration, through October 25, 2013. If you should have any questions, please contact our office at (206) 431 -3670. Sincerely, fer Marshall t Technician File: Permit No. EL12 -0976 W: (Permit CenterlExtension Letters1Permits120121EL12 -0976 Permit E.rtension.docx 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone 206 - 431 -3670 • Fax 206 - 431 -3665 A DIVISION OF CUTAERESON SIGN SERVICE. L.L.C. 1U UC 0 CULNSSTMMU 03 -13 -2012 Jennifer Marshall 6300 Southcenter Blvd. Suite # 100 Tukwila WA 98188 RE: Permit No. ELI 2 -0976 H & R Block 652 Strander Blvd. Tukwila WA Dear Jennifer: YOUR FULL, SERVICE SIGN PROFESSIONALS 5209 - I 22nd Street E. Tacoma. WA 98446 -4905 culbertsonsignservice @comcast.net 800 - 925 -6011 OFFICE 253 -538 -0752 FAX 253 -538 -0778 We received notification from you regarding Permit # ELI2 -0976 for wall signs at the H & R Block located at the above address. The notification was that the permit will expire on 04/29/2013. In the notification, it was noted that we could apply for a permit extension and that is what we are requesting at this time. The reason for the delay is that the order for the sign that the customer placed a while ago has not been filled by the company that produces the H & R Block sign and therefore has not shipped to us for the installation. The customer has made inquiry into this matter and has been assured that the signs will ship as soon as production has been completed. Once we receive them, we will facilitate the installation. The customer has not been able to tell us what the anticipated ship date for their signs will be so with that in mind, we are requesting that said permit be extended for the additional 180 days. Please let me know when /if this extension is granted or if there are any additional fees associated with this process. Thankyou for your time in this matter. Sincerely, Cliff Mihm Culbertson Sign Service. ef,•,(4.5 /0-/a/5 7 017;03 cmik 03 -05 -2013 CLIFF MIHM 5209 122 ST E TACOMA WA 98446 • Jrzi..Hdggetton;:. )epizrtrrient of Community ,Development Jack Pace, Director RE: Permit No. EL12 -0976 H & R BLOCK 652 STRANDER BL TUKW Dear Permit Holder: 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 04/29/2013. Based on the above, you are hereby advised to: 1) Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 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 04/29/2013, 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, Marshall echnician File: Permit File No. EL12 -0976 6300'Southcehter Boulevard Surte #L.o6.• Tukwil0, Gi�ashmgt n y81.88 Phone 26 431 -3676 • Fczx 206 431 3665 Contractors or Tradespeople Prin er Friendly Page 1 Electrical Contractor A business licensed by Lai to contract electrical work within the scope of its specialty. Electrical Contractors must maintain a surety bond or assignment of savings account. They also must have a designated Electrical Administrator or Master Electrician who is a member of the firm or a full -time supervisory employee. Business and Licensing Information Name Phone Address Suite /Apt. City State Zip County Business Type Parent Company CULBERTSON SIGN SERVICE LLC 2535380752 5209 122Nd St E Tacoma WA 98446 Pierce Limited Liability Company UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 602043276 Active CULBESS984MU Electrical Contractor 8/30/2002 8/30/2014 Sign Unused Other Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status CULBESSO42N2 CULBERTSON SIGN SERVICE Electrical Contractor Sign Unused 8/22/1996 8/22/2002 Archived Master Electrician INFORMATION License CULBEP'979QL Name CULBERTSON, PAUL Status Active Business Owner Information Name Role Effective Date Expiration Date CULBERTSON, PAUL Partner /Member 07/31/2002 2/3/2010 CULBERTSON, PAUL JR Partner /Member 07/31 /2002 $250.00 Bond Information No records found for the previous 6 year period Assignment of Savings Information Page 1 of 1 Savings Assignment of Savings Account Number Effective Date Release Date Assignment Type Impaired Date Amount Received Date 1 8/30/2002 Until Released Bond $4,000.00 8/30/2002 Insurance Information No records found for the previous 6 year period Summons /Complaint Information Summons and Complaints are not filed with the department for this contractor type Warrant Information Warrants are not filed with the department for this contractor type Infractions /Citations Information Infraction / Citation Date RCW Code Type Status Violation Amount ECAM000267 2/3/2010 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 EALEJ00261 7/16/2012 19.28.101 RCW ELECTRICAL CITATION Satisfied $2,000.00 ELEIS00416 2/1/2011 19.28.101 RCW ELECTRICAL CITATION Satisfied $1,000.00 EOXFJ00292 2/19/2010 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 https: // fortress .wa.gov /lni/bbip /Print.aspx 10/31/2012