HomeMy WebLinkAboutPermit EL17-0876 - LIDS - ILLUMINATED SIGNSThis 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.
EL17-0876
LIDS
990 SOUTHCENTER MALL
RECORDSDIGITAL
D-) EXEMPTION LOG
THE ABOVE MENTIONED PERMIT FILE INCLUDES
THE FOLLOWING REDACTED INFORMATION
Pae # Code Exem floe ,
Bdef x lanat6 Descd floe', statute/Rulle
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concern. As such, individuals' social security
Personal Information —
numbers are redacted to protect those
Social Security Numbers
individuals' privacy pursuant to 5 U.S.C. sec.
5 U.S.C. sec.
DR1
Generally — 5 U.S.C. sec.
552(a), and are also exempt from disclosure
552(a); RCW
552(a); RCW
under section 42.56.070(1) of the Washington
42.56.070(1)
42.56.070(1)
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 numbers, electronic check numbers, credit
Personal Information —
expiration dates, or bank or other financial
RCW
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DR2
Financial Information —
account numbers, which are exempt from
42.56.230(5)
RCW 42.56.230(4 5)
disclosure pursuant to RCW 42.56.230(5),
except when disclosure is expressly required by
or governed by other law.
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DR3
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& c)
7a & c
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Redacted content contains a communication
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RCW
42.56.070(1)
communications, and RCW 42.56.070(1), which
42.56.070(1)
protects, under the PRA, information exempt or
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LIDS
990 SOUTHCENTER MALL
ELI 7-0876
Parcel No:
Address:
C
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
ELECTRICAL OTC PERMIT
9202470010
990 SOUTHCENTER MALL
Project Name: LIDS
Permit Number: EL17-0876
Issue Date:
Permit Expires On:
11/3/2017
5/2/2018
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
License No:
Lender:
Name:
Address:
WESTFIELD PROPERTY TAX DEPT
PO BOX 130940 , CARLSBAD, WA,
92013
HANS VISSER
5209 122ND ST E , TACOMA, WA,
98446
CULBERTSON SIGN SERVICE LLC
5209 122ND ST E , TACOMA, WA,
98446
CULBESS984MU
Phone: (253) 538-0752
Phone: (800) 925-6011
Expiration Date:
DESCRIPTION OF WORK:
INSTALL TWO INTERNALLY ILLUMINATED SIGNS ONTO THE MALL TENANT'S MAIN (MALL -FACING) FACADE
Valuation of single family: $0.00
Valuation of mf/comm: $300.00
Type of Work: TENANT IMP
Fees Collected: $74.22
Electrical Service Provided by: PUGEST SOUND ENERGY
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:
Permit Center Authorized Signature:
2015
2015
2015
2015
2015
National Electrical Code:
WA Cities Electrical Code:
WAC 296-46B:
WA State Energy Code:
LYAA ---P
2014
2014
2014
2015
Date:
O
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: jGad �,�r dd/' Date: 201
Print Name: 1 -/Ai S 1S5 /,
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: ***ELECTRICAL PERMIT CONDITIONS***
2: A copy of the electrical work permit shall be posted or otherwise made readily accessible to the Electrical
Inspector at each work site.
3: Approved plans shall be maintained at the construction site and shall be readily available to the Electrical
Inspector.
4: All electrical work shall be in accordance with NFPA 70 - NEC, and requirements for electrical installations,
Chapter 296-46B WAC.
5: 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.
6: 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.
7: 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.
PERMIT INSPECTIONS REQUIRED
Permit Inspection Line: (206) 438-9350
2100 ELECTRICAL FINAL
7003 ROUGH -IN ELECTRICAL
7002 SERVICE
7001 UNDERGROUND/SLAB
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd, Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
Electrical Permit No. L -1--I '7 0 U 1 Y
Project No.
Date Application Accepted:
Date Application Expires:
(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
q c?
Site Address: )8416 Southcenter Mall
Tenant Name: Lids
PROPERTY OWNER
Name: WESTFIELD PROPERTY TAX DEPT
Address: PO BOX 130940
City: CARLSBAD State: CA Zip: 92013
CONTACT PERSON — person receiving all project
communication
Name: Hans Visser
Address: 5209 122nd St E
Address: 5209 122nd St E
Phone: (253) 538-0752 Fax: (253) 538-0778
City: Tacoma State: WA
Zip: 98446
Phone: (253) 538-0752 Fax: (253)
538-0778
Email: csspermits@gmail.com
King Co Assessor's Tax No.: 9202470010
Suite Number: 446 Floor: 1
New Tenant: ❑ Yes ®..No
ELECTRICAL CONTRACTOR INFORMATION
Company Name: Culbertson Sign Service
Address: 5209 122nd St E
City: Tacoma State: WA Zip: 98446
Phone: (253) 538-0752 Fax: (253) 538-0778
Contr Reg No.: CULBESS984Maxp Date: 08/30/2018
Tukwila Business License No.; BUS -0993893
Valuation of Project (contractor's bid price): $ 300
Scope of Work (please provide detailed information): Install two internally -illuminated signs onto the mall tenant's
main (mall -facing) facade.
Will service be altered? ❑ Yes m No
Adding more than 50 amps? ❑ Yes No
Type of Use: Internally illuminated sign
Type of work:
❑ New ❑ Addition ❑ Service Change ❑ Remodel ❑ Tenant Improvement
❑ Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service
Property Served by:
❑ Puget Sound Energy ❑ Seattle City Light
W:U'ermit Center\Applications-Handouts\Permit Applications\PDF's\Electrical Permit Application Revised 1-1-17.docx
Revised: January 2017
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Page 1 of 2
RESIDENTIAL
NEW RESIDENTIAL SERVICE
❑ New single family dwellings $155.91
(including an attached garage)
❑ Garages, pools, spas and outbuildings $83.54 ea
❑ Low voltage systems
(alarm, furnace thermostat) $61.05 ea
RESIDENTIAL REMODEL AND SERVICE CHANGES
❑ Service change or alteration $83.54
(no added/altered circuits)
❑ Service change with added/altered circuits $83.54
number of added circuits $12.00 ea
❑ Circuits added/altered without service change $55.69
(up to 5 circuits)
❑ Circuits added/altered without service change $55.69
(6 or more circuits) $7.65 ea
❑ Meter/mast repair $69.62
❑ Low voltage systems $61.05
(alarm, furnace thermostat)
MULTI -FAMILY AND COMMERCIAL
Fees are based on the valuation of the electrical contract.
MISCELLANEOUS FEES
❑ Temporary service (residential) $66.30
❑ Temporary service (generator) $82.52
❑ Manufactured/mobile home service $87.98
(excluding garage or outbuilding)
❑ Carnivals $82.21
Number of concessions $11.02 ea
Each ride and generator truck $11.02 ea
***EFFECTIVE JANUARY 1, 2014 EACH
PERMIT WILL BE ASSESSED A 5%
TECHNOLOGY FEE***
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 ELECTRICAL CONTRACTOR:
Signature:
Date:
11/03/2017
Print Name: Hans Visser Day Telephone: (253) 538-0752
Mailing Address: 5209 122nd St E Tacoma WA 98446
City State Zip
W:\Permit Center\Applications-rlandouts\Permit Applications \PDF's\Electrical Permit Application Revised 1-1-17.docx
Revised: January 2017
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Page 2 of 2
Cash Register Receipt
City of Tukwila
DESCRIPTIONS
ACCOUNT
QUANTITY
PAID
PermitTRAK
$74.22
EL17-0876 Address: 990 SOUTHCENTER'MALL Apn: 9202470010
$74.22
ELECTRICAL
$70.69
PERMIT FEE MULTI-FAM/COMM
R000.322.101.00.00
0.00
$70.69
TECHNOLOGY FEE
$3.53
TECHNOLOGY FEE
R000.322.900.04.00
0.00
$3.53
TOTAL FEES PAID BY RECEIPT: R12720
$74.22
Date Paid: Friday, November 03, 2017
Paid By: CULBERTSON SIGN SERVICE LLC
Pay Method: CHECK 13121
Printed: Friday, November 03, 2017 11:30 AM 1 of 1
CriWSYSTEMS
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO..
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188
Permit Inspection Request Line (206) 438-9350
(206) 431-3
Project: Z-05
Type of Inspection:
hof
Address:
frlitt-
Date Called:
Special Inst?To ons:
�
514 )
Date Wanted:
t' Zpp
`
m.
Requester:
Phone No:
;Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
L
61-
E411(\
REINSPECTION EE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Sou hcenter Blvd., Suite 100. Call to schedule reinspection.
w7q
CULBERTSON SIGN SERVICE I
tt
Home Espanol Contact.
Page 1 of 2
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• Washington State Department of
l% Labor & Industries
CULBERTSON SIGN SERVICE LLC
Owner or tradesperson
Principals
CULBERTSON, PAUL, PARTNER/MEMBER
CULBERTSON, PAUL
JR, PARTNER/MEMBER
Doing business as
CULBERTSON SIGN SERVICE LLC
WA UBI No.
602 043 276
5209 122ND ST E
TACOMA, WA 98446
253-538-0752
PIERCE County
Business type
Limited Liability Company
Governing persons
PAUL
E JR
CULBERTSON
PAUL E SR CULBERTSON;
License
Verify the contractor's active registration / license / certification (depending on trade) and any past violations.
Electrical Contractor Active.
Meets current requirements.
License specialties
SIGN
License no.
CULBESS984MU
Effective — expiration
08/30/2002— 08/30/2018
Designated administrator
CULBERTSON, PAUL ....'...
License type
Master Electrician
Active.
Meets current requirements.
License no.
CULBEP*979QL
Bond
No bond accounts during the previous 6 year period.
Savings
(in lieu of bond) $4,000.00
Received by L&I Effective date
08/30/2002 08/30/2002
Release date Impaired date
N/A N/A
Savings account ID
License Violations
Infraction no.
EALEJ00261
Satisfied
RCW/WAC
Help us improve
https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602043276&LIC=CULBESS984MU&SAW= 11/3/2017
CULBERTSON SIGN SERVICE LLC
Issue date
07/16/2012
Violation city
TACOMA
Type of violation
ELECTRICAL CITATION
Description
Fading to obtain or post an
electrical/telecommunications work permit
prior to beginning the
electrical/telecommunication installation or
alteration as referenced in WAC 296-46B-900
(3)(6), effective after 12/30/2008 see WAC 296-
46B-901. No permit for 2nd sign installed at
this address.
19.28.101 RCW
Violation amount
$2,000.00
Workers' comp
Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums.
L&I Account ID
964,604-01
.................................
Doing business as
CULBERTSON SIGN SERVICE LLC
Estimated workers reported
Pending current quarter filing
L&I account contact
T4 / TERRI MADISON (360)902-4654 - Email: KIRT235@Ini.wa.gov
Account is current.
Public Works Strikes and Debarments
Verify the contractor is eligible to perform work on public works projects.
Contractor Strikes
..._...............................................
No strikes have been issued against this contractor.
Contractors not allowed to bid
............................................................................................
No debarments have been issued against this contractor.
Workplace safety and health
No inspections during the previous 6 year period.
Page 2 of 2
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