HomeMy WebLinkAboutPermit EL07-113 - PEDERSON CLASSIC HOMEPEDERSON CLASSIC HOMES
4246 S 150 ST
ELO7-1 13
Parcel No.: 0042000095
Address:
Suite No:
Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name: OWNER AFFIDAVIT- TED PEDERSON
Address:
Contractor License No:
DESCRIPTION OF WORK:
TEMP SERVICE
Value of Electrical:
Type of Fire Protection:
Electrical Service provided by:
The granting of this pe
construction or the
Signature:
Print Name:
doc: EL -4/07
4246S150STTUKW
City* Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 -431 -3665
Web site: http. / /www.ci.tukwila.wa.us
PEDERSON CLASSIC HOME
4246 S 150 ST , TUKWILA WA
PEDERSON TED
27148 12 AV S , DES MOINES WA
TED PEDERSON
27148 12 AV S , DES MOINES WA
$0.00 Fees Collected: $58.00
National Electrical Code Edition: 2005
Permit Center Authorized Signature: / J
/' � r72,Sad)
ELECTRICAL PERMIT
I hereby certify that I have read and x
governing this work will be compile will, whether specified herein or not.
Permit Number:
Issue Date:
Permit Expires On:
Expiration Date:
Phone:
Phone: 206 947 -0638
Phone:
EL07 -113
05/11/2007
11/07/2007
'�l ^ Date: IC" t 1
ed this permit and know the same to be true and correct. All provisions of law and ordinances
es not presume to give authority to violate or cancel the provisions of any other state or local laws regulating
ce of • am authorized to sign and obtain this electrical permit.
Date: "/"/9 1
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.
EL07 -113 Printed: 05-11 -2007
Parcel No.: 0042000095
Address:
Suite No:
Tenant:
1: ** *ELECTRICAL * **
4246 S 150 ST TUKW
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206 - 431 -3665
Web site: http: / /www.ci.tukwila.wa.us
PEDERSON CLASSIC HOME
PERMIT CONDITIONS
Permit Number:
Status:
Applied Date:
Issue Date:
ELO7 -113
ISSUED
05/11/2007
05/11/2007
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.
I hereby certify that I have read these conditions and will comply with them as outlined. 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 provision of any other work or local
laws regulating construction or the performance of work.
Signature:
doc: Cond -Elec
Print Name: As5=2
Date:
EL07 -113 Printed: 05-11 -2007
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.ci.tukwila.wa.us
Name: l Pt a
Mailing Address: " `! 4/,h Ca
H:Mppliations\Fomu- Applications On lineal -2007 - Electrical Permit Appliation.doc
bh
Electrical Permit
Project No.
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 **
King Co Assessor's Tax No.: &L( w
_' (
Site Address: �ZZ! [ S s� Suite Number: Floor:
Tenant Name:
Property Owners Name: .1t�� L l2 50 IJ S C /, Q-SS Ic
New Tenant: ❑ Yes
Mailing Address: I `f tZ 4. 1-` A1 5 O l>S 1110(1U.PS Lt) /4
City State
Valuation of Project (contractor's bid price): $ 1 0 •
Scope of Work (please provide detailed information): 71'L ) Se' tC�'
.No
Q ?tei
Zip
CONTACT PERSON Who do we contact when your permit is ready to be issued
Day Telephone: 2 06 - 9 `(7 - 063 x
City State Zip
E -Mail Address: Fax Number:Z06 - qZ C1— ZS Z
ELECTRICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
Zip
State
Cit
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
Contractor Registration Number: Expiration Date:
Will service be altered? ❑ Yes ❑ No Adding more than 50 amps? ❑ Yes ❑ No
Type of Use:
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
Page 1 oft
RESIDENTIAL
NEW RESIDENTIAL SERVICE
❑ New single family dwellings $140.00
(including an attached garage)
❑ Garages, pools, spas and outbuildings $75.00 ea
❑ Low voltage systems
(alarm, furnace thermostat) $55.00 ea
RESIDENTIAL REMODEL AND SERVICE CHANGES
❑ Service change or alteration $75.00
(no added/altered circuits)
❑ Service change with added/altered circuits $75.00
number of added circuits $10.00 ea
❑ Circuits added/altered without service change $50.00
(up to 5 circuits)
❑ Circuits added/altered without service change $50.00
(6 or more circuits) $7.00 ea
❑ Meter /mast repair $65.00
❑ Low voltage systems $55.00
(alarm, furnace thermostat)
BUILDING OWNER QR ELECTRICAL CONTRACTOR:
Signature:
Print Name: C)
Date Application Accepted:
H:Wpplications\Fonns- Applications On Line\4 -2007 - Electrical Permit Appliation.doc
bh
MULTI - FAMILY AND COMMERCIAL
Fees are based on the valuation of the electrical contract.
MISCELLANEOUS FEES
Temporary service (residential) $58.00
❑ Temporary service (generator) $75.00
❑ Manufactured/mobile home service $80.00
(excluding garage or outbuilding)
❑ Carnivals $75.00
Number of concessions $10.00 ea
PERMIT APPLICATION NOTE
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.
City
Date: 5.' 07
Day Telephone: ZC& • q4'7 O&
Mailing Address: z7 /4f k /Z "g Afie 5 i7 vas I %i b f w/7 . 9 / 9�
State Zip
Date Application Expires:
Staff Initials:
Page 2 of 2
Receipt No.: R07 -00814
Initials: JEM
User ID: 1165
Payee: PEDERSON'S CLASSIC HOME, INC.
TRANSACTION LIST:
Type Method Description
ACCOUNT ITEM LIST:
Description
ELECTRICAL PERMIT - RES
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 -431 -3665
Web site: http: / /www.ci.tukwila.wa.us
RECEIPT
Parcel No.: 0042000095 Permit Number: EL07 -113
Address: 4246 S 150 ST TUKW Status: APPROVED
Suite No: Applied Date: 05/11/2007
Applicant: PEDERSON CLASSIC HOMES Issue Date:
Amount
Payment Check 4560 58.00
Account Code Current Pmts
000.322.101.00.0 58.00
Total: $58.00
Payment Amount: $58.00
Payment Date: 05/11/2007 01:22 PM
Balance: $0.00
8116 05/11 9716 TOTAL 58.00
doc: Receiot -06 Printed: 05-11 -2007
Project:
'wh 5o C4/c- /,�o�`
Type of Inspection:
X 30 - z
v
V5 e4 c / tV 7 §
Date Called:
Special Instructions:
Date Wanted:
....5 (�
a r
p.m.
Requester:
Phone No:
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
INSPECTION RECORD
Retain a copy with permit
roved per applicable codes. El Corrections required prior to approval.
COMMENTS:
sic
Inspector &7tij?,4'( ��LG
D j /y A7
❑ $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to sechedute reinspection.
Receipt No.:
Date:
10 -08 -2007
TED PEDERSON
27148 12 AV S
DES MOINES WA 98198
RE: Permit No. EL07 -113
4246 S 150 ST 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 Codes, Uniform Plumbing/Fuel Gas Code and/or the National Electrical Code, every permit issued by the
Building Division under the provisions of the code shall expire by limitation and become null and void if the building or work
authorized by such permit is not commenced within 180 days from the date of such permit issuance, or if the building or work
authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days.
Based on the above, you are hereby advised to:
Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 to schedule for the next or final inspection.
This inspection is intended to determine if substantial work has been accomplished since issuance of the permit or last inspection; or if
the project should be considered abandoned.
If such determination is made, the International Codes, Uniform Plumbing/Fuel Gas Code and/or the National Electrical Code does
allow the Building Official to approve one extension of time for an additional period not exceeding 180 days. Extension requests
must be in writine and provide satisfactory reasons why circumstances beyond the applicants control have prevented action from
being taken.
In the event you do not call for the above inspection and receive an extension prior to 11/10/2007 , your permit will become null and
void and any further work on the project will require a new permit application and associated fees.
Thank you for your cooperation in this matter.
Sincerely,
fifer Marshall
Permit Technician
xc: Permit File No. EI07 -113
City of Tukwila Steven M. Mullet, Mayor
Department of Community Development Steve Lancaster, Director
6300 .Snathrent•r Rnulovard Nulty *100 • Tukwila Wachinotnn OR1RR • Phnno• 2IM 421 - %R7n • V. 2fA 421 - 2AAS
CITY OF TUKWIL4
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
Permit Center /Building Division:
206 - 431 -3670
Public Works Department:
206 - 433 -0179
Planning Division:
206 -431 -3670
STATE OF WASHINGTON)
COUNTY OF KING )
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
ss.
flor
PERMIT NO.:
/ 7 Q2.5 V NI , states as follows:
[please print]
1. I have made application for a building permit from the City of Tukwila, Washington.
2. I understand that state law requires that all building construction contractors be registered with the State of
Washington. The exceptions to this requirement are stated under Section 18.27.090 of the Revised Code of
Washington, a copy of which is printed on the reverse side of this Affidavit. I have read or am familiar with RCW
18.27.090.
3. I understand that prior to issuance of a building permit for work which is to be done by any contractor, the City of
Tukwila must verify either that the contractor is registered by the State of Washington, or that one of the exemptions
stated under RCW 18.27.090 applies.
4. In order to provide verification to the City of Tukwila of my compliance with this requirement, I hereby attest that
after reading the exemptions from the registration requirement of RCW 18.27.090, I consider the work authorized
under this building permit to be exempt under No. f 3 , and will therefore not be performed by a registered
contractor.
I understand that I may be waiving certain rights that I might otherwise have under state law in any decision to engage an
unregistered contractor to perform construction work.
G e A. Will
i = QJ
S 1 . P UB P UBLA G .
O •
8-411'1. Op WAS.....
\applications\8 -2004 affidavit in lieu of contractor registration
APPLICANT
Signed and sworn to before me this
I/iA day of A/ Ay , 20d7.
atie. a. ,e-
NOTARY PUBLIC in and for State of Washington,
Residing at Hi1ni
Name as commissioned: Alice A. Deacy
My commission expires: 646-08
, County.
18.27.090 Exemptions. This chapter shall not apply to:
1.
2. An authorized representative of the United States
Government, the State of Washington, or any
incorporated city, town, county, township,
irrigation district, reclamation district or other
municipal or political corporation or subdivision of
this state;
3. Officers of the court when they are acting within
the scope of their office;
4. Public utilities operating under the regulations of
the utilities and transportation commission in
construction, maintenance, or development work
incidental to their own business;
5. Any construction, repair or operation incidental to
the discovering or producing of petroleum or gas,
or the drilling, testing, abandoning, or other
operation of any petroleum or gas well or any
surface or underground mine or mineral deposit
when performed by an owner or lessee;
6. The sale or installation of any finished products,
materials, or articles of merchandise which are not
actually fabricated into and do not become a
permanent fixed part of the structure;
7. Any construction, alteration, improvement or
repair of personal property, except this chapter
shall apply to all mobile, manufactured housing. A
mobile/manufactured home may be installed, set
up, or repaired by the registered or legal owner,
by a contractor licensed under this chapter, or by
a mobile/manufactured home retail dealer or
manufacturer licensed under chapter 46.70 RCW;
8. Any construction, alteration, improvement, or
repair carried on within the limits and boundaries
of any site or reservation under the legal
jurisdiction of the federal government;
9. Any person who only furnished materials,
supplies, or equipment without fabricating them
into, or consuming them in the performance of, the
work of the contractor,
10. Any work or operation on one undertaking or
project by one or more contractors, the aggregate
contract price of which for labor and materials and
all other items is less than $500.00, such work, or
operations being considered as of a casual, minor,
or inconsequential nature. The exemption
prescribed in this subsection does not apply in all
instance wherein the work or construction is only a
part of a larger or major operation, whether
undertaken by the same or a different contractor,
or in which a division of the operation is made into
\applications\8 -2004 affidavit in lieu of contractor registration
V
contracts of amounts less than $500.00 for the
purpose of the evasion of this chapter or
otherwise. The exemption prescribed in this
subsection does not apply to a person who
advertises or puts out any sign or card or other
device which might indicate to the public that he is
a contractor, or that he is qualified to engage in
the business of contractor;
11. Any construction or operation incidental to the
construction and repair of irrigation and drainage
ditches of regularly constituted irrigation districts
or reclamation districts; or to farming, dairying,
agriculture, viticulture, horticulture, or stock or
poultry raising; or to clearing or other work upon
land in rural districts for fire prevention purposes;
except then any of the above work is performed
by a registered contractor;
12. An owner who contracts for a project with a
registered owner;
13. Any person working on his own property, whether
occupied by him or not, and any person working
on his residence, whether owned by him or not but
his exemption shall not apply to any person
otherwise covered by this chapter, who constructs
an improvement on his own property with the
intention and for the purpose of selling the
improved property;
14. Owners of commercial properties who use their
own employees to do maintenance, repair, and
alteration work in or upon their own properties;
15. A licensed architect or civil or professional
engineer acting solely in his professional capacity,
an electrician licensed under the laws of the state
of Washington, or a plumber licensed under the
laws of the state of Washington while operating
within the boundaries of such political subdivision.
The exemption provided in this subsection is
applicable only when the licensee is operating
within the scope of his license;
16. Any person who engages in the activities herein
regulated as an employee of a registered
contractor with wages as his sole compensation;
17. Contractors on highway projects who have been
prequalified as required by chapter 13 of the Laws
of 1961, RCW; 47.28.070 with the department of
transportation to perform highway construction,
reconstruction,` or maintenance work.