HomeMy WebLinkAboutPermit EL07-313 - JENSEN RESIDENCEJENSEN RESIDENCE
4106 S 130 ST
EXPIRED 10 -08 -08
ELO7-3 13
Signature:
Print Name:
doc: EL -4/07
Parcel No.: 7340600769
Address: 4106 S 130 ST TUKW
Suite No:
Tenant:
Name: JENSEN RESIDENCE
Address: 4106 S 130 ST , TUKWILA WA
Value of Electrical: $500.00
Type of Fire Protection:
Electrical Service provided by: PUGET SOUND ENERGY
Permit Center Authorized Signature:
Cityf 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
Owner:
Name: JENSEN JOEL +SOPHIA L Phone:
Address: 4106 S 130TH ST , TUKWILA WA
Contact Person:
Name: JOEL JENSEN Phone: 206 - 353 -3479
Address: 4106 S 130 ST , TUKWILA WA
Contractor:
Name: OWNER AFFIDAVIT - JOEL JENSEN Phone: 206 - 353 -3479
Address: 4106 S 130 ST , TUKWILA WA
Contractor License No: Expiration Date:
tioa
ELECTRICAL PERMIT
DESCRIPTION OF WORK:
DEMO KNOB AND TUBE AND REPLACE WITH GROUNDED CIRCUITS. ADD 4 CIRCUITS
Fees Collected:
Permit Number: EL07 -313
Issue Date: 07/18/2007
Permit Expires On: 01/14/2008
National Electrical Code Edition: 2005
$50.00
Date:
I hereby 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 . uthorized to sign and obtain this electrical permit.
Date: 7- /27--01-
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 - 313 Printed: 07 -18 -2007
Parcel No.: 7340600769
Address: 4106 S 130 ST TUKW
Suite No:
Tenant: JENSEN RESIDENCE
1: ** *ELECTRICAL * **
Signature:
Print Nam
doc: Cond -Elec
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
PERMIT CONDITIONS
Permit Number: EL07 -313
Status: ISSUED
Applied Date: 07/18/2007
Issue Date: 07/18/2007
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.
- ,0
Date:
EL07 -313 Printed: 07 -18 -2007
Sfte
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
httn://www.citukwila.wa.us
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 Address: `710 rP <e vrp4 130 ) - 1 5T
Tenant Name:
Property Owners Name:
Mailing Address:
c.)E t_ TsErr
•
i'
Name: jor6 i- jC t
Mailing Address: / s:
H:Npplicatior Pomu- Applications On IUne\4 -2007 - Electrical Permit Application.doc
bh
City
King Co Assessor's Tax No.:
Suite Number: Floor:
New Tenant: ❑ Yes ❑ .. No
State
State
Zip
CONTACT PERSON Who do we contact when. your permit is ready to he issued
Day Telephone: �CQ 3- 3 `-t`7 cl
•
i
4 •h. . 1
City State Zip
E -Mail Address: �(� -�) Fax Number: CV2s- ZZ g -
ELECTRICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
Contractor Registration Number: Expiration Date:
Zip
ed
Valuation of Project (contractor's bid price): $ c3' )
Scope of Work (please provide detailed information): pC t4-cA Am, (,3 } T� $ t 19e4-c.G
tr'1 17 t°.. god A 1) C1 (ZCU,TS
Will service be altered? ❑ Yes / No Adding more than 50 amps? ❑ Yes
Type of Use:
Type of work:
❑ New ❑ Addition ❑ Service Change a Remodel ❑ Tenant Improvement
❑ Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service
Property Served by:
Puget Sound Energy
❑ Seattle City Light
Page 1 of 2
RESIDENTIAL
NEW RESIDENTIAL SERVICE
❑ New single family dwellings
(including an attached garage)
❑ Garages, pools, spas and outbuildings
❑ Low voltage systems
(alarm, furnace thermostat)
RESIDENTIAL REMODEL AND SERVICE CHANGES
❑ Service change or alteration $75.00
(no added/altered circuits)
s Service ge 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 OR ELECTRICAL CONTRACTOR:
Signature:
Print Name
Mailing • dress:
I Date Application Accepted:
Sr
H:Upplications\Fonns- Applications On Line41- 2007 - Electrical Permit Application.doc
bh
$140.00
$75.00 ea
$55.00 ea
rif
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.
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
Date: 7 -/e-- 0
Day Telephone: C2(*) ?5 - 3 of
s c 72t,et.✓f Gc
State Zip
Date Application Expires:
Staff Initials:
Page 2 of 2
Payee: JOEL JENSEN
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.: 7340600769 Permit Number: EL07 -313
Address: 4106 S 130 ST TUKW Status: PENDING
Suite No: Applied Date: 07/18/2007
Applicant: JENSEN RESIDENCE Issue Date:
Receipt No.: R07 -01429 Payment Amount: $50.00
Initials: WER Payment Date: 07/18/2007 05:33 PM
User ID: 1655 Balance: $0.00
Amount
Payment Cash 50.00
Account Code Current Pmts
000.322.101.00.0 50.00
Total: $50.00
0462 07/20 9716 TOTAL 266.00
doc: Receipt -06 Printed: 07- 18-2007
COMMENTS:
vT &Ka fol W 1 c-- 4
f lig' li7P-43 7 cfACP(4
1/tisThtt- co/4 A/rit ilie Tile
,_ Ncifi 1 -4 0
0 &WS 7D ,e6 f401/ iVil
canaTingtt oca -gz/Xfolict5,
Boica pi) / /4_ eie-, -V1_//s, /2e#' 4,
pfix/R104 /e/ ke-a -- A 4 c 4 .'7fale -
fiou (- — cnAimr et _cfrod,o/(74
f?)' 771C c.oiM im7
/o .c094. mi/on,w
5 m/5-spy&
,r compa.;y p4/vb4,
Pjlc : se/ v /44 s
Type of Inspection:
0
Address s 11/470
i
Date Called:
Special Instructions:
Date Wanted: a i
/ / 7
ehr
Requester:
Phone No:
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERAANO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431-3670
Approved per applicable codes.
orrections required prior to approval.
insPecati— arre,IMON
Date:1 /7408
$58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection.
'Receipt No.:
'Date:
Project:
/e, t1v Ie"$
Type of Inspection:
70
Ad
Address /
1i0& s /I0 S r
Date Called:
Special Instructions:
/1
Date Wanted:
a.m.
Requester:
Phone No:
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION ►r.
6300 Southcenter Blvd., #100, Tukwila, WA 98188
M M ENTS:
a t
proved per applicable codes. El Corrections required prior to approval.
Ew7 -373
'Inspecto . ) t .suri,��irc,q I
(206)431 -3670
$58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call the schedule reinspection.
'Receipt No.:
'Date:
COMMENTS:
606kyhtiiv/g- s / 7Z;47 To /4
/9/V: - t/° 4 7 7 of /04/# " //t
2 -- BUD / Gori/6 A //eiGt S 7
,,
F 0 v6 g G' /Wan /9 ,ef c.- C -
t A
4 A GJ //Z4 I) / /N7Z'Xc.oir/ /r- G7 )
,94W/ /'C A• - 7z6-7 - a4 s ,/44 1//4,67)
/A - 4 ,4 / ,944 4 r
----- P 9- 'd %/Ur of -Cr,' ,/ _c
Special Instructions:
Date Wanted:
/ � / / -. Z
m.
�—
Project:
Type of Inspection:
7
Add '// �j & 5 /2o 73 1
5
Date Called:
Special Instructions:
Date Wanted:
/ � / / -. Z
m.
�—
Requester:
Phone No:
eko7 -313
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
Approved per applicable codes. Qorrections required prior to approval.
I ���� _ ` , , Pate: O / /
$58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection.
'Receipt No.:
'Date:
09 -08 -2008
JOEL JENSEN
4106S 130 ST
TUKWILA WA 98168
RE: Permit No. EL07 -313
4106 S 130 ST TUKW
Dear Permit Holder:
In reviewing our current records the above noted permit has not received a fmal 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 fmal 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 10/04/2008 , 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,
xc:
fer Marshall
't Technician
Permit File No. ELO7 -313
City of Tukwila
Jim Haggerton, Mayor
Department of Community Development Jack Pace, Director
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
03 -05 -2008
JOEL JENSEN
4106 S 130 ST
TUKWILA WA 98168
RE: Permit No. EL07 -313
4106 S 130 ST TUKW
Dear Permit Holder:
Thank you for your cooperation in this matter.
Sincerely,
C hall
Permit Technician
xc: Permit File No. ELO7 -313
City of Tukwila Jim Haggerton, Mayor
Department of Community Development Jack Pace, Director
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 04 /12/2008 , your permit will become null and
void and any further work on the project will require a new permit application and associated fees.
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
STATE OF WASHINGTON)
COUNTY OF KING )
ss.
CITY OF TUKWILA
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
AFFIDAVIT IN LIEU OF CONTRACTOR REGISTRATION
3 6' J S E W , 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. / } , 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.
\applications\8 -2004 affidavit in lieu of contractor registration
PERMIT NO.: L / 313
_ rr
A gTct /
Sig
and sworn to be ore me this
/874) day of Tudy , 20 07.
NOTARY PUBLIC in and for of Washington,
Residing at /l / , County.
Name as commissioned: 4 /ice r7• £ ac S/
My commission expires: 6 /