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Home My WebLink AboutPermit EL07-354 - HIGHLINE MEDICAL CENTERHIGHLINE MEDICAL CENTER 12844 MILITARY RD S ELO7-354 Parcel No.: 1623049001 Address: 12844 MILITARY RD S TUKW Suite No: City►f Tukwila Tenant: Name: HIGHLINE MEDICAL CENTER Address: 12844 MILITARY RD S , TUKWILA WA 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 ELECTRICAL PERMIT Owner: Name: HCH SPECIALTY CENTER Phone: Address: ATTN ACCOUNTING DEPT , 12844 MILITARY RD S Contact Person: Name: DAN RONCO Phone: 206 762 -3311 Address: 5005 3 AV S , SEATTLE WA Contractor: Name: MCKINSTRY ELECTRIC Phone: 206 832 -8513 Address: PO BOX 24567 , SEATTLE WA Contractor License No: MCKINE *982KG Expiration Date: 05/08/2008 DESCRIPTION OF WORK: LOW VOLTAGE: INSTALL LV NURSE WALL STATIONS AT RECEPTION AREA AND NORTH WING ER. INTALL (6) PATIENT CARE PULL STATIONS AND LIGHTS IN BATHROOMS. OTHER STATIONS INSTALL THROUGHOUT FACILITY (10 ADDITIONAL). JEM Value of Electrical: $16,000.00 Type of Fire Protection: National Electrical Code Edition: 2005 Electrical Service provided by: PUGET SOUND ENERGY I hereby certify that I have read and governing this work will be complie doc: EL -4/07 Print Name: L2-MI, ! 1' /64-1 c Fees Collected: Permit Number: EL07 -354 Issue Date: 08/01/2007 Permit Expires On: 01/28/2008 $344.40 Permit Center Authorized Signature Jj Lj Date: () n10(, 01 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 presume to give authority to violate or cancel the provisions of any other state or local laws regulating construction or the performance /o of work. Il am authorized to sign and obtain this electrical permit. / Signature: i f' / ._— Date: 9 l 1 l ° 7 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 -354 Printed: 08 -01 -2007 Parcel No.: 1623049001 Address: Suite No: Tenant: 1: ** *ELECTRICAL * ** 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 12844 MILITARY RD S TUKW HIGHLINE MEDICAL CENTER Signature: � % C / Print Name: �F h PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: EL07 -354 ISSUED 08/01/2007 08/01/2007 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. Date: Eh 7 EL07 -354 Printed: 08-01 -2007 SI t E LOCATIOT Name: D G r Mailing Address: E -Mail Address: Type of work: ❑ New ❑ Addition 4 49w Voltage ❑ Generator Property Served by: ,1Et.. Puget Sound Energy ❑ Seattle City Light CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 httv://www.ci.tukwilawa.us Site Address: / Z K if M i t , `fr ltd .r Tenant Name: • %�.._ /"/ic� .. l Property Owners Name: I, ' 1 v►. /t . it' uP (2 kj- Mailing Address: /2. 1' t t T ! 4 j /a it) f Wh do we contact when your permit is ready to be issu YLD ll A _ .5-00‘ 39 Ay. S `_ ► 1 l /4 e IM tic ELECTRICAL CONTRACTOR INFORMATION Company Name: rl L tQrt r Mailing Address: sun Z✓4 /4.,c s tie. l (,4 fer31 City State Zip Contact Person: ( 1 c t,.. flo t., L.0 Day Telephone: E -Mail Address: Fax Number: Contractor Registration Number: IA Llc ,A) E.; ' 1 Y2 k_6 Expiration Date: S 1 c I Cy Valuation of Project (contractor's bid price): $ f6 0 4 c Scope of Work (please provide detailed information): T Si it tow V o / b. S / ,f yr r- c-'- f ( f tls, 1-7.1... a .1 re cc, kK ar• ,eaJ Aloe r-v,a O . -Z t^ rl: f G ,` tee. t Ga r , ' a t . • �. f:. '�a e„ . e // a .3 t�z4 :a Will service be altered? ❑ Yg No Adding more than 50 amps? ❑ Yes to Type of Use: A4Q d i .J H:Upplications\Fonns- Applications On Line\4 -2007 - Electrical Permit Applicationdoc bh ❑ Service Change ❑ Fire Alarm / �/ 'e City 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.: Suite Number: Floor: New Tenant: ❑ Yes X,No 4 State Fax Number: 2?) (o- 83 Z r t ? Zip Day Telephone: '23 .- 33 1 1 f -rho w� FrI7Y City State Zip ❑ Remodel ❑ Tenant Improvement ❑ Telecommunication ❑ Temporary Service Page 1 of 2 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) 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. BUILDING OWNER OR ELECTRICAL CONTRACTOR: I Date Application Accepted: H:Applicaticnt\Forms- Applications On Liner .2007 . Electrical Permit Applicationdoc bh City Date: Signature: ` J Print Name: /04 a.. / At Le Day Telephone: Mailing Address: SFn S 3 ofe l` Tc r 717, 4J State Date Application Expires: Staff Initials: 6 1..f:T ft, ___ ? 4/ 3 Y Zip Page 2 of 2 Payee: MCKINSTRY CO ACCOUNT ITEM LIST: Description ELECTRICAL PERMIT - NONR 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.: 1623049001 Permit Number: EL07 -354 Address: 12844 MILITARY RD S TUKW Status: PENDING Suite No: Applied Date: 08/01/2007 Applicant: HIGHLINE MEDICAL CENTER Issue Date: Receipt No.: R07 -01559 Payment Amount: $344.40 Initials: JEM Payment Date: 08/01/2007 03:12 PM User ID: 1165 Balance: $0.00 TRANSACTION LIST: Type Method Description Amount Payment Check 8963 344.40 Account Code Current Pmts 000.322.101.00.0 344.40 Total: $344.40 0953 08/02 9710 TOTAL 344.40 doc: Receiot -06 Printed: 08 -01 -2007 Pr ject: nni /A PANCO a Type of Inspection: �(� l Date Address: -5<Y its ,4'� S Called: Special Instructions: Date Wanted: / .3...._ Requester: Phone No: INSPECTION RECORD Retain a copy with permit INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300. Southcenter Blvd., #100, Tukwila, WA 98188 PER (20•)431 -367 OMMENTS: 10// f/A)42- ved per applicable codes. El Corrections required prior to approval. in s p e j 9)G 4 1,0 ,.. exive6# I /' El $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection. r eceipt No.: 'Date: Business Owner Information Name Role Effective Date Expiration Date BLACK, STEPHEN PARTNER/MEMBER 05/07/2002 ALLEN, DEAN C PARTNER/MEMBER 05/07/2002 MOORE, DOUGLAS Look Up a Contractor, Electric' an or Plumber License Detail Page 1 of 2 Washington State Department of Labor and Industries Electrical Contractor A business licensed by L &I 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. License Information License Licensee Name Licensee Type UBI Ind. Ins. Account Id Business Type Address 1 Address 2 City County State Zip Phone Status Specialty 1 Specialty 2 Effective Date Expiration Date Suspend Date Separation Date Parent Company Previous License Next License Associated License MCKINE *982KG MCKINSTRY ELECTRIC ELECTRICAL CONTRACTOR 602198837 LIMITED LIABILITY COMPANY PO BOX 24406 SEATTLE KING WA 98124 2067623311 ACTIVE GENERAL UNUSED 5/7/2002 5/8/2008 FACILITY ELECTRICAL SRVCS LLC ZEHNER *962CJ Master Electrician Information License Name Status ZEHNER *962CJ ZEHNER, RICK A ACTIVE https: // fortress. wa. gov /lni/bbip /printer.aspx ?License =MCKINE *982KG 08/01/2007