HomeMy WebLinkAboutPermit EL07-552 - DR BARUFFIDR BARUFFI
411 STRANDER BL
ELO7-552
Parcel No.: 0223200052
Address: 411 STRANDER BL TUKW
Suite No:
City►f Tukwila
Tenant:
Name: DR. BARUFFI
Address: 411 STRANDER BL , 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: MEDICAL CENTERS CO LLC Phone:
Address: C/O NEWCASTLE SERVICES , 15642 SE 24TH ST
Permit Number: ELO7 -552
Issue Date: 09/26/2007
Permit Expires On: 03/24/2008
Contact Person:
Name: TIM STIDHAM Phone: 206 329 -1596
Address: 1905 S JACKSON ST , SEATTLE WA
Contractor:
Name: NORTH STAR ELECTRIC INC Phone: 206 329 -1596
Address: 1905 S JACKSON ST , SEATTLE WA
Contractor License No: NORTHSE 136OB Expiration Date: 09/28/2007
DESCRIPTION OF WORK:
DEMO EXISTING SPACE, INSTALL NEW LIGHTING, SWITCHING, RECEPTACLE, MAKE
ELECTRICAL CONNECTION TO NEW HOT WATER TANK, X -RAY (INTERNATIONAL &
PANOELIPSE), HVAC UNITS (REPLACING EXISTING), AND REUSE EXISTING PANELS.
Value of Electrical: $38,850.00 Fees Collected:
Type of Fire Protection: National Electrical Code Edition: 2005
Electrical Service provided by: PUGET SOUND ENERGY
Permit Center Authorized Signature:
I hereby certify that I have read and e
governing this work will be complied
The granting of this permit do
construction or the perfo
Signature:
Print Name:
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 -4/07
$721.60
Date: 0119-ctiol-
ed this permit and know the same to be true and correct. All provisions of law and ordinances
whether spe ' * herein or not.
o give authority -to violate or cancel the provisions of any other state or local laws regulating
am a tho ' edTo sign and obtain this electrical permit.
Date:
EL07 -552 Printed: 09-26 -2007
Parcel No.: 0223200052
Address: 411 STRANDER BL TUKW
Suite No:
Tenant: DR. BARUFFI
1: ** *ELECTRICAL * **
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
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 the outlined. All provisions of law and
ordinances governing this work will be complied with, whether spe ' he ein or not.
The granting of this permit does not presume
laws regulating construction o • e perf . lce of
Print Name:
doc: Cond - Elec
Signature: � / __ �► Date:
t q " w7
PERMIT CONDITIONS
e au
Permit Number:
Status:
Applied Date:
Issue Date:
EL07 -552
ISSUED
09/26/2007
09/26/2007
ty to violate or cancel the provision of any other work or local
EL07 -552 Printed: 09 -26 -2007
SITE LOCATION
King Co Assessor's Tax No.: f 2 7 3 2_ 6005' Z
Site Address: 4/1 .577 a I wet Suite Number: 67 to Floor:
Tenant Name: Pr. S e ru 641 -C- 13a. r..1, FF r' New Tenant: El Yes
Property Owners Name: Or, 3 4s✓ti a Qu r FE;
//
Mailing Address: '/// �r�ccrv -v- B1✓o'�. �a,T 308 /u/cwa/4 w4&. `781x
State Zip
CONTACT PERSON -Who do we contact when your permit is ready to be issued
Name: / L Ai, ST; e11t & wt.
Day Telephone: 2D6i " 3 Z7 — FS
Mailing Address: / 9 0 S S E A ce, Jc S c/ ' S S�ZIZL u/ • °le! Yy
City State Zip
Fax Number: ,06 32 ' 4 13 7
E -Mail Address: TT 01 4 4 S CZ Aj S /u 4^c. 6t
ELECTRICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Contractor Registration Number: Expiration Date:
Qo_
Valuation of Project (contractor's bid price): $ 3 8 8S
Scope of Work (please provide detailed information): De-M.1.0 e...-Ws s , • 0 7 S cc /.4,,s77. I ( 0_, c.c.>
j i 417 w .SS CV L � L -a, t w r`� G� a f an, c- l J « E� [ �c-�r � /� COs✓ tXG (L o .,
/O #.'C dad v ! GLJ (t a - .. +S I C , X - r a •y ct wTtx. 0 o f t Awe G t p i C/ j ` ` Ui
Will service be altered? 0 Yes 21 No Adding more than 50 amps? 0 Yes g No
Type of Use:
Tvpe of work:
O New 0 Addition 0 Service Change 0 Remodel M Tenant Improvement
O Low Voltage E3 Generator 0 Fire Alarm 0 Telecommunication 0 Temporary Service
El Puget Sound Energy
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.atukwila.wa.us
❑ Seattle City Light
H:wppiications\Ponns Applications On Line \4-2007 • Electrical Permit Application.doc
bh
E fe�
Electrical Perm
Project.No_
office rise 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 **
0 V S7 ST z We.h
City State
Day Telephone: Z [1G' " 3 ° j - / S c l'
Fax Number: Zo6 - 32-1 - 1
City
1
❑
g41 v4
Zip
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)
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:
Date: T jZ F�a7
Print Name: •-r < < dl li �-t Day Telephone: ZvC — 52 — l5?C
Signature:
Mailing Address: / IOS S. V 4� *i % CeA• ' s/ `fy
City State Zip
Date Application Accepted:
H:VApplicatiorn\Fonns- Applications On Line4-2007 - Electrical Permit Applicationdoc
bh
i ,fr " Date Application Expires:
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
Staff Initials:
Page 2 of 2
Parcel No.: 0223200052
Address: 411 STRANDER BL TUKW
Suite No:
Applicant: DR. BARUFFI
Receipt No.: R07 -02100
Initials: JEM Payment Date: 09/26/2007 11:50 AM
User ID: 1165 Balance: $0.00
Payee: NORTH STAR ELECTRIC, INC.
Payment Check 130290 721.60
TRANSACTION LIST:
Type Method Description Amount
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
Account Code Current Pmts
000.322.101.00.0 721.60
Total: $721.60
Permit Number: EL07 -552
Status: APPROVED
Applied Date: 09/26/2007
Issue Date:
Payment Amount: $721.60
7259 07/26 9710 TOTAL 7 21.6
don! Rar.eint -(1R Printed: ()9 -26- 70117
Project: 4 ,. 2
Type of Inspection:
gs. 6 „., 77z6,14364
z")
KIVA
Date Called:
Special Instructions:
'
Date Wanted:
Ca.m.
p.m.
Requester:
Phone No:
INSPECTION RECORD
Retain a copy with permit F
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
INSPECTION NO.
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431-3670
• .. roved per applicable codes. Corrections required prior to approval.
MMENTS:
Inspect
i r
El $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:
M 4,44011X
Type of Inspection:
70v3
J
Address: /
/]
Date Called:
Special Instructions:
Date Wanted:
/
/
a.m.
p.m.
Requester:
Phone No:
INSPECTION RECORD
Retain a copy with permit 1!-0 7 -Cr -2-
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION 1Z
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -360
OMMENTS:
czw_m/G_ c._m/z/
roved per applicable codes. Corrections required prior to approval.
Inspecto( ii % f/` S ? /)/ 6// (Date/v2,6
$58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection.
'Receipt No.:
'Date:
1
Pro'ect:
4 //if /
Type of Inspection:
7(763
Address:
1 57 2 4r/h
Date Called:
Special Instructions:
Date Wanted:
c" ....'
a.m.
p.m.
Requester:
Phone No:
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
#(4°7 ■C:rZ
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION V--
6300 Southcenter Blvd., #100, Tukwila, WA 981 88 (206)431-3670
COMMENTS:
/
Pw57 AW1$
<rnoP0A7KA 14(e., A/vb Mf
Approved per applicable codes.
Inspect e? urticzn/iiii6 . 9.
orrections required prior to approval.
Date gA
D $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:
Project:
gyp, J3ARuFF,
Type of Inspection:
`70o
Address:
`/11 .S ri2AN.D
13 L v..
Date Called:
/U 3D-0 '7
Special Instructions:
Date Wanted:
/Q •2 ) /) ?
a.m.
/{ / p.m.
Requester:
9 999
Phone No:
?1,
INSPECTION NO.
•
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
pZI Approved per applicable codes. El Corrections required prior to approval.
COMMENTS:
-2, t7K t//4lT) C'i ►i-1Plt 4
'Inspector:
Date:
/0 •0
$58.00 REINSP CTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call the schedule reinspection.
'Receipt No.:
IDate:
Business Owner Information
Name
Role
Effective Date
Expiration Date
OSTERGAARD, DOUGLAS
01/01/1980
FREDERICKS, DOLORES
01/01/1980
Look Up a Contractor, Electric.; to 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
fine 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
NORTHSE 13608
NORTH STAR ELECTRIC INC
ELECTRICAL CONTRACTOR
601034594
CORPORATION
1905 S JACKSON ST
SEATTLE
KING
WA
98144
2063291596
ACTIVE
GENERAL
UNUSED
9/28/1987
9/28/2009
NORTHSEI93LS
OSTERDS 193JP
Electrical Administrator Information
License
Name
Status
OSTERDS 193JP
OSTERGAARD, DOUGLAS S
ACTIVE
Bond Information
https: // fortress. wa. gov /lni/bbip /printer.aspx ?License= NORTHSE 13608 09/26/2007