HomeMy WebLinkAboutPermit EL07-565 - HABITAT FOR HUMANITYHABITAT FOR
HUMANITY
12230 43 AV S
ELO7-565
Parcel No.: 0179000270
Address: 12230 43 AV S TUKW
Suite No:
Tenant:
Name: HABITAT FOR HUMANITY
Address: 12230 43 AV S , TUKWILA WA
Owner:
Name: HABITAT FOR HUMANITY Phone:
Address: 15439 53RD AVE S #B , TUKWILA WA
Contact Person:
Name: ANTHONY LACKEY Phone: 253- 228 -4255
Address: 10207 184 AV E , BONNEY LAKE WA
Contractor:
Name: AMERICO ELECTRIC Phone: 253 332 -3477
Address: 10207 184 AV E , BONNEY LAKE WA
Contractor License No: AMERIE *951JR Expiration Date: 04/19/2009
DESCRIPTION OF WORK:
SERVICE AND WIRING FOR NEW 1400 SQ FT SINGLE FAMILY RESIDENCE
Value of Electrical: $7,300.00
Type of Fire Protection:
Electrical Service provided by: SEATTLE CITY LIGHT
Permit Center Authorized Signature:
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 au • • 'ty to vi late or cancel the provisions of any other state or local laws regulating
construction or th; performance of work. I am authoriz > sign = d obtain this electrical permit.
Signature:
doc: EL -4/07
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
(A),V,'Z,J
ELECTRICAL PERMIT
Permit Number: EL07 -565
Issue Date: 10/05/2007
Permit Expires On: 04/02/2008
Fees Collected:
National Electrical Code Edition:
$140.00
2005
Date:lO'S
Date: OCT ( O —7
Print Name: /' 1 V Y- U (A, 0 y 6- -
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 -565 Printed: 10-05 -2007
Parcel No.: 0179000270
Address:
Suite No:
Tenant:
1: ** *ELECTRICAL * **
12230 43 AV S 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
HABITAT FOR HUMANITY
PERMIT CONDITIONS
Permit Number:
Status:
Applied Date:
Issue Date:
EL47 -565
ISSUED
10/05/2007
10/05/2007
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 xork.
doc: Cond -Elec
EL07 -565 Printed: 10-05 -2007
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
htto://www.ci.tukwila.wa.us
Site Address: I -) 30
Tenant Name:
Property Owners Name:
Mailing Address:
ti3,0 A.,,e
t-FAT ,c Vfr n t
CONTACT' PERSON Who do we contact when your permit.is ready` to be issued
Name:
• Mailing Address: 0 C.)
E -Mail Address:
ELECTRICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
ontact Person:
E -Mail Address:
Contractor Registration Number:
e Gc3 (% ri c..
A C-
H:1AppIications\Ponns- Applications On tine41•2007 - Electrical Permit Application.doc
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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.: Q I 9'1 — Q.P 0
Suite Number:
Day Telephone:
City
Day Telephone:
Fax Number
./- i e_- - Zd i Expiration Date:
State
State
Floor:
New Tenant: ❑ Yes ❑ ..No
Zip
/L1
Zip
q
City Zip
C am) Fax Number: 836 b97 I
Valuation of Project (contractor's bid price): $ � - Ct
Sco a of Work (please provide detailed information): /1100 S 11 1" .? � Jt/ � B h � re
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:
El 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)
❑ 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 RAPPLICATION NOT
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 CONTRAC
I Date Application Accepted:
(A/
H:Uppliations\Forms- Applications On Line \4.2007 - Electrical Permit Application.doc
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$140.00
$75.00 ea
$55.00 ea
Signature:
Print Name: /,
Mailing Address: t! Q��> t! /kh ' C
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
• Date: C3T J 0 -Z -
• Day Telephone: S-3\ 5 D- 8 — v
rev 13s2t 1 State
Staff Initials:
Page 2 of 2
I
Parcel No.: 0179000270
Address: 12230 43 AV S TUKW
Suite No:
Applicant: HABITAT FOR HUMANITY
Receipt No.: R07 -02179
Initials: WER Payment Date: 10/05/2007 09:07 AM
User ID: 1655 Balance: $0.00
Payee: AMERICO ELECTRIC
TRANSACTION LIST:
Type Method Description Amount
Payment Check 2497 140.00
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
000.322.101.00.0 140.00
Total: $140.00
Permit Number: EL07 -565
Status: PENDING
Applied Date: 10/05/2007
Issue Date:
Payment Amount: $ 140.00
3652 C/O 9710 TOTAL 14 00
doc: Receiot -06 Printed: 10 -05 -2007
Project:
/ *S/ni i FDA / 11//40 Y
Type of Inspection:
0V0
Address: + q Z AA N
✓ �
Date Called:
Special Instructions:
Date Wanted:/ Z / / V
m.
Requester:
Phone No:
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
eta 3j
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION -
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
MMENTS:
roved per applicable codes.
Corrections required prior to approval.
Ins/ ` tbr ` L /
$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:
\Ak
Project:
/ME M7 r foe flu�Ar 7'/
Type of Inspection:
/U-
A es nd
Amid - —DES
Date Called:
Special Instructions:
Date Wanted: ,
a
m.
Requester:
Phone No:
INSPECTION RECORD
Retain a copy with permit
izo7-as"
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
PERMIT NO.
Approved per applicable codes.
r�r
orrections required prior to approval.
COMMENTS:
(/) 577Z4P
P/zo7Ecr AIM c4,0_
6'N /< G.4Q /4v47
Inspect6L (, r 4'lf/'W # I
$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:
/f Pro ' ect:
,iPi RA HYMN/77
Type of Inspection:
ddress: Q— y3 4 �v� -S
�
Date Called:
pecial Instructions:
Date Wanted: j /
/0
a.m.
p.m.
Requester:
Phone No:
feo7 - -g4r
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
proved per applicable codes. El Corrections required prior to approval.
COMMENTS:
v/< - se'Rr/icF
(o4- N6/1 //i/
Inspectors L I am A, /6 Al IDae: 1 / /b / ) 7
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:
License Information
License
AMERIE *951JR
Licensee Name
AMERICO ELECTRIC
Licensee Type
ELECTRICAL CONTRACTOR
UBI
601794242
Ind. Ins. Account Id
Business Type
INDIVIDUAL
Address 1
10207 184TH AVE E
Address 2
City
BONNEY LAKE
County
PIERCE
State
WA
Zip
98391
Phone
2533323477
Status
ACTIVE
Specialty 1
GENERAL
Specialty 2
UNUSED
Effective Date
4/19/2005
Expiration Date
4/19/2009
Suspend Date
Separation Date
Parent Company
Previous License
Next License
Associated License
LACKE *S961LG
Business Owner Information
Name
Role
Effective Date
Expiration Date
LACKEY, ANTHONY W SR
OWNER
04 /19/2005
Look Up a Contractor, Electrician 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.
Electrical Administrator Information
License
Name
Status
LACKE *S961 LG
LACKEY, ANTHONY W SR
ACTIVE
Bond Information
I Bond I Bond
https: // fortress .wa.gov /lni/bbip /printer.aspx ?License= AMERIE *951JR 10/05/2007