HomeMy WebLinkAboutPermit EL07-627 - SOUTHCENTER DENTALSOUTHCENTER DENTAL
411 STRANDER BL
ELO7-627
Parcel No.: 0223200052
Address: 411 STRANDER BL TUKW
Suite No:
Tenant:
Name: SOUTBCENTER DENTAL
Address: 411 STRANDER BL, STE 108 , TUKVVILA WA
Owner:
Name: MEDICAL CENTERS CO LLC Phone:
Address: C/O NEWCASTLE SERVICES , 15642 SE 24TH ST
Contact Person:
Name: CORRIE BENDER Phone: 253 862 -7600
Address: PO BOX 1453 , SUMNER WA
Contractor:
Name: PACIFIC BUSINESS SYSTEMS INC Phone: 253 862 -7600
Address: PO BOX 1453 , SUMNER WA
Contractor License No: PACIFBS991JT Expiration Date: 04/30/2009
DESCRIPTION OF WORK:
LOW VOLTAGE: INSTALL VOICE DATA TV SPEAKER
Value of Electrical: $5,000.00 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 pe
construction or
Signature:
Print Name:
doc: EL -4/07
Cityef 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
Afivt9-Ipta
Date: 01
ed this permit and know the same to be true and correct. All provisions of law and ordinances
whether specified herein or not.
ELECTRICAL PERMIT
does not presume to give authority to violate or cancel the provisions of any other state or local laws regulating
of wo am authorized to sign and obtain this electrical permit.
Date: J 2 tl 0 7
Permit Number: EL07 -627
Issue Date: 10/30/2007
Permit Expires On: 04/27/2008
$164.00
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 -627 Printed: 10 -30 -2007
Parcel No.: 0223200052
Address:
Suite No:
Tenant:
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
411 STRANDER BL TUKW
SOUTHCENTER DENTAL
PERMIT CONDITIONS
Permit Number:
Status:
Applied Date:
Issue Date:
EL07 -627
ISSUED
10/30/2007
10/30/2007
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.
doc: Cond -Eiec
Date:
EL07 -627 Printed: 10-30 -2007
E -Mail Address:
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
httol/www.crtukwila.wa.us
Electrical Permit No.
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 **
SITE LOCATION
King Co Assessor's Tax No.: O2 "' Z
L
Site Address: 9 I -fv el P „/-- 6144 4 Suite Number: 1 6$ Floor: :I—
Tenant Name: 5 ou÷' % tom.-= 'fr/ Pe.../1 f1 ( New Tenant: V1......Yes ❑..No
Property Owners Name:
Mailing Address:
Zip
de/'
v t
1
City
State
CONTACT PERSON - Who do we contact when your permit is ready to be issued
Name: g et Day Telephone: Z-573 6 ��i - - Tic ,{ ��0 l�
Mailing Address: I ” �C �- �Vl"`� 70
City r State Zip
ax Number: 2,1.E —e G 6 S9c7tD
ELECTRICAL CONTRACTOR INFORMATION
Company Name: P4 f3 U,S r'✓tr ,/ �p q
Mailing Address: / 6 .80 .k l I5J S £ J't 1.-%04- 7,3 L 0
Contact Person: � -
City Stat Zip
��
Day Telephone: - 7'' O p
E -Mail Address: G� ,e ^vim- #u"e+► C.O Fax Number: - ..3 _ = — S o O
fT
Contractor Registration Number: G Fs S 77/J' piration Date:
Valuation of Project (contractor's bid price): $ —00
Scope of Work (please provide detailed information):
s �4
1/ 1/.61-c. 5
Will service be altered? ❑ Yes ❑ No Adding more than 50 amps? ❑ Yes ❑ No
Type of Use:
Type of work:
W lew ❑ Addition ❑ Service Change ❑ Remodel ❑ Tenant Improvement
T Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service
Property Served by:
Puget Sound Energy
❑ Seattle City Light
HAApplications\Fonns- Applications On Line \4 -2007 - Electrical Permit Application.doc
bh
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)
BUILDING OWNER O3 EJ TRICAL CONTRACTOR:
Signature:
Print Name:
Mailing Address:
[Date Application Accepted:
P v 136)<
y‘f
H:\Applications\Forms- Applications On Line \4 -2007 - Electrical Permit Application.doc
bh
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
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.
1 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.
Day Telephone:
S y - t
City
Date:
/o- ? -7--
6.14 7s 7 0
State Zip
Staff Initials:
Page 2 of 2
Parcel No.: 0223200052
Address: 411 STRANDER BL TUKW
Suite No:
Applicant: SOUTHCENTER DENTAL
Receipt No.: R07 -02362
Payee: CORRIE D BENDER
TRANSACTION LIST:
Type Method Description
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
Initials: gm Payment Date: 10/30/2007 12:04 PM
User ID: 1165 Balance: $0.00
Amount
Payment Check 1049 164.00
Account Code Current Pmts
000.322.101.00.0 164.00
Total: $164.00
Permit Number: EL07 -627
Status: PENDING
Applied Date: 10/30/2007
Issue Date:
Payment Amount: $ 164.00
doc: Receiot -06 Printed: 10 -30 -2007
Project:
Sprile:"Arri...4 Al APR' t,
Type of Inspection
;* /00
Aress:
i, 37
16-1/
Date Called:
Special Instructions:
Date Wanted:
Or
- .--. .
-...o.e.••
Requester:
Phone No:
4 7-621
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
pproved per applicable codes. Corrections required prior to approval.
OMMENTS:
lin s pep t (a 4: 01fi - 41/4 /7/ I Date> ihrh
f'
$513.00 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:
rr3',N7*4- e/1/7;1"
Type of Inspection:
7a-k7
Adflyrss:
i fl C et 4.1
Date Called:
Special Instructions:
Date Wanted:
:.
Requester:
Phone Phone No:
3
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
4/4
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431-3670
;COMMENTS:
Cl< P
4 'Pr
oved per applicable codes. Corrections required prior to approval.
Inspect4 Dat
ii 'e:
Aire/ifinii6# ///
fJ $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call the schedule reinspection.
r eceipt No.:
IDate:
Project:
. 11
Type of Inspection:
70
A ress:
.S t i /tin
Date Called:
Special Instructions:
Date Wanted: // /
a. .
Requester:
Phone No:
Z
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
proved per applicable codes. 0 Corrections required prior to approval.
COMMENTS: 4//
0/ — fa r2 AEi/ ` T /dX)$
CUK - l-/79/lb 4 /66
h75
J ez7zA4 4/44/ I D a t7
$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:
INSPECTION RECORD
Retain a copy with permit
thL.
3
Project:
56Y771 4411 7
&-MX I,
Type of Inspection:
7(703
V
Address:
y// ,57,1//1A
1/6
Date Called:
Special Instructions:
Date Wanted:
/ /
1n
a.
Requester:
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 -3
proved per applicable codes. El Corrections required prior to approval.
COMMENTS: /p4"
CX
G M 4- GrpI /
S Ed L- ,C G cog 4'61/47 42 )
Inspec ( /`` 67 (Date: // / 7
$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:
Business Owner Information
Name
Role
Effective Date
Expiration Date
BENDER, CORRIE
AGENT
04 /30/2001
BENDER, CORRIE D
PRESIDENT
04/30/2001
Look Up a Contractor, Electric". or Plumber License Detail
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
PACIFBS991JT
PACIFIC BUSINESS SYSTEMS INC
ELECTRICAL CONTRACTOR
601601545
CORPORATION
PO BOX 1453
SUMNER
PIERCE
WA
98390
2538627600
ACTIVE
LIMITED ENERGY
HVAC/RFRG LTD ENERGY
4/30/2001
4/30/2009
PACIFBS008P8
BENDECD962NF
Master Electrician Information
License
Name
Status
BENDECD962NF
BENDER, CORRIE D
ACTIVE
Bond Information
https: // fortress .wa.gov /lni/bbip /printer.aspx ?License= PACIFBS991 JT
Page 1 of 2
10/30/2007