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Home My WebLink AboutPermit EL07-680 - OBJECTIVE MEDICAL ASSESSMENTSOBJECTIVE MEDICAL ASSESSMENTS 411 STRANDER BL ELO7-680 Parcel No.: 0223200052 Address: 411 STRANDER BL TUKW Suite No: Tenant: Name: OBJECTIVE MEDICAL ASSESSMENTS Address: 411 STANDER BL, STE 106 , TUKWILA WA Owner: Name: MEDICAL CENTERS CO LLC Phone: Address: C/O NEWCASTLE SERVICES , 15642 SE 24TH ST Contact Person: Name: GEORGE GAHRETT Phone: 206 774 -9221 Address: 401 2 AV S #110 , SEATTLE WA Contractor: Name: HOLMES ELECTRIC CO Address: PO BOX 179 , RENTON WA Contractor License No: HOLMEEC549BH DESCRIPTION OF WORK: ADD LIGHT SWITCH/RELOCATE (2) DUPLEX RECEPTACLES (REPLACING EXPIRED L&I PERMIT) Value of Electrical: $500.00 Type of Fire Protection: Permit Center Authorized Signature: Electrical Service provided by: PUGET SOUND ENERGY Citof 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 ELECTRICAL PERMIT Permit Number: ELM-680 Issue Date: 11/13/2007 Permit Expires On: 05/11/2008 Phone: (425)255 -8666 Expiration Date: 10/31/2008 Fees Collected: National Electrical Code Edition: $70.00 2005 Date: I( (t3(" I hereby certify that I have read and ed this permit and know the same to be true and correct. All provisions of law and ordinances governing this wor . • 1 i • e complie wi , whether specified herein or not. The granting o this pe 't does not pre o give authority to violate or cancel the provisions of any other state or 1 al laws regulating construction • the p = ormance of w I authorized to sign and obtain this electrical permit. Signature: Date: /l Print Name: This permit shall become null . d 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 EL07 -680 Printed: 11 -13 -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 OBJECTIVE MEDICAL ASSESSMENTS PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: EL07 -680 ISSUED 11/13/2007 11/13/2007 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 c • c-t ction or the performance of work. Signature: Print Name: doc: Cond -Elec EL07 -680 Date: Printed: 11 -13 -2007 CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http: //www. ci. tukwila. wa. us SITE LOCATION Site Addres Tenant Name: Property Owners Name ,c - ' b Mailing Address: CONTACT PERSON Who do we contact When your permit is ready to be issued; Name: Mailing Address: /— ? >� di /D E -Mail Address: ELECTRIC 'CONTRACTORINFORMATION Company Name: Mailing Address: Contact Person: E -Mail Address: Contractor Regi tration Number: /4, T Bbt Valuation of Project (contractor's bid price): $ Scope of Wor (pie e provide detailed inf at n): Will service be altered? ❑ Yes p.,No Type of Use: Type of work: ❑ New ❑ Addition ❑ Service Change ❑ Remodel 1Tenant Improvement ❑ Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service Property Served by: y Ll Puget Sound Energy ❑ Seattle City Light ,. Ps 5". .de-TT H:Upplieanons\Forms- Applications On Line \4-2007 - Electrical Permit Appliation.doc bh 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.: ite Number: (U (I Floor: / W New Tenant: ❑ Yes $..No Day Telephone y� City State Fax Number: Zip 13`fs+. c 4 x4 99a.. -P City State Zip Day Telephone:6, ) )5tfr ax Number: Expiration Date: Adding more than 50 amps? ❑ Yes No 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) BUILDIN s . ' if BUILDING CONTRACTOR: Signature Print Nam Mailing dress: I Date Application Accepted: • /=L * S ? //c,i HAApplications\Forms- Applications On Line\4 -2007 - Electrical Permit Application.doc bh $140.00 $75.00 ea $55.00 ea City MULTI -FAMILY AND COMMERCIAL Fees are based on the valuation of the electrical contract. ❑ 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 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. Day Teleph o e: MISCELLANEOUS FEES Date: stat .P.tl Zip Date Application Expires: Staff Initials: Page 2 of 2 Receipt No.: R07 -02476 TRANSACTION LIST: Type Method Description ACCOUNT ITEM LIST: Descript ion 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.: 0223200052 Permit Number: ELOT -680 Address: 411 STRANDER BL TUKW Status: PENDING Suite No: Applied Date: 11/13/2007 Applicant: OBJECTIVE MEDICAL ASSESSMENTS Issue Date: Initials: JEM Payment Date: 11/13/2007 02:38 PM User ID: 1165 Balance: $0.00 Payee: OBJECTIVE MEDICAL ASSESSMENTS CORPORATION Amount Payment Cash 70.00 Account Code Current Pmts 000.322.101.00.0 70.00 Total: $70.00 Payment Amount: $70.00 4914 11/13 9710 TOTAL 70.00 doc: Receipt -06 Printed: 11 -13 -2007 COMMENTS: 0/4 — r / /ye i_ scoAk c) frodp< Address: if/1 577ZiftIV,4 &, Date Called: fuo Tr_ - coAe Wo e /9 r/ odc 73Asr wo4x F/XT2M4.5 /944 Nor „ciecolq 7 71/4 6/1/1) 4A/6 "10 SiS 51/1W To glithpac -<77e 95 Aeav/teb f 5 z..",4 wet) As "ixwlet .4)by/e5 frAt;6711/c/4- Pfxri-r- A&'1g 01(4 V/04070/ Project: A 0A,T Z7.7 7 0 - 49eA /044- fisriS Type of Inspection: \ Address: if/1 577ZiftIV,4 &, Date Called: Special Instructions: Date Wanted: a. . Requester: Phone No: 11IL ;!!'1.,t It INSPECTION RECORD Retain a copy with permit INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 PERMIT NO. (206)431-36 0 El roved per applicable codes. Corrections required prior to approval. pp Ins pectorA 6 /744841/071 Date: p iil o 2 $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: aire-7/V6 la Ale , I i. nfisetmer Type of Inspection: Address: i 'M S7r4/144 a VA Date Called: Special Instructions: ' Date Wanted: /#1. - f r n n i Requester: Phone No: INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION Lir< 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)4.31- E1 Approved per applicable codes. COMMENTS: 0 6 Ccr c cGX- 4:0e11/7F-tC #t 777, P400,6, A cces 7r) /4/, fv/ /4/VdreTiofr/ ,prections required prior to approval. Ilnspect !Date: / / elerr,-"M a 1 /// 2-C/07 $513.00 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 HOLMEEC549BH Licensee Name HOLMES ELECTRIC CO Licensee Type ELECTRICAL CONTRACTOR UBI 177003752 Ind. Ins. Account Id Business Type CORPORATION Address 1 PO BOX 179 Address 2 City RENTON County KING State WA Zip 98057 Phone 4252558666 Status ACTIVE Specialty 1 GENERAL Specialty 2 UNUSED Effective Date 1/8/1946 Expiration Date 10/31/2008 Suspend Date Separation Date Parent Company Previous License Next License Associated License RICHAM* 178LZ Business Owner Information Name Role Effective Date Expiration Date RICHARDS, MICHAEL W 01/01/1980 RICHARDS, EUGENE M 01/01/1980 HOLMES, MICHAEL J 01/01/1980 HOLMES, JERAY A AGENT 01/01/1980 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 RICHAM* 178LZ RICHARDS, MICHAEL ACTIVE https: // fortress. wa. gov /lni/bbip /printer.aspx ?License= HOLMEEC549BH 11/13/2007