HomeMy WebLinkAboutPermit EL09-0055 - MEDICAMEDICA
10802 EAST MARGINAL WY S
ELO9-0055
Parcel No.: 0323049046
Address: 10802 EAST MARGINAL WY S TUKW
Suite No:
CitAf 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
Tenant:
Name: MEDICA
Address: 10802 EAST MARGINAL WY S , TUKWILA WA
ELECTRICAL PERMIT
Owner:
Name: EAST MARGINAL WAY PROP LLC Phone:
Address: 3006 NORTHUP WAY #303 , BELLEVUE WA
Permit Number: EL09 -0055
Issue Date: 01/26/2009
Permit Expires On: 07/25/2009
Contact Person:
Name: ROGER HILL Phone: 425 485 -4321
Address: PO BOX 1095 , WOODINVILLE WA
Contractor:
Name: HILL ELECTRIC CORPORATION Phone: 425 485 -4321
Address: PO BOX 1095 , WOODINVILLE WA
Contractor License No: HILLEC *045B9 Expiration Date: 01/29/2010
DESCRIPTION OF WORK:
UPGRADE EXISTING SERVICE TO 200 AMPS AND PROVIDE POWER TO FUTURE OFFICE TRAILER
DISCONNECT.
Value of Electrical: NRES: $6,000.00 Fees Collected: $233.00
RES: $0.00
Type of Fire Protection: UNKNOWN National Electrical Code Edition: 2005
Electrical Service provided by: SEATTLE CITY LIGHT
Permit Center Authorized Signature:
I hereby certify that I have read and el am3ned this permit and know the same to be true and correct. All provisions of law and ordinances
governing this work will be complied th!! whether specified herein or not.
Signature:
Print Name:
doc: EL -4/07
V 0 t h
Date: 0(I710
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 t . e performance of work. I am authorized to sign and obtain this electrical permit.
Date: 1 [i-41
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.
EL09 -0055 Printed: 01 -26 -2009
Parcel No.: 0323049046
Address:
Suite No:
Tenant: MEDICA
1: ** *ELECTRICAL * **
Signature:
Print Name:
doc: Cond -Elec
10802 EAST MARGINAL WY S TUKW
ek e/\ - \ \
S
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
PERMIT CONDITIONS
Permit Number:
Status:
Applied Date:
Issue Date:
EL09 -0055
ISSUED
01/21/2009
01/26/2009
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: Of\hn
EL09 -0055 Printed: 01 -26 -2009
SITE LOCATION
ti
Site Address: /0 90 Z 6/ Gf/a s Suite Number:
/ New Tenant:
Tenant Name:
i' GA
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.ci.tukwila.wa.us
Property Owners Name: /0 C� 4e 7 Atiei , m f
Mailing Address: 3006 .G/y1-t� ✓ // � a 4/a„rq * 3 0 3
Name: /-1/
Mailing Address: ea, 6, /.99s
__ O 9(
//
E -Mail Address: '07 ✓ �l
ELECTRICAL CONTRACTOR INFORMATION
Company Name:
Valuation of Project (contractor's bid price): $
Scope of Work (please provide detailed information):
-o
Type of Use:
Type of work:
p New ❑ Addition
❑ Low Voltage ❑ Generator
Property Served by:
❑ Puget Sound Energy
Xi Seattle City Light
H \Applications \Fortes- Apphcanons On Line \4 -2007 - Electrical Pernut Application.doc
bh
• 6
[' Service Change
❑ Fire Alarm
Electrical Permit No.
04)1 oc/
Project No.
(For office use 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 **
King Co Assessor's Tax No.: 0 3 2 3 0
Mailing Address: Po 0. /3 Ic /0 9S
l edu(
City
Contact Person: g0 9 fir" LL Day Telephone:
E -Mail Address: r oc / t.,- O A i ` /P�e c Tv� G C p ✓ . 0 41 #) Fax Number:
Contractor Registration Number: /JZL_L. c 04/S73 9 Expiration Date:
00
OJI G b >.i .rT / mi l
Ia • �wc
Will service be altered? Yes ❑ No Adding more than 50 amps?
Floor:
4Z Yes ❑ .. No
40
State
9,-
Zip
CONTACT PERSON - Who do we contact when your permit is ready to be issued
Day Telephone: ' y rS Y 3 2 /
,e/ .1-,A //e bi/A
City State
Fax Number: 1 17S— 41 5 z -
4 , 7 7 2 - z
l7 # 7Z
Ito
Zip
City State Zip
YZS- el&S 6 /3 z/
YZS tif rS- Y3z o
_ / -Zq Z
A 'es ❑ No
❑ Remodel ❑ Tenant Improvement
❑ Telecommunication ❑ Temporary Service
Page I oft
Signature:
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 demonstra
I HEREBY CERTIFY
PENALTY OF PE
BUILDING OWN
Date: /— /f!, —v
Print Name: j � .tr"" j2 ILA, ll / Day Telephone: 'WS: '/Zs 1 / 3 z /
Mailing Address: ; di , Aoye `P?? /il/00 �r- 3ai.,7 /f £'t/A VD7 Z 'l 0 9`�
City State Zip
Date Application Accepted: O t I Lt G 1 )
HAApplications \Forms - Applications On Line \4 -2007 - Electrical Permit Appltcanon.doc
bh
VE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
LAWS OF THE STATE OF WASHINGTON, AND J AM AUTHORIZED TO APPLY FOR THIS PERMIT.
CTRICAL CONTRACTOR:
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
I
Parcel No.: 0323049046 Permit Number: EL09 -0055
Address: 10802 EAST MARGINAL WY S TUKW Status: , PENDING
Suite No: Applied Date: 01/21/2009
Applicant: MEDICA Issue Date:
Receipt No.: R09 -00110
Initials:
User ID:
Payee:
doc: Receiot -06
JEM
1165
HILL ELECTRIC CORPORATION
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 18783 233.00
ACCOUNT ITEM LIST:
Description
ELECTRICAL PERMIT - NONR
ELECTRICAL PLAN - NONRES
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
000.322.101.00.0 186.40
000.345.832.00.0 46.60
Total: $233.00
Payment Amount: $233.00
1725 01/21 9707 TOTAL 233.00
Payment Date: 01/21/2009 11:02 AM
Balance: $0.00
Printed: 01 -21 -2009
Project:
Type of Inspection:
■
Address: O � O �
I .1.902,4 .
Date Called:
Special Instructions:
Date Wanted:
06/0
(If
Requester:
Phone No: '-
z
6w7 cor51
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION ae-,
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (2 -3670
vg Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
tecolo45 riA9C
� -K . (A) /41.
Inspector:
Date:
o4raa
El $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee mist be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
Project: �� ,
Type of Inspection:
•�
r
Address:
lo1o2 (. /IAA.
Date Called:
Special Instructions:
Date Wanted:
06 al
pri.
Requester:
Phone No:
El Approved per applicable codes.
INSPECTION RECORD
Retain a copy with permit
INSPE ION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION-
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -36
Date: 0(0 1
El $60.00 REINS(PECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Corrections required prior to approval.
COMMENTS:
GRoAp 445 G•J12.0> iF
5/44 Mt, Mar + .6 Re
()RAJA/ OF 1-S 0415 oR. Ler35
- - 7- L1 AP &
Foy £ . t JSL
p4.o1i0 A{c s -tom f4JiQrt
�l o 9 o> '- r M,4 lei
1 5� 5
Inspector:
Receipt No.:
(Date:
" 11497
a
HILL ELECTRIC
PANEL S C H E D U L E
Project: Medica
Project#
Location:
Pole mount north property line
Panel #: L -1 Main - breaker
Phase:
3
BussAmp: 200 Volt: 2401120
Wire :
4
Style:
Surface
Fed From: SCL Lug Type: feed thru
DESCRIPTION
PHASE
DESCRIPTION
AMP P WATT
CKT#
A B
C
CKT#
WATT
P
AM P
space
1
1305
2
1305
pole lights
2
20
.
3
1305
4
1305
200 2 job trailer feeder 17494
5
17494
6
space
16750
7
16750
8
space
9
1305
10
1305
pole lights
2
20
11
1305
12
1305
"
"
"
13
0
14
space
15
0
16
17
0
18
..
"
1 9
0
20
II
"
21
0
22
,.
II
23
0
24
II
25
0
26
,.
II
27
0
28
II
"
29
0
30
31
0
32
..
II
33
0
34
II
"
35
0
36
..
37
0
38
..
39
0
40
..
41
0
42
..
TOTAL WATTS /PHASE:
18055 2610
18799
TOTAL WATTS:
39464
240/120 NOLTS*1 .73:
415 POWER
FACTOR
CONNECTED AMP LOAD:
95.1 AMPS
medica.XLS 1/19/2009
06 -03 -2009
ROGER HILL
PO BOX 1095
WOODINVILLE WA 98072
City of Tukwila
RE: Permit No. EL09 -0055
10802 EAST MARGINAL WY S TUKW
Dear Permit Holder:
Thank you for your cooperation in this matter.
Sincerely,
Bill Rambo
Permit Technician
xc: Permit File No. ELO9 -0055
Jim Haggerton, Mayor
epartment of Community Development Jack Pace, Director
In reviewing our current records the above noted permit has not received a final inspection by the City of Tukwila Building Division.
Per the International Codes, Uniform Plumbing/Fuel Gas Code and/or the National Electrical Code, every permit issued by the
Building Division under the provisions of the code shall expire by limitation and become null and void if the building or work
authorized by such permit is not commenced within 180 days from the date of such permit issuance, or if the building or work
authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days.
Based on the above, you are hereby advised to:
Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 to schedule for the next or final inspection.
This inspection is intended to determine if substantial work has been accomplished since issuance of the permit or last inspection; or if
the project should be considered abandoned.
If such determination is made, the International Codes, Uniform Plumbing/Fuel Gas Code and/or the National Electrical Code does
allow the Building Official to approve one extension of time for an additional period not exceeding 180 days. Extension requests
must be in writing and provide satisfactory reasons why circumstances beyond the applicants control have prevented action from
being taken.
In the event you do not call for the above inspection and receive an extension prior to 07/25/2009 , your permit will become null and
void and any further work on the project will require a new permit application and associated fees.
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
ACTIVITY NUMBER: EL09 -0055 DATE: 01 -21 -09
PROJECT NAME: MEDICA
SITE ADDRESS: 10802 EAST MARGINAL WY S
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter # Revision # After Permit Issued
DEPARTMENTS: ( � 0 1
B n
uilding Df�Yision
Public Works
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
Comments:
APPROVALS OR CORRECTIONS:
Documents/rout! sli p.doc
2 -28 -02
• PERMIT COORD COPY.'
PLAN REVIEW /ROUTING SLIP
Fire Prevention
n Structural
Incomplete
Approved n Approved with Conditions
Notation:
REVIEWER'S INITIALS:
DUE DATE: 01 -22 -09
Permit Center Use Only
INCOMPLETE LETTER MAILED:
LETTER OF COMPLETENESS MAILED:
Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUES/THURS RO TING:
Please Route Structural Review Required No further Review Required n
REVIEWER'S INITIALS:
DATE:
DATE:
Planning Division
Permit Coordinator
Not Applicable
El
n
DUE DATE: 02-19-09
Not Approved (attach comments) n
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
Name
Role
Effective Date
Expiration Date
HILL, ROGER D
01/01/1980
HILL, CHERI L
01/01/1980
HILL, CHERI L
AGENT
01/01/1980
Untitled Page
•
Electrical Contractor
A business licensed by LEtI 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.
Business and Licensing Information
Name
Phone
Address
Suite /Apt.
City
State
Zip
County
Business Type
Parent
Company
HILL ELECTRIC
CORPORATION
4254854321
PO BOX 1095
WOODINVILLE
WA
980721095
KING
CORPORATION
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Previous License
Next License
Associated
License
Specialty 1
Specialty 2
601684223
ACTIVE
HILLEC *045B9
ELECTRICAL
CONTRACTOR
1/29/1996
1/29/2010
HILLE * *137BA
HILL *RD964KG
GENERAL
UNUSED
MASTER ELECTRICIAN INFORMATION
License H ILL *RD964KG
Name HILL, ROGER D
Status ACTIVE
Business Owner Information
Assignment of Savings Information
Assignment of Effective
Release
Assignment
•
Impaired
Page 1 of 2
Received
https: // fortress. wa. gov /lni/bbip/Detail.aspx ?License= HILLEC *045B9 01/26/2009