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Home My WebLink AboutPermit EL09-0234 - HIGHLINE MEDICAL CENTERHIGHLINE MEDICAL CENTER 12844 MILITARY ELO9O234 Parcel No.: 1623049001 Address: Suite No: City* Tukwila d 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 12844 MILITARY RD S TUKW ELECTRICAL PERMIT Permit Number: EL09 -0234 Issue Date: 04/03/2009 Permit Expires On: 09/30/2009 Tenant: Name: Address: Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: HIGHLIGHN MEDICAL CENTER 12844 MILITARY RD 3 , TUKWILA WA HCH SPECIALTY CENTER ATTN ACCOUNTING DEPT , 12844 MILITARY RD S RICK ZEHNER 5005 3 AV S , SEATTLE WA MCKINSTRY ELECTRIC Address: PO BOX 24567 , SEATTLE WA Contractor License No: MCKINE *982KG Phone: Phone: 206 423 -4195 Phone: 206 832 -8513 Expiration Date: 05/08/2010 DESCRIPTION OF WORK: REPLACE EXISTING WORN OUT X -RAY W.;TH NEW /SAME LOAD Value of Electrical: Type of Fire Protection: NRES: $18,500.00 RES: $0.00 UNKNOWN National Electrical Code Edition: 2005 Fees Collected: $399.60 Electrical Service provided b f: SEATTLE CITY LIGHT Permit Center Authorized Signature: I hereby certify that I have read and e governing this work will be complied The granting of this permit does not construction or ormaaee of Signature:_ Print Name: Date: 6414,14 ed this permit and know the same to be true and correct. All provisions of law and ordinances hether specified herein or not. e to give authority to violate or cancel the provisions of any other state or local laws regulating 1 am authorized to sign and obtain this electrical permit. Date: Wil? 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 [80 days from the last inspection. doc: EL -4/07 EL09 -0234 Printed: 04 -03 -2009 Parcel No.: 1623049001 Address: Suite No: Tenant: 0 City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite 11100 Tukwila, Washington 98188 Phone: 206-431-3670 Fax: 206- 431 -3665 Web site: http: / /www.ci.tukwila.wa.us 12844 MILITARY RD S TUKW HIGHLIGHN MEDICAL CENTER PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: EL09 -0234 ISSUED 04/03/2009 04/03/2009 1: ** *ELECTRICAL * ** 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 cf 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 vi.olate or cancel the provision of any other work or local laws regulating construction Dr the perfori7ance of work. Signature: Print Name: Date: doc: Cond -Elec EL09 -0234 Printed: 04 -03 -2009 CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 htto://www.ci.tukwila.rva.us Electrical Permit No. 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 ** SITE LOCATION Site Address: Tenant Name: King Co Assessor's Tax No.: (L .b 04 IC I i2.131,11/ VM i&ti-Aty Ad ,wry / l/,Y N& 1/11Ebe,9 -L C$&JJFtot, New Tenant: ❑ Yes Et..No Property Owners Name: %l /G/il,/ NE Ol is It f¢ L Cep rr 4, Mailing Address: /2.8 till Wli1LI'Trti / gio '5014TH 714)40 Vd 4. 9b/48 City State Zip Suite Number: Floor: CONTACT PERSON - Who do we contact when your permit is ready to be issued Name:1lC-1C-• 5-00.5— 7.ekver Mailing Address: 3 k" '44J € S E -Mail Address: qtCK ?el dtAC.4LMY$YILY , CC>M Day Telephone: 200 't 23 5'EoFTTLJI gcfs/3I City State Zip Fax Number: 2dG R32- $6G 5' ELECTRICAL CONTRACTOR INFORMATION Company Name: /14 G.K 'NJ $ (T2y £ l [ 7'Q_I C. Mailing Address: 6-4>05- 3 9 v* Contact Person: :l<XN ke)vte...( E -Mail Address: Z-0 IAA clCiL)srley,Cv 1 Contractor Registration Number :K / Al E r f i!& .SE 'it City State Zip Day Telephone: 20C) "123 q 195 Fax Number: 2O Co 832 -- 8.46' Expiration Date: 51/ / 0 Valuation of Project (ccntractor's bid price): $ Scope of Work (please provide detailed information): t�rc. 4C.I €)(IST/ c- \) eta r �A y ;� (1 ft F if Le % S el- 1 04D Will service be altered? ��❑ Yes ONo f4t1._ Type of Use: Type of work: ❑ New ❑ Additio:l ❑ Low Voltage ❑ Generator Property Served by: ❑ Puget Sound Energy kSeattle City Light Adding more than 50 amps? ❑ Yes ON No ❑ Service Change ❑ Fire Alarm H.Upphcanons\Ponns- Applications Or line \1 -2009 - Electrical Permit Application doc bh ❑ Remodel ❑ Tenant Improvement ❑ Telecommunication ❑ Temporary Service Page 1 oft RESIDENTIAL NEW RESIDENTLAL SERVICE ❑ New single family dwellings $145.60 (including an attached garage) ❑ Garages, pools, spas and outbuilding $78.00 ea ❑ Low voltage system: (alarm, furnace thermostat) $57.00 ea RESIDENTIAL REMODEL AND SERVICE CHANGES ❑ Service change or alteration $78.00 (no added/altered circuits) ❑ Service change with added/altered circuits $78.00 number of added circuits $11.00 ea ❑ Circuits added/altered without service change $52.00 (up to 5 circuits) ❑ Circuits added/altered without service change $52.00 (6 or more circuits) $7.30 ea ❑ Meter /mast repair $65.00 ❑ Low voltage systems $57.00 (alarm, fumace thermostat) MULTI - FAMILY AND COMMERCIAL Fees are based on the valuation of the electrical contract. MISCELLANEOUS FEES ❑ Temporary service (residential) $60.00 ❑ 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 mad grant one extension of time for an additional period not to exceed 90 days. The extension shall be requested in writing and justifiable cause demc•nstrated. I HEREBY CERTIFY THAT I HAV:3 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 OWNE OR ELECTRICAL 1 %,I NTRACTOR: Signature: Print Name: Za- Mailing Address: ' , IDate Application Accepted: 0,4100;5[(21 Date Application Expires: H.\Apphcanons \Forms - Applications On Lne \I -2009 - Electric a Perrot Apphcanon.doc bh Day Telephone: City Date: #2- X)/ 2C4a x/23 Vac dt6 L3'j State Zip Staff Initials: fAi._ Page 2 of 2 0 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.: 1623049001 Permit Number: EL09 -0234 Address: 12844 MILITARY RD S TUKW Status: PENDING Suite No: Applied Date: 04/03/2009 Applicant: HIGHLIGHN MEDICAL CENTER Issue Date: Receipt No.: R09 -00521 Initials: User ID: JEM 1165 Payment Amount: $399.60 Payment Date: 04/03/2009 10:40 AM Balance: $0.00 Payee: MCKINSTRY CO SERVICE ACCOUNT TRANSACTION LIST: Type Method Descriptio Amount Payment Check: 10232 399.60 Authorization No. ACCOUNT ITEM LIST: Description ELECTRICAL PERM] T - NONR Account Code Current Pmts 000.322.101.00.0 399.60 Total: $399.60 PAYMENT RECEIVED doc: Receipt -06 Printed: 04 -03 -2009 INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 INSPECTION RECORD Retain a copy with permit P RMIT NO. 12-. (206)431 -3670 Project: �( t)114poL1Nc. ritolc41/ Type of Inspection: 210 Address: II 23 qH i�li,(I - Date Called: Date Wanted: 0) �� r--- a:m: Special Instructions: i Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. i COMMENTS: Inspector: (3e4Ji Date: �� -/rtj El $60.00 REINS ECTION FEE REQUIRED. Prior to inspection. fee rr{ust be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: Date: Untitled Page • Page 1 of 2 Electrical Contractor A business licensed by LftI to contract electrical work within the scope of its specialty. Electrical Contractors must maintain a surety bond or assignment of savings account. They also mus: 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 MCKINSTRY ELECTRIC 2067623311 PO BOX 24567 SEATTLE WA 98124 KING Limited Liability Company FACILITY ELECTRICAL SRVCS LLC UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Previous License Next License Associated License Specialty 1 Specialty 2 602198837 ACTIVE MCKINE *982KG ELECTRICAL CONTRACTOR 5/7/2002 5/8/2010 ZEHNER *962CJ GENERAL UNUSED MASTER ELECTRICIAN INFORMATION License ZEHNER *962CJ Name ZEHNER, RICK A Status ACTIVE Business Owner Information Name Role Effective Date Expiration Date BLACK, STEPHEN PARTNER /MEMBER 05/07/2002 ALLEN, DEAN C PARTNER /MEMBER 05/07/2002 MOORE, DOUGLAS J. PARTNER /MEMBER 05/07/2002 TEPLICKY, J. WILLIAM PARTNER /MEMBER 05/07/2002 Bond Information Bond Bond https: / /fortress.w 3.gov /lni/bbip /Detail.aspx ?License= MCKINE *982KG 04/03/2009