HomeMy WebLinkAboutPermit EL09-0815 - JORGENSEN FORGEThis record contains information which is exempt from public disclosure
pursuant to the Washington State Public Records Act, Chapter 42.56 RCW
as identified on the Digital Records Exemption Log shown below.
EL09 -0815
Jorgenson Forge
8531 East Marginal Way South
RECORDS DIGITAL D- ) EXEMPTION LOG
THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION
Page # tode Exemption = 8rlef Explanatory DeSclriptiop �t�tutel ule
The Privacy Act of 1974 evinces Congress'
intent that social security numbers are a private
concern. As such, individuals' social security
Personal Information —
numbers are redacted to protect those
Social Security Numbers
individuals' privacy pursuant to 5 U.S.C. sec.
5 U.S.C. sec.
DR1
Generally — 5 U.S.C. sec.
552(a), and are also exempt from disclosure
552(a); RCW
552(a); RCW
under section 42.56.070(1) of the Washington
42.56.070(1)
42.56.070(1)
State Public Records Act, which exempts under
the PRA records or information exempt or
prohibited from disclosure under any other
statute.
Redactions contain Credit card numbers, debit
card numbers, electronic check numbers, credit
Personal Information —
expiration dates, or bank or other financial
RCW
12
DR2
Financial Information —
account numbers, which are exempt from
42.56.230(5)
RCW 42.56.230(4 5)
disclosure pursuant to RCW 42.56.230(5),
except when disclosure is expressly required by
or governed by other law.
JORGENSON FORGE
8531 EAST MARGINAL
WAY S
ELO9-08 15
Parcel No.:
Address:
Suite No:
Cityllf Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
inspection Request Line: 206 - 431 -2451
Web site: http: / /www.ci.tukwila.wa.us
ELECTRICAL PERMIT
0001600023
8531 EAST MARGINAL WY 5 TUKW
Permit Number:
Issue Date:
Permit Expires On:
EL09 -0815
12/22/2009
06/20/2010
Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
JORGENSEN FORGE CORP
8531 EAST MARGINAL WY S , TUKWILA WA
JORGENSEN FORGE CORP
C/O DOUG JAMES , 8531 E MARGINAL WAY S
SUPPRESSION SYSTEMS INC
4417 PACIFIC HY E , TACOMA WA
SUPPRESSION SYSTEMS INC
4417 PACIFIC HY E , TACOMA WA
Contractor License No: SUPPRSI995NS
Phone:
Phone: 253 926 -3300
Phone: 253 926 -3300
Expiration Date: 08/10/2011
DESCRIPTION OF WORK:
PROVIDE TWO CO2 SUPRESSION SYSTEMS W ADDRESSABLE CONTROLS FOR 01 & Q6 QUENCH
TANKS
Value of Electrical:
Type of Fire Protection:
NRES: $15,000.00
RES: $0.00
UNKNOWN
Electrical Service provided by: SEATTLE CITY LIGHT
Permit Center Authorized Signature:
I hereby certify that I have read and
governing this work will be complied
a
ith,
otA4? &19
Fees Collected: $334.00
National Electrical Code Edition: 2008
Date: 12`2 -lr1°l
ed this permit and know the same to be true and correct. All provisions of law and ordinances
hether specified herein or not.
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 the performance of work. I am authorized to sign and obtain this electrical permit.
20.c-�an
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.
Date: /2/Z 2/d 1
doc: EL -4/07
EL09 -0815 Printed: 12 -22 -2009
Parcel No.: 0001600023
Address:
Suite No:
Tenant:
•
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
8531 EAST MARGINAL WY S TUKW
JORGENSEN FORGE CORP
Permit Number:
Status:
Applied Date:
Issue Date:
EL09 -0815
ISSUED
12/22/2009
12/22/2009
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 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.
Signature:
Print Name: 2A06 —T2 c
Date:
z
doc: Cond -Elec
EL09 -0815 Printed: 12 -22 -2009
CITY OF TUKWIL1P
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
httpJ/Www. ci.tukwila. wa. us
Electrical Permit No. u 0 ct — O 1
Project No.
(For office we 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
King Co Assessor's Tax No.: V 0 t L lX V _ vO 3
Site Address:M\ e.Nrsc. a) . Suite Number: Floor:
Tenant Name: %.\l .S.leN►'Sjz,N4 j-taC t Y_- _ New Tenant: ❑ Yes ,r..No
Property Owners Name: SIAM 1L.
Mailing Address: Sys v
City
State
Zip
CONTACT PERSON - Who do we contact when your permit is ready to be issued
Name: a 'l £jl`E. r' . 1 tv C C. Day Telephone: p % -pbOO
Mailing Address: L N f (,�t s C N64- c_ _ TV�_• �1F� �,2 -(aL1
l city state Zip
E -Mail Address:
Fax NumberOS • c p l.p
ELECTRICAL CONTRACTOR INFORMATION
Company Name: >4r's'NC.,.
Mailing Address:
City
Contact Person: 1■.‘ t L 2_ i IBS Day Telephone:
E -Mail Address: Fax Number:
Contractor Registration Number: T7 ?QsS 1°19514.5 Expiration Date: oe / ID
State
Zip
Valuation of Project (contractor's bid price): $ )3', c 9C51:"—Cr:7—' \t , 0 00
Scope of Work (please provide detailed information): c-, 'TO p'1 St . )V$; (Nr-1 .E:A.ts.6.2r71.
Will service be altered? ❑ Yes CNo
Type of Use: LQ..J V D LT . t 1L„
Adding more than 50 amps? ❑ Yes NSrNo
'l'vpe of work:
❑ New ❑ Addition ❑ Service Change
Low Voltage ❑ Generator re Fire - Alarm
Property Served by: 11--
❑ Puget Sound Energy
❑ Seattle City Light
10: Wppliationstronns- Apphcaa®s On Line( -2009 - Menthes/ Permit Applicance doe
bh
❑ Remodel ❑ Tenant Improvement
® Telecommunication ❑ Temporary Service
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)
$145.60
$78.00 ea
$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. furnace 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 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 CONTRACTOR:
Signature: - M _ .._ Date: /2/2 2 Z A) 7
1 i ame:
Mailing Address. yyi 7 , , .- -. , C
IIDate Application Accepted: 12I rs
Day 'telephone: 02 3 2 21 29317
Tmeo A% cAJ A RPclay
City State Zip
I)ate Application Expires:
H:\Apphcatrm.Wmma -App1, na On lane \I -2009 - Electrical Pemut Apple ahemtdoc
hh
Staff Initials: / l 1
Page 2 of 2
•
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.: 0001600023 Permit Number: EL09 -0815
Address: 8531 EAST MARGINAL WY S TUKW Status: APPROVED
Suite No: Applied Date: 12/22/2009
Applicant: JORGENSEN FORGE CORP Issue Date:
Receipt No.: R09 -02037
Initials:
User ID:
Payee:
JEM
1165
Payment Amount: $334.00
Payment Date: 12/22/2009 09:58 AM
Balance: $0.00
ZACHARY TUCK/SUPPRESSION SYSTEMS
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd MC -
Authorization No. 842735
ACCOUNT ITEM LIST:
Description
334.00
Account Code Current Pmts
ELECTRICAL PERMIT - NONR
000.322.101.00.00 334.00
Total: $334.00
PAYMENT
RECEIVED
doc: Receiot -06 Printed: 12 -22 -2009
INSPECTION RECORD r� _ 671 Retain a copy with permit
P MIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
INSPECTION NO.
Project iz f_ 64S nteype
of Inspection 2 / oo
Date Called:
�^'
Address:c.�55, � rIA A .
gg
Special Instructions:
10 :00 03%446
Date Wanted:
����
/�.m.
(p.m
Requester:
Phone No:
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
Inspector:
666,),464c
Date: 212,4s,/ ,0
IT $60.00 REINSP CTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit LO D
HERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Proje DR4 /5(� 6f?4r
�„J/ !�", tit.
Type of Inspection:
DO
Address:�i,_ t
Date Called:
Special Instructions:
eillit./ PR 1 0
Date Wanted:
2 l
/Z JJ
a.rn
p.m.
'
Requester:
(
Phone No:
DApproved per applicable codes. El Corrections required prior to approval.
COMMENTS:
I(
o hcct;55
4cJ InI5P6u toN)
/:(-2446-1
El $60.00 REINSP CTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Inspector:
Date: oz Z /to
Receipt No.:
Date:
c?%
INSPECTION NUMBER
INSPECTION RECORD
_Retain a copy with permit
01.6(1- 0"1
/0 - on/
PERMIT NUMBERS
CITY OF TUKWILA FIRE DEPARTMENT
444 Andover Park East, Tukwila, Wa. 98188 206 - 575 -4407
II�
Project: —
,
Type of Inspection:
IC: Vie
Address: X31
Suite #:
G vin WI S
Contact Person:
7a , (.t T LAc L �7 a p. e]
S fe.,„1,
Special Instructions:
.'A5k c / 3/
Phone No.: 2 j-2 27 —2 SC
5
pproved per applicable codes.
Corrections required prior to approval.
COMMENTS:
,
/-1,./,ca v (<___
Sprinklers:
Fire Alarm:
(,�1eC
wado_
is 6,j ,�re s J
ion,.
.'A5k c / 3/
Monitor:
,"
t
I,4..,
‹.
Pre -Fire:
Permits:
Occupancy Type:
9 (40 ii.-7AA 6a) afi
7, I 0
4,
c.c.., 4
a
,n, n, , .
1w
(;/ a‘,
I
4..
Needs Shift Inspection:
+_
f v 1 5'd
Sprinklers:
Fire Alarm:
q
Hood & Duct:
Monitor:
(
t
I,4..,
‹.
Pre -Fire:
Permits:
Occupancy Type:
Inspector: -c;62 .,U
+_
f v 1 5'd
Date: 9/7 S J((J
Hrs.: 7 a
$80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from
the City of Tukwila Finance Departrnent. Call to schedule a reinspection.
Word /Inspection Record Form.Doc 1/13/06
T.F.D. Form F.P. 113
G,
INSPECTION NUMBER
INSPECTION RECORD
Retain a copy with permit
csi -
/0 "oo f
PERMIT NUMBERS
CITY OF TUKWILA FIRE DEPARTMENT
444 Andover Park East, Tukwila,Wa. 98188 206- 7S -4407
Project: 0 ,,,
r o(14.
Type of Inspection:
X 02 l'ci ,,
//
4y 5 If
/
Address: c' ; /
Suite #:
.. W
Contact Person:
2Ac.ijMk - roc u„
Special Instructions:
Phone N6.:
e'Z 5,3 - ,- q -2 8S s k
p .
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
Sprinklers:
Fire Alarm:
Hood & Duct:
Monitor:
Pre -Fire:
Permits:
-- 7f'P //
p .
/
L /
li
(,ate/ cee t? /a /
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Needs Shift Inspection:
Sprinklers:
Fire Alarm:
Hood & Duct:
Monitor:
Pre -Fire:
Permits:
Occupancy Type:
Inspector: ',,,,.z, l/
�
IAA c"
Date:
/0
1
t $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from
t City of Tukwila Finance Department. CaII to schedule a reinspection.
e .
rs:
..
Word /Inspection Record Form.Doc 1/13/06
T.F.D. Form. F.P. 113
Untitled Page
•
•
Page 1 of 2
Electrical Contractor
A business licensed by LW 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 SUPPRESSION SYSTEMS INC UBI No. 600212586
Phone 2539263300 Status ACTIVE
Address 4417 PACIFIC HWY E License No. SUPPRSI995NS
Suite /Apt. License Type ELECTRICAL CONTRACTOR
City TACOMA Effective Date 8/10/2001
State WA
Zip 984242611
County PIERCE
Business Type Corporation
Parent Company
Expiration Date 8/10/2011
Suspend Date
Specialty 1 LIMITED ENERGY
Specialty 2 HVAC /RFRG LTD ENERGY
MASTER ELECTRICIAN INFORMATION
License TUCK *SH965BM
Name TUCK, STEVEN H
Status ACTIVE
Business Owner Information
Name
Role
Effective Date
Expiration Date
TUCK, STEVEN H
AGENT
08/10/2001
Received
Date
TUCK, STEVEN H
PRESIDENT
08/10/2001
Until
Released
DEPALMA, VINCE J
VICE PRESIDENT
08/10/2001
Assignment of Savings Information
Savings
Assignment of
Savings Account
Number
Effective
Date
Release
Date
Assignment
Type
Impaired
Date
Amount
Received
Date
1
8/10/2001
Until
Released
Bond
$4,000.008/14/2001
https: // fortress .wa.gov /lni/bbip /Detail.aspx
12/22/2009