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HomeMy WebLinkAboutPermit EL08-0266 - WASHINGTON STATE NURSING ASSOCIATIONWA STATE NURSING ASSOCIATION 575 ANDOVER PK W ELO8-266 Cityitf 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 Parcel No.: 2623049144 Address: 575 ANDOVER PK W TUKW Suite No: ELECTRICAL PERMIT Permit Number: EL08 -266 Issue Date: 03/18/2008 Permit Expires On: 09/14/2008 Tenant: Name: WASHINGTON STATE NURSING ASSOCIATION Address: 575 ANDOVER PK W , TUKWILA WA Owner: Name: SOUTHCENTER CORPORATE SQUAR Phone: Address: 150 CALIFORNIA ST , SAN FRANCISCO CA Contact Person: Name: PAUL KLUTZ Phone: 425 742 -4200 Address: 15103 60 AV W , EDMONDS WA Contractor: Name: EVERGREEN ELECTRICAL SRVCS INC Phone: 425 742 -4200 Address: 15103 60 AV W , EDMONDS WA Contractor License No: EVERGES039KF Expiration Date: 05/06/2009 DESCRIPTION OF WORK: INSTALL ELECTRICAL FOR NEW ADDTITON - (8) NEW CIRCUITS FOR POWER Value of Electrical: $3,000.00 Type of Fire Protection: Electrical Service provided by: PUGET SOUND ENERGY Permit Center Authorized Signature Fees Collected: National Electrical Code Edition: $124.00 2005 Date: 01 IS tol I hereby certify that I have read andtexaed this permit and know the same to be true and correct. All provisions of law and ordinances governing this work will be complie vin h, whether specified herein or not. The granting of thi • ermit does not presume to give authority to violate or cancel the provisions of any other state or local laws regulating construction or th r•erformance of womil - a horized to sign and obtain this electrical permit. Signature: i _I, ILA. LJ 46 fib Date: 3 110P Print Name: a r,' L/ I/ This permit shall become n{ill 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. doc: EL -4/07 EL08 -266 Printed: 03 -18 -2008 • • 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 Parcel No.: 2623049144 Permit Number: EL08 -266 Address: 575 ANDOVER PK W TUKW Status: ISSUED Suite No: Applied Date: 03/18/2008 Tenant: WASHINGTON STATE NURSING ASSOCIATION Issue Date: 03/18/2008 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 cony ction or the performance of work. Signature dig, it. LJ ,t Date: 3 t /oU doc: Cond -Elec EL08 -266 Printed: 03 -18 -2008 CITY OF TUKWILIP Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 htto://Www.ci.tukwila.wa.us Electrical Permit No. 0/09) - 21E4 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 �`/ N,1 p \ , , King Co Assessor's Tax No.: /J,J2.12014 "1 1 q q 5 Site Address: / �, �(JQv�c �1��� W Suite Number: Floor: Tenant Name: IOCA,6,-)V `-3`1- l\ \uv�,\V\c 14% New Tenant: ❑ Yes N..No Property Owners Name: \5� %�",1 A COr P Mailing Address: J i[ ■ \ V\ E_ City State Zip CONTACT PERSON - Who do we contact when your permit is ready to be issued Name: c ) 6 ‘ , 0 \ Y `u - z Day Telephone: 4/25-- 17 ? 3 -sa. T I Mailing Address: E -Mail Address: City State Zip Fax Number: ELECTRICAL CONTRACTOR INFORMATION Company Name: E\% ex --0AN \ \-e(A-4(k u.A r �l • Mailing Address: Contact Person: mac. A E -Mail Address: Ke_)(l. ep G9 t 7 k, J* Se City 3h( L,v ctvz. �17C State / ��,7.i Day Telephone: !G� /` '7L/� `4 �X Fax Number: Contractor Registration Number: vt.r6 ecs ()`-4C1 W\7 Expiration Date: Valuation of Project (contractor's bid price): $ (3C.iI.C_la` f II _ /� f� , q Scope of Work (plelasg provide detailed information): 'Y\54C4 1 EIed r czA \ /r Y�-LV %4-DDd i ©i7 . c4 - Vl P_Lt) r_; t` CO 11 for 0,U r` Will service be altered? El Yes No Type of Use: Type of work: ❑ New P Addition ❑ Service Change ❑ Remodel 1 Tenant Improvement ❑ Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service Adding more than 50 amps? ❑ Yes ,k No Pro s e Served b : Puget Sound Energy ❑ Seattle City Light HAApplicaaonsWorms- Applications On 1 -in64 -20117 - Fiectncal Penult Applicat'on.doc bh 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) $140.00 575.00 ea $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) 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. BUILDING 0 R O'. ECT' L C • RACTOR: Signature: Print Name: PU,7*/ / 44'III. ..2 I Mailing Address: Date: 3 _i (id Day Telephone: LIZ" —% t12 C Date Application Accepted: City State Zip olts(0.1, Date Application Expires: H:Wpplications\Forms- Applicahom On Lane\4 -2007 - Electrical Permit Application.doc bh Staff Initials: / I 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.citukwila.wa.us RECEIPT Parcel No.: 2623049144 Permit Number: EL08 -266 Address: 575 ANDOVER PK W TUKW Status: PENDING Suite No: Applied Date: 03/18/2008 Applicant: WASHINGTON STATE NURSING ASSOCIATION Issue Date: Receipt No.: R08 -00814 Initials: JEM User ID: 1165 Payment Amount: $124.00 Payment Date: 03/18/2008 02:23 PM Balance: $0.00 zy Payee: EVERGREEN ELECTRICAL SERVICES, INC. TRANSACTION LIST: Type Method Descriptio Amount Payment Check 20871 124.00 ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.0 124.00 Total: $124.00 07 118 ,'7 ?O TO-AL 124,0 :: doc: Receiot -06 Printed: 03 -18 -2008 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 -3670 Eau ? -2f6 Project: W // liheASt ,94/(f Type of Inspection: •/a0 A`ddress: Date Called: Special Instructions: Date Wanted: // T-4/2 p.m. Requester: Phone No: roved per applicable codes. Corrections required prior to approval. OMMENTS: o.4 f /4/41- Inspec or�``L rEaZ /Z // $58.00 REINSPECTION FEE REQUIRED. Prior o inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call the schedule reinspection. Receipt No.: Date: # 3 INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 INSPECTION RECORD Retain a copy with permit (bo\is'- 114 PERMIT NO. (206)431 -3670 Project: � TAB � aCtri Type of Inspection: -7 QQ Address: Date Called: Special Instructions: Date Wanted: (11 a:m: Requester: Phone No: Approved per applicable codes. COMMENTS: Corrections required prior to approval. PA-- cot„),4,,, NI Dalt k Occoofp,10-1 /law /�I(7Tf � - Fit L�GAT 5A) i mart c yT. l,Jli-I1 To 8C i w' . ft.10-111 h Inspector: &LI Date: OY11o`$ 0 $58.00 REINSPECTION FEE RE UIRED. 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 INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION - 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Proje t: frI —.<9,77f. 4.0Z5://1/6,-. Type of Inspection: )O' J' .. , -0//c/c6 //7 ,1 /'/, //. Address: S7j /MN0114PK Date Called: Special Instructions: Date Wanted: -V7 2-6, a.m. p.m. Requester: Phone No: pproved per applicable codes. Ei Corrections required prior to approval. COMMENTS: /9:9 g-- E g T-1,4 /c,� 11)44L--5 - 4/4./9 117 .. , -0//c/c6 //7 ,1 /'/, //. Inspect ,�� /G� � -4l7,. _ :At/ 17 Date / /0 El $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: 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 EVERGES039KF Licensee Name EVERGREEN ELECTRICAL SRVCS INC Licensee Type ELECTRICAL CONTRACTOR UBI 601788846 Ind. Ins. Account Id PRESIDENT Business Type CORPORATION Address 1 15103 60TH AVE W Address 2 04/24/2001 City EDMONDS County SNOHOMISH State WA Zip 98026 Phone 4257424200 Status ACTIVE Specialty 1 GENERAL Specialty 2 UNUSED Effective Date 5/6/1997 Expiration Date 5/6/2009 Suspend Date Separation Date Parent Company Previous License EVERGES066QB Next License Associated License GISEBJR975RJ Master Electrician Information License GISEBJR975RJ Name GISEBURT, JOE R Status ACTIVE Business Owner Information Name Role Effective Date Expiration Date JACKSON, MIKE AGENT 04/24/2001 GISEBURT, JOE R PRESIDENT 01/01/1980 HINES, JOHN AGENT 01/01/1980 04/24/2001 HINES, JOHN TREASURER 01/01/1980 04/24/2001 • Page 1 of 2 https: // fortress. wa. gov /lni/bbip /printer.aspx ?License= EVERGES039KF 03/18/2008