HomeMy WebLinkAboutPermit EL08-0554 - HEALTH FORCEHEALTH FORCE
6720 FORT DENT WY
SUITE 110
ELO8-554
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
Parcel No.: 2954900455
Address: 6720 FORT DENT WY TUKW
Suite No:
ELECTRICAL PERMIT
Permit Number: EL08 -554
Issue Date: 06/16/2008
Permit Expires On: 12/13/2008
Tenant:
Name: HEALTH FORCE
Address: 6720 FORT DENT WY, STE 110 , TUKWILA WA
Owner:
Name: JOHN C RADOVICH LLC Phone:
Address: 2835 82ND AVE SE #300 , MERCER ISLAND WA
Contact Person:
Name: JOHN C TARABOCCHIA Phone: 206 794 -1380
Address: 11805 NORTH CREEK PY S , BOTHELL WA
Contractor:
Name: UNITED ELECTRIC CONTRACTORS INC Phone: 425 - 252 -7811
Address: 5301 S 2 AV, #A , EVERETT WA
Contractor License No: UNI TEEC 176M6 Expiration Date: 10/30/2009
DESCRIPTION OF WORK:
RENNOVATION OF EXISTING CLINIC: REROUTING AND RELOCATION OF EXISTING
Value of Electrical: $22,400.00
Fees Collected:
$459.20
Type of Fire Protection: National Electrical Code Edition: 2005
Electrical Service provided by: PUGET SOUND ENERGY
Permit Center Authorized Signature:
I hereby certify that I have read and
Date: alibi/ (iX I A
ed this permit and know the same to be true and correct. All provisions of law and ordinances
governing this work will be complied th, hether s•ecified herein or not.
The granting of this permit does not pres a •i ' e authority to violate or cancel the provisions of any other state or local laws regulating
construction or the performance of w -: thorized to sign and obtain this electrical permit.
Signature:
Print Name:
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.
doc: EL -4/07 EL08 -554
Printed: 06 -16 -2008
Parcel No.: 2954900455
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
6720 FORT DENT WY TUKW
HEALTH FORCE
PERMIT CONDITIONS
Permit Number:
Status:
Applied Date:
Issue Date:
EL08 -554
ISSUED
05/12/2008
06/16/2008
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 presum
laws regulating construction or the perfo2,,
Signature:
o give authority to violate or cancel the provision of any other work or local
ce of work.
Print Name: J2t%'J i4o/% /76/e.
Date:
doc: Cond -Elec EL08 -554 Printed: 06-16 -2008
• •
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.ci.tukwila.wa.us
Electrical Permit No. a05-sgf
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
°ic'i'v 7 ~MC
Site Address: (07 0 ci,,e
7 44_ =wr /A64^ -7
Tenant Name: /5 .44-%.-Y• e.
Property Owners Name: mow►,,, c. AtioKatie
a Pas' S-a-.a A SE , 74e ace
King Co Assessor's Tax No.: /33045)0
Suite Number: I/O Floor: / sr
New Tenant: ❑ Yes Er:No
Mailing Address:
/li e 2:3e 4.�/J wA
City state
"8"e, 'ea
Zip
CONTACT PERSON - Who do we-contact when your permit is ready to be'issued
•
Name: !? _ �evac, s,4
Day Telephone: ?06 -- 77Y- /are'
Mailing Address: / /8os /1/eR- L /141, .tgl 4 .47 -4-4 . Avrar 5�//
City State Zip
Fax Number: .4,7S - •mod 7 -/,j17
E -Mail Address: ✓ .v774,,oz�,pr"4e4- ZrArodJ. C�•�
ELECTRICAL CONTRACTOR IlOORMATION
Company Name:
Mailing Address:
1 viz 4 t '7 d9.4 L ( it7 ‘744.s; .r e
.67.30/ 7,4e r,2,60 A f25 7?' / /iv,¢ - -C3' — y// /a
City State Zip
Contact Person: ii,44.0zsg.ere Day Telephone: fc2$ — a.3-62
E -Mail Address: ezyr7Le41ELZe772ia Q eg sa.usTT•t.9-- Fax Number: 4675/— $3 —/S 6
Contractor Registration Number: 41i(//TF FC / ?G/1G Expiration Date: 7 8
Valuation of Project (contractor's bid price): $L (oC90
Scope of Work (please provide detailed information): ftv.r.:str& 43uvic Tr e444"
/1<111s, des -ed+c 7 ' ,t /74,, t Acta c )A / T ('r..✓6 R= o.-. ,<(.44_
A
C ci. L.: s =: lG.✓
Will service be altered? ❑ Yes RrNo Adding more than 50 amps? ❑ Yes [t-No
Type of Use:
Type of work:
❑ New ❑ Addition ❑ Service Change ❑ Remodel [Tenant Improvement
❑ Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service
Property Served by:
[2/Puget Sound Energy
❑ Seattle City Light
H:\Applications\ Forms - Applications On Line \4 -2007 - Electrical Permit Application.doc
bh
Page 1 of 2
RESIDENTIAL
NEW RESIDENTIAL SERVICE
❑ New single family dwellings $140.00
(including an attached garage)
❑ Garages, pools, spas and outbuildings $75.00 ca
❑ 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)
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 $l 0.00 ea
PERMIT APPLICATION NOTES -
IDate Application Accepted:
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 ST4TE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER OR ELECT RI L Gf NL1t TOR:
Signature:
Print Name:
Mailing Address:
rfivr /-7/4E-rm
53'/ Sv ..i/i9v�
Day Telephone:
E I A Z
City
64 7-1A
Date Application Expires:
I t
Date: y/,30704ar
- 7I //
414 9f0 9J
State Zip
Staff Initials:
HAWpplications\Forms- Applications On Linc \a -2007 - Electrical Penmt Application.doc
bh
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:/lwww.ci.tukwila.wa.us
RECEIPT
Parcel No.: 2954900455 Permit Number: EL08 -554
Address: 6720 FORT DENT WY TUKW Status: APPROVED
Suite No: Applied Date: 05/12/2008
Applicant: HEALTH FORCE Issue Date:
Receipt No.: R08 -02129
Initials: JEM
User ID: 1165
Payment Amount: $459.20
Payment Date: 06/16/2008 11:34 AM
Balance: $0.00
Payee: UNITED ELECTRICAL CONTRACTOR, INC.
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 28712 459.20
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
ELECTRICAL PERMIT - NONR
000.322.101.00.0 459.20
Total: $459.20
3669 06/16 9711 TOTAL
459.0
doc: Receiot -06 Printed: 06-16 -2008
INSPECTION NO.
INSPECTION' RECORD
Retain a copy with permit
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION g-
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Project: /
Type of Inspection: X/00 / 7 0 03
Address: Fr: Doe
Date Called:
Special Instructions:
Date Wanted:
0//0‘
C661130
P.m.
Requester:
Phone No:
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
Inspector:
�7
Date:
01/0G/07
ri $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
/Z
_ ........a....f...m_ :• _ • •..ym,. _•....•r., ____.. - .. _.�. r .�, .._ ,.�_ . —
INSPECTION RECORD
645 CI
Retain a copy with permit
INSPE ION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION 12—
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Project: 1jJ
/
Type of Inspection:
70
Address:612O �T • D
Date Called:
Special Instructions:
Date Wanted:
I, D
a:m
m.
Requester:
Phone No:
Approved per applicable codes. Corrections required prior to approval. el
COMMENTS:
YA-
(o -LA CTloo5 MM)'
ri $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
'Date:
INSPE ION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
INSPECTION RECORD
Retain a copy with permit
t 55
PERMIT NO.
01\L
.
t t 1 V r°14.6
Type of Inspection:
Do
Address:
Date Called:
Special nstructions:
Date Wanted:
/'
p�
a1I
Requester:
Phone No:
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
gv50-‘4k5 4COvtt..C-D Fog LDu
VatA-Drtl,E 16T#kL p -11",i
STJO pn P
Inspector: 614J VC
I F'�
Date:
11 (09 0\g
El $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
'Date:
INSPECTION RECORD
Retain a copy with permit
eld -C
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Project: deta,
14 k�+
Type of Inspection:
Address:
OW ri•
ere
Date Called:
Special Instructions:
Date Wanted:
(2�
F/
61.tne.
Requester:
Phone No:
EIApproved per applicable codes. Corrections required prior to approval.
COMMENTS:
\()
fA
04. - critkom 4a-Tinki
aJ P�wsE z
Inspector: 111 f 7ec_
Date: I 2i r�
0
r7 $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
.�... •._
INSPECTION RECORD �t�.s��
Retain a copy with permit
INSPE ION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION R
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431-
Project: �_�� ��r
Type of Inspection: Z/00/7 00Y
Address:
67i° ri--
ff4-1-
Date Called:
Special Instructions:
Date Wanted:
/Z r
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p.m.
Requester:
Phone No:
Approved per applicable codes. EJ Corrections required prior to approval.
COMMENTS:
Ce I Li /A 0 Futsfsa.
rFuA-5f 2
Inspector:
Date: D' j ( 1 o\
El $60.00 REINS ECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
INSPECTION RECORD CS
Retain a copy with permit J
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION R
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Project: 1/64014 kce
Type of Inspection: 70D/
Address: 'J �/r
i7io Pr- P &� V
Date Called:
?A
Special Instructions:
Date Wanted:
0 2, . .
Requester:
1
Phone No:
Approved per applicable codes. ❑ Corrections required prior to approval.
COMMENTS:
?A
... 0.K... 66,4,461 Cov& ? 6(
1
- OCCvPlPMc 6 1
O.K. - vJ° -5 A4D $orcir$
PwA-$e Z-
Inspector:
.7hQssroies
Date: 002/A7
D$60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
v
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION ``-
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Project:
1/6404
`e6
Type of Inspection:
700
3
Address:
6917-0 F
^�
VG,+' •
Date Called:
��
f
Special Instructions:
Date Wanted:
/�
a.m.
Requester:
Phone No:
DApproved per applicable codes. Corrections required prior to approval.
COMMENTS:
Q
(.0140 LiD5
(3,061+QtxH5
Inspector:
Date: 1
to ins b O�
El $60.00 REINSPECTION FEE REQUIRED. Prior p ec Ion ee
must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
'Date:
gbaelidilieFfafiran4AHILRIFWEAffellablbelnts0 •111km.:Lakiw..ftaaVegratbi4LIL.L.-._■us4.1. saidi. ii..•LA:e. -- �..a.r
INSPECTION RECORD ,g. ,1
Retain a copy with permit �?
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION V-
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Project:
'RAU
11LC
Type of Inspection:
Address 71.-0 �t
���
Date Called:
Special Instructions:
Date Wanted:
1 ti
n..
are
Phone No:
ElApproved per applicable codes. LJ Corrections required prior to approval.
COMMENTS:
P�+
D.K. c-04tc,
'-6Tlil1 RooN5
Inspector:
Date:
b 01?
1-1$60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
(Date:
•
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
1
:REVISION °SUBiVIITT
Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through
the mail, fax, etc.
Date: er7g Plan Check/Permit Number:
❑ Response to Incomplete Letter #
❑ Response to Corre ti Letter #
tif Revision # l Permit is Issued
❑ Revision requested by a City Building Inspector or Plans Examiner
RECEIVED
wwu
JUN 16 2008
f'tHiMll CENTER
Project Name: 41,4 77y faeee
Project Address: - ?.ZO// /C%e4T,QF,JI ' 2qy 5y/ /%
Contact Person: Ave �i�fr/i - Phone Number: ?4.2,5"--- 45.2- -25-1/
Summary of Revision: 44) ,eEV /S/ ...1-e.,' .=''" GO.e,C
, 5c-(A Z1 _7a/ �eJJ' - /LP�j /4/B.. 0f e®O —
Sheet Number(s):
"Cloud" or highlight all areas of revision including date of revision
Received at the City of Tukwila Permit Center by
Entered in Permits Plus on (101 41 2 Dv
\applications\forms- applications on line\revision submittal
Created: 8 -13 -2004
Revised:
Look Up a Contractor, Elect an 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
UNITEEC176M6
Licensee Name
UNITED ELECTRIC CONTRS INC
Licensee Type
ELECTRICAL CONTRACTOR
UBI
600496316
Ind. Ins. Account Id
Business Type
CORPORATION
Address 1
5301 S 2ND AVE A
Address 2
City
EVERETT
County
SNOHOMISH
State
WA
Zip
98203
Phone
4252527811
Status
ACTIVE
Specialty 1
GENERAL
Specialty 2
UNUSED
Effective Date
7/26/1983
Expiration Date
10/30/2009
Suspend Date
Separation Date
Parent Company
Previous License
Next License
Associated License
HAMMEDL979DM
Master Electrician Information
License
HAMMEDL979DM
Name
HAMMER, DAVID L
Status
ACTIVE
Business Owner Information
Name
Role
Effective Date
Expiration Date
ANDERSON, LIANNE M
01/01/1980
COMPOSANA, KAREN R
01/01/1980
HAMMER, BETTY J
01/01/1980
HAMMER, BETTY J
AGENT
01/01/1980
•
Page 1 of 2
https:// fortress .wa.gov /lni/bbip /printer. aspx ?License= UNITEEC 176M6 06/16/2008