HomeMy WebLinkAboutPermit EL08-0753 - GROUP HEALTH PRIMARY CAREGROUP HEALTH
PRIMARY CARE
12400 EAST MA
wys
GINAL
CitAif 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
ELECTRICAL PERMIT
Parcel No.: 7340600480
Address: 12400 EAST MARGINAL WY S TUKW
Suite No:
Permit Number: EL08 -753
Issue Date: 06/12/2008
Permit Expires On: 12/09/2008
Tenant:
Name: GROUP HEALTH PRIMARY CARE
Address: 12400 EAST MARGINAL WAY S , TUKWILA WA
Owner:
Name: ANNE ARUNDEL APARTMENTS LLC Phone:
Address: 10 W MARKET -1200 MARKET TOWE , INDIANAPOLIS IN
Contact Person:
Name: TERRAH BENSON Phone: 206 -774 -7145
Address: 549 S DAWSON ST , SEATTLE WA
Contractor:
Name: NETVERSANT WASHINGTON INC Phone: (206)774 -7100
Address: 3849 1ST AVE S , SEATTLE WA
Contractor License No: NETVEWI972RN Expiration Date: 12/15/2009
DESCRIPTION OF WORK:
REMOVE TAG & COIL EXISTING CABLE AND REINSTALL, PROVIDE OVERHEAD SPEAKERS
Value of Electrical: $10,000.00
Fees Collected:
$246.00
Type of Fire Protection: National Electrical Code Edition: 2005
Electrical Service provided by: SEATTLE CITY LIGHT
Permit Center Authorized Signature:
J1L
Date: (9— t - O
I hereby certify that I have read and examined this permit and know the same to be true and correct. 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 provisions of any other state or local laws regulating
construction • • rmancjof; ork. I am authorized to sign and obtain this electrical permit.
Signature:
Print Name:
aray1n
Date:
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 -753 Printed: 06-12 -2008
Parcel No.: 7340600480
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
12400 EAST MARGINAL WY S TUKW
GROUP HEALTH PRIMARY CARE
Permit Number:
Status:
Applied Date:
Issue Date:
EL08 -753
ISSUED
06/12/2008
06/12/2008
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 construction or the performance of work.
Signature:
Print Name:
Date:
doc: Cond -Elec
EL08 -753 Printed: 06-12 -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. l.-O 753
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
/� •��_]� /� 1 King Co Assessor's Tax No.: —1340 (PD' 0 4 U 0
Site Address: 12400 • -0■4l�l �^',"1►Q`V t \ rn'(' 5. Suite Number: Floor:
Tenant Name: VYC W� L4 1 rt I' av Care New Tenant: ❑ Yes ..No
Property Owners Name:
�/�//��/-1 +"_� G.- ��/�,
Mailing Address: �24Vb ' O& Mtn ( k YVA1.3 cS .
Sto -It W �1
( state
Zip
CONTACT PERSON - Who do we contact when your permit is ready to be issued
Name: 'L Vr1 Oh Ii e nan c p/�j��Day Telephone: 2/ )19- Y19 -1145
Mailing Address: 5% s • DaNNi 5k S. C.� �-t/t 1 lei WP g t Vj
COity State p
E -Mail AddressT25 N5bN @NtAN eYSran}
• m Fax Number: 20Lp "1 -1y — io t
ELECTRICAL CONTRACTOR INFORMATION
Company Name: Vt4' S w t"f
Mailing Address: S 1 S . DD , 01 ) T:-.A • sj/►' \ -e l¢ 1 sl
Contact PersonTt�[,,I�tJ�tri 1 f�/VI 1ZJ,Sb-t , p
E -Mail Address: fr/`G14 61J G4N G� 4 Y 1* • W *M�
Contractor Registration Number:Nty ''W 1- 112 �^%
City State 1 , 4S
,' Zip
Day Telephone: �201D "�'7 -it
Fax Number: G0t0
-- 17LI-1
Expiration Date: -31
-200
Valuation of Project (contractor's bid price): $ 1° i 00
Scope of Work (please provide detail d information): g • LIN
�t--1n ,11 , NoN We 5? •
YehrS )(1541 r) Pub1P AA5b
Will service be altered? ❑ Yes • No Adding more than 50 amps? ❑ Yes No
Type of Use:
Type of work:
❑ New ❑ Addition ❑ Service Change
❑ Low Voltage ❑ Generator ❑ Fire Alarm
Property Served by:
❑ Puget Sound Energy
❑ Seattle City Light
H:\Applications\Fonns- Applications On Line \4 -2007 - Electrical Permit Application doc
bh
❑ Remodel ❑ Tenant Improvement
NI Telecommunication ❑ Temporary Service
Page 1 of 2
IDate Application Accepted:
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)
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 he 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: nn
Print Name: M1 Wy
Date: b 0 " On
Telephoone:2d 11 ^-1 t
Mailing Address: k"IrpL • Pckn c bn -e, (1,
V V R- •
City
State
Zip
Date Application Expires:
Staff Initials:
H.\Applications\Forms- Applications On Line4-2007. Electrical Permit Application -doe
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.: 7340600480 Permit Number: EL08 -753
Address: 12400 EAST MARGINAL WY S TUKW Status: PENDING
Suite No: Applied Date: 06/12/2008
Applicant: GROUP HEALTH PRIMARY CARE Issue Date:
Receipt No.: R08 -02094
Payment Amount: $246.00
Initials: WER Payment Date: 06/12/2008 02:08 PM
User ID: 1655 Balance: $0.00
Payee: NETVERSANT
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 10303758 246.00
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
ELECTRICAL PERMIT - NONR
000.322.101.00.0 246.00
Total: $246.00
3585 06/12 9711 TOTAL 246.00
�1nr Raraint -OR
Printed. OR-12 -2008
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION it.
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3
Project: � t
�a eJ e ���`y1
Type of Inspection:
00
Address
/1110° 11�• �l'
Called:
Special Instructions:
L.,%/ , S16 -,� S
r `+C�It
,
Date Wanted:
vii
{`
a:m
Requester:
Phone No:
Approved per applicable codes. 0 Corrections required prior to approval.
j0
COMMENTS:
rA)A,
Inspector:- &wets
1
(Date: /(S'as
❑$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:
.411:4 acoehadilmkoteti.ev•e-tild.senalgelligniatti^..-•4.12zeisfebefew=a1SP
INSPECTION REORD��_ ��
Retain a copy with permit
INSPECTI N N0. PERMIT N0. ✓
CITY OF TUKWILA BUILDING DIVISION I
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Gto,1 P Project:
te-
Type of Inspection:
7003
Address:
i
Date Called:
Special Instructions:
Date Wanted:
1 /01
�a.D
p.m.
Requester:
Phone No:
ElApproved per applicable codes. Corrections required prior to approval.
COMMENTS:
CA-
D.K. - coi.oltA cAufA CiCCe1'
ear PovJe. Poi -E.5 ADD
witu. tif2-Df5
Inspector:
611S
1-1$60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Date: 0 I a f IC4
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
NETVEWI972RN
Licensee Name
NETVERSANT WASHINGTON INC
Licensee Type
ELECTRICAL CONTRACTOR
UBI
601628538
Ind. Ins. Account Id
40450001
Business Type
CORPORATION
Address 1
3849 1ST AVE S
Address 2
City
SEATTLE
County
KING
State
WA
Zip
98134
Phone
2067747100
Status
ACTIVE
Specialty 1
TELECOMMUNICATIONS
Specialty 2
UNUSED
Effective Date
12/15/2003
Expiration Date
12/15/2009
Suspend Date
Separation Date
Parent Company
Previous License
Next License
Associated License
NEWMAGM972RN
Electrical Administrator Information
License
NEWMAGM972RN
Name
NEWMAN, GEOFFREY M
Status
ACTIVE
Business Owner Information
Name
Role
Effective
Date
Expiration
Date
CAPITOL CORP SVCS
INC
AGENT
12/15/2003
NEWMAN, GEOFFREY
M PRESIDENT
12/15/2003
Page 1 of 2
https:// fortress .wa.gov /lni/bbip /printer.aspx ?License= NETVEWI972RN 06/12/2008