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HomeMy WebLinkAboutPermit EL10-0015 - AMERICAN LASER CENTERAMERICAN LASER CENTER 6840 FORT DENT WAY EL1O-0015 CitAf 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 Parcel No.: 2954900425 Address: 6840 FORT DENT WY TUKW Suite No: ELECTRICAL PERMIT Permit Number: EL10 -0015 Issue Date: 01/25/2010 Permit Expires On: 07/24/2010 Tenant: Name: AMERICAN LASER CENTER Address: 6840 FORT DENT WY , TUKWILA WA Owner: Name: PEPPERWOOD HOLDINGS LLC Phone: Address: 2835 82ND AVE SE #300 , MERCER ISLAND WA Contact Person: Name: DARYL ANDERSON Phone: 206 - 768 -4216 Address: 7717 DETROIT AVE SW , SEATTLE WA Contractor: Name: MACDONALD MILLER FAC SOL INC Phone: 206 763 -9400 Address: PO BOX 47983 , SEATTLE WA Contractor License No: MACDOMF972BF Expiration Date: 01/06/2011 DESCRIPTION OF WORK: RELOCATE (5) EXISTING T -STAT Value of Electrical: NRES: $520.00 RES: $0.00 Type of Fire Protection: UNKNOWN Electrical Service provided by: PUGET SOUND ENERGY Permit Center Authorized Signature: I hereby certify that I have read and ex governing this work will be complied Fees Collected: $75.60 National Electrical Code Edition: 2008 Date: 0II4Uv d 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 pres a to give authority to violate or cancel the provisions of any other state or local laws regulating construction e performance of work. I am authorized to sign and obtain this electrical permit. Signature �� _i` _ Date: Y2s /I C!7 Print Name: g9i S� 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 EL10 -0015 Printed: 01 -25 -2010 Parcel No.: 2954900425 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 6840 FORT DENT WY TUKW AMERICAN LASER CENTER PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: EL10 -0015 ISSUED 01/08/2010 01/25/2010 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. Signatur Print Name: /Lid 4 Date: b doc: Cond -Elec EL10 -0015 Printed: 01 -25 -2010 -J} • CITY OF TUKWILA Community Development Department Permit Center 6300 Soufhcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us SITE LOCATION Electrical Permit No. Project No. 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 ** King Co Assessor's Tax No.: 2954900425 Site Address: 6840 FORT DENT WAY TUKWILA, WA Tenant Name: FORT DENT II - AMERICAN LASER CENTER Property Owners Name: JC RADOVICH Mailing Address: 2000 124TH AVE NE B103 MERCER ISLAND WA 98040 Suite Number: 140 Floor: 1 New Tenant: ❑ Yes ® ..No City State Zip CONTACT PERSON — Who do we contact when your permit is ready to be issued Name: DARYL ANDERSON Mailing Address: 7717 DETROIT AVE SW E -Mail Address: DARLY.ANDERSON @MACMILLER.COM Day Telephone: SEATTLE City State Fax Number: (206) 768 -4217 (206) 768-4216 WA 98106 Zip ELECTRICAL CONTRACTOR INFORMATION Company Name: Mailing Address: Contact Person: MACDONALD MILLER 7717 DETROIT AVE SW DARYL ANDERSON E -Mail Address: SAME AS ABOVE Contractor Registration Number: MACDOMF972BF SEATTLE WA 98106 City State Zip Day Telephone: (206) 7684216 Fax Number: Expiration Date: 01/06/2011 Valuation of Project (contractor's bid price): $ 520 Scope of Work (please provide detailed information): RELOCATE (5) EXISTING T -STAT Will service be altered? ❑ Yes ® No Adding more than 50 amps? ❑ Yes ® No Type of Use: Type of work: ❑ New ❑ Addition ❑ Service Change ❑ Remodel • Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication Property Served by: ® Puget Sound Energy ❑ Seattle City Light H:' pplicanons\Forms- Appbcanons On Line \1.2009 - Electrical Permit Application.doc bh ❑ Tenant Improvement ❑ Temporary Service otiv\ ci-)/' Page 1 of 2 - -1 RESIDENTIAL NEW RESIDENTIAL SERVICE ❑ New single family dwellings $145.60 (including an attached garage) ❑ Garages, pools, spas and outbuildings $78.00 ea ❑ Low voltage systems (alarm, furnace thermostat) $57.00 ea RESIDENTIAL REMODEL AND SERVICE CHANCES ❑ 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: Date: 01/08/2010 Print Name: DARLA DOLL Mailing Address: 7717 DETROIT AVE SW Day Telephone: (206) 768 -4278 SEATTLE WA 98106 Date Application Accepted: City State Zip Date Application Expires: Staff Initials: H:\Applications\Forms - Applications On Line \I.2009 - Electrical Permit Application.doc bh Page 2 of 2 ri • CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 httn://www.ci.tukwila.wa.us Electrical Permit No. E),,,..‘0- 0015 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: 6840 FORT DENT WAY TUKWILA, WA Tenant Name: FORT DENT II - AMERICAN LASER CENTER Property Owners Name: JC RADOVICH Mailing Address: 2000 124TH AVE NE B103 King Co Assessor's Tax No.: 2954900425 Suite Number: 140 New Tenant: Floor: 1 ❑ Yes ® .. No MERCER ISLAND City WA State 98040 Zip CONTACT PERSON - Who do we contact when your permit is ready to be issued Name: DARYL ANDERSON Mailing Address: 7717 DETROIT AVE SW E -Mail Address: DARLY.ANDERSON @MACMILLER.COM Day Telephone: SEATTLE City Fax Number: (206) 768 -4216 WA 98106 State Zip (206) 768 -4217 ELECTRICAL CONTRACTOR INFORMATION Company Name: MACDONALD MILLER Mailing Address: 7717 DETROIT AVE SW Contact Person: DARYL ANDERSON E -Mail Address: SAME AS ABOVE Contractor Registration Number: MACDOMF972BF SEATTLE WA 98106 City State Zip Day Telephone: (206) 768 -4216 Fax Number: Expiration Date: 01/06/2011 Valuation of Project (contractor's bid price): $ 520 Scope of Work (please provide detailed information): RELOCATE (1) EXISTING T -STAT 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\Forms- Applications On Line\I -2009 - Electrical Permit Application.doc bh ❑ Remodel ❑ Tenant Improvement ❑ Telecommunication ❑ Temporary Service Page 1 of 2 RESIDENTIAL NEW RESIDENTIAL SERVICE ❑ New single family dwellings $145.60 (including an attached garage) ❑ Garages, pools, spas and outbuildings $78.00 ea ❑ Low voltage systems (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, 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: Print Name: DARLA DOLL Mailing Address: 7717 DETROIT AVE SW Date: 01/08/2010 Day Telephone: (206) 768 -4278 SEATTLE WA 98106 City State Zip Date Application Accepted: Date Application Expires: Staff Initials: H:\Applications \Forms - Applications On Line \1 -2009 - Electrical Permit 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.• / /www.ci.tukwila.wa.us Parcel No.: 2954900425 Address: 6840 FORT DENT WY TUKW Suite No: Applicant: AMERICAN LASER CENTER RECEIPT Permit Number: EL10 -0015 Status: PENDING Applied Date: 01/08/2010 Issue Date: Receipt No.: R10 -00033 Initials: WER User ID: 1655 Payment Amount: $75.60 Payment Date: 01/08/2010 01:51 PM Balance: $0.00 Payee: MACDONALD MILLER TRANSACTION LIST: Type Method Descriptio Amount Payment Check 2336 75.60 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 75.60 Total: $75.60 PAYMENT RECEIVED doc: Receiot -06 Printed: 01 -08 -2010 ato-bbt( INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 INSPECTION RECORD Retain a copy with permit PERMIT NO. r (206)431 -3670 Project _fA' / �A Type of Inspection: �1 J© Addrees'1s:�f tV0"�, rer. Date Called: Special Instructions: 7 C 7.-- 5 Date Wanted: 210�2102-- Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Inspector: -//f Dater 02 0211 0 ri $60.00 REINSP CTION FEE REQUIRED. Prior to inspec on, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: 'Date: sys�,..synnA.,....... s,.....r..c.,r�J..._�..,._ Untitled Page Electrical Contractor A business licensed by Lid 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 Phone Address Suite /Apt. City State Zip County Business Type Parent Company MACDONALD MILLER FAC SOL INC 2067639400 PO BOX 47983 SEATTLE WA 98106 KING Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 602254260 ACTIVE MACDOMF972BF ELECTRICAL CONTRACTOR 1/6/2003 1/6/2011 GENERAL UNUSED Other Associated Licenses Page 1 of 2 License Name YP Type Specialty 1 p y Specialty 2 p y Effective Date Expiration Date Status ENCOMMS984JP ENCOMPASS MECHANICAL SERVICES ELECTRICAL CONTRACTOR MAINTENANCE HVAC /RFRG LTD ENERGY 4/17/2002 4/17/2004 EXPIRED ENCOMMS981JP ENCOMPASS MECHANICAL SERVICES ELECTRICAL CONTRACTOR HVAC /RFRG LTD ENERGY UNUSED 4/17/2002 4/17/2004 OUT OF BUSINESS MACDOMS982BM MACDONALD MILLER SERVICE INC ELECTRICAL CONTRACTOR MAINTENANCE UNUSED 1/14/2002 1/14/2004 OUT OF BUSINESS MACDOMS011 RS MACDONALD MILLER SERVICE INC ELECTRICAL CONTRACTOR HVAC /RFRG LTD ENERGY UNUSED 12/10/199912/10 /2003 OUT OF BUSINESS MACDOMC329B5 MACDONALD MILLER CO INC ELECTRICAL CONTRACTOR GENERAL UNUSED 1/25/1968 1/31/2003 OUT OF BUSINESS MASTER ELECTRICIAN INFORMATION License MCGIVMH979N8 Name MCGIVERN, MICHAEL H https:// fortress .wa.gov /lni/bbip/Detail.aspx 01/25/2010