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Home My WebLink AboutPermit EL10-0054 - SCHRYVER MEDICALSCHRYVER MEDICAL 12668 INTERURBAN AV S EL 10-0054 Citylk 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.c tu kwila.wa.us Parcel No.: 2716000030 Address: 12668 INTERURBAN AV S TUKW Suite No: ELECTRICAL PERMIT Permit Number: EL10 -0054 Issue Date: 01/26/2010 Permit Expires On: 07/25/2010 Tenant: Name: SCHRYVER MEDICAL IN Address: 12668 INTERURBAN AV S , TUKWILA WA Owner: Name: RREEF AMERICA REIT II CORP/ Phone: Address: PO BOX 4900 #207 , SCOTTSDALE AZ Contact Person: Name: DON CHISHOLM Phone: 206 714 -6259 Address: 3921 ANGELINE ST , SEATTLE WA Contractor: Name: FLEX VIDEO AND MULTIMEDIA LLC Phone: 206 714 -6259 Address: 3921 S ANGELINE ST , SEATTLE WA Contractor License No: FLEXVVM913CL Expiration Date: 02/21/2011 DESCRIPTION OF WORK: ETHERNET CAT 5E CABLING Value of Electrical: NRES: $2,600.00 RES: $0.00 Type of Fire Protection: 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 complie Fees Collected: $136.50 National Electrical Code Edition: 2008 Date: 0 t 1 T O ned this permit and know the same to be true and correct. All provisions of law and ordinances whether specified herein or not. The grantin• . s pe t does not p constructi.. or t e perfrman¢e of w Signature: Print Name: to give authority to violate or cancel the provisions of any other state or local laws regulating thorized to sign and obtain this electrical permit. 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 ELI 0-0054 Printed: 01 -26 -2010 Parcel No.: 2716000030 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 12668 INTERURBAN AV S TUKW SCHRYVER MEDICAL IN PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: EL10 -0054 ISSUED 01/26/2010 01/26/2010 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: Arty 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: -Da„ 0 f 1 J- a: s L 01, Date: ((2,6 (( (3 doc: Cond -Elec ELI 0-0054 Printed: 01 -26 -2010 CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us 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.: 2'1 I L€CO _(2CP30 Site Address: o2C�$ 1 �V-Fe2 v R B N VL14° Suite Number: Floor: Tenant Name: SC., 11. i - vet), il/e xPi CO J J C, New Tenant: Yes ❑..No Property Owners Name: vrVi . (149-1 II- 6-C__Mickfir- e- s City Mailing Address: / _ N Name: b t L % 5 Lb tAh Mailing Address;' 711u ii�e,I 1/4)Q-51 E -Mail Address: bolo et Flex V t b e° t co " State Day Telephone: �U 7" i-2-6.1 sCw �/ VAS gl(:�� City State Zip Fax Number: Company Name: rfex S pep 4- nv J 4-1 1� �,� ! /9' L L Mailing Address:39,.a.1 4-16 Gam) 4t) Pi s I r � � t.i, i i City State Contact Person: DO 10 5h0 `rt' E -Mail Address: Aoki t -k' 1/i DIf.o t C 5 h Zip Day Telephone: -O 7 01 2-57 Fax Number: Contractor Registration Number: F /.5( V 11 I (3 ('11-, Expiration Date: Te:F, .20 fa m�— Valuation of Project (contractor's bid price): $ b d j ,1 / Scope of Work (please provide detailed information): 11'e /�% °c_� Cf't 5L (4 B/t,pc) (T— Will service be altered? ❑ Yes No Adding more than 50 amps? ❑ Yes No Type of Use: Type of work: ❑ New ❑ Addition ❑ Service Change ❑ Remodel ❑ Tenant Improvement Z1 Low Voltage ❑ Generator ❑ Fire Alarm. ❑ Telecommunication ❑ Temporary Service Property Served by: _R ❑ Puget Sound Energy Seattle City Light H:\Applications\Forms- Applications On Line\2010 Applications \I-2010 - Electrical Permit Application.doc bh Page 1 of 2 IDate Application Accepted: RESIDENTIAL NEW RESIDENTIAL SERVICE ❑ New single family dwellings $152.85 (including an attached garage) ❑ Garages, pools, spas and outbuildings $81.90 ea ❑ Low voltage systems (alarm, furnace thermostat) $59.85 ea RESIDENTIAL REMODEL AND SERVICE CHANGES ❑ Service change or alteration $81.90 (no added /altered circuits) ❑ Service change with added /altered circuits $81.90 number of added circuits $11.55 ea ❑ Circuits added /altered without service change $54.60 (up to 5 circuits) ❑ Circuits added /altered without service change $54.60 (6 or more circuits) $7.65 ea ❑ Meter /mast repair $68.25 ❑ Low voltage systems $59.85 (alarm, furnace thermostat) PERMIT:APPLICATION NOTES `= MULTI - FAMILY AND COMMERCIAL Fees are based on the valuation of the electrical contract. MISCELLANEOUS FEES ❑ Temporary service (residential) $63.00 ❑ Temporary service (generator) $78.75 ❑ Manufactured /mobile home service $84.00 (excluding garage or outbuilding) ❑ Carnivals $78.75 Number of concessions $10.50 ea 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 • PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDIN O ' NE ' , R EL t ICAL CONTRACTOR: Signature. Print Name Mailing Address: Date: 4126 Day Telephone: t4-0 State Date Application Expires: Staff Initials: H:\Applications \Forms - Applications On Line\2010 Applications \I -2010 - Electrical Permit Application,doc bh Page 2 of 2 Zip 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.: 2716000030 Permit Number: EL10 -0054 Address: 12668 INTERURBAN AV S TUKW Status: PENDING Suite No: Applied Date: 01/26/2010 Applicant: SCHRYVER MEDICAL IN Issue Date: Receipt No.: R10 -00123 Payment Amount: $136.50 Initials: JEM Payment Date: 01/26/2010 01:04 PM User ID: 1165 Balance: $0.00 Payee: DONALD J CHISHOLM, FLEX VIDEO & MULTIMEDIA TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd MC - Authorization No. 010416 ACCOUNT ITEM LIST: Description 136.50 Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 136.50 Total: $136.50 PAYMENT RECEIVED doc: Receiot -06 Printed: 01 -26 -2010 INSPECTION RECORD Retain a copy with permit 640-004 00)7 INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION • ' 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Project: <; 1d tll CAL%' Type of Inspection: Boa Address: Date Called: Special Instructions: Date Wanted: h' 1 p.m, Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: 0 K., 4, Inspector: 1&141erN ri $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Date: Receipt No.: Date: L INSPECTION RECORD Retain a copy with permit 0-10 -OOf INSPE&rION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Proje,s v t`Cirk Type of Inspection: , _ „ 74 Date Called: Address: / 2-443 /446 Special Instructions: ,o n y Date Wanted: / O a.m. Requester: Phone No: EiApproved per applicable codes. D Corrections required prior to approval. COMMENTS: arodbi cotitc 4)(414 id emillor �c5ftdkC. TATA- Ilf1{.!4 -ro Yaci Gaod,Jj> 9A-TA RAc►c Inspector:✓Jr 86/14e.c �f �� $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Date: OgOt � V Receipt No.: Date: Untitled Page • • Page 1 of 1 General /Specialty Contractor A business registered as a construction contractor with L&tI to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name Phone Address Suite /Apt. City State Zip County Business Type Parent Company FLEX VIDEO AND MULTIMEDIA LLC 2067146259 3921 S ANGELINE ST SEATTLE WA 98188 KING Individual UBI No. 602125478 Status ACTIVE License No. FLEXWM913CL License Type CONSTRUCTION CONTRACTOR Effective Date 2/13/2009 Expiration Date Suspend Date Specialty 1 HANDYMAN Specialty 2 UNUSED 2/13/2011 Business Owner Information Name Role Effective Date Expiration Date CHISHOL, DONALD J HANDYMAN 02/13/2009 Bond Amount Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 1 DEVELOPERS SURETY Et INDEM CO 799675C 02/13/2009 Until Cancelled $6,000.00 02/13/2009 Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date HARTFORD 1 CAS INS 6803534M071 05/15/200805/15 /2010 $1,000,000.0005 /20/2009 CO https://fortress.wa.gov/lni/bbip/Detail.aspx 01/26/2010