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Home My WebLink AboutPermit EL10-0330 - PACIFIC MEDICALPACIFIC MEDICAL 12644 INTERURBAN AV S EL1O-0330 CityIf 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.: 2716000030 Address: 12644 INTERURBAN AV S TUKW Suite No: ELECTRICAL PERMIT Permit Number: EL10 -0330 Issue Date: 05/04/2010 Permit Expires On: 10/31/2010 Tenant: Name: PACIFIC MEDICAL Address: 12644 INTERURBAN AV S , TUKWILA WA Owner: Name: RREEF AMERICA REIT II CORP/ Phone: Address: PO BOX 4900 #207 , SCOTTSDALE AZ Contact Person: Name: BOB WORLEY Phone: 425- 251 -0244 Address: 287 SW 41 ST , RENTON WA Contractor: Name: CAPITAL LIGHTING COMPANY INC Phone: 425 251 -0244 Address: 287 SW 41 ST , RENTON WA Contractor License No: CAPITLC964RN Expiration Date: 12/15/2010 DESCRIPTION OF WORK: LIGHTING RETROFIT Value of Electrical: NRES: $960.00 RES: $0.00 Type of Fire Protection: UNKNOWN Electrical Service provided by: SEATTLE CITY LIGHT Permit Center Authorized Signature: Fees Collected: $96.60 National Electrical Code Edition: 2008 Date: �_ V 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 ,• ermi does not res construction or the . erfo • ce of or ,�am authorized to sign and obtain this electrical permit. e to give authority to violate or cancel the provisions of any other state or local l s regulating Signature: Date: d /� J Print Name: e61_4 � This permit shall become null and void if the 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 -0330 Printed: 05 -04 -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 12644 INTERURBAN AV S TUKW PACIFIC MEDICAL PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: EL10 -0330 ISSUED 05/04/2010 05/04/2010 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 thi does not presume to give authority to violate or cancel the provision of any other work or local laws regulating onstruc ' n or the performance of work. Signature: �-- Date: Print Name: g'e doc: Cond -Elec ELI 0-0330 Printed: 05 -04 -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 No. L 1()' D 33 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 King Co Assessor's Tax No.: 31 1 (D 00 ` 0030 Site Address: / Z fl 2,-.4 v,26RA/ d,t&- J 77//</./.444-Suite Number: Floor: Tenant Name: , C/iC/G' 74e 1VCA[, Property Owners Name: /e /2'E!�` i;ize. /GAF / Y,11°44 . Mailing Address: / O t/ 4 ( 41 9OD Pft. ZO 7 ,SCiTT5 / »Z, /4Z City New Tenant: ❑ Yes .No State Zip CONTACT PERSON - Who do we contact when your permit is ready to be issued Name: C J� Gl /IJ�P�L'G c' LIL� Day Telephone: 4'25— z57 --D 2 r,G 5/ Mailing Address: 2 f'7 5.0 T g€%/t/j DA/ /44- 9's- 7 City State Zip E -Mail Address: 4:34046711W 40/749C./.1 6/511)4/e4,44 ( Fax Number: .2,7" —6 2...9 f ELECTRICAL CONTRACTOR INFORMATION Company Name: / /gam %,1i,c O 2,ilc Mailing Address: Contact Person: ete E -Mail Address: Contractor Registration Registration Number: 6/4-//7.L. C 97‘9//e-/t/ City Day Telephone: Fax Number: Expiration Date: State Zip 514- /2-//5//0 / O Valuation of Project (contractor's bid price): $ �® - O Scope of Work (please provide detailed information): •� / IG e44-7;- Will service be altered? ❑ Yes Adding more than 50 amps? ❑ Yes ArNo Type of Use: Type of work: ❑ New ❑ Addition ❑ Service Change ❑ Remodel ❑ Tenant Improvement ❑ Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service Property Served by: ❑ Puget Sound Energy Seattle City Light H: Applications \Forms - Applications On Line \2010 Applications \1 -2010 - Electrical Permit Application.doc bh Page 1 of 2 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) 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 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 0 ECTRICA,�. CONTACTOR: Signature: Print Name: ,deeC Date: Day Telephone: Mailing Address: Zip City State Date Application Accepted: Date Application Expires: Staff Initials: H:\Applications\Forms- Applications On Line \2010 Applications \I -2010 - 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 RECEIPT Parcel No.: 2716000030 Permit Number: EL10 -0330 Address: 12644 INTERURBAN AV S TUKW Status: PENDING Suite No: Applied Date: 05/04/2010 Applicant: PACIFIC MEDICAL Issue Date: Receipt No.: R10 -00767 Initials: User ID: Payee: WER 1655 Payment Amount: $96.60 Payment Date: 05/04/2010 02:36 PM Balance: $0.00 ROBERT WORLEY TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 02565C ACCOUNT ITEM LIST: Description 96.60 Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 96.60 Total: $96.60 PAYMENT RECEIVED doc: Receiot -06 Printed: 05 -04 -2010 INSPECTION RECORD Retain a copy with permit 6)o -o330 INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 PERMIT NO. LI61 uQ- (206)431 -3670 Project: )K FI AP'�Ti -' 6)1 Type of Inspection: Z/00 Address: /111/ /,r J, - Date Called: Special Instruction : 1-11A. Reli, ° � Date Wanted: 5/0c (r Requester: Phone No: 174 Approved per applicable codes. ❑ Corrections required prior to approval. COMMENTS: Inspector: &Wei\Date: oS OS l v ri $60.00 REINSPECTION FEE RE UIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: Date: Contractors or Tradespeople P ter Friendly Page • 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. Business and Licensing Information Name Phone Address Suite /Apt. City State Zip County Business Type Parent Company Capital Lighting Company Inc 4252510244 287 Sw 41St St Renton Wa 98055 King Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 601004603 Active CAPITLC964RN Electrical Contractor 12/15/2004 12/15/2010 Maintenance Unused MASTER ELECTRICIAN INFORMATION License LITTLD`963QP Name Little, David Status Active Business Owner Information Name Role Effective Date Expiration Date Caldwell, C. Michael Agent 12/15/2004 3/6/2009 Caldwell, C. Michael President 12/15/2004 $250.00 Worley, Robert C Secretary 12/15/2004 ELECTRICAL CITATION Worley, Robert C Vice President 12/15/2004 3/6/2009 Bond Information Page l of l Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 1 CBIC SF9198 12/08/2004 Until Cancelled $4,000.00 12/15/2004 Assignment of Savings Information No records found for the previous 6 year period Insurance Information No records found for the previous 6 year period Summons /Complaint Information Summons and Complaints are not filed with the department for this contractor type Infractions /Citations Information Infraction / Citation Date RCW Code Type Status Violation Amount EJORP02763 3/6/2009 19.28.271 RCW ELECTRICAL CITATION Satisfied $250.00 EJORP02761 3/6/2009 19.28.041 RCW ELECTRICAL CITATION Satisfied $500.00 EJORP02762 3/6/2009 19.28.271 RCW ELECTRICAL CITATION Satisfied $250.00 EJORP02878 4/23/2009 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 EJORP02874 4/23/2009 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 EJORP02879 4/23/2009 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 EJORP02880 4/23/2009 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 EJORP02877 4/23/2009 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 EJORP02873 4/23/2009 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 EJORP02875 4/23/2009 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 EJORP02876 4/23/2009 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 https: // fortress .wa.gov /lni/bbip /Print.aspx 05/04/2010