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Home My WebLink AboutPermit EL10-0433 - WESTFIELD SOUTHCENTER MALL - FOREVER 21This record contains information which is exempt from public disclosure pursuant to the Washington State Public Records Act, Chapter 42.56 RCW as identified on the Digital Records Exemption Log shown below. El-1 0-0433 Forever 21 836 Southcenter Mall RECORDS DIGITAL D- ) EXEMPTION LOG THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION Page # tode Exemption = 8rlef Explanatory DeSclriptiop �t�tutel ule The Privacy Act of 1974 evinces Congress' intent that social security numbers are a private concern. As such, individuals' social security Personal Information — numbers are redacted to protect those Social Security Numbers individuals' privacy pursuant to 5 U.S.C. sec. 5 U.S.C. sec. DR1 Generally — 5 U.S.C. sec. 552(a), and are also exempt from disclosure 552(a); RCW 552(a); RCW under section 42.56.070(1) of the Washington 42.56.070(1) 42.56.070(1) State Public Records Act, which exempts under the PRA records or information exempt or prohibited from disclosure under any other statute. Redactions contain Credit card numbers, debit card numbers, electronic check numbers, credit Personal Information — expiration dates, or bank or other financial RCW 9 DR2 Financial Information — account numbers, which are exempt from 42.56.230(5) RCW 42.56.230(4 5) disclosure pursuant to RCW 42.56.230(5), except when disclosure is expressly required by or governed by other law. FOREVER 21 836 SOUTHCENTER MALI. EL1 0-0433 City oPTukwila • 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.: 9202470010 Address: 836 SOUTHCENTER MALL TUKW Suite No: ELECTRICAL PERMIT Permit Number: EL10 -0433 Issue Date: 06/11/2010 Permit Expires On: 12/08/2010 Tenant: Name: FOREVER 21 Address: 836 SOUTHCENTER MALL , TUKWILA WA Owner: Name: WESTFIELD PROPERTY TAX DEPT Phone: Address: PO BOX 130940 , CARLSBAD CA Contact Person: Name: JEFF COY Phone: 206 393 -7545 Address: 1407 132 AV NE , BELLEVUE WA Contractor: Name: CJ ELECTRICAL SUPPLY & SVCS LL Phone: 425 766 -7677 Address: 24317 NE 27 PL , SAMMAMISH WA Contractor License No: CJELEES966M7 Expiration Date: 10/23/2010 DESCRIPTION OF WORK: INSTALL (12) NEW MULTI SPOT (AH6 3 -LAMP) LIGHT FIXTURES Value of Electrical: NRES: $5,000.00 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 governing this work will be complie The granting o constructio Fees Collected: $178.50 National Electrical Code Edition: 2008 Date: M(l GO ed this permit and know the same to be true and correct. All provisions of law and ordinances hether specified herein or not. give authority to violate or cancel the provisions of any other state or local laws regulating am autho ' ed 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 0-0433 Printed: 06 -11 -2010 • 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: luv://www.ci.tulcwila.wa.us Parcel No.: 9202470010 Address: Suite No: Tenant: 836 SOUTHCENTER MALL TUKW FOREVER 21 PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: EL10 -0433 ISSUED 06/11/2010 06/11/2010 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. Date: L—/ ( _//° doc: Cond -Elec EL10 -0433 Printed: 06 -11 -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. ato- 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.: `v 1 1)01-0 Site Address: 836 Southcenter Mall, Tukwila WA 98188 Suite Number: Floor: New Tenant: ❑ Yes 21 ..No Tenant Name: Forever 21 Property Owners Name: Mailing Address: 836 Southcenter Mall, Tukwila WA 98188 Tukwila City WA State 98188 Zip CONTACT PERSON - Who do we contact when your permit is ready to be issued Name: Jeff Coy Mailing Address: 1407 132nd Ave NE E -Mail Address: admin @cjlightingservices.com Day Telephone: Bellevue (206) 393 -7545 WA 98005 City State Zip Fax Number: (425) 452 -7009 ELECTRICAL CONTRACTOR INFORMATION Company Name: Mailing Address: CJ Electrical Supply and Service 24317 NE 27th Place Sammamish WA 98074 Contact Person: Dwayne Humenny E -Mail Address: dwayne@cjlightingsevices.coom Contractor Registration Number: City State Day Telephone: (425) 452 -7000 Fax Number: (425) 452 -7009 Zip Expiration Date: Valuation of Project (contractor's bid price): $ 5,000 Scope of Work (please provide detailed information): Install (12) new multi spot (AH6 3 -lamp) light fixtures in the store. Will service be altered? ® Yes ❑ No Type of Use: Altering and / or adding up to 3 circuits. Type of work: ❑ New ® Addition ❑ Low Voltage ❑ Generator Property Served by: ® Puget Sound Energy ❑ Seattle City Light H:\Applications \Forms - Applications On Line12010 Applications \1.2010 - Electrical Permit Application.doc Adding more than 50 amps? ❑ Yes J No ❑ Service Change ❑ Fire Alarm bh Page 1 of 2 ❑ Remodel ❑ Tenant Improvement ❑ Telecommunication ❑ Temporary Service 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. 1 HEREBY CERTIFY THAT l HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERDU: BY THE LAWS OF THE STATE OF WASHINGTON, AND 1 AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING O ER ORE ECT ty;! L C &Jr ' ACTOR: Signature: WXIMIrA Print Name: Mailing Address: Date: b Day Telephone: —7-01. ? Y-7595 IDate Application Accepted: City State Zip oce Date Application Expires: H:\Applications \Forms - Applications On Line \2010 Applications\ 1-2010 - Electrical Permit Application.doc bh Page 2 of 2 Staff Initials: 1 1 • 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.: 9202470010 Permit Number: EL10 -0433 Address: 836 SOUTHCENTER MALL TUKW Status: PENDING Suite No: Applied Date: 06/11/2010 Applicant: FOREVER 21 Issue Date: Receipt No.: R10 -01047 Payment Amount: $178.50 Initials: JEM Payment Date: 06/11/2010 03:15 PM User ID: 1165 Balance: $0.00 Payee: CJ ELECTRICAL SUPPLY & SERVICES LLC TRANSACTION LIST: Type Method Descriptio Amount Payment Check 3662 178.50 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 178.50 Total: $1.78.50 PAYMENT RECEIVED doc: Receipt -06 Printed: 06 -11 -2010 INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 INSPECTION RECORD Retain a copy with permit kip-5'133 qa PERMIT NO. W- (206)431-3670 Project: ret(2,6i&k ti Type of Inspection: 2 /00 Address: .... $5G _x Date Called: Special Instructions: Date Wanted: / /�� /a.m P Requester: i i Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: (0 VI Inspector: Date: / 11 $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: Contractors or Tradespeople Alter Friendly Page • Electrical Contractor A business licensed by LEtl 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 Cj Electrical Supply Et Svcs 4254527000 24317 Ne 27Th Pi Sammamish Wa 98074 King Limited Liability Company Ll UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 602327997 Active CJELEES966M7 Electrical Contractor 7/27/2004 10/23/2010 General Unused ADMINISTRATOR INFORMATION License RABOICE985RW Name Raboin, Christian E Status Active Business Owner Information Name Role Effective Date Expiration Date Humenny, Dwayne M Partner /Member 07/27/2004 7/19/2005 Bond Information No records found for the previous 6 year period Assignment of Savings Information Page 1 of 2 Savings Assignment of Savings Account Number Effective Date Release Date Assignment Type Impaired Date Amount Received Date 1 5/26/2004 Until Released Bond $4,000.00 7/27/2004 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 Warrant Information Warrants are not filed with the department for this contractor type Infractions /Citations Information Infraction / Citation Date RCW Code Type Status Violation Amount E52554 7/19/2005 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 E52555 7/19/2005 19.28.161 RCW ELECTRICAL CITATION Satisfied $250.00 E52556 7/19/2005 19.28.271 RCW ELECTRICAL CITATION Satisfied $100.00 E52557 7/19/2005 19.28.271 RCW ELECTRICAL CITATION Satisfied $100.00 EBRIC01406 11/14/2008 19.28.161 RCW ELECTRICAL CITATION Satisfied $250.00 EBRIC01459 1/23/2009 19.28.061 RCW ELECTRICAL CITATION Satisfied $1,000.00 EBRIC01462 1/23/2009 19.28.061 RCW ELECTRICAL CITATION Satisfied $1,000.00 EBRIC01460 1/23/2009 19.28.061 RCW ELECTRICAL CITATION Satisfied $1,000.00 EBRIC01457 1/23/2009 19.28.061 RCW ELECTRICAL CITATION Satisfied $1,000.00 EBRIC01463 1/23/2009 19.28.061 RCW ELECTRICAL CITATION Satisfied $1,000.00 https: // fortress .wa.gov /lni/bbip/Print.aspx 06/11/2010