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Home My WebLink AboutPermit EL10-0487 - STATE FARM INSURANCESTATE FARM 7100 FORT DENT WY EL 10-0487 City eilTukwila • Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 =3670 Inspectio n Request Line: 206 - 431 -2451 Web site: http: //www.ci.tukwila.wa.us Parcel No.: 2954900440 Address: 7100 FORT DENT WY TUKW Suite No: ELECTRICAL PERMIT Permit Number: EL10 -0487 Issue Date: 06/25/2010 Permit Expires On: 12/22/2010 Tenant: Name: STATE FARM Address: 7100 FORT DENT WY , TUKWILA WA Owner: Name: RADOVICH PROPERTIES LLC Phone: Address: 2835 82ND AVE SE STE 300 , MERCER ISLAND WA Contact Person: Name: BRAD ROSS Phone: 360 789 -0567 Address: 5914 CAPITOL FOREST DR SW , OLYMPIA WA Contractor: Name: A/V DESIGNS Phone: 360 789 -0567 Address: 5914 CAPITOL FOREST DR SW , OLYMPIA WA Contractor License No: AVDES * *994L8 Expiration Date: 06/28/2010 DESCRIPTION OF WORK: INSTALL SPEAKERS, PROJECTOR, AND SCREEN IN OFFICE MEETING ROOM Value of Electrical: NRES: $1,500.00 RES: $0.00 Type of Fire Protection: UNKNOWN Electrical Service provided by: PUGET SOUND ENERGY Permit Center Authorized Signature: Fees Collected: $115.50 National Electrical Code Edition: 2008 Date: O.(1 I hereby certify that I have read and xamined thi permit and know the same to be true and correct. All provisions of law and ordinances governing this work will be complie 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 or the performance of work. I am authorized to sign and obtain this electrical permit. Signature: Print Name: /J2G6)// z, Date: '62 Z,p /v 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 0-0487 Printed: 06 -25 -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: http: / /www. ci. tukwila. wa. us Parcel No.: 2954900440 Address: Suite No: Tenant: 7100 FORT DENT WY TUKW STATE FARM • PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: EL10 -0487 ISSUED 06/25/2010 06/25/2010 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. Signature: Print Name: -(7i(e/Z Date: &6-.7 Xe doc: Cond -Elec ELI 0-0487 Printed: 06 -25 -2010 CITY OF TUKOA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 htto://www.citukwila.wa.us • Electrical Permit No. atiO 1)1-1t1 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: �y1-k �\ \ 1 l ttb �I-v(Lk- "NAN* Tenant Name: 3 Al Fi 'Gor2+i\ King Co Assessor's Tax No.: 7s— f-0-0 y4 2 Suite Number: Floor: a'nS New Tenant: ❑ Yes 0..No Property Owners Name: So j .)V L R O V I L h 1...ekte to p i-ILA - Mailing Address: Z $3S O Z/1 A-v . SF /'g_ti14 _ /A-No City ?8vIA) State Zip CONTACT PERSON - Who do we contact when your permit is ready to be issued Name: Brad Ross Mailing Address: 5914 Capitol Forest Drive SW, Olympia, Wa, 98512 E -Mail Address: brad @av- designs.com Day Telephone: (360) 789 -0567 City State Fax Number: (360) 352 -5328 Zip ELECTRICAL CONTRACTOR INFORMATION Company Name: AN Designs Mailing Address: 5914 Capitol Forest Drive SW, Olympia, Wa, 98512 Contact Person: A/V Designs E -Mail Address: brad @av- designs.com Contractor Registration Number: AVDES * *994L8 City State Day Telephone: (360) 789 -0567 Fax Number: (360) 352 -5328 Expiration Date: 06/28/2010 Zip Valuation of Project (contractor's bid price): $ 1,500 Scope of Work (please provide detailed information): Install speakers, projector and screen in office meeting room Will service be altered? ❑ Yes m No Adding more than 50 amps? ❑ Yes m No Type of Use: Type of work: ❑ New ❑ Addition ❑ Service Change ❑ Remodel ❑ Tenant Improvement VI Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service Property Served by: m Puget Sound Energy ❑ Seattle City Light H: Applications\Fonns- Applications On Line \2010 Application0-2010 - 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 OR ELECTRICAL CONTRACTOR: Signature: 4 Date: 06/26/2010 Print Name: BR. A-t I E yr 2(2.5 Day Telephone: (360) 789 -0567 Mailing Address: 5914 Capitol Forest Drive SW, Olympia, Wa, 98512 City State Zip IDate Application Accepted: Staff Initials: 1 1 Date Application Expires: 12(2d{o H:\Applications\Forms- Applications On Line12010 Applications \7 -2010 - Electrical Permit Application,doc bh Page 2 of 2 V 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.: 2954900440 Address: 7100 FORT DENT WY TUKW Suite No: Applicant: STATE FARM RECEIPT Permit Number: EL10 -0487 Status: PENDING Applied Date: 06/25/2010 Issue Date: Receipt No.: R10 -01162 Initials: User ID: Payee: JEM 1165 Payment Amount: $115.50 Payment Date: 06/25/2010 10:09 AM Balance: $0.00 BRADLEY K ROSS TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd MC Authorization No. 37941Z ACCOUNT ITEM LIST: Description 115.50 Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 115.50 Total: $115.50 PAYMENT RFCFIVFD doc: Receiot -06 Printed: 06 -25 -2010 INSPECTION RECORD Retain a copy with permit 6/0-D INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Project: Type of Inspection: Address: Date Called: Special Ins ructions: Date Wanted: Y a r p.m. Requester: Phone No: cti Approved per applicable codes. 0 Corrections required prior to approval. COMMENTS: fiK Date: 010A Sit a ri $60.00 REINSP CTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to■schedule reinspection. Receipt No.: Date: - �� -"3ci Y^:. - - = tib 'pis r. �..�t. �,.M..z .«.� "�`e..��.�:�'.Ye. �i.a►: �Si,sdd, Contractors or Tradespeople liter 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 A/V Designs 3603525135 5914 Capitol Forest Dr Sw Olympia Wa 98512 Thurston Individual UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 601987537 Active AVDES "994L8 Electrical Contractor 6/28/2001 6/28/2010 Telecommunications Unused ADMINISTRATOR INFORMATION License ROSS'BK994L0 Name Ross, Bradley K Status Active Business Owner Information Name Role Effective Date Expiration Date Ross, Bradley K Owner 06/20/2001 Bond Information Page 1 of 1 Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 1 STATE FARM FIRE Et CAS CO 98EF53771 05/23/2001 Until Cancelled $4,000.00 06/20/2001 Assignment of Savings Information No records found for the previous 6 year period Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date 10 STATE FARM FIRE &CAS CO 98BGS6406 10/22/2009 10/22/2010 $1,000,000.00 10/21/2009 9 STATE FARM FIRE &CAS CO 98 BC L387 0 10/22/2008 10/22/2009 $1,000,000.00 10/03/2008 8 STATE FARM FIRE & CAS CO 98 G4 4893 1 10/22/2007 10/22/2008 $170,000.0010/01 /2007 7 STATE FARM FIRE a CAS CO 98 -GV- 0322 -0 10/22/2006 10/22/2007 $170,000.00 09/26/2006 6 STATE FARM FIRE a CAS CO 98 GM 5559 5 10/22/2005 10/22/2006 $170,000.00 10/06/2005 5 STATE FARM FIRE Et CAS CO 98GA89842 10/22/2004 10/22/2005 $1,000,000.00 12/30/2004 4 STATE FARM FIREEt CASCO 98E339852 10/22/2003 10/22/2004 $1,000,000.00 06/21/2004 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 https://fortress.wa.gov/lni/bbip/Print.aspx 06/25/2010