HomeMy WebLinkAboutPermit EL10-0722 - 76 GAS STATION76 GAS STATION
16200 WEST VALLEY HY
EL1 0-0722
Parcel No.:
Address:
Suite No:
City c*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
0005800038
16200 WEST VALLEY HY TUKW
ELECTRICAL PERMIT
Permit Number:
Issue Date:
Permit Expires On:
EL10 -0722
09/09/2010
03/08/2011
Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
76 GAS STATION
16200 WEST VALLEY HY , TUKWILA WA
SOUTHCENTER GAS STATION LLC
2224 KAMBER RD , BELLEVUE WA
STEVEN THOMSON
PO BOX 2849 , RENTON WA
INSIGNIA SIGN INC
PO BOX 2849 , RENTON WA
Contractor License No: INSIGSI055JS
Phone:
Phone: 425 917 -2109
Phone: 425 917 -2109
Expiration Date: 04/10/2011
DESCRIPTION OF WORK:
REMOVE EXISTING GAS PRICE FACES ILLUMINATED WITH FLUORESCENT BULBS AND INSTALL
NEW LOW VOLTAGE LED GAS FACES AND WIRE TO EXISTING ELECTRICAL CIRCUIT. NO OTHER
STRUCTURAL CHANGES.
Value of Electrical: NRES: $2,000.00
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 of this permit does
construction o t . performanc
Signature:
exa
wit
•
Print Name: v 1
Fees Collected:
$115.50
National Electrical Code Edition: 2008
Date:
0011001\p
ned this permit and know the same to be true and correct. All provisions of law and ordinances
, whether specified herein or not.
esume to give authority to violate or cancel the provisions of any other state or local laws regulating
rk. I am authorized to sign and obtain this electrical permit.
I hornsen
Date: q/9 D
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
EL1 0-0722
Printed: 09 -09 -2010
•
J�`Nt�A wq� 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.: 0005800038
Address:
Suite No:
Tenant:
16200 WEST VALLEY HY TUKW
76 GAS STATION
PERMIT CONDITIONS
Permit Number:
Status:
Applied Date:
Issue Date:
EL10 -0722
ISSUED
09/09/2010
09/09/2010
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 • resume to give authority to violate or cancel the provision of any other work or local
laws regulating co . truction or the .e •rmance of work.
Signature:
Print Name:
Ago- Id wi 114
• T-Ps AAP. _•
Date:
doc: Cond -Elec
EL10 -0722 Printed: 09 -09 -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. 'tAo
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: 16200 West Valley Hwy
Tenant Name: 76 Gas Station
Property Owners Name: SouthCenter Gas Station LLC.
Mailing Address: 16200 West Valley Hwy
King Co Assessor's Tax No.: 0005800038
Suite Number:
New Tenant:
Tukwila
City
Floor:
❑ Yes ❑ .. No
WA 98188
State Zip
CONTACT PERSON — Who do we contact when your permit is ready to be issued
Name: Steven Thomson
Mailing Address: PO BOX 2849
E -Mail Address: steven @insigniasign.com
Day Telephone:
Renton
City
Fax Number:
(425) 917 -2109
WA 98056
State
(425) 917 -0153
Zip
ELECTRICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
Insignia Sign Inc
PO BOX 2849
Contact Person: Insignia Sign Inc
Renton WA 98056
City State Zip
Day Telephone: (425) 917 -2109
E -Mail Address: steven @insigniasign.com Fax Number: (425) 917 -0153
Contractor Registration Number: INSIGSI055JS Expiration Date: 04/10/2011
Valuation of Project (contractor's bid price): $ 2,000
Scope of Work (please provide detailed information): Remove existing gas price faces illuminated with fluorescent bulbs;
Install new low voltage led gas price faces & wire to existing electrical circuit. No other structural changes.
Will service be altered? ❑ Yes m No Adding more than 50 amps? ❑ Yes m No
Type of Use: LED Gas Price
Type of work:
IA New ❑ Addition ❑ Service Change ❑ Remodel m Tenant Improvement
m 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 \7 -2010 - Electrical Permit Application.doc
bit
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, fumace 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 0 R OR E Vii' AL CONTRACTOR:
Signature:
Date: 09/09/2010
Print Name: VQi J i CA 011 Day Telephone: (425) 917 -2109
Renton
Mailing Address: PO BOX 2849
IDate Application Accepted: oq
City
state
98056
Zip
Date Application Expires:
H :\Appltcanons\Forms- Appltcanons On Line\2010 Applications \7 -2010 - Electrical Permit Application.doc
bit
Page 2 of 2
Staff Initials:
Cif■ 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
SET RECEIPT
Copy Reprinted on 09 -09 -2010 at 11:50:36 09/09/2010
RECEIPT NO: R10 -01790
Initials: JEM
Payment Date: 09/09/2010
User ID: 1165 Total Payment: 327.50
Payee: INSIGNIA SIGN, INC.
SET ID: 0909 SET NAME: Temporary Set
SET TRANSACTIONS:
Set Member
EL10 -0722
S10 -052
TOTAL:
Amount
115.50
212.00
115.50
TRANSACTION LIST:
Type Method Description Amount
Payment Check 3792 327.50
TOTAL: 327.50
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
ELECTRICAL PERMIT - NONR 000.322.101.00.0
SIGN PERMIT 000.322.100
115.50
212.00
TOTAL: 327.50
PAYMENT
RECEIVED
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
(oo-071
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION FL (l
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
Project: 3t/ 66
Type of Inspection:
! {�,�
Address: dd
/11
IA) .
`i/
Date Called:
Special Instructions:
Date Wanted:
a.m.
VZI rp,
Requester:
Phone No:
C
OApproved per applicable codes.
ElCorrections required prior to app fovar.
COMMENTS:
Inspector:
6fAci\
Date: � ��Z a /O
n REINSPECTIO11 FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
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
INSIGNIA SIGN INC
4259172109
Po Box 2849
Renton
WA
98056
King
Corporation
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
601507324
Active
INSIGSI055JS
Electrical Contractor
4/10/1995
4/10/2011
Sign
Unused
MASTER ELECTRICIAN INFORMATION
License THOMSBE954L8
Name THOMSON, BRYAN E
Status Active
Business Owner Information
Name
Role
Effective Date
Expiration Date
THOMSON, CINDY A
Agent
02/04/2002
1/23/2006
THOMSON, BRYAN E
Member
02/04/2002
$250.00
THOMSON, CINDY A
President
01/01/1980
ELECTRICAL CITATION
BOWEN, BRYAN E
$250.00
01/01/1980
02/04/2002
BOWEN, BRYAN E
Agent
01/01/1980
02/04/2002
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
3
COLONIAL AM CAS &
SURETY OF MD
LPM4051223
04/23/2000
Until Cancelled
$4,000.00
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
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
ESHA000208
1/23/2006
19.28.101 RCW
ELECTRICAL CITATION
Satisfied
$250.00
EHRAL00569
1/30/2009
19.28.101 RCW
ELECTRICAL CITATION
Satisfied
$250.00
https: // fortress .wa.gov /lni/bbip /Print.aspx 09/09/2010