HomeMy WebLinkAboutPermit EL10-0859 - MATTRESS KINGThis 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.
EL10 -0859
Mattress King
17305 Southcenter Parkway
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
13
Personal Information —
expiration dates, or bank or other financial
RCW
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.
MATTRESS KING
17305 SOUTHCENTER PY
EL1O-0859
City Of 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 i. to kwil a. wa. us
Parcel No.: 2623049024
Address: 17305 SOUTHCENTER PY TUKW
Tenant Name: MATTRESS KING
ELECTRICAL PERMIT
Permit Number: EL10 -0859
Issue Date: 10/25/2010
Permit Expires On: 05/15/2011
Owner:
Name: TR5 LLC
Address: 117 E LOUISA ST #230 , SEATTLE WA 98102
Contact Person:
Name: SEAN MCCUBBIN
Address: 4314 103 AV SE , EVERETT WA 98205
Contractor:
Name: NORTHLAND ELECTRIC INC
Address: 4314 103 AV SE , EVERETT WA 98205
Contractor License No: NORTHEI21879
Phone: 425 343 -4832
Phone: 425 377 -1514
Expiration Date: 03/31/2011
DESCRIPTION OF WORK:
MOVE TWO OUTLETS AND MOVE CIRCUITS FOR TRACKING LIGHTING TO EXISTING PANEL.
REVISION #1 TO ADD TO EXISTING EMERGENCY LIGHTING CIRCUIT
Value of Electrical Work: NRES: $1,100.00 Fees Collected: $115.50
RES: $0.00
Type of Fire Protection: UNKNOWN
Electrical Service provided by: PUGET SOUND ENERGY
Permit Center Authorized Signature:
National Electrical Code Edition: 2008
tOIL q-1
Date: R-11-46
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 permit does not presume to give authority to violate or cancel the provisions of any other state or local laws regulating
construction or the pP*+oY**+?nce of w I am authorized to sign and obtain this electrical permit and agree to the conditions on the back
of this permit.
Signature:
Print Name:
Date: g---/ T ` ( 0
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 -9/09
EL1 0-0859
Printed: 11 -19 -2010
PERMIT CONDITIONS
Permit No. EL10 -0859
* *ELECTRICAL **
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.
doc: EL -9/09
ELI 0-0859 Printed: 11 -19 -2010
CitItf 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.: 2623049024
Address: 17305 SOUTHCENTER PY TUKW
Tenant Name: MATRESS KING
ELECTRICAL PERMIT
Permit Number: EL10 -0889
Issue Date: 10/25/2010
Permit Expires On: 04/23/2011
Owner:
Name: TRS LLC
Address: 117 E LOUISA ST #230 , SEATTLE WA 98102
Contact Person:
Name: SEAN MCCUBBIN Phone: 425 343 -4832
Address: 4314 103 AV SE , EVERETT WA 98205
Contractor:
Name: NORTHLAND ELECTRIC INC
Address: 4314 103 AV SE , EVERETT WA 98205
Contractor License No: NORTHEI21879
Phone: 425 377 -1514
Expiration Date: 03/31/2011
DESCRIPTION OF WORK:
MOVE TWO OUTLETS AND MOVE CIRCUITS FOR TRACKING LIGHTING TO EXISTING PANEL.
Value of Electrical Work: NRES: $1,100.00
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: 10(7K1 �•0
1
I hereby certify that I have read an. exa 'ned this permit and know the same to be true and correct. All provisions of law and ordinances
governing this work will be compli=d wit , whether specified herein or not.
The granting of this permit
construction oithe perfo
Signature.
Print Name:
not pr ume to give authority to violate or cancel the provisions of any other state or local laws regulating
e of wo I am authorized to sign and obtain this electrical permit.
SEA M ccuU )0
Date: 10 --2C4 C
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 -9/09
ELI 0-0859 Printed: 10 -25 -2010
4111
City of Tukwila
Department of Community Development
n _
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.: 2623049024
Address:
Suite No:
Tenant:
17305 SOUTHCENTER PY TUKW
MATRESS KING
•
PERMIT CONDITIONS
Permit Number:
Status:
Applied Date:
Issue Date:
EL10 -0859
ISSUED
10/25/2010
10/25/2010
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 o performance of work.
Signature:
Print Name: S E P' `CC U
Date: /Oa---f 0
doc: Cond -Elec
ELI 0-0859 Printed: 10 -25 -2010
CITY OF K T LA
U
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http: / /www. ci. tukwila. wa. us
Electrical Permit No.
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 73 o 5 SO UTH C N i E P- Ari T r= 19 0
? C King Co Assessor's Tax No.: — i �l (� L�')V"► 6��
Site Address: I7JU5 S0uThCa Ec_ Q Kt-a'4`( COrtf, Suite Number: l Y 0 Floor: (
Tenant Name: t 6 fr'fl 5 S )( ( L C7 New Tenant: ❑ Yes ❑ .. No
Property Owners Name: lJ F C K€ C. DL nR PI e#,,1"--- (511V--,- L■(/)
Mailing Address:
City
State
Zip
CONTACT PERSON – Who do we contact when your permit is ready to be issued
Name:
Day Telephone:
Mailing Address:
City
E -Mail Address:
State
Zip
Fax Number:
ELECTRICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
1V° V ILL �L EG`T'�IG
1--- 1111-1 tb3rd AVE S�, Fl 1 �
City
Contact Person: _ /\ i I U� [� % N Day Telephone:
E -Mail Address: Se A JJE @ C o-rl cm-5-n NE-1T Fax Number:
Contractor Registration Number: %\%O RT14 E I 2.1 S 7
Expiration Date:
State
�f3 1 g 3 Z,
92c377 I`ll y
3 -31 -Zola
Valuation of Project (contractor's bid price): $ 1 10 0
Scope of Work (please provide detailed information): MO V% E T(.cJ 0 0 L> TL F_ f S Ho E
Cl TS X60- r -AGIC L,IL,HT Iu <? 'To x 15TI 'J& ?f. EL
Will service be altered? ❑ Yes kNo Adding more than 50 amps? ❑ Yes kNo
Type of Use:
Type of work: `1
❑ New ❑ Addition ❑ Service Change ❑ Remodel , Tenant Improvement
❑ Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑0 Temporary Service
Pro , e erved b :
►1� Puget Sound Energy
❑ Seattle City Light
H:\Appltcanons \Forms - Apphcanons On Line\2010 Applications \7 -2010 - Electrical Permit Application.doc
bh
Page 1 of 2
�-IZ5
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 cadse 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: a/-
SEPT l 66 g� ► i.) _
Mailing Address: LI3 114 1 b 3 r UE
Print Name:
IDate Application Accepted:
Date: ! 0 -25- 10
Day Telephone: I-% 25 3 Li 3 L a 3
- JFwwTr 910
City State Zip
10
Date Application Expires:
Staff Initials:
HAApplications\Fonns- Applications On Line\2010 Applications \7 -2010 - Electrical Permit Application.doc
bh
Page 2 of 2
0
City of Tukwila
2 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.tulcwila.wa.us
RECEIPT
•
Parcel No.: 2623049024 Permit Number: EL10 -0859
Address: 17305 SOUTHCENTER PY TUKW Status: PENDING
Suite No: Applied Date: 10/25/2010
Applicant: MATRESS KING Issue Date:
Receipt No.: R10 -02157
Payment Amount: $115.50
Initials: JEM Payment Date: 10/25/2010 01:10 PM
User ID: 1165 Balance: $0.00
Payee: SEAN T MCCUBBIN, NORTHLAND ELECTRIC INC
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd VISA
Authorization No. 001690
ACCOUNT ITEM LIST:
Description
115.50
Account Code Current Pmts
ELECTRICAL PERMIT - NONR
000.322.101.00.00 115.50
Total: $115.50
doc: Receiot -06 Printed: 10 -25 -2010
2'
INSPECTION NO.
INSPECTION RECORD �{�—�Q
Retain a copy with permit 0
PERMIT NO.
CITY OF.TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431 -2451
\\,‘Q_
Project: `_
40424 S f Itjt
Type of Inspection:
en
Address: �( ff
Date Called:
Special Instructions:
Date Wanted:
11 /27 ,-
Requester:
I
Phone No:
Approved per applicable codes. ❑ Corrections required prior to.approval. Z •
OMMENTS:
Inspector:
-,--11:7130\1n16\
Date: (1d
n REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
1
NSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO. 1
CITY OF TUKWILA BUILDING DIVISION'
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
I
6AD - 0751
Project:
ff (//
Type of Inspection:
el
Address: 1,61 3
5 , 6+ 0
Date Called:
-\,
Special Instructions:
111
iY
Date Wanted:
1 0 I ao
a.m.
p.m.
Requester:
Phone No:
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
(,,x0 11)('11E 101,er9 -wt e_t ais
14
?tit- ft,
i.1
•
ex,
Ga r4- rDK(o(% 60?t
Ay) F11. raeit Tt4 ( Tb
c?)RiAithg d4e4Dtt r!,44-1P4 U 0 f a
r* o Ctcuff. i3
Inspector:
dr6C-N6\161\
REINSPECTIO FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
Date: a 16 /1
•
City of Tukwila
•
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Web site: http: //www.ci.tukwila.wa.us
REVISION
SUBMITTAL
Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through
the mail, fax, etc.
Date: l (/ / ID
Plan Check/Permit Number: l V D
❑ Response to Incomplete Letter #
❑ Response to Correction Letter #
Revision # / after Permit is Issued
❑ Revision requested by a City Building Inspector or Plans Examiner
Project Name:
M/TT -ES Kuuc,
Project Address: t 7 &5^ sc, .QktJ-(
Contact Person: SEAN MccU SS) 0 Phone Number:
Summary of Revision: D l 43 GNL ^( L 16 H 1 I.1(7 7?) 17
RECEIVED
,NOV 19 2010
PERMIT CerrEc,
Sheet Number(s):
"Cloud" or-highlight all areas of revision including date of revisio
Received at the City of Tukwila Permit Center b :
Y Y
®Entered in Permits Plus on `l "I - 1 0
H:\Applications\Fonns- Applications On Line\2010 Applications \7 -2010 - Revision Submittal.doc
Created: 8-13-2004
Revised: 7 -2010
Contractors or Tradespeople P ter Friendly Page
•
Electrical Contractor
A business licensed by Lai 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
NORTHLAND ELECTRIC INC
4253771514
Po Box 2080
Snohomish
WA
98291
Snohomish
Corporation
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
600344369
Active
NORTHEI21879
Electrical Contractor
10/29/1979
3/31/2011
General
Unused
Master Electrician INFORMATION
License MCCUBCM970RH
Name MCCUBBIN, CLINTON M JR
Status Active
Business Owner Information
Name
Role
Effective Date
Expiration Date
HECKMAN, DAVID G
Violation Amount
01/01/1980
4/9/2009
MCCUBBIN, CLINT M JR
ELECTRICAL CITATION
01/01/1980
$250.00
HECKMAN, DAVID G
Agent
01/01/1980
Bond Information No records found for the previous 6 year period
Assignment of Savings Information
Page 1 of 1
Savings
Assignment of Savings Account Number
Effective Date
Release Date
Assignment Type
Impaired Date
Amount
Received Date
1
11/9/1989
Until
Released
Bond
$4,000.00
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
EBIEA00274
4/9/2009
19.28.271 RCW
ELECTRICAL CITATION
Satisfied
$250.00
https: // fortress .wa.gov /lni/bbip /Print.aspx 10/25/2010