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Home My WebLink AboutPermit EL10-0870 - PACIFIC NORTHWEST PERIODONTICSThis 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 -0870 Pacific NW Periodontics 411 Strander Boulevard 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 12 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. PACIFIC NW PERIODONTICS 411 STRANDER BL EL 10-0870 Parcel No.: Address: Tenant Name: Cityltf 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 0223200052 411 STRANDER BL TUKW PACIFIC NW PERIODONTICS ELECTRICAL PERMIT Permit Number: EL10 -0870 Issue Date: 10/28/2010 Permit Expires On: 04/26/2011 Owner: Name: MEDICAL CENTERS CO LLC Address: 411 STRANDER BLVD STE 107 , TUKWILA WA 98188 Contact Person: Name: MALCOLM MCDONALD Address: 23008 56 AV W , MOUNTLAKE TERRACE WA 98043 Phone: 425 672 -6797 Contractor: Name: ELECTRI -CITY INC Phone: 425 - 672 -6797 Address: 16212 BOTHELL HWY STE F PMB 135 , MILL CREEK WA 98012 Contractor License No: ELECTI* 110BA Expiration Date: 01/01/2011 DESCRIPTION OF WORK: TENANT IMPROVEMENT: REMODEL OF RECEPTION AREA, WAITING ROOM, OFFICES, LAB, AND STAFF LOUNGE. Value of Electrical Work: NRES: $36,870.00 Fees Collected: RES: $0.00 Type of Fire Protection: UNKNOWN Electrical Service provided by: PUGET SOUND ENERGY Permit Center Authorized Signature:) / V $728.90 National Electrical Code Edition: 2008 Date: tti) U� I hereby certify that I have read and exa 'ned this permit and know the same to be true and correct. All provisions of law and ordinances governing this work will be complie wit whether specified herein or not. The granting of hi pe f • • es not presu to give authority to violate or cancel the provisions of any other state or local laws regulating construction or/1l)4 perf r ance of wor am authorized to sign and obtain this electrical permit. Signature% / Print Name: 1 " 1 G9 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. Date: /4/24 ! t A doc: EL -9/09 EL10 -0870 Printed: 10 -28 -2010 • wq� City of Tukwila zDepartment 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.: 0223200052 Address: Suite No: Tenant: 411 STRANDER BL TUICW PACIFIC NW PERIODONTICS PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: EL10 -0870 ISSUED 10/28/2010 10/28/2010 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 co "t •. ction or e performance of work. Signature: Print Name: m. 0v,._ Date: doc: Cond -Elec ELI 0-0870 Printed: 10 -28 -2010 CITY OF TU• LA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us Electrical Permit No. Project No. ? Vo'fAco (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 4411 S av`dar a.I VA Sv t ' 4- 307- 0 Site Address: 4/( S1 i v�d-✓ vd Tenant Name: PGtGf& /kJ of��`\+'�sf AWlatip,n,e' s Property Owners Name: Pt c-o(i c-a ( G s C Lc.. Mailing Address: '4 I t S../ -" 4-er R I d ° to$ King Co Assessor's Tax No.: Suite Number: ,it' 2— Floor: 'd - �)r g. opor�' New Tenant: ❑ Yes ?06wt (A- City •4 State 91(18'P Zip CONTACT PERSON — Who do we contact when your permit is ready to be issued Name: Malcolm Macdonald Mailing Address: 23008 56th Ave W E -Mail Address: malcolm@electri-dtyinc.com Day Telephone: (425) 672 -6797 Mountlake Terrace WA 98043 City State Fax Number: (425) 672 -6799 Zip ELECTRICAL:- CONTRACTOR INFORMATION Company Name: Mailing Address: Contact Person: Malcolm Macdonald 23008 56th Ave W Cr'-( A INC, Mountlake Terrace WA 90043 Malcolm Macdonald E -Mail Address: malcolm @electri- cityinc.com Contractor Registration Number: ELECTI * 110BA City State Day Telephone: (425) 672 -6797 Fax Number: (425) 672 -6799 Expiration Date: 01/01/2011 Zip Valuation of Project (contractor's bid price): $ 3‘,R70.. a Scope of Work (please provide detailed information): Rw`i ota l o1- (e c_y1-4-01.A Q ✓eA r.✓tL4- W ✓atot,n, D a cr¢.s 1 ab 1 S.4.616 •'t 1'41v h 74. • Will service be altered? ❑ Yes jig- No Type of Use: Type of work: ❑ New ❑ Addition ❑ Service Change ❑ Low Voltage ❑ Generator ❑ Fire Alarm Property Served by: Puget Sound Energy ❑ Seattle City Light H:\Applications\Forms- Applications On Line\2010 Applications \7 -2010 - Electrical Permit Applicationdoc bh Page I of 2 Adding more than 50 amps? ❑ Yes No - 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, fumace 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: Print Name: Mailing Address: 23 s Date: (,o /2S/ f Day Telephone: 9 L - 6'71- G 7 Qi 0104 v, l•ck TC'/r4.4A. City State Zip I Date Application Accepted: T t}-, (D Date Application Expires: —rte Staff Initials- • 1 H:\AppliationsWorns- Applications On Line \2010 Applcations\7 -2010 - Electrical Permit Applicatioadoc bh Page 2 of 2 • �vJt�A w 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.tukwi la. wa. us Parcel No.: 0223200052 Address: 411 STRANDER BL TUKW Suite No: Applicant: PACIFIC NW PERIODONTICS RECEIPT Permit Number: EL10 -0870 Status: PENDING Applied Date: 10/28/2010 Issue Date: Receipt No.: R10 -02187 Payment Amount: $728.90 Initials: JEM Payment Date: 10/28/2010 10:52 AM User ID: 1165 Balance: $0.00 Payee: ELECTRI -CITY, INC. TRANSACTION LIST: Type Method Descriptio Amount Payment Check 034925 728.90 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 728.90 Total: $728.90 doc: Receipt -06 Printed: 10 -28 -2010 INSPEI ION NO. INSPECTION RECORD Retain a copy with permit e o -V7L) PERMIT NO. CITY OF TUKWILA BUILDING DIVISION l 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 . Projec : A-C- 41,1)- P toDb476') Type of Inspection: v wi Address: 1/i 51111Wb Date Called: Special Instructions: Date Wanted: 2� t .m. . Requester: Phone No: Approved per applicable codes. Corrections required prior to, approval. 7 COMMENTS: Inspector: ,:r6f,i46\ Date: 0 /277 I n REINSPECTION I EE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit INSPE ION NO. PERMIT NO CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Project: il 1�t� ARA). t �� Type of Inspection: �y (/00 Address: // e�) � Date Called: Special I structions: Date Wanted: / m p.m. Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: av/i4 4J(4 c} (Ai Cs4)1,67( Inspector: Date: 2/1 e� REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. (Z CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 ato-Dglo Project: kkf(c_ rci(lopoiyicie of Inspection: 7oo3 Address: 4/1I �� Date Called: Special Instructions: Date Wanted: S2 /0 a:m: Requester: Phone No: DApproved per applicable codes. Corrections required prior to approval. COMMENTS: bt/ CmJ(6, Can%aE4.e,F tJa-10 Inspector: Date: n REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INSPECTION NO. INSPECTION RECORD Retain a copy with permit 61a -olio PERMIT NO. . CITY OF TUKWILA BUILDING DIVISION'` 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 `tom Project: PAtFai Ni` k - K r(- Type of Inspection: 7003 Address: �y Li f p STAI��DM, Date Called: — Special Instructions: Date Wanted: II �I a.m.. p.m. Requester: Phone No: ElApproved per applicable codes. Corrections required prior to approval. COMMENTS: l/r ` 030 Inspector: --1;74\ide(k n REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Date: P9 9L Pao Contractors or Tradespeople Peter Friendly Page Electrical Contractor A business licensed by L&l 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 ELECTRI -CITY INC UBI No. 601133632 Phone 4256726797 Status Active Address 16212 Bothell Hwy Ste F Pmb135 License No. ELECTI *110BA Suite /Apt. License Type Electrical Contractor City Mill Creek Effective Date 1/1/1989 State WA Expiration Date 1/1/2011 Zip 98012 Suspend Date County Snohomish Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Master Electrician INFORMATION License MACDOM *953DA Name MACDONALD, MALCOLM A Status Active Business Owner Information Name Role Effective Date Expiration Date RICHARDSON, DIANA L Violation Amount 01/01/1980 10/22/2008 RICHARDSON, DAVID J ELECTRICAL CITATION 01/01/1980 $500.00 RICHARDSON, DIANA L Agent 01/01/1980 ELECTRICAL CITATION 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 12/13/1990 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 EDUNV00256 10/22/2008 19.28.161 RCW ELECTRICAL CITATION Satisfied $500.00 EDUNV00252 10/22/2008 19.28.161 RCW ELECTRICAL CITATION Satisfied $500.00 EMILD00204 1/26/2006 19.28.161 RCW ELECTRICAL CITATION Satisfied $250.00 ESTRL00225 3/14/2006 19.28.101 RCW ELECTRICAL CITATION Satisfied $1,000.00 EJORP02283 7/2/2008 19.28.271 RCW ELECTRICAL CITATION Satisfied $250.00 EJORP02284 7/2/2008 19.28.271 RCW ELECTRICAL CITATION Satisfied $250.00 EJORP02285 7/2/2008 19.28.271 RCW ELECTRICAL CITATION Satisfied $250.00 https: // fortress .wa.gov /lni/bbip /Print.aspx 10/28/2010