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Home My WebLink AboutPermit EL10-0919 - SEIU HEATHCARE NORTHWESTThis 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 -0919 SEIU Healthcare 635 Andover Park West 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 10 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. SEIU HEALTHCARE NW 635 ANDOVER PK W EL1O-0919 Parcel No.: Address: Tenant Name: Cit011f Tukwila Department of Connmunity 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 2623049143 635 ANDOVER PK W TUKW SEIU HEATHCARE NW ELECTRICAL PERMIT Permit Number: Issue Date: Permit Expires On: EL10 -0919 11/12/2010 05/11/2011 Owner: Name: SOUTHCENTER CORPORATE SQUAR Address: 150 CALIFORNIA ST , SAN FRANCISCO CA 94111 Contact Person: Name: TIM NELSON Address: 5113 PACIFIC HY E #12 , FIFE WA 98424 Contractor: Name: SIGN -TECH ELECTRIC LLC Address: 5113 PACIFIC HWY E, SUITE 12 , 98424 Contractor License No: SIGNTEL988BG Phone: 206 719 -8020 Phone: 253 - 922 -2146 Expiration Date: 01/07/2012 DESCRIPTION OF WORK: ELECTRICAL BOX FOR SIGN ON BUILDING WALL Value of Electrical Work: NRES: $350.00 RES: $0.00 Type of Fire Protection: UNKNOWN Electrical Service provided by: PUGET SOUND ENERGY Permit Center Authorized Signature: Fees Collected: $67.20 National Electrical Code Edition: 2008 Date: U`1z {'v I hereby certify that I have read and cxarru ed this'{ermit 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 • 've � hority to violate or cancel the provisions of any other state or local laws regulating construction or the perf mance of work. I am ed to si. n and obtain this electrical permit. Signature: i Date: Print Name: -✓� / 1 6b �-e�l, � 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 EL10 -0919 Printed: 11 -12 -2010 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.: 2623049143 Address: Suite No: Tenant: 635 ANDOVER PK W TUKW SEIU HEATHCARE NW PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: EL10 -0919 ISSUED 11/12/2010 11/12/2010 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 Nam me,t6t(e(46( Date: doc: Cond -Elec ELI 0-0919 Printed: 11 -12 -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. 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.: /--{ Site Address: 6,335 -4-4 Othief ffcLP /( • 774K0-' Tenant Name: 5 e g-cf . I %7, w Property Owners Name: �nU,\r- X17 Mailing Address: /61 C-. ,'-gvv.,u '/ SOH,vtvtGS, iez) Cct , ?' // r City Suite Number: Floor: New Tenant: Yes ❑ ..No State Zip CONTACT PERSON — Who do we contact when your permit is ready to be issued Name: Mailing Address: E -Mail Address: 5/(3 ASS l L 1/2— Day Telephone: City Fax Number: ao 7t7-- Ro - State 9zy Zip ELECTRICAL CONTRACTOR INFORMATION Company Name: Mailing Address: j // acC, - i7 " l �^ �j' * / / City State Zip Contact Person: ` / ;'n1 4e /,'- Day Telephone: 9eo4,-- :D' —//15i E -Mail Address: Fax Number: - — Contractor Registration Number: Expiration Date: Valuation of Project (contractor's bid price): $ c 5 ' ' '3 � Scope of Work (please provide detailed information): f'le &i-vvm_ &,>e 1314. (A,51 -r/ Will service be altered? ❑ Yes ❑ No Adding more than 50 amps? ❑ Yes ❑ No Type of Use: Type of work: ❑ New ❑ Addition ❑ Service Change ❑ Remodel ❑ Tenant Improvement ❑ Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service Pronertv Served bv: Puget Sound Energy ❑ Seattle City Light HAApplications\Forms- Applications On Line \2010 Applications \7 -2010 - Electrical Permit Applicaticn.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 CONTRACTO Signature: Print Name: Mailing Address: J/ /5 f/1' % j r_k_c4 to-cod-QAL/ ( Date: /NO r--/ Day Telephone: 4a7 City State Zip Date Application Accepted: Date Application Expires: Staff Initials: H:Wpplications\Fonns- Applications On Line\2010 Applications \7 -2010 - Electrical Pertnit Application.dec bh Page 2 of 2 • • 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.: 2623049143 Permit Number: EL10 -0919 Address: 635 ANDOVER PK W TUKW Status: APPROVED Suite No: Applied Date: 11/12/2010 Applicant: SEIU HEATHCARE NW Issue Date: Receipt No.: R10 -02283 Initials: User ID: Payee: JEM 1165 Payment Amount: $67.20 Payment Date: 11/12/2010 11:09 AM Balance: $0.00 JOHN MENDENHALL, SIGN TECH ELECTRIC LLC TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 077224 ACCOUNT ITEM LIST: Description 67.20 Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 67.20 Total: $67.20 doc: Receipt -06 Printed: 11 -12 -2010 INSPECTION RECORD a copy with permit [ %%� INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION iiSo 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 12-- Project: r i"�(j ik0�, 4 Type of Inspection: af) Address: 63�� (4) Date Called: Special Instructions: 5/6 Date Wanted: � /C] %., p.m. Requester: Phone No: pApproved per applicable codes. Corrections required prior to approval. COMMENTS: Of (--tAikty Inspector: Ji'sc' Date: n REINSPECTION FEE REQUIRED. 1rior 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 NI. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100,.Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Project: ‹ ,61J l AC.. Type of Inspection: 2/00 Address: tag' 5 Date Called: -\ Special Instructions: Date Wanted: 12//0i, a.m.! . Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: gEudit, 44.19 ?Room( Arcti5 944 r.0( 14)16e � ON.V.0D5 k2 4DIA1 0\ Inspector: Date: I� 014 n REINSPECTIONFEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Contractors or Tradespeople Per Friendly Page • Electrical Contractor A business licensed by LEti 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 SIGN -TECH ELECTRIC LLC 2539222146 5113 Pacific Hwy E #12 Fife WA 98424 Pierce Limited Liability Company UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 602152490 Active SIGNTEL988BG Electrical Contractor 1/7/2002 1/7/2012 General Unused Other Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status SIGNTE`055MMSIGN TECH ELECTRIC Electrical Contractor General Unused 7/14/1995 7/14/2003 Archived SIGNTE*055DA SIGN TECH ELECTRIC Electrical Contractor Sign Unused 3/1/1995 3/1/1997 Archived Electrical Administrator INFORMATION License MORRIT*943K6 Name MORRISON, TRAVIS Status Active Business Owner Information Name Role Effective Date Expiration Date MENDENHALL, JOHN C Partner /Member 01/07/2002 Received Date MENDENHALL, LINDA D Partner /Member 01/07/2002 Until Released 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 2 1/14/2002 8/4/2010 Bond $4,000.00 1/18/2002 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 EROHB00202 7/18/2007 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 https://fortress.wa.gov/lni/bbip/Print.aspx 11/12/2010