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HomeMy WebLinkAboutPermit EL10-0980 - UNIVERSAL HOSPITAL SERVICESUNIVERSAL HOSPITAL SERVICES 3225 S 116 ST EL1 0-0980 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 ELECTRICAL PERMIT 0923049066 3225 S 116 ST TUKW UNIVERSAL HOSPITAL SERVICES Permit Number: Issue Date: Permit Expires On: EL10 -0980 12/02/2010 05/31/2011 Owner: Name: RRTEEF AMERICA REIT II Address: PO BOX 4900 #207 , SCOTTSDALE AZ 85261 Contact Person: Name: CHAD OWNBEY Address: 12556 120 AV NE, STE 322 , KIRKLAND WA 98034 Contractor: Name: CRANE CREEK HOLDINGS LLC Address: 12556 120 AV NE, STE 322 , KIRKLAND WA 98034 Contractor License No: CRANECH9366F Phone: 425 864 -2070 Phone: 425 864 -2070 Expiration Date: 09/06/2011 DESCRIPTION OF WORK: INSTALLATION OF 56 CABLE RUNS FOR DATA COMMUNICATIONS AND TELEPHONE CONNECTIVITY Value of Electrical Work: NRES: $4,100.00 Fees Collected: RES: $0.00 Type of Fire Protection: UNKNOWN Electrical Service provided by: PUGET SOUND ENERGY $178.50 National Electrical Code Edition: 2008 Permit Center Authorized Signature: I hereby certify that I have read an governing this work will be compli ex- •wit Date: 21052-11, t) ned this permit and know the same to be true and correct. All provisions of law and ordinances 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 th =7p= rform- c: of work. I am authorized to sign and obtain this electrical permit and agree to the conditions on the back of this permit. Signature: Print Name: ( aaid6,619 Date: 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 0-0980 Printed: 12 -02 -2010 PERMIT CONDITIONS Permit No. EL10 -0980 * *ELECTRICAL ** 1: A copy of the electrical work permit shall be posted or otherwise made readily accessible to the Electrical Inspector at each work site. 2: Approved plans shall be maintained at the construction site and shall be readily available to the Electrical Inspector. 3: All electrical work shall be in accordance with NFPA 70 - NEC, and requirements for electrical installations, Chapter 296 -46B WAC. 4: 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. 5: The issuance of an electrical work permit shall not be construed to be a permit for, or an approval of, arty 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. 6: 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 EL10 -0980 Printed: 12 -02 -2010 CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.citukwila.wa.us Electrical Permit No. LL —DL9 O 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: 3225 S 116th ST, Tukwila, WA 98168 King Co Assessor's Tax No.: 0 293ci-{ - qup:e Suite Number: 109 Floor: 1 Tenant Name: Universal Hospital Services Property Owners Name: Mailing Address: "-V- Awn - Clc V-61-1 P O to,1 Go 4 2-°'1 New Tenant: I Yes ❑..No CtiCI-cD0A -tg A i le-,262( City State Zip CONTACT PERSON — Who do we contact when your permit is ready to be issued Name: Chad Ownbey Mailing Address: 12556 120th AVE NE Suite 322 E -Mail Address: cownbey @cchsolutions.com Day Telephone: (425) 864 -2070 Kirkland WA 98034 City State Fax Number: (425) 699 -0452 Zip ELECTRICAL CONTRACTOR INFORMATION Company Name: Mailing Address: Chad- Owribey Gz %- C C''e1G v()01 1-)CfC 12556 120th AVE NE Suite 322 Kirkland WA 98034 Contact Person: Chad Ownbey E -Mail Address: cownbey @cchsolutions.com Contractor Registration Number: 'cranech9366F City Day Telephone: Fax Number: State (425) 864 -2070 (425) 699 -0452 Expiration Date: 09/06/2011 Zip Valuation of Project (contractor's bid price): $ 4,100 Scope of Work (please provide detailed information): Installation of 56 cable runs for data communications and telephone connectivity. Will service be altered? ❑ Yes Type of Use: low voltage only Type of work: ❑ New ❑ Addition Low Voltage ❑ Generator Property Served by: VI Puget Sound Energy ❑ Seattle City Light m No Adding more than 50 amps? ❑ Yes m No ❑ Service Change ❑ Fire Alarm H:\Applications\Forms- Applications On Line\2010 Applications \7 -2010 - Electrical Permit Application.doc bh Page 1 of 2 ❑ 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; 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 OW Signature: Print Name: C 1 eild& Delyav CTRICAL CONTRACTOR: Mailing Address: 12556 120th AVE NE, Suite 322 Date: 12/02/2010 Day Telephone: Kirkland City 98034 State Zip IDate Application Accepted: io..., v2- 10 Date Application Expires: .r- Staff Initials: H:Wpplications \Forms - Applications On Line\2010 Applications \7 -2010 - Electrical Permit Application.doc bh Page 2 of 2 `N ALA 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: hto://www.ci.tukwila.wa.us RECEIPT Parcel No.: 0923049066 Permit Number: EL10 -0980 Address: 3225 S 116 ST TUKW Status: PENDING Suite No: Applied Date: 12/02/2010 Applicant: UNIVERSAL HOSPITAL SERVICES Issue Date: Receipt No.: R10 -02418 Initials: User ID: Payee: JEM 1165 Payment Amount: $178.50 Payment Date: 12/02/2010 12:11 PM Balance: $0.00 CHAD R OWNBEY TRANSACTION LIST: Type Method Descriptio Amount Payment Check 6937 178.50 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 178.50 Total: $178.50 doc: Receiot -06 Printed: 12 -02 -2010 INSPECTION NO. INSPECTION RECORD Retain a copy with permit 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 f J t r&50/1"/ 110(S- Type of Inspection: if Address: 315" 5 , 9 16 5� Date Called: Special Instructions: Date Wanted: 6.n.. Requester: Phone No: Approved per applicable codes. El Corrections required prior to approval. COMMENTS: Inspector: Date: ©t /0 n REINSPECTION P`EE 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 i 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 CRANE CREEK HOLDINGS LLC 4258642070 12556 120Th Ave Ne SUITE 322 Kirkland WA 98034 King Limited Liability Company UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 602734364 Active CRANECH9366F Electrical Contractor 9/6/2007 9/6/2011 Telecommunications Other Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status CRANECH909P7 CRANE CREEK HOLDINGS LLC Electrical Contractor General Unused 10/27/2010 10/27/2012 Active REOTETL950LN REO TECHNOLOGY LLC Electrical Contractor General Unused 6/15/2005 6/15/2007 Expired REOTEL *983N1 REO TECHNOLOGY LLC Electrical Contractor Telecommunications TRAVELERS CAS & SURETY CO 8/21/2002 8/21/2008 Expired Electrical Administrator INFORMATION License OWNBERROO7MA Name OWNBEY, R RANDAL Status Active Business Owner Information Name Role Effective Date Expiration Date OWNBEY, CHAD R Partner /Member 09/06/2007 Amount OWNBEY, RANDY Partner /Member 04/06/2009 52SBSF07163 Bond Information Page 1 of 2 Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 1 TRAVELERS CAS & SURETY CO 105001911 08/31/2007 Until Cancelled $4,000.00 09/06/2007 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 4 Sentinel Insurance co 52SBSF07163 03/10/2010 03/10/2011 $1,000,000.00 03/10/2010 3 TRAVELERS CAS & SURETY CO 680 1808M797 03/10/2009 03/10/2010 $1,000,000.00 02/20/2009 2 TRAVELERS CAS & SURETY CO 680- 1807M797 03/10/2008 03/10/2009 $1,000,000.00 09/24/2008 1 FIRST MERCURY INS CO FMIL002755 08/31/2007 08/31/2008 $1,000,000.00 09/06/2007 https: // fortress .wa.gov /lni/bbip /Print.aspx 12/02/2010