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Home My WebLink AboutPermit EL10-1016 - DR BENCA DDSDR BENCA DDS 200 ANDOVER PK E EL1O-1016 Parcel No.: Address: Tenant Name: City* 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 0223100099 200 ANDOVER PK E TUKW DR BENCA DDS ELECTRICAL PERMIT Permit Number: EL10 -1016 Issue Date: 12/15/2010 Permit Expires On: 06/13/2011 Owner: Name: ANDOVER PLAZA LLC Address: 1501 N 200TH ST , SHORELINE WA 98133 Contact Person: Name: PAUL LAKEMAN Address: PO BOX 3205 , KIRKLAND WA 98083 Contractor: Name: C F M HEATING & COOLING INC Address: P 0 BOX 3205 , IURKLAND WA 98083 Contractor License No: CFMHEFM953QT Phone: 206 - 391 -1771 Phone: 425 821 -1293 Expiration Date: 11/30/2011 DESCRIPTION OF WORK: INSTALL VVT CONTROL SYSTEM, INCLUDES (3) THERMOSTATS ON (1) HVAC UNIT Value of Electrical Work: NRES: $1,950.00 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: rd 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 tl performance 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: GL� Date: G2 /i-/ 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 -1016 Printed: 12 -15 -2010 PERMIT CONDITIONS Permit No. EL 10 -1016 * *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, 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. 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 -1016 Printed: 12 -15 -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. tL- U) - (0 (o Project No. T (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: 2oc ieindoller Pcv,L E . s 7 Tenant Name: �c14-1': c-ict 8 eel c 4 New Tenant: J Yes ❑ ..No King Co Assessor's Tax No.: Wall Suite Number: 4/ Floor: /sr! Property Owners Name: V'{t3rt ioccQ .2 11E'Sh?7eF?is/ LL G. Mailing Address: /.5-6/ Al o4 4 2ocr14 S%retelt Scl:pit /CD S4jc1YC /7r !�/� 9 a 3 /City State Zip CONTACT PERSON - Who do we contact when your permit is ready to be issued Name: pc..3 1 e frnct,n Mailing Address: ?.0 • B Ox 3�o J Day Telephone: 266, -39 / "% 7 7/ E -Mail Address: (e G' FF/1'1- / ,e. Caw" City State Zip Fax Number: 112S= $ a / —/,3 (-13 ELECTRICAL CONTRACTOR INFORMATION Company Name: C fi"'1 /�°ceTP, ei 4340 /-? -s7 Mailing Address: ?.O. e x 3 ao S Contact Person: 114-,-A, Lock. E- Mail Address: 'Pao 1 61 G 4.- . cOrn K;rkk LAM- 5'8083 Contractor Registration Number: GF/h ALE F/n 9,53 Or" City Day Telephone: State Zip 206- 39/ -/7 7/ Fax Number: Y ?a= $ ?/' /393 Expiration Date: ///30/.70// Valuation of Project (contractor's bid price): $ f/ 'SD. 00 Scope of Work (please provide detailed information): .T.:75./4// J!U % .4r>7 ,S-d / S)/1-4--,.., Pic /dc4 eJ '3 -74-%)?---, /4lds'4 ?S per? / m'-' - G U r/• ' 7th' Will service be altered? ❑ Yes pg No Adding more than 50 amps? ❑ Yes No Type of Use: Type of work: ❑ New ❑ Addition ❑ Service Change ❑ Remodel ❑ Tenant Improvement Eti Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service Property Served by: ❑ Puget Sound Energy ❑ Seattle City Light H:\Applications\Porms- Applications On Line\2010 Applications \7.2010 - Electrical Permit Application.doc bh Page 1 of 2 • C CS:'0/l Gt`G NEW RESIDENTIAL SERVICE ❑ New single family dwellings (including an attached garage) ❑ Garages, pools, spas and outbuildings F/ Low voltage systems (alarm, furnace thermostat) $152.85 $81.90 ea $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 - IDate Application Accepted: 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: patty Print Name: PC,LU ( La k e, u.eI Mailing Address: P.O. [3 c )C '3010 Day Telephone: City Date: 121 / / c:slO 39i/ -/7'? / c4— State 98033 Zip Date Application Expires: Staff Initials: H:\Applications \Farms - Applications On Line\2010 Applications \7 -2010 - Electrical Permit Application.doc 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: htqx//www.ci.tukwila.wa.us Parcel No.: 0223100099 Address: 200 ANDOVER PK E TUKW Suite No: Applicant: DR BENCA DDS RECEIPT Permit Number: EL10 -1016 Status: PENDING Applied Date: 12/15/2010 Issue Date: Receipt No.: R10 -02503 Initials: User ID: Payee: WER 1655 Payment Amount: $115.50 Payment Date: 12/15/2010 09:00 AM Balance: $0.00 PAUL LAKEMAN TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 015195 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: 12 -15 -2010 INSPECTION RECORD Retain a copy with permit INSPECTION 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 Ex-ID I(, Project: )1r,\ o k Type of Inspection: ,-.7ro(.2 Address: ZOO 4J00%/1 C. Date Called: Special Instructions: Date Wanted: /�J z. )3m�,., Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Inspector: /L'4 Date: 021-23/1 r n REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. Contractors or Tradespeople Peter 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 C F M HEATING & COOLING INC 4258211293 11447 120Th Ave Ne #200 Kirkland WA 98033 King Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 602361244 Active CFMHEFM953QT Electrical Contractor 11/30/2005 11/30/2011 Hvac /Rfrg Ltd Energy Unused Electrical Administrator INFORMATION License SELLMMA916B6 Name SELLMAN, MICHAEL A Status Active Business Owner Information Name Role Effective Date Expiration Date CLANCY, SHAUN P Agent 11/30/2005 Bond Amount CLANCY, SHAUN P President 11/30/2005 797048C 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 2 DEVELOPERS SURETY & INDEM CO 797048C 11/21/2008 Until Cancelled 19.28.271 RCW ELECTRICAL CITATION $4,000.0012/19/2008 5250.00 1 RELIANCE INS CO SRS1008650 11/21/2005 Until Cancelled 01/08/2009 $4,000.0011 /30/2005 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 ECHAE00296 12/28/2007 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 EMEHU03041 10/26/2009 19.28.271 RCW ELECTRICAL CITATION Satisfied 5250.00 https: // fortress .wa.gov /lni/bbip /Print.aspx 12/15/2010