HomeMy WebLinkAboutPermit EL11-0045 - GENOA HEALTHCAREGENOA HEALTHCARE
18300 CASCADE AV
EL1 1 -0045
Parcel No.:
Address:
Tenant Name:
Cityef 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
7888900175
18300 CASCADE AV TUKW
GENOA HEALTHCARE
ELECTRICAL PERMIT
Permit Number: EL11 -0045
Issue Date: 01/24/2011
Permit Expires On: 07/23/2011
Owner:
Name: RIVERPOINT TWO LLC
Address: PO BOX 20399 , SEATTLE WA 98102
Contact Person:
Name: ERIC CARLSON
Address: 3240 118 AV SE #100 , BELLEVUE WA 98005
Contractor:
Name: FIRSTLINE COMMUNICATIONS INC
Address: 3240 118 AV SE #100 , BELLEVUE WA 98005
Contractor License No: FIRSTCI008PD
Phone: 425 - 460 -3050
Phone: 425 688 -1634
Expiration Date: 10/04/2012
DESCRIPTION OF WORK:
LOW VOLTAGE VOICE & DATA CABLING
Value of Electrical Work: NRES: $3,000.00
RES: $0.00
Type of Fire Protection: UNKNOWN
Electrical Service provided by: PUGET SOUND ENERGY
Permit Center Authorized Signature:
Fees Collected: $136.50
National Electrical Code Edition: 2008
Date: 1— 14
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 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: Date: ki24/(
Print Name: ��"— (f ,(Ltt \)
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
EL11 -0045 Printed: 01 -24 -2011
1 •
PERMIT CONDITIONS
Permit No. EL11 -0045
* *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
EL 11 -0045 Printed: 01 -24 -2011
•
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
htt0://www.ci.tukwila.wa.us
•
Electrical Permit No. t Lt l— ODD S
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:/ eat 0-0156110F AVE S
Tenant Name: ( AoA
Property Owners Name:
Mailing Address:
King Co Assessor's Tax No.: 7&$& q0 — 0 (-1 S
Suite Number: Floor: 2-Np
New Tenant: Yes ❑..No
City
State
Zip
CONTACT PERSON — Who do we contact when your permit is ready to be issued
Name: k---/WC- CAP-4120
Mailing Address: 3 2.-`/D // e Ave E 11
E -Mail Address: C-0" /tZ C. e'_ %•-S7 L'/1 , 4/C
Day Telephone: % 2) Lt/ 65'0
fe vac u��4 47 .E
City State Zip
Fax Number: qZ� - -3 8,r
ELECTRICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
Contact Person:
E -Mail Address:
Contractor Registration Number: ci1116%G1ri Pp
Day Telephone:
Fax Number:
Expiration Date: / t,H/7�/ 2-
Valuation of Project (contractor's bid price): $ !/li22
Scope of Work (please provide V' rovide etailed information):
V ,t
alit/ � 1 ®Ira
h` - oosAk,°
p4-7-4 Q_PIP/ii25
Will service be altered? ❑ Yes
Type of Use:
Type of work:
❑ New ❑ Addition ❑ Service Change
Low Voltage ❑ Generator ❑ Fire Alarm
❑ No Adding more than 50 amps? ❑ Yes ❑ No
Property Served by:
❑ Puget Sound Energy
❑ Seattle City Light
n:\Applications\Forms- Applications On Lne\2010 Applications \7 -2010 - Electrical Permit Application. doc
bh
Page I 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 1 AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER OR ELECTRICAL CONTRACTOR:
Signature:
Date: / ( //
U t
Print Name: .�Z7 t% t_ . . m // Day Telephone:.��C 0 QSD
Mailing Address:6j )1 //0 /i,4 5 EA/e90 ffir /�C � 3
Slate Zip
City
Date Application Accepted:
Date Application Expires: Staff Initials:
H:\Applications\Forms- 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: http: //www.ci.tukwila.wa.us
Parcel No.: 78889001 75
Address: 18300 CASCADE AV TUKW
Suite No:
Applicant: GENOA HEALTHCARE
RECEIPT
Permit Number: EL11 -0045
Status: PENDING
Applied Date: 01/24/2011
Issue Date:
Receipt No.: R11 -00123
Initials: WER
User ID: 1655
Payment Amount: $136.50
Payment Date: 01/24/2011 01:44 PM
Balance: $0.00
Payee: FIRST LINE COMMUNICATIONS INC
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 27156 136.50
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
ELECTRICAL PERMIT - NONR
000.322.101.00.00 136.50
Total: $136.50
rind Racaint -06
PrintPr1 01 -24 -2011
Fl•
•
INSPECTION RECORD
Retain a copy with permit
INSPEC ION NO. P RMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd.,• #100, Tukwila. WA 98188 (206) 431 -367
Permit Inspection Request Line (206) 431 -2451 R• t.-
Project: j
fAIOA 4654;n4
Type of Inspection:
Address: 8300 CASCOe
•
Date Called:
Special Instructions:
Date Wanted:
7-4- �
�.
Requester:
Re q
r
Phone No:
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
ketonots mope
(/1614(..,
( 1[1:1 864JC-1
REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
Inspector:
!Date: 02... J _ i
*101 :,smi, -' • 1 -..
- '41•°1-. • - r ...
r-
‘. •
R
s
•
Li..
MM • �.`� a+ LCD
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 •
CU i
-ors
Project:
Type of Inspection:
Address:
j
Date Called:
Special Instructions:
-llD
Date Wanted:
���
a.m.
Requester:
Phone No: •
0 Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
£04D bgrik ass
Inspector: .,/ (Date: A� _ fit
n REINSPECTION FEE REQUIRED.. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd.. Suite f00. Call to schedule reinspection.
•
•
r.
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
Project:
1
Type of Inspection:
Address:
Date Called.
Special Instructions:
11
Date Wanted:
f
7
a.m.
p.m.
Requester:
Phone No
71 Approved per applicable - codes. • ` 0 Corrections required prior to-approval.
COMMENTS:
4:”.16 14 tni 60116if
Inspector: %
Pty
n REINSPECTION FEE REQ ,IRED. Prior to next inspection. fee must be-
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
Date: 0 lg % +
INSPECTION RECORD
a copy with permit + I' (✓�+"( 5
INSPECTION NO. PERMIT NO.
P
. CITY OF TUKWILA BUILDING DIVISION P-
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 =3670
Permit Inspection Request Line (206) 431 -2451
Project: f
Type of Inspection:
r�
Address: �A�
T�
���
Date Called:
‘
Special Instructions:
.
-
Date Wanted:
1#(
a.m.
-.
Requester:
Phone No:
ElApproved per applicable codes.
DCorrections requiredd, prior to approval. /�
COMMENTS:
ulikw (Awl
Inspector:
Date: 0 t /e
ri REINSPECTIO$1 FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd:; Suite 100. Call to schedule reinspection:
Contractors or Tradespeople P ter 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
FIRSTLINE COMMUNICATIONS INC
4256881634
3240 118Th Ave Se #100
Bellevue
WA
98005
King
Corporation
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
601096381
Active
FIRSTCI008PD
Electrical Contractor
10/4/2000
10/4/2012
Telecommunications
Electrical Administrator INFORMATION
License WALTEM'001NG
Name WALTER, MINDY
Status Active
Business Owner Information
Name
Role
Effective Date
Expiration Date
MAIO, TIM P
Cancel Date
01/01/1980
Bond Amount Received Date
CARLSON, ERICA
CBIC
01/01/1980
09/26/2000
EVERGREEN CORP SVS INC
Agent
01/01/1980
$4,000.0011 /08/2000
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
1
CBIC
SD2354
09/26/2000
Until Cancelled
$4,000.0011 /08/2000
Assignment of Savings Information No records found for the previous 6 year period
Insurance Information
Insurance I Company Name
I
Policy Number
Effective Date I Expiration
https: // fortress .wa.gov /lni /bbip /Print.aspx 01/24/2011
r
F625- 052 - 000 (8/97)
DEPARTMENT OF LABOR AND INDUSTRIES
LICENSED AS PROVIDED BY LAW AS
ELEC CONTR TELECOM
LICENSE # EXP. DATE
FIRSTCI008PD . 10/4/2012
FECTI'VE DATE 10/4/2000
FIRSTLINE COMMUNICATIONS INC
3240 118TH AVE SE #100
BELLEVUE WA 98005
Detach And Display Certificate
LICENSED AS PROVIDED BY LAW AS
ELEC CONTR TELECOM
LICENSE # EXP. DATE
ECO9 FIRSTCI008PD 10/4/2012
EFFECTIVE DATE 10/4/2000
FIRSTLINE COMMUNICATIONS INC
3240 118TH AVE SE #100
BELLEVUE WA 98005
Signature
Issued by DEPARTMENT OF LABOR AND INDUSTRIES
F625- 052 -000 (8/97)
Please Remove
And Sign
Identification
Card Before
Placing In
Billfold