HomeMy WebLinkAboutPermit EL11-0062 - DR BENCA DDSDR BENCA DDS
200 ANDOVER PK E
EL1 1 -0062
Parcel No.:
Address:
Tenant Name:
City it 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: / /wwwci.tukwila.wa.us
0223100099
200 ANDOVER PK E TUKW
DR BENCA DDS
ELECTRICAL PERMIT
Permit Number:
Issue Date:
Permit Expires On:
EL11 -0062
01/28/2011
07/27/2011
Owner:
Name:
Address:
ANDOVER PLAZA LLC
1501 N 200TH ST , SHORELINE WA 98133
Contact Person:
Name: SHARI HUBBELL
Address: PO BOX 3407 , LACEY WA 98509
Contractor:
Name: ALARM CENTER INC
Address: PO BOX 3407 , LACEY WA 98509
Contractor License No: ALARMCI055CW
Phone: 360 - 491 -6320
Phone: 360 - 491 -6320
Expiration Date: 02/16/2011
DESCRIPTION OF WORK:
INSTALL LOW VOLTAGE SECURITY & CCTV SYSTEMS
Value of Electrical Work: NRES: $9,300.00
RES: $0.00
Type of Fire Protection: UNKNOWN
Electrical Service provided by: PUGET SIOUND ENERGY
Permit Center Authorized Signature:
Fees Collected:
$264.50
National Electrical Code Edition: 2008
Date:
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 t . e perform e of work. I am authorized to sign and obtain this electrical permit and agree to the conditions on the back
of this pe t:
Signature: //� /� .
Print Name: Y v �l ��/I i( (AL
Ecye4a-
Date: ( 2-8 -1
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
EL1 1-0062
Printed: 01 -28 -2011
• •
PERMIT CONDITIONS
Permit No. EL11 -0062
* *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
EL11 -0062 Printed: 01 -28 -2011
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
htto://www.atukwila.wa.us
/D (as6. -4m4t323 B /4-4 —`2
Electrical Permit Na.
Project No
(Far ofi
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: 'dPO Ar 40 rt._r Pte,r +� U
Tenant Name: lJr. pa y c-t r. �� InC Cti
King Co Assessor's Tax No.:
Suite Number:
O )-) tn- od9gr
Floor:
New Tenant:
❑ Yes ❑ .. No
Property Owners Name:
Mailing Address:
City
State
Zip
CONTACT PERSON - Wit
do we contact +when
your permit is ready to b
sued
Name: �a r� tddntr1,Q. .
Mailing Address: P O 6o x 3L.10/
E -Mail Address: a v c t ) ca. r vM es_ n te_s- 01\4, • (' O N\
Day Telephone: Z io c7 - Lj Cl 1 -
State Zip
Fax Number: 'Ig[7 q3$ -
CTRICAL CONTRACTOR INFORMATION
Company Name: A1.61. C
Mailing Address: ) 0 0,0 s 3HO7
Contact Person: -S hG C Ci LAJD belt
(J3( c/8'50
E -Mail Address: S \AA.f 1
ac e iln±sLA Y\G. eow._
Contractor Registration Number: ALA-2M 0_,M. O 5Sc
Ci
State Zip
Day Telephone: to " LIi ' 3 qv
Fax Number: t, 0 ° 1/38 - ( 9,1-144
Expiration Date:
Valuation of Project (contractor's bid price): $ Y! 300 t—
Scope of Work (please provide detailed information): \ r S4 t .)v\ \ O ►) v o a CAA r-
Will service be altered? ❑ Yes J No Adding more than 50 amps? ❑ Yes L" No
Type of Use:
Type of work:
❑ New ❑ Addition ❑ Service Change
, Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service
❑ Remodel ❑ Tenant Improvement
Property Served by:
❑ Puget Sound Energy
❑ Seattle City Light
H:\ Applications\Forms- Applications On Line \2010 Applications \7 -2010 - Electrical Permit Application.doc
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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
PL-aE�Rs^M1T APPI ICATION ;NO TES'-
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:
- A\ \ 0)2_00
Print Name:
Mailing Address: ? 0 d O x . -gc-4O7
Date: i l Lo
Day Telephone: 2 to O' y38- -L/7iy4-1
Lc
City
vJA 9�szx�
State Zip
Date Application Accepted:
Date Application Expires:
Staff Initials:
H: Applications \Forms - Applications On Line\2010 Applications \7 -2010 - Electrical Permit Application.doc
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Page 2 of 2
•
C 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.: 0223100099
Address: 200 ANDOVER PK E TUKW
Suite No:
Applicant: DR BENCA DDS
RECEIPT
Permit Number: EL1 1-0062
Status: PENDING
Applied Date: 01/28/2011
Issue Date:
Receipt No.: R11 -00166
Payment Amount: $264.50
Initials: WER Payment Date: 01/28/2011 09:45 AM
User ID: 1655 Balance: $0.00
Payee: CUSTOM SECURITY SYSTEMS
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 114650 264.50
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
ELECTRICAL PERMIT - NONR
000.322.101.00.00 264.50
Total: $264.50
doc: Receiot -06 Printed: 01 -28 -2011
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT N0.
CITY OF TUKWILA BUILDING DIVISION
(206) 431 -3670
6300 Southcenter Blvd., #100, Tukwila. WA 98188
Permit Inspection Request Line (206) 431 -2451
Project:
em
Type of Inspection:
n e )
(.In,
Address: .,
AttbVell)
f
Date Called:
Special Instructions:
iria.s.1-44\114(1
564111/41T7
Date Wanted:
3/2y
.m:
Requester:
Phone No:
Approved per applicable codes. a Corrections required prior to approval.
OMMENTS:
Inspector:
ix-446s,
Date: 93
REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
{
r.
•
INSPECTION RECORD �/�
Retain a copy with permit Ept _ ot k INSPECTION N0. MIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd.; #100, Tukwila. WA 98188 (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
Project: &AC*
Type of Inspection:
��/}}
Address:
04 01 6
Date Called:
Special Instructions:
•
Date Wanted:
2. 12 y
a.m
Requester:
Phone No:
ElApproved per applicable codes.
• ❑ Corrections required prior to approval.
COMMENTS:
gt-KA1/41 tkiscite,
Inspector: �" r
Date: OZ 24 r'
REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
7
�u� -oobv
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 -367
Permit Inspection Request Line (206) 431 -2451
Project: ` gOkse
Type of Inspection:
/5
Address: 200 44
Date Called:
Special Instructions:
Date Wanted:
2.43.
a
Requester:
Phone No:
Approved per applicable codes.
aCorrections required prior to approval. 14
COMMENTS:
OK
Celt
ti44 /Ai tbiParrE
Inspector: / _ Date:
• REINSPECTIONrFEE REQUIRED: Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
N., I 02- 5 it i
Contractors or Tradespeople P;ir Friendly Page
•
Electrical Contractor
A business licensed by Lal 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
ALARM CENTER INC
3604916320
Po Box 3407
Lacey
WA
985093407
Thurston
Corporation
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
600464099
Active
ALARMCI055CW
Electrical Contractor
2/16/1995
2/16/2013
Limited Energy
Hvac /Rfrg Ltd Energy
Other Associated Licenses
License
Name
Type
Specialty
1
Specialty
2
Effective
Date
Expiration
Date
Status
ALARMCI055BC
ALARM CENTER
INC
Electrical
Contractor
General
Unused
1/3/1995
1/3/1997
Archived
Electrical Administrator INFORMATION
License SWIDER'939KS
Name SWIDECKI, ROBERT
Status Active
Business Owner Information
Name
Role
Effective Date
Expiration Date
HARRIS, PHILLIP G
Cancel Date
01/01/1980
Bond Amount
DOWNIE, CLARENCE E
4
01/01/1980
S15632
HARRIS, PHILLIP G
Agent
01/01/1980
HELSTROM, ROBERT L
President
01/01/1980
MERCHANTS BONDING
CO (MUTUAL)
JOHN BUNTIN
Agent
09/19/2000
09/19/2000
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
4
CBIC
S15632
04/15/2010
Until Cancelled
$4,000.0004/15/2010
3
MERCHANTS BONDING
CO (MUTUAL)
14201
05/30/2005
Until Cancelled
04/15/2010
$4,000.0006/01/2005
2
CUMBERLAND CAS
SURETY CO
MB008005027
12/29/2000
Until Cancelled
05/30/2005
$4,000.00
01/06/2003
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 1 Date 1 RCW Code
1
Type
1 Status 1 Violation Amount
https://fortress.wa.gov/lni/bbip/Print.aspx
01/28/2011