HomeMy WebLinkAboutPermit EL11-0123 - DR BENCA DDSDR BENCA DDS
200 ANDOVER PK E
EL1 1 -0123
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: / /wwwci.tukwila.wa.us
0223100099
200 ANDOVER PK E TIIKW
DR BENCA DDS
ELECTRICAL PERMIT
Permit Number:
Issue Date:
Permit Expires On:
EL11 -0123
02/16/2011
08/15/2011
Owner:
Name: ANDOVER PLAZA LLC
Address: 1501 N 200TH ST , SHORELINE WA 98133
Contact Person:
Name: RON MOORE Phone: 206 - 441 -7497
Address: 16212 BOTHEL EVERETT HY, SUITE F332 , MILL CREEK WA 98012
Contractor:
Name: RAMTEL ENTERPRISES
Address: 1201 180 ST SW , LYNNWOOD WA 98037
Contractor License No: RAMTEE *003LH
Phone: 206 - 441 -7497
Expiration Date: 06/30/2012
DESCRIPTION OF WORK:
LOW VOLTAGE VOICE & DATA WIRING
Value of Electrical Work: NRES: $3,500.00
RES: $0.00
Type of Fire Protection: UNKNOWN
Electrical Service provided by: PUGET SOUND ENERGY
Permit Center Authorized Signature:
Fees Collected:
$160.00
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 d
construction or the perfo
of this permit.
Signature:
Print Name:
ume to .i - thority to violate or cancel the provisions of any other state or local laws regulating
ed to sign and obtain this electrical permit and agree to the conditions on the back
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
EL11 -0123
Printed: 02 -16 -2011
0 •
PERMIT CONDITIONS
Permit No. EL11 -0123
* *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
EL11-0123 Printed: 02 -16 -2011
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
htto://www.ci.tukwila.wa.us
Electrical Permit No.
Project No.
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.: oo -d-31 O - ()Ogg
Site Address: >100 ,,,/%/%4 // /e /1`9AA C,h7 Suite Number: ,L� Floor:
Tenant Name:
Dig, Y //hA 4-v
New Tenant: ® Yes ❑ ..No
Property Owners Name:
Mailing Address:
City
State Zip
CONTACT PERSON - Who do we contact when your permit is ready to be issued
Name: RAN 170/2/? ✓ Day Telephone: .246 `/f/ %y9%
Mailing Address: 1/421. /C`22‘`-`, ./W.1 x/332 , A// e.f - -- J44 9P6/;
//� %1 City State Zip
E -Mail Address: /690% - -7,2 aQD g f!'Q�j%%,/, D�� Fax Number: � = /7 r os'
ELECTRICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address: /6a 1 2 / n 7 , e - w . //of #1:33.f % % % % 1 , l GI f(' %D /.g
City State Za p
7 /7r . rise-=.�
Contact Person: dill / %'/ j9D12 Day Telephone: .2106 - '/41- 71/9/
E -Mail Address: )J0 74:4 .,qL #L .407)IAi.L. C"/ % Fax Number. WS. -,i 7 r -
Contractor Registration Number: 74.L no 34.,9 _ Expiration Date: 06 /36li14/2
Valuation of Project (contractor's bid price): $ (3C
Scope of Work (please provide detailed information): /.5a..) �D,P7/�fic�- P'/'/') 407;1 �//�/1.4/// •
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
El Low Voltage ❑ Generator ❑ Fire Alarm m Telecommunication ❑ Temporary Service
Property Served by:
❑ Puget Sound Energy
❑ Seattle City Light
H:\Appticatii thTorms- Applicaiions On Line \2010 Applications \7 -2010 - Electrical Permit Application.doc
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Page 1 of 2
1
RESIDENTIAL
NEW RESIDENTIAL SERVICE
❑ New single family dwellings
(including an attached garage)
❑ Garages, pools, spas and outbuildings
❑ 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 $78,79
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 T OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER OJR- 1 AL CQNTRACTOR:
Signature:
Print Name:
Date: £i?'_ 7 • ."-e4 // •
Day Telephone:
Mailing Address: //...0 (jo�.(/�L� � y�Fly, /w y r/— - ' - �j�F wiy 9fsO-
City State Zip
IDate Application Accepted:
Date Application Expires: Staff Initials:
H:Vlpplications \Farms - Applications On Line\2010 Applications \7 -2010 - Electrical Permit Application.doc
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Page 2 of 2
•
�J��1LA wqs City of Tukwila
o�? Department of Community Development
G7 6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
�\ �2 Phone: 206 -431 -3670
Fax: 206 - 431 -3665
1906 Web site: http: / /www.ci.tukwila.wa.us
Parcel No.: 0223100099
Address:
Suite No:
Applicant: DR BENCA DDS
200 ANDOVER PK E TUKW
RECEIPT
Permit Number:
Status:
Applied Date:
Issue Date:
EL11 -0123
ISSUED
02/16/2011
02/16/2011
Receipt No.:
Initials:
User ID:
R11 -00293
WER
1655
Payment Amount: $157.50
Payment Date: 02/16/2011 10:18 AM
Balance: $0.00
Payee: RAMTEL ENTERPRISES
TRANSACTION LIST:
Type Method
Descriptio Amount
Payment Cash
Authorization No.
ACCOUNT ITEM LIST:
Description
157.50
Account Code
Current Pmts
ELECTRICAL PERMIT - NONR
000.322.101.00.00
Total: $157.50
157.50
doc: Receiot -06
Printed: 02 -16 -2011
•
City of Tukwila
ZDepartment 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: EL11 -0123
Status: PENDING
Applied Date: 02/16/2011
Issue Date:
Receipt No.: R11 -00294
Initials:
User ID:
WER
1655
Payment Amount: $2.50
Payment Date: 02/16/2011 10:20 AM
Balance: $0.00
Payee: RAMTEL ENTERPRISES
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Cash
Authorization No.
ACCOUNT ITEM LIST:
Description
2.50
Account Code Current Pmts
MAPS /PUBLIC /MAILING
000.341.500 2.50
Total: $2.50
doc: Receiot -06 Printed: 02 -16 -2011
INSPECTION RECORD
Retain a copy with permit 6'117 05
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 f�
Project:Q gmczt
Type of Inspection:
Address: 00 AAA!!
Date Called:
Special Instructions:
'reL4 M-1- of
Date Wanted:
3/2-2-
6.m.... p.m.
Requester:
Phone No:
IA Approved per applicable codes. a Corrections required prior to approval.
COMMENTS:
9
Inspector: /r i _I I
Date:
1
n REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
•
i •
M1•
•
fr
•
•
2.
INSPECTION RECORD if if
Retain a copy with permit ! Ot23
INSPECTION NO. PERMIT NO.
• CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA,98188 s . ' (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
Project: 'fri‘, 6tc
Type of Inspection:
700
Address:
;CI) III
.-
. J
Date Called:
Special Instructions:
Date Wanted:
• a.m..
Requester:
•
Phone No:
Approved per applicable codes. El Corrections required prior to approval.
OMMENTS:
!¢
an4
Rod a
n REINSPECTION FEE REQUIRED: Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100: Call to schedule reinspection.
"sha t. 1.e7c+1013.- ■Sa,4100:••• • ■+r .._ ..t'++e'e S.... ...« •• s. y+4.. • .9 -2 .. SF:. ^. •
Contractors or Tradespeople Prater Friendly Page
sr
Electrical Contractor
A business licensed by LEN 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
RAMTEL ENTERPRISES
2064417497
1202 180Th St Sw
Lynnwood
WA
98037
Snohomish
Individual
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
600618918
Active
RAMTEE'003LH
Electrical Contractor
6/8/2000
6/30/2012
Telecommunications
Electrical Administrator INFORMATION
License MOORER *000LH
Name MOORE, RON A
Status Active
Business Owner Information
Name
Role
Effective Date
Expiration Date
MOORE, RON A
Owner
01/01/1980
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
HARTFORD FIRE INS
CO
72BSBAX8833
06/06/2001
Until Cancelled
$4,000.00
06/22/2001
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
AMERICAN
STATES INS CO
01 CG 290302
1
01/19/2003
Until Cancelled
$500,000.00
01/17/2003
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
https: // fortress .wa.gov /lni/bbip /Print.aspx 02/16/2011