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Home My WebLink AboutPermit EL11-0215 - GENOA HEALTHCAREThis record contains information which is exempt from public disclosure pursuant to the Washington State Public Records Act, Chapter 42.56 RCW as identified on the Digital Records Exemption Log shown below. EL11 -0215 Genoa Healthcare 18300 Cascade Avenue RECORDS DIGITAL D- ) EXEMPTION LOG THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION Page # tode Exemption = 8rlef Explanatory DeSclriptiop �t�tutel ule The Privacy Act of 1974 evinces Congress' intent that social security numbers are a private concern. As such, individuals' social security Personal Information — numbers are redacted to protect those Social Security Numbers individuals' privacy pursuant to 5 U.S.C. sec. 5 U.S.C. sec. DR1 Generally — 5 U.S.C. sec. 552(a), and are also exempt from disclosure 552(a); RCW 552(a); RCW under section 42.56.070(1) of the Washington 42.56.070(1) 42.56.070(1) State Public Records Act, which exempts under the PRA records or information exempt or prohibited from disclosure under any other statute. Redactions contain Credit card numbers, debit card numbers, electronic check numbers, credit Personal Information — expiration dates, or bank or other financial RCW 9 DR2 Financial Information — account numbers, which are exempt from 42.56.230(5) RCW 42.56.230(4 5) disclosure pursuant to RCW 42.56.230(5), except when disclosure is expressly required by or governed by other law. GENOA HEALTHCARE 18300 CASCADE AV EL11-0215 Parcel No.: Address: Tenant Name: City0f 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: Issue Date: Permit Expires On: EL11 -0215 03/15/2011 09/11/2011 Owner: Name: RIVERPOINT TWO LLC Address: PO BOX 20399 , SEATTLE WA 98102 Contact Person: Name: BUTCH HUMPHRES Phone: 206 793 -2421 Address: 855 TROSPER RD #108, BOX 365 , TUMWATER WA 98512 Contractor: Name: S & H ELECTRIC INC Address: 855 TROSPER RD #108 , TUMWATER WA 98512 Contractor License No: SHELEI *044JZ Phone: 360 352 -1621 Expiration Date: 04/10/2012 DESCRIPTION OF WORK: ADD (1) DUPLEX OUTLET IN CEILING AT RECEPTION DESK Value of Electrical Work: NRES: $70.00 Fees Collected: RES: $0.00 Type of Fire Protection: SPRINKLERS /AFA Electrical Service Provided by: Permit Center Authorized Signature. I hereby certify that I have read and ex governing this work will be compl.ed wit The granting of this permit does not construction or the performance of wor of this permit. $63.00 National Electrical Code Edition: 2008 Date: 04 cf I ned this permit and know the same to be true and correct. All provisions of law and ordinances whether specified herein or not. Signature: Print Name: e to give authority to violate or cancel the provisions of any other state or local laws regulating am authorized to sign and obtain this electrical permit and agree to the conditions on the back Date: G ` 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 -0215 Printed: 03 -15 -2011 • 4 PERMIT CONDITIONS Permit No. EL11 -0215 * *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 -0215 Printed: 03 -15 -2011 • CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 htto://www.ci.tulovila.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 /g34o e' GR--De AV . qq �y ing Co Assessor's Tax No.: 1� 1) U1 Ot1 Site Address: /d 3 O - Gf?S G 4 DE Ave. Q" Suite Number: Floor: Tenant Name: GEN DR /-/E4L77-( .,4ge New Tenant: E6 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: /5iLTZ./-1 11/1// , E s� "� Day Telephone: �D� Mailing Address: d 5—S Tip 0 �/L /peer . °1�4 ,80 6 s M,OrT a9/1- ?1:572 E -Mail Address: city State Fax Number: ..153 2 - 7;Y5-4.71 ELECTRICAL CONTRACTOR INFORMATION Company Name: S 4 E 7- ,2/GJAk . p Mailing Address: g 5 T,eOSPG.2 R I /Dg 230)431:6- /7/NuastTre, 1-. 9tS72- / / City State Zip' / Contact Person: DU 7'G/ / /--Zi l`oM( .$ Day Telephone: .2063 - 793- )'/ E -Mail Address: Fax Number: .,75-3 - 2 6-.2 - S g On Contractor Registration Number: SA/6 L .1Z 4 6w3--z.. Expiration Date: V— /0 — 30/A-- oa Valuation of Project (contractor's bid price): $ D = Scope of Work (please provide detailed information): � /) UI L 'Lgg /N C E /L /N G £e 7a,q Will service be altered? ❑ Yes No Type of Use: COM m g —_ Type of work: ❑ New ❑ Addition ❑ Service Change ❑ Low Voltage ❑ Generator ❑ Fire Alarm Property Served by: ti Puget Sound Energy ❑ Seattle City Light H: Applications\Fomm npplieailons On IUne12010 Applications17 -2010 - Electrical Permit Applieaom.mc bb Page 1 of 2 Adding more than 50 amps? ❑ Yes *No ❑ Remodel 14 Tenant Improvement ❑ Telecommunication ❑ Temporary Service RESIDENTIAL Nov RESIDENTIAL SERVICE ❑ New single family dwellings .._ ................ ..$145.60 (including an attached garage) ❑ Garages, pools, spas and outbuildings ...... $78.00 ea ❑ Low voltage systems (alarm, fiunace thermostat) $57.00 ea RESIDENTIAL REMODEL AND SERVICE CHANGES ❑ Service change or alteration ....._._ $78.00' (no added/altered circuits) ❑ Service change with added/altered circuits $78.00 number of added circuits $11.00 ea ❑ Circuits added/altered without service change $52.00 (up to 5 circuits) ❑ Circuits added/altered without service change .... $52.00 (6 or more circuits) ... $7.30 ea ❑ Meter /mast repair $65.00 ❑ Low voltage systems ... .. .... S57.00 (alarm, furnace thermostat) MULTI - FAMILY AND COMMERCIAL Fees are based on the valuation of the electrical contract. MISCELLANEOUS FEES ❑ Temporary service (residential) $60.00 ❑ Temporary service (generator)...__ $75.00 ❑ Manufactured/mobile home service $80.00 (excluding garage or outbuilding) ❑ Carnivals:.. $75.00 Number of concessions $10.00 ea 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: Print Name: E • C • G1-477/0 2E S Date: ■/5 1/ ,,��// 2/ r Day Telephone: ' D`v — 76,93 - T2/ Mailing Address:gSJrTROSPF,Q ICS• / )I gZ C3 7ilinlU,l 7 i k%4 ' / �•S�' 2 State Zip IDate Application Accepted: 1 Date Application Expires: I Staff Initials: 1 Ci, 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 SET RECEIPT RECEIPT NO: R11 -00493 Initials: JEM Payment Date: 03/15/2011 User ID: 1165 Total Payment: 258.70 Payee: EARL C HUMPHRES, S AND H ELECTRIC, INC. SET ID: 0315 SET NAME: S & H ELECTRIC SET TRANSACTIONS: Set Member Amount EL11 -0213 EL11 -0215 TOTAL: 195.70 63.00 195.70 TRANSACTION LIST: Type Method Description Amount Payment Credit C VISA 258.70 TOTAL: 258 .7 0 ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.0 258.70 TOTAL: 258.70 _. .; ..va.:;�';+"'r -,: . r,.� =: , .rr 9 v 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 -367 Permit Inspection Request Line (206) 431 -2451 Project: cleivalt Type of Inspection: Zoo Address: rff200 l , 0!L Date Called: --■ Special Instructions: Date Wanted: 3/4 (a.m. Requester: Phone No: tij Approved per applicable codes. a Corrections required prior to approval. COMMENTS: 0 K Inspector: Date: 03 /10/11 n REINSPECTION FEE REQUIRED. Prior to next inspectoo , fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Contractors or Tradespeople P ter Friendly Page o 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 S a H ELECTRIC INC 3603521621 855 Trosper Rd #108 BOX 365 Tumwater WA 98512 Thurston Corporation UBI No. 601703614 Status Active License No. SHELEI'044JZ License Type Electrical Contractor Effective Date 4/9/1996 Expiration Date 4/10/2012 Suspend Date Specialty 1 General Specialty 2 Unused Electrical Administrator INFORMATION License SCHWESR9320J Name SCHWENK, SCOTT R Status Active Business Owner Information Name Role Effective Date Expiration Date HUMPHRES, EARL Agent 04/09/1996 4/25/2007 HUMPHRES, BRIAN President 01/18/2011 $500.00 HUMPHRES, EARL Vice President 01/18/2011 ELECTRICAL CITATION SMITH, WILLIAM H Member 04/09/1996 01/03/2011 HUMPHRES, TERRI Secretary 04/09/1996 01/03/2011 Bond Information No records found for the previous 6 year period Assignment of Savings Information Page 1 of 1 Savings Assignment of Savings Account Number Effective Date Release Date Assignment Type Impaired Date Amount Received Date 1 4/8/1996 Until Released Bond $4,000.00 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 EBRIC00799 4/25/2007 19.28.161 RCW ELECTRICAL CITATION Satisfied $500.00 EVANC00253 3/12/2007 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 EHATR00288 7/10/2007 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 https: // fortress .wa.gov /lni/bbip /Print.aspx 03/15/2011