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Home My WebLink AboutPermit EL11-0259 - ANGOLKAR 4 SMILESANGOLKAR 4 SMILES 13530 53 AV S EL1 1 -0259 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 0003000038 13530 53 AV S TUKW ANGOLKAR 4 SMILES ELECTRICAL PERMIT Permit Number: EL11 -0259 Issue Date: 03/18/2011 Permit Expires On: 09/14/2011 Owner: Name: Address: Contact Person: Name: Address: PRATE] LLC 17000 SE 65TH PL , BELLEVUE WA 98006 GLEN DISBROW 644 STRANDER BL, SUITE 11 , TUKWILA WA 98188 Contractor: Name: COMPUTER SYSTEMS SERVICE CORP Address: 644 STRANDER BL, SUITE 11 , TUKWILA WA 98188 Contractor License No: COMPUSS995LR Phone: 206 - 396 -0848 Phone: 206 - 394 -7777 Expiration Date: 07/11/2011 DESCRIPTION OF WORK: LOW VOLTAGE DATA & PHONE CABLE AND INSTALLATION Value of Electrical Work: Type of Fire Protection: NRES: $6,000.00 RES: $0.00 UNKNOWN Electrical Service Provided by: SEATTLE CITY LIGHT Permit Center Authorized Signature: Fees Collected: $195.70 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 construction or th of this permit. Signature: does no presume to give authority to violate or cancel the provisions of any other state or local laws regulating ce work. I am authorized to sign and obtain this electrical permit and agree to the conditions on the back Print Name: 1440 dp"`I Date: g —�O- 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 -0259 Printed: 03 -18 -2011 • • PERMIT CONDITIONS Permit No. EL 11-0259 * *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 -0259 Printed: 03 -18 -2011 CITY OF TUK4A Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 htto://www.ci.tukwila.wa.us • Electrical Permit No. Project No. L- ill - nol_zs 1 (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: 1 3 J 3 0 -5 3 .. Tenant Name: P \ I p5 Property Owners Name:U LcJ )(- Mailing Address: King Co Assessor's Tax No.: 000 ?j £ (- 6030 Suite Number: New Tenant: Floor: 1 "4 Z ❑ Yes ❑ .. No City State Zip CONTACT PERSON - Who do we contact when your permit is ready to be issued Name: C L' ✓Z Mailing Address: City ' S o w CS< - Sp a J7eer .Fax Number: Z 5 3 ^ o �I 1- 7 Day Telephone: Z 0 6 �, 0 g `P a �`P ( Siv - c� P� �v d ) 1 I v <<t.) \� L-V �i � l cg t State Zip E -Mail Address: ELECTRICAL CONTRACTOR INFORMATION Company Name: Mailing Address: Y STv/1k, e(J 4/i �\�tvuce (16 v -7`J <<wi /A w A �R � �(1' Contact Person -Y to 1 S b v GLA-) E- Mail Address:/ ,t.) Cka SC ) g Contractor Registration Numbejo Q s 1 9 / City State Zip Day Telephone: `: P -1. a a Fax Number: - S j 8 j- Expiration Date: J `2.- ro -C c7 ate. Valuation of Project (contractor's bid price): $ 6/t) Scope of Work (please provide detailed information): L o w (41 lY' 5>'o!1to- 7 e Will service be altered? ❑ Yes /El No Type of Use: L o W U 1.) 4-7 .� Type of work: At New ❑ Low Voltage Property Served by: ❑ Puget Sound Energy 14 Seattle City Light ❑ Addition ❑ Generator Adding more than 50 amps? ❑ Yes a No ❑ Service Change ❑ Fire Alarm H:\Applications \Forms - Applications On Line \2010 Applications \7 -2010 - Electrical Permit Application.doc bh Page 1 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 I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING 0 L ?i� • �'LECTRICAL CONTRACTOR: Signature: �( Print Name: 2 Mailing Address::„ ./ tf 5-71, ,,, ci r t, # ( IDate Application Accepted: Date: 3� /Cj Day Telephone: Z 06 si 9 6 o X 1-vi Fg/9S City State Zip Date Application Expires: Staff Initials: H: Applications\Potrns- Applications On Line\2010 Applications17.2010 - Electrical Permit Application.doc bh Page 2 of 2 1 • • 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.: 0003000038 Address: 13530 53 AV S TUKW Suite No: Applicant: ANGOLKAR 4 SMILES RECEIPT Permit Number: EL11 -0259 Status: PENDING Applied Date: 03/18/2011 Issue Date: Receipt No.: R11 -00538 Initials: User ID: Payee: WER 1655 Payment Amount: $195.70 Payment Date: 03/18/2011 03:18 PM Balance: $0.00 GLEN DISBROW TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 043153 ACCOUNT ITEM LIST: Description 195.70 Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 195.70 Total: $195.70 doc: Receiot -06 Printed: 03 -18 -2011 • • l.: INSPECTION NO. INSPECTION RECORD Retain a copy with permit aita25 P IT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 K (206) 431 -3670 .Permit Inspection Request Line (206) 431 -2451 Project: Type of Inspection: �V Address: z ,.% Date Called: Special Instructions: • Date Wanted:. 9 �i 0 6.1....n p.m. Requester: Phone No: ,Approved per applicable codes. COMMENTS: ElCorrections required prior to approval. Inspector: Date: 092e11I REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. 3 INSPECTION RECORD 6,11" Retain copy. with permit 0751 INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 _ (206) 431 -3 Permit Inspection Request Line (206) 431 -2451 Project A,,f//t Li mat5 Type of Inspection: Address, .3 3 Date Called: Special Instructions: r Date Wanted:. a.m.„„ Requester: Phone No: LIApproved per applicable codes. 1- Corrections required prior to approval. COMMENTS: 644.47 ri REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INSPECTION NO. INSPECTION RECORD Retain a copy with permit t257ERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 pc (206) 431 -36 Permit Inspection Request Line (206) 431 -2451 Project: Type o Inspection: 21400 ddress: 13530 Special Instructions: Date Called: Requester: Phone No: 12 Approved per applicable codes. Corrections required prior to approval. COMMENTS: Inspector: Date: 07/i 3 r 4:164j r n REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. '20. F..; .f.• 77, -7 .i.•• • l• •-;• -s•-• INSPECTION NO. INSPECTION RECORD Retain a copy with permit ozq RMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-367 Permit Inspection Request Line (206) 431-2451 Project: A i /4A/6 OtA4 11 511 '11 Type of Inspection: Address:)35730 53 aw . Date Called: Special Instructions: rral Delt Date Wanted: 00 n 3.....r.. Requester: Phone No: ElApproved per applicable codes. IXICorrections required prior to approval. COMMENTS: tiovisif IZA-Gt( frioistA\ &kip itkuic 646it Itictrius/01045 Inspector: Date: 040111 REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. • • • . • I:. INSPECTION RECORD Retain a copy with permit INS' CTION NO. PERMIT NO. • 0-1/-24,-5 CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Project: . Type of I - pection: Address: /JD. S''a Date Called: . Special Instructions: • • Date Wan d: a.m. m. Requester: Phone No: Approved per applicable codes. El Corrections requiredprior to approval. • COMMENTS: re.) -74 d `Inspecto : IDat_e: i . �r,T)0 4 — / —// ri REINSP CTION FEE REQUIRED: Prior to next inspection. fee must be paid a 6300 Southcenter Blvd:, Suite 100. Call to schedule reinspection. Contractors or Tradespeople Printer 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 COMPUTER SYSTEMS SERVICE CORP 2063947777 644 Strander Blvd ##11 Tukwila WA 98188 King Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 601086038 Active COMPUSS995LR Electrical Contractor 6/19/2001 7/11/2011 Telecommunications Electrical Administrator INFORMATION License DISBRGL990LQ Name DISBROW, GLEN L Status Active Business Owner Information Name Role Effective Date Expiration Date DISBROW, GLEN L Agent 06/19/2001 Bond Amount DISBROW, GLEN L President 06/19/2001 98 BF 5346 0 MAYES, JOSEPH M Secretary 06/19/2001 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 2 STATE FARM FIRE & CAS CO 98 BF 5346 0 05/01/2010 Until Cancelled $4,000.00 04/29/2010 1 CBIC LB7272 05/08/2001 Until Cancelled 07/05/2010 $4,000.0006/11/2001 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 14 STATE FARM FIRE & CAS CO 98bfk8966 06/08/2010 06/08/2011 $500,000.00 08/16/2010 13 STATE FARM FIRE & CAS CO 98BJE4983 06/08/2010 06/08/2011 $500,000.00 08/09/2010 12 STATE FARM FIRE &CAS CO 98 BF K896 6 06/08/2009 06/08/2010 $500,000.00 05/29/2009 11 HARTFORD CAS INS CO 52SBAUJ0839 06/08/2009 06/08/2010 06/19/2009 $2,000,000.0005 /07/2009 10 HARTFORD CAS INS CO 52 SBA UJ0839 06/08/2008 06/08/2009 $170,000.0005/02 /2008 9 HARTFORD CAS INS CO 52SBAUJ0839 06/08/2007 06/08/2008 $170,000.00 06/01/2007 8 HARTFORD CAS INS CO 52S8AUJ0839 06/08/2006 06/08/2007 $2,000,000.00 05/22/2006 7 HARTFORD CAS INS CO 52SBAUJ0839 06/08/2005 06/08/2006 $2,000,000.00 06/08/2005 https://fortress.wa.gov/lni/bbip/Printaspx 03/18/2011