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Home My WebLink AboutPermit EL11-0282 - PUGET SOUND INTERVENTIONAL PAIPUGET SOUND INTERVENTIONAL PAIN CLINIC 7200 S 180 ST EXPIRED 09 -24-11 EL1 1 -0282 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: / /www.ci.tukwila.wa.us ELECTRICAL PERMIT Parcel No.: 3623049013 Address: 7200 S 180 ST TUKW Tenant Name: PUGET SOUND INTERVENTIONAL PAIN CLINIC Permit Number: EL11 -0282 Issue Date: 03/28/2011 Permit Expires On: 09/24/2011 Owner: Name: KHK INVESTMENT LLC Address: 7200 S 180TH ST , TUKWILA WA 98188 Contact Person: Name: THOMAS KIM Address: 4525 S WARNER ST #A8 , TACOMA WA 98409 Contractor: Name: JOHN'S ELECTRICAL INC Address: 4525 S WARNER ST #A8 , TACOMA WA 98409 Contractor License No: JOHNSEI961 OM Phone: 253 226 -6748 Phone: 253 226 -6748 Expiration Date: 09/14/2012 DESCRIPTION OF WORK: PROVIDE NEW 120/208V 100 A 3 PHASE SUBPANEL AND FEEDER TAPPING BRANCH FROM EXISTING MAIN PANEL (400 AMP 3 PHASE). ALSO ALTER OR ADJUST EXISTING LIGHT AND OUTLETS. Value of Electrical Work: NRES: $11,000.00 RES: $0.00 Type of Fire Protection: UNKNOWN Electrical Service Provided by: PUGET SOUND ENERGY 1 � Permit Center Authorized Signature �� .. Date: V J Fees Collected: $281.70 National Electrical Code Edition: 2008 tot4 I hereby certify that I have read an ex ned this permit and know the same to be true and correct. All provisions of law and ordinances governing this work will be compli - d wit i whether specified herein or not. The granting of this permit does not • res e to give authority to violate or cancel the provisions of any other state or local laws regulating construction or the performance of wo authorized to sign and obtain this electrical permit and agree to the conditions on the back of this permit. Signature: Print Name: Date: /110.4/2,k )-0 // 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 -0282 Printed: 03 -28 -2011 • • PERMIT CONDITIONS Permit No. EL11 -0282 * *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 ELI 1-0282 Printed: 03 -28 -2011 CITY OF TUKWt Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 htto://www.ci.tukwila.wa.us Electrical Permit No. eC ✓l 62192-, 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 King Co Assessor's Tax No.: Parcal#3623049013 Site Address: 7200 So. 180th Tukwila WA 98032 Tenant Name: PUSET SOUND INTERVENTIONAL PAIN CLINIC Property Owners Name: Puget Sound Interventional Clinic / Dr. Dan Kim Mailing Address: 11306 Bridgeport Way SW Suite Number: 101 Floor: 1st New Tenant: m Yes ❑ ..No Lakewood City WA 98499 State Zip CONTACT PERSON — Who do we contact when your permit is ready to be issued Name: Thomas Kim Day Telephone: (253) 226 -6748 Mailing Address: City Fax Number: E -Mail Address: thomasdskim @hotmail.com State Zip ELECTRICAL CONTRACTOR INFORMATION Company Name: John's Electrical Inc Mailing Address: 4525 So. Wamer St #A -8 Contact Person: John's Electrical Inc E -Mail Address: thomasdskim @hotmail.com Contractor Registration Number: JOHNEI9600M Tacoma City Day Telephone: Fax Number: Expiration Date: 09/14/2012 WA State (253) 226 -6748 98409 Zip Valuation of Project (contractor's bid price): $ 11,000 Scope of Work (please provide detailed information): Provide a new 120/208V 100A 3Phase Sub Panel and feeder - Tapping branch from Existing main panel(400A 3phase) and Alteration or adjustment for existing light and outlet's Will service be altered? ❑ Yes ® No Adding more than 50 amps? m Yes ❑ No Type of Use: Commercial Type of work: ❑ New ❑ Addition ❑ Low Voltage ❑ Generator Property Served by: O Puget Sound Energy ❑ Seattle City Light ❑ Service Change ❑ Fire Alarm H:IApplicationsWornts- Applications On Line\2010 Applicationsl7 -2010 - Electrical Permit Applicationdoc bh Page 1 of 2 m Remodel m 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, fumace 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 OWNE)t OR ELECTRICAL CONTRACTOR: Signature: Print Name: 0/%4/04.,S. Se VNA Mailing Addless: 4525 So. Wamer St #A -8 IDate Application Accepted: AYJ_ [ je Day Telephone: Tacoma City Date: 03/28/2011 (253) 226 -6748 98409 State Zip Date Application Expires: Staff Initials: H:\Applications \Forms - Applications On Line\2010 Applications \7 -2010 - Electrical Permit Applicaliordoc 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 RECEIPT Parcel No.: 3623049013 Permit Number: EL11 -0282 Address: 7200 S 180 ST TUKW Status: PENDING Suite No: Applied Date: 03/28/2011 Applicant: PUGET SOUND INTERVENTIONAL PAIN CLINIC Issue Date: Receipt No.: R11 -00593 Initials: User ID: Payee: JEM 1165 Payment Amount: $281.70 Payment Date: 03/28/2011 12:05 PM Balance: $0.00 THOMAS D KIM TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 418250 ACCOUNT ITEM LIST: Description 281.70 Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 281.70 Total: $281.70 doc: Receiot -06 Printed: 03 -28 -2011 08 -01 -2011 0 carp of Tukwila • Jim Haggerton, Mayor Department of Community Development Jack Pace, Director THOMAS KIM 4525 S WARNER ST #A8 TACOMA WA 98409 RE: Permit No. EL11 -0282 7200 S 180 ST TUKW Dear Permit Holder: In reviewing our current records, the above noted permit has not received a final inspection by the City of Tukwila Building Division. Per the International Building Code, International Mechanical Code, Uniform Plumbing Code and /or the National Electric Code, every permit issued by the Building Division under the provisions of these codes shall expire by limitation and become null and void if the building or work authorized by such permit has not begun within 180 days from the issuance date of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work has begun for a period of 180 days. Your permit will expire on 09/24/2011. Based on the above, you are hereby advised to: 1) Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 to schedule for the next or final inspection. Each inspection creates a new 180 day period, , provided the inspection shows progress. -or- 2) Submit a written request for permit extension to the Permit Center at least seven (7) days before it is due to expire. Address your extension request to the Building Official and state your reason(s) for the need to extend your permit. The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is determined that your extension request is granted, you will be notified by mail. In the event you do not call for an inspection and /or receive an extension prior to 09/24/2011, your permit will become null and void and any further work on the project will require a new permit and associated fees. Thank you for your cooperation in this matter. Sincerely, Bill Rambo Permit Technician File: Permit File No. EL11 -0282 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 Contractors or Tradespeople Pr ter Friendly Page a 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 JOHN'S ELECTRICAL INC 2532266748 4525 5 Warner St #A8 Tacoma WA 98409 Pierce Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 602428713 Active JOHNSEI961 OM Electrical Contractor 9/14/2004 9/14/2012 General Unused Electrical Administrator INFORMATION License KIM'TTD9610G Name KIM, THOMAS D Status Active Business Owner Information Name Role Effective Date Expiration Date KIM, THOMAS D Agent 09/14/2004 Bond Amount Received Date KIM, THOMAS D President 09/14/2004 12/21/2010 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 RLI INS CO LSM0199604 12/21/2010 Until Cancelled $4,000.0011 /23/2010 1 OLD REPUBLIC INS CO YLI248204 09/14/2004 Until Cancelled 12/21/2010 $4,000.0009/14/2004 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 https: // fortress .wa.gov /lni/bbip /Print.aspx 03/28/2011