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Home My WebLink AboutPermit EL11-0325 - PUGET SOUND INTERVENTIONAL PAIThis 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 -0325 Puget Sound Interventional Pain Clinic 7200 South 180th Street 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 12 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. PUGET SOUND INTERVENTIONAL PAIN CLINIC 7200 S 180 ST EL1 1 -0325 City OF 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 -0325 Issue Date: 04/12/2011 Permit Expires On: 10/09/2011 Owner: Name: NICK RILEY LLC Address: 7200 S 180TH ST , TUKWILA WA 98188 Contact Person: Name: JAMES LEE Phone: 206 - 679 -7696 Address: 14027 69 AV SE , SNOHOMISH WA 98296 Contractor: Name: BEST ELECTRIC CORP Address: 14027 69 AV SE , SNOHOMISH WA 98290 Contractor License No: BESTEEC919J1 Phone: 206 679 -7617 Expiration Date: 04/21/2011 DESCRIPTION OF WORK: 100 AMP 3 PHASE SUBPANEL FED FROM EXISTING MAIN PANEL. INSTALL OUTLETS. RELOCATE FEW LIGHTING. POWER FOR BACKFLOW PUMP Value of Electrical Work: NRES: $9,000.00 Fees Collected: $247.30 RES: $0.00 Type of Fire Protection: UNKNOWN Electrical Service Provided by: PUGET SOUND ENERGY Permit Center Authorized Signature: National Electrical Code Edition: 2008 LdiLt' rZJ` ■ 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 the performance of work. I a • authorized to sign and obtain this electrical permit and agree to the conditions on the back of this permit. Signature: Print N• e: 4rn Date: 1--/2 / 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 EL 11 -0325 Printed: 04 -12 -2011 • • PERMIT CONDITIONS Permit No. EL11 -0325 * *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 -0325 Printed: 04 -12 -2011 CITY OF TUK A Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us • Electrical Permit No. Project No. ELI[ -73 (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.: —7 Site Address: /'2 0 S, /2O j. Suite Number: Floor: Tenant Name: Pve-1' Sound Pain C /(fl i L New Tenant: ❑ Yes i.No Property Owners Name: Mailing Address: :Z 6, 3 2c1 A S, ,Oes /l0; c City eiwt te Zip CONTACT PERSON - Who do we contact when your permit is ready to be issued Name: :Gt W Q 5 c_ q�� /— Mailing Address: Pi 0A7 � y irc /E C c/a) kfoil ks4 dP� / l qq n City E -Mail Address: P 2 C rt C .1.. ('� 9 /201 / �.�'a✓%� Fax Number: Day Telephone: 206- 67? -7' 96. t;✓ir 982?' State Zip - 376/ —?(/7K ELECTRICAL CONTRACTOR INFORMATION Company Name: Qs'+ E/QCri(c Co( t Mailing Address: 110,27 6 ,C/ti& Sc Contact Person: -30l y✓I.Q S 1 -e 0 I E -Mail Address: e c4- Q ter jc C a. (Di ei 1, /, (O,1 Contractor Registration Number: ce..s-r8rc cz,iciTi S je)/MSJ -t 634- 9 276 City State Zip Day Telephone: ..20G-67 OG -67 9=20 Fax Number: q2.s =3 7 e--/-7 4' 7 " Expiration Date: if' 20 13 Valuation of Project (contractor's bid price): $ PO U Scope of Work lease p ovi . e detailed information 1. 14 VI • Will service be altered? ❑ Yes 0 No Adding more than 50 amps? Yes Type of Use: Type of work: ❑ New ❑ Addition ❑ Service Change ❑ Remodel jg Tenant Improvement ❑ Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service Property Served by: ® Puget Sound Energy ❑ Seattle City Light HA Applications On Line\2010 Apphcanons \7 -2010 - Electrical Permit Application.doc bh Page 1 of 2 i3O 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 $78.75 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 OWNER OR ELECTRICAL CONTRACTOR: Date: 7 Day Telephone: 20 7% WIC Mailing Address: City Date Application Accepted: State Zip Date Application Expires: Staff Initials: H ?Appltcahons\Forms- Applications On Line12010 Applicahons17.2010 - Electrical Penn il Application. doc bh Page 2 of 2 1 • � wqs 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 -0325 Address: 7200 S 180 ST TUKW Status: PENDING Suite No: Applied Date: 04/12/2011 Applicant: PUGET SOUND INTERVENTIONAL PAIN CLINIC Issue Date: Receipt No.: R11 -00694 Initials: WER User ID: 1655 Payment Amount: $247.30 Payment Date: 04/12/2011 10:53 AM Balance: $0.00 Payee: JAMES LEE TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 21213C ACCOUNT ITEM LIST: Description 247.30 Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 247.30 Total: $247.30 doc: Receiot -06 Printed: 04 -12 -2011 -1-7•4•T'^ • "-}"7 , • .7 • ;:•.. • - • . 7 — 7 S..s.ri INSPECTION NO. INSPECTION RECORD Retain a copy with permit 61-0325' PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 0_ (206) 431-367 Permit Inspection Request Line (206) 431-2451 Projer 5Iv) Arm/ Type of Inspection: 244x, Addrespo 5 • 0 S r. Date Called: . Special Instructions: Date Wanted: 7/137 Ceon. Requester: Phone No: EfliApproved per applicable codes. ElCorrections required prior to approval: COMMENTS: (fiK661043 timx, Inspector: /1 Date: 07/67 REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southc4nter Blvd.. Suite 100. Call to schedule reinspectiOn. ' • .• 4 INSPECTION RECORD eu o3 Retain a copy with permit INSP CTION N0. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 i_4._ (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Project .5•u'1'."/t�11 `_ pko4 Type of Inspection: Q8 , Address: 5 4051% Date Called: - _S . E . old ct 11(04 0642 it> Sf t.a.11 - Mc 1 D . in 60s. ! Ate' real Special Instructions: Date Wanted: 7 Do m. p.m Requester: Phone No: ❑ Approved per applicable codes. Corrections required prior to approval. 41' COMMENTS: t< ' / €-1W t A D C� L\( AND � V 5 RT R kti41/ 4 a or( a( a tuAItA - _S . E . old ct 11(04 0642 it> Sf t.a.11 - Mc 1 D . in 60s. ! Ate' real J iikckt4T-T' oJ4t# ep, kip, o rni. ,-- A14_ calx-eCk epio.&-inemi, cceddikrr . ktitive pr44D0Alt, tAid,1 u Mt.. . . N. (Ali Inspector: Date: /(X /(/ • n REINSPECTION'FEE REQUIRE d. Prior to next inspection. fee must be. paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.: :. 4 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 -36 Permit Inspection Request Line (206) 431 -2451 • 3 teuf-a3a5' Proj Y �4l jrG Type of Inspection: & .5iG464) To 51t,kKt'e f /4 JD 4 &tP 00 - *404X 40+J , I-4 cad Lt,) . iPP r Address: 72..00 5 ./Yo r Date Called: FAA-1.- Cr ~ • GC/7 U.D4pett -5 `k `_ E ' Special Instructions: Date Wanted: ` (fa ap /(� P.m. Requester: Phone No: ElApproved per applicable codes. Corrections required prior to approval.. COMMENTS:. Do 401 °posy awl F' - ei-tU44 KIStf 's, Tu sVPPos tic ;z3. & .5iG464) To 51t,kKt'e f /4 JD 4 &tP - qbb (TO MC_ 5 4PPo3r R ► '.. • - *404X 40+J , I-4 cad Lt,) . iPP r Ke-livi-t4 IAN O ra (A -1.411 Pa J.- DeSIL/40Xi 4 5* - FAA-1.- Cr ~ • GC/7 U.D4pett -5 `k `_ E - i /Aix, R»&( ,SFrvii L- • • . 5P -5 K6OHLES KtrchtepJ Oc. P ► 11 _, Date: 11 • ❑ REINSPECTION EE REQUIRED. Prior to next inspection; fee must be ,. paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection: � Inspector: Retain a copy with permit INSPECTION RECORD INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 R (206) 431 -36 Permit Inspection Request Line (206) 431 -2451 ProjectP [ _A cL,,J �, J V Type of Inspection: .Address: /�Q Date Called: Special Instructions: . Date Wanted: 5//� a.m p.m. Requester: Phone No: ❑ Approved per applicable codes. a Corrections required prior to approval. 7 COMMENTS: 7p, • n.. Inspector: �� Date: n REINSPECTION FEE REQUIR D. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. INSPECTION RECORD en ` v3L4{' Retain a copy with permit �l J INSPECTION NO. ERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -367 Permit Inspection Request Line (206) 431 -2451 ProjectAff .>t) tD /t �f� N (� Ty of Inspection: 700/ Address: I� .5. 2 148 sr. Date Called: �. Special Instructions: CAMI t4/1114E Date Wanted: VOL' C / p.m. Requester: Phone No: Approved per applicable codes. 0 Corrections required prior to approval. COMMENTS: Inspector: 'Date: ❑ REINSPECTI01� FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. Contractors or Tradespeople Prater Friendly Page • Electrical Contractor A business licensed by L8I 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 BEST ELECTRIC CORP 2066797696 14027 69Th Ave Se Snohomish WA 98296 Snohomish Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 601480887 Active BESTEEC919J1 Electrical Contractor 4/21/2009 4/21/2013 General Unused Other Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status BESTEC*070M7 BEST ELECTRIC CORP Electrical Contractor General Unused 7/27/1993 8/4/2009 Expired Master Electrician INFORMATION License LEE**S*973DS Name LEE, SAM Status Active Business Owner Information Name Role Effective Date Expiration Date LEE, SAM Agent 04/21/2009 LEE, JAMES C President 04/21/2009 LEE, CHANG H Secretary 04/21/2009 LEE, JAMES C Treasurer 04/21/2009 LEE, CHANG H Vice President 04/21/2009 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 2 4/21/2009 Until Released Bond $4,000.00 4/21/2009 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 04/12/2011