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Home My WebLink AboutPermit EL11-0343 - GROUP HEALTHGROUP HEALTH 455 ANDOVER PK E EL1 1 -0343 Parcel No.: Address: Tenant Name: City er 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.citukwila.wa.us 0223400060 455 ANDOVER PK E TUKW GROUP HEALTH ELECTRICAL PERMIT Permit Number: EL11 -0343 Issue Date: 04/19/2011 Permit Expires On: 10/16/2011 Owner: Name: GIBSON PROPERTIES LLC Address: PO BOX 50268 , BELLEVUE WA 98015 Contact Person: Name: RANDY DREYER Address: 11816 NE 116 ST , KIRKLAND WA 98034 Contractor: Name: JOHNSON ELECTRIC INC Address: 11816 NE 116TH ST , KIRKLAND WA 98034 Contractor License No: JOHNSEI384RU Phone: 425 - 821 -8226 Phone: (425) 821 -8226 Expiration Date: 11/30/2012 DESCRIPTION OF WORK: FURNISH AND INSTALL LED EXIT SIGNS. MODIFY WAREHOUSE LIGHTING CONTROLS. REPAIR LIGHTING IN OPEN OFFICE AREA. REPAIR LIGHTING IN WAREHOUSE AREA. Value of Electrical Work: NRES: $19,000.00 Fees Collected: RES: $0.00 Type of Fire Protection: UNKNOWN Electrical Service Provided by: PUGET SOUND ENERGY Permit Center Authorized Signature: $419.30 National Electrical Code Edition: 2008 Date: 4-1 q- 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 pe .i ce f work. I am authorized to sign and obtain this electrical permit and agree to the conditions on the back of this permit. Signature: Print Name: 2 /T/\j 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 -0343 Printed: 04 -19 -2011 • • PERMIT CONDITIONS Permit No. EL11 -0343 * *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 -0343 Printed: 04 -19 -2011 CITY OF TUKWIL. Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us • r� Electrical Permit No. � 1 43 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 Site Address: 155 /n/L( b�Q.a ��2K � r Suite Number: Tenant Name: awe Ft -L.-Ii Property Owners Name: & (11 C Mailing Address: x(55' /1I!)UIP /ni72K G 45/ King Co Assessor's Tax No.: O))-3 L.(o_ 6010 C) Floor: New Tenant ❑ Yes OA- State City Zip CONTACT PERSON — Who do we contact when your permit is ready to be issued Name: kituADY 1 t' fr - /I& N - I(Gt sf Mailing Address: E -Mail Address: (-cog. d (4 Ji eLE • ca Day Telephone: '(ZS — 6z1— e KIRRogo w. rit / 9 ,605y Fax Nwnber: �2! 'bZ1 ye. 5(o Ztp ELECTRICAL CONTRACTOR INFORMATION Company Name: SD ( 4(a,li btef D(✓ ( .1-/a C Mailing Address: t I S 1 6 Contact Person: '% <6(uy uycrt- E -Mail Address: CL(M144 4 ��SwEZi]i Contractor Registration Number: J!J (4g S E 3 89 1ZGL K(flk[A.tn City Day Telephone: Fax Number: Expiration Date: tate '01— 6z (-' 13zz6 Zl- "(g3. it/ 3oll Valuation of Project (contractor's bid price): $ 1 tX2 Scope of Work (please provide detailed information): f (kteri 440 rit 5t f(/ LED rX(`l - 516LE5 /floDi ry Wi4Me(laos - 1- rottrrU6 400i?,L y, l"'EPr+elL tobtr :cf vikid 6r-re . �Efifilx. G1c H r &k - L.( idoe i4%its& 4 . Will service be altered? ❑ Yes jJ. No Adding more than 50 amps? ❑ Yes ® No Type of Use: Type of work: ❑ New ❑ Addition ❑ Service Change ❑ Remodel El Tenant Improvement ❑ Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service Property Served by: ❑ Puget Sound Energy 13 Seattle City Light H:1Applicatiom\Pon®- Applications On Ime\2010 Applications \7.2010- Electrical Permit Applicabortdoc bh Page 1of2 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 Buildinj 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: ?4(16i( 1/16YCA-- Mailing Address: / /,l,Q Ale /I'( 5r Day Telephone: City Date: illi(4 tiinz- /MK State Zip Date Application Accepted: Date Application Expires: Staff Initials: H:\Applicatioeslfomn- Appliarioos On t;M12010 Application:M -2010 - Electrical Pemmit Apphicationdoc m 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 Parcel No.: 0223400060 Address: 455 ANDOVER PK E TUKW Suite No: Applicant: GROUP HEALTH RECEIPT Permit Number: EL11 -0343 Status: PENDING Applied Date: 04/19/2011 Issue Date: Receipt No.: R11 -00750 Initials: User ID: Payee: WER 1655 Payment Amount: $419.30 Payment Date: 04/19/2011 09:13 AM Balance: $0.00 SCOTT MORGAN TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 417080 ACCOUNT ITEM LIST: Description 419.30 Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 419.30 Total: $419.30 doc: Receipt -06 Printed: 04 -19 -2011 INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION la- £ul -33 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 431 -2451 (206) 431 -367 Project: 6itoup f ici , ,,.� , Type of Inspection: 2.4o0 Address: ti 55- �6. Date Called: Special Instructions: Date Wanted: 0�0 P.m. Requester: Phone No: 1504 Approved per applicable codes. D Corrections required prior to approval. COMMENTS: Inspector: Date: 6/11 REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. Contractors or Tradespeople Pr;r Friendly Page • Electrical Contractor A business licensed by LEI 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 JOHNSON ELECTRIC INC UBI No. 600361519 Phone 4258218226 Status Active Address 11816 Ne 116Th St License No. JOHNSEI384RU Suite /Apt. License Type Electrical Contractor City Kirkland Effective Date 12/31/1962 State WA Expiration Date 11/30/2012 Zip 980347105 Suspend Date County King Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Electrical Administrator INFORMATION License JOHNSDB250MT Name JOHNSON, DANIEL B Status Active Business Owner Information Name Role Effective Date Expiration Date JOHNSON, DANIEL B JR Violation Amount 01/01/1980 8/12/2009 JOHNSON, DANIEL B SR ELECTRICAL CITATION 01/01/1980 $250.00 JOHNSON, JEFFREY J 8/12/2009 01/01/1980 ELECTRICAL CITATION JOHNSON JR, DANIEL B Agent 01/25/1980 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 INS GROUP RN5038112 11/20/1980 Until Cancelled $4,000.00 11/20/1980 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 Infractions /Citations Information Infraction / Citation Date RCW Code Type Status Violation Amount EMABQ03047 8/12/2009 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 EMABQ03046 8/12/2009 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 https: // fortress .wa.gov /Ini/bbip /Print.aspx 04/19/2011