HomeMy WebLinkAboutPermit EL11-0360 - JOS A BANKJOS A BANK
321 STRANDER BL
EL1 1 -0360
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: / /www,ci.tukwila.wa.us
2623049064
321 STRANDER BL TIIKW
JOS A BANK
ELECTRICAL PERMIT
Permit Number: EL11 -0360
Issue Date: 04/22/2011
Permit Expires On: 10/19/2011
Owner:
Name:
Address:
REGENCY CENTERS LP
C/O PROPERTY TAX DEPT , PO BOX 790830 78279
Contact Person:
Name: DAIMIAN BINGHAM
Address: 727 S KENYON ST , SEATTLE WA 98108
Contractor:
Name:
EVERGREEN REFRIGERATION LLC
Address: 727 S KENYON ST , SEATTLE WA 98108
Contractor License No: EVERGRL915LR
Phone: 206 - 763 -1744 X 247
Phone: 206 763 -1744
Expiration Date: 06/12/2011
DESCRIPTION OF WORK:
INSTALL THREE (3) THERMOSTATS, ONE (1) REMOTE
Value of Electrical Work: NRES: $950.00
RES: $0.00
Type of Fire Protection: UNKNOWN
Electrical Service Provided by: PUGET SOUND ENERGY
Permit Center Authorized Signature:
Fees Collected:
$92.40
National Electrical Code Edition: 2008
OA.
Date: 14--)-)--L
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 am authorized to sign and obtain this electrical permit and agree to the conditions on the back
of this permit. i� �
Z_ Date: ' ..47 / //
Signature:
Print Name-- /l/,77 /Q/
This permit shall become null and void if t 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
E L11 -0360
Printed: 04 -22 -2011
• •
PERMIT CONDITIONS
Permit No. EL11 -0360
* *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
E L 11 -0360 Printed: 04 -22 -2011
CITY OF TUKWIL
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.ci.tukwila.wa.us
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
�// pp King Co Assessor's Tax No.: a 6a.-19i/ q06/
Site Address: A / S +rai er /� /v Suite Number: Floor:
Tenant Name: TD S A, Rank / — 1 New Tenant:
�
Property Owners Name: C•, ei,c y C 4rs 1 / p
Mailing Address: /77. %3px /72'0830 Sall 4n}oluQ
❑ Yes ❑ ..No
7ga79
Zip
City
7-k
State
CONTACT PERSON !- Who do we contact when your permit i
eady to be issued
Name: -baInni0.1 gnjho,y.
Mailing Address: 7c 7 S. i ?il /O'7 g71
E -Mail Address: rn-, i ale fv,40,-91t-Pen //161C . COM
Day Telephone: c O6 763 / 7”' ' -1- n)
Seakk
City
4/.4 'n /OF
State Zip
Fax Number:
ELECTRICAL CONTRACTOR INFORMATION
Company Name: Eves reeri / 7 / g €.- a7"/'vn
Mailing Address: 7r2 ke'410i7
Contact Person:./�Jkz //Y7 /cm
E -Mail Address:Da fin, ion eve/ -eee/ y/�Ac. GOin
Contractor Registration Number: E,f2 lT R2 9/S AA
17/'e'
City
98 /og
State Zip
Day Telephone: )0‘, 76 3 /7 ' .- o2` /7
Fax Number:
Expiration Date: 6/42/
Valuation of Project (contractor's bid price): $ -Ca -O�9_ /
Scope of Work (please provide detailed information): / /7iee C3) /Ae.r/yiOS /a71c 2,s' (7J %2/yjG7'e
Se";co /. .
Will service be altered? ❑ Yes
Type of Use:
Type of work:
❑ New ❑ Addition
Low Voltage ❑ Generator
Property Served by:
❑ Puget Sound Energy
❑ Seattle City Light
No Adding more than 50 amps? ❑ Yes ,J No
❑ Service Change
❑ Fire Alarm
H:\Applications \Forms- Applications On Line \1 -2009 - Electrical Permit Application.doc
bh
❑ Remodel ❑ Tenant Improvement
❑ Telecommunication ❑ Temporary Service
Page 1 of 2
RESIDENTIALW
NEW RESIDENTIAL SERVICE
❑ New single family dwellings $145.60
(including an attached garage)
❑ Garages, pools, spas and outbuildings $78.00 ea
❑ Low voltage systems
(alarm, furnace 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 $57.00
(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:i/n /r/1 i
Mailing Address: Z7 S /r�y 04 S7`
Date: "IZOZ oZ /
Day Telephone: c?O` - 7g3- /7 -k-01-4/7
City
State
7y /O1
Zip
Date Application Accepted:
Date Application Expires:
Staff Initials:
H:Wpplications\Forms- Applications On Line \I -2009 - Electrical Permit Application.doc
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.tukwi la. wa. us
RECEIPT
Parcel No.: 2623049064 Permit Number: EL11 -0360
Address: 321 STRANDER BL TUKW Status: PENDING
Suite No: Applied Date: 04/22/2011
Applicant: JOS A BANK Issue Date:
Receipt No.: R11 -00789 Payment Amount: $92.40
Initials: WER Payment Date: 04/22/2011 02:21 PM
User ID: 1655 Balance: $0.00
Payee: EVERGREEN REFRIGERATION
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 004817 92.40
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
ELECTRICAL PERMIT - NONR
000.322.101.00.00 92.40
Total: $92.40
doc: Receiot -06 Printed: 04 -22 -2011
INSPECTION RECORD
Retain a copy,. with permit
INSPECTION NO. PERMIT NO.
6-1/-
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 981881 (206) 431 -36
Permit Inspection Request Line (206) 431 -2451
Project:` 644
Type of Inspection:
w cam'
Address: ,
C__w
3 2 t Otk
Date Called:
Special Ins ructions:
3 1 im4
"'�' %
Date Wanted:
OZ
/m_.
Requester:
Phone No:
Approved per applicable codes. Corrections required prior to approval.
OMMENTS:
Inspector: \:7141
Date:
00 lb
❑ REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
t
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
641-660
t'^
Project: ..01-5
A gtvfr-
Type of Inspection:
Address: 32 s
Date Called:
Special Instructions:
T 5ciscT
Date Wanted:
I/1/
m.
Requester:
Phone No:
n Approved per applicable codes.
COMMENTS:
/•
DCorrections required prior to approval. '
.K.
Inspector:
Date: Os-
❑ REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Contractors or Tradespeople PEster 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
EVERGREEN REFRIGERATION LLC
2067631744
727 S Kenyon St
Seattle
WA
98108
King
Limited Liability Company
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
602512953
Active
EVERGRL915LR
Electrical Contractor
6/12/2009
6/12/2011
Residential
Hvac /Rfrg Ltd Energy
Other Associated Licenses
License
Name
Type
Specialty 1
Specialty
2
Effective
Date
Expiration
Date
Status
EVERGRL957R9EVERGREEN
REFRIGERATION LLC
Electrical
Contractor
Hvac /RfrgLtdUnused
Energy
1/15/2006
1/15/2010
Expired
Electrical Administrator INFORMATION
License DUCHAGC910CR
Name DUCHARME, GEOFFREY C
Status Active
Business Owner Information
Name
Role
Effective Date
Expiration Date
PATTON, DAVID
Partner /Member
06/12/2009
9/1/2010
PATTON, RODGER
Partner /Member
06/12/2009
$250.00
PATTON, MATTHEW A
Partner /Member
06/12/2009
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
1
TRAVELERS CAS &
SURETY CO
105264448
05/22/2009
Until Cancelled
$4,000.00
06/12/2009
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
EJORP04024
9/1/2010
19.28.271 RCW
ELECTRICAL CITATION
Satisfied
$250.00
https: // fortress .wa.gov /lni/bbip /Print.aspx 04/22/2011