HomeMy WebLinkAboutPermit EL11-0480 - ANDOVER PARK BUILDINGANDOVER PARK BUILDING
1165 ANDOVER PK W
EL1 1 -0480
Parcel No.:
Address:
Tenant Name:
City* Tukwila
to
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.c i. to kwil a. wa. us
3523049097
1165 ANDOVER PK W TUICW
ANDOVER PARK BUILDING
ELECTRICAL PERMIT
Permit Number:
Issue Date:
Permit Expires On:
EL11 -0480
05/25/2011
11/21/2011
Owner:
Name:
Address:
Contact Person:
Name:
Address:
WALTON CWWA SOUTHCENTER 4 L
C/O CTMT - WALTON RE TAX , 4678 WORLD PARKWAY CIR 63134
SAM NAM
16010 60 AV W , EDMONDS WA 98026
Contractor:
Name: ENERGY MANAGEMENT SERVICES INC
Address: 15008 35TH AV W STE C , LYNNWOOD WA 98087
Contractor License No: ENERGMS913B6
Phone: 425 273 -7300
Phone: 425 - 741 -3526
Expiration Date: 06/15/2011
DESCRIPTION OF WORK:
INSTALLATION OF EMERGENCY BALLAST AND FIXTURE OF EGRESS LIGHTING
Value of Electrical Work: NRES:
RES:
$600.00 Fees Collected: $79.80
$0.00
Type of Fire Protection: UNKNOWN
Electrical Service Provided by:
PUGET SOUND ENERGY
Permit Center Authorized Signature:
I hereby certify that I have read an
governing this work will be compli
National Electrical Code Edition: 2008
Date: OSI
ed this permit and know the same to be true and correct. All provisions of law and ordinances
, whether specified herein or not.
The granting of this permit does not pre
construction or the performance o wo k. I am authorized to sign and obtain this electrical permit and agree to the conditions on the back
of this permit.
e to give authority to violate or cancel the provisions of any other state or local laws regulating
Signature:
Print Name:
d
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 -0480
Printed: 05 -25 -2011
• a
PERMIT CONDITIONS
Permit No. EL11 -0480
* *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
EL1 1-0480 Printed: 05 -25 -2011
CITY OF TUKWIL'
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.ci.tukwila.wa.us
Electrical Permit No.
Project No.
(Fo
so
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 **
ITE LOCATION
King Co Assessor's Tax No.: — l 1
Site Address: 1165 Andover Park W. Tukwila, WA 98188
Tenant Name:
Suite Number:
Floor:
New Tenant: 0 Yes ❑ ..No
Property Owners Name:
Mailing Address: 1165 Andover Park W.
Tukwila
WA 98188
City
State
Zip
CONTACT PERSON - Who do
Name: Sam Nam
Mailing Address:
16010 60th Ave. W.
Day Telephone: (425) 273 -7300
Edmonds WA 98026
E -Mail Address: sam @emsiwa.com
City
State
Fax Number: (425) 741 -3521
Zip
ELECTRICAL CONTRACTOR INFORMATION
Company Name: Energy Management Services
Mailing Address: 15008 35th Ave W Ste C
Lynnwood
WA 98087
Contact Person: David Silvy
E -Mail Address: ems @emsiwa.com
Contractor Registration Number: ENERGMS913B6
City
Day Telephone:
Fax Number:
Expiration Date:
State
(425) 741 -3526
(425) 741 -3521
01/26/2013
Zip
Valuation of Project (contractor's bid price): S 600
Scope of Work (please provide detailed information): Installation of Emergency Ballast & Fixture for Egress lighting.
Will service be altered? ❑ Yes
Type of Use:
Type of work:
❑ New ❑ Addition ❑ Service Change
❑ Low Voltage ❑ Generator ❑ Fire Alarm
No Adding more than 50 amps? ❑ Yes 0 No
Property Served by:
❑ Puget Sound Energy
❑ Seattle City Light
Applications \Forms - Applications On Line \1 -2009 - Electrical Permit Applicanon.doc
❑ Remodel
❑ Telecommunication
❑ Tenant Improvement
❑ Temporary Service
Page 1 of 2
RESIDENTIAL
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
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:
Signature:
Print Name: ;' l/1 QC1" .77/7.-s Day Telephone:
Mailing Address, 5 c
r ' City State Zip
Date: 1`,
I Date Application Accepted:
15 2c
Date Application Expires:
H: \Applications \Forms - Applications On Line l -2009 - Electrical Permit Application.tioc
bh
Staff Initials: J�'r
Page 2 of 2
•
C 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.TukwilaWA.gov
Parcel No.: 3523049097
Address: 1165 ANDOVER PK W TUKW
Suite No:
Applicant: ANDOVER PARK BUILDING
RECEIPT
Permit Number: EL11 -0480
Status: PENDING
Applied Date: 05/25/2011
Issue Date:
Receipt No.: R11 -01070
Payment Amount: $79.80
Initials: JEM Payment Date: 05/25/2011 12:31 PM
User ID: 1165 Balance: $0.00
Payee: ENERGY MANAGEMENT SERVICE
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd VISA
Authorization No. 123109
ACCOUNT ITEM LIST:
Description
79.80
Account Code Current Pmts
ELECTRICAL PERMIT - NONR
000.322.101.00.00 79.80
Total: $79.80
doc: Receiot -06 Printed: 05 -25 -2011
-71s •
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
(iifvo
P IT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188
Permit Inspection Request Line (206) 431 -2451
(206) 431 -36
Project:.
is at
Type of Inspection:
Address: ''640-,
(J
Date Called:
Special Instructions:
i 0 p.M
Date Wanted:
a
Requester:
Phone No:
p. Approved per applicable codes. a Corrections required prior to approval.
COMMENTS:
Inspector: Date: 67 a l
n REINSPECTION FEE REQUIRE . Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
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
611-04go
(30 Project: fie....
Type of Inspection:
2/40
Address: 1114.-
Date Called:
Special Instructions:
Date Wanted:
7
`�
a._
Requester:
Phone No:
0 Approved per applicable codes.
aCorrections required prior to approval. 11.
COMMENTS:
6sct. 7Pk P.,.
Inspector:
Date:
REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection:
Contractors or Tradespeople Peer 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
Phone
Address
Suite /Apt.
City
State
Zip
County
Business Type
Parent Company
ENERGY MANAGEMENT SERVICES INC
4257413526
15008 35Th Ave W Ste C
Lynnwood
WA
98087
Snohomish
Corporation
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
602881485
Active
ENERGMS913B6
Electrical Contractor
1/26/2009
1/26/2013
General
Unused
Electrical Administrator INFORMATION
License DAVISEB961B8
Name DAVIS, EDWARD B
Status Active
Business Owner Information
Name
Role
Effective Date
Expiration Date
NAM, SANG
Agent
07/13/2009
Bond Amount
NAM, SANG
President
07/13/2009
6664485
LEE, KYUNG T
Agent
01/26/2009
07/13/2009
KIM, DAVID T
President
01/26/2009
07/13/2009
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
2
AM STATES INS
6664485
08/20/2009
Until Cancelled
19.28.101 RCW
ELECTRICAL CITATION
$4,000.00
10/21 /2009
1
STATE FARM FIRE 8
CAS CO
98bas1616
01/20/2009
Until Cancelled
10/18/2009
EJONV01359
$4,000.0001
/26/2009
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
EJORP04571
4/19/2011
19.28.161 RCW
ELECTRICAL CITATION
Not satisfied
$500.00
EJORP04572
4/19/2011
19.28.101 RCW
ELECTRICAL CITATION
Not satisfied
$500.00
EJORP04570
4/19/2011
19.28.161 RCW
ELECTRICAL CITATION
Not satisfied
$500.00
EJONV01359
10/18/2010
19.28.161 RCW
ELECTRICAL CITATION
Satisfied
$250.00
EBEAK00271
1/13/2010
19.28.161 RCW
ELECTRICAL CITATION
Satisfied
$250.00
EAARG00401
2/15/2011
19.28.101 RCW
ELECTRICAL CITATION
Satisfied
$250.00
https: // fortress .wa.gov /lni/bbip /Print.aspx 05/25/2011