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Home My WebLink AboutPermit EL11-0484 - SIGHTLINE HEALTHSIGHTT.INE HEALTH 200 ANDOVER PK E EL1 1 -0484 Parcel No.: Address: Tenant Name: Cityylkf 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: / /wwwcitukwila.wa.us 0223100099 200 ANDOVER PK E TUKW SIGHTLINE HEALTH ELECTRICAL PERMIT Permit Number: Issue Date: Permit Expires On: EL11 -0484 05/26/2011 11/22/2011 Owner: Name: ANDOVER PLAZA LLC Address: 1501 N 200TH ST , SHORELINE WA 98133 Contact Person: Name: ALEX GOODWIN Address: 828 POPLAR PL S , SEATTLE WA 98144 Contractor: Name: PACIFIC FIRE AND SECURITY INC Address: 828 POPLAR PL , SEATTLE WA 98144 Contractor License No: PACIFFS914MF Phone: 206 391 -0483 Phone: 206 - 957 -0907 Expiration Date: 07/01/2011 DESCRIPTION OF WORK: COMMUNICATIONS CABLING Value of Electrical Work: NRES: $4,500.00 RES: $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 and - governing this work will be complied Fees Collected: $178.50 National Electrical Code Edition: 2008 017 j Date: OCI AA t ed this permit and know the same to be true and correct. All provisions of law and ordinances whether specified herein or not. e to give authority to violate or cancel the provisions of any other state or local laws regulating am authorized to sign and obtain this electrical permit and agree to the conditions on the back The granting of this permit does not pres construction or the performance of wor of this permit. Signature: Print Name: AO: (_0(9‘sto' ‘.-si 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 -0484 Printed: 05 -26 -2011 PERMIT CONDITIONS Permit No. EL 11 -0484 * *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 1-0484 Printed: 05 -26 -2011 • CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us (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: 200 Andover Park E Tenant Name: Sight Line Seattle King Co Assessor's Tax No.: 02-2-27I 1 Suite Number: Floor: 1st Flcei New Tenant: ❑ Yes ❑..No Property Owners Name: Mailing Address: City State Zip CONTACT PERSON — Who do we contact when your permit is ready to be issued Name: Alex Goodwin Mailing Address: 828 Poplar PI. S Day Telephone: (206) 391 -0483 Seattle WA 98144 E -Mail Address: alexg@pacificfiresecurity.com City State Fax Number: (206) 726 -8160 Zip ELECTRICAL CONTRACTOR INFORMATION Company Name: Mailing Address: Contact Person: E -Mail Address: Contractor Registration Number: PACIFFS914MF Pacific Fire & Security, Inc. 828 Poplar PI. S Pacific Fire & Security, Inc. Seattle WA City State Day Telephone: (206) 957 -0907 Fax Number: (206) 726 -8160 Expiration Date: 07/01/2011 98144 Zip Valuation of Project (contractor's bid price): $ 4,500 Scope of Work (please provide detailed information): Communications cabling Will service be altered? ❑ Yes Type of Use: Type of work: ❑ New ❑ Addition ❑ Service Change m Low Voltage ❑ Generator ❑ Fire Alarm ❑ No Adding more than 50 amps? ❑ Yes ❑ No Property Served by: Puget Sound Energy ❑ Seattle City Light H :'Applications\Eonns- Applications On Line12010 Applications \7 -2010 - Electrical Permit Application.doc bh Page 1 of 2 ❑ Remodel ❑ 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, 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 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 Signature: A Print Name: A 1 1- ELECTRICAL CONTRACTOR: Mailing Address: Z PgPk ar yikoa e Date Application Accepted: $ Day Telephone: Sew -(e City Date: r /Z6% [( 2-66 - -co 3 604 9pdiv State Zip t I. Date Application Expires: Staff Initials: (r` H:\Applications\Fonns- Applications On Line \2010 Applications \7 -2010 - 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.TukwilaWA.gov Parcel No.: 0223100099 Address: 200 ANDOVER PK E TUKW Suite No: Applicant: SIGHTLINE HEALTH RECEIPT Permit Number: EL11 -0484 Status: PENDING Applied Date: 05/26/2011 Issue Date: Receipt No.: R11 -01081 Payment Amount: $178.50 Initials: JEM Payment Date: 05/26/2011 12:52 PM User ID: 1165 Balance: $0.00 Payee: PACIFIC FIRE & SECURITY, INC. TRANSACTION LIST: Type Method Descriptio Amount Payment Check 2964 178.50 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 178.50 Total: $178.50 doc: Receipt -06 Printed: 05 -26 -2011 INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION P; 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -36 Permit Inspection Request Line (206) 431 -2451 Project:. SSG f4drUttii / kitarType of Inspection: 240 0 Address: 700 atiNhfweit ,[ Date Called: Special Instructions: Date Wanted: 1<— ap.m.m. . Requester: Phone No: TApproved per applicable codes. Ei Corrections required prior to approval. COMMENTS: Inspector: _rte 6C4/46, Date: en/lc-II n REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. +day. . -.e.. .- Contractors or Tradespeople liter Friendly Page 1 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 PACIFIC FIRE AND SECURITY INC 2069570907 828 Poplar Pl S Seattle WA 98144 King Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 602335521 Active PACIFFS914MF Electrical Contractor 7/1/2009 7/1/2011 General Unused her Associated Licenses icense License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status PACIFFS973PU PACIFIC FIRE AND SECURITY INC Electrical Contractor Limited Energy Unused 10/30/2003 10/30/2009 Expired Master Electrician INFORMATION License BAKERJT973LR Name BAKER, JON T Status Active Business Owner Information Name Role Effective Date Expiration Date PINSKY, ADAM A Agent 07/01/2009 11/12/2009 BAKER, JON T President 07/01/2009 $250.00 WITTMAN, JOHN P Secretary 07/01/2009 PINSKY, ADAM A Treasurer 07/01/2009 MARVICH, STEPHEN E Vice President 07/01/2009 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 AMERICAN STATES INS CO 6251633 10/27/2003 Until Cancelled $4,000.00 10/27/2003 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 EMABQ03219 11/12/2009 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 https: // fortress .wa.gov /lni/bbip/Print.aspx 05/26/2011