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Home My WebLink AboutPermit EL11-0651 - GROUP HEALTH COOPERATIVEGROUP HEALTH COOPERATIVE 12400 EAST MARGINAL WY S EL1 1 -0651 City ATukwila 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 ELECTRICAL PERMIT Parcel No.: 7340600480 Address: 12400 EAST MARGINAL WY S TUKW Project Name: GROUP HEALTH COOPERATIVE Permit Number: EL11 -0651 Issue Date: 07/19/2011 Permit Expires On: 01/15/2012 Owner: Name: ANNE ARUNDEL APARTMENTS LLC Address: 10 W MARKET -1200 MARKET TOWE , INDIANAPOLIS IN Contact Person: Name: LARRY SALZBRUN Address: 3623 EAST MARGINAL WY S , SEATTLE WA Contractor: Name: EVERGREEN TECHNOLOGIES INC Address: 3623 EAST MARGINAL WAY S , SEATTLE WA Contractor License No: EVERGTI929K9 Phone: 206 774 -1333 Phone: Expiration Date: 05/22/2012 DESCRIPTION OF WORK: INSTALLATION OF 80 SINGLE LOW - VOLTAGE NETWORK LOCATIONS Value of Electrical: NRES: $17,165.00 RES: $0.00 Type of Fire Protection: SPRINKLERS /AFA Electrical service provided by: SEATTLE CITY LIGHT Permit Center Authorized Signature: / I hereby certify that I have read and exami d this permit and know the same to be true and correct. All provisions of law and ordinances governing this work will be complied with, hether specified herein or not. Fees Collected: $402.10 National Electrical Code Edition: 2008 Date: ()ILK The granting of this permit does not prey construction or the p¢1?forman Signature: Print Name: % A( to give authority to violate or cancel the provisions of any other state or local laws regulating I am authorized to sign and obtain this electrical permit. Date: (/ q 6Z( 4((62L( 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 -4/10 EL11 -0651 Printed: 07 -19 -2011 PERMIT CONDITIONS Permit No. EL11 -0651 * *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 -4/10 EL11 -0651 Printed: 07 -19 -2011 CITY OF TUKAPA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Electrical Permit No. 1 — (VD 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: glim / ii E Tenant Name: 6p t u(1 /414 1 ,c1M-,- Property Owners Name: Mailing Address: King Co Assessor's Tax No.: 1 714 al 0— 01-4 t 0 �^( Ai (,c2A Suite Number: rill Floor: a., Pi New Tenant: ❑ Yes a..No City State Zip CONTACT PERSON - Who do we contact when your permit is ready to be issued Name: 14 ?P./ S4I ita ) Mailing Address: .36 / E / A2gIn(q ` l.U/l r S E -Mail Address: L kb..t . 7Erien12tt. 7' -' cop'- Day Telephone: ,?CG-"Pri -/.33 3 City State Zip Fax Number: j0G -1Ihq - /Af D( ELECTRICAL CONTRACTOR INFORMATION Company Name: ,)t/:.y/:,ee /Gc v iale9les Mailing Address:J42, —tA wf Contact Person: /Arta y SA It btiw E -Mail Address: LC/Alzll/att4/ @rieity2Eeti7 e . C6._ Contractor Registration Number: e291-- I12t l4cl City State Day Telephone: ,Q,61-4124- H- 3 3 Fax Number: PO4- 114- PO/ / Expiration Date: t r 2 - 2t l 2 Zip Valuation of Project (contractor's bid price): $ /71 /65", 00 Scope of Work (please provide detailed information): /4P-tide/Lk / A f Chti Will service be altered? ❑ Yes X No Adding more than 50 amps? ❑ Yes IXNo Type of Use: Type of work: ❑ New ❑ Addition ❑ Service Change la Low Voltage ❑ Generator ❑ Fire Alarm Property Served by: ❑ Puget Sound Energy li(Seattle City Light H:Wpplications \Forms - Applications On Line\2010 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 OWNER OR ELECTRICAL CONTRACTOR: Signature: Print Name: IDate Application Accepted: 01 (-14A Iq �IeA(4 Date: 7'19' .0D ll Day Telephone: ,2 Q (- 17 '% / - 1313 l3� State Zip S S ffle. City Date Application Expires: Staff Initials: H:1ApplicationsWonns- Applications On Line12010 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 RECEIPT Parcel No.: 7340600480 Permit Number: EL11 -0651 Address: 12400 EAST MARGINAL WY S TUKW Status: PENDING Suite No: Applied Date: 07/19/2011 Applicant: GROUP HEALTH COOPERATIVE Issue Date: Receipt No.: R11 -01508 Initials: User ID: Payee: JEM 1165 Payment Amount: $402.10 Payment Date: 07/19/2011 01:27 PM Balance: $0.00 LARRY SALZBRUN TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 02578C ACCOUNT ITEM LIST: Description 402.10 Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 402.10 Total: $402.10 doc: Receipt -06 Printed: 07 -19 -2011 INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6-41-oloci 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 431 -2451 (206) 431 -36 Project: /� �7 �y Type of Inspection: �00 Address: /21 00 6.- 14044 Date Called: Special Instructions: ibil nA�; �. 1J'T Date Wanted:. 7 p m� Requester: Phone No: Approved per applicable codes. a Corrections required prior to approval. OMMENTS: (Date: Oti 8L I ri REINSPECTIO FEE REQUIRE . Prior to next inspectio , fee must be paid at 6300 Southcenter Blvd.. Suite 100: Call to schedule reinspection. Inspector: t INSPECTION NO. INSPECTION RECORD Retain a copy with permit 611451 PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -36 Permit Inspection Request Line (206) 431 -2451 Project: /6 i /4 , Type of Inspection: • 7ad 3 Address. p° Date Called: Special Instructions: Date Wanted:. ei, Requester: . Phone No: Approved per applicable codes. 11 Corrections required prior to approval. OMMENTS: Inspector: 'Date: 6s REINSPECTION FEE REQUIRED. Prior to next inspection, fee must he.. paid at 6300 Southcenter Blvd., Suite 100. Call to schedule•reinspectioh.. Contractors or Tradespeople Pri ter 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 TECHNOLOGIES INC 2067741400 3623 E Marginal Way S Seattle WA 98134 King Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 602821961 Active EVERGTI929K9 Electrical Contractor 5/22/2008 5/22/2012 Limited Energy Unused Master Electrician INFORMATION License SALZBLG972CK Name SALZBRUN, LARRY Status Active Business Owner Information Name Role Effective Date Expiration Date SCHRIFFRIN, DAVID W Agent 05/22/2008 MACKEY, JAMES E President 05/22/2008 MACKEY, QUINN C Secretary 05/22/2008 MACKEY, JAMES E Treasurer 05/22/2008 MACKEY, DREW W Vice President 05/22/2008 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 HARTFORD FIRE INS CO 52BSBFA6318 05/16/2008 Until Cancelled $4,000.00 05/29/2008 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 https: // fortress .wa.gov /lni/bbip /Print.aspx 07/19/2011