HomeMy WebLinkAboutPermit EL11-0712 - KWAN DENTAL CLINICKWAN DENTAL CLINIC
6715 FORT DENT WY
EL1 1 -0712
City oilfukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -43 1 -3670
Fax: 206 - 431 -3665
Web site: http: / /www.TukwilaWA.gov
Parcel No.: 2954900446
Address: 6715 FORT DENT WY TUKW
Project Name: KWAN DENTAL CLINIC
ELECTRICAL PERMIT
Permit Number:
Issue Date:
Permit Expires On:
EL1 1-0712
08/01/2011
01/28/2012
Owner:
Name: KWAN FAMILY L L C
Address: 18501 BRITTANY DR SW , SEATTLE WA
Contact Person:
Name: KAYCEE VANKIRK
Address: 7617 S 180 ST , KENT WA
Contractor:
Name: PROTECTION ONE ALARM MNTRG INC
Address: 1035 N 3 ST, STE 101 , LAWRENCE KS
Contractor License No: PROTEOA033BP
Phone: 425 656 -7111
Phone: 425 656 -7153
Expiration Date: 01/24/2013
DESCRIPTION OF WORK:
ADD PLUNGER SWITCH TO REPLACE LOCK BOX WITH NEW KNOX BOX AT FIRE MARSHAL'S
REQUEST.
Value of Electrical:
NRES: $313.00
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 complie
Fees Collected:
National Electrical Code Edition:
$67.20
2008
`OJkS Date: Mk of ill
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
I am authorized to sign and obtain this electrical permit.
The granting of this permit does not pr
construction or tide perfor a ce of work.
Signature:
Print Name:
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 -0712 Printed: 08 -01 -2011
III II
PERMIT CONDITIONS
Permit No. EL 11 -0712
* *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
EL11-0712 Printed: 08 -01 -2011
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
htto://wwwci.tukwila.wa.us
SITE LOCATION
Electrical Permit No.
Project No.
m12
(For o
ice 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 Address: 6715 FORT DENT WAY
Tenant Name: KWAN DENTAL CLINIC
King Co Assessor's Tax No.:
Suite Number:
New Tenant:
Floor:
❑ Yes 0..No
Property Owners Name:
Mailing Address: SAME AS SITE
City
State
Zip
CONTACT PERSON -`
ho do
Intactwhen your permit is ready to be i
ued
Name: KAYCEE VANKIRK
Mailing Address: 7617 S 180TH ST
Day Telephone: (425) 656 -7111
KENT WA
98032
E -Mail Address: kayceevankirk @protection1.com
City State
Fax Number: (425) 656 -7145
Zip
ELECTRICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address:
PROTECTION ONE
7617 S 180TH ST
Contact Person: PROTECTION ONE
E -Mail Address: same as above
Contractor Registration Number: PROTEOA033BP
KENT
City
Day Telephone:
Fax Number:
WA
State
(425) 656 -7111
(425) 656 -7145
98032
Zip
Expiration Date: 01/24/2013
Valuation of Project (contractor's bid price): $ 313
Scope of Work (please provide detailed information): ADD PLUNGER SWITCH TO REPLACE LOCK BOX WITH NEW
KNOX BOX AT FIRE MARSHAL'S REQUEST.
Will service be altered? ❑ Yes 0 No Adding more than 50 amps? ❑ Yes m No
Type of Use:
Type of work:
❑ New ❑ Addition ❑ Service Change
m Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service
❑ Remodel ❑ Tenant Improvement
Property Served by:
x- Puget Sound Energy
❑ Seattle City Light
H'. \ Applications \Forms-Applications On Line \2010 Applications \7 -2010 - Electrical Permit Applicmion. doc
bh
Page 1 of 2
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 $10.50 ea
PERMIT APPLICATION NOTES -
Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject
to possible revision by the Permit Center to comply with current fee schedules.
Expiration of Plan Review — Applications for which no permit is issued within 180 days following the date of application shall expire by limitation.
The Building Official may grant one extension of time for an additional period not to exceed 90 days. The extension shall be requested in writing
and justifiable cause demonstrated.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER OR ELEC RICAL CONTRACTOR:
Signature: / Ij /� Date: 62 / ('
wl95 F-L2
Print Name: l
Mailing Address:
7617 S 180TH ST
IDate Application Accepted:
Day Telephone: (425) 656 -7111
KENT 98032
City State Zip
!$ I, o►.
Date Application Expires: Staff initials:
r--
H.Wpphcations \Forms - Applications On Line \2010 Applications\7 -2010 - Electrical Permit Application.doc
bh
Page 2 of 2
III Ili
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.: 2954900446
Address: 6715 FORT DENT WY TUKW
Suite No:
Applicant: KWAN DENTAL CLINIC
RECEIPT
Permit Number: EL11 -0712
Status: PENDING
Applied Date: 08/01/2011
Issue Date:
Receipt No.: R11 -01643
Initials: JEM
User ID: 1165
Payment Amount: $67.20
Payment Date: 08/01/2011 11:53 AM
Balance: $0.00
Payee: PROTECTION ONE ALARM MONITORING
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 3801 67.20
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
ELECTRICAL PERMIT - NONR
000.322.101.00.00 67.20
Total: $67.20
doc: Receipt -06 Printed: 08 -01 -2011
•
INSPECTION RECORD
Retain a copy with permit
Sul -610-1
w
INSPECTION NO. PERMIT NO.
I7:. - CITY OF TUKWILA BUILDING DIVISION •
' .6300 Soithcenter BIvd., #100, Tukwila. WA 98188 V. (206) 431 -36
. . . . Permit Irispection Request Line (206) 431 -2451
K •
.
Project:'
•
Type of Inspection:
3c?
Address:
1
Date Called:
Special Instructions:
.
•
•
Date Wanted: .
f]�
m.
. p.m
Requester:
Phone No:
Approved per applicable codes. Corrections required prior to approval.
OMMENTS:
/,>
0
Inspector:
111
Date:
oi/6(112,--
0 REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
•
City of Tukwila
•
Jim Haggerton, Mayor
Department of Community Development Jack Pace, Director
KAYCEE VANKIRK
7617 S 180 ST
KENT WA 98032
RE: Permit No. EL11 -0712
KWAN DENTAL CLINIC
6715 FORT DENT WY TUKW
Dear Permit Holder:
In reviewing our current records, the above noted permit has not received a final inspection by the City of
Tukwila Building Division. Per the International Building Code, International Mechanical Code, Uniform
Plumbing Code and/or the National Electric Code, every permit issued by the Building Division under the
provisions of these codes shall expire by limitation and become null and void if the building or work authorized
by such permit has not begun within 180 days from the issuance date of such permit, or if the building or work
authorized by such permit is suspended or abandoned at any time after the work has begun for a period of 180
days. Your permit will expire on 01/28/2012.
Based on the above, you are hereby advised to:
1) Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 to schedule for the next or final
inspection. Each inspection creates a new 180 day period, provided the inspection shows progress.
-or-
2) Submit a written request for permit extension to the Permit Center at least seven (7) days before it is
due to expire. Address your extension request to the Building Official and state your reason(s) for
the need to extend your permit.
The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is
determined that your extension request is granted, you will be notified by mail.
In the event you do not call for an inspection and/or receive an extension prior to 01/28/2012, your permit will
become null and void and any further work on the project will require a new permit and associated fees.
Thank you for your cooperation in this matter.
Sincerely,
Bill Rambo
Permit Technician
File: Permit File No. EL11 -0712
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
Contractors or Tradespeople Peer Friendly Page
•
Page 1 of 2
Electrical Contractor
A business licensed by L8J 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
PROTECTION ONE ALARM MNTRG INC
4256567153
Attn: Justin B. Vise
1035 N 3rd St Ste 101
Lawrence
KS
66044
Out Of State
Corporation
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
601354926
Active
PROTEOA033BP
Electrical Contractor
1/17/1997
1/24/2013
Limited Energy
Unused
Electrical Administrator INFORMATION
License BERGEMA893BL
Name BERGENER, MATTHEW A
Status Active
Business Owner Information
Name
Role
Effective Date
Expiration Date
MACKENZIE, JAMES M JR
01/01/1980
RANKIN, THOMAS K
01/01/1980
HESSE, JOHN W
01/01/1980
CORNELL, MONTGOMERY W
01/01/1980
C T CORPORATION SYSTEM
Agent
01/01/1980
BECK, ANNETTE
President
10/27/2000
SOMMA,TONY
Secretary
10/27/2000
KINGSLEY, RENEE T
Vice President
10/27/2000
CHRETIEN, CRAIG
Vice President
10/27/2000
SANCHEZ, JOSEPH
Vice President
10/27/2000
WILSON, TONY
Vice President
10/27/2000
SIMONETTI, RICH
Vice President
10/27/2000
DEVIN, ANDY
Vice President
10/27/2000
WIENGARTNER, CRAIG
Vice President
10/27/2000
CORY, DENNIS (MIKE)
Vice President
02/25/2002
GRIFFIN, JOHN ERIC
Vice President
01/09/2003
https: // fortress .wa.gov /lni/bbip /Print.aspx
08/01/2011