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Home My WebLink AboutPermit EL11-0738 - SIGHTLINE HEALTHSIGHTI.INE HEALTH 200 ANDOVER PK E EL1 1 -0738 City otiOTukwila • 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 Project Name: SIGHTLINE HEALTH ELECTRICAL PERMIT Permit Number: EL11 -0738 Issue Date: 08/08/2011 Permit Expires On: 02/04/2012 Owner: Name: ANDOVER PLAZA LLC Address: 1501 N 200TH ST , SHORELINE WA Contact Person: Name: ROB KINGSLEY Address: 1905 S JACKSON ST , SEATTLE WA Contractor: Name: NORTH STAR ELECTRIC INC Address: 1905 S JACKSON ST , SEATTLE WA Contractor License No: NORTHSE 13608 Phone: 206 - 571 -2450 Phone: 206 - 329 -1596 Expiration Date: 09/28/2011 DESCRIPTION OF WORK: INSTALL LOW VOLTAGE WIRING FOR THE FIRE ALARM PANEL & DEVICES Value of Electrical: NRES: $20,000.00 RES: $0.00 Type of Fire Protection: UNKNOWN Electrical service provided by: PUGET SOUND ENERGY Permit Center Authorized Signature: Fees Collected: $436.50 National Electrical Code Edition: 2008 Date: V " 0-- ii 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. Signature: /- /2r----1--- Date: .0 0 Print Name: /206 ,e)4,/6s«vf 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 -0738 Printed: 08 -08 -2011 • PERMIT CONDITIONS Permit No. EL11 -0738 * *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 -0738 Printed: 08 -08 -2011 CITY OF TUKWIII Community Developffient Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http: / /www.TukwilaWA.gov Electrical Permit No. ` 1 —p -739 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 n King Co Assessor's Tax No.: Site Address: h 7O ,4N U g v e r / 9,4 - 645-7- Suite Number: Floor: Tenant Name: S-16 New Tenant: Yes ❑ .. No Property Owners Name: 9NIovr2 f1A2.9 LAG Mailing Address: / S4 / /t/ City State Zip CONTACT PERSON - Who do we contact when your permit is ready to be issued Name: Mailing Address: / 9d 5 S , Div S� E -Mail Address: 06 ka NS -n- i eon" Day Telephone:() . 4/. City State Zip Fax Number:(.302 -`J — 2'Y3 7 ELECTRICAL CONTRACTOR INFORMATION Company Name: Mailing Address: / 90 5 G-7'7Z l L 5, je-iGK -sb.J Contact Person: 72,6 �)n-' S E -Mail Address: (rvb/& NS i n- 2J , Contractor Registration Number: //-17' S�c /..;60 Si-rt. , j,9 9g/ yid City l State Zip Day Telephone:rgJ 5:7/ �60 Fax Number: .V,016) 3c71-9 _ 9,,5 7 Expiration Date: 9/v,a8/ Valuation of Project (contractor's bid price): $ c71-0/ Scope of Work (please provide detailed information):,ZNSTi4//--/ tOk) 110/.7t b- ')/L /yN 1. 444» - Lievvyvi f-/ /% ✓i s Will service be altered? ❑ Yes I"No Adding more than 50 amps? ❑ Yes ErNo Type of Use: Type of work: ❑ New ❑ Addition ❑ Service Change ❑ Remodel ❑ Tenant Improvement 1/d Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service Property Served by: ❑ Puget Sound Energy ❑ Seattle City Light co H:\Applications\Porms- Applications On Line\2010 Applications \7 -2010 - Electrical Permit Application.doc Revised: May 2011 bh Page 1 of 2 1 RESIDENTIAL NEW RESIDENTIAL SERVICE ❑ New single family dwellings (including an attached garage) ❑ Garages, pools, spas and outbuildings $152.85 $81.90 ea $59.85 ea Low voltage systems (alarm, furnace thermostat) 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: A, 6 / ivbs ") Mailing Address: /' v $ 5- , J-RGrp of,/ ST■ IDate Application Accepted: Date: de/.0/ Day Telephone:: CVO— City State Zip Date Application Expires: H:\ Applications \Form - Applications On Line\2010 Applications \7 -2010 - Electrical Permit Application.doc Revised: May 2011 bh Page 2 of 2 Staff Initials: • 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.2ov Parcel No.: 0223100099 Address: 200 ANDOVER PK E TUKW Suite No: Applicant: SIGHTLINE HEALTH RECEIPT Permit Number: EL11 -0738 Status: PENDING Applied Date: 08/08/2011 Issue Date: Receipt No.: R11 -01704 Payment Amount: $436.50 Initials: WER Payment Date: 08/08/2011 11:26 AM User ID: 1655 Balance: $0.00 Payee: ROB KINGSLEY TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 008631 ACCOUNT ITEM LIST: Description 436.50 Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 436.50 Total: $436.50 doc: Receiot -06 Printed: 08 -08 -2011 INSPECTION NO. INSPECTION RECORD Retain a copy with permit RMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 if (206) 431 -3 Permit Inspection Request Line (206) 431 -2451 Project: $IA' e 44414 Type of Inspection: ^ d J ` Address: r, Date Called: __ Special Instructions: rI k Date Wanted:. f m. Requester: ((( Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Inspector: 1Date: oy,Ayi REINSPECTION FEE REQUIRED Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. . _ r.a_ emu .. ..�i.v... . -•.- - a"-` -' -.- Contractors or Tradespeople Printer 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 NORTH STAR ELECTRIC INC 2063291596 1905 5 Jackson St Seattle WA 98144 King Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 601034594 Active NORTHSE13608 Electrical Contractor 9/28/1987 9/28/2011 General Unused ther Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status NORTHSE193LS NORTH STAR ELECTRIC Electrical Contractor General Unused 6/10/1981 3/31/1989 Archived Electrical Administrator INFORMATION License OSTERDS193JP Name OSTERGAARD, DOUGLAS S Status Active Business Owner Information Name Role Effective Date Expiration Date OSTERGAARD, DOUGLAS Violation Amount 01/01/1980 1/16/2009 FREDERICKS, DOLORES ELECTRICAL CITATION 01/01/1980 $250.00 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 5 TRAVELERS CAS /SURETY CO OF AME 206085610 05/20/2001 Until Cancelled $4,000.00 04/02/2001 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 ESLOD00275 1/16/2009 19.28.271 RCW ELECTRICAL CITATION Satisfied $250.00 ESLOD00276 1/16/2009 19.28.161 RCW ELECTRICAL CITATION Satisfied $250.00 EBERA00004 3/1/2006 19.28.101 RCW ELECTRICAL CITATION Satisfied $1,000.00 ECERM00570 11/1/2010 19.28.101 RCW ELECTRICAL CITATION Satisfied $1,000.00 EBRIC01866 12/3/2009 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 https: // fortress .wa.gov /lni/bbip /Print.aspx 08/08/2011