HomeMy WebLinkAboutPermit EL12-0349 - H2 OFFICE LLCH2O OFFICE LLC
7100 FUN CENTER WY
EL1 2-0349
Parcel No.:
Address:
City oili'ukwila
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
2423049092
7100 FUN CENTER WY TUKW
Project Name: H2 OFFICE LLC
ELECTRICAL PERMIT
Permit Number: EL12 -0349
Issue Date: 04/16/2012
Permit Expires On: 10/13/2012
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
H2 OFFICE LLC
7100 FUN CENTER WAY STE 100 , TUKWILA WA
MARK BEDAAR Phone: 360- 458 -2927
PO BOX 982 , MCKENNA WA
OTI SERVICES INC
PO BOX 982 , MCKENNA WA
Contractor License No: OTISESI940Q 1
Phone: 360- 458 -2927
Expiration Date: 11/21/2012
DESCRIPTION OF WORK:
MOVE ELECTRICAL PANEL TO NEW LOCATION FOR FUTURE TENANT - WASHINGTON
CHIROPRACTIC
Value of Electrical:
NRES: $2,270.00
RES: $0.00
Type of Fire Protection: UNKNOWN
Electrical service provided by: PUGET SOUND ENERGY
Permit Center Authorized Signature:
Fees Collected:
National Electrical Code Edition:
Date:
$136.50
2008
I hereby certify that I have read and examined this per 't and know the same to be true and corriar 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 ork. I am authorized to sign and obtain this electrical permit.
performance
Print Name: ��7 eu 'k %Ji.a I/
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.
Signature:
Date:
doc: EL -4/10
EL12 -0349 Printed: 04 -16 -2012
• •
PERMIT CONDITIONS
Permit No. EL12 -0349
* *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
EL12 -0349 Printed: 04 -16 -2012
Site Address:
CITY OF TUKWI
Community Developme )apartment
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http: //www.Tul:wilaWA.gov
Tenant Name:
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 **
/
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Name:
City: State: Zip:
Address:
')/e. C
/-; M C'fbt/&/' 11:ef
City: ,----
/G' itt ../ t/A
State: A
King Co Assessor's Tax No.:
Suite Number: /a co Floor:
New Tenant: ❑ Yes ❑.. No
Company Name:
Address: /461
City:
eke: ii14
State: 14 Zip: qs.,
Phone: 360 4lS66'A � �/ Fax: 360 ey6.s, `7c, j 6
Contr Reg No.: Exp Date:
Tukwila Business License No.;
Valuation of Project (contractor's bid price): $ 2.. ci.. :?C) !
Scope of Work (please provide detailed information): 42 6 L' F e /e c.r--7l'1 Ca / v"-6 iZ P 1 -
/ o �/
/6" P-Pp v�
Will service be altered? ❑ Yes No
Adding more than 50 amps? ❑ Yes 1E1 No
Type of Use:
Type of work: ia P
❑ New ❑ Addition k Servive Change ❑ Remodel ❑ Tenant Improvement
❑ Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service
Property Served by:
A Puget Sound Energy ❑ Seattle City Light
H:IApplications\Forms- Applications On Line \2011 Applications\Electrical Permit Application Revised 8 -9 -1 I.docx
Revised. August 2011
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Page 1 of 2
Name: / )14. ir /C JQco /hit --
Address:
S' 4 tce as F? 7-2-
City: State: Zip:
Phone360 —.1 3y •30.x:
/
Email: /
atla�C C 0>L .5--, VGS //4c.' ccpI
King Co Assessor's Tax No.:
Suite Number: /a co Floor:
New Tenant: ❑ Yes ❑.. No
Company Name:
Address: /461
City:
eke: ii14
State: 14 Zip: qs.,
Phone: 360 4lS66'A � �/ Fax: 360 ey6.s, `7c, j 6
Contr Reg No.: Exp Date:
Tukwila Business License No.;
Valuation of Project (contractor's bid price): $ 2.. ci.. :?C) !
Scope of Work (please provide detailed information): 42 6 L' F e /e c.r--7l'1 Ca / v"-6 iZ P 1 -
/ o �/
/6" P-Pp v�
Will service be altered? ❑ Yes No
Adding more than 50 amps? ❑ Yes 1E1 No
Type of Use:
Type of work: ia P
❑ New ❑ Addition k Servive Change ❑ Remodel ❑ Tenant Improvement
❑ Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service
Property Served by:
A Puget Sound Energy ❑ Seattle City Light
H:IApplications\Forms- Applications On Line \2011 Applications\Electrical Permit Application Revised 8 -9 -1 I.docx
Revised. August 2011
bh
Page 1 of 2
RESIDENTIAL
NEW RESIDENTIAL SERVICE
❑ New single family dwellings
(including an attached garage)
❑ Garages, pools, spas and outbuildings
❑ Low voltage systems
(alarm, furnace thermostat)
MULTI- FAMILY AND COMMERCIAL
$152.85 Fees are based on the valuation of the electrical contract.
$81.90 ea
$59.85 ea 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
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)
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: &Ga Date:
% F ',Lc? t— Day Telephone: 3' (7 ?--
Mailing Address: /(5 /63DXC 9 444 e AMC? cvtit RP S J (r
Print Name:
City
H: \Applications\Forms- Applications On Line \2011 Applications\Electrical Permit Application Revised 8- 9- 11.docx
Revised: August 2011
bh
State Zip
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.: 2423049092 Permit Number: EL12 -0349
Address: 7100 FUN CENTER WY TUKW Status: APPROVED
Suite No: Applied Date: 04/16/2012
Applicant: H2 OFFICE LLC Issue Date:
Receipt No.: R12 -01325
Initials: TLS
User ID: 1670
Payment Amount: $136.50
Payment Date: 04/16/2012 11:03 AM
Balance: $0.00
Payee: OTI SERVICES INC
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 7906 136.50
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
ELECTRICAL PERMIT - NONR
000.322.101.00.00 136.50
Total: $136.50
doc: Receipt -06 Printed: 04 -16 -2012
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
et I 03L ?
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 R- i.(206) 431 -367
Permit Inspection Request Line (206) 431 -2451
Project:
ti 2
Type of Inspection:
2,00
Address: 1j�D IA/ /l
Date Called:
Special Instructions:
Date Wanted:.
i / D /
Requester:
' i
Phone No:
giApproved per applicable codes. • 0 Corrections required prior to approval.
COMMENTS:
At A
{
//
Inspector:` jet
Date:
7(
n REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Contractors or Tradespeople Prier Friendly Page
•
Electrical Contractor
A business licensed by LEt1 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
OTI SERVICES INC
3604582927
Po Box 982
Mckenna
WA
98558
Pierce
Corporation
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
602662140
Active
OTISESI940Q1
Electrical Contractor
11/21/2006
11/21/2012
General
Unused
ther Associated Licenses
License
Name
Type
Specialty
1
Specialty
2
Effective
Date
Expiration
Date
Status
OTISEED986K9
OTI SERVICES ELECT
DIVISION
Electrical
Contractor
General
Unused
5/29/2002
5/29/2008
Expired
Master Electrician INFORMATION
License BEDNAMJ968MN
Name BEDNAR, MARK J
Status Active
Business Owner Information
Name
Role
Effective Date
Expiration Date
UNISEARCH INC
Agent
11/21/2006
Bond Amount
OTTWELL, RAMONA J
President
11/21/2006
9806159
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
Lexon Ins Co
9806159
05/29/2011
Until Cancelled
$4,000.0006/08/2011
1
INSCO INSURANCE
SERVICES INC
857805C
11/20/2006
Until Cancelled
06/19/2011
$4,000.0011/21/2006
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
EBOES00381
5/12/2009
19.28.101 RCW
ELECTRICAL CITATION
Satisfied
$1,000.00
https: // fortress .wa.gov /lni/bbip /Print.aspx 04/16/2012