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HomeMy WebLinkAboutPermit EL12-0580 - HILL-ROMHILL-ROM 12610 INTERURBAN AV S EL1 2-0580 City oftukwila 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.: 0004800003 Address: 12610 INTERURBAN AV S TUKW Project Name: HILL -ROM ELECTRICAL PERMIT Permit Number: EL12 -0580 Issue Date: 06/22/2012 Permit Expires On: 12/19/2012 Owner: Name: GATEWAY OLYMPIA INC Address: PO BOX 4900 #207 , SCOTTSDALE AZ 85261 Contact Person: Name: SCOTT JENNINGS Phone: 253- 859 -2000 Address: 4826 B ST NW, SUITE 101 , AUBURN WA, 98001 Contractor: Name: KIRBY ELECTRIC INC Address: 4826 B ST NW, STE 101 , AUBURN WA 98001 Contractor License No: KIRBYEI077BN Phone: 253 859 -2000 Expiration Date: 01/13/2013 DESCRIPTION OF WORK: TENANT IMPROVEMENT BUILDOUT - CORD DROPS IN THE WAREHOUSE, ADD NEW FILE ROOM AND WAREHOUSE RESTROOM Value of Electrical: NRES: $8,250.00 RES: $0.00 Type of Fire Protection: UNKNOWN Electrical service provided by: SEATTLE CITY LIGHT Permit Center Authorized Signature: Fees Collected: $247.30 National Electrical Code Edition: 2008 Date: lY - ✓v 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: �/� Date: 0c940— 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. Print Name: doc: EL -4/10 EL12 -0580 Printed: 06 -22 -2012 • PERMIT CONDITIONS Permit No. EL 12 -0580 * *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 -0580 Printed: 06 -22 -2012 CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http: / /www.TukwilaWA.gov Electrical Permit No. L1)____ as-go Project No. Date Application Accepted: Date Application Expires: (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: 12610 Interurban Ave S. Tenant Name: Hill -Rom PROPERTY OWNER Name: Scott Jennings Name: Gateway Olympic City: Auburn State: WA Zip: 98001 Address: PO Box 4900 #207 Email: scoff @kirbyelectric.com City: Scottsdale State: AZ Zip: 85261 CONTACT PERSON — person receiving all project communication Name: Scott Jennings Address: 4826 B St. NW Suite 101 City: Auburn State: WA Zip: 98001 Phone: (253) 859 -2000 Fax: (253) 859 -2363 Email: scoff @kirbyelectric.com King Co Assessor's Tax No.: Suite Number: Floor: New Tenant: m Yes ..No ELECTRICAL CONTRACTOR INFORMATION Company Name: Kirby Electric Inc. Address: 4826 B St. NW Suite 101 City: Auburn State: WA Zip: 98001 Phone: (253) 859 -2000 Fax: (253) 859 -2363 Contr Reg No.: KIRBYEI077BN Exp Date: 01/13/2013 Tukwila Business License No.: Valuation of Project (contractor's bid price): $ 8,250 Scope of Work (please provide detailed information): TI Buildout - Cords drops in the warehouse, add new file room and warehouse restroom. Will service be altered? ❑ Yes FA I No Adding more than 50 amps? ❑ Yes © No Type of Use: Distribution Type of work: ❑ New ❑ Addition ❑ Service Change ❑ Remodel ® Tenant Improvement ❑ Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service Property Served by: ▪ Puget Sound Energy ❑ Seattle City Light H:\Applications\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 $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: Vitaly Kalchik Date: 06/22/2012 Day Telephone: (253) 859 -2000 Mailing Address: 4826 B St. NW Suite 101 Auburn WA 98001 City H:\Applications\Forms- Applications On Line 2011 Applications\Electrical Permit Application Revised 8 -9 -1 I.docx Revised: August 2011 bh State Zip Page 2 of 2 • wqs City of Tukwila ti 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.ov Parcel No.: 0004800003 Address: 12610 INTERURBAN AV S TUKW Suite No: Applicant: HILL -ROM RECEIPT Permit Number: EL12 -0580 Status: PENDING Applied Date: 06/22/2012 Issue Date: Receipt No.: R12 -01966 Payment Amount: $247.30 Initials: WER Payment Date: 06/22/2012 03:08 PM User ID: 1655 Balance: $0.00 Payee: KIRBY ELECTRIC INC TRANSACTION LIST: Type Method Descriptio Amount Payment Check 513850 247.30 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 247.30 Total: $247.30 doc: Receiot -06 Printed: 06 -22 -2012 INSPECTION RECORD Retain a copy with permit INSPE{{TION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Project: 1-1114,- Type of Inspection: ;/D O Address: t� 1�� fn Date Called: Special Instructions: 9150- l io :vv Date Wanted:. �� /a ;d iTil Requester: N Phone No: Approved per applicable codes. Corrections required prior to approval. COMMENTS. Ala-Ws vioif 1 N Inspector: Cam" //1 64 Date: o n REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit Joi 3 PERMIT NO. - • CITY OF TUKWILA- BUILDING DI- VISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 IZ' (206) 431-3670 Permit Inspection Request Line (206) 431 -2451 INSPECTION NO. Project: &A—M./AY age APoA Type of Inspection: .: / 00 Address: /7 A/ 0 ....7 s- .4rAu iv Ala- Date Called: S, Special Instructions: Date Wawnnt�t,ed:. /"117')2 a.m Requester: Phone No: ElApproved per applicable codes. porrections required prior to approval. COMMENTS: VOLv-AeA- cSYs -ruse Na if)A., JJ7 Pere rr( ow* a; hOil D 111,4 Nei. 4 A� /orb' f "0,./.}LlP776.A c.5a4 c s v7sD-l.s -xr-". Frwels AL9712,3840 2.746-77mA 33 A 757A N - errs fCug n REINSPEC 'ION FEE REQUIRED. Prior to next inspection. fee must paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INSPECTION•RECORD Retain a copy with permit /07 2 / :3 PERMIT NO. CITY OF TUKWILA BUILDING DIVISION. 6300 Southcenter Blvd., #100, Tukwila. WA 98188 ; -., (206) 431'3670 Permit Inspection Request Line (206) 431 -2451 INSP CTION NO. Project: � 'ice, r Type of Inspection: ,2 /00 �. Address: ,2 /o 1-;/7' Ahr Date Called: '` 74%'7,1 L Zd✓c-'tt72, i'4 PI1ve . mfr , 1-44' ; ,:.. Special nstructions: Date Wanted:. /2'/ /Via;.: a. m. p:rn. Requester: A )) H721'/.e A111",!" r Ai er° (,�sJA/1(IY Y. Phone No: 1; DApproved per applicable codes. 'Corrections required -.prior to approval: COMMENTS: 1/21/1// fle- T 4 4., c colt)" #../e9 0M C" if 17 n R20-72 r e7i 1 (9A 2 /74,, A 970....0 / .0401 DCr )14,4 N I./FA e 12/27-"5 ., 9aien Ats)-. -7.4 •ia, .. /a).S`y".41.tA-r7o" 42, 17,4Aisrl"2441/T .4...,. 74%'7,1 L Zd✓c-'tt72, i'4 PI1ve . mfr , 1-44' ; ,:.. 40 Ai 's* 1A N to 14 EV:2K 1} mod' iy'. .ret W i . e / -,-, is 1/ less" t i)A i-le if ("I ftrt., r-se ..] 1eV/IV :� . . h 9 A Pa714 nu 5 k.-- 1 ►Sp9S %lr Tar 4,ie iYL t�D - 0 (Ae,, 5" z, iihiss 7; /14 4 r rf.aace - A )) H721'/.e A111",!" r Ai er° (,�sJA/1(IY Y. 3J ,-rTi'79 Fi f--iS ,X.it` ILL -7-4,,r-' ‹ C `l a • . rpolv.77.Gic-iN 'pit i047A48' Si-:01t0-7 ,. Inspector: —Th Date: /,2 n REINSP6ION FEE REQUIRED. Prior to nextjnspection. fee must be. paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule'reinspectiion. b4t INSPECTION' RECORD Retain a copy with permit. INSPECTION NO. . PERMIT NO. CITY OF TUKWILA' BUILDING DIVISION: 6300 Southcenter Blvd., #100, Tukwila. WA 9818g- , :. (206) 431- 3670. Permit Inspection Request Line (206) 431 -2451 - 1. 12 - Sd Project: Address: Special Instructions: Type of Inspection: ,277174? Date Called: . El Approved per applicable codes. "3 Jy COMMENTS: Date Wanted: . Requester: Phone No: a.m.. -p.m corrections required • prior to approval. 7;4/ 57-.4 L e"X)-r ' > S jl Pl°Rot1t .i4ris cK< tt ,tNA"T /0A./ A 94 911-ii 2_;lray's "6- 4)e7 fJI if 1,9 rc cAl. Sk'VA e sa 7 s Inspector: 1' I/2' £�M?' zr- Date: n REINSPECTION FEE REQUIRED. Prior to next inspection, fee•must be . paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. • INSPECTION RECORD Retain a cop"with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila: WA 98188 CZ (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 ..� Project: �^ t�,f"Tef7�i4 y Type of In pection: O 'WO - \J ■ Address: Date Called: _ Special'Instructions: Date Wanted:. 1 . Z a. P.m. Requester: Phone No: E(Approved per applicable codes. Corrections required -prior to approval. COMMENTS: O/c Ir 1 Inspector: enr2Y dmtlyttef Date: - /.:'/�Z. n REINSPE ?ETION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit . INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300: Southcenter Blvd., #100, Tukwila. WA 98188 1Z.. (206) 431 73670 -Permit Inspection. Request Line (206) 431 -2451 Project: r- Address:. Ra Special Instructions: Type of Inspection: Date Called: 7003 Approved per applicable codes. COMMENTS: -' Date Wanted:: Zb 6a;ri. Requester: Phone No: ElCorrections required prior to approval. viktv CoJL- h _co W i L9 Inspector: 1 Date: v� r� zb ' ri REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.. Contractors or Tradespeople *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 KIRBY ELECTRIC INC 2538592000 4826 B St Nw Ste 101 Auburn WA 98001 King Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 601433048 Active KIRBYEI077BN Electrical Contractor 1/15/1993 1/13/2013 General Unused ther Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status KIRBYE *101QEKIRBY ELECTRIC Electrical Contractor General Unused 11/5/1990 11/5/1994 Archived Master Electrician INFORMATION License KIRBYDE962LZ Name KIRBY, DOUGLAS E Status Active Business Owner Information Name Role Effective Date Expiration Date DOUGLAS, KIRBY Agent 01/04/2012 Bond Amount KIRBY, DOUGLAS E President 01/01/1980 70607132 KIRBY, SHANNON Agent 01/01/1980 01/04/2012 KIRBY, SHANON E Agent 12/22/1992 01/04/2012 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 WESTERN SURETY CO 70607132 01/14/2009 Until Cancelled 19.28.271 RCW ELECTRICAL CITATION $4,000.00 11 /05/2008 4 MERCHANTS BONDING CO (MUTUAL) WA 12415 01/14/2005 Until Cancelled 01/14/2009 $4,000.00 11/04/2004 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 ENORW00271 1/27/2009 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 ECHIR00274 9/24/2007 19.28.271 RCW ELECTRICAL CITATION Satisfied $250.00 EBIEA00522 9/3/2010 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 https: // fortress .wa.gov /lni/bbip /Print.aspx 06/22/2012