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Home My WebLink AboutPermit EL12-0646 - CLEARSIGN COMBUSTIONCLEAR SIGN COMBUSTION 12870 INTERURBAN AV S EL1 2-0646 City oilltukwila • 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.: 2716000010 Address: 12870 INTERURBAN AV S TUKW Project Name: CLEARSIGN COMBUSTION ELECTRICAL PERMIT Permit Number: EL12 -0646 Issue Date: 07/11/2012 Permit Expires On: 01/07/2013 Owner: Name: EPROPERTY TAX INC DEPT #207 Address: PO BOX 4900 , SCOTTSDALE AZ 85261 Contact Person: Name: JENNIFER BURGESS Phone: 206 - 774 -9499 Address: 1345 GULF RD , POINT ROBERTS WA, 98281 Contractor: Name: ADT SECURITY SERVICES INC Phone: 206 - 719 -0347 Address: 11824 NORTH CREEK PY N #105 , BOTHELL WA 98011 Contractor License No: ADTSESI032O5 Expiration Date: 09/25/2013 DESCRIPTION OF WORK: INSTALL LOW VOLTAGE SECURITY SYSTEM Value of Electrical: NRES: $1,348.00 RES: $0.00 Type of Fire Protection: UNKNOWN Electrical service provided by: SEATTLE CITY LIGHT Permit Center Authorized Signature: Fees Collected: National Electrical Code Edition: $115.50 2008 Date: -' Y ' L 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 • this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws regulating constructio'' •e or/ponce of w . I am authorize, o sign and obtain this electrical permit. g /� �)L2j'1'I Si nature: Date: 7--1 , This permit shall become null and void if the work is no 4 mmenced 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: .\'Ner=x) doc: EL -4/10 EL12 -0646 Printed: 07 -11 -2012 • * *ELECTRICAL ** PERMIT CONDITIONS Permit No. EL12-0646 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 EL12-0646 Printed: 07 -11 -2012 CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Electrical Permit No. L\ )__O bit T 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: 12870 Interurban Ave SW Tenant Name: Clearsign Combustion Corporation PROPERTY OWNER Name: Clearsign Combustion Corporation Address: SAME AS SITE City: TUKWILA State: WA Zip: 98168 CONTACT PERSON — person receiving all project communication Name: JENNIFER BURGESS/NWPERMIT -AGENT Address: 1345 GULF RD City: PT. ROBERTS State: WA Zip: 98281 Phone: (206) 774 -9499 Fax: (888) 400 -0383 Email: JENNIFER @NWPERMIT.COM King Co Assessor's Tax No.: 2716000010 Suite Number: Floor: New Tenant: ❑ Yes ..No ELECTRICAL CONTRACTOR; INFORMATION Company Name: ADT SECURITY SERVICES INC. Address: 11824 NORTH CREEK PKWY N # 105 City: BOTHELL State: WA Zip: 98011 Phone: (206) 774 -9499 Fax: (888) 400 -0383 Contr Reg No.: ADTSESI032O5 Exp Date: 09/25/2013 Tukwila Business License No.: Valuation of Project (contractor's bid price): $ 1,348 Scope of Work (please provide detailed information): Install low voltage security system Will service be altered? ❑ Yes in No Adding more than 50 amps? ❑ Yes j No Type of Use: Commercial 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:Wpplications'Forms- Apphcauons On Line12011 Apphcatlons\Electncal Penns Application Revised 8- 9- 11.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 !P4ERMITPRLICATION 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 0 ROtc ,r:LECT AL CONTRACTOR: Si tune: :�,�11 �'' /; fir / 07/11/2012 " w w r � i_ Date: Prim game: Kathleen Genge , Day Telephone: (206) 774 -9499 Mailing Address: 1345 GULF RD PT. ROBERTS WA 98281 City H:WpplicationsWorns- Applications On Line \2011 Apphcations\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 -43 1 -3670 Fax: 206 - 431 -3665 Web site: http: / /www.TukwilaWA.gov RECEIPT Parcel No.: 2716000010 Permit Number: EL12 -0646 Address: 12870 INTERURBAN AV S TUKW Status: PENDING Suite No: Applied Date: 07/11/2012 Applicant: CLEARSIGN COMBUSTION Issue Date: Receipt No.: R12 -02095 Initials: WER User ID: 1655 Payment Amount: $115.50 Payment Date: 07/11/2012 11:48 AM Balance: $0.00 Payee: NORTHWEST PERMIT INC TRANSACTION LIST: Type Method Descriptio Amount Payment Check 2138 115.50 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 115.50 Total: $115.50 doc: Receiot -06 Printed: 07 -11 -2012 INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA }BUI,LDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 4;112 -1,v Project: Type of Inspection: . Address: tl A .. rii-f.9R1.124.A4) Date Called: .1,..2 Special Instructions:.0" Date Wantesd::. as i Requester: Phone No: )/lo 9- yy J' pproved per applicable codes. ■ COMMENTS: Corrections required prior to approval.: Inspector: �`ti Date: 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 • Page 1 of 3 Electrical Contractor A business licensed by LEtI 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 ADT SECURITY SERVICES INC UBI No. 601636830 Phone 2067190347 Status Active Address 11824 North Creek Pkwy N #105 License No. ADTSESI03205 Suite /Apt. License Type Electrical Contractor City Bothell Effective Date 9/25/1997 State WA Expiration Date 9/25/2013 Zip 98011 Suspend Date County King Specialty 1 Limited Energy Business Type Corporation Specialty 2 Unused Parent Company Other Associated Licenses License icense Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status AMERIDT283LZ AMERICAN DISTRICT TELEGRAPH CO Electrical Contractor Limited Energy Unused 6/9/1972 1/31/1990 Archived Business Owner Information Name Role Effective Date Expiration Date C T CORPORATION SYSTEM Agent 01/01/1980 KOCH, JOHN B President 09/13/2011 BLEISCH, NELSON DAVID Secretary 09/13/2011 FAXAS, MAGIN ANTHONY Treasurer 09/13/2011 SNYDER, MICHAEL President 01/01/1980 09/13/2011 MONROZE, M BRIAN Secretary 06/15/2006 09/13/2011 FLANIGAN, TIMOTHY E Secretary 06/15/2006 09/13/2011 ABROMEIT, RICHARD H Treasurer 08/21/2003 09/13/2011 BOGGESS, JERRY R Secretary 01/01/1980 06/15/2006 DOHERTY, BERNARD J Secretary 01/01/1980 06/15/2006 RUZIKA, STEPHEN J Secretary 01/01/1980 06/15/2006 BECK, JAN S Secretary 01/01/1980 06/15/2006 DINIUS, DAVID Secretary 01/01/1980 06/15/2006 FINNEY, P GRAY Vice President 01/01/1980 06/15/2006 ROBINSON,MICHAEL A Treasurer 08/28/2001 08/21/2003 Bond Information https: // fortress .wa.gov /lni /bbip /Print.aspx 07/11 /2012