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Home My WebLink AboutPermit EL12-0683 - 76 STATION76 STATION 16200 WEST VALLEY HY EL1 2-0683 City AP 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 Parcel No.: 0005800038 Address: 16200 WEST VALLEY HY TUKW Project Name: 76 STATION ELECTRICAL PERMIT Permit Number: Issue Date: Permit Expires On: EL12 -0683 07/23/2012 01/19/2013 Owner: Name: SOUTHCENTER GAS STATION LLC Address: 2224 'CAMBER RD , BELLEVUE WA 98007 Contact Person: Name: STEVEN THOMSON Address: PO BOX 2849 , RENTON WA, 98056 Contractor: Name: INSIGNIA SIGN INC Address: PO BOX 2849 , RENTON WA 98056 Contractor License No: INSIGSI055JS Phone: 425 917 -2109 Phone: 425 917 -2109 Expiration Date: 04/10/2013 DESCRIPTION OF WORK: WIRE (2) NEW LED PRICE SIGN FACES TO EXISTING ELECTRICAL CIRCUITS Value of Electrical: NRES: $500.00 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: Date: $75.60 2008 2 ed this permit and know the same to be true and correct. All provisions of law and ordinances whether specified herein or not. The granting of this permit does not pre construction or th ; performance of work / I e to give authority to violate or cancel the provisions of any other state or local laws regulating am authorized to sign and obtain this electrical permit. a vQ Luca Date: 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 EL12 -0683 Printed: 07 -23 -2012 PERMIT CONDITIONS Permit No. EL 12 -0683 * *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 -0683 Printed: 07 -23 -2012 CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Electrical Permit No. ' /V) O Project No. Date Application Accepted: ,� L `L 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 King Co Assessor's Tax No.: 0005800038 Site Address: 16200 West Valley Highway Suite Number: Floor: Tenant Name: 76 Gas Station PROPERTY OWNER Name: SOUTHCENTER GAS STATION LLC Address: 16200 West Valley Highway City: Tukwila State: WA Zip: 98188 CONTACT PERSON — person receiving all project communication Name: Steven Thomson Address: PO BOX 2849 City: Renton State: WA Zip: 98056 Phone: (425) 917 -2109 Fax: (425) 917 -0153 Email: steven @insigniasign.com New Tenant: ❑ Yes m ..No ELECTRICAL CONTRACTOR INFORMATION Company Name: Insignia Sign Inc. Address: PO BOX 2849 City: Renton State: WA Zip: 98056 Phone: (425) 917 -2109 Fax: (425) 917 -0153 Contr Reg No.: INSIGSI055JS Exp Date: 04/10/2013 Tukwila Business License No.: N/' _ _ O1'1 2-'2-1/ Valuation of Project (contractor's bid price): $ 500 Scope of Work (please provide detailed information): Wire 2 new led price sign faces to existing electrical circuits. Will service be altered? ❑ Yes No Type of Use: Commercial Adding more than 50 amps? ❑ Yes 0 No Type of work: m New m Addition ❑ Service Change ❑ Remodel ❑ Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication Property Served by: m Puget Sound Energy ❑ Seattle City Light H:\Applications\Forms- Applications On Line \2011 Applications \Electrical Permit Application Revised 8- 9- 11.docx Revised: August 2011 bh ❑ Tenant Improvement ❑ Temporary Service 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 0 R OR ELE ' AL CONTRACTOR: Signature: Date: Print Name: Steve Day Telephone: (425) 917 -2109 Mailing Address: PO BOX 2849 Renton WA 98056 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 -43 1 -3670 Fax: 206 -431 -3665 Web site: http: / /www.Tukwila WA.tov Parcel No.: 0005800038 Address: 16200 WEST VALLEY HY TUKW Suite No: Applicant: 76 STATION RECEIPT Permit Number: EL12 -0683 Status: PENDING Applied Date: 07/23/2012 Issue Date: Receipt No.: R12 -02184 Payment Amount: $75.60 Initials: JEM Payment Date: 07/23/2012 02:03 PM User ID: 1165 Balance: $0.00 Payee: INSIGNIA SIGN, INC. TRANSACTION LIST: Type Method Descriptio Amount Payment Check 3951 75.60 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 75.60 Total: $75.60 doc: Receiot -06 Printed: 07 -23 -2012 INSPECTION „RECORD Retain a copy with permit INSPECTION NO. PERMIT NO: CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 R (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 Project: 7' T> 0 4 Type of Inspection: av Address: - b� W - j t , ,/ Date Called: Special Instructions: Date Wanted:. _ A � ,(J !m. p'i Requester: Phone No: J Approved per applicable codes. Corrections required prior to approval. COMMENTS: • / Date: citiqf 2/— n REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Inspector: Contractors or Tradespeople Prr er 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 INSIGNIA SIGN INC 4259172109 Po Box 2849 Renton WA 98056 King Business Type Corporation Parent Company UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 601507324 Active INSIGSI055JS Electrical Contractor 4/10/1995 4/10/2013 Sign Unused Master Electrician INFORMATION License THOMSBE954L8 Name THOMSON, BRYAN E Status Active Business Owner Information Name Role Effective Date Expiration Date THOMSON, CINDY A Agent 02/04/2002 Bond Amount THOMSON, BRYAN E Member 02/04/2002 9805360 THOMSON, CINDY A President 01/01/1980 BOWEN, BRYAN E 01/01/1980 02/04/2002 BOWEN, BRYAN E Agent 01/01/1980 02/04/2002 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 4 Lexon Ins Co 9805360 04/23/2011 Until Cancelled $4,000.0004/15/2011 3 COLONIAL AM CAS & SURETY OF MD LPM4051223 04/23/2000 Until Cancelled 05/26/2011 $4,000.00 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 EHRAL00569 1/30/2009 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 https: // fortress .wa.gov /lni /bbip /Print.aspx 07/23/2012