HomeMy WebLinkAboutPermit EL12-0828 - BEVERAGES & MOREBEVERAGES & MORE
17197 SOUThCENTER PY
EL1 2-0828
Parcel No.:
Address:
City dftukwila
•
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
2623049069
17197 SOUTHCENTER PY TUKW
Project Name: BEVERAGES & MORE
ELECTRICAL PERMIT
Permit Number:
Issue Date:
Permit Expires On:
EL12 -0828
08/31/2012
02/27/2013
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
KTM GROUP LLC
635 HIGH SCHOOL RD NE , BAINBRIDGE ISLAND WA 98110
LEE STOLL
23632 HWY 99, SUITE F PMB 234 , EDMONDS WA, 98026
WESTAR TELEPHONE SERVICE
23632 HY 99 #F PMB 234 , EDMONDS WA 98026
Contractor License No: WESTATS995BH
Phone: 206 - 841 -4300
Phone: 206 841 -4300
Expiration Date: 08/26/2014
DESCRIPTION OF WORK:
INSTALL (18) DATA, (6) VOICE & (23) SPEAKERS IN 10,700 SQ FT BUILDING.
APPROXIMATELY 3500 FT OF CABLE.
Value of Electrical:
NRES: $4,500.00 Fees Collected:
RES: $0.00
Type of Fire Protection: UNKNOWN National Electrical Code Edition:
Electrical service provided by: PUGET SOUND ENERGY
Permit Center Authorized Signature:
$178.50
2008
Date: 3 1— I C
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 wo k I . authorized t9 sign and obtain this electrical permit.
Signature:
Print Name:
-e ,e
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 -0828 Printed: 08 -31 -2012
•
PERMIT CONDITIONS 1
Permit No. EL12 -0828
* *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 -0828 Printed: 08 -31 -2012
CITY OF TUKWt
Community Developme... Department
Permit Center
6300 Southcenter Blvd, Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
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 **
King Co Assessor's Tax No.: o D o 6 G' 6 z Z
Site Address: / 7/ 9 7 $d V 71/ ` /2 /11 7'7ik' x° /31{ k N )quite Number: /1/17 Floor: .2'5"/-
Tenant Name: i3el'€/ 4 4 it S /) A'O /D'7 iL
Name:
Address:
City:
State:
Zip:
New Tenant: Q' Yes ❑.. No
Company Name:
(/d% S'?"- 1? 7^,c /'#O?
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Address: ./2
Z 3 G ?2 '4v y 9 9 ST!'. 40041. Pr3.s2
City: A..0.701, ,).?
State: � Zip: Nvz
Phone: 2 o - y/ igDFax: Yz 5 - ? ' . 4 A 40
Contr Reg NW,�S -tA %s'g9Se yxPD t :4 zO
Tukwila Business License No.;
6
3
Valuation of Project (contractor's bid price): $ / S 00 . D a
Scope of Work (please provide detailed information): 4' V 1/ i �' O /`J �/� 6 //O / /� 7•
Z3 5�, a - ,rev 10 700 19 p Vz 1 PX 35.6g
/494?
Will service be altered? ❑ Yes [ No
Type of Use:
Type of work:
[ ` New ❑ Addition ❑ Service Change ❑ Remodel
Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service
Adding more than 50 amps? ❑ Yes (o
❑ Tenant Improvement
Property Served by:
❑ Puget Sound Energy ❑ Seattle City Light
H:WpplicationsWorms- Applications On Line \2011 Applications\Electrical Permit Application Revised 8- 9- 11.docx
Revised: August 2011
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Page 1 of 2
Name:
Z e'° 674d i/
Address: Z? 3l ,y kvY 79 ST•EF
fin 8
City:
A-0 3anvlJ S State:
(/1/ Zip:
, i'u
Phone:
zo f ° 45y,/, %,�0,� Fax:
ti Z 5 w ? 246- 40
Email:
4 e.e..0 c.t.01f . X11 e7i:
New Tenant: Q' Yes ❑.. No
Company Name:
(/d% S'?"- 1? 7^,c /'#O?
31/
Address: ./2
Z 3 G ?2 '4v y 9 9 ST!'. 40041. Pr3.s2
City: A..0.701, ,).?
State: � Zip: Nvz
Phone: 2 o - y/ igDFax: Yz 5 - ? ' . 4 A 40
Contr Reg NW,�S -tA %s'g9Se yxPD t :4 zO
Tukwila Business License No.;
6
3
Valuation of Project (contractor's bid price): $ / S 00 . D a
Scope of Work (please provide detailed information): 4' V 1/ i �' O /`J �/� 6 //O / /� 7•
Z3 5�, a - ,rev 10 700 19 p Vz 1 PX 35.6g
/494?
Will service be altered? ❑ Yes [ No
Type of Use:
Type of work:
[ ` New ❑ Addition ❑ Service Change ❑ Remodel
Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service
Adding more than 50 amps? ❑ Yes (o
❑ Tenant Improvement
Property Served by:
❑ Puget Sound Energy ❑ Seattle City Light
H:WpplicationsWorms- Applications On Line \2011 Applications\Electrical Permit Application Revised 8- 9- 11.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)
$152.85
$81.90 ea
$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
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:
Mailing Address:
/ S 7'o // Day Telephone:
,;(4 7.0 /V2
2 3 6 3 2• h' r+/ % "" 9 s r( .�. /0/),5 Z 3
City
H;\Applications\Forms- Applications On Line \2011 Applications'Electrical Permit Application Revised 8 -9 -11. docx
Revised, August 2011
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Date: 1- 7-
z06-
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.: 2623049069 Permit Number: EL12 -0828
Address: 17197 SOUTHCENTER PY TUKW Status: PENDING
Suite No: Applied Date: 08/31/2012
Applicant: BEVERAGES & MORE Issue Date:
Receipt No.: R12 -02518
Payment Amount: $178.50
Initials: WER Payment Date: 08/31/2012 01:42 PM
User ID: 1655 Balance: $0.00
Payee: LEE STOLL
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd VISA
Authorization No. 014648
ACCOUNT ITEM LIST:
Description
178.50
Account Code Current Pmts
ELECTRICAL PERMIT - NONR
000.322.101.00.00 178.50
Total: $178.50
doc: Receiot -06 Printed: 08 -31 -2012
INSPECTION RECORD
Retain a copy with permit.
INSPECTION 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: De V G6 4 —doffs
Type of Inspection:
O
Address: �
'
.s 4. .
0
Date Called:
Special Instruction
Date Wanted:.
A /
/!^
a:m.1
m
Requester:
' .r
Phone No:
si!Approved per applicable codes.
COMMENTS:f2r/
ElCorrections required prior to approval,
Date:
Wijek
n REINSPECTION FEE REQUIRED. Prior to next inspection, fee mustbe
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule.reinspection.
Inspector:
C„
Contractors or Tradespeople Peter 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
WESTAR TELEPHONE SERVICE
2068414300
23632 Hwy 99 Ste F, Pmb 234
Edmonds
WA
98026
Snohomish
Individual
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
600472711
Active
WESTATS995BH
Electrical Contractor
6/12/2000
8/26/2014
Telecommunications
Electrical Administrator INFORMATION
License STOLLLROO4LK
Name STOLL, LEE R
Status Active
Business Owner Information
Name
Role
Effective Date
Expiration Date
STOLL, LEE R
Owner
01/01/1980
Bond Information
Page 1 of 2
Bond
Bond Company Name
Bond Account Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Bond Amount
Received Date
2
CBIC
SD0056
07/07/2000
Until Cancelled
$4,000.00
10/01/2002
Assignment of Savings Information No records found for the previous 6 year period
Insurance Information
Insurance
Company Name
Policy Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Amount
Received Date
13
American
States
Insurance Co
01C118502340
04 /27/2012
04/27/2013
$1,000,000.0004
/24/2012
12
American
States
Insurance Co
01C11850233-3
04/27/2011
04/27 /2012
$1,000,000.0004
/09/2011
11
AMERICAN
STATES INS CO
01ci1185023.2
04/27/2010
04/27 /2011
$2,000,000.00
03/26/2010
10
AMERICAN
STATES INS CO
01c11185023 -1
04/27/2009
04/27 /2010
$2,000,000.00
04 /06/2010
8
AMERICAN
STATES INS CO
01C1185023 -1
03/30/2009
03/30/2010
$1,000,000.00
04 /08/2009
7
AMERICAN
STATES INS CO
010E583440 0
04/27/2008
04/27/2009
$170,000.00
04/15 /2008
6
AMERICAN
STATES INS CO
010E583440 9
04/27/2007
04/27 /2008
$170,000.00
04/11/2007
5
AMERICAN
STATES INS CO
010E5834408
04/27/2006
04/27/2007
$170,000.00
04/17/2006
Summons /Complaint Information Summons and Complaints are not filed with the department for this contractor type
https: // fortress .wa.gov /lni/bbip/Print.aspx
08/31/2012