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HomeMy WebLinkAboutPermit EL12-1006 - HIGH FIVEThis record contains information which is exempt from public disclosure pursuant to the Washington State Public Records Act, Chapter 42.56 RCW as identified on the Digital Records Exemption Log shown below. EL12 -1006 High Five 18300 Cascade Avenue RECORDS DIGITAL D- ) EXEMPTION LOG THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION F,age # Code Exemption � � �� Brief Explsnatoty Description, Statute /Rule The Privacy Act of 1974 evinces Congress' intent that Personal Information — social security numbers are a private concern. As such, individuals' social security numbers are Social Security Numbers redacted to protect those individuals' privacy pursuant 5 U.S.C. sec. DR1 Generally — 5 U.S.C. sec. to 5 U.S.C. sec. 552(a), and are also exempt from 552(a); RCW 552(a); RCW disclosure under section 42.56.070(1) of the 42.56.070(1) 42.56.070(1) Washington State Public Records Act, which exempts under the PRA records or information exempt or prohibited from disclosure under any other statute. Redactions contain Credit card numbers, debit card Personal Information — numbers, electronic check numbers, credit expiration 10 DR2 Financial Information — dates, or bank or other financial account numbers, RCW RCW 42.56.230(4 5) which are exempt from disclosure pursuant to RCW 42.56.230(5) 42.56.230(5), except when disclosure is expressly required by or governed by other law. HIGH FIVE 18300 CASCADE AV EL12 -1006 City of.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 Parcel No.: 7888900175 Address: 18300 CASCADE AV TIIKW Project Name: HIGH FIVE ELECTRICAL PERMIT Permit Number: Issue Date: Permit Expires On: EL12 -1006 11/01/2012 04/30/2013 Owner: Name: RIVERPOINT TWO LLC Address: PO BOX 20399 , SEATTLE WA 98102 Contact Person: Name: BUTCH HIIMPHRES Address: 855 TROSPER RD #108 BOX 365 , TUMWATER WA, 98512 Contractor: Name: S & H ELECTRIC INC Address: 855 TROSPER RD #108 , TUMWATER WA 98512 Contractor License No: SHELEI *044JZ Phone: 206 793 -2421 Phone: 360 352 -1621 Expiration Date: 04/10/2014 DESCRIPTION OF WORK: CONNECT 15KVA UPS UNIT, ADD (2) POWER POLES, AND (1) DUPLEX OUTLET. Value of Electrical: NRES: $4,500.00 RES: $0.00 Type of Fire Protection: UNKNOWN Electrical service provided by: Permit Center Authorized Signature: I hereby certify that I have read and e governing this work will be complied AkikijortS Fees Collected: $223.13 National Electrical Code Edition: 2008 Date: o 2 ed this permit and know the same to be true and correct. All provisions of law and ordinances hether specified herein or not. The granting of this permit does not pre construction or the performance of • rk. e to give authority to violate or cancel the provisions of any other state or local laws regulating I am autho ed to sign and obtain this electrical permit. C /-76,/-Y1 /7x6' S Date: /7-7-72--- 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 -1006 Printed: 11 -01 -2012 • PERMIT CONDITIONS Permit No. EL12 -1006 * *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 -1006 Printed: 11 -01 -2012 CITY OF TUKWISP Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 htto://www.ci.tukwila.wa.us 41101 Electrical Permit No. Project No. 6L12 -tots (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 / g ?0 Q / xs cAD E Ay S. sOGG7.ii1' 8QL Gk I •J c` King Co Assessor's Tax No.: 11 U S 1 D On cc- Site Address: / ...9O) (4 4/4 DE A Y 3 /de Suite Number: o41:1 Floor: c2 Tenant Name: l7 / G #74 A./ V F //%%¢ .0,M/j64 / LZ$ New Tenant: Yes ❑ .. No Property Owners Name: Mailing Address: City State Zip CONTACT PERSON — Who do we contact when your permit is ready to be issued Name: Gc7 /# Me-/71742e. s Mailing Address: City State Zip Fax Number:.. 3 — 8J`oJ— SBga Day Telephone: aDlo — 79,3 — 2 2 E -Mail Address: ELECTRICAL CONTRACTOR INFORMATION aj„ L O° L) Company Name: 4 H ELECTZ f G l N C_. Mailing Address: ,t 5 7 RO 3 P_ R 4//D& EOX 3 IL`L M(4)r 14../4 / 6' $ZZ City State Zip Day Telephone: c7^— 7/ .3 '—oV 9c7/ E -Mail Address: Fax Fax Number: tq/'m Sv!' �2 ! /e3 Contractor Registration Number: —514 EL. E.I ' o 4l .3- Z Expiration Date: 9— /6 —�0 / T Contact Person: 8u-r -,41 iht,77,or-N, . s ', gJO V Valuation of Project (contractor's bid price): $ .5- ©O ColtiniEc7 /5XVi4 aPs at i-r , ,4Jd Scope of Work (please provide detailed information): a7 - IDDCv E po tr E s � / - d L. F 51 6u:7-Lb' Will service be altered? ❑ Yes gr No Adding more than 50 amps? ❑ Yes prNo Type of Use: 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: Applicat ions \Fomu - Applications On Line\2010 Applications \7 -2010 - Electrical Permit Application.doc 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 $10.50 ea PERMIT APPLICATION NOTES - Value of Construction – In all cards, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject to possible revision by the Permit Center to comply with current fee schedules. Expiration of Plan Review – Applications for which no permit is issued within 180 days following the date of application shall expire by limitation. The Building Official may grant one extension of time for an additional period not to exceed 90 days. The extension shall be requested in writing and justifiable cause demonstrated: I HEREBY CERTIFY THAT I HAViRgAD AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE'UNDER PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNER OR ELECTRICAL CONTRACTOR: Signature: —8/LL C Date: /D — c,2 lag Print Name: £,& 1 C • h'GGl�'1p,�J,ii _ .S Day Telephone: o![:6 - 2g..3—‘29/c2 Mailing Address: g55 . �ie0$P /may' /4 k 3 S % vo,47Ee, Zak 9/57.20 City State Zip Staff Initials: I IDate Application Accepted: 10 Date Application Expires: H:Wpplications\Fonns- Applications On Line\2010 Applications \7 -2010 - Electrical Permit Application.doc bh Page 2 of 2 ICI �ti21 I� • 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 Parcel No.: 7888900175 Address: 18300 CASCADE AV TUKW Suite No: Applicant: HIGH FIVE RECEIPT Permit Number: EL12 -1006 Status: PENDING Applied Date: 10/22/2012 Issue Date: Receipt No.: R12 -02921 Payment Amount: $223.13 Initials: JEM Payment Date: 10/22/2012 10:34 AM User ID: 1165 Balance: $0.00 Payee: S & H ELECTRIC INC. TRANSACTION LIST: Type Method Descriptio Amount Payment Check 8875 223.13 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PERMIT - NONR ELECTRICAL PLAN - NONRES 000.322.101.00.00 178.50 000.345.832.00.00 44.63 Total: $223.13 rinr• RPCaint -(1R PrintMrl• 1(1 -22 -2(112 INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT N0. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 ' (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 tooc Project: ki-at( rqk .4 Type of Inspection:, Address: (y etc500x Date Called: Special Instructions: Om. RI 0Ik tat- 4003 Date Wanted:. If v& a.m., p.m: Requester: Phone No XlApproved per applicable codes. COMMENTS: 1 ElCorrections required prior to approval.. Inspector: ,311/56,)„i Date: 09 /i- n REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinsPection. 'PERMIT COORD COPA� PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: EL12 -1006 DATE: 10/22/12 PROJECT NAME: HIGH FIVE SITE ADDRESS: 18300 CASCADE AV, STE 220 X Original Plan Submittal Response to Correction Letter # Response to Incomplete Letter # Revision # after Permit Issued DEPARTMENTS: ��.94.11, Building Division III Public Works Fire Prevention Structural Planning Division E ❑ Permit Coordinator ❑ DETERMINATION OF COMPLETENESS: (Tues., Thurs.) DUE DATE: 10/25/12 Complete IR Incomplete ❑ Not Applicable ❑ Comments: Permit Center Use Only INCOMPLETE LETTER MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: LETTER OF COMPLETENESS MAILED: TUESITHURS ROUTING: Please Route ki Structural Review Required ❑ No further Review Required ❑ REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 11/22/12 Approved ❑ Approved with Conditions g. Not Approved (attach comments) ❑ Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Contractors or Tradespeople Pr °r 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 5 13 H ELECTRIC INC 3603521621 855 Trosper Rd #108 BOX 365 Tumwater WA 98512 Thurston Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 601703614 Active SHELEI *044JZ Electrical Contractor 4/9/1996 4/10/2014 General Unused Electrical Administrator INFORMATION License SCHWESR9320J Name SCHWENK, SCOTT R Status Active Business Owner Information Name Role Effective Date Expiration Date HUMPHRES, EARL Agent 04/09/1996 9/17/2012 HUMPHRES, BRIAN President 01/18/2011 $250.00 HUMPHRES, EARL Vice President 01/18/2011 ELECTRICAL CITATION SMITH,WILLIAMH Member 04/09/1996 01/03/2011 HUMPHRES, TERRI Secretary 04/09/1996 01/03/2011 Bond Information No records found for the previous 6 year period Assignment of Savings Information Page 1 of 1 Savings Assignment of Savings Account Number Effective Date Release Date Assignment Type Impaired Date Amount Received Date 1 4/8/1996 Until Released Bond $4,000.00 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 EPEJP00335 9/17/2012 19.28.161 RCW ELECTRICAL CITATION Satisfied $250.00 EBRIC00799 4/25/2007 19.28.161 RCW ELECTRICAL CITATION Satisfied $500.00 EVANC00253 3/12/2007 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 EHATR00288 7/10/2007 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 https: // fortress .wa.gov /lni/bbip/Print.aspx 11/01/2012 L' L P S V. A -. 39 l REVIEWED FOH COMPLIANCE WITH NFPA 70 NEC SEPARATE PERMIT REQUIRED FOR: Eg Mechanical ❑ Electrical 1 Plumbing 12 Gas Piping City of Tukwila BUILDING DIVISION OCT 3 0 2012 'Ew City o BUILDING ISION, d11 to t 'Wj+ S'A t. "rY "'A+�'•+LLr "Ilr CUSTOM N 1VIC PLY HAM '. W44. 41 r44,1,%- y. u. 4h N ?4,444014i.M!4.14wwNHar'i4.lit. '. " -I J:.v•:,`•, •I ':1 "Pr'Wi104, 1,i. -'0,1,.,41,1,0.r4.'i%„e%+r+eN •:At:.1- .t•'.:A}•.nm -.m -. F,,'' ;r'.. M .•.:••••I'1: :Iti M.Y, "e!,?'dt:w 1::'5,: ,::. AhNWIr4r:,;;:c. 31,0* SERVE • . Vm{t:s14+w Aur NA u'A+M ?•M; {! !wuT.l,y .: 4.wii r+Im'N4' nao•*4nnnF,m.T+ "1411=44'.V.' _:. Fw:M .'.:.• :. '.' ':+F +;i N•k. .: ,, t_ 4Y'..1' ', r+wr..wA: '. .. M+,.riF 4 +A x' ii, �rryHFMnM.MeArwrj r ".i: Nw.M'.rih.wv.. AIW A4 ri4-4 µMAR W4-414.044110 11tryU.MfVNN CONFERENCE h +4^14TI,FAYMM•YInA! ' rr.%nn- ..."*...,..+H,4,,, • . ':• • •. I,. 'b H'a+y.FH4:4444 !6NANM :, 4I d WIN I. ∎,1 NnyllN. ro- ... wr ' 0.nl.rteMmM.V14. ! ,,,. '.. '.. ' •irnM:fnh' •erad-lkrvielF.Nn'i1;.• tl. 'ld lwlotWNINn ' 111tOn ■ •FR0r"1'1"'t' 'H.:1'. Y.."...rW44,,,,%n..tM .AL ■4 . 1.F ■■.+ ww,r PRINTER , Wit ,' .1 4' 1 tl t' 1F 11K . 0111' R "I 4r... <'.,;15 HY'AtiVh N.t #'.d•gy•FM�h+irMW.w{.wp Y4#4%ifk .A'{NMItN 0k.4rrt .4'':1;11 ' itl:A..1:0- 1'$.1:1: •..4 11 y...n 1. {. GRANT A TNT .rr rylHIT sr 47 ERIC TAMMY EMILY •.VHttlA..l'AA4Md'� . - n14IF,1Vl'+tA 1. 5.x.+1W1A41mlI' + "I' ‘,44‘ t1' TWA 1&5e)e) • rrMF'rnxM+,u�1'MWAV.�A'- ,•.rn'. 1f —no Ku) \ / /AA ' 0 % - 20'2 AVE .. S. 4, 1 61/4 .. 1 1111, 414,1 b+A■ REVISIONS No changes shall be made to the scope of work without prior approval of Tukwila Building Division. t\ r1 : Revisions will require a new plan submittal 'n :i rn:A j include additional plan review fz.e3. j FILE COPY . Permit N0.. tn-- -100Co Pion r:'view approval is subject to errors and omissions. Approval of construction documents does not authelz ezc E olation of any adopted code or ordinary.. Receipt el approved Field Copy and }' s > , s is acknowledged: By Date: * //. City Of Tukwila . BUILLING DIVISION CITY OFTUK IA' OCT 222012 PERMIT CENTER 12- I Qo(