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Home My WebLink AboutPermit EL12-1043 - PERGOLA RESIDENCEPERGOLA RESIDENCE 16005 47 AV S EL12-1 043 City off 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.: 5379800175 Address: 16005 47 AV S TUKW Project Name: PERGOLA RESIDENCE ELECTRICAL PERMIT Permit Number: EL12 -1043 Issue Date: 11/02/2012 Permit Expires On: 05/01/2013 Owner: Name: PERGOLA GERRI ANN BENEDETTI Address: 16005 47TH AVE S , TUKWILA WA 98188 Contact Person: Name: JENNIFER BURGESS - NW PERMITS Phone: Address: 1345 GULF RD , POINT ROBERS WA, 98281 Contractor: Name: ADT LLC Phone: 561 - 988 -3600 Address: 11824 N CREEK PARKWAY N, SUITE 105 , BOTHELL WA 98011 Contractor License No: ADTLLL *881D0 Expiration Date: 03/20/2014 DESCRIPTION OF WORK: INSTALL LOW VOLTAGE SECURITY SYSTEM Value of Electrical: NRES: $285.00 RES: $0.00 Fees Collected: Type of Fire Protection: UNKNOWN National Electrical Code Edition: Electrical service provided by: PUGET SOUND ENERGY Permit Center Authorized Signature: $67.20 2008 Date: l I hereby certify that I have read and ex ned thi7. ermit 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 t performance of work. I am authorized to sign and obtain this electrical permit. Signature: Date: /4— ? -/z- Print Name: VV /- kCQ-✓L'L A -1 t t kO 'I j✓\ 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 -1043 Printed: 11 -02 -2012 • PERMIT CONDITIONS • Permit No. EL 12 -1043 * *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 -1043 Printed: 11 -02 -2012 CITY OF TUKW� Community Developm epartment Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 lutp://www.TukwilaWA.gov ' Electrical Pet Project No. Date Application Accepted: Date. Application Expires: (For eke use only) .6t1,2 16L-(-3 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: /6 0.03 � 4 S Tenant Name: f et/i4 ?„ryo% PROPERTY OWNER Name: l�°414; )j4--- -' �°�j NI/1�! / 171D Address: c 3 , 5 Lu JF )7 City: )?6,14- /�[ State: 4i _ Q lt. Zip: q G� l Name: �pl�� t/1/0 P��A Email: Rl/% ye_ Ci6VW1"er "'VTiam4 Phone: Fax: Address: Zp Are, City: ji 1,/ /- )1 f D._. State: p„ �A- Zip: q Rp CONTACTPERSON — person receiving all project communication Name: l�°414; )j4--- -' �°�j NI/1�! / 171D Address: c 3 , 5 Lu JF )7 City: )?6,14- /�[ State: 4i _ Q lt. Zip: q G� l ?/ Phone: Fax: City: �_GA� State: . Zip: Y" Email: Rl/% ye_ Ci6VW1"er "'VTiam4 Phone: Fax: King Co Assessor's Tax No.: Suite Number: Floor: New Tenant: ❑ Yes ,.. No :ELECTRICAL CONTRACTOR INFORMATION. Company Name: /1V7- iLLL Address: 021.t No g -A ( e J/( j( 4 City: �_GA� State: . Zip: Y" Phone: Fax: Contr Reg No.: pn 9 L f 6 1)v Exp Date: Vanc, l Tukwila Business License No.; Valuation of Project (contractor's bid price): $ 2 v S Scope of Work (please provide detailed information): Will service be alte ed? Di Yes , 7 No Adding more than 50 amps? ❑ Yes Type of Use: 1 e/l, /1/9 -�( Type of work: ❑ New ❑ Addition 70 Low Voltage ❑ Generator Property Served by: ❑ Puget Sound Energy ❑ Seattle City Light ❑ Service Change ❑ Fire Alarm H:\Applications\Forms- Applications On Line \2011 Applications\Eleclrical Permit Application Revised 8- 9- 1I.docx Revised: August 2011 bh ❑ Remodel ❑ Telecommunication ❑ 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 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: W /!/I /GL-%// /17/4(51/1 A Mailing Address: 1341.c T. / f l'cf H:\Applications\Forms- Applications On Line \2011 Applications'Electrical Permit Application Revised 8 -9 -1 1.docx Revised: August 2011 bh Day Telephone: City Date: /1-'Z- _�ZZ_ 36o - qq _pz 7 - e 7z( 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 Parcel No.: 5379800175 Address: 16005 47 AV S TUKW Suite No: Applicant: PERGOLA RESIDENCE RECEIPT Permit Number: EL12 -1043 Status: PENDING Applied Date: 11/02/2012 Issue Date: Receipt No.: R12 -03026 Initials: TLS User ID: 1670 Payment Amount: $67.20 Payment Date: 11/02/2012 10:52 AM Balance: $0.00 Payee: NORTHWEST PERMIT - ADT ACCT TRANSACTION LIST: Type Method Descriptio Amount Payment Check 2374 67.20 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 67.20 Total: $67.20 doc: Receiot -06 Printed: 11 -02 -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 -367 Permit Inspection Request Line (206) 431 -2451 Project: PeAct.oLk t5- k Type of Inspection: Address: 1 ooc H7 Av. Date Called: Special Instructions: Date Wanted:. 1( -0 " a:m P: m. Requester: Phone No: 1)t Approved per applicable codes. 0 Corrections required prior to approval.: COMMENTS: ./`\ 1.. Date: 1 iimel./ �7 1 H r7 REINSPECTION FEE REQUIRED. Prior to next inspection,: fee Must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.: Contractors or Tradespeople Prrr Friendly Page • Electrical Contractor A business licensed by List 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 ADT LLC 2067190347 11824 N Creek Parkway, N, Ste 105 Bothell WA 98011 County King Business Type Limited Liability Company Parent Company UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 603190246 Active ADTLLL`881 D0 Electrical Contractor 3/20/2012 3/20/2014 Limited Energy Unused Electrical Administrator INFORMATION License NICKOT`902DA Name NICKOLS, TIM Status Active Business Owner Information Name Role Effective Date Expiration Date GURSAHANEY, NAREN K Partner /Member 03/20/2012 BELEISCH, NELSON D Partner /Member 03/20/2012 TULSYAN, RAVI Partner /Member 03/20/2012 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 1 Federal Ins Co 82295435 03/01/2012 Until Cancelled $4,000.00 03/20/2012 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 No records found for the previous 6 year period https: // fortress .wa.gov /lni/bbip /Print.aspx 11/02/2012