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Home My WebLink AboutPermit EL13-0017 - JACKSON FOOD STORES - LOW VOLTAGEJACKSON FOOD STORES 13138 INTERiTRBAN AV S EL13-0017 City oiei'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.Qov Parcel No.: 0003000108 Address: 13138 INTERURBAN AV S TUKW Project Name: JACKSON FOOD STORES ELECTRICAL PERMIT Permit Number: EL13-0017 Issue Date: 01/08/2013 Permit Expires On: 07/07/2013 Owner: Name: PACWEST ENERGY LLC Address: 3450 COMMERCIAL CT , MERIDIAN ID 83642 Contact Person: Name: PHILIP GAUNTLETT Address: PO BOX 397 , JEFFERSON OR, 97352 Contractor: Name: COUNTRYSIDE ELECTRIC Address: PO BOX 397 , JEFFERSON OR 97352 Contractor License No: COUNTEI893N4 Phone: 541 974-6415 Phone: (541)974-6415 Expiration Date: 08/24/2013 DESCRIPTION OF WORK: RECABLE LOW VOLTAGE WIRING AND ADD (1) OUTDOOR FIXTURE Value of Electrical: NRES: $700.00 RES: $0.00 Type of Fire Protection: UNKNOWN Electrical service provided by: SEATTLE CITY LIGHT Permit Center Authorized Signature: I hereby certify that I have read an governing this work will be compli The granting of t 's constructio Signature: Print Name: rmitd'y��-,• 14... Fees Collected: $84.00 National Electrical Code Edition: 2008 N '\7Y� Date: DI I I1J ned this permit and know the same to be true and correct. All provisions of law and ordinances whether specified herein or not. e to give authority to violate or cancel the provisions of any other state or local laws regulating I am authorized to sign and obtain this electrical permit. Date: 1-8 f --rd �2 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 EL13-0017 Printed: 01-08-2013 • **ELECTRICAL** PERMIT CONDITIONS Permit No. EL 13-0017 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 EL 13-0017 Printed: 01-08-2013 CITY OF TUKWII Community Developmeepartment Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.Tul:w i la WA .gov Electrical PerliNo. \' 0D' Project No. Date Application Accepted: Date Application Expires: (Forojice 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** Kin Co Assessor's Tax No.: Site Address: Ly . ra al�'G f l t d Aue... 6 T -t CVOASuite umber: Floor: Tenant Name: JOt: 95106 Feae to t � C. .6 c511 New Tenant: ❑ Yes No C/( OW() -Q1c4 PROPERTY OWNER Name: !�� wC.�� ``+�C6x1Q6 ` Vu1-00c1 G 10 re Address:•(7) /NS rkiAC r-rl �, 0 I 0 Al) City: 1 Li1.W `� SUtate: N Zip: 1 iv, CONTACT PERSON — person receiving all project communication Name: ph t< t (1:xtordtv4 Address ,6 I City: U L c 40 State:®" Zip:11662 1111 Phone:591 17 1L" Fax: ! l Email \Ci °CV' COOT I%(At"e-K 4s1.C. IC, CYH ELECTRICAL CONTRACTOR INFORMATION, Company Name:e _:xi 1- cc j4e. ;� 1 C roc j.1 .1 .<J Address: y 7 City: VL t ' :,)ri.J State: OR Zip:9 35,Q Fax: Phone: ri' /p./ 1 V' 406' Contr Reg No. ° Exp Date: �et1�/��(313 Tukwila Business License No.; 5q -19 I t c 4 Valuation of Project (contractor's bid price): $ "7®� Scope of WO (please rovide detailed information): �GpliC LO�,A.d Veli cat.)3 V;ytuft .j Will service be altered? ❑ Y s Type of Use: h,C3 Type of work: ❑ New Low Voltage Property Served by: No k Adding more than 50 amps? ❑ Yes y No get Addition ❑ Generator y ❑ Service Change ❑ Fire Alarm Seattle City Light H:Wpplications'Forms-Applications On Lme\2011 Applicauons\Electncal Permit Application Revised 8-9-1 I.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) El 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 111 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 OWIER 0 ELEC 0 TRACTOR: Signatu Print Name: tt � Mailing Address: 91 H \Applications\Forms-Applications On Line \201 I Apphcations\Electrical Permit Application Revised 8-9-11 docx Revised August 2011 bh ay Telephone: City Date: 1 g'031 3 X91 q 71 (0 LI L6 a ct State Zip Page 2 of 2 it �`N1LA w 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.: 0003000108 Permit Number: EL13-0017 Address: 13138 INTERURBAN AV S TURIN Status: APPROVED Suite No: Applied Date: 01/08/2013 Applicant: JACKSON FOOD STORES Issue Date: Receipt No.: R13-00084 Initials: JEM User ID: 1165 Payment Amount: $84.00 Payment Date: 01/08/2013 09:33 AM Balance: $0.00 Payee: PHILIP GAUNTLETT, COUNTRYSIDE ELECTRIC INC TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd MC Authorization No. 07240Z ACCOUNT ITEM LIST: Description 84.00 Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 84.00 Total: $84.00 Drin+od• n1_na_�n1z INSPECTION.NO. CITY OF•TUKWILA BUILDING DIVISION r 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 INSPECTION RECORD Retain a copy with permit PERMIT NO. Permit Inspection Request Line (206) 431-2451 Project.: °-''� 60 A 0 D Type of Inspection: G fou Address: 1 310 / t— ,k/7 Date Called: SpecialInstructions: . Date Wanted:. /hi" m� Requester: Phone No: EApproved per applicable codes. a COI1MENTS; i Corrections required prior tQ.approval. 1 / Inspector: Date: of 13 n REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. I CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 , (206) 431-36 Permit,Inspection Request Line (206) 431-2451 { j,13-oo(J Project:: -C 50- 0� Type of Inspection: 7100 Address: r -: - i3 f3Y OriAik3 Date Called: — Special Instructions: - Date Wanted:. a".m. Requester: I Phone No: jApproved per applicable codes. O Corrections required prior to approval. COMMENTS: g(-lock4-Viik IfILI • et f/ Inspector:: LAI % r f e Date: Of/Ei 1, 3 ri 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 Electrical Contractor A business licensed by L&1 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 COUNTRYSIDE ELECTRIC INC 5419746415 Po Box 397 Jefferson OR 97352 Out Of State Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 603137454 Active COUNTEI893N4 Electrical Contractor 8/24/2011 8/24/2013 General Unused Electrical Administrator INFORMATION License BROMLJJ981 C2 Name BROMLEY, JEFFREY JAY Status Active Business Owner Information Name Role Effective Date Expiration Date GALLOWAY, DALE III Agent 08/24/2011 BROMLEY, JEFFERY J President 08/24/2011 GAUNTLETT, PHILIP D President 08/24/2011 RONER, JOSHUA A President 08/24/2011 Bond Information Page 1 of 1 Bond 1 Bond Company Name Developers Surety & Indem Co Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 253609C 08/22/2011 Until Cancelled $4,000.00 08/24/2011 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 EBRR000604 9/4/2012 19.28.101 RCW ELECTRICAL CITATION S Status Violation Amount atisfied $250.00 https://fortress.wa.gov/lni/bbip/Print.aspx 01/08/2013