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Home My WebLink AboutPermit EL13-0352 - TAHOMA CLINIC - LOW VOLTAGETAHOMA CLINIC 6835 FORT DENT WY EL1 3-0352 City ofTukwila 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.: 2954900445 Address: 6835 FORT DENT WY TIIKW Project Name: TAHOMA CLINIC ELECTRICAL PERMIT Permit Number: EL13-0352 Issue Date: 04/12/2013 Permit Expires On: 10/09/2013 Owner: Name: FORT DENT WAY LLC Address: 801 SW 16TH ST #121 , RENTON WA 98057 Contact Person: Name: KIRSTEN FAUSKO Address: 1221 2 AV N , KENT WA, 98032 Contractor: Name: HERMANSON COMPANY LLP Address: 1221 2 AV N , KENT WA 98032 Contractor License No: HERMACL995DK Phone: 253 796-5892 Phone: 206 575-9700 Expiration Date: 03/12/2015 DESCRIPTION OF WORK: LOW VOLTAGE: ADDING CONTROLS TO (10) AIR HANDLING UNITS AND (2) OUTDOOR UNITS. Value of Electrical: NRES: $19,000.00 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: I hereby certify that I have read and ex governing this work will be complie with Date: $419.30 2008 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 pr e to give authority to violate or cancel the provisions of any other state or local laws regulating construction or t e = - orm• - of work. I am authorized to sign and obtain this electrical permit. Signature: .rrAs. -= Date: yif` Zi f -3 Print Name: K-1,,r5I c r FCTIX,5 This permit 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 EL13-0352 Printed: 04-12-2013 0 • PERMIT CONDITIONS Permit No. EL13-0352 **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 EL13-0352 Printed: 04-12-2013 CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaW A. 9,ov Electrical Permit No. - U(2, --p 9A-2_, Project No. Date Application Accepted: d1LI1- l3 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.: 295490-0445 Site Address: 6835 Fort Dent Way Suite Number: Floor: Tenant Name: Tahoma Clinic PROPERTY OWNER Name: Kirsten Fausko Name: Tahoma Clinic Address: 1221 2nd Ave N Address: 801 SE 16th Street Suite 121 City: Kent State: WA City: Renton State: WA Zip: 98057 CONTACT PERSON — person receiving all project communication Name: Kirsten Fausko Address: 1221 2nd Ave N Address: 1221 2nd Ave N City: Kent City: Kent State: WA Zip: 98032 Phone: (253) 796-5892 Fax: (253) 796-5992 Email: kfausko@hermanson.com Tukwila Business License No.: New Tenant: ❑ Yes ELECTRICAL CONTRACTOR INFORMATION Company Name: Hermanson Address: 1221 2nd Ave N City: Kent State: WA Zip: 98032 Phone: (206) 575-9700 Fax: (206) 575-9800 ContrReg No.:HE( 1AC1 15-D4xpDate: p3/'iiS Tukwila Business License No.: 0-9,._ i 1 Sq Valuation of Project (contractor's bid price): $ °I) 000 Scope of Work (please provide detailed information): Adding controls to 10 air handling units and 2 outdoor units Will service be altered? ❑ Yes ❑ No Adding more than 50 amps? ❑ Yes ❑ No Type of Use: Type of work: 0 New 0 Addition 0 Service Change 0 Remodel ❑ Tenant Improvement m Low Voltage 0 Generator ❑ Fire Alarm 0 Telecommunication 0 Temporary Service Property Served by: Puget Sound Energy 0 Seattle City Light H:\Applications\Forms-Applications On Line \2011 Apphc lions\Electncal Permit Application Revised 8-9-11 docx Revised' August 2011 bh 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 OWNER OR ELECTRICAL CONTRACTOR: Signature: Print Name: 41xsf e V!Forits,o Mailing Address: 1 2--2-1 Z V' JV • H:Upplicazions\Forms-Applications On Line \2011 Applications \Electrical Permit Application Revised 8-9-11.docx Revised: August 2011 bh Date: a Day Telephone: 253 ---7°16, -S l 2.. Vlfi WA- `'1 Spy 2 City State Zip Page 2 of 2 SET RECEIPT RECEIPT NO: R13-01308 Initials: JEM User ID: 1165 Payee: KRISTEN FAUSKO, HERMANSON COMPANY LLP Payment Date: 04/12/2013 Total Payment: 1,203.11 SET ID: 0412 SET NAME: HERMANSON SET TRANSACTIONS: Set Member Amount EL 01 3 419.30 3-066 783.81 TOTAL: 4719 : 3ar' TRANSACTION LIST: Type Method Description Amount Payment Credit C VISA ACCOUNT ITEM LIST: Description TOTAL: 1,203.11 1,203.11 Account Code Current Pmts ELECTRICAL PERMIT - NONR MECHANICAL - NONRES PLAN CHECK - NONRES 000.322.101.00.0 000.322.102.00.0 000.345.830 TOTAL: 419.30 627.05 156.76 1,203.11 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 65cz- Project: ,1r/i / /A-40 11 t IA i Type of Inspection: 2i Do Address:Date �n83�'�r--��Jr" Called: Special Instructions: Date Wanted:a.m. -7(i.3 p. • Requester: Phone No: Approved_ per applicable codes. 0 Corrections required prior to approval. gm COMMENTS: Date: 07 3 n REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite .100. Call to schedule reinspection. Contractors or Tradespeople .ter Friendly Page 1 Electrical Contractor A business licensed by LEtI 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 HERMANSON COMPANY LLP 2065759700 1221 2Nd Ave N Kent WA 98032 King Limited Liability Partnership UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 602004844 Active HERMACL995DK Electrical Contractor 3/12/2001 3/12/2015 General Unused Other Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status HERMAC*01303 HERMANSON CORPORATION Electrical Contractor Hvac/Rfrg Ltd Energy Unused 9/23/1999 9/23/2001 Archived HERMAC'066QQHERMANSON CORPORATION Electrical Contractor Limited Energy Unused 11/18/1994 11/18/2000 Archived Electrical Administrator INFORMATION License REINHJS956RK Name REINHARDT, JEFFREY S Status Active Business Owner Information Name Role Effective Date Expiration Date HENGL, STEPHEN Partner/Member 03/14/2011 DYCKMAN, KENNETH Partner/Member 03/14/2011 ROBINETT, PAUL Partner/Member 03/14/2011 NICOLAISEN, KNUT Partner/Member 03/14/2011 BROCK, DANIEL Partner/Member 03/14/2011 FOX, DEAN Partner/Member 03/14/2011 HERMANSON, RICHARD L Partner/Member 01/01/1980 ALMON, KEVIN L Partner/Member 01/01/1980 03/14/2011 MACDONALD, JAMES A Partner/Member 01/01/1980 03/14/2011 Bond Information Bond Company Name WESTERN SURETY CO Bond 2 Page 1 of 2 Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 929352307 03/09/2005 Until Cancelled $4,000.00 03/11/2005 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 httns://fortress.wa.gov/lni/bbin/Print.asnx 04/12/2013