HomeMy WebLinkAboutPermit EL13-0484 - TAHOMA CLINIC - LOW VOLTAGETAHOMA CLINIC
6835 FORT DENT WY
EL1 3-0484
City okukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Fax: 206-431-3665
Web site: httn://www.TukwilaWA.gov
Parcel No.: 2954900445
Address: 6835 FORT DENT WY TUKW
Project Name: TAHOMA CLINIC
ELECTRICAL PERMIT
Permit Number: EL13-0484
Issue Date: 05/20/2013
Permit Expires On: 11/16/2013
Owner:
Name: FORT DENT WAY LLC
Address: 801 SW 16TH ST #121 , RENTON WA 98057
Contact Person:
Name: KARINA VELIZ
Address: 1743 FIRST AV S , SEATTLE WA, 98134
Contractor:
Name: GUARDIAN SECURITY SYSTEMS INC
Address: 1743 1 AV S , SEATTLE WA 98134
Contractor License No: GUARDSS233K5
Phone: 206-622-6545
Phone: 206 622-6545
Expiration Date: 09/30/2014
DESCRIPTION OF WORK:
NEW FIRE ALARM INSTALLATION.
Value of Electrical: NRES: $22,320.00
RES: $0.00
Type of Fire Protection: UNKNOWN
Electrical service provided by: PUGET SOUND ENERGY
Permit Center Authorized Signature:
tio
Fees Collected:
National Electrical Code Edition:
$488.10
2008
Date:
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 o the performance of work. (II am authorized to sign and obtain this electrical permit. G�
1-7
Signature: J\1\JN`(:;k_, - Date: J .Eo. 1
arA
Print Name:
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
EL13-0484 Printed: 05-20-2013
! i
PERMIT CONDITIONS
Permit No. EL 13-0484
**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
EL13-0484 Printed: 05-20-2013
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
11.1.1PC�4
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.: 295490-0445
Site Address: 6835 Fort Dent Way Suite Number: Floor:
Tenant Name: Tahoma Clinic
PROPER.' 1.14' NER
Name: Karina Veliz
Name: Fort Dent Way LLC
Address: 1743 First Avenue South
Address: 801 SW 16th St., #121
City: Seattle State: WA
City: Renton State: WA
Zip: 98057
Cbl"TA''I"`,a',',,RSON person recag 1 projeot
C►tnutntcatti
Name: Karina Veliz
Address: 1743 First Avenue South
Address: 1743 First Avenue South
Phone: (206) 628-4990 Fax: (206) 628-4990
City: Seattle State: WA
Zip: 98134
Phone: (206) 622-6545 Fax: (206)
349-5889
Email: kveliz@guardiansecurity.com
New Tenant: m Yes ❑ ..No
ELECTRICAL CONTRACTOR INFOR11,A'IQN
Company Name: Guardian Security
Address: 1743 First Avenue South
City: Seattle State: WA Zip: 98134
Phone: (206) 628-4990 Fax: (206) 628-4990
Contr Reg No.: GUARDSS233K5 Exp Date: 07/01/2014
Tukwila Business License No.: UBI 600189667
Valuation of Project (contractor's bid price): $ 22,320
Scope of Work (please provide detailed information):
Will service be altered? ❑ Yes LZ No Adding more than 50 amps? ❑ Yes ® No
Type of Use: Low voltage
Type of work:
❑ New ❑ Addition ❑ Service Change ❑ Remodel m Tenant Improvement
m Low Voltage ❑ Generator m Fire Alarm ❑ Telecommunication ❑ Temporary Service
Property Served by:
D Puget Sound Energy ❑ Seattle City Light
H \Applications\Forms-Applications On Line \2011 Application\Electrical Pernut Application Revised 8-9-11 docx
Revised. August 2011
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Page 1 of 2
RESIDENTIAL
NEW RESIDENTIAL SERVICE
❑ New single family dwellings $152.85
(including an attached garage)
O Garages, pools, spas and outbuildings $81.90 ea
O Low voltage systems
(alarm, furnace thermostat) $59.85 ea
RESIDENTIAL REMODEL AND SERVICE CHANGES
O 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
0 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
O 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
O Temporary service (generator) $78.75
O Manufactured/mobile home service $84.00
(excluding garage or outbuilding)
❑ Carnivals $78.75
Number of concessions $10.50 ea
* 4; A;'IyLICATION
i ,3ip�,0a it I��I�hl
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:
CU\J\
Date:
05/16/2013
Print Name: Karina Veliz Day Telephone: (206) 349-5889
Mailing Address: 1743 First Ave S. Seattle WA 98134
City
H \Applications\Forms-Applications On Line \2011 Applications \Electrical Permit Application Revised 8-9-11 docx
Revised August 2011
bh
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.: 2954900445
Address: 6835 FORT DENT WY TUKW
Suite No:
Applicant: TAHOMA CLINIC
RECEIPT
Permit Number: EL13-0484
Status: PENDING
Applied Date: 05/20/2013
Issue Date:
Receipt No.: R13-01677
Payment Amount: $488.10
Initials: WER Payment Date: 05/20/2013 01:59 PM
User ID: 1655 Balance: $0.00
Payee: KARINA VELIZ
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd VISA
Authorization No. 685752
ACCOUNT ITEM LIST:
Description
488.10
Account Code Current Pmts
ELECTRICAL PERMIT - NONR
000.322.101.00.00 488.10
Total: $488.10
,a..... o......:..4 nc
Printed: 05-20-2013
INSPECTION, RECORD
Retain a copy with permit
INSPE IDN NO. ERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
Project: ••-�'�_� f Type of Inspection: ,� t1tr 1
-
Project
rIA L rC/
A/ Ii
Address:5.--(1- �rS
3
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Date Called:
Special Instructions:
V1/4#
Date Wanted:
•/o7
P•m
Reqnester:
Phone No:
Approved per applicable codes:
Corrections required prior to approval.
COMMENTS:
Date: .4
0/1/13
n REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd., Suite 100. Calt to schedule reinspection.
3
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
06) 431-3670
6300 Southcenter Blvd., #100, Tukwila. WA 98188
Permit Inspection Request Line (206) 431-2451
Projec�� llAry
Type of Inspection:
7003
Address:6,g35 6.,.
WW
Date Called:
t
^
Special Instructions:
F (...
Date Wanted:
2
l3
a.m.
P.m..„.
Phone No:
Approved per applicable codes. Corrections required prior to approval.
OMMENTS:
O
(014c,i-o•Js P1.06
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F0,44 1,1
(ziji3
REINSPECTION FEE REQUI ED. Prior to next inspection. fee must be
� p
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
Inspector:
Date: 07
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO. 1
CITY OF TUKWILA BUILDING DIVISION ke_
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
project:tl�`'
Ar
Type of Inspection:
i
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Address: %
INSPECTION RECORD
Retain a copy with permit
INSPE TION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 BUILDING,
(206) 431-3670
Permit Inspection Request Line (206) 431-2451
Project:
l eAAAlto
Type of Inspection:
7oo3
Address.- rr-
Date Called:
Special Instructions:
v\ ` ",y,"\
OA(
Date Date Wanted:
W (g
(�
a M.
Requester:
Phone No:
ElApproved per applicable codes.
t__ J Corrections required prior to approval.
COMMENTS:
kJ
24 et- fk,, eftiAAAI
efkt
Inspector:i
j
Date:! (3
n REINSPECTION' FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
12/2/2013
• •
City of Tukwila
Department of Community Development
KARINA VELIZ
1743 FIRST AV S
SEATTLE, WA 98134
RE: Permit No. EL13-0484
TAHOMA CLINIC
6835 FORT DENT WY
Dear Permit Holder:
Jim Haggerton, Mayor
Jack Pace, Director
In reviewing our current records, the above noted permit has not received a final inspection by the City of Tukwila Building
Division. Per the International Building Code, International Mechanical Code, Uniform Plumbing Code and/or the National
Electric Code, every permit issued by the Building Division under the provisions of these codes shall expire by limitation and
become null and void if the building or work authorized by such permit has not begun within 180 days from the issuance date of
such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work has begun
for a period of 180 days. Your permit will expire on 1/19/2014.
Based on the above, you are hereby advised to:
1) Call the City of Tukwila Inspection Request Line at 206-431-2451 to schedule for the next or final inspection. Each
inspection creates a new 180 day period, provided the inspection shows progress.
-or-
2) Submit a written request for permit extension to the Permit Center at least seven(7) days before it is due to expire.
Address your extension request to the Building Official and state your reason(s) for the need to extend your permit.
The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is determined that your
extension request is granted, you will be notified by mail.
In the event you do not call for an inspection and/or receive an extension prior to 1/19/2014, your permit will become null and void
and any further work on the project will require a new permit and associated fees.
Thank you for your cooperation in this matter.
Sincerely,
Je inife Marshall
Petechnician
File No: ELI3-0484
6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665
Contractors or Tradespeople toter 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
GUARDIAN SECURITY SYSTEMS INC
2066226545
1743 1St Ave S
Seattle
WA
98134
King
Corporation
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
600189667
Active
GUARDSS233K5
Electrical Contractor
5/25/1977
9/30/2014
Limited Energy
Hvac/Rfrg Ltd Energy
Master Electrician INFORMATION
License CLOSEF`9730H
Name CLOSE, FRANK A
Status Active
Business Owner Information
Name
Role
Effective Date
Expiration Date
DUNHAM, JOHN R
Cancel Date
01/01/1980
Bond Amount
DWTR&J CORP
Agent
11/05/2007
72BSBFT5007
CLOSE, FRANK A
President
05/25/1977
ELECTRICAL CITATION
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
8
HARTFORD FIRE INS
CO
72BSBFT5007
06/11/2010
Until Cancelled
19.28.271 RCW
ELECTRICAL CITATION
$4,000.0006/18/2010
$500.00
7
OHIO CAS INS CO
3 610 465
06/11/2003
Until Cancelled
09/02/2010
ENASE00306
$4,000.00
06/16/2003
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
Status
Violation Amount
ESHA000351
10/8/2009
19.28.101 RCW
ELECTRICAL CITATION
Satisfied
$2,000.00
EMEHU03697
2/11/2011
19.28.271 RCW
ELECTRICAL CITATION
Satisfied
$500.00
ECOXE00599
1/9/2012
19.28.101 RCW
ELECTRICAL CITATION
Satisfied
$250.00
ENASE00306
1/26/2009
19.28.101 RCW
ELECTRICAL CITATION
Satisfied
$250.00
EHRAL01075
9/5/2012
19.28.101 RCW
ELECTRICAL CITATION
Satisfied
$250.00
EJEFS00338
7/25/2011
19.28.101 RCW
ELECTRICAL CITATION
Satisfied
$2,000.00
ERADW00296
6/15/2012
19.28.161 RCW
ELECTRICAL CITATION
Satisfied
$500.00
EROAC00309
3/8/2012
19.28.101 RCW
ELECTRICAL CITATION
Satisfied
$2,000.00
httns://fortress.wa.aov/lni/bbin/Print.asnx 05/20/2013