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Home My WebLink AboutPermit EL13-0542 - PROVIDENCE INFUSION & PHARMACY - REMODELPROVIDENCE INFUSION & PHARMACY 3333 S 120 PL EL1 3-0542 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.: 1023049079 Address: 3333 S 120 PL TIIKW Project Name: PROVIDENCE ELECTRICAL PERMIT Permit Number: EL13-0542 Issue Date: 06/04/2013 Permit Expires On: 12/01/2013 Owner: Name: SABEY CORPORATION Address: 12201 TUKW1LP 1NTL BLVD 4THFL , SEATTLE WA 98168 Contact Person: Name: GUNNAR PETZOLD Address: PO BOX 4399 , EVERETT WA, 98204 Contractor: Name: INNOVATIVE ELECTRIC INC Address: PO BOX 6783 , LYNNWOOD WA 98036 Contractor License No: INNOVEI055KE Phone: 425-290-7803 Phone: 425 290-7803 Expiration Date: 05/05/2015 DESCRIPTION OF WORK: INSTALL 1 HP MOTOR WITH 1 VFD AND 2 STOP/STARTS Value of Electrical: NRES: $1,290.00 RES: $0.00 Type of Fire Protection: UNKNOWN Electrical service provided by: SEATTLE CITY LIGHT Permit Center Authorized Signature: tat - Fees Collected: $115.50 National Electrical Code Edition: 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 • local laws regulating construction or the performance of irk.) am authorized to sign and obtain this electrical permit. Signature: Print Name: G c' (k.( t(.( e 2 2 (?S Date: 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 EL13-0542 Printed: 06-07-2013 • PERMIT CONDITIONS • Permit No. EL13-0542 **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 EL13-0542 Printed: 06-07-2013 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.Tukwila WA .gov ELECTRICAL PERMIT Parcel No.: 1023049069 Address: 3411 S 120 PL TUKW Project Name: PROVIDENCE INFUSION & PHARMACY Permit Number: EL13-0542 Issue Date: 06/04/2013 Permit Expires On: 12/01/2013 Owner: Name: SABEY CORPORATION Address: 12201 TUKWILA INTL BLVD 4THFL , SEATTLE WA 98168 Contact Person: Name: GUNNAR PETZOLD Address: PO BOX 4399 , EVERETT WA, 98204 Contractor: Name: INNOVATIVE ELECTRIC INC Address: PO BOX 6783 , LYNNWOOD WA 98036 Contractor License No: INNOVEI055KE Phone: 425-290-7803 Phone: 425 290-7803 Expiration Date: 05/05/2015 DESCRIPTION OF WORK: INSTALL 1 HP MOTOR WITH 1 VFD AND 2 STOP/STARTS Value of Electrical: NRES: $1,290.00 RES: $0.00 Fees Collected: $115.50 Type of Fire Protection: UNKNOWN National Electrical Code Edition: 2008 Electrical service provided by: SEATTLE CITY LIGHT Permit Center Authorized Signature: Je,k Date: Co ` 2-1 ( 3 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 pe 't does not presume to give authority to violate or cancel the provisions of any other state or local laws regulating construction or a ormance of # I am authorized to sign and obtain this electrical permit. Signature: � Date: �- (3 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 EL13-0542 Printed: 06-04-2013 • PERMIT CONDITIONS • Permit No. EL13-0542 **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 EL13-0542 Printed: 06-04-2013 CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Electrical Permit No. (r L,1 as142 Project No. Date Application Accepted: 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.: Site Address: 3411 S 120 Place Suite Number: Floor: Tenant Name: Providence PROPERTY OWNER Name: Gunnar Petzold Address: P.O. Box 4399 Name: City: Everett State: WA City: Everett State: WA Address: Phone: (425) 290-7803 Fax: (425) 355-1965 City: State: Zip: CONTACT PERSON — person receiving all project communication Name: Gunnar Petzold Address: P.O. Box 4399 Address: P.O. Box 4399 City: Everett State: WA City: Everett State: WA Zip: 98204 Phone: (425) 290-7803 Fax: (425) 355-1965 Email: gunnar@innovative-electric.com New Tenant: ❑ Yes ® ..No ELECTRICAL CONTRACTOR INFORMATION Company Name: Innovative Electric, Inc. Address: P.O. Box 4399 City: Everett State: WA Zip: 98204 Phone: (425) 290-7803 Fax: (425) 355-1965 Contr Reg No.: INNOVEI055KE Exp Date: 05/05/2015 Tukwila Business License No.: 0993236 Valuation of Project (contractor's bid price): $ 1,290 Scope of Work (please provide detailed information): 1 HP Conveyor motor with 1 VFD and 2 stop/starts Will service be altered? ❑ Yes j No Adding more than 50 amps? ❑ Yes No Type of Use: Commercial Type of work: ❑ New ® Addition 0 Service Change ❑ Low Voltage 0 Generator 0 Fire Alarm Property Served by: ❑ Puget Sound Energy ® Seattle City Light H:Wpplications\Forms-Applications On Line'2011 Applications\Electrical Permit Application Revised 8-9-11.docx Revised: August 2011 bh ❑ Remodel ❑ Telecommunication O Tenant Improvement O Temporary Service 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 ❑ 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 O 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 O Low voltage systems $59.85 (alarm, furnace thermostat) MULTI -FAMILY AND COMMERCIAL Fees are based on the valuation of the electrical contract. MISCELLANEOUS FEES O 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 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 OWER OR ELECT ,., AL CONTRACTOR: Signature: r' Date: 06/04/2015 Print Name: Gunnar Petzold Day Telephone: (425) 290-7803 Mailing Address: gunnar@innovative-electric.cm Everett WA 98204 City H:\Applications\Forms-Applications On Line 12011 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 RECEIPT Parcel No.: 1023049069 Permit Number: EL13-0542 Address: 3411 S 120 PL TUKW Status: PENDING Suite No: Applied Date: 06/04/2013 Applicant: PROVIDENCE INFUSION & PHARMACY Issue Date: Receipt No.: R13-01796 Initials: WER User ID: 1655 Payment Amount: $115.50 Payment Date: 06/04/2013 11:50 AM Balance: $0.00 Payee: INNOVATIVE ELECTRIC INC TRANSACTION LIST: Type Method Descriptio Amount Payment Check 14569 115.50 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 115.50 Total: $115.50 Prinfori• nR-n4.7ni 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 Project: ?"06. j ct, Type of Inspection: 2100 Address: 3333 5 f ) 24 r Date Called: Special Instructions: • Date Wanted: 1 a.m. Requester: Phone No: Approved per applicable codes. 0 Corrections required prior to approval. toolg COMMENTS: Date: 04/143 n REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. • City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206-431-3670 Web site: http://www.ci.tukwila.wa.us REVISION SUBMITTAL Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Date: i (i(t, Plan Check/Permit Number: 0 Response to Incomplete Letter # ❑ Response to Correction Letter # Revision # after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner Project Name: Project Address: 3 3 3 5' (tO 10( ut4r ?e,7- (6( Contact Person Summary of Revision: E < <3 D54ea Phone Number: - c2 O - 760 y Sheet Number(s): "Cloud" or highlight all' areds of revision ineluding da'te'of redisiori`''"" " Received at the City of Tukwila Permit Center by: O Entered in Permits Plus on H:\Applications\Forms-Applications On Gne@010 Appbcauons\7-2010 - Revision Submittal.dac Created: 8-13-2004 Revised: 7-2010 Contractors or Tradespeople er Friendly Page • Electrical Contractor A business licensed by L8i 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 INNOVATIVE ELECTRIC INC 4252907803 Po Box 4399 Everett WA 98204 Snohomish Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 601581090 Active INNOVEI055KE Electrical Contractor 5/5/1995 5/5/2015 General Unused Master Electrician INFORMATION License PETZOG'974K7 Name PETZOLD, GUNNAR Status Active Business Owner Information Name Role Effective Date Expiration Date PETZOLD, GUNNAR HORST Cancel Date 01/01/1980 Bond Amount PETZOLD, DONNA L Agent 01/01/1980 747922C PETZOLD, DONNA L Vice President 01/01/1980 ELECTRICAL CITATION 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 3 DEVELOPERS SURETY Et INDEM CO 747922C 10/24/2007 Until Cancelled 19.28.271 RCW ELECTRICAL CITATION $4,000.0008/07/2007 $250.00 2 COLONIAL AM CAS i3 SURETY OF MARYLAND LPM4064787 10/24/2003 Until Cancelled 12/09/2007 $4,000.00 10/13/2003 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 EFONC00221 2/18/2010 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 ELEEK00242 6/16/2008 19.28.271 RCW ELECTRICAL CITATION Satisfied $250.00 EBOES00666 2/6/2012 19.28.101 RCW ELECTRICAL CITATION Satisfied $1,000.00 httns://fortress.wa.eov/lni/bbin/Print.aspx 06/04/2013