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Permit EL13-0819 - TAHOMA CLINIC - LOW VOLTAGE
TAHOMA CLINIC 6839 FORT DENT WY EXPIRED 04/05/14 EL13-0819 City Aukwila • 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: 6839 FORT DENT WY TUKW Project Name: TAHOMA CLINIC ELECTRICAL PERMIT Permit Number: EL13-0819 Issue Date: 08/28/2013 Permit Expires On: 02/24/2014 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: LOW VOLTAGE: REPLACE SECURITY PANEL AND ADD WIRELESS DEVICE. Value of Electrical: NRES: $7,000.00 Fees Collected: $218.70 RES: $0.00 Washington Cities Electrical Code: 2011 Type of Fire Protection: UNKNOWN Electrical service provided by: PUGET SOUND ENERGY Permit Center Authorized Signature: I hereby certify that I have read and governing this work will be complie The granting of this permit does not pres construction or the performance of work. I am authorized to sign and obtain this electrical permit. Signature: Print Name: Date: 04011'5 d this permit and know the same to be true and correct. All provisions of law and ordinances hether specified herein or not. to give authority to violate or cancel the provisions of any other state or local laws regulating Date iPzb'/13 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 -7/13 EL13-0819 Printed: 08-28-2013 • • PERMIT CONDITIONS Permit No. EL13-0819 **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 -7/13 EL13-0819 Printed: 08-28-2013 CITY OF TUKWIA Community Development Department Permit Center 6300 Southcenter Blvd, Suite 100 Tukwila, WA 98188 http://www.TukwilaWA. gov • I I Electrical Permit No. L k 9— Oi (.1 Project No. Date Application Accepted: n t2elAL 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 Site Address: 6839 Fort Dent Way Tenant Name: Tahoma Clinic PROPERTY OWNER Name: Karina Veliz Name: Fort Dent Way LLC City: Seattle State: WA Zip: 98134 Address: 6835 Fort Dent Way Email: kveliz@guardiansecurity.com City: Tukwila State: WA Zip: 98168 CONTACT PERSON — person receiving all project communication Name: Karina Veliz Address: 1743 First Avenue South City: Seattle State: WA Zip: 98134 Phone: (206) 622-6545 Fax: (206) 349-5889 Email: kveliz@guardiansecurity.com King Co Assessor's Tax No.: 9202470010 Suite Number: Floor: New Tenant: ❑ Yes ® ..No ELECTRICAL CONTRACTOR INFORMATION Company Name: Guardian Security Systems 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.: 01121 Valuation of Project (contractor's bid price): $ Scope of Work (please provide detailed information): Low Voltage: Replace Security Panel. Add wireless device Will service be altered? ❑ Yes © No Adding more than 50 amps? ❑ Yes © No Type of Use: Low Voltage: Installing AES Radio Transmitter Type of work: 0 New m Addition ❑ Service Change 0 Remodel ❑ Tenant Improvement Low Voltage ❑ Generator ❑ Fire Alarm ❑ Telecommunication ❑ Temporary Service Proser Served b Puget Sound Energy 0 Seattle City Light H:\Applications\Forms-Applications On Line \201 I Applications\Electrical Permit Application Revised 8-9-I Ldocx 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 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) O 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 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 O 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: Karina Veliz Date: f7L3 Day Telephone: (206) 349-5889 Mailing Address: 1743 First Ave S. Seattle WA 98134 City H:Wpplicanons\Forms-Applications On Line \201 I ApplicationsTlectrical 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.: 2954900445 Permit Number: EL13-0819 Address: 6839 FORT DENT WY TUKW Status: APPROVED Suite No: Applied Date: 08/28/2013 Applicant: TAHOMA CLINIC Issue Date: Receipt No.: R13-02489 Initials: JEM User ID: 1165 Payment Amount: $218.70 Payment Date: 08/28/2013 10:15 AM Balance: $0.00 Payee: GUARDIAN SECURITY SYSTEMS, ANDREW VEZZANI TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 653463 ACCOUNT ITEM LIST: Description 218.70 Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 218.70 Total: $218.70 ,4,.n• Derci,+j Printed. 08-28-2013 INSPECTION NO. INSPECTION RECORD Retain a copy with permit kf 34/ 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:Type kto,'k CL;A+lit, of Inspection: Zrtoo Address: (J3rer Der.4,.. Date Called: Special Instruction ��1 `^ ""'' 1 Date Wanted: /o�6 a.. Requester: Phone No: - Approved per applicable codes. COMMENTS: FiCorrections required prior to approval. - (i01oJ�, /b451/441)oP4`1) EQJ� P hfy�J'i Amu) cA6unceti Inspector: r f* Date: REINSPECTION FEE REQUIRED. Priorto next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. 3/3/2014 • • City of Tukwila Department of Community Development KARINA VELIZ 1743 FIRST AV S SEATTLE, WA 98134 RE: Permit No. EL13-0819 TAHOMA CLINIC 6839 FORT DENT WY Dear Permit Holder: Jim Haggerton, Mayor Jack Pace, Director New inspection Re 206 43 quest Line 8-9356 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 4/5/2014. 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 4/5/2014, 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, S fer Marshall t Technician File No: EL13-0819 6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 Contractors or Tradespeople Peter Friendly Page I Page 1 of 2 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 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*973OH 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 DWTREtJ CORP Agent 11/05/2007 72BSBFT5007 CLOSE, FRANK A President 05/25/1977 Bond Information 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 $4,000.00 06/18/2010 7 OHIO CAS INS CO 3 610 465 06/11/2003 Until Cancelled 09/02/2010 $4,000.00 06/16/2003 Assignment of Savings Information No records found for Insurance Information No records found for the previous https://fortress.wa.gov/1ni/bbip/Print.aspx • the previous 6 year period 6 year period 08/28/2013