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Home My WebLink AboutPermit EL13-0983 - QDOBA - TENANT IMPROVEMENTQDOBA 100 ANDOVER PK W CANCELLED 10-25-13 EL1 3-0983 City oPfukwila 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.: 0223000020 Address: 100 ANDOVER PK W TURIN Project Name: QDOBA ELECTRICAL PERMIT Permit Number: EL13-0983 Issue Date: 10/09/2013 Permit Expires On: 04/07/2014 Owner: Name: OPEN FRAME LLC Address: PO BOX 654 , KIRKLAND WA 98083 Contact Person: Name: RHONDA MILLER Address: 3400 JR DAVIS DRIVE , LITTLE ROCK AR, 72209 Contractor: Name: STALEY INC Address: 3400 JE DAVIS DR , LITTLE ROCK AR 72209 Contractor License No: STALEI*907CK Phone: 720 259-4667 Phone: 501 565-3006 Expiration Date: 02/10/2014 DESCRIPTION OF WORK: INSTALL (1) 20 AMP 120V CIRCUIT AT COKE MACHINE Value of Electrical: NRES: $200.00 RES: $0.00 Type of Fire Protection: SPRINKLERS/AFA 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 xami with, Fees Collected: $65.00 Washington Cities Electrical Code: 2011 Date: ed this permit and know the same to be true and correct. All provisions of law and ordinances hether specified herein or not. The granting of this permit does not pre e to give authority to violate or cancel the provisions of any other state or local laws regulating construction thg perfc�m�tµce of work. I am authorized to sign and obtain this electrical permit.i. (( Signature: Print Name: 1 - ' 1 k''(,/ CA ft L- L..."— This 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. • Date: ID/ / /13 doc: EL -7/13 EL13-0983 Printed: 10-09-2013 PERMIT CONDITIONS Permit No. EL13-0983 **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 EL13-0983 Printed: 10-09-2013 • CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Electrical Permit No. E D ii; 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 Site Address: I c3 O A-4 1)y\ E42. Tenant Name: ab 3 A. King Co Assessor's Tax No.: v002—V Suite Number: Floor - New Tenant: ❑ Yes Er No PROPERTY OWNER , Name: IZ1404t p A Mki1.14F e_. - _ _ - __ Name: Phone:'720 • ZS9 •'lb (o%Fax. 3 O 3 , r7 r-1 el- Lis01 Email: rw,•o, Il ex -P s -4-e. 4 if.t.c .cow -L Address: City: State: Zip: CONTACT PERSON - person receiving all project , "communication ,_•________2 • -_ --'--_-'___-� Name: IZ1404t p A Mki1.14F e_. Address: 3 4 00 3 F, D Atv i 5 D12_14/G City: LATH.& ZOOG,- State: Zip: Phone:'720 • ZS9 •'lb (o%Fax. 3 O 3 , r7 r-1 el- Lis01 Email: rw,•o, Il ex -P s -4-e. 4 if.t.c .cow -L : ELECTRICAL CONTRACTOR INFORMATION „_ Company Name: STA LE\/. 1 "IC / Address: 3 Li 0 C.) J•E- . t•AVI 3 !-Ce City: Lt-rrL—e-R.0CV . State: tot. Zip'22.04 Phone:. 2JD ' 2SC1 •'4 (1 Fax 303'779 -1 S 0 I. Contr Reg No.: s�� * °JOiLiLExp Date: OZ! t4 Tukwila Business License No.; G�sOqQ 4'7 LI S Valuation of Project (contractor's bid price): $ .2.13 0 .0° Scope of Work (please provide detailed information): 14. S TiN Lit l , 2.0 P.,M,iP • I L.o e.-.1 f-.1- t "- Ar C`fD ve- NV/1,0441.4 • Will service be altered? ❑ Yes It -No Adding more than 50 amps? ❑ Yes [] No Type of Use: Tvae of work: ❑ New ❑ Addition ❑ Service Change [Remodel ❑ Tenant Improvement ❑ Low Voltage 0 Generator 0 Fire Alarm 0 Telecommunication ❑ Temporary Service Property Served by: aPuget Sound Energy 0 Seattle City Light 1-BApplicatiuno\Fonus•Applicatwns On Lwe\2013 Apphcauonsl[item umai Pc:Alba Apphcauon Revised 7-I-13.doux Revised: July 2013 bh Page I 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 71. 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 O Temporary service (residential) $65.00 ❑ Temporary service (generator) - $80.90 ❑ Manufactured/mobile home service $86.25 (excluding garage or outbuilding) ❑ Carnivals, $80.60 Number of concessions $10.80 ca Each ride and generator truck $10.80 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 fec 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 I-IEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY TI -IE LAWS OF THE STATE OF WASHINGTON, AND 1 AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNER OR ELECTRICAL CONTRACTOR: Signature: Rk•ar4.-_ u.9f2 Print Name: Date: 1,0 13 Day Telephone: w • 25c1.- to'"? Mailing Address: 34160 JE AV.S ()ewe _ TtLee.O'( -. ''1.27_09 I City H'1ApplicanonsWorms•Applicauons On 1.ine1201.1 Applicanons1Electrical Permit Application Revised 7-1-13,docx Revised: July 2013 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.: 0223000020 Permit Number: EL13-0983 Address: 100 ANDOVER PK W TUKW Status: PENDING Suite No: Applied Date: 10/09/2013 Applicant: QDOBA Issue Date: Receipt No.: R13-02839 Initials: User ID: JEM 1165 Payment Amount: $65.00 Payment Date: 10/09/2013 11:34 AM Balance: $0.00 Payee: MIKE SCHRECK 24, STALEY INC TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 085856 ACCOUNT ITEM LIST: Description 65.00 Account Code Current Pmts ELECTRICAL PERMIT - NONR 000.322.101.00.00 65.00 Total: $65.00 Printed: 10-09-2013 November 20, 2013 City of Tukwila Jim Haggerton, Mayor Department of Community Development Jack Pace, Director Rhonda Miller Saley, Incorporated 425 W 112 Ave, Unit 2 Northglenn, CO 80234 RE: Refund for Permit Number EL13-0983 Dear Ms. Miller A request for permit cancellation and refund of permit EL13-0983 was received by the Tukwila Permit Center. The Building Official has determined that this permit can be cancelled and eighty percent of the permit fee refunded. Enclosed is a check for a refund in the amount of $52.00 (fifty-two dollars and zero cents). Sincerely, �i ftit Jenntfe ' M hall ern t ech 'cian File: Permit No. EL13-0983 Encl: Check No. 364892 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 TO: FROM: DATE: SUBJECT: MEMORANDUM Laurie Anderson Brenda Holt 11/01/2013 Qdobas, Permit EL13-0983 Please draw a check in the amount of $52.00 (fifty-two dollars and zero cents) to be payable to Staley Incorporated at 425 W 112 Ave, Unit 2 in Northglenn, CO 80234. The applicant has requested this permit be cancelled due to the fact that the permitted was not required. In response to this information, the Building Official has approved an eighty percent refund of the permit fee. Please provide the refund as follows: Account 000.322.101 (Eleetrical Permit - Res): $52.00 Please forward the check to me and I will forward it on to the applicant. Thank you! SINCE 1951 4e1Inc. 425 W. 112Th Ave. Unit 2 Northglenn, CO 80234 10/25/13 City of Tukwila Building Dept. Attn: Bob Benedicto Email to: bill.rambo@tukwilawa.gov Please accept this letter requesting a refund for permit # EL13-0983 ($65.00) that we pulled on 10/09/13. We are contracted to add a dedicated circuit for the new style coke machines in several Qdobas locations in Washington. ,However, this location already had a dedicated circuit when we arrived and a new circuit wasn't necessary. Thank you in advance for your help in any refund of the fees for this. Our corporate address is: 3400 JE Davis Drive Little Rock, AR 72209 Sincerely, Rhonda Miller Staley, Inc. Administrative Assistant (720) 259-4667 1D/3�2013 RECEIVED Crit/ OF TUKWIIA OCT 2 5 201 4'ERa4IT CENTER Contractors or Tradespeople Prier Friendly Page 1 Electrical Contractor A business licensed by LEI 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 STALEY INC 5015653006 3400 Je Davis Dr Little Rock AR 72209 Out Of State Corporation UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 602390484 Active STALEI*907CK Electrical Contractor 2/10/2010 2/10/2014 General Unused Electrical Administrator INFORMATION License FERREGG962P0 Name FERRELL, GARY G. Status Active Business Owner Information Name Role Effective Date Expiration Date CT CORPORATION SYSTEM Agent 02/10/2010 11/16/2012 STALEY, ROYCE E JR Chief Executive Officer 02/10/2010 $9,000.00 O'GARY, GREGORY President 02/10/2010 ELECTRICAL CITATION HARPER, BRENDA K Secretary 02/10/2010 9/12/2012 MOREHART, EDMOND A Vice President 02/10/2010 $250.00 STALEY, BRENT E Vice President 02/10/2010 ELECTRICAL CITATION Bond Information Page 1 of 1 Bond 1 Bond Company Name TRAVELERS CAS & SURETY CO Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 105357133 02/01/2010 Until Cancelled $4,000.00 02/10/2010 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 EJORP05374 11/16/2012 19.28.101 RCW ELECTRICAL CITATION Satisfied $9,000.00 ESTEF00388 10/19/2011 19.28.470 RCW ELECTRICAL CITATION Satisfied $250.00 ENASE00534 9/12/2012 19.28.271 RCW ELECTRICAL CITATION Satisfied $250.00 ENASE00535 9/12/2012 19.28.101 RCW ELECTRICAL CITATION Satisfied $250.00 https://fortress.wa.gov/lni/bbip/Print.aspx 10/09/2013