HomeMy WebLinkAboutPermit EL13-0997 - SUPER SAVER FOODS - TENANT IMPROVEMENT
This record contains information which is exempt from public disclosure
pursuant to the Washington State Public Records Act, Chapter 42.56 RCW
as identified on the Digital Records Exemption Log shown below.
EL13-0997
Super Saver Foods
th
3725 S 144 St
DIGITAL RECORDS (DR) EXEMPTION LOG
THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION
Page # Code Exemption Brief Explanatory Description Statute/Rule
The Privacy Act of 1974 evinces Congress'
intent that social security numbers are a private
concern. As such, individuals’ social security
Personal Information –
numbers are redacted to protect those
Social Security Numbers 5 U.S.C. sec.
individuals’ privacy pursuant to 5 U.S.C. sec.
DR1 Generally – 5 U.S.C. sec. 552(a); RCW
552(a), and are also exempt from disclosure
under section 42.56.070(1) of the Washington
552(a); RCW 42.56.070(1)
State Public Records Act, which exempts under
42.56.070(1)
the PRA records or information exempt or
prohibited from disclosure under any other
statute.
Redactions contain Credit card numbers, debit
card numbers, electronic check numbers, credit
Personal Information –
expiration dates, or bank or other financial
RCW
9 DR2 Financial Information –
account numbers, which are exempt from
42.56.230(5)
disclosure pursuant to RCW 42.56.230(5)
RCW 42.56.230(4 5)
,
except when disclosure is expressly required by
or governed by other law.
SUPER SAVER FOODS
3725 S 144 ST
EXPIRED
04/09/14
EL1 3-0997
City okukwila
•
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-43 1-3670
Fax: 206-431-3665
Web site: http://www.TukwilaWA.gov
Parcel No.: 0040000115
Address: 3725 S 144 ST TUKW
Project Name: SUPER SAVER FOODS
ELECTRICAL PERMIT
Permit Number: EL13-0997
Issue Date: 10/11/2013
Permit Expires On: 04/09/2014
Owner:
Name: SILVERDALE-TUKWILA LLC
Address: 5209 LAKE WASHINGTON BLVD NE #100 , KIRKLAND WA 98033
Contact Person:
Name: TREVOR PETERSEN
Address: 23124 25TH AVE W , LYNNWOOD WA, 98036
Contractor:
Name: K E PETERSEN ELECTRIC INC
Address: 23124 25TH AVE W , LYNNWOOD WA 98036
Contractor License No: KEPETEI148JP
Phone: (206) 794-4293
Phone: (425) 775-1199
Expiration Date: 11/30/2014
DESCRIPTION OF WORK:
REMODEL ELECTRICAL FOR NEW CUSTOMER SERVICE AREA. ELIMINATE TWO CHECKSTANDS.
RELOCATE THREE EXISTING REFRIGERATED CASES. ELIMINATE POWER FOR ICE MACHINE.
Value of Electrical: NRES: $6,500.00
RES: $0.00
Type of Fire Protection: UNKNOWN
Electrical service provided by: SEATTLE CITY LIGHT
Fees Collected: $218.70
Washington Cities Electrical Code: 2011
Permit Center Authorized Signature: /lam �C/� Date: �U/// /(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 permit does not presume to give authority to violate or cancel the provisions of any other state or local laws regulating
construction or the performance of work.
I1 am authorized to sign and obtain this electrical permit.
Signature: k ivUlv
Print Name: c 12V0( Pf y\
Date: 16'1 ``,-77
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
EL13-0997 Printed: 10-11-2013
PERMIT CONDITIONS
Permit No. EL13-0997
**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
EL13-0997 Printed: 10-11-2013
CITY OF TUKKI
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
Electrical Permit No. EL/3 z% 7
Project No.
Date Application Accepted:
Date Application Expires:
1b/Illl3
oyfii//c/
(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:
Tenant Name:
King Co Assessor's Tax No.:
1Z'5 So I,Chh —1/1��-
7►,&Iel'Davey t oO2-`-7
Suite Number:
PROPERTY OWNER
Name:les)of \--?de ^
Address: nt v_(_ 26 'vie, Vim-'
Name:
Phone: -ri l I _ 1454,ax:
Email: K ' Ael ethi\/1i�0 AACia
Address:
City:
State:
Zip:
CONTACT PERSON - person receiving all project
communication
Name:les)of \--?de ^
Address: nt v_(_ 26 'vie, Vim-'
City: Ok‘p00 4 State: t , 1 Zip p ./',-
1l�
Phone: -ri l I _ 1454,ax:
Email: K ' Ael ethi\/1i�0 AACia
LOYV
Floor:
New Tenant:A Yes I=1.. No
ELECTRICAL CONTRACTOR INFORMATION
Company Name: K L�'i p(_ ,t e. Ei efAii
_
Address: Z JI1 4 -z -v \\)L- t _ )
City: ) A0� State: `, 1 p,. Zip
W rA.
lLille-y-175-1M
Phone: L' C t Fax:
'i 77-ITl -1��no �
Contr Reg No.:KepE- i Sxrate:
JJ
Tukwila Business License No.;
Valuation of Project (contractor's bid price): $ (71 1E.X _(kto^tt \ ^i'�,�
Scope of Work (please provide detailed information): VAily Jt1t.t e\Cly 1 -C-of cjj_»1
aim '-.*tA A.s. i [ , h
Will service be altered?�❑ Yes �No
Type of Use: ��C cm` " ��(
Type of work:
Adding more than 50 amps? ❑ Yes RNo
❑ New ❑ Addition 0 Service Change 0 Remodel /Tenant Improvement
0 Low Voltage 0 Generator 0 Fire Alarm :❑ Telecommunication ❑ Temporary Service
Property Served by:
0 Puget Sound Energy 0 Seattle City Light
H:Wpplications\Forms-Applications On Line\2013 Applications\Electrical Permit Application Revised 7-I-13.docx
Revised: July 2013
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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) $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 ea
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 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: (6A.AY CAS'2rin
Print Name: V O(
Mailing Address:
H:Wpplications\Forms-Application On Line \2013 Apphcations\Electncal Permit Application Revised 7-1-13.docx
Revised: July 2013
bh
Date:
Day Telephone: Zc 2 6 "t'42, J
nom• \! J ? C 7o
City State Zip
Page 2 of 2
•
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-43 1-3670
Fax: 206-431-3665
Web site: http://www.Tukwila WA .gov
Parcel No.: 0040000115
Address: 3725 S 144 ST TUKW
Suite No:
Applicant: SUPER SAVER FOODS
RECEIPT
Permit Number: EL13-0997
Status: APPROVED
Applied Date: 10/11/2013
Issue Date:
Receipt No.: R13-02870
Initials:
User ID:
LAW
1632
Payment Amount: $218.70
Payment Date: 10/11/2013 02:36 PM
Balance: $0.00
Payee: TREVOR D PETERSEN
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd VISA
Authorization No. 035880
ACCOUNT ITEM LIST:
Description
218.70
Account Code Current Pmts
ELECTRICAL PERMIT - NONR
000.322.101.00.00 218.70
Total: $218.70
Printed: 10-11-2013
3/3/2014
1
City of Tukwila
Department of Community Development
TREVOR PETERSEN
23124 25TH AVE W
LYNNWOOD, WA 98036
RE: Permit No. EL13-0997
SUPER SAVER FOODS
3725 S 144 ST
Dear Permit Holder:
•
Jim Haggerton, Mayor
Jack Pace, Director
New inspection Re
206 4 quest Line
438-9350
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 4/9/2014.
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 4/9/2014, 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,
fer Marshall
it Technician
File No: EL13-0997
6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665
Contractors or Tradespeople Peter Friendly Page
•
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
K E PETERSEN ELECTRIC INC
4257751199
23124 25Th Ave W
Lynnwood
WA
98036
Snohomish
Corporation
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Specialty 1
Specialty 2
600611850
Active
KEPETEI148JP
Electrical Contractor
4/17/1986
11/30/2014
General
Unused
Electrical Administrator INFORMATION
License PETERTD9261M
Name PETERSEN, TREVOR D
Status Active
Business Owner Information
Name
Role
Effective Date
Expiration Date
PETERSON, TREVOR D
Agent
11/30/2010
Received Date
PETERSON, TREVOR D
President
11/30/2010
Until
Released
PETERSEN, KRIS E
01/01/1980
12/01/2010
PETERSEN, JACQUELINE
4/14/1986
6/18/1986
Bond
$3,000.00
4/14/1986
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
EJONM00521
1/14/2010
19.28.101 RCW
ELECTRICAL CITATION
Satisfied
$250.00
httns://fortress.wa. i?ov/lni/bbip/Print.aspx 10/11/2013