HomeMy WebLinkAboutPermit EL14-0372 - WASHINGTON CENTER FOR PAIN MAN - TENANT IMPROVEMENTThis 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.
EL14-0372
WASHINGTON CENTER FOR PAIN MANAGEMENT
th
7200 South 180Street
DIGITAL RECORDS (DR)EXEMPTION LOG
THE ABOVE MENTIONED PERMIT FILE INCLUDESTHE FOLLOWING REDACTED INFORMATION
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552(a), and are also exempt from disclosure 552(a); RCW
DR1Generally –5 U.S.C. sec.
under section 42.56.070(1) of the Washington 42.56.070(1)
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WASHINGTON CENTER FOR
PAIN MANAGEMENT
7200 S 180 ST
EL1 4-0372
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Inspection Request Line: 206-438-9350
Web site: http://www.TukwilaWA.gov
ELECTRICAL OTC PERMIT
Parcel No: 3623049013 Permit Number: EL14-0372
Address: 7200 S 180 ST 102 Issue Date: 4/21/2014
Permit Expires On: 10/18/2014
Project Name: WASHINGTON CENTER FOR PAIN MAN
Owner:
Name: KHK INVESTMENT LLC
Address: 26329 8TH AVE S , DES MOINES, WA,
98198
Contact Person:
Name: BRANDON HAGGARD
Address: 12912 BEVERLY PARK RD, MUKILTEO,
WA, 98275
Phone: (425) 672-6799
Contractor:
Name: ELECTRI-CITY INC Phone: (425) 672-6797
Address: 16212 BOTHELL HWY STE F PMB 13 ,
MILL CREEK, WA, 98012
License No: ELECTI*110BA Expiration Date: 1/1/2015
Lender:
Name:
Address:
I / ,
DESCRIPTION OF WORK:
NEW ELECTRICAL FOR REMODELED RECEPTION, HALLWAY, OFFICE AND BATHROOMS
Valuation of single family: $0.00
Valuation of mf/comm: $20,000.00
Type of Work: TENANT IMP
Fees Collected: $471.24
Electrical Service Provided by: PUGET SOUND ENERGY
Water District: RENTON
Sewer Distric: RENTON SEWER SERVICE
Current Codes adopted by the City of Tukwila:
Internations Building Code Edition:
International Residential Code Edition:
International Mechanical Code Edition:
Uniform Plumbing Code Edition:
Permit Center Authorized Signature:
2012 International Fuel Gas Code:
2012 WA Cities Electrical Code:
2012 WA State Energy Code:
2012
2012
2012
2012
Date: " —. ij `( _I
I hearby 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. I am authorized to sign and obtain this
development permit and agree to the conditions attached to this permit.
Signature: -
Print Name: ,Occv,14,1_ /sir
Date: t7
This permit shall become null and void if the work is not commenced within 180 days for the date of issuance, or
if the work is suspended or abandoned for a period of 180 days from the last inspection.
PERMIT CONDITIONS:
1: ***ELECTRICAL PERMIT CONDITIONS***
2: A copy of the electrical work permit shall be posted or otherwise made readily accessible to the Electrical
Inspector at each work site.
3: Approved plans shall be maintained at the construction site and shall be readily available to the Electrical
Inspector.
4: All electrical work shall be in accordance with NFPA 70 - NEC, and requirements for electrical installations,
Chapter 296-46B WAC.
5: 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.
6: 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.
7: 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.
PERMIT INSPECTIONS REQUIRED
Permit Inspection Line: (206) 438-9350
2100 ELECTRICAL FINAL
7003 ROUGH -IN ELECTRICAL
7002 SERVICE
7001 UNDERGROUND/SLAB
\JoD77 -! ((vo
CITY OF TUKWILA
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.ci.tukwila.wa.us
Electrical Permit `No. EL) "t ~- 6372.
ProjectNo.
(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: 7..00 S l 2" " ST Pt/G
Tenant Name: Wo s-k )hn reit4^ f oCI Arictyeeleol-
Suite Number: /dam
New Tenant:
Floor: 1
❑ Yes 1Q<.. No
Property Owners Name:
Mailing Address:
City
Statc
Zip
CONTACT PERSON
ho do we contac
when your permit is ready to be issued
Name: S C% /j/uu,„e'
Mailing Address: /2 %/2. #Ge✓Q/y Pc--,4 /Zo
E-Mail Address: i2,-A_fri 0e/ec //,-c'/7,nc . cowl
Day Telephone:
City
Fax Number:
WA
State
k.27S-
Zip
ELECTRICAL CONTRACTOR INFORMATION
Company Name: 4/eci-K71- C' /y y' i c•
Mailing Address: / 2 `( /2. BeyRid, i2cl
Contact Person: ffic4 &44. fiWo,c./
E-Mail Address: hr',c10,^ (7e/eci'r �/' Cr /,ic. co
Contractor Registration Number: 5L E C rs i (/ OA
City
State
Day Telephone: 4/ r- 672 - 6797
Fax Number: 471-2-S-672 - (<797
b<27s
Zip
Expiration Date:
Valuation of Project (contractor's bid price): $ �Orocp
Scope of Work (please provide detailed information): /'I eln/ e/ec/r cc,( /'e,v‘dde/er.itreceplronf
ho,,l/wo y/ ®P ICC c w( Arn.//arm, S,
Will service be altered? ❑ Yes ErNo
Type of Use: Csv'ii tt. cio,% 6Prke bit,/(2,42�
Type of work:
D New
❑ Addition
❑ Low Voltage ❑ Generator
Property Served by:
[v]7Puget Sound Energy
❑ Seattle City Light
❑ Service Change
❑ Fire Alarm
Adding more than 50 amps? ❑ Yes
[Remodel
❑ Telecommunication
No
❑ Tenant Improvement
❑ Temporary Service
H:\Applications\Forms-Applications On Line\I -2009 - Electrical Permit Application.doc
Page 1 of 2
RESIDENTIAL
NEW RESIDENTIAL SERVICE
❑ New single family dwellings $145.60
(including an attached garage)
❑ Garages, pools, spas and outbuildings $78.00 ea
❑ Low voltage systems
(alarm, furnace thermostat) $57.00 ea
RESIDENTIAL REMODEL AND SERVICE CHANGES
❑ Service change or alteration $78.00
(no added/altered circuits)
❑ Service change with added/altered circuits $78.00
number of added circuits $11.00 ea
❑ Circuits added/altered without service change $52.00
(up to 5 circuits)
❑ Circuits added/altered without service change $52.00
(6 or more circuits) $7.30 ea
❑ Meter/mast repair $65.00
❑ Low voltage systems $57.00
(alarm, furnace thermostat)
MULTI -FAMILY AND COMMERCIAL
Fees are based on the valuation of the electrical contract.
MISCELLANEOUS FEES
❑ Temporary service (residential) $60.00
❑ Temporary service (generator) $75.00
❑ Manufactured/mobile home service $80.00
(excluding garage or outbuilding)
❑ Carnivals $75.00
Number of concessions $10.00 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: ,OftA/Tyy,,,r^tZ
Date:
Day Telephone: 4/.2-5"-672 -6 79'7
Mailing Address:
City
State
Zip
Date Application Accepted:
Date Application Expires: Staff Initials:
H:\Applications\Farms-Applications On Line\1-2009 - Electrical Perniit Application.doc
Page 2 of 2
Cash. Register Receipt
City of Tukwila
DESCRIPTIONS
PermitTRAK
ACCOUNT
QUANTITY PAID
$471.24
E114-0372 Address: 7200 S 180 ST'102
Apn: 3623049013
$471.24
ELECTRICAL
$448.80
PERMIT FEE MULTI-FAM/COMM
R000 322 101.00 00
$448.80
TECHNOLOGY FEE
$22.44
TECHNOLOGY FEE
TOTAL FEES PAID BY RECEIPT: R1868
R000.322.900.04.00
$22.44
$471.24
Date Paid: Monday, April 21, 2014
Paid By: ELECTRI-CITY INC
Pay Method: CHECK 039665
Printed: Monday, April 21, 2014 1:25 PM 1 of 1
art
SYSTEMS
INSPECTIONI,RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
6,e1-611,
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
Project: 1
rok Vftet Ai
Type of Inspection: FIVAI-
Address:
7lo .5 -ran sr-.
Date Called:
Special Instructions: If 10L
Date Wanted:
6b/
P•
Requester:
Phone No:
ZApproved per applicable codes. Corrections required prior to approval.
COMMENTS:
i
61
1J - - r
Inspector:
1
Date: Oar/
REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-367!INSPECTION-RECORD
Retain a copy with permit 057 Z
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 /t
A-`N 6Q(%
"-^ 1
Type of Inspection: S
r/C`"�'
g`N
Address: _
7, 5./5'Os,-
Date Called:
Special Instructions:
Date Wanted:
/ d
a.m.
p.m.
Requester:
Phone No:
lJ� {Approved per applicable codes. tCorrections required prior to approval.
COMMENTS:
/
• - aridA) i,b1/4,1
Inspector:
\iiii6fdiJe.,\
6 Date: i01.bi
U j`' • f
REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
INSPECTION RECORD
Retain a copy with permit
INSPE0TI0N 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
6io372-
'1
Project:
Type of Inspection: I�
Address: 7b 5 /X'O S i
Date Called:
Special Instructions: IF %n�
Date Wanted:
6 02— rr
Requester:
+ '"
Phone No:
Llc 3'l re os17
Approved per applicable codes. L.J Corrections required prior to approval.
COMMENTS:
‘ft
1
f
tAikt ibtO, it4irsf
Inspector:
Date: O f 6 jr
1 1
n REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
ettat 0371,
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
Project: WA • i p
Fp Al
Type of Inspection: %
,►j`�.c,, lik/
Address:
72ov �5- /6D sr-
Date Called:
�.�
Special Instructions:
Date Wanted:
5 , g�j
!i1 pm,
Requester:
Phone No:
`f L s 3y40 am
❑ Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
")
IA
/40RW1046 I h<
C
/ 1
0 V
I/ I. - (G(AJt
CJEk pf-kSG 1
Inspector:
Date: o /23h i"
l ,
REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
1'4
fiNUK.
Z
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
tv1-0572,
Project:.
itikih
', ! YA�I
Type of Inspection: ,i\/
Address:
72
S- ad Sr
Date Called:
Special Instructions: lc roL,
Date Wanted:
Z C .m)
n
Requester:
Phone No:
10'5- 34t0 O S1 7
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
-- l6511'Ci Klwad<i>
NPPoki Fi
- A T i,-L, Ca.JiJ tr s.A -.ice
-- t.C. ta,Js . r -' t 3 r
"
_gctlt:o-
0( .°x isJD CV/4a-i i0 Ft
Inspector: DaCe: 05127 /r Y
t
REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
1
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
hAq -o37L
Project: t, y A,��(r,�.,p
Type of Inspection: NO
j
Address:
7100 3 - 110 s(fOZ
Date Called:
Special Instructions:
Date Wanted:
cj�r-
a
Requester:
gY /?4
l
Phone No:
y2.SrPic os91
p3Approved per applicable codes. Q Corrections required prior to approval.
COMMENTS:
Inspector:
Date: c /0(9
r
REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
ELECTRI-CITY INC
Page 1 of 7
4.4 Washington State Department of
Labor & Industries
ELECTRI-CITY INC
Owner or tradesperson
RICHARDSON, DIANA L
Principals
RICHARDSON, DIANA L RICHARDSON, DAVID
J RICHARDSON, DIANA L
Doing business as
ELECTRI-CITY INC
WA UBI No.
601 133 632
16212 BOTHELL HWY STE F PMB135
MILL CREEK, WA98012
425-672-6797
SNOHOMISH County
Business type
Corporation
Governing persons
DAVID I RICHARDSON DIANA L RICHARDSON;
License
Verify the contractor's active registration / license / certification (depending on trade) and any past violations.
Electrical Contractor
License specialties
GENERAL
License no.
ELECTI*110BA
Effective — expiration
01/01/1989 — 01/01/2015
Designated administrator
MACDONALD, MALCOLM A
License type
Master Electrician
Bond
No bonds during the previous 6 year period.
Insurance
No insurance accounts during the previous 6 year period.
Savings
(in lieu of bond)
Savings account ID
Active.
Meets current requirements.
Active.
Meets current requirements.
License no.
MACDOM*953DA
$4,000.00
Effective date
12/13/1990
https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601133632&LIC=ELECTI* 110BA&SAW= 04/21/2014