HomeMy WebLinkAboutPermit EL14-0692 - SIEBENBAUM DUPLEX A - PANEL CHANGE OUTSIEBENBAUM DUPLEX A
3928 S 113 ST
EL1 4-0692
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.aov
Parcel No: 3351400245
ELECTRICAL OTC PERMIT
Permit Number: EL14-0692
Address: 3928 S 113TH ST 1 Issue Date: 7/24/2014
Permit Expires On: 1/20/2015
Project Name: SIEBENBAUM DUPLEX A
Owner:
Name: SIEBENBAUM JOHN B
Address: 3928 S 113TH ST, TUKWILA, WA,
98168
Contact Person:
Name: ROBERT SHIVELY Phone: (253) 250-6047
Address: 2207 E GEORGE ST, TACOMA, WA,
98404
Contractor:
Name: CRYSTAL ELECTRIC Phone: (253) 250-6047
Address: 2207 E GEORGE ST, TACOMA, WA,
98404
License No: CRYSTE*948PF Expiration Date: 10/6/2014
Lender:
Name:
Address:
DESCRIPTION OF WORK:
PANEL CHANGEOUT
Valuation of single family: $700.00
Valuation of mf/comm: $0.00
Type of Work: SERV CHNG
Fees Collected: $86.00
Electrical Service Provided by: SEATTLE CITY LIGHT
Water District: TUKWILA
Sewer District: NONE
Current Codes adopted by the City of Tukwila:
International Building Code Edition:
International Residential Code Edition:
International Mechanical Code Edition:
Uniform Plumbing Code Edition:
2012 International Fuel Gas Code:
2012 WA Cities Electrical Code:
2012 WA State Energy Code:
2012
2012
2012
2012
Permit Center Authorized Signature:
Date: VI 12-CAH
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: k�Lrytt„"� 4e
ff
Print Name: RCi g4 S,'e L/
Date: 7/0 4
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: 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.
PERMIT INSPECTIONS REQUIRED
Permit Inspection Line: (206) 438-9350
2100 ELECTRICAL FINAL
7003 ROUGH -IN ELECTRICAL
7002 SERVICE
7001 UNDERGROUND/SLAB
CITY OF TUK :A
Community Development Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
Electrical Permit No. r
Project No.
Date Application Accepted: Z()( VLdr
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
Q King Co Assessor's Tax No.: 14CO 2-1-12-1-1j
Site Address: 3 l 2 O G S_ l 1.3 5 /V lt %,4 let Suite Number: Floor: 1
Tenant Name: New Tenant: El Yes ❑.. No
PROPERTY OWNER
Name:
Tb%ln Siebeelbat,).'J
Address:
2/agS_i13f65-f
City: State:
Tv h's.vi I et wet
Zip:
CONTACT PERSON — person receiving all project
communication
Name:
(..5tQ"1e
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
ELECTRICAL CONTRACTOR INFORMATION
Company Name:
ry s fet / 0 `eC fY; C
Address:
2- Zp7 - Gec' 5. --
City: �aGor ma
Stt a Zi4BL/oL/
"�
Pho 353- Z50 - rail7 Fax:
Contr Reg No.: Exp Date:.
Tukwila Business License No.; G. f 0j81 _0
Valuation of Project (contractor's bid price): $ ��1 ?a' �—
Scope of Work (please provide detailed information): Pane/ Chari' y '
Will service be altered? ❑ Yes a No Adding more than 50 amps? ❑ Yes 21., No
Type of Use: /CP�S`lrj9lc,
Type of work:- `
w Vg Panel Chase \
❑ New 0 Addition ❑ Service Change ❑ Remodel - ❑ Tenant Improvement
❑ Low Voltage ElGenerator 0 Fire Alarm ❑''Telecommunication ❑ Temporary Service
Property Served by:
❑ Puget Sound Energy 25. Seattle City Light
H:\Applications\Forms-Applications On Line\2014 Applications\Electrical Permit Application Revised I-I-14.docx
Revised: July 2013
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Page 1 of 2
RESIDENTIAL
NEW RESIDENTIAL SERVICE
❑ New single family dwellings
(including an attached garage)
O Garages, pools, spas and outbuildings
O Low voltage systems
(alarm, furnace thermostat)
$152.85
$81.90 ea
$59.85 ea
RESIDENTIAL REMODEL AND SERVICE CHANGES
(a Service change or alteration $81.90
(no added/altered circuits)
❑ Service change with added/altered circuits $81:90
number of added circuits $1'1.55 ea
0 Circuits added/altered without service change $54.60
(up to 5 circuits)
O Circuits added/altered without service change $54.60
(6 or more circuits) $7.65 ea
❑ Meter/riaastrepair - $68.25
❑ Low voltage systems - r 1 $59.85
(alarm, fuinace�thermostat)
MULTI -FAMILY AND COMMERCIAL
Fees are based on the valuation of the electrical contract.
MISCELLANEOUS FEES
O Temporary service (residential) $65.00
0 Temporary service (generator) $80.90
❑ Manufactured/mobile home service $86.25
(excluding garage or outbuilding)
O Carnivals $80.60
Number of concessions $10.80 ea
tach ride and generator truck $10.80 ea
***EFFECTIVE JANUARY 1, 2014
EACH PERMIT WILL BE ASSESSED A
5% TECHNOLOGY FEE***
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 foran,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: Robe✓+
Day Telephone:
Date:
Mailing Address:
City State Zip
H:\Applications\Forms-Applications On Line\2014 Applications'alectrical Permit Application Revised 1-1-14.docx
Revised: July 2013
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Page 2 of 2
DESCRIPTIONS
ermitTRAK'
Cash Register Receipt
City of Tukwila
ACCOUNT QUANTITY PAID
�2'
L14-0692
ddress: 3928 S 113TH ST 1 ADn:3351400245
6
ELECTRICAL
$81.90
PERMIT FEE SINGLE FAMILY
R000.322.101.00.00
0.00
$81.90
TECHNOLOGY FEE
$4.10
TECHNOLOGY FEE
R000.322.900.04.00
0.00
$4.10
EL14-0693 ° Address:° 3928 S 113TH ST 2
n:3351400245
ELECTRICAL
$81.90
PERMIT FEE SINGLE FAMILY
R000.322.101.00.00
0.00
$81.90
TECHNOLOGY FEE
$410
TECHNOLOGY FEE
TOTAL FEES PAID BY RECEIPT: R2660
R000.322.900.04.00
0.00
$4.10
$172.00
Date Paid: Thursday, July 24, 2014
Paid By: CRYSTAL ELECTRIC
Pay Method: CREDIT CARD 159697
Printed: Thursday, July 24, 2014 9:14 AM 1 of 1
CRW SYSTEMS
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
EL 4 o(4Z
Project:
Type,of Inspection:
A'reSs
C-1 lt3
'-f-i-
Date Called:
Special Instructions: ,
1'f•' -
lA1
Date Wanted: _
`7- L.7-('{
(�a.m;
p.m.
Requester:
Phone No:
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
n // /
0 .ie
(
/ /'"T-"�
//////[[[[,.
/7`)14 -
r I " j 1 -
1/4.....„-1
,-,,,
inspector-`
Dat"/-// 4/
n REINSPECTION FEE REQUIRED. Prior to
paid at 6300 Southcenter Blvd.. Suite 100.
next inspection, fee must be
Call to schedule reinspection.
CRYSTAL ELECTRIC
Page 1 of 2
Washington State Department of
Labor •& Industries
CRYSTAL ELECTRIC
Owner or tradesperson
SHIVELY, ROBERT R
Principals
SHIVELY, ROBERT R, OWNER
Doing business as
CRYSTAL ELECTRIC
WA UBI No.
602 078 887
2207 e George ST
TACOMA, WA98404
253-250-6047
PIERCE County
Business type
Individual
License
Verify the contractor's active registration / license / certification (depending on trade) and any past violations.
Electrical Contractor Active.
Meets current requirements.
License specialties
GENERAL
License no.
CRYSTE*948PF
Effective — expiration
10/06/2006-10/06/2014
Designated administrator
SHIVELY, ROBERT RAMON
License type
Master Electrician
Bond
CBIC
Bond account no.
SG9648
Received by L&I
10/06/2006
Savings
No savings accounts during the previous 6 year period.
License Violations
No license violations during the previous 6 year period.
Active.
Meets current requirements.
License no.
SHIVERR954RB
$4,000.00
Effective date
10/05/2006
Expiration date
Until Canceled
Workers' comp
Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums.
https://secure. lni.wa.gov/verify/Detail.aspx?UBI=602078887&LIC=CRYSTE*948PF&SAW= 07/24/2014