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Home My WebLink AboutPermit EL14-0782 - CHAMP SPORTS NIKE YARDLINE - SIGNThis 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. EL14-0782 CHAMP SPORT NIKE 1030 Southcenter Mall DIGITAL RECORDS (DR)EXEMPTION LOG THE ABOVE MENTIONED PERMIT FILE INCLUDESTHE FOLLOWING REDACTED INFORMATION Page #CodeExemptionBrief Explanatory DescriptionStatute/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 individuals’ privacy pursuant to 5 U.S.C. sec. 5 U.S.C.sec. 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) 552(a); RCW 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 account numbers, which are exempt from 9DR2Financial Information – 42.56.230(5) disclosurepursuant to RCW 42.56.230(5), RCW 42.56.230(45) except when disclosure is expressly required by or governed by other law. Personal Information – Redactions contain information used to prove RCW Driver’s License. –RCW identity, age, residential address, social security 42.56.230 (7a DR3 number or other personal information required to 42.56.230 & c) apply for a driver’s license or identicard. (7a & c) Redacted content contains a communication between client and attorney for the purpose of obtaining or providing legal advice exempt from RCW Attorney-Client Privilege –disclosure pursuant to RCW 5.60.060(2)(a), 5.60.060(2)(a); RCW 5.60.060(2)(a); RCW which protects attorney-client privileged DR4 RCW 42.56.070(1)communications, and RCW 42.56.070(1), which 42.56.070(1) protects, under the PRA, information exempt or prohibited from disclosure under another statute. CHAMP SPORTS NIKE 1030 SOUTHCENTER MALL EL1 4-0782 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: 9202470010 Permit Number: EL14-0782 Address: 1030 SOUTHCENTER MALL Issue Date: 8/12/2014 Permit Expires On: 2/8/2015 Project Name: CHAMP SPORTS NIKE YARDLINE Owner: Name: WESTFIELD PROPERTY TAX DEPT Address: PO BOX 130940 , CARLSBAD, WA, 92013 Contact Person: Name: CLIFF MIHM Phone: (253) 538-0752 Address: 5209 122 ST E , TACOMA, WA, 98446 Contractor: Name: CULBERTSON SIGN SERVICE LLC Phone: (800) 925-6011 Address: 5209 122ND ST E , TACOMA, WA, 98446 License No: CULBESS984MU Expiration Date: Lender: Name: Address: DESCRIPTION OF WORK: Valuation of single family: $0.00 Valuation of mf/comm: $180.00 Type of Work: LOW VOLTAGE Fees Collected: $68.25 Electrical Service Provided by: PUGET SOUND ENERGY Water District: TUKWILA Sewer District: TUKWILA SEWER SERVICE 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: (Ali 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 ae to the conditions attached to this permit. Signature: Print Name: C1-I0ozz7 r- IAA(HM Date:< f ZI (7 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 Tenant Name: 141 V[� PROPERTY OWNER Name: (k (71 �-\ ti,52 1ZOP(< bEPr• Address: e0 NJ� 127 01 v City: Gip,4ticph State: Zip:0i2.0v3 CONTACT PERSON — person receiving all project communication Name: (l1A F4 IYI I N W\ Address: S.01 I ZZ - City: I KO m 4 State: iv Zip: pa 6 Phone: (5-3) ,5 _0152_ Fax: (zs..„3) �,i g�1)D7 8,.. f Email: ((,•l .MlHWI 06-Wlb41(_gCOr CITY OF TUK "LA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Electrical l'erinit No. - L '1)1 Project No. Date Application Accepted: t (H Date Application Expires: ~� (For once 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.: 9 2O2 7-00/ O Site Address: 1020 6001 ieN.31-Erz VY) at-t_.4321I Suite Number: -3 y Floor: New Tenant: Ei/ Yes Z . No ELECTRICAL CONTRACTOR INFORMATION Company Name: CVI.T3E7ri k) 516N 9E-xvlc6 Address: /7...v.id1% �E City: State: ,. /# Zip:9 J 7-4 rDm� Phone: CZ ?, 533.-0] 52 Fax: /2) l XV-0 %% f Contr Reg No.: (00_3 T1 D"1 oV Exp Date: c r q)l (1 i Tukwila Business License No.; "IN 5, oqn 3 $,e 72 Valuation of Project (contractor's bid price): $ 1 : Scope of Work (please provide detailed information): N oCK vP Gjt (a CtZCv�( Will service be altered? ❑ Yes ❑ No Adding more than 50 amps? ❑ Yes E./No Type of Use: Type of work: 0 /New ❑ Addition 0 Service Change 0 Remodel 0 Tenant Improvement Low Voltage 0 Generator 0 Fire Alarm ❑ Telecommunication ❑ Temporary Service Property Served by: Puget Sound Energy 0 Seattle City Light H:\Applications\Forms-Applications On Line\2014 Applications\Electrical Permit Application Revised 1-1-14.docx Revised: July 2013 bh Page 1 of 2 RESIDENTIAL NEW RESIDENTIAL SERVICE ❑ New single family dwellings $152.85 (including an attached garage) 0 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 O Temporary service (residential) $65.00 ❑ 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 Each 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 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: Mailing Address: LI f-roZp W _ i I f -(kMM Day Telephone City Date: g7 /L Zr7i v751, State Zip H:\Applications\Forms-Applications 0n Line\2014 Applications\Electrical Permit Application Revised I-I-14.docx Revised: July 2013 bh Page 2 of 2 Cash Register Receipt City of Tukwila DESCRIPTIONS ACCOUNT QUANTITY PAID PermitTRAK 68: EL14-0782 Address: 1030 SOUTHCENTER MALL pn: 9202470010 68. ELECTRICAL`. $6500 PERMIT FEE MULTI-FAM/COMM R000.322.101.00.00 0.00 $65.00 TECHNOLOGY FEE $3.25 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R2845 R000.322.900.04.00 0.00 $3.25 $68.25 Date Paid: Tuesday, August 12, 2014 Paid By: CULBERTSON SIGN SERVICE LLC Pay Method: CHECK 12729 Printed: Tuesday, August 12, 2014 3:38 PM 1 of 1 i?SYSTEMS tjtJbz i.s INSPECTION NO. INSPECTION RECORD Retain a copy with permit CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 431-2451 (14-o722, PERMIT NO. Project: 6 r l n5 Type of Inspection: r' ` NAL_ Address: Date Called: Special Instructions: SitIAi Date Wanted: ill % l / a.r p.m. Requester: t Phone No: Approved per applicable codes. EJCorrections required prior to approval. COMMENTS: n � ri (te AP/ V/Aikv Inspector: Date: ffll r'I I REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. i CULBERTSON SIGN SERVICE LT C Page 1 of 4 Washington State Department of Labor & Industries CULBERTSON SIGN SERVICE LLC Owner or tradesperson CULBERTSON, PAUL Principals CULBERTSON, PAUL, PARTNER/MEMBER CULBERTSON, PAUL JR, PARTNER/MEMBER Doing business as CULBERTSON SIGN SERVICE LLC WA UBI No. 602 043 276 5209 122ND ST E TACOMA, WA98446 253-538-0752 PIERCE County Business type Limited Liability Company License Verify the contractor's active registration / license / certification (depending on trade) and any past violations. Electrical Contractor Active. Meets current requirements. License specialties SIGN License no. CULBESS984MU Effective — expiration 08/30/2002— 08/30/2016 Designated administrator CULBERTSON, PAUL License type Master Electrician Bond Active. Meets current requirements. License no. CULBEP*979QL No bond accounts during the previous 6 year period. Savings (in lieu of bond) $4,000.00 Received by L&I 08/30/2002 Savings account ID Effective date 08/30/2002 License Violations Infraction no. EALEJ00261 Satisfied https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602043276&LIC=CULBESS984MU&SAW= 08/12/2014