The URL can be used to link to this page

Home My WebLink AboutPermit EL15-0234 - WASHINGTON CENTER FOR PAIN MAN - COMMUNICATION DEVICE TO INSTRUSION ALARMWASHINGTON CENTER FOR PAIN MANAGEMENT 7200 S 180 ST EL15-0234 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: EL15-0234 Address: 7200 S 180TH ST 102 Issue Date: 3/13/2015 Permit Expires On: 9/9/2015 Project Name: WASHINGTON CENTER FOR PAIN MAN Owner: Name: KHK INVESTMENT LLC Address: 26329 8TH AVE S , DES MOINES, WA, 98198 Contact Person: Name: TIM NICKOLS Address: 6102 N NINTH ST STE 700, TACOMA, WA, 98406 Contractor: Name: ADT LLC Address: 11824 N CREEK PARKWAY N, SUITE, BOTHELL, WA, 98011 License No: ADTLLL*881DO Lender: Name: Address: DESCRIPTION OF WORK: Phone: (253) 948-9103 Phone: (561) 988-3600 Expiration Date: 3/20/2016 ADD COMMUNICATION DEVICE TO EXISTING LOW VOLTAGE INTRUSION ALARM Valuation of single family: $0.00 Fees Collected: $68.25 Valuation of mf/comm: $99.00 Type of Work: LOW VOLTAGE Electrical Service Provided by: PUGET SOUND ENERGY Water District: RENTON Sewer District: RENTON SEWER SERVICE Current Codes adopted by the City of Tukwila: International Building Code Edition: 2012 National Electrical Code: 2014 International Residential Code Edition: 2012 WA Cities Electrical Code: 2014 International Mechanical Code Edition: 2012 WAC 296-46B: 2014 Uniform Plumbing Code Edition: 2012 WA State Energy Code: 2012 International Fuel Gas Code: 2012 C (l -� � Permit Center Authorized Signature: /d\ ` Date: I ( 1-{`� 1 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 p rmit and agree to the conditions attached to this permit. Signatur : LL 11 / Date: Y 13 av tj Print N`�� 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 ELECTRICAL CONTRACTOR INFORMATION Company Name: // /Z-�[ Address: %0 / /1/ City---,-*-4,z-0m State " /4 /� PhoneZ ��/g 7 Fax: - Contr Reg No.: Exp Date: Tukwila Business License No.; CITY OF TUKWILA Community Development Department Permit Center • 6300 Southcenter Blvd., Suite 100 Tuktvila, WA 98188 http://www.TukwilaWA.gov SITE LOCATION Electrical Permit No. �� , 22�1 Project No. Date Application Accepted: Date Application Expires: use 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`* f� King Co Assessor's Tax No.3� ZSUy%d�3 D Suite Number: Z Floor: Site Address: Q Tenant Name:�� i-_ O1- Pe -,'A- /"1Ct.'tGZgG� �rt� New Tenant: ❑ .....Yes ®—No PROPERTY OWNER Name: e, /— > z Address: % � [' < City: J� State: w)4 Zip: �p CONTACT PERSON — person receiving all project communication Name: 00 Address: State:ifA Zip:94W Phone:G c� J G? Fax: Email: / OO Valuation of Project (contractor's bid price): $—�/n � Scope of Work (please provide detailed information): Will service be altered? ❑ Yes No Adding more than 50 amps? ❑ Yes Io Type of Use: Tvne of work: ❑ El El Addition [I Service Change Low Voltage ❑ Generator ❑ Fire Alarm Property Served by: Puget Sound Energy ❑ Seattle City Light H:Upplications\Forms-Applications On Line\2014 Applications0ectrical Permit Application Revised 1-1-14.docx Revised: January 2014 bh ❑ Remodel ❑ Tenant Improvement ❑ Telecommunication ❑ Temporary Service 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 ❑ 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) PERMIT APPLICATION NOTES - MULTI -FAMILY AND COMMERCIAL Fees are based on die 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 ***EFFECTIVE JANUARY 1, 2014 EACH PERMIT WILL BE ASSESSED A 5% TECHNOLOGY FEE*** 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. — y� - ;; � � /^ Date: J - Print Name: ! `+mil !I-0 5 Day Telephone: Mailing Address: f�/d Z- /1/ / City State Zip H:\ApplicationsTorms-Applications On Line\2014 ApplicationsTlectrical Permit Application Revised 1-1-14.docx Revised: January 2014 bh Page 2 of 2 DESCRIPTIONS PermitTRAK ACCOUNT QUANTITY PAID $68.25 EL15-0234 Address: 7200 S 180TH ST 102 Apn: 3623049013 $68.25 ELECTRICAL $65.00 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: R000.322.900.04.00 0.00 $3.25 Date Paid: Friday, March 13, 2015 Paid By: ADT LLC Pay Method: CHECK 019844 Printed: Friday, March 13, 2015 10:11 AM 1 of 1 SYSTEMS INSPECTION RECORD Retain a copy with permit INSPECTION NO, PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206) 431-367 Permit Inspection Request Line (206) 438-9350 1. Projecw, P'ti d I"W", "W'a"""', IYD57- -11r/a N L—i paid at 6300 Southcenter Btvd., Suite 100. Call to schedule reinspection. - J1INSPECTION RECORD INS PIT — ION —N 0—J Retain a copy with permit P ERMITNO CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Project � (A- �6v,-C--c Type �oflnspectlon: Address . / �-1 Date Gaited:72oo —.M Special Instructions'. 4- IvZ, Date Wanted: a c p.m. Requester: Phone M1io; Approved per applicable codes. corrections require($ prior to approval. COMMENTS'. tj 0 r 9l ()lam Inspector: ElREINSPECTIOA FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. ADT LLC Page 1 of 2 Home Inicio ell I;cpaiiol Contact. Safety Washington State Department of Labor & Industries ADT LLC Owner or tradesperson Gursahaney, Naren K Principals Gursahaney, Naren K, PARTNER/MEMBER Beleisch, Nelson D, PARTNER/MEMBER Tulsyan, Ravi, PARTNER/MEMBER Doing business as ADT LLC WA UBI No. 603 190 246 License A-'/. Index Help My Secure I.,IkI Claims & Insurance Workplace Rights Trades & Licensing 6102 N 9TH ST TACOMA, WA98406 206-719-0347 PIERCE County Business type Limited Liability Company Verify the contractor's active registration / license / certification (depending on trade) and any past violations. Electrical Contractor Active. Meets current requirements. License specialties LIMITED ENERGY License no. ADTLLL*881 DO Effective — expiration 03/20/2012— 03/20/2016 Designated administrator ................ IN, ickols, Tim License type Electrical Administrator Bond ................ Federal Ins Co Bond account no. 82295435 Received by L&I 03/20/2012 Savings No savings accounts during the previous 6 year period. License Violations No license violations during the previous 6 year period. Workers' comp Active. Meets current requirements. License no. N ICKOT*902DA $4,000.00 Effective date 03/01/2012 Expiration date Until Canceled Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. This company has multiple workers' comp accounts. https:Hsecure.Ini.wa.gov/verify/Detail.aspx?UBI=603190246&LIC=ADTLLL*881DC&SAW= 3/13/2015