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Home My WebLink AboutPermit EL15-0777 - RED ROBIN - ELECTRICAL CIRCUITS TO WALL SIGNSThis 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. EL15-0777 RED ROBIN 17300 SOUTHCENTER PKWY RECORDSDIGITAL D-) EXEMPTION LOG THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION Page # Coda Exemption, � � � I3ri6f Explanatory 6escrlofion, Sfatutte/Ruilo 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. DR1 Generally — 5 U.S.C. sec. 552(a), and are also exempt from disclosure 552(a); RCW 552(a); RCW under section 42.56.070(1) of the Washington 42.56.070(1) 42.56.070(1) State Public Records Act, which exempts under 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) RCW 42.56.230(4 5) disclosure pursuant to RCW 42.56.230(5), except when disclosure is expressly required by or governed by other law. Personal Information — Redactions contain information used to prove RCW DR3 Driver's License. — RCW identity, age, residential address, social security 42.56.230 (7a 42.56.230 number or other personal information required to & c) (7a & c) apply for a driver's license or identicard. 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); DR4 RCW 5.60.060(2)(a); RCW which protects attorney -client privileged 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. RED ROBIN 17300SOUTHCENTER PKWY EL15-0777 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.Rov ELECTRICAL OTC PERMIT Parcel No: 2623049110 Permit Number: EL15-0777 Address: 17300 SOUTHCENTER PKWY Issue Date: 9/4/2015 Permit Expires On: 3/2/2016 Project Name: RED ROBIN Owner: Name: KIR TUKWILA 050 LLC Address: 3333 NEW HYDE PARK RD #100 PO C/O KIMCO REALTY CORP, NEW HYDE PK, WA, 11042 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: HOOK UP WALL MOUNTED SIGNS TO EXISTING ELECTRICAL CIRCUITS. Valuation of single family: $0.00 Fees Collected: $77.28 Valuation of mf/comm: $360.00 Type of Work: LOW VOLTAGE Electrical Service Provided by: PUGET SOUND ENERGY Water District: HIGHLINE,TUKWILA Sewer District: TUKWILA 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 296-466: 2014 Uniform Plumbing Code Edition: 2012 WA State Energy Code: 2012 International Fuel Gas Code: 2012 a Permit Center Authorized Signature: ��% Date: 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 e o the conditions attached to this permit. Signature: , Date•' G �- Print Name: ZD 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 El CITY OF TUKWILA Community Development Department Permit Center • 6300 Southeenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov SITE LOCATION Site Tenant N Electrical Permit No. t:7 �' 0 %7 % Project No. Date Application Accepted: Date Application Expires: -3 1(2�f! 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" PROPERTY OWNER Name: ) T ' O Address: %1'1 2 ow GW \ N 00 City: _ State: �� _• (lO�- CONTACT PERSON — person receiving all project communication Name: r r rA A Address: L✓l��, J (� City: At0v M State: /, , Zip v� Phone: 2� Z72 _6S Fax: j- 7 �^ Email: (-U F�o ` King Co Assessor's Tax No.: Suite Number: Floor:_ New Tenant: ❑..... Yes ❑..No ELECTRICAL CONTRACTOR INFORMATION Company Name:. L Address: 1 1� 0I) "I� , City: State: p ZipQJQL1 Phone:L{3 51Fax: .`/vT _O l Conti• Reg No. J• 0 Exp ate: 4g[51 I' to Tukwila Business License No.; -51S t,1p ZC6 Valuation of Project (contractor's bid price): $ 1&0, Vy �� Scope of Work (please provide detailed information): l- pO K Wif O AL�-_ MoU1 G5( 61 ) Will service be altered? ❑ Yesrqm LP No Type of Use: Tvpe of work: ❑ New ❑ Addition ❑ Service Change 1�. Low Voltage ❑ Generator ❑ Fire Alarni Property Served by: 19 Puget Sound Energy ❑ Seattle City Light H:\Applications\Forms-Applications On Linc\2014 Applications\Electrical Permit Application Revised 1-1-14.doex Revised: January2014 bh Adding more than 50 amps? ❑ Yes No ❑ Remodel ❑ Tenant Improvement ❑ Telecommunication ❑ Temporary Service Pagc 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 ....................... $1 1.55 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. Print Name: C L11W K9 CYO M k Al (N N. /Date: Day Telephone: { �3 J "K-0% ia Mailing Address:'52QQ!3 �2N '7 - 'R Aco m o- City State Zip H:\Applications\Form¢-Applications On Linc\2014 ApplieationsTIcorical Permit Application Rcvised 1-1-14.docx Revised: January2014 bh Page 2 of 2 DESCRIPTIONS• QUANTITY PermitTRAK PAID $77.28 EL15-0777 Address: 17300 SOUTHCENTER PKWY Apn: 2623049110 $77.28 ELECTRICAL $73.60 PERMIT FEE MULTI-FAM/COMM R000.322.101.00.00 0.00 $73.60 TECHNOLOGY FEE $3.68 TECHNOLOGY FEE R000.322.900.04.00 0.00 . . 6' . TOTAL FEES PAID : RECEIPT: $3.68 Date Paid: Friday, September 04, 2015 Paid By: CULBERTSON SIGN SERVICE LLC Pay Method: CHECK 12858 Printed: Friday, September 04, 2015 11:12 AM 1 of 1 SYSTEMS INSPECTION RECORD Retain a copy with permit INSPECTION N0. PERMIT N0. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-367 Permit Inspection Request Line (206) 438-9350 Project: * 46(V Type of inspection: Address: Date Called: Special Instructions: 1514J) Date Wanted: a. f P.m. Requester: Phone No: toApproved per applicable codes. LJ Corrections required prior to approval. IInspector: /—/1H"6L IDate: ©`/f I l/(d I REINSPECTION ftE REQUIRED. Prior to next inspection, fele must be paid at 6300 Southcenter Blvd., Suite 100. Gall to schedule reinspection. CULBERTSON SIGN SERVICE T T C Page 1 of 3 Home Inicio en Espanol Contact Safety Washington State Department of Labor & Industries CULBERTSON SIGN SERVICE LLC Search L&I A-'Z. Index Help My Secure I &1 Claims & Insurance Workplace Rights Trades & Licensing Owner or tradesperson 6209 122ND ST E TACOMA, WA Principals 253-538-0762 CULBERTSON, PAUL, PARTNERIMEMBER PIERCE County CULBERTSON,PAUL JR, PARTNER/MEMBER Doing business as CULBERTSON SIGN SERVICE LLC WA UBI No. Business type 602 043 276 Limited Liability Company Governing persons PAUL E JR CULBERTSON PAUL E SR CULBERTSON; 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 08/3012002— 08/3012016 Designated administrator Active. CULBERTSON,PAUL Meets current requirements. License type License no. Master Electrician CULBEP`979QL Bond ................. No bond accounts during the previous 6 year period. Savings .................. (in lieu of bond) $4,000.00 Received by L&I Effective date 08/30/2002 08/30/2002 Release date Impaired date NIA NIA Savings account ID License Violations ...--................................................. Infraction no. EALEJ00261 Satisfied .......................... Issue date RCWIWAC 07/16/2012 19.28.101 RCW https:Hsecure.Ini.wa.gov/verify/Detail.aspx?UBI=602043276&LIC=CULBESS984MU&SAW= 9/4/2015