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Home My WebLink AboutPermit EL17-0074 - MARRIOTT RESIDENCE INN - MONUMENT 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. EL17-0074 MARRIOTT RESIDENCE INN 16201 W VALLEY HWY RECORDSDIGITAL D-) EXEMPTION LOG THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION Pae # Code Exem floe , Bdef x lanat6 Descd floe', statute/Rulle 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 11 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. MARRIOTT RESIDENCE INN 16201 W VALLEY HWY EXPIRED 12/12/17 ELI 7-0074 Parcel No: Address: 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 0005800006 Permit Number: EL17-0074 16201 W VALLEY HWY Project Name: MARRIOTT RESIDENCE INN Issue Date: 1/31/2017 Permit Expires On: 7/30/2017 Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: Address: License No: Lender: Name: Address: GRAND PRIX TUKWILA LLC 340 ROYAL POINCIANA WAY #306 C/O HEMA GANDHI, PALM BEACH, WA, 33480 HANS VISSER 5209 122ND ST E , TACOMA, WA, 98446 CULBERTSON SIGN SERVICE LLC 5209 122ND ST E , TACOMA, WA, 98446 CULBESS984MU I!1 Phone: (253) 538-0752 Phone: (800) 925-6011 Expiration Date: DESCRIPTION OF WORK: INSTALL MONUMENT SIGN ON TENANTS EAST R -O -W (WEST VALLEY HWY). TIE INTO SUPPLIED CIRCUIT AT SIGN LOCATION. Valuation of single family: $0.00 Valuation of mf/comm: $300.00 Type of Work: TENANT IMP Fees Collected: $74.22 Electrical Service Provided by: PUGEST SOUND ENERGY Water District: TUKWILA Sewer District: TUKWILA Current Codes adopted by the City of Tukwila: International Building Code Edition: International Residential Code Edition: International Mechanical Code Edition: Uniform Plumbing Code Edition: International Fuel Gas Code: Permit Center Authorized Signature: 2015 2015 2015 2015 2015 National Electrical Code: WA Cities Electrical! Code: WAC 296-46B: WA State Energy Code: Date: 2014 2014 2014 2015 3� 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: 4N3 ISSX/e. Date: 0/306 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: 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 CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Electrical Permit No. L1 7 - 00711 Project No. Date Application Accepted: 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 King Co Assessor's Tax No.: 000580-0006 Site Address: 16201 West Valley Hwy Tukwila, WA 98188 Suite Number: Floor: Tenant Name: Marriott Residence Inn PROPERTY OWNER _ Name: GRAND PRIX TUKWILA LLC 670563 ` Address: 222 LAKEVIEW AVE #200AY #306 City: W PALM BEACH State: FL Zip: 33401 CONTACT PERSON — person receiving all project communication Name: Hans Visser Address: 5209 122nd St E Address: 5209 122nd St E Phone: (253) 538-0752 Fax: (253) 538-0778 City: Tacoma State: WA Zip: 98446 Phone: (253) 538-0752 Fax: (253) 538-0778 Email: csspermits@gmail.com New Tenant: ❑ Yes ® ..No ELECTRICAL CONTRACTOR INFORMATION Company Name: Culbertson Sign Service Address: 5209 122nd St E Cit': Tacoma State: WA Zip: 98446 Phone: (253) 538-0752 Fax: (253) 538-0778 Contr Reg No.: CULBESS984MI Exp Date: 08/24/2018 Tukwila Business License No.; BUS -0993893 Valuation of Project (contractor's bid price): $ 300 Scope of Work (please provide detailed information): Install monument sign on tenant's east ROW (West Valley Hwy). Tie in to supplied circuit at sign location. Will service be altered? ❑ Yes m No Type of Use: Internally -illuminated monument sign Adding more than 50 amps? 0 Yes m No Type of work: ' ® New ❑ Addition ❑ Service Change ❑ Low Voltage ❑ Generator ❑ Fire Alarm Property Served by: ❑ Puget Sound Energy ❑ Seattle City Light W:\Permit Center\Applications-Handouts Permit Applications\PDFs\Electrical Permit Application Revised I-1-17.docx Revised: January 2017 bh El Remodel ❑ Telecommunication ❑ Tenant Improvement ❑ Temporary Service Page I of 2 RESIDENTIAL NEW RESIDENTIAL SERVICE ❑ New single family dwellings $155.91 (including an attached garage) ❑ Garages, pools, spas and outbuildings $83.54 ea ❑ Low voltage systems (alarm, furnace thermostat) $61.05 ea RESIDENTIAL REMODEL AND SERVICE CHANGES ❑ Service change or alteration $83.54 (no added/altered circuits) ❑ Service change with added/altered circuits $83.54 number of added circuits $12.00 ea ❑ Circuits added/altered without service change $55:69 (up to 5 circuits) ❑ Circuits added/altered without service change $55.69 (6 or more circuits) $7.65 ea ❑ Meter/mast repair $69.62 ❑ Low voltage systems $61.05 (alarm, furnace thermostat) MULTI -FAMILY AND COMMERCIAL Fees are based on the valuation of the electrical contract. MISCELLANEOUS FEES ❑ Temporary service (residential) $66.30 ❑ Temporary service (generator) $82.52 ❑ Manufactured/mobile home service $87.98 (excluding garage or outbuilding) ❑ Carnivals $82.21 Number of concessions $11.02 ea Each ride and generator truck $1.1.02 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: • Date: 01/25/2017 Print Name: Hans Visser Day Telephone: (253) 538-0752 Mailing Address: 5209 122nd St E Tacoma WA 98446 City WAPermit CenterApplications-Handouts\Permit Applications \PDFs\Electrical Permit Application Revised 1-1-17.docx Revised: January 2017 bh State Zip Page 2 of 2 Cash Register Receipt City of Tukwila DESCRIPTIONS 1 ACCOUNT QUANTITY I PAID $339.87 PermitTRAK EL17-0074 Address: 16201 W VALLEY HWY Apn: 0005800006 $74.22 ELECTRICAL $70.69 PERMIT FEE MULTI-FAM/COMM I R000.322.101.00.00 I 0.00 $70.69 TECHNOLOGY FEE $3.53 TECHNOLOGY FEE R000.322.900.04.00 I 0.00 $3.53 517-0012 Address: 16201 WEST VALLEY HWY Apn: 0005800006 $265.65 SIGN $253.00 PERMANENT SIGN PERMIT FEE R000.322.100.00.00 I 0.00 $253.00 TECHNOLOGY FEE. $12.65 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R10657 R000.322.900.04.00 0.00 $12.65 $339.87 Date Paid: Tuesday, January 31, 2017 Paid By: CULBERTSON SIGN SERVICE LLC Pay Method: CHECK 13043 Printed: Tuesday, January 31, 2017 11:13 AM 1 of 1 CEJ SYSTEMS INSPECTION RECORDI/"�J '001 Retain a copy with permit ' INSPECTION NO. P RMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Project: Or" A Type of Inspection:// p , 1i,/Vpa, ('. ti Address: l 41 ' / V''. n v"" Date Called: Special Instructions: p (Alr ilo PI ,, col Date Wanted: ✓ COe5 a. m Requester: Phone No: Approved per applicable codes. LJ Corrections required prior to approval. COMMENTS: Inspector: Date: 06 i 7 REINSPECTIO FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. 11/2/2017 City of Tukwila Department of Community Development HANS VISSER 5209 122ND ST E TACOMA, WA 98446 RE: Permit No. EL 17-0074 MARRIOTT RESIDENCE INN 16201 W VALLEY HWY Dear Permit Holder: Allan Ekberg, Mayor Jack Pace, Director In reviewing our current records, the above noted permit has not received a final inspection by the City of Tukwila Building Division. Per the International Building Code, International Mechanical Code, Uniform Plumbing Code and/or the National Electric Code, every permit issued by the Building Division under the provisions of these codes shall expire by limitation and become null and void if the building or work authorized by such permit has not begun within 180 days from the issuance date of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work has begun for a period of 180 days. Your permit will expire on 12/12/2017. Based on the above, you are hereby advised to: 1) Call the City of Tukwila Inspection Request Line at 206-438-9350 to schedule for the next or final inspection. Each inspection creates a new 180 day period, provided the inspection shows progress. -or- 2) Submit a written request for permit extension to the Permit Center at least seven(7) days before it is due to expire. Address your extension request to the Building Official and state your reason(s) for the need to extend your permit. The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is determined that your extension request is granted, you will be notified by mail. In the event you do not call for an inspection and/or receive an extension prior to 12/12/2017, your permit will become null and void and any further work on the project will require a new permit and associated fees. Thank you for your cooperation in this matter. Sincerely, Bill Rambo Permit Technician File No: EL17-0074 6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 6/5/2017 City of Tukwila Department of Community Development HANS VISSER 5209 122ND ST E TACOMA, WA 98446 RE: Permit No. EL17-0074 MARRIOTT RESIDENCE INN 16201 W VALLEY HWY Dear Permit Holder: Allan Ekberg, Mayor Jack Pace, Director In reviewing our current records, the above noted permit has not received a final inspection by the City of Tukwila Building Division. Per the International Building Code, International Mechanical Code, Uniform Plumbing Code and/or the National Electric Code, every permit issued by the Building Division under the provisions of these codes shall expire by limitation and become null and void if the building or work authorized by such permit has not begun within 180 days from the issuance date of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work has begun for a period of 180 days. Your permit will expire on 7/30/2017. Based on the above, you are hereby advised to: 1) Call the City of Tukwila Inspection Request Line at 206-438-9350 to schedule for the next or final inspection. Each inspection creates a new 180 day period, provided the inspection shows progress. -or- 2) Submit a written request for permit extension to the Permit Center at least seven(7) days before it is due to expire. Address your extension request to the Building Official and state your reason(s) for the need to extend your permit. The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is determined that your extension request is granted, you will be notified by mail. In the event you do not call for an inspection and/or receive an extension prior to 7/30/2017, your permit will become null and void and any further work on the project will require a new permit and associated fees. Thank you for your cooperation in this matter. Sincerely, 17'1 (144,i E �I „ I� Rachel e Ripley Permit Technician File No: EL17-0074 6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 CULBERTSON SIGN SERVICE LI r. Home Espanol Contact Safety & Health Claims & Insurance Washington State Department of Labor & Industries Search L&I Page 1 of 2 A -Z index Help My Ma Workplace Rights Trades & Licensing CULBERTSON SIGN SERVICE LLC Owner or tradesperson 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, WA 98446 253-538.0752 PIERCE County Business type 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 08/30/2002— 08/30/2018 Designated administrator CULBERTSON, PAUL License type Master Electrician Active. Meets current requirements. License no, 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 N/A N/A Savings account ID License Violations Infraction no. EALEJ00261 Satisfied ......................... RCW/WAC Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602043276&LIC=CULBESS984MU&SAW= 1/31/2017 CULBERTSON SIGN SERVICE LI.0 Issue date 07/16/2012 Violation city TACOMA Type of violation ELECTRICAL CITATION Description Failing to obtain or post an electrical/telecommunications work permit prior to beginning the electrical/telecommunication installation or alteration as referenced in WAC 296-46B-900 (3)(6), effective after 12/30/2008 see WAC 296- 46B-901. No permit for 2nd sign installed at this address. Infraction no. ELEIS00416 Issue date 02/01/2011 Violation city Tacoma Type of violation ELECTRICAL CITATION Description Failing to obtain or post an electrical/telecommunications work permit prior to beginning the electrical/telecommunication installation or alteration as referenced in WAC 296-46B-900 (3)(6), effective after 12/30/2008 see WAC 296- 46B-901(3)(6). 19.28.101 RCW Violation amount $2,000.00 Satisfied ........................ RCW/WAC 19.28.101 RCW Violation amount $1,000.00 Workers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID Account is current. 964,604-01 ................................. Doing business as CULBERTSON SIGN SERVICE LLC Estimated workers reported Quarter 3 of Year 2016 "4 to 6 Workers" L&I account representative T4 / TERRI MADISON (360)902-4654 - Email: KIRT235@Ini.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Page 2 of 2 G Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington. Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602043276&LIC=CULBESS984MU&SAW= 1/31/2017