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Home My WebLink AboutPermit EL18-0564 - HORIZON FORD - INSTALL ILLUMINATED MONUMENT SIGN ALONG INTERURBAN AVE SThis 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. EL18-0564 HORIZON FORD 14027 INTERURBAN AVE S THE ABOVE MENTIONED Page # DIGITAL Code RECORDS PERMIT FILE INCLUDES Exemptio (DR) EXEMPTION LOG THE FOLLOWING REDACTED INFORMATION defExplanatory Description S a u el ule DR1 Personal Information — Social Security Numbers Generally — 5 U.S.C. sec. 552(a); RCW 42.56.070(1) The Privacy Act of 1974 evinces Congress' intent that social security numbers are a private concern. As such, individuals' social security numbers are redacted to protect those individuals' privacy pursuant to 5 U.S.C. sec. 552(a), and are also exempt from disclosure under section 42.56.070(1) of the Washington State Public Records Act, which exempts under the PRA records or information exempt or prohibited from disclosure under any other statute. 5 U.S.C. sec. 552(a); RCW 42.56.070(1) 9 DR2 Personal Information — Financial Information — RCW 42.56.230(4 5) Redactions contain Credit card numbers, debit card numbers, electronic check numbers, credit expiration dates, or bank or other financial account numbers, which are exempt from disclosure pursuant to RCW 42.56.230(5), except when disclosure is expressly required by or governed by other law. RCW 42.56.230(5) DR3 Personal Information — Driver's License. — RCW 42.56.230 (7a & c) Redactions contain information used to prove identity, age, residential address, social security number or other personal information required to apply for a driver's license or identicard. RCW 42.56.230 (7a & c) DR4 Attorney -Client Privilege — RCW 5.60.060(2)(a); RCW 42.56.070(1) Redacted content contains a communication between client and attorney for the purpose of obtaining or providing legal advice exempt from disclosure pursuant to RCW 5.60.060(2)(a), which protects attorney-client privileged communications, and RCW 42.56.070(1), which protects, under the PRA, information exempt or prohibited from disclosure under another statute. RCW 5.60.060(2)(a); RCW 42.56.070(1) HORIZON FORD 14027 INTERURBAN AVE S EXPIRED 12/18/18 EL1 8-0564 Parcel No: Address: City of Tukwila a � Department o^ Community Development 6300 Southcenter Boulevard, Suite #100 Tukwlla, Washington 98188 Phone: 206~431-3670 Inspection Request Line: 206'438'9350 Web site; http://www.TukwIIaWA.gov ELECTRICAL OTC PERMIT 3365900845 14027 INTERURBAN AVE 5 Project Name: HORIZON FORD Permit Number: EL10-0564 Issue Date: 6/21/2018 Permit Expires On: 12/18/2018 Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: Address: License No: Lender: Name: Address: TUKWILA GAMING LLC 8200 TACOMA MALBLVD, LAKEWOOD, WA, 98499 HANS VISSER 5209 122ND ST E TACOMA, WA, 98446 CULBERTSON SIGN SERVICE LLC (ELECTRIC) 5209 122ND ST E , TACOMA, WA, 98446 CULBE25984MU ''' Phone: (253) 538-0752 Phone: (800) 925-6011 Expiration Date: DESCRIPTION OF WORK: INSTALL ONE INTERNALLY ILLUMINATED MONUMENT SIGN ALONG INTERURBAN AVE S Valuation of single family: $0.0 Valuation of mf/comm: $600.80 Type of Work: TENANT IMP Fees Collected: $88.05 Electrical Service Provided by: PUGET SOUND ENERGY Water District: TUKWILA Sewer District: TUKWILA Current Codes adopted by the City of Tukwila: International Buliding Code Edition: nternationaI Residential Code Edition: International Mechanical Code Edition: Uniform Plumbing Code Edition: International FueI 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: 2017 2017 2017 2015 Date: L°)/_16 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: //AAA VSSEE Da 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 and the Washington Cities Electrical Code. 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. c L t V-0sI 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 I V027 P,epi 8A6.,4 Avg S Site Address: -1-1000 T Tenant Name: Horizon Ford PROPERTY OWNER Name: W S CAPITAL VENTURES LLC Address: 14600 AMBAUM BLVD SW City: Burien State: WA Zip: 98166 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 King Co Assessor's Tax No.: 3365900830 Suite Number: Floor: 1 New Tenant: ❑ Yes ® ..No ELECTRICAL CONTRACTOR INFORMATION Company Name: Culbertson Sign Service Address: 5209 122nd St E City: Tacoma State: WA Zip: 98446 Phone: (253) 538-0752 Fax: (253) 538-0778 Contr Reg No.: CULBESS984MI Exp Date: 08/30/2018 Tukwila Business License No.; BUS -0993893 Valuation of Project (contractor's bid price): $ 600 Scope of Work (please provide detailed information): Install one internally illuminated monument sign along Interurban Ave S. Will service be altered? ❑ Yes No Type of Use: Internally illuminated sign Adding more than 50 amps? ❑ 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\PDF's\Electrical Permit Application Revised 1-1-17.docx Revised: January 2017 bh ❑ Remodel ❑ Telecommunication ❑ Tenant Improvement ❑ Temporary Service Page 1 of 2 RESIDENTIAL NEW RESIDENTIAL SERVICE O New single family dwellings $155.91 (including an attached garage) O Garages, pools, spas and outbuildings $83.54 ea O Low voltage systems (alarm, furnace thermostat) $61,05 ea RESIDENTIAL REMODEL AND SERVICE CHANGES O Service change or alteration $83.54 (no added/altered circuits) O 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 0 Low voltage systems $6L05 (alarm, furnace thermostat) MULTI -FAMILY AND COMMERCIAL Fees are based on the valuation of the electrical contract. MISCELLANEOUS FEES O 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 $11.02 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 PERM BUILDING OWNER OR ELECTRICAL CONTRACTOR: Signature: Date: 06/21/2018 Print Name: Hans Visser Day Telephone: (253) 538-0752 Mailing Address: 5209 122nd St E Tacoma WA 98446 City W:\'ermit Center1Applications-Handouts\Permit Applications\PDFs\Electrical Permit Application Revised I -I-17 dacx Revised: January 2017 bh State Zip Page 2 of 2 Cash Register Receipt City of Tukwila DESCRIPTIONS PermitTRAK ACCOUNT QUANTITY PAID $358.95 EL18-0564 Address:14027 INTERURBAN AVE 5 Apn: 3365900845 $88.05 ELECTRICAL $83.86 PERMIT FEE MULTI-FAM/COMM R000.322.101.00.00 I 0.00 I $83.86 TECHNOLOGY FEE $4.19 TECHNOLOGY FEE I R000.322.900.04.00 I 0.00 I $4.19 S18-0037 Address: 14027 INTERURBAN AVE S Apn: 3365900845 $270.90 SIGN $258.00 PERMANENT SIGN PERMIT FEE 1 R000.322.100.00.00 I 0.00 $258.00 TECHNOLOGY FEE $12.90 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R14763 R000.322.900.04.00 0.00 $12.90 $358.95 Date Paid: Thursday, June 21, 2018 Paid By: CULBERTSON SIGN SERVICE LLC (E Pay Method: CHECK 13187 Printed: Thursday, June 21, 2018 9:00 AM 1 of 1 SYSTEMS 11/1/2018 c City of Tukwila Department of Community Development HANS VISSER 5209 122ND ST E TACOMA, WA 98446 RE: Permit No. EL18-0564 HORIZON FORD 14027 INTERURBAN AVE S 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 12/18/2018. 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 12/18/2018, 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, ---LW Bill Rambo Permit Technician File No: ELI8-0564 6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665 CULBERTSON SIGN SERVICE L I belle Es pahol ('ont Act Safety & Health Claims & Insurance 4111/14 4/k Washington State Department of Labor & Industries 0 [Search L&I Page 1 of 2 SiARCH A-7. Index 1 Id, My 141 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 RCWNvAC Help us improve haps://secure.lni.wa.gov/verify/Detail.aspx?UBI=602043276&LIC=CULBESS984MU&SAW= 6/21/2018 CULBERTSON SIGN SERVICE LL 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. 19.28.101 RCW Violation amount $2,000.00 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 964,604-01 Doing business as CULBERTSON SIGN SERVICE LLC Estimated workers reported Quarter 1 of Year 2018 "4 to 6 Workers" L&I account contact T4 / TERRI MADISON (360)902-4654 - Email: KIRT235@Ini.wa.gov Account is current. Public Works Strikes and Debarments Verify the contractor is eligible to perform work on public works projects. Contractor Strikes No strikes have been Issued against this contractor. Contractors not allowed to bid No debarments have been issued against this contractor. Workplace safety and health No inspections during the previous 6 year period. Page 2 of 2 0 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= 6/21/2018