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HomeMy WebLinkAboutPermit EL18-0643 - EXAMWORKS - INSTALL TOTAL OF 40 DATA CABLES TO 15 LOCATIONSEXAMWORKS 16300 CHRISTENSEN RD 350 EL18-0643 Parcel No: Address: City of Tukwila a Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206'431'3670 Jnspection Request Line: 206'438'9350 Web site: httm://xmmw.Tukvvi|aVVA.gov ELECTRICAL OTC PERMIT 2523049078 Permit Number: EL18'0643 16300 CHRISTENSEN RD 350 Project Name: EXAMWORKS Issue Dat : 7/20/2018 Permit Expires On: 1/16/2019 Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: Address: License No: Lender: Name: Address: TALON RIVERVEW PLAZA LLC 72OOLIVE WAY STI1O2U,SEATTLE, WA, 98101 JASON BURRIS 1402 LAKE TAPPS PKWY SE , AUBURN WA, 98092 STRUCTUREDCABLING SOLUTIONS LLC l98141l5TE'BONNEYLAKE, WA, 98391 5TRUCC58548L Phone: (253) 732-5909 Phone: (253) 732-5909 Expiratlon Date: 1/13/2019 DESCRIPTION OF WORK: NSTALL A TOTAL OF 40 DATA CABLES TO 15 LOCATIONS Valuation of single family: $0.00 Valuation of mf/comm: $3,500.00 Type of Work: TELECOM Fees Collected: $178.48 Electrical Service Provided by: PUGET SOUND ENERGY Water District: TUKVV/LA Sewer District: TUKWILA Current Codes adopted by the City of Tukwila: International Buflding Code Edition: lnternational Residential Code Edition: International Mechanical Code Edition: Uniform Plumbing Code Edition: International FueI Gas Code: Permit Center Authorized Signature: 2015 20152015 2015 2015 National Electrical Code: WA Cities Electrical Code: WAC 296-46B: WA State Energy Code: / / Date: 2017 20172017 2015 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 pQrmit and agree to the conditions attached to this permit. Signature: Print Name a v\ v k,ia S G v\ In �►✓� 1 � Date: / 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 Rik CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Electrical Pemiitt? Project No Date Application. :Accepted: Date Application Expire : 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 Address: 14 306 C' S4eM eVI t2 Tenant Name: EXotmikie k,S King Co Assessor's Tax No.: Suite Number: 365— Floor: PROPERTY OWNER Name: 1 0., g ��r„,5 City: titmu�� tate: W Q Zip: Cr n Oq 17 i1 Address: /q v a jy t' iYn 5*6- c Contr Reg No.: 1 autL Cca $ay e` Date: `_ 13 _ !i ' LLC - Address:/ o co c h e1' Vl; A 2b 61e !a City: y -a 'i tot State: u j a Zip: eigiee CONTACT PERSON — person receiving all project communication Company Name: 51 ` cetbi Cv'uht Name: 1 0., g ��r„,5 City: titmu�� tate: W Q Zip: Cr n Oq 17 i1 Address: /q v a jy t' iYn 5*6- c Contr Reg No.: 1 autL Cca $ay e` Date: `_ 13 _ !i ' City: p , I _ State: to A. Zip: tanLtact 861 Phone: gs7 01 Fax: .4SZ , 5Q6 Email: CJ4,SOri'�./ N tJ6T6tLT1Jld'.Q.L . Cc w\ 3” New Tenant: r,t, Yes ❑..No ELECTRICAL CE TRACTOINFORMATION Company Name: 51 ` cetbi Cv'uht alt. 1 Address:1440Z LeAkt 1-,p f 164' City: titmu�� tate: W Q Zip: Cr n Oq 17 i1 Phone:sx. �? �s°loct Fax: c Contr Reg No.: 1 autL Cca $ay e` Date: `_ 13 _ !i ' Tukwila Business License No.; p U/ ^ a R 44-_01 I r_ Valuation of Project (contractor's bid price): $ 35 00 Scope of Work (please provide detailed inf rmation): J.:14544 (1 'Id a I I d �'/ / 84-6, Q Ca��.S AU is but tdk5 Will service be altered? ❑ Yes U9 --No Adding more than 50 amps? 1=1 Yes [23. No Type of Use: Type of work: ❑ New ❑ Addition 0 Service Change 0 Remodel 0 Tenant Improvement 0 Low Voltage ❑ Generator 0 Fire Alarm 511. Telecommunication ❑ Temporary Service Property Served by: 1s, Puget Sound Energy ❑ Seattle City Light II: \Applications\Forms-Applications On Line\2014 Applications\Electrical Permit Application Revised I-1-14.docx Revised: January 2014 bh Page 1 of 2 RESIDENTIAL NEW RESIDENTIAL SERVICE 0 New single family dwellings $152.85 (including an attached garage) O Garages, pools, spas and outbuildings $81.90 ea O Low voltage systems (alarm, fumace thermostat) $59.85 ea RESIDENTIAL REMODEL AND SERVICE CHANGES O Service change or alteration $81.90 (no added/altered circuits) O Service change with added/altered circuits $81.90 number of added circuits $11.55 ea 0 Circuits added/altered without service change $54.60 (up to 5 circuits) O Circuits added/altered without service change $54.60 (6 or more circuits) $7.65 ea 0 Meter/mast repair $68.25 O 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 0 Temporary service (generator) $80.90 0 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. 1 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: od\ Print Name: OtSolik tit Mailing Address: Noz tak,e. -ram Pete601 54-e I o1/4 -k- 4o II: \ App I ie at ions \ Fo mis-Appl i cat ions On Line \ 2014 App I ie at ions Elect rico! Permit App I i cat ion Revised I -1 -14.docs Revised: January 2014 bh Day Telephone: AA INA VIA City Date: q 1 e A6.S-732— 64t0' ff-8188.State zip Mocti Page 2 of 2 Cash Register Receipt City of Tukwila DESCRIPTIONS PermitTRAK I ACCOUNT QUANTITY PAID $178.48 EL18-0643 Address: 16300 CHRISTENSEN RD 350 Apn: 2523049078 $178.48 Credit Card Fee $5.20 Credit Card Fee I R000.369.908.00.00 I 0.00 $5.20 ELECTRICAL $165.03 PERMIT FEE MULTI-FAM/COMM I R000.322.101.00.00 I 0.00 $165.03 TECHNOLOGY FEE $8.25 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R14994 R000.322.900.04.00 0.00 $8.25 $178.48 Date Paid: Friday, July 20, 2018 Paid By: JASON BURRIS Pay Method: CREDIT CARD 09164G Printed: Friday, July 20, 2018 9:52 AM 1 of 1 SYSTEMS Page 1 of 2 ‘pei CO TUKWILA ETRAKIT 6200 SOUTHCENTER BLVD TUKWILA, WA 98188 206-433-1870 CITY OF TUKWILA 0017340000802374464500 Date: 07/20/2018 09:52:01 AM CREDIT CARD SALE VISA CARD NUMBER: **********9877 K TRAN AMOUNT: $178.48 APPROVAL CD: 09164G RECORD #: 000 CLERK ID: Rachelle X (CARDHOLDER'S SIGNATURE) I AGREE TO PAY THE ABOVE TOTAL AMOUNT ACCORDING TO THE CARD ISSUER AGREEMENT (MERCHANT AGREEMENT IF CREDIT VOUCHER) Thank you! Merchant Copy haps ://classic .convergepay.com/VirtualMerchant/transaction.do?dispatchMethod—printTra... 7/20/2018 Page 2 of 2 CO TUKWILA ETRAKIT 6200 SOUTHCENTER BLVD TUKWILA, WA 98188 206-433-1870 CITY OF TUKWILA Date: 07/20/2018 09:52:01 AM CREDIT CARD SALE VISA CARD NUMBER: **********9877 K TRAN AMOUNT: $178.48 APPROVAL CD: 09164G RECORD #: 000 CLERK ID: Rachelle Thank you! Customer Copy https://classic.convergepay.com/VirtualMerchant/transaction.do?dispatchMethod=printTra... 7/20/2018 INSPECTION RECORD Retain a copy with permit INSPECTION NO, PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 438-9350 fi-t8-6613 (206) 431- Project: r VA -11 u,100--4-5 Type of Inspection: 6- &Ph, Address: /6300 C4-12.0 rsiedf\ Date Called: Special Instructions: r 13 q( lkif Date Wanted: . . Requester: Phone No: 2-3 0yApproved per applicable codes. Corrections required prior to approval. COMMENTS: ,„/ Inspector: Date: REINSPECTIO FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INSPECTION RECORD kily_at6 Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 - Permit Inspection Request Line (206) 438-9350 Project: L.— CY 1 tAJOkiCi Type of Inspectionv' if (0 14 i/V Address:?, /000 tigi•-•l:5 rbs8 64 bate Called: Special Instructions: q0 Date Wanted: p.m. Requester: Phone No: zoc, 5.1 c_.co gx to Approved per applicable codes. LJ Corrections required prior to approval. COMMENTS: 01 664/lIt tkify_k: cle0‘)41). Rfrokeor 7E) iki4K) F& Pvii-7_, Inspector Date: REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Structured Cabling Solutns LLC 4016, 1-10111e Espanol Contact Safety & Health Claims & Insurance k Washington State Department of Labor & Industries 0 riearch L&I L_ A-7, Index Help Page 1 of 2 "SCAttot My 1S:1 Workplace Rights Trades & Licensing Structured Cabling Solutns LLC Owner or tradesperson Principals Burris, Jason C, PARTNER/MEMBER Burris, Beth A, PARTNER/MEMBER Doing business as Structured Cabling Solutns LLC WA UB I No 603 465 659 19814 11th St E BONNEY LAKE, WA 98391 253-732-5909 PIERCE County Business type Limited Liability Company Governing persons BETH BURRIS JASON BURRIS; License Verify the contractor's active registration / license / certification (depending on trade) and any past violalions. Electrical Contractor License specialties LIMITED ENERGY License no. STRUCCS854BL Effective — expiration 01/13/2015— 01/13/2019 Designated administrator Burris, Jason License type Electrical Administrator Bond American Contractors Indem CO Bond account no 100266103 Received by L&I 01/13/2015 Savings No savings accounts during the previous 6 year period. License Violations No license violations during the previous 6 year period. Active. Meets current requirements. Active. Meets current requirements. License no BURRIJ*876J2 $4,000.00 Effective date 01/12/2015 Expiration date Until Canceled Workers' comp Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=603465659&LIC=STRUCCS854BL&SAW= 7/20/2018 Structured Cabling Solutns LLC Page 2 of 2 Do you know if the business has employees? If .rift' the business is up-to-date on workers' comp premiur L&I Account ID 522,709-00 Doing business as STRUCTURED CABLING SOLUTIONS Estimated workers reported Quarter 1 of Year 2018 "Less than 1 Workers" L&I account contact T4 / ALISON WOODWARD (360)902-4629 - Email: WOAL235@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. © 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=603465659&LIC=STRUCCS854BL&SAW= 7/20/2018