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Home My WebLink AboutPermit EL18-0727 - FOREVER 21 - SPOT RE-LAMP INSTALLING 72 LED PAR30 LAMPS ON SALES FLOORFOREVER 21 836 SOUTHCENTER MALL ELI 8-0727 Parcel No: Address: Cityof Tukwila " ��o��Uoa �� Department -^ Community Development 6300 Southcenter BoulevardSuite 4100 Tukwila, Washington 98188 Phone: 206'431'3670 Inspection Request Line: 206-438'9350 Web site: htto://www.TukwilaWA.gov ELECTRICAL OTC PERMIT 9202470010 Permit Number: EL10'0737 836 SOUTHCENTER MALL Project Name: FOREVER 21 Issue Date: 8/21/2018 Permit Expires On: 2/17/2019 Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: Address: License No: Lender: Name: Address: WESTFIELD PROPERTY TAX DEPT POBOX 13O94O'CARLSBAD WA, 92013 BRYAN CUSTER 217D666AVE VV'KxDUNTLAKE TERRACE, WA, 98043 LUMENAL LIGHTING ILC 21706 66TH AVE W, MOUNTLAKE TERRACE, WA, 98043-2104 LUMENLL864LW Phone: (425) 481-5001 Phone: (425) 481-5001 Expiration Date: 6/16/2020 DESCRIPTION OF WORK: SPOT RE -LAMP INSTAWNG 72 LED PAR30 LAMPS ON SALES FLOOR Valuation of single family: 0. Valuatior, of mf/comm: $1,120M Type of Work: TENANT IMP Fees Collected: $130.83 Electricat Service Provided by: PUGET SOUND ENERGY Water District: TUKWILA Sewer District: TUKWILA Current Codes adopteby the City of Tukwila: lnternational Building Code Edition: International Residential Code Edition: International Mechanical Code Edtion: 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: Date: 2017 2017 2017 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 regul ing construction or the performance of work. I am authorized to sign and obtain this development permit nd gree to the conditions attached to this permit. Signature: Print Name:---n/-1^J /_'D/1 #1.14/4/2 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 CITY OF TUKW ,ai Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http:i/www.TukwilaW A.gov Electrical Permit No. E LI81U 727 7 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.: Site Address: 836 Southcenter Mall Tukwila, WA 98188 Suite Number: Floor: 1 Tenant Name: Forever 21 New Tenant: ❑ Yes ❑..No PROPERTY OWNER Name: Address: City: State: Zip: CONTACT PERSON — person receiving all project communication Name: Bryan Custer Address: 21706 66th Ave W City:Mountlake Terrace State: WA zip: 98043 Address: 21706 66th Ave W Contr Reg No.: LUMENLL864L Exp Date: 06/16/2020 Tukwila Business License No.; #BUS -0993683 City: Mountlake Terrace State: WA Zip: 98043 Phone: (425) 481-5001 Fax: Email: service@lumenal.com ELECTRICAL CONTRACTOR INFORMATION Company Name: Lumenal Lighting Address: 21706 66th Ave W City:Mountlake Terrace State: WA zip: 98043 Phone: (425) 481-5001 Fax: Contr Reg No.: LUMENLL864L Exp Date: 06/16/2020 Tukwila Business License No.; #BUS -0993683 Valuation of Project (contractor's bid price): $ 1,120 Scope of Work (please provide detailed information): Spot re -lamp installing 72 LED PAR30 lamps on sales floor Will service be altered? ❑ Yes ❑ No Adding more than 50 amps? 0 Yes ❑ No Type of Use: Type of work: ❑ New ❑ Addition 0 Service Change 0 Remodel 0 Tenant Improvement ❑ Low Voltage 0 Generator 0 Fire Alarm 0 Telecommunication 0 Temporary Service Property Served by: ❑ Puget Sound Energy W:\Permit Center\Applicatioru-Handoutx\Permit Appl Revised: January 2017 bh 0 Seattle City Light \DF'stElectrcal Permit Application Revisal l-I-17_ducx Page 1 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 0 RESIDENTIAL REMODEL AND SERVICE CHANGES 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 Service change or alteration $83.54 (excluding garage or outbuilding) (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, fumace thermostat) ❑ Camivals $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 tirne 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 OW1 R OR ELECTRICAL CONTRACTOR: Signature: Print Name: Jot":Dannar Day Telephone: hone: (206) 376-2897 Mailing Address: 21706 66th Ave W Mountlake Terrace WA 98043 Date: 08/21/2018 City W:\Pennit Center \Applications-HanduuenPermit Application PDFs\Electrical Permit Application Revised 1-1-17.ducx Revised: January 2017 bh State Zip Page 2 of 2 Cash Register Receipt City of Tukwila DESCRIPTIONS I PermitTRAK ACCOUNT I QUANTITY PAID $130.83 EL18-0727 Address: 836 SOUTHCENTER MALL. Apn: 9202470010 $130.83 Credit Card Fee $3.81 Credit Card Fee R000.369.908.00.00 0.00 I $3.81 ELECTRICAL $120.97 PERMIT FEE MULTI-FAM/COMM R000.322.101.00.00 0.00 $120.97 TECHNOLOGY FEE $6.05 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R15215 R000.322.900.04.00 0.00 $6.05 $130.83 Date Paid: Tuesday, August 21, 2018 Paid By: JAOHN DANNAR Pay Method: CREDIT CARD 021751 Printed: Tuesday, August 21, 2018 1:41 PM 1 of 1 CRWSYSTEMS Page 1 of 2 CO TUKWILA ETRAKIT 6200 SOUTHCENTER BLVD TUKWILA, WA 98188 206-433-1870 CITY OF TUKWILA 0017340000802374464500 Date: 08/21/2018 01:40:59 PM CREDIT CARD SALE MASTERCARD CARD NUMBER: **********7211 K TRAN AMOUNT: $130.83 APPROVAL CD: 02175J RECORD #: 000 CLERK ID: Bill 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 https://classic.convergepay.com/VirtualMerchant/transaction.do?dispatchMethod=printTra... 8/21/2018 INSPECTION NO. 6300 Sou Permit Inspection Request Line (206) 438-9350 INSPECTION RECORD Retain a copy with permit 64—ON PERMIT NO. CITY OF TUKWILA BUILDING DIVISION thcenter Blvd., #100, Tukwila. WA 98188 (206) 431-367 Project: / Type of Inspection: T Address: ,8,3 W ri Date Called: Special Instructions: n �� ...JMf5 ' 1/t"` k� �� X1I _ Date Wanted: � � /gym. f�pm. Requester: Phone No: 2<4 / 0 zn7 Approved per applicable codes. Corrections required prior to approval. OMMENTS: ‘1A1 Inspector: ®7 Date: 0c IY C REINSPECTION EE REQUIRED. Prior to next inspection, fee musk be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. LUMENAL LIGHTING LLC 114)m c Espaiiol Contact Safety & Health Claims & Insurance Washington State Department of kJ Labor & Industries Search L8.1 Page 1 of 3 ,'SEAfitCt4 21.--Z Index I lelp My IX( Workplace Rights Trades & Licensing LUMENAL LIGHTING LLC Owner or tradesperson Principals K3 LLC, PARTNER/MEMBER NIELSEN, DONALD P, PARTNER/MEMBER ASSIST INC, A WASHINGTON CORP, AGENT Doing business as LUMENAL LIGHTING LLC WA UBI No 602 503 496 21706 66TH AVE W MOUNTLAKE TERRACE, WA 98043 425-481-5001 SNOHOMISH County Business type Limited Liability Company Governing persons DONALD PETER NEILSON MELISA NIELSEN; PACIFIC COAST INDUSTRIAL LIG; LLC K3 KURT DONALD NIELSEN; License Verify the contractor's active registration / license / certification (depending on trade) and any past violations. Electrical Contractor Active. Meets current requirements. License specialties GENERAL License no. LUMENLL864LW Effective — expiration 06/16/2014— 06/16/2020 Designated administrator WYLL, JASON Active. Meets current requirements, License type License no. Master Electrician VVYLL*,r973D0 Bond Western Surety Co Bond account no 929614006 $4,000.00 Received by L&I Effective date 06/25/2015 08/01/2015 Expiration date Until Canceled Bond history Savings Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602503496&LIC=LUMENLL864LW&SAW= 8/21/2018 LUMENAL LIGHTING LLC No savings accounts during the previous 6 y di"ariod. License Violations Infraction no. EZINS00208 Issue date 07/18/2017 Violation city MOUNTLAKE TERRACE Type of violation ELECTRICAL CITATION Description Employing electricians and electrical trainees for the purposes of chapter 19.28 RCW in an improper ratio. Infraction no. EJORP06995 Issue date 08/17/2016 Violation city MOUNTLAKE TERRACE Type of violation ELECTRICAL CITATION Description Energizing electrical equipment without an electrical inspection as referenced in WAC 296-46B-901. Infraction no. EJORP06994 Issue date 08/17/2016 Violation city MOUNTLAKE TERRACE Type of violation ELECTRICAL CITATION Description Failing to get an inspection or obtain a valid electrical/telecommunications work permit or post a provisional electrical work permit prior to beginning the electrical/telecommunication installation or alteration as referenced in WAC 296-46B-901. Satisfied ...................... RCW/WAC 19.28.161 RCW Violation amount $250.00 Satisfied RCW/WAC 19.28.101 RCW Violation amount $250.00 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 861,055-04 ............................ Doing business as LUMENAL LIGHTING LLC Estimated workers reported Quarter 2 of Year 2018 "51 to 75 Workers" L&I account contact T1 / FEARAED FEROZE (360)902-4797 - Email: FERH235@lni.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. Page 2 of 3 Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602503496&LIC=LUMENLL864LW&SAW= 8/21/2018