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Home My WebLink AboutPermit EL18-0742 - CITY OF TUKWILA - IMPROVEMENTS ALONG CHRISTENSEN ROAD & BAKER BOULEVARD AND ANDOVER PARK EAST & BAKER BOULEVARDCITY OF TUKWILA 130 ANDOVER PARK E COMPLEX ELI 8-0742 City of Tukwila a of Department -_— Community Development 63O0 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206^431-3670 Inspection Request Line: 206-438'9350 Web site: http://www.TukwilaWA.gov Parcel No: 0223100040 Address: ELECTRICAL OTC PERMIT 130 ANDOVER PARK E COMPLEX Project Name: CITY OF TUKWILA Permit Number: EL10-07/2 Issue Date: 8/27/2018 Permit Expires On: 2/23/2019 Owner: Name: Address: Contact Person Name: Address: Contractor: Name: Address: License No: Lender: Name: Address: PUGET SOUND BLOOD CENTER 921 TERRY AVENUE DIRECTOR OF ADMINISTRATION, SEATTLEWA, 98104 JON MOGENSEN Phone: (206) 595-6656 20111 208 AVE SE , RENTON, WA, 98058 WEST COAST SIGNAL INC Phone: (206) 695-6656 Z01112U8THAVE 6E'RENTOKiWA, 98058 VVE9TC[38928G Expiration Date: 11/21/2019 ''' DESCRIPTION OF WORK **FINAL INSPECTION ONLY** ORIGINAL PERMIT EL17-0687 INSTALL NEW 100A 120/240V SERVICE CABINET FOR NEW STREET LIGHTING SYSTEM ALONG CHRISTENSEN RD/BAKER BLVD. PROVIDE CONDUIT, WIRE, FOUNDATIONS, POLES, AND FIXTURE. ALSO, INSTALL NEW PUSH BUTTON POLES AT THE INTERSECTION OF ANDOVER PARK E/BAKER BLVD. PROVIDE CONDUIT, WIRE, BOXES, AND POLES. Valuation of single family: $0.00 Valuation of mf/comm: $124,013.00 Type of Work: NEW Fees Collected: $143.84 Electrical Service Provided by: PUGET SOUND ENERGY Water District: TUKVv.LA Sewer District: TUKWILA Current Codes adopted by the City of Tukwila: 01111116, 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: 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 1. gulating construction or the performance of work. I am authorized to sign and obtain this development pe nd agree t* he onditions attached to this permit. Signature: Print Name: Date: e- . L7 .• J f This permit shall become null and v. id 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 7003 7002 7001 ELECTRICAL FINAL ROUGH -IN ELECTRICAL SERVICE UNDERGROUND/SLAB CITY OF TUKWIL4 Community Development Department Penni! Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.Tukwi aW A. gov Electrical Permit No. Vt di 41 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: Intersection of Baker Blvd/Christensen Rd Suite Number: Floor: Tenant Name: City of Tukwila PROPERTY OWNER Name: Jon Mogensen Address: 20111 208th Ave SE Name: City of Tukwila Phone: (206) 595-6656 Fax: Email: moge@westcoastsignal.com Address: 6300 Southcenter Blvd City: Tukwila State: WA Zip: 98188 CONTACT PERSON -- person receiving all project communication Name: Jon Mogensen Address: 20111 208th Ave SE City: Renton State: WA Zip: 98058 Phone: (206) 595-6656 Fax: Email: moge@westcoastsignal.com New Tenant: D Yes 121. No ELECTRICAL CONTRACTOR INFORMATION Company Name: West Coast Signal, Inc. Address: 20111 208th Ave SE City: Renton State: WA Zip: 98058 Phone: (206) 579-3675 Fax: Contr Reg No.: WESTCCS8928C Exp Date: 11/07/2017 Tukwila Business License No.; BUS -0997246 Valuation of Project (contractor's bid price): $ 124,013 Scope of Work (please provide detailed information): Install new 100A 120/240V service cabinet for new street lighting system along Christensen Rd/Baker Blvd. Provide conduit, wire, foundations, poles, and fixture. Also install new pushbutton poles at the intersection of Andover Park E/Baker Blvd. Provide conduit,wire, boxes, and poles. Will service be altered? gi] Yes EJ No Adding more than 50 amps? IZJ Yes No Type of Use: Tvoe ofwork: New 0 Addition 0 Service Change 0 Remodel 0 Tenant Improvement Low Voltage 0 Generator 0 Fire Alarm 0 Telecommunication 0 Temporary Service Property Served by: 12 Puget Sound Energy 0 Seattle City Light W:\Pmit Caitro1Applications-HaniloutsTormit Applications \PDFAElectrical Pormit Application Revisal 1-1-17.doot Rcuiscch January 2017 bh Page 1 of 2 RESIDENTIAL NEW RESIDENTIAL SERVICE ❑ New single family dwellings (including an attached garage) ❑ Garages, pools, spas and outbuildings ❑ Low voltage systems (alarm, furnace thermostat) $155.91 $83.54 ea $61.05 ea REESIDENTIAL REMODEL AND SERVICE CHANGES ❑ Service change or alteration $83.54 (no added/altered circuits) • Service change with added/altered circuits $83.54 1 number of added circuits $12.00 ea ❑ Circuits added/altered without service change $55.69 (np 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 $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 issucd 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 OW Signature: EL CAL CONTRACTOR: Date: Print Name: Jon ogensen Day Telephone: (206) 595-6656 Mailing Address: 20111 208th, ve SE Renton WA 98058 W:Wamit CemeVAppli nauxu. wnuny wI. bh ¢mit AppticatianslPDF'slElechicel Permit Application Revisal 1-1-17. door City State Zip Page 2 of 2 Page 1 of 2 CO TUKWILA ETRAKIT 6200 SOUTHCENTER BLVD TUKWILA, WA 98188 206-433-1870 CITY OF TUKWILA 0017340000802374464500 Date: 08/27/2018 12:40:00 PM CREDIT CARD SALE VISA CARD NUMBER: **********8263 K TRAN AMOUNT: $143.84 APPROVAL CD: 417204 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 CO TUKWILA ETRAKIT 6200 SOUTHCENTER BLVD TUKWILA, WA 98188 206-433-1870 CITY OF TUKWILA Date: 08/27/2018 12:40:00 PM CREDIT CARD SALE VISA CARD NUMBER: **********8263 K TRAN AMOUNT: $143.84 APPROVAL CD: 417204 RECORD #: 000 CLERK ID: Rachelle Thank you! Customer Copy https://classie.convergepay .com/VirtualMerchant/transaction.do?dispatchMethod=prinara... 8/27/2018 Page 2 of 2 https://classic.convergepay.comNirtualMerchant/transaction.do?dispatchMethod=printTra... 8/27/2018 Cash Register Receipt City of Tukwila Receipt Number R15256 DESCRIPTIONS PermitTRAK ACCOUNT 1 QUANTITY I PAID $143.84 EL18-0742 Address: 130 ANDOVER PARK E COMPLEX Apn: 0223100040 $143.84 Credit Card Fee $4.19 Credit Card Fee R000.369.908.00.0() 0.00 $4.19 ELECTRICAL $133.00 PERMIT FEE MULTI-FAM/COMM R000.322.101.00.00 0.00 $133,00 TECHNOLOGY FEE 6.65 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R15256 R000.322.900.04.00 0.00 $6.65 $143.84 Date Paid: Monday, August 27, 2018 Paid By: JON MOGENSEN Pay Method: CREDIT CARD 417204 Printed: Monday, August 27, 2018 12:40 PM 1 of 1 SYSTEMS INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 07Eiz 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 438-9350 (206) 431-367 Project: /j0( �� Type of Inspection: Address: Date Called: Special Instructions: Date Wanted: C.m. Requester: '1— Phone No: 705-75 // %%5 Approved per applicable codes. Corrections required prior to approval. COMMENTS: o Inspector:'' J�J Date: o7 06 a REINSPECT' i7N FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. WEST COAST SIGNAL INC Homo Espanol Contact Safety & Health Claims & Insurance Washington State Department of kl Labor & Industries A -Z Index help Page 1 of 2 -SEARCH.' My I.,Sd Workplace Rights Trades & Licensing WEST COAST SIGNAL INC Owner or tradesperson Principals Mogensen, Becky, PRESIDENT Mogensen, Becky, AGENT SHERWOOD, ROGER P, PRESIDENT (End: 08/15/2018) UNITED STATES CORP AGENTS INC, AGENT (End: 08/15/2018) MOGENSEN, JON E, PRESIDENT (End: 11/13/2015) Doing business as WEST COAST SIGNAL INC WA UBI No. 603 149 602 20111 208TH AVE SE RENTON, WA 98058 206-595-6656 KING County Business type Corporation Governing persons JON ERIC MOGENSEN ROGER PAUL SHERWOOD; 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. WESTCCS8928G Effective — expiration 11/21/2011-11/21/2019 Designated administrator REED, STEVEN J License type Master Electrician Bond Contractors Bonding & Insurance Co Bond account no. SJ4016 Received by L&I 11/07/2011 Active. Meets current requirements. License no. REED`SJ972N5 $4,000.00 Effective date 11/07/2011 Expiration date Help us improve https://secureini.wa.gov/verify/Detail.aspx?UBI=603149602&LIC=WESTCCS8928G&SAW= 8/27/2018 WEST COAST :.'iGNAL INC Until Canceled r.. Savings No savings accou, is during the previous 6 year period. License Violations No license violaticns during the previous 6 year period. Workers' comp Do you know if the Lusiness has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID 223,621-00 ................... _ ...... Doing business as WEST COAST SIGNAL INC Estimated workers reported Quarter 2 of Year :.018 "11 to 20 Workers" L&I account contact T2 / LINDA ALGUIi :E (360)902-4678 - Email: POTH235@Ini.wa.gov Account is current. Public Worcs Strikes and Debarments Verify the contractor is eligible to perform work on public works projects. Contractor Strikes No strikes have b' an issued against this contractor. Contractors not a. owed to bid No debarments he ,e been issued against this contractor. Workplace :safety and health No inspections dun, .g the previous 6 year period. Page 2 of 2 t, Washington State Dept. vt Labor & Industries. Use of this site is subject to the laws of the state of Washington. Help us improve https://secure.lni Na.gov/verify/Detail.aspx?UBI=603149602&LIC=WESTCCS8928G&SAW= 8/27/2018