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Home My WebLink AboutPermit EL18-1049 - PROLIANCE SURGEONS - RUN 130 NEW CAT 6 CABLES TO 37 LOCATIONSPROLIANCE SURGEONS 150 ANDOVER PARK W ELI 8-1049 Parcel No: Address: Project Name: c 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 0223100010 ELECTRICAL OTC PERMIT Permit Number: 150 ANDOVER PARK W Issue Date: Permit Expires On: PROLIANCE SURGEONS EL18-1049 12/7/2018 6/5/2019 Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: Address: License No: Lender: Name: Address: OPEN FRAME LLC 14900 INTERURBAN AVE S #130 C/O JSH PROPERTIES INC, TUKWILA, WA, 98168 MICHAEL RUSSELL 6825 216 ST SW - SUITE E , LYNNWOOD, WA, 98036 INTERFACE TECHNOLOGIES NW INC 6825 216 ST SW , LYNNWOOD, WA, 98036 INTERTN858DS Phone: (425) 977-2408 Phone: (425) 774-1377 Expiration Date: 3/_0/2019 DESCRIPTION OF WORK: RUNNING 130 NEW CAT 6 CABLES TO 37 LOCATIONS Valuation of single family: $0.00 Valuation of mf/comm: $20,372.00 Type of Work: LOW VOLTAGE Fees Collected: $499.56 Electrical Service Provided by: PUGET 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: 2015 2015 2015 2015 2015 National Electrical Code: WA Cities Electrical Code WAC 296-46B: WA State Energy Code: 2017 2017 2017 2015 Permit Center Authorized Signature: Date: 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 gree to the conditions attached to this permit. Signature: Print Name: %it /1101 N/1 �✓1 Date: (z/..P 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 ANN CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd, Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Electrical Permit No. 1e C L 9 - 161 61 Project No. Date Application Accepted: a - ig Date Application Expires: (— — 1 1 (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.: 0223100010 Site Address: 150 West Andover Parkway, Tukwila 98188 Suite Number: Floor: 1 New Tenant: ® Yes ❑..No Tenant Name: Proliance Surgeons PROPERTY OWNER Name: Michael Russell Name: Open Frame LLC City: Lynnwood State: WA Z''P: 98036 Address: 150 Andover Park West Email: michaelr@interfacetechnw.com City: Tukwila State: WA ZIP: 98188 CONTACT PERSON — person receiving all project communication Name: Michael Russell Address: 6825 216th St SW, Suite E City: Lynnwood State: WA Z''P: 98036 Phone: (425) 977-2408 Fax: (425) 771-7810 Email: michaelr@interfacetechnw.com ELECTRICAL CONTRACTOR INFORMATION Company Name: Interface Technologies NW Address: 6825 216th St SW, Suite E City: Lynnwood State: WA Zip: 98036 Phone: (425) 977-2408 Fax: (425) 771-7810 Contr Reg No.: INTERTN858DS Exp Date: 03/10/2019 Tukwila Business License No.; BUS -0997501 Valuation of Project (contractor's bid price): $ 20,372 Scope of Work (please provide detailed information): Running 130 New Cat 6 Cables to 37 Locations Will service be altered? ❑ Yes m No Adding more than 50 amps? ❑ Yes m No Type of Use: Type of work: 0 New 0 Addition 0 Service Change 0 Remodel 0 Tenant Improvement m Low Voltage 0 Generator 0 Fire Alarm 0 Telecommunication 0 Temporary Service Property Served by: Puget Sound Energy 0 Seattle City Light CenterW Applications -Handouts Applications Permit W:\Pe PP PP Application Revised 1-1-17.docx Revised: January 2017 bh 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 ❑ Low voltage systems (alarm, furnace thermostat) 561.05 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 O 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 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: Michael RussellDigitallyned Michael tk7:m=Michxl Ruszeq. �IrtteRace Technologies NW. ou, small=01812. gented29-echnw.mm.t=its 12/03/2019 Signature: Date 2018.12.6;04".29-08'00' Date: Print Name: Michael Russell Day Telephone: (425) 977-2408 Mailing Address: 6825 216th St SW, Suite E Lynnwood WA 98036 W:\Permit Center\Applicabbre-HaxdouMPennit Applications\PDF'slElectricel P Revised: January 2017 bh plicetibn Revised 1-I-17.docx City State Zip Page 2 of 2 Cash Register Receipt City of Tukwila DESCRIPTIONS PermitTRAK ACCOUNT QUANTITY PAID $499.56 EL18-1049 Address: 150 ANDOVER PARK W Apn: 0223100010 $499.56 ELECTRICAL $475.77 PERMIT FEE MULTI-FAM/COMM R000.322.101.00.00 0.00 $475.77 TECHNOLOGY FEE $23.79 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R15992 R000.322.900.04.00 0.00 $23.79 $499.56 Date Paid: Friday, December 07, 2018 Paid By: INTERFACE TECHNOLOGIES NW INC Pay Method: CHECK 50111 Printed: Friday, December 07, 2018 7:54 AM 1 of 1 SYSTEMS INTERFACE TECHNOLOGIES N Contractors not allowed to bid No debarments have been issued against this contractor. Page 3 of 3 Workplace safety and health No inspections during the previous 6 year period. Washington State Dept. of Labor & Industries. Use of this s e is subject to the laws of the state of Washington. Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602103938&LIC=INTERTN858DS&SAW= 12/7/2018 INSPECTION NO. INSPECTION RECORD Retain a copy with permit 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 438-9350 PERMIT NO. 4° (206) 431-36 CITY OF TUKWILA BUILDING DIVISION Project: T e DineI`le io Al Address:1� O rai &04-4,(4tN1 Date Called: Special Instructions: Date Wanted: /1-..nvei.' ` Requester: kb Phone No: ti,.._ t I n S Approved per applicable codes. a Corrections required prior to approval. COMMENTS: Calk6eflitAr, MAD t 04 - ‘tt 14# LA &04-4,(4tN1 Inspector: Date: REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. INSPECTION RECORD . Retain a copy with permit (314 0- Oil INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 438-9350 Project: 9, &C)Lk AIJC.,-r Type of Inspection: i 0 kill 4 tiki Address: /5-0 A -PUJ Date Called: Special Instructions: V 111 111 2/i a Date Wanted: a.m . i. Requester: At, mi ' - .1 Phone No: _ tri -C- ttri NI/ r ElApproved per applicable codes. Corrections required prior to approval. COMMENTS: IldlUrl CA4M06 601\lbLE Fok _(.c.t/NIC\ ost4 5aPP0kr iNic,ebixe, — 4:r Ift-00(--, Tro se-Q-acrua....c-' ,c)( 0-441kkici Sc-tt&DO(,6 kt-64)P6-cnoA1/Rivivt---- Foi\ L2424 P - 11 Inspector: ,1/41,1/4K Date: rrn REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INTERFACE TECHNOLOGIES Nt\IC Washington State Department of )Labor & Industries 0 Home .Espanol Contact Safety & Health Claims & Insurance Page 1 of 3 Search L&I A -Z, Index Workplace Rights INTERFACE TECHNOLOGIES NW INC Owner or tradesperson Principals Reed, Jeremy L, PRESIDENT Reed, Elizabeth L, SECRETARY Adams, Christopher, AGENT Schmidt, Kevin G, PRESIDENT (End: 10/01/2018) Anthony, Andrew S, VICE PRESIDENT (End: 10/01/2018) Wiedmer, Lisa, SECRETARY (End: 10/01/2018) Wiedmer, Lisa, TREASURER (End: 10/01/2018) Adams, Christopher, AGENT (End: 10/01/2018) Anthony, Andrew S, AGENT (End: 10/01/2018) Doing business as INTERFACE TECHNOLOGIES NW INC WA UBI No. 602 103 938 6825 216th St SW Suite E LYNNWOOD, WA 98036 425-774-1377 SNOHOMISH County Business type Corporation Governing persons VICKI L BATTISTA DONALD G COOK; TROY J POND; KEVIN G SCHMIDT; - ?rove https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602103938&LIC=INTERTN858DS&SAW= 12/7/2018 INTERFACE TE CHNOLOGIES NW INC eft. Licensel' Page 2 of 3 Verify the cont actor's active registration / license / certification (depending on trade) and any past violations. Electrical Cc'ntractor Active. Meets current requirements. License specialties LIMITED EN 1RGY License no. INTERTN85C DS Effective — vpiration 03/10/2015— 03/10/2019 t• Designated tddministrator Schmidt, Ke/in G Active. Meets current requirements. License type License no. Electrical AZ ministrator SCHMIKG856DF Bond Federated Ili dtual Ins Co Bond accouri: no. 6081400 Received by,841 10/10/2018 ir Bond historyij Savings 64,000.00 Effective date 08/29/2018 Expiration date Until Canceled No savings at ounts during the previous 6 year period. License Violaons No license vic. ations during the previous 6 year period. Worker r ' comp Do you know i the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account 009,325-00 Doing busines as INTERFACE 1 iCHNOLOGIES NORTHWE Estimated wor ers reported Quarter 3 of N ar 2018 "21 to 30 Workers" L&I account cc Itact T3 / NATHAN #13ZAK (360)902-6243 - Email: KOZN235@lni.wa.gov Account is current. Public V 'orks Strikes and Debarments Verify the cont actor is eligible to perform work on public works projects. Contractor St 'kes No strikes ha a been issued against this contractor. Help us improve https://sccure.lni .va.gov/verify/Detail.aspx?UBI=602103938&LIC=INTERTN858DS&SAW= 12/7/2018