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Home My WebLink AboutPermit EL18-1056 - INDIGO CLINIC - RELOCATED 4 CEILING RECEPTACLESINDIGO CLINIC 17275 SOUTHCENTER PKWY 160 ELI 8-1056 Parcel No: Address: 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.Rov ELECTRICAL OTC PERMIT 2623049063 17275 SOUTHCENTER PKWY 160 Project Name: INDIGO CLINIC Permit Number: EL18-1056 Issue Date: 12/10/2018 Permit Expires On: 6/8/2019 Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: Address: License No: Lender: Name: Address: MASAO 117 E LOUISA #230 C/O SCR LLC, SEATTLE, WA, 98102 JAROD SCHUSTER 29220 31ST AVE 5 , ROY, WA, 98580 KEN BOBKO ELECTRIC CO INC PO BOX 7009 , TACOMA, WA, 98417 KENBOEC066BA I Phone: (253) 686-4369 Phone: (253) 756-0944 Expiration Date: DESCRIPTION OF WORK: 4 RELOCATED CEILING RECEPTACLES FED FROM EXISTING 120 VOLT POWER. Valuation of single family: $0.00 Valuation of mf/comm: $1,125.00 Type of Work: REMODEL Fees Collected: $130.83 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: 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: le -UJ-Lb' 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: cav--cf>, S4 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 296-460 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 TUR" i%t«.,A u' Electrical Permit No. -CL 1 — I U Project No. Date Application Accepted: — 10 - 1 Date Application Expires: '4) — — 19 (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** I SITE LOCATION Site Address: 17275 Southcenter Pkwy Tenant Name: Indigo Clinic PROPERTY OWNER Name: Jarod Schuster Name: Multicare City: Roy State: WA Zip: 98580 Address: 17275 Southcenter Pkwy Email: jarod@kbeelectric.com City: Tukwilla State: wa Zip: 9188 CONTACT PERSON — person receiving all project communication Name: Jarod Schuster Address: 29220 31st ave South City: Roy State: WA Zip: 98580 Phone: (253) 686-4369 Fax: Email: jarod@kbeelectric.com King Co Assessor's Tax No.: Suite Number: 160 Floor: 1 New Tenant: 0 Yes O..No ELECTRICAL CONTRACTOR INFORMATION Company Name: Ken Bobko Electric CO INC Address: PO BOX 7009 Cit': Tacoma State: WA Zip: 98417 Phone: (253) 756-0944 Fax: Contr Reg No.: KENBOEC066B4 Exp Date: 12/29/2019 Tukwila Business License No.; BUS -0994404 Valuation of Project (contractor's bid price): s 1,125 Scope of work (please provide detailed information): 4 relocated ceiling receptacles fed from existing 120 volt power for white noise speakers. Will service be altered? ❑ Yes m No Adding more than 50 amps? Cl Yes No Type of Use: Type of work: ❑ New 0 Addition ❑ Service Change 0 Remodel ❑ Tenant Improvement ❑ Low Voltage 0 Generator 0 Fire Alarm ❑ Telecommunication 0 Temporary Service Property Served bv: El Puget Sound Energy ❑ Seattle City Light W: Permit Cerner,Applicactons-HandoutstPcrmit Applications'P()Fs•Elertrical Permit Applicacion Revised 1-1.17-d0cx Rcvrxd.- January_ 2017 Ft. 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).. S155.91 $83.54 ea 561.05 ea RESIDENTIAL REMODEL AND SERVICE CHANGES ❑ Service change or alteration $83.54 (no addedialtered circuits) ❑ Service change with added/altered circuits 583.54 number of added circuits S 12.00 ea ❑ Circuits added,'altered without service change 555.69 (up to 5 circuits) ❑ Circuits added'altered without service change 555.69 (6 or more circuits) 57.65 ca ❑ Meter/mast repair $69.62 ❑ Low voltage systems 561.05 (alarm. furnace thermostat) MULTI -FAMILY AND COMMERCIAL Fees arc based on the valuation of the electrical contract. MISCELLANEOUS FEES ❑ Temporary service (residential) 566.30 ❑ Temporary service (generator) 582.52 ❑ Manufactured/mobile home service $87,98 (excluding garage or outbuilding) ❑ Camivals 582.21 Number of concessions $11.02 ca Each ride and generator truck 51 I.02 ca ***ErrEC-11 /'E JANUARY I. 2014 EACH PERMIT WILL BE ASSESSED A 5°1, 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 1 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: Date: llp.a/a Print Name: Txroci S u s \---e_r Day Telephone: Ds5 3 —(//O 8j G — 4 3 (o ck Mailing Address: 1 o .7039 To, coruo, 1 - City Sutc zip W Permit Center Applicators -I undo=rumis Applications ,PPFbEk cutin Permit Application k v.sed I - I-I'.docx Reascd: January 2017 bh Page 2 of 2 'i. Cash Register Receipt City of Tukwila DESCRIPTIONS I ACCOUNT PermitTRAK QUANTITY PAID $130.83 E118-1056 Address: 17275 SOUTHCENTER PKWY 160 Apn: 2623049063 $130.83 Credit Card Fee $3.81 Credit Card Fee R000.369.908.00.00 I 0.00 I $3.81 ELECTRICAL $120.97 PERMIT FEE MULTI-FAM/COMM R000.322.101.00.00 I 0.00 $120.97 TECHNOLOGY FEE $6.05 TECHNOLOGY FEE R000.322.900.04.00 TOTAL FEES PAID BY RECEIPT: R16008 0.00 $6.05 $130.83 Date Paid: Monday, December 10, 2018 Paid By: JAROD SCHUSTER Pay Method: CREDIT CARD 210195 Printed: Monday, December 10, 2018 10:59 AM 1 of 1 SYSTEMS CO TUKWILA ETRAKIT 6200 SOUTHCENTER BLVD TUKWILA, WA 98188 206-433-1870 CITY OF TUKWILA 0017340000802374464500 Date: 12/10/2018 10:59:14 AM CREDIT CARD SALE VISA CARD NUMBER: **********2503 K TRAN AMOUNT: $130.83 APPROVAL CD: 210195 RECORD #: 000 CLERK ID: jazzel 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 Page 1 of 2 https://classic.convergepay.comNirtualMerchant/transaction.do?dispatchMethod=printTr... 12/10/2018 .11"••• ION CO TUKWILA ETRAKIT 6200 SOUTHCENTER BLVD TUKWILA, WA 98188 206-433-1870 CITY OF TUKWILA Date: 12/10/2018 10:59:14 AM CREDIT CARD SALE VISA CARD NUMBER: **********2503 K TRAN AMOUNT: $130.83 APPROVAL CD: 210195 RECORD #: 000 CLERK ID: jazzel Thank you! Customer Copy Page 2 of 2 haps ://c las sic. convergepay. com/VirtualMerchant/transaction. do?dispatchMethod=printTr... 12/1 0/20 1 8 INSPECTION NO. INSPECTION RECORD Retain a copy with permit ERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Project:/) t ittO Type of Inspection: r , Address: 0.7(s c pi Date Called: Special Instructions: Date Wanted: . . Requester: No: 3 - C41Phone 77 / yyApproved per applicable codes. 0 Corrections required prior to approval. COMMENTS: inspector: r--- REINSPECTIO FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. KEN BOBKO ELECTRIC CO IN Hoinv Espanol Contact Search L81 A -Z Index Help Aly Page 1 of 2 Safety & Health Claims & Insurance Workplace Rights Trades & Licensing Washington State Department of Labor & Industries KEN BOBKO ELECTRIC CO INC Owner or tradesperson Principals BOBKO, KEN, PRESIDENT BOBKO, TAMI, VICE PRESIDENT BOBKO, KEN, AGENT Doing business as KEN BOBKO ELECTRIC CO INC WA UBI No 601 481 263 PO BOX 7009 TACOMA, WA 98406-0009 253-756-0944 PIERCE County Business type Corporation Governing persons KEN EDWIN BOBKO TAMI LEE BOBKO; License Verify the contractor's active registration / Iicen Electrical Contractor License specialties GENERAL License no. KENBOEC066BA Effective — expiration 01/01/1994— 01/01/2020 Designated administrator BOBKO, KEN License type Master Electrician Bond WESTERN SURETY CO Bond account no. 60939377 tion (depending on trade) and any past violations. Active. Meets current requirements. Savings No savings accounts during the previous 6 year period. License Violations Infraction no. Active. Meets current requirements. License no. BOBKOK*962C4 $4,000.00 Effective date 01/01/1998 Expiration date Until Canceled Satisfied Help us improve https://seeureini.wa.gov/verify/Detail.aspx?UBI=601481263&LIC=KENBOEC066BA&SAW= 12/10/2018 KEN BOBKO ELECTRIC CO INC ,••. ECHB000414 Issue date 09/24/2018 Violation city TACOMA Type of violation ELECTRICAL CITATION Description Failing to provide proper supervision to an electrical trainee as required by chapter 19.28 RCW. Infraction no. ECHB000413 Issue date 09/24/2018 Violation city TACOMA Type of violation ELECTRICAL CITATION Description Failing to ensure an electrical installation is in strict conformity with electrical statutes, rules, regulations, and ordinances for safety to life and property by working without a permit in the jurisdiction of a city or town or electrical supply agency which has established an electrical inspection jurisdiction pursuant to RCW 19.28.010 or RCW 19.28.141. RCW/WAC 19.28.161 RCW Violation amount $250.00 Satisfied ....................... RCW/WAC 19.28.010 RCW Violation amount $250.00 Workers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. This company has multiple workers' comp accounts. Active accounts L&I Account ID 461,936-01 Account is current. Doing business as KEN BOBKO ELECTRIC COMPANY INC Estimated workers reported Quarter 3 of Year 2018 "21 to 30 Workers" L&I account contact T2 / DALE RIUTTA (360)902-4834 • Email: RIUD235@Ini.wa.gov Track this contractor 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 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.Ini.wa.gov/verify/Detail.aspx?UBI=601481263&LIC=KENBOEC066BA&SAW= 12/10/2018