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Home My WebLink AboutPermit EL19-0151 - COWLITZ TRIBAL HEALTH - ADD NRE CIRCUITSThis record contains information which is exempt from public disclosure pursuant to the Washington State Public Records Act, Chapter 42.56 RCW as identified on the Digital Records Exemption Log shown below. EL19-0151 COWLITZ TRIBAL HEALTH 6450 SOUTHCENTER BLVD #102 THE ABOVE MENTIONED Page # DIGITAL Code RECORDS PERMIT FILE INCLUDES Exemption (DR) EXEMPTION LOG THE FOLLOWING REDACTED INFORMATION Brief E> lanatory Description Statute/Rule Personal Information — The Privacy Act of 1974 evinces Congress' intent that social security numbers are a private concern. As such, individuals' social security numbers are redacted to protect those Social Security Numbers individuals' privacy pursuant to 5 U.S.C. sec. 5 U.S.C. sec. DR1 Generally — 5 U.S.C. sec. 552(a), and are also exempt from disclosure 552(a); RCW 552(a); RCW under section 42.56.070(1) of the Washington 42.56.070(1) 42.56.070(1) State Public Records Act, which exempts under the PRA records or information exempt or prohibited from disclosure under any other statute. Redactions contain Credit card numbers, debit card numbers, electronic check numbers, credit Personal Information — expiration dates, or bank or other financial RCW 15 DR2 Financial Information — RCW 42.56.230(4 5) account numbers, which are exempt from disclosure pursuant to RCW 42.56.230(5), except when disclosure is expressly required by or governed by other law. 42.56.230(5) Personal Information — Driver's License. RCW Redactions contain information used to prove RCW DR3 — identity, age, residential address, social security 42.56.230 (7a 42.56.230 (7a & c) number or other personal information required to apply for a driver's license or identicard. & c) Redacted content contains a communication between client and attorney for the purpose of obtaining or providing legal advice exempt from RCW DR4 Attorney -Client Privilege — RCW 5.60.060(2)(a); RCW disclosure pursuant to RCW 5.60.060(2)(a), which protects attorney -client privileged 5.60.060(2)(a); RCW 42.56.070(1) communications, and RCW 42.56.070(1), which protects, under the PRA, information exempt or prohibited from disclosure under another statute. 42.56.070(1) COWLITZ TRIBAL HEALTH 6450 SOUTHCENTER BLVD 102 ELI9-0151 C Parcel No: Address: �~^�xx ^�� Tukwila .~U~� v�n v ��m^w��na Departmentof Community Development 630VSmuthcenterBoulevard, Suite #1VV Tukwila ,h0ashingtong8188 n�onwnnx'u��'�*ro �'�� ' Inspection Request Line: 206-Q8'93S0 Web site: http://www.TukwilaWA.gov ELECTRICAL OTC PERMIT 0003200011 Permit Number: EL19-0151 Project Name: COWLITZ TRIBAL HEALTH Issue Date: 2/19/2019 Permit Expires On: 8/18/2019 Owner: Address: Contact Person: Name. Address: Contractor: Address: License No: u*nuen Name: Address: 1O559THAVE STED'LONGVEVV WA, 98632 SUPERIOR HVACQELECTRICAL 149OOINTERURBAN AVE S, STE 130' TUKVV|UA,VVA 98168 5UPERHE869LQ Phone: (I06)74]-7460 Phone: (206)6744666 Expiration Date: 6/18/2020 DESCRIPTION OFWORK: TI ADD NRE CIRCUITS Valuation ofsingle family: $0.00 Valuation ofmVconnm� $8,000,00 Type cfWork: TENANT IMP Fees Collected: $26078 Electrical Service Provided by� PUGETSOUND ENERGY Water District: TUKvV|Lx Current Codes adopted bythe City nfTukwila: international Building Code Edition: international Residential Code Edition: International Mechanical Code Edition: Uniform Plumbing Code Edition: International Fuel Gas Code: 2015 20152015 2015 2015 National Electrical Code: VVACities Electrical Code: VVACZ96'468: Code: Permit Center Authorized Signature: 14W— 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 agree to the conditions attached to this permit. Signature: Print Name: Date: /9 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 TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Electrical Permit No. ft01 0 J Project No. Date Application Accepted: Ae— 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 ei/ eiLl cerbicr- 64/(1_ ,2,14e- 107_ King Co Assessor's Tax No.: Site Address: 61u,-1 Suite Number: Floor: Tenant Name: lie4/4A New Tenant: /2- Yes LI ..No PROPERTY OWNER Name: Address: City: State: Zip: CONTACT PERSON — person receiving all project communication Name: b--) (1.13r4,11CA Address: 7 323zc2 City: lee clmor.A State44 Zip:9gr:/_ .., Phone: Z/16/-76/.3-7-16e)x: Email: dr,r-- h Lic.c - e/iz'-c:' ELECTRICAL CONTRACTOR INFORMATION Company Name: .." Pe-Plic-P i-it/4C - "i'i/,'Cifiln I Address:730,_ /6Z-'14(4- iliF 'Z(„0 City: 1 Z11)."0 tue-c-Vrion,-i. State:m44). Phone:tiz3- 73--.15ax: Contr Reg No.:50106-4)4L- p Date: Tukwila Business License No.; COW 3 117q Valuation of Project (contractor's bid price): $ c C Scope of Work (please provide detailed information): 1-7 . A-,1 /9 et).- c/rzz),14-5 Will service be altered? El Yes No Adding more than 50 amps? Type of Use: 7" e/414k Yes No 7n4i1 CICV(1) Type of work: I=1 New 1=1 Addition El Service Change 1:1 Remodel X Tenant Improvement 12 Low Voltage El Generator 0 Fire Alarm El Telecommunication 1=I Temporary Service Property Served by: )2( Puget Sound Energy 0 Seattle City Light W:\Pennit CentenApplications-HandoutsWennit Applications \PDFAElectrical Permit Application Revised I-17-19.docx Pagela2 RESIDENTIAL NEW RESIDENTIAL SERVICE o New single family dwellings $180.00 (including an attached garage) o Garages, pools, spas and outbuildings $120.00 ea o Low voltage systems (alarm) $60.00 ea RESIDENTIAL REMODEL AND SERVICE CHANGES 0 Service change or alteration $120.00 (no added/altered circuits) El Service change with added/altered circuits $100.00 number of added circuits $10.00 ea o Circuits added/altered without service change.... $60.00 (up to 5 circuits) CI Circuits added/altered without service change $60.00 (6 or more circuits) .. .. .... . ..... ..... ..... $10.00 ea 0 Meter/mast repair ................. .......... ...... ......... $80.00 El Low voltage systems $60.00 (alarm, furnace thermostat) MULTI -FAMILY AND COMMERCIAL Fees are based on the valuation of the electrical contract. MISCELLANEOUS FEES o Temporary service (residential) $60.00 o Temporary service (generator) $90.00 0 Manufactured/mobile home service .......-. ....... $100.00 (excluding garage or outbuilding) o Carnivals $100.00 Number of concessions $11.00 ea Each ride and generator truck $11.00 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 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: Print Name: CrA"CL, Date: %%-..7.--/9- /9 Day Telephone: 766- -7/3 - & Mailing Address: 7:3'K'‹ /fe:7; la2c-AOr2CA/4- City State Zip W: \Permit Cent er1Applications-Hemdouts1Permit ApplieationsTDPs Electrical Permit Application Revised I -1 7- I Peloce Page 2 of 2 DESCRIPTIONS PermitTRAK ACCOUNT QUANTITY PAID $260.78 EL19-0151 Address: 6450 SOUTHCENTER BLVD 102 Apn: 0003200011 $260.78 Credit Card Fee $7.60 Credit Card Fee R000.369.908.00.00 0.00 $7.60 ELECTRICAL $241.12 PERMIT FEE MULTI-FAM/COMM R000.322.101.00.00 0.00 $241.12 TECHNOLOGY FEE $12.06 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: *16900 R000.322.900.04.00 0.00 $12.06 $260.78 Date Paid: Tuesday, February 19, 2019 Paid By: RUBEN CARDONA Pay Method: CREDIT CARD 319145 Printed: Tuesday, February 19, 2019 11:55 AM 1 of 1 SYSTEMS CO TUKWILA [TKAKIT 6200 SUUTH[ENTEK 8LVD TUKWILA, WA 98188 206'433'1870 CITY OF TUKWILA 0017340000802374464500 Date: 02/19/2019 11:54:46 AM CREDIT CARD SALE VISA CARD NUMBER: **********8774 K T:4N AMOUNT: $260.78 APPROVAL [n: 319145 RECORD #: 000 cLsnx ID: jazzel X {CARDHOLDER'S SIGNATURE} I AGREE TO PAY THE ABOVE TOTAL AMOUNT 4[[UnoING TO THE CARD ISSUER AGREEMENT (MERCHANT AGREEMENT IF CREDIT VOUCHER) Thank you! Merchant Copy CO TUKWILA ETRAKIT 6200 SOUTHCENTER BLVn TUKWILA, WA 98188 206-433'1878 CITY OF TUKWILA Date: 02/19/2019 II:54:46 AM CREDIT [Ann SALE VISA CARD NUMBER: **********8774 x TRAN AMOUNT: $260.78 APPROVAL [D: 319145 RECORD #: 080 CLERK ID: jazzel Thank you! Customer Copy INSPECTION RECORD Retain a copy with permit INSPECTION NO. OMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100. Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Project: �-� Type of inspection: (. Address: S - C - E Late Called: Special [nsfructians: Date War ted: a.m Requeste Phone No: oiApproved per applicable codes. COMMENTS: Corrections required prior to approval. ns pector: REINSPECTION. FEE REQUIRED. Prior to next inspection, tee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit P RMIT 0. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-367 Permit Inspection Request Line (206) 438-9350 Project: Type ns p e tio� . Address: 0 5 �' Date Called: Speciat Instructions: Date Wanted: 1 �n Requesters Phone No: Approved per applicable codes. Corrections required prior to approval. COMMEI' TS: 171, nspec REINSPECT! N 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 PECTIN NO. RMIT N CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit inspection Request Line (206) 438-9350 Project: Type of Inspection: Address: Date Called: Special lns'tructions:10 Date Wanted: _ Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. REINSPECT, E' N FEE REQUIRED. Prior to next inspection. fee ust be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INSPECTION NO. INSPECTION RECORD Retain a copy with permit EMiT N CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 Permit Inspection Request Line (206) 438-9350 (206) 431- Project: Type of Inspection: Li / Address: Date Called: Spec a nstruction. '‘Date Wanted: a. . Requester: Phone No: Approved per applicable codes. Corrections required prior to approval. 1 nspecto Date: REINSPECTION FEE REQUIRED. Prior to next inspection, fee mtist be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit NSPECTION NO. PEMIT CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 438-9350 Project: Address: tA) ,.5 Type of Inspection: Date Called: ti pecial uctions: Date Wanted: a. Requester: Phone No:206, ElApproved per applicable codes. Corrections required prior to approval. COMMENTS: ns pector: Date: oz., REINSPECT 0 FEE REQUIRED. Prior to next inspection, fee mut be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. !Ionic Espanol Contnet A-Z dw Help My 1.11:1 Safety & Health Claims & Insurance Workplace Rights Trades & Licensing °Ilk Washington State Department of Labor & Industries SUPERIOR HVAC & ELECTRICAL Owner or tradesperson Principals HANSEN, STEPHEN J, PARTNER/MEMBER HANSEN, STEPHEN J, AGENT Doing business as SUPERIOR HVAC & ELECTRICAL 7325 166th Ave NE Suite F260 REDMOND, WA 98052 425-283-5460 KING County WA UBI No. Business type 602 974 859 Limited Liability Company Parent company Governing persons SUPERIOR HVAC & ELECTRICAL LLC INC JSH PROPERTIES STEVE HANSEN, License Verify the contractors active registration / license / certification (depending on trade) and any past violations, Electrical Contractor Active. Meets current requirements. License specialties GENERAL License no. SUPERHE869LQ Effective — expiration 06/18/2014— 06/18/2020 Designated administrator Hoover, Eric Scott License type Electrical Administrator Active. Meets current requirements. License no. HOOVEES902D6 Bond No bond accounts during the previous 6 year period. Sayings (in lieu of bond) $4,000.00 Received by L&I Effective date 06/18/2014 06/18/2014 Release date Impaired date N/A N/A Savings account ID License Violations No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. Help us improve L&I Account ID 567,703-01 Account is current. Doing business as SUPERIOR ENGINEERING SERVICE Estimated workers reported Quarter 4 of Year 2018 "7 to 10 Workers" L&I account contact T2 / SUSAN BETTS (360)902-4828 - Email: BETT235®Ini.wa.gov 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 Check for any past safety and health violations found on jobsites this business was responsible for. Inspection results date 01/08/2016 Inspection no. 317938320 Location 810 River Road Puyallup, WA 98371 Violations t) Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington. Help us improve