HomeMy WebLinkAboutPermit PG07-220 - ETHAN ALLENThis 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.
PG07 -220
Ethan Allen
17333 Southcenter Parkway
RECORDS DIGITAL D- ) EXEMPTION LOG
THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION
Page # tode Exemption = 8rlef Explanatory DeSclriptiop �t�tutel ule
The Privacy Act of 1974 evinces Congress'
intent that social security numbers are a private
concern. As such, individuals' social security
Personal Information —
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
13
DR2
Financial Information —
account numbers, which are exempt from
42.56.230(5)
RCW 42.56.230(4 5)
disclosure pursuant to RCW 42.56.230(5),
except when disclosure is expressly required by
or governed by other law.
ETHAN ALLEN
17333 SOUTHCENTER PY
CANCELLED 12 -05 -07
PGO7-220
Parcel No.: 2623049066
Address:
Suite No:
Tenant:
Name:
Address:
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Value of Plumbing /Gas Piping:
Fees Collected:
Urinals
Water Closet
doc: UPC -10/06
City...f Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206 -431 -3665
Web site: http: / /www.ci.tukwila.wa.us
17333 SOUTHCENTER PY TUKW
ETHAN ALLEN
17333 SOUTHCENTER PY , TUKWILA WA
ETHAN ALLEN HOME INTERIORS
20120 72ND AVE S , KENT WA
KEN GEE
12704 NE 124 ST #43 , IURKLAND WA
Contractor:
Name: ACTION WATER HEATERS ONLY INC
Address: 12704 NE 124 ST #43 , KIRI{LAND WA
Contractor License No: ACTIOWHO55DP
$1,400.00
$98.00
Plumbing
Bathtub or combination bath/shower 0
Bidet 0
Clothes washer, domestic 0
Dental unit, cuspidor 0
Dishwasher, domestic, with independent drain
Drinking fountain or water cooler (per head)
Food -waste grinder, commercial
Floor drain
Shower, single head trap
Lavatory
Wash fountain
Receptor, indirect waste
Sinks
PLUMBING /GAS PIPING PERMIT
DESCRIPTION OF WORK:
REPLACE ELECTRIC WATER HEATER AND INSTALL PRESSURE REDUCING VALVE
FIXTURE TYPE AND QUANTITY
* *continued on next page **
Permit Number:
Issue Date:
Permit Expires On:
Phone:
Phone: 425 - 820 -8848
Phone: 425 820 -8848
Expiration Date: 11/17/2007
PG07 -220
08/24/2007
02/20/2008
Uniform Plumbing Code Edition: 2006
International Fuel Gas Code Edition: 2006
Plumbing (cont.)
Building sewer and each trailer park sewer 0
Rain water system - per drain (inside bldg) 0
Water heater and/or vent 1
Industrial waste treatment interceptor, including
0 its trap and vent, except for kitchen type
0 grease interceptors 0
0 Repair or alteration of water piping and/or water
0 treatment equipment 1
0 Repair or alteration of drainage or vent piping 0
0 Medical gas piping system serving (1 -5)
0 inlets /outlets for a specific gas 0
0 Medical gas piping (6 +) inlets /outlets 0
0 Gas Piping
0 Gas piping outlets (0 -5) 0
0 Gas piping outlets (6 +) 0
PG07 -220 Printed: 08 -24 -2007
Permit Center Authorized Signature:
City orTukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206 - 431 -3665
Web site: http: / /www.ci.tukwila.wa.us
Permit Number: PG07 -220
Issue Date: 08/24/2007
Permit Expires On: 02/20/2008
Date: 8 _ D— (
I hereby 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 plumbing /gas piping permit.
Signature:
Print Name:
doc: UPC -10/06
,7l/e /reJ /c rteL.
Date: % /cL 6 // 0 7
This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is suspended
or abandoned for a period of 180 days from the last inspection.
PG07 - 220 Printed: 08 -24 -2007
Parcel No.: 2623049066
Address:
Suite No:
Tenant:
ETHAN ALLEN
1: ** *PLUMBING AND GAS PIPING * **
doc: Cond -10/06
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 -431 -3665
Web site: http: / /www.ci.tukwila.wa.us
17333 SOUTHCENTER PY TUKW
PERMIT CONDITIONS
* *continued on next page **
Permit Number:
Status:
Applied Date:
Issue Date:
PG07 -220
ISSUED
08/24/2007
08/24/2007
2: No changes shall be made to applicable plans and specifications unless prior approval is obtained from the Tukwila
Building Division.
3: All permits, inspection records and applicable plans shall be maintained at the job and available to the plumbing
inspector.
4: All plumbing and gas piping systems shall be installed in compliance with the Uniform Plumbing Code and the Fuel Gas
Code.
5: No portion of any plumbing system or gas piping shall be concealed until inspected and approved.
6: All plumbing and gas piping systems shall be tested and approved as required by the Plumbing Code and Fuel Gas Code.
Tests shall be conducted in the presence of the Plumbing Inspector. It shall be the duty of the holder of the permit to
make sure that the work will stand the test prescribed before giving notification that the work is ready for inspection.
7: No water, soil, or waste pipe shall be installed or permitted outside of a building or in an exterior wall unless,
adequate provision is made to protect such pipe from freezing. All hot and cold water pipes installed outside the
conditioned space shall be insulated to minimum R-3.
8: Plastic and copper piping running through framing members to within one (1) inch of the exposed framing shall be
protected by steel nail plates not less than 18 guage.
9: Piping through concrete or masonry walls shall not be subject to any load from building construction. No plumbing
piping shall be directly embedded in concrete or masonry.
10: All pipes penetrating floor /ceiling assemblies and fire- resistance rated walls or partitions shall be protected in
accordance with the requirements of the building code.
11: Piping in the ground shall be laid on a firm bed for its entire length. Trenches shall be backfilled in thin layers to
twelve inches above the top of the piping with clean earth, which shall not contain stones, boulders, cinderfill,
frozen earth, or construction debris.
12: The issuance of a permit or approval of plans and specifications shall not be construed to be a permit for, or an
approval of, any violation of any of the provisions of the Plumbing Code or Fuel Gas Code or any other ordinance of the
jurisdiction.
PG07 - 220 Printed: 08 -24 -2007
Signature:
Print Name: /� 1e- f e -1 t' -7 -(
doc: Cond -10/06
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 -431 -3665
Web site: http: / /www.ci.tukwila.wa.us
I hereby certify that I have read these conditions and will comply with them as outlined. 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 provision of any other work or local laws regulating
construction or the performance of work.
Date: 941 y/o 7
PG07 -220 Printed: 08 -24 -2007
Name: I� .QL.� �!� ACTION WATER HE..VItr ONLI
Mailing Address: TOTEM COMMERCIAL CENTER
E -Mail Address:
Company Name:
Mailing Address:
CITY OF TUKWILAT
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
11 /U4 NE 124th ST # 43 City
KIRKLAND. WA. 9 8'
q:bpentiits plualicc ahanges'pecmit application (7-2004)
Revved: 6-8-05
bh
ACTION WATER HEATER ONLY INC
TOTEM COMMERCIAL CENTER
12704 NE 124th ST N 43
Cqntact Person:
E -Mail Address:
Page 1
TGo Lzo
Building Permit No.
Mechanical Permit No.
Public Works Permit No.
Project No
or o 'tce use onl
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 / 1 333 5- CC)J Pk&a i
King Co Assessor's Tax No.: 6 23Y1 "/d 6&
Site Address: I 1 ;33 I ►l Sd i i" Nome l jet PkL..k �t, Suite Number: Floor:
Tenant Name: G A p I & J t)t eUUltS New Tenant: ❑ Yes A<No
Property Owners Name: ,.}� �{, G
Mailing Address: 333 ��I �( Q sd � til ! � r I14 ��d
cly State Zi p
CONTACT PERSON
Day Telephone:
State Lp
Number: « t ^ e20 ' 789 Cr
GENERAL CONTRACTOR INFORMATI9N - (Mechanical Co or information on back page)
City State Zip
Contact Person: KI �/Aa 98034. Day Telephone:
E -Mail Address: Fax Number.
Contractor Registration Number. Expiration Date:
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
ARCHITECT OF RECORD- All plans must be wet stamped by Architect of Record
Company Name:
Mailing Address:
City
Day Telephone:
Fax Number:
State
ENGINEER OF RECORD - MI plans must be wet stamped by Engineer of Record
Company Name:
Mailing Address:
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
State
Zip
zip
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Boiler /Compressor:
Qty
Fumace<IOOK BTU
Air Handling Unit >10,000
CFM
Fire Damper
0 -3 HP/I00,000 BTU
Furnace >100K BTU
Evaporator Cooler
Diffuser
3 -15 HP /500,000 BTU
Floor Furnace
Ventilation Fan Connected
to Single Duct
Thermostat
15 -30 HP /1,000,000 BTU
Suspended/Wall/Floor
Mounted Heater
Ventilation System
Wood/Gas Stove
30-50 HP /1,750,000 BTU
Appliance Vent
Hood and Duct
Water Heater
,
50+ HP /1,750,000 BTU
Repair or Addition to
Heat/Refrig/Cooling
System
Incinerator - Domestic
Emergency
Generator
Air Handling Unit
<10,000 CFM
Incinerator — Comm/Ind
Other Mechanical
Equipment
. 1 G t
�t -
i
MECHANICAL PERMIT INFORMATION - 206- 431 -3670
MECHANICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address: ACTION WATER HEATER ONLY INC
TV 1 tM COMMERCIAL CENTER city state Zip
Contact Person: 12704 NE 124th ST # 43 Day Telephone: 4 25 - SZv - R g41 se
E -Mail Address: KIRKLAND, WA. 98034 Fax Number:. -'2D " 7 g 9
Contractor Registration Number: ACT/0 U) 14 0 55 p Expiration Date: / / 7 — 9 9 ' 7
**An original or notarized copy of current Washipton Sto� tractor License must be presented at the time of permit issuance**
Valuation of Project (contractor's bid price): $ I ((
Scope of Work (please provide detailed information): Ate/et e I eC-Ert i . (�/ o fee' ye
PM- i-
rA Vc h,c-
Use: Residential: New .... ❑ Replacement .... ❑
Commercial: New .... ❑ Replacement ....�
Fuel Type: Electric '_ Gas .... Other:
Indicate type of mechanical work being installed and the quantity below:
PERMIT APPLICATION NOTES Applicable to all permits in this application
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 or more extensions of time for additional periods not exceeding 90 days each. The extension shall be requested
in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition).
• 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 O' t a R AUTHORIZED A
Signature: u_647 1
Print Name:
4 iijq -ti, Gam_
Mailing Address: 12'7 014 kf F t? *4 Tk i 1 a
Date:
Day Telephone:
1Lt Loot 91_
City
g//z, y /o7
State Zip
Date Application Expires:
Date Application Accepted:
Opermks p tp apps (7-2004)
Ravd: 64-05
bh
Page 4
Staff Initials:
BUILDING PERMIT INFOLATION - 206 -431 -3670
Valuation of Project (contractor's bid price): $ Existing Building Valuation: $
Scope of Work (please provide detailed information):
Will there be new rack storage? ❑..Yes ❑...No If `yes ", see Handout No. for requirements.
Provide All Building Areas in Square Footage Below
PLANNING DIVISION:
Single - family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft):. Floor area of principal dwelling: Floor area for accessory dwelling:
'Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard:
Will there be a change in use? ❑ ....Yes ❑ ..No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
0.. Sprinklers 0-Automatic Fire Alarm ❑..None ❑ ..Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑.. Yes 0.. No
If "yes ", attach list of materials and storage locations on a separate 8 -1/2 x 11 paper indicating quantities and Material Safety Data Sheets.
q spermits plwlim eban®es'permit application (7-2004)
Revised 6-8-05
bh
Page 2
Compact: Handicap:
Existing
Interior
Remodel
Addition to
Existing
Structure
New
Type of
Construction
per IBC
Type of
Occupancy per
IBC
1 u Floor
r Floor
,
3" Floor
Floors thru
Basement
Accessory Structure*
Attached Garage
Detached Garage
.
Attached Carport
Detached Carport
Covered Deck
Uncovered Deck
BUILDING PERMIT INFOLATION - 206 -431 -3670
Valuation of Project (contractor's bid price): $ Existing Building Valuation: $
Scope of Work (please provide detailed information):
Will there be new rack storage? ❑..Yes ❑...No If `yes ", see Handout No. for requirements.
Provide All Building Areas in Square Footage Below
PLANNING DIVISION:
Single - family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft):. Floor area of principal dwelling: Floor area for accessory dwelling:
'Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard:
Will there be a change in use? ❑ ....Yes ❑ ..No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
0.. Sprinklers 0-Automatic Fire Alarm ❑..None ❑ ..Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑.. Yes 0.. No
If "yes ", attach list of materials and storage locations on a separate 8 -1/2 x 11 paper indicating quantities and Material Safety Data Sheets.
q spermits plwlim eban®es'permit application (7-2004)
Revised 6-8-05
bh
Page 2
Compact: Handicap:
PUBLIC WORKS PERMIT INF *RMATION - 206 - 433 -0179
Scope of Work (please provide detailed information):
Water District
❑ ...Tukwila ❑...Water District #125
❑ ...Water Availability Provided
Sewer District
❑ ...Tukwila ❑... ValVue ❑ .. Renton ❑ .. Seattle
❑ ...Sewer Use Certificate 0... Sewer Availability Provided ❑ .. Approved Septic Plans Provided
❑ ...Septic System - For onsite septic system, provide 2 copies of a current septic design approval by King County Health Department.
Submitted with Application (mark boxes which apply):
❑ ...Civil Plans (Maximum Paper Size — 22" x 34 ")
❑ ...Technical Information Report (Storm Drainage) ❑ .. Geotechnical Report ❑...Traffic Impact Analysis
❑ ...Bond ❑ .. Insurance ❑ .. Easement(s) t ❑ .. Maintenance Agreement(s) ❑ ...Hold Harmless
Proposed Activities (mark boxes that apply):
❑ ...Right -of -way Use - Nonprofit for less than 72 hours
❑ ...Right -of -way Use - No Disturbance
❑ ...Construction/Excavation/Fill - Right -of -way
Non Right -of -way
❑ ...Total Cut
❑ ...Total Fill
❑...Sanitary Side Sewer
❑ ...Cap or Remove Utilities
❑ ...Frontage Improvements
❑ ...Traffic Control
❑ ...Backflow Prevention - Fire Protection "
irrigation
Domestic Water
❑ ...Permanent Water Meter Size...
❑ ...Temporary Water Meter Size..
❑ ...Water Only Meter Size
❑ ...Sewer Main Extension Public
❑ ...Water Main Extension Public
a: NpetmitsplusliachangeAsvmit application (7 -
Revised: 68-05
bb
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
cubic yards
cubic yards
If
„
Call before you Dig: 1400 -424 -5555
❑ .. Abandon Septic Tank
❑ .. Curb Cut
❑ .. Pavement Cut
❑ .. Looped Fire Line
WO#
WO#
WO#
Private _
Private _
❑ .. Highline
❑ .. Right -of - -way Use - Profit for less than 72 hours
❑ .. Right -of -way Use — Potential Disturbance
Page 3
❑ .. Work in Flood Zone
❑ .. Storm Drainage
❑ .. Renton
❑ .. Grease Interceptor
❑ .. Channelization
❑ .. Trench Excavation
❑ .. Utility Undergrounding
❑ ...Deduct Water Meter Size ........
„
FINANCE INFORMATION
Fire Line Size at Property Line
Number of Public Fire Hydrant(s)
❑...Sewage Treatment
❑...Water ❑...Sewer
Monthly Service Billing to;
Name: Day Telephone:
Mailing Address:
Water Meter Refund /Billing:
Name:
(Sty State
tip
Day Telephone:
Mailing Address:
city State Zip
Parcel No.: 2623049066 Permit Number: PG07 -220
Address: 17333 SOUTHCENTER PY TUKW Status: PENDING
Suite No: Applied Date: 08/24/2007
Applicant: ETHAN ALLEN Issue Date:
Receipt No.: R07 -01798
Initials: WER Payment Date: 08/24/2007 11:50 AM
User ID: 1655 Balance: $0.00
Payee: ACTION WATER HEATERS
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 -431 -3665
Web site: http: / /www. ci. tukwila. wa. us
RECEIPT
TRANSACTION LIST:
Type Method Description Amount
Payment Check 35513 98.00
ACCOUNT ITEM LIST:
Description
PLUMBING - NONRES
Account Code Current Pmts
000/322.100 98.00
Total: $98.00
Payment Amount: $98.00
2023 08/24 9710 TOTAL 98.00
doc: Receiot -06 Printed: 08-24 -2007
January 4, 2008
Paula Stockwell
Action Water Heater Only Inc
12704 NE 124 Street, Suite 43
Kirkland, WA 98034
RE: Permit Fee Refund
Dear Ms. Stockwell:
Enclosed is a check in the amount of $78.40 which is 80% of the permit fee paid for the
project located at 17333 Southcenter Py, Tukwila, Washington. Per you letter dated
December 5, 2007, your client chose to cancel the scope of work, therefore a refund is
being sent to you.
If you have any questions, please feel free to contact our office at 206 - 431 -3670.
Sincerely,
Brenda Holt,
Permit Coordinator
encl
xc: Permit No. PG07 -220
City of Tukwila Jim Haggerton, Mayor
Department of Community Development Jack Pace, Director
H:'Documents\Letters\PG07 -220 - refund letter.doc
bh
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
INVOICE NUMBER ° " '
DATE
P.O. NUMBER .
• DESCRIPTION':
AMOUNT-'-'04
122407307
12/19/2007
80% PERMIT REVIEW FEE
78.40
CITY OF TUKWILA, WA 98188 -2544
ACCOUNTS PAYABLE CHECK ko,„„,
PLEASE DETACH BEFORE DEPOSITING
NO.
THE FACE OF THIS DOCUMENT HAS A COLORED BACKGROUND -NOT A WHITE BACKGROUND
PAY
TO THE
ORDER
OF
CITY OF TUKWILA
6200 Southcenter Boulevard
Tukwila WA 98188 -2544
Seventy Eight Dollars and Forty Cents
ACTION WATER HEATER ONLY INC
12704 NE 124TH SUITE 43
KIRKLAND WA 98034
PAYABLE THROUGH
5 %U.S. SANK
151 AndoverP.rk East
.TJwua.WA,st8s .
19-10
1250 .
004727
12/24/2007
78.40
THE BACK OF THIS DOCUMENT HAS AN ARTIFICIAL WATERMARK -HOLD AT AN ANGLE TO VIEW
Memo
Deo rater 14,2007
To: Laurie Anderson
From: Brenda Holt
Re: PG07 -220
City of Tukwila
Permit Center
Please refund the following fees to Action Water Heaters. The project has been canceled.
80% of Permit Review Fee $78.40
Please make the check out to them and I will forward it to them:
Action Water Heaters
12704 NE 124 Street, #43
Kirkland, WA 98034
Xc: File No. PG07 -220
H:1Documents\Letters1D07 -204 - refund memo.doc
bh
12/5/2007
Brenda Holt,
a R gopaND
gD % Qf1 r
FOE, lZ -/D - dT
ACTION WATER HEATERS °rt,'
When Your Tank Goes...We Go...7 Days a Week!
Specialists in Repairs & Replacements
We went to Ethan Allan Home Interiors at 17333 Southcenter Parkway, Tukwila, WA.
98188 and gave them an estimate to do some plumbing work.
They wanted the work done, so we requested the permit and in the meantime they either
decided to not have the work done or had another company do the work for them.
We are requesting a refund of $98.00 for a permit that is not needed. I have included the
permit with this letter.
Thank you for your attention in this matter.
Paula Stockwell
Action Water Heaters Only, Inc.
Corporate Office: 12704 N.E. 124th Street, #43 • Kirkland, Washington 98034
(425) 820.8848 • 1. 888. 468.8265 • FAX (425) 820-7896
Visit us at: actionwaterheaters.com
Auburn • Bellevue • Bothell • Everett • Federal Way • Iuaquah • Kirkland • Lacey • Lynnwood • Olympia • Mukilteo • Puyallup • Redmond • Renton • Seattle • Tacoma • Turn water
License Information
License
ACTIOWH055DP
Licensee Name
ACTION WATER HEATERS ONLY INC
Licensee Type
CONSTRUCTION CONTRACTOR
UBI
601609114
Ind. Ins. Account Id
#5
Business Type
CORPORATION
Address 1
12704 NE 124TH ST #43
Address 2
City
KIRKLAND
County
KING
State
WA
Zip
98034
Phone
4258208848
Status
ACTIVE
Specialty 1
PLUMBING
Specialty 2
UNUSED
Effective Date
3/17/1995
Expiration Date
1/17/2009
Suspend Date
Separation Date
Parent Company
Previous License
Next License
Associated License
Business Owner Information
Name
Role
Effective Date
Expiration Date
MEDLAND, BRETT P
Cancel
Date
01/01/1980
Bond
Amount
Bond Information
Bond
Bond
Company
Name
Bond
Account
Number
Effective
Date
Expiration
Date
Cancel
Date
Impaired
Date
Bond
Amount
Received
Date
#5
COLONIAL
AM CAS &
SURETY
OF MD
LPM4042735
12/31/2001
Until
Cancelled
$6,000.00
01/17/2002
Look Up a Contractor, Electrician or Plumber License Detail Page 1 of 3
Washington State Department of Labor and Industries
General/Specialty Contractor
A business registered as a construction contractor with L &I to perform
construction work within the scope of its specialty. A General or Specialty
construction Contractor must maintain a surety bond or assignment of
account and carry general liability insurance.
https: // fortress. wa. gov /lni/bbip /printer.aspx ?License= ACTIOWHO55DP 08/24/2007