HomeMy WebLinkAboutPermit PG06-098 - REHABITAT NORTHWESTREHABITAT NORTHWEST
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13534 MACADAM RD S
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PG06 -098
City oit Tukwila
Steven M. Mullet, Mayor
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 - 431 -3665
Web site: ci.tukwila.wa.us
PLUMBING /GAS PIPING PERMIT
Parcel No.: 2613200049
Address: 13534 MACADAM RD S TUKW
Suite No:
Permit Number:
Issue Date:
Permit Expires On:
Steve Lancaster, Director
PGO6 -098
07/24/2006
01/20/2007
Tenant:
Name:
Address:
Owner:
Name:
Address.
Contact Person:
Name:
REHABITAT NW, INC.
13534 MACADAM RD S, TUKW ILA WA
SHAMROCK ASSOCIATES ATT:JUNE NAILON
P O BOX 69208, SEATTLE WA
OLIVER PROCK
Address: 3601 W MARGINAL WY S, SEATTLE WA
Contractor:
Name: SUMMERS PLUMBING INC
Address: 12917 203 AV SE, MONROE WA
Contractor License No: SUMMERPI974BU
Phone:
Phone: 206 931 -9891
Phone: 360 794 -3136
Expiration Date: 01/31/2007
DESCRIPTION OF WORK:
NEW PLUMBING SYSTEM FOR ENTIRE ADULT FAMILY HOME AND (4) GAS PIPING OUTLETS
Value of Plumbing /Gas Piping: $0.00
Fees Collected: $386.00
Uniform Plumbing Code Edition: 2003
International Fuel Gas Code Edition: 2003
FIXTURE TYPE AND QUANTITY
Plumbing
Bathtub or combination bath /shower
Bidet
Clothes washer, domestic
Dental unit, cuspidor
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
Urinals
Water Closet
Plumbing (cont.)
2 Building sewer and each trailer park sewer 0
0 Rain water system - per drain (inside bldg) 0
2 Water heater and /or vent 2
0 Industrial waste treatment interceptor, including
2 its trap and vent, except for kitchen type
0 grease interceptors 0
2 Repair or alteration of water piping and /or water
0 treatment equipment 0
1 Medical gas piping system serving one to five
4 inlets /outlets for a specific gas 0
0
0
7 Gas Piping
0 Gas piping outlets (0 -5) 4
0 Gas piping outlets (6 +) 0
* *continued on next page **
doc: UPC - Permit
PG06 -098 Printed: 08-16-2006
City tni Tukwila
Steven M. Mullet, Mayor
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 -431 -3665
Web site: cttukwila.wa.us
Steve Lancaster, Director
Permit Number: PGO6 -098
Issue Date: 07/24/2006
Permit Expires On: 01/20/2007
Permit Center Authorized Signature'
1.,/ 1 1.1fA
Date: iyi t e { ac
I hereby certify that I have read an • ex. mi ed his permit and know the same to be true and correct. All provisions of law and
ordinances governing this work will • - om.. . 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 o her state or local laws
regulating construction or the performance of work. I am authorized to sign and obtain this plumbing /gas piping permit.
Signature: 3 --, Date: 8116lnlo
Print Name: tL\ ln:_
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.
doe: UPC - Permit PG06 -098 Printed: 08 -16 -2006
City of T>wila
Steven M. tigramet, Mayor
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 -431 -3665
Web site: si.tukwila.wa.us
Steve Lancaster, Director
PLUMBING /GAS PIPING PERMIT
Parcel No.: 2613200049
Address: 13534 MACADAM RD S TUKW
Suite No:
Permit Number:
Issue Date:
Permit Expires On:
PG06 -098
07/24/2006
01/20/2007
Tenant:
Name:
Address'
Owner:
Name:
Address:
REHABITAT NW, INC.
13534 MACADAM RD S, TUKWILA WA
SHAMROCK ASSOCIATES ATT:JUNE NAILON
P 0 BOX 69208, SEATTLE WA
Contact Person:
Name: OLIVER PROCK
Address: 3601 W MARGINAL WY S, SEATTLE WA
Contractor:
Name: SUMMERS PLUMBING INC
Address: 12917 203 AV SE, MONROE WA
Contractor License No: SUMMERPI974BU
Phone:
Phone: 206 931 -9891
Phone: 360 794 -3136
Expiration Date:01 /31/2007
DESCRIPTION OF WORK:
NEW PLUMBING SYSTEM FOR ENTIRE ADULT FAMILY HOME
Value of Plumbing /Gas Piping: $0.00
Fees Collected: $298.00
Uniform Plumbing Code Edition: 2003
International Fuel Gas Code Edition: 2003
FIXTURE TYPE AND QUANTITY
Plumbing
Bathtub or combination bath /shower
Bidet
Clothes washer, domestic
Dental unit, cuspidor
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 0
Sinks 7
Urinals 0
Water Closet 0
Plumbing (cont.)
2 Building sewer and each trailer park sewer 0
0 Rain water system - per drain (inside bldg) 0
2 Water heater and /or vent 2
0 Industrial waste treatment interceptor, including
2 its trap and vent, except for kitchen type
0 grease interceptors 0
2 Repair or alteration of water piping and /or water
0 treatment equipment 0
1 Medical gas piping system serving one to five
4 inlets /outlets for a specific gas 0
0
Gas Piping
Gas piping outlets (0 -5) 0
Gas piping outlets (6 +) 0
* *continued on next page **
doc: UPC - Permit PGO6 -098 Printed: 07 -24 -2006
City of Ttwi1a
Steven M. et, Mayor
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206 -431 -3665
Web site: ri.lukwi/a.wa.us
Steve Lancaster, Director
Permit Number: PGO6 -098
Issue Date: 07/24/2006
Permit Expires On: 01/20/2007
Permit Center Authorized Signature:
I hereby certify that I have read and
Date: 01-I/4 4 Lae
is permit and know the same to be true and correct. All provisions of law and
ordinances governing this work will b4ompl 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 pe rmance of work. 1 am authorized to sign and obtain this plumbing /gas pipin. permit.
Signature: t..:-, ie Date: L. 0
Print Name: C ) (,.._.1 1 1 C
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.
doc: UPC - Permit
PG06 -098 Pdnted: 07 -24 -2006
City the Tukwila
Steven M. Mullet, Mayor
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206- 431 -3665
Web site: cttukwila.wa.us
Parcel No.: 2613200049
Address: 13534 MACADAM RD S TUKW
Suite No:
Tenant: REHABITAT NW, INC.
PERMIT CONDITIONS
Steve Lancaster, Director
Permit Number: PGO6 -098
Status: ISSUED
Applied Date: 07/24/2006
Issue Date: 07/24/2006
1: No changes shall be made to applicable plans and specifications unless prior approval is obtained from the Tukwila
Building Division.
2: ** *PLUMBING AND GAS PIPING * **
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: 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.
* *continued on next page **
doc: Conditions
PG06 -098 Printed: 07 -24 -2006
City Or Tukwila
Steven M. Mullet, Mayor
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 -431 -3670
Fax: 206-431-3665
Web site: ci.tukwila.wa.us
Steve Lancaster, Director
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.
Signature:
Print Name: (fly i
Date: -1
2L4 JhG
doc: Conditions
PG06 -098 Printed: 07 -24 -2006
ttA. tIIYUt 1 UK MLA
Community DeyelopmeNt,partment
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
htto://www.ci tukwila.wa.us
11-
Project.„
• ertu t No. Tata re:Mic
PLUMBING / GAS PIPING 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 Address: I35k IVIIVC.-A-,e) A 11
Tenant Name: 'KC. N
Property Owners Name: .--..-i4.0tffez,CT 1•1W M C_
Mailing Address: 3con W tk-RGANI \AIP's\I \N( SE NI SS OG
Zip
King Co Assessor's Tax No.: 2(0 1 31 00
Suite Number:
New Tenant:
Floor:
D.... Yes
„No
City
Slate
C0141!8.0.:t
Name: CM
Mailing Address: SAME
Day Telephone: 200 ?fkk S k
City
State
Zip
E-Mail Address: Fax Number:
Company Name: SaLflI\ are, S. Ltj 11/4-4-6 1 b3 Cr
Mailing Address: 4-15=:=7;2:ZSr yzAq w3'?-b mc sc 1..4 0 C C122-1 2
City State Zip
Contact Person. RO WP(g..11., Day Telephone: Li 25 2:32- 354 &
E-Mail Address: Fax Number:
Expiration Date: 0 I s 2-067
Contractor Registration Number: S 0 IA 101 e'PT ccl
Company Name:
Mailing Address.
City
Contact Person: Day Telephone:
E-Mail Address: Fax Number:
State
Zip
.'ENGINISER
.,„
VORD:;+:Altplatts tikootbe wet $tatopettb,Y,,tiigi,nee-fr„OtRetor4,:;:... .
Company Name:
Mailing Address:
■Al A-N1 e:NC_,---■NcEat
City
Contact Person: Day Telephone:
E-Mail Address: Fax Number:
State
Zip
QAApplicationeWonninapplications On LineU-2006 - Plumbing-Gas Piping Pennit Application.doc
leveled: 0-2006
bit
Page 1 of 2
Valuation of Project (contractor's bid price): $ i t o00
Scope of Work (please provide detailed information): 1\A Etnl 4 STC M C-1\3-1 \ j -oo S E
Building Use (per Intl Building Code): M' L1 FhM1L`( 1{nME
Occupancy (per Inf I Building Code): is -`
Utility Purveyor: Water: D I j-T (2S Sewer: J P. L�%V C
Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below:
FIxture'fype:
Qty .:
Fixture Type:
Qfy
Fixture Type: ,
Qty
Fixture Ty pe:
Qty
Bathtub or combination
bath/shower
45�-
Drinking fountain or water
cooler (per head)
Wash fountain
Gas piping outlets
Bidet
Food -waste grinder,
commercial
-
Receptor, indirect
waste
Clothes washer, domestic
Floor drain
Sinks
7
Dental unit, cuspidor
Shower, single head trap
(
Urinals
Dishwasher, domestic,
with independent drain
ei.
Lavatory
H
Water Closet
Building sewer or trailer
park sewer
Rain water system — per
drain (inside building)
Water heater and/or
vent
,
I.-
Additional medical gas
inlets/outlets — six or more
Industrial waste
pretreatment interceptor,
including its trap and vent,
except for kitchen type
grease interceptors
Repair or alteration of water
piping and/or water treating
equipment
, -
Repair or alteration
of drainage or vent
piping
Medical gas piping system
serving one to five
inlets/outlets for specific gas
`PERMITAPPLICATIQN,NQiES 4
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 180 days. The extension shall be requested in writing
and justifiable cause demonstrated. Section 103.4.3 International Plumbing 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 1 AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER OR AUTHORIZED AGENT:
Signature: CD
Print Name: CDUTAFre--- ec
Date:
-7 (2-M
Day Telephone:
Mailing Address: -2,C, CD \ i1 C7tNPs& " S cc nth_ \' (r 99i0G
City sate Zip
Date Application Accepted: f to
Date Application Expires: 12-
a
Staff Initial
Q1Applicuions\Fmms- Applications On LineVd006- Plumbing-Gas Piping Pami Application doc
Raised: 4-2006
bh
Page 2 of 2
City of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
RECEIPT
Parcel No.: 2613200049 Permit Number: PGO6 -098
Address: 13534 MACADAM RD S TUKW Status: ISSUED
Suite No: Applied Date: 07/24/2006
Applicant: REHABITAT NW, INC. Issue Date: 07/24/2006
Receipt No.: R06 -01277 Payment Amount: 88.00
Initials: JEM Payment Date: 08/16/2006 02:22 PM
User ID: 1165 Balance: 50.00
Payee: REHABITAT NORTHWEST, INC.
TRANSACTION LIST:
Type Method Description
Amount
Payment Check 5963 88.00
ACCOUNT ITEM LIST:
Description
Current Pmts
Account Code
GAS - RES
000/322.100 88.00
Total: 88.00
8695 08 /16 9716 TOTAL 88.00
doc: Receipt _ - Printed: 08 -16 -2006
SET RECEIPT
RECEIPT NO: R06 -01103
Initials: JEM Payment Date: 07/24/2006
User ID: 1165 Total Payment: 308.38
Payee: REHABITAT NORTHWEST, INC.
SET ID: 0724 SET NAME: REHABITAT NW
SET TRANSACTIONS:
Set Member Amount
M05 -029
PG06 -098
TOTAL:
10.38
298.00
308.38
TRANSACTION LIST:
Type Method Description
Amount
Payment Check 5968
ACCOUNT ITEM LIST:
Description
TOTAL:
308.38
308.38
Account Code Current Pmts
MECHANICAL - RES
PLAN CHECK - RES
PLUMBING - RES
000/322.100 8.31
000/345.830 2.07
000/322.100 298.00
TOTAL: 308.38
INSPECTION RECORD
Retain a copy with permit /� PERMIT O�t� 'AN
NO.
06)4313670
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #1 00, Tukwila, WA 98188
Project:
jlehab'.1A -/ N&)
Type of lnspection: /(,J
Fi ves
A /353 ij !h4Mz Ate? 4 j
ate Called:
Special Instructions:
Date Wanted:
a.m.
Requester:
rAfil / ally,, /FTr
Phone No:
Approved per applicable codes.
EJ Corrections required prior to approval,
COMMENTS:
��7,M.A; /c,
rAfil / ally,, /FTr
r:
/4ew/a �2
Da /D/ /L7 r)
$58.00 REINSPECTION FE REQUIRE6. Prior to inspection, fee muse
paidsat 6300 Southcenter B d., Suite 100. Call to sechedule reinspection.
'Receipt No.:
Date:
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
(206)431 -3670
Project:
.,[
Type of section:
Address: _
Date Called:
Special Instructions:
Date Wanted:
�; -L S -c
m
4
Requester:
Phone No:
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
Try, , to g,Z 2) ,04> ii
nspector:
Date
558.00 REINSPECTION FEE r QUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Bl d., Suite 100. Call to sechedule reinspection.
Receipt No.:
Date:
S
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
INSPECTION RECORD
Retain a copy with permit
P oject: !
Ik� 1'i 4: Y l A 1 N • tit/
Type of Inspection:
D R
Address:
1353LI 1•nACADA,v.RtJ
Date Called:
s
Special Instructions:
Date Wanted:
—Li, — ° C
�''-.
a.m.
`p•m.
Requester:
Phone No:
2O — 3G 1_ °t 8R I
ElApproved per applicable codes.
giCorrections required prior to approval.
COMMENTS:
!n Ori-
att....../ 5.t
tk. /
vt t
n ran, .4_271\
Date 62,264,
Inspect
❑ $58. REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
Receipt No.:
Date:
INSPECTI,, N NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
INSPECTION RECORD .
Retain a copy with permit
(206)431 -3f'7
Project:
Type of Inspection: i
DY9
Address:
%3534 rnReAt a
2r
Date Called:
Special Instructions:
Date Wanted: !!
g"ZZ -0 V
a.m.
p.m.
Requester:
Phone No:
Approved per applicable codes. Corrections required prior to approval.
OMMENTS:
ri $58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
Receipt No.:
Date:
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
T
0.
Proje t:
•
s% i, .J A
Type of inspection:
✓_
A•dress:
J.3S3y A9 C4 S 11
Date Called:
7--
Special Instructions:
Date Wanted:dw /�
e
a.m.
/
Requester:
Phone No:
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
Inspector: (1)
Date: i%],
$58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
Receipt No.:
Date:
INSPECTION RECORD
Retain a copy with permit
INSPE ION 0.
p606 -o9&
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
PE
(20•)431 -36
Protect:
Re hRb:riA1 NAJ
Type of Inspection:
j)t4'& 2cft5re fititn-
Address:
/3 53 y in 91'ADA-r ,
Date Called:
Special Instructions:
Date Wanted: / a.m.
e- /moo & p.m.
Requester:
Phone No:
(9,06- 39/ Pt?,
0Approved per applicable codes.
tytl Corrections required prior to approval.
COMMENTS:
atid) g// z,,ivd,/7&57
Inspec
Dace:
c2 ft
8.00 REINSPECTION FEE REQUIRED. P to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
Receipt No.:
(Date:
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
INSPECTION RECORD
Retain a copy with permit
6)431 -3
Project:
Rei/A06/ I Ai R.)
Type of Inspection: \.
)2eu5,hriniAtm.6rhc
Date Called: ,
Address:
t; 534 rn4PfDa141
Special Instructions:
Date Wanted:
a - /04.
a.m.
P.m.
Requester:
Phone No:
Approved per applicable codes.
g
--gcorrections required prior to approval.
COMMENTS:
.61.) m.---/ev A.,c0
C7) &in�Y,, i Ate ,J ;55. 'I
s y •ems 0 ,e,�r.� /s��, ''mac
$ 0 REINSPECTION FEE RE • RED. P '.r to inspection, fee must be
�a at 6300 Southcenter Blvd., Suite 10r. Call to sechedule reinspection.
Receipt No.:
Date:
City of Tukwila
Steven M. Mullet, Mayor
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Fax: 206 -431 -3665
Web site: htp✓ /www.citukwilawa.us
Steve Lancaster, Director
Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through
the mail, fax, etc.
Date: 8 I r s
❑
Plan ChecWPermit Number:
Pc-06-09?
Response to Incomplete Letter #
Response to Correction Letter #
Revision # 1— after Permit is Issued
Revision requested by a City Building Inspector or Plans Examiner
Project Name: (2>CV-1 MPvc,t -AM
Project Address: (S S 3 k M 'At A- A-MM ?I S
Contact Person: CO t-t V Eit 1�tz oC l� Phone Number: 20 C, 3Pt 1
Summary of Revision: A b N CAS F Oct u'R ,
1- FIR -c1LA C
q I
-W R'ifit- atM g-
2— 'F u 12- mic-E.
Sheet Number(s):
"Cloud" or highlight all areas of revision including date of revision
Received at the City of Tukwila Permit Center by
IA Entered in Permits Plus on D / t iiiMO
\applicauons\forms- applications on Imetrevision submittal
Created: 8 -13 -2004
Revised:
Look Up a Contractor, Electnctan or Plumber License Detail Page 1 of 2
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.
License Information
License
SUMMEPI974BU
Licensee Name
SUMMERS PLUMBING INC
Licensee Type
CONSTRUCTION CONTRACTOR
UBI
602257310
Ind. Ins. Account Id
SECRETARY
Business Type
CORPORATION
Address 1
12917 203RD AVE SE
Address 2
City
MONROE
County
SNOHOMISH
State
WA
Zip
98272
Phone
3607943136
Status
ACTIVE
Specialty 1
PLUMBING
Specialty 2
UNUSED
Effective Date
1/31/2003
Expiration Date
1/31/2007
Suspend Date
Separation Date
Parent Company
Previous License
SUMMEP•005PK
Next License
Associated License
Business Owner Information
Name
Role
Effective Date
Expiration Date
SUMMERS, HOWARD A JR
PRESIDENT
01/31/2003
SUMMERS, KRISTIN M
SECRETARY
01/31/2003
Bond Information
Bond
Bond
Company
Name
Bond Account
Number
Effective
Date
Expiration
Date
Cancel
Date
Impaired
Date
Bond
Amount
Received
Date
GREAT
AMERICAN
INS CO OF
Until
https: / /fortress .wa.gov /lni/bbip /printer.aspx ?License= SUMMEPI974BU 07/24/2006
SET RECEIPT
RECEIPT NO: R06 -01103
Initials: JEM Payment Date: 07/24/2006
User ID: 1165 Total Payment: 308.38
Payee: REHABITAT NORTHWEST, INC.
SET ID: 0724 SET NAME: REHABITAT NW
SET TRANSACTIONS:
Set Member Amount
M05 -029
PG06 -098
TOTAL:
10.38
298.00
308.38
TRANSACTION LIST:
Type Method Description Amount
Payment Check 5968 308.38
TOTAL: 308.38
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
MECHANICAL - RES
PLAN CHECK - RES
PLUMBING - RES
000/322.100 8.31
000/345.830 2.07
000/322.100 298.00
TOTAL: 308.38