HomeMy WebLinkAboutPermit PG08-246 - HART RESIDENCEHART RESIDENCE
13215 40 AV S
EXPIRED 04 -14-09
PGO8-246
Parcel No.: 7340600900
Address:
Suite No:
Citylif 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
13215 40 AV S TUKW
PLUMBING /GAS PIPING PERMIT
Permit Number:
Issue Date:
Permit Expires On:
PG08 -246
10/06/2008
04/04/2009
Tenant:
Name:
Address:
HART RESIDENCE
13215 40 AVE S , TUKWILA WA
Owner:
Name: HART MADOLIN F
Address: 13215 40TH AVE S , TUKW!LA WA
Contact Person:
Name: BRUCE ROBERTSON
Address: 1115 NW 51 ST , SEATTLE WA
Contractor:
Name: FISCHER PLUMBING CO INC, THE
Address: 1115 NW 51ST ST , SEATTLE WA
Contractor License No: FLSCHPC131R1
Phone:
Phone: 206- 783 -4129
Phone: (206)783 -4129
Expiration Date: 02/22/2010
DESCRIPTION OF WORK:
REPLUMB EXISTING PLUMBING FOR TWO BATHROOMS
Value of Plumbing /Gas Piping:
Fees Collected:
$3,500.00
$214.00
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
Uniform Plumbing Code Edition: 2006
International Fuel Gas Code Edition: 2006
FIXTURE TYPE AND QUANTITY
Plumbing (cont.)
2 Building sewer and each trailer park sewer 0
0 Rain water system - per drain (inside bldg) 0
0 Water heater and /or vent 0
0 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 0
0 Repair or alteration of drainage or vent piping 0
2 Medical gas piping system serving (1 -5)
0 inlets /outlets for a specific gas 1
0 Medical gas piping (6 +) inlets /outlets 1
0 Gas Piping
0 Gas piping outlets (0 -5) 0
2 Gas piping outlets (6 +) 0
* *continued on next page **
doc: UPC -10/06
PG08 -246 Printed: 10 -06 -2008
City 041P 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
Permit Number: PG08 -246
Issue Date: 10/06/2008
Permit Expires On: 04/04/2009
Permit Center Authorized Signature:
I hereby certify that I have read and e
governing this work will be complied
•th
Date: 1,010(61 L Deb
ed this permit and know the same to be true and correct. All provisions of law and ordinances
whether specified herein or not.
The gr. . ting •f this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws regulating
constru tion r the performance of worlr I am authorized to sign and obtain this plumbing /gas piping permit.
Signatur
Print Name:
Date:
l01 !o /OPj
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 -10/06
PG08 -246 Printed: 10 -06 -2008
•
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
Parcel No.: 7340600900
Address: 13215 40 AV S TUKW
Suite No:
Tenant: HART RESIDENCE
PERMIT CONDITIONS
Permit Number:
Status:
Applied Date:
Issue Date:
PG08 -246
ISSUED
09/05/2008
10/06/2008
1: ** *PLUMBING AND GAS PIPING * **
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.
* *continued on next page **
doc: Cond -10/06
PG08 -246 Printed: 10 -06 -2008
•
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
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
construction or the performance of work.
Signature.
1/2-4S 15■- Date: 10/100)
Print Name: 1 Q Q S 7%' V
ordinances governing
or local laws regulating
doc: Cond -10/06 PG08 -246
Printed: 10 -06 -2008
CITY OF TUKWILA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
hup://www.ci.tiilcwila.wa.us
Building Permit No. /
Mechanical Permit No.
Plumbing /Gas Permit No. loco g- 22-10
Public Works Permit No.
Project No.
(For office use only)
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
Site Address: 1 3a 15 1-10-41 S
Tenant Name:
Property Owners Name: PICA T
King Co Assessor's Tax No.:—.7 3 `I Q ecn `d0
Suite Number: Floor:
New Tenant: ❑ Yes ❑ .. No
Mailing Address: S OtYV.Q_
City
State
Zip
CONTACT PERSON - who do we contact when your permit is ready to be issued
Name:
Day Telephone:
Mailing Address:
City
E -Mail Address:
State
Zip
Fax Number:
GENERAL CONTRACTOR INFORMATION —
(Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5))
Company Name:
Mailing Address:
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
Contractor Registration Number:
State
Zip
Expiration Date:
ARCHITECT OF RECORD - All plans must be wet stamped by Architect of Record
Company Name:
Mailing Address: _
City
Day Telephone: _
Fax Number:
Contact Person:
E -Mail Address:
State
Zip
ENGINEER OF RECORD - All plans must be wet stamped by Engineer of Record
Company Name:
Mailing Address:
City
Day Telephone:
E -Mail Address: Fax Number:
Q:Wpplications\Forms- Applications On Line\3 -2006 - Permit Application.doc
Revised: 9 -2006
bh
Contact Person:
State
Zip
Page 1 of 6
PLUMBING AND GAS PIPING PERMIT INFORMATION - 206 -431 -3670
PLUMBING AND GAS PIPING RACTOR INFORMATION
Company Name: FT .S.aP • _ 10 1144
Mailing Address: (M � S N_\ - 5) 5 T J sp Gl il c7
� City State Zip
y
Contact Person: 1 J &t, O/ •0i) Day Telephone: Q6"* ?' — // act
I Fax Number: 3C , /� � IaL)
Contractor Registration Number: 'FI SC.V1 pCI 31 la) Expiration Date:
E -Mail Address:
Valuation of Plumbing work (contractor's bid price): $ 3,509
Valuation of Gas Piping work (contractor's bid price): $
Scope of Work (please provide detailed information): _ b ��{� U-)1 p mnJoi -co(
1'1.1 0 YSa1' c0G\m4)
Building Use (per Int'l Building Code):
Occupancy (per Int'l Building Code):
Utility Purveyor: Water: Sewer:
Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below:
Fixture Type:
Qty
Fixture Type:
Qty
Fixture Type:
Qty
Fixture Type:
Qty
Bathtub or combination
bath /shower
r1
p(
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
Dental unit, cuspidor
Shower, single head trap
Urinals
Dishwasher, domestic,
with independent drain
Lavatory
R.
Water Closet
Building sewer or trailer
park sewer
Rain water system — per
drain (inside building)
Water heater and/or
vent
_
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
Q:\Applications \Forms - Applications On Line\ -2006 - Permit Application.doc
Revised: 9 -2006
bh
Page 5 of 6
PERMIT APPLICATION NO
— 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.
Building and Mechanical Permit
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).
Plumbing Permit
The Building Official may grant one extension of time for an additional period not exceeding 180 days. The extension shall be requested
in writing and justifiable cause demonstrated. Section 103.4.3 Uniform 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 I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWNER 0 : I THORIZE
Signature: Date:
Print Name: t"j,((�ifj,y'�jclj
gic �1 ST
Mailing Address:
Day Telephone:
City
State �
75/o7
Zip
Date Application Accepted:
q� S -��
Date Application Expires:
6 -S -09
Staff Initials:
u4e.
1
Q:\Applications\Forms- Applications On Line\3 -2006 - Permit Application.doc
Revised: 9 -2006
bh
Page 6 of 6
13-1641MINGJVIDWALS'
NiOtOftt
Lr'•
• • h..: Y:
• Ni; •
)1 • ■*.••••••
. • •":'',1
• • • t.: 's.•••;-1. •• '
PLUMBING AND GAS PIPING CONTRACTOR INFORMATION
Company Name:
Mailing Address:
Contact Person:
E-Mail Address:
Contractor Registration Number:
city
Day Telephone:
Fax Number:
Expiration Date:
State
Zip
Valuation of Plumbing work (contractor's bid price): $
Valuation of Gas Piping work (contractor's bid price): $
Scope of Work (please provide detailed information):
Building Use (per Intl Building Code):
Occupancy (per Intl Building Code):
Utility Purveyor: Water: Sewer:
Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity below:
QAApplications\Forms-Applications On Line13-2006 - Permit Application.doc
Revised: 9-2005
bh
Page 5 of 6
Qty. 2,
..-, — .
,.Q.ts,"
yixorfilRyti0:-:,
:14V2-..7
";..,}20g: • '
... .,
.-QtY",i,
Bathtub or combination
bath/shower
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
Dental unit, cuspidor
Shower, single head trap
Urinals
Dishwasher, domestic,
with independent drain
Lavatory
Water Closet
Building sewer or trailer
park sewer
RaM water system — per
drain (inside building)
Water heater and/or
vent
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
QAApplications\Forms-Applications On Line13-2006 - Permit Application.doc
Revised: 9-2005
bh
Page 5 of 6
•
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
Parcel No.: 7340600900
Address: 13215 40 AV S TUKW
Suite No:
Applicant: HART RESIDENCE
RECEIPT
Permit Number: PG08 -246
Status: PENDING
Applied Date: 09/05/2008
Issue Date:
Receipt No.: R08 -03158 Payment Amount: $214.00
Initials: WER Payment Date: 09/05/2008 02:53 PM
User ID: 1655 Balance: $0.00
Payee: FISCHER PLUMBING
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 72213 214.00
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
PLAN CHECK - RES
PLUMBING - RES
000/345.830 38.00
000.322.103.00.0 176.00
Total: $214.00
7250 )9/08 ?707 TOTAL 214 OO
doc: Receipt-06 Printed: 09 -05 -2008
INSPECTION RECORD
Retain a copy with permit
19L
PCO82L(
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Project:
Type of Inspection:
PL1.4'w
Address:
r321 S 110
/10 C
Date Called:
Special Instructions:
Date Wanted:
ap.m..
()'t�A -%T t,-)4 i I )(7,. -,_J (
Requester:
IA r
Phone No:
DApproved per applicable codes. O Corrections required prior to approval.
COMMENTS: p J JN ,� f (J a. k
l
f)&'f1AAt ,J J S P 11 A-+-
! / J 3 M S — te,th -- .. X 17-A
I. j f LA.J =- A -r4 sIV u d 1-1 O n
()'t�A -%T t,-)4 i I )(7,. -,_J (
()e •],
IA r
t � � 1
Inspect
�A
Date:
!c -f-�
❑$60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
NSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
Re-L13-ztie,
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -367
Project:
HA QT
(Z e c>
Tyke of Inspection: ,. N
l)., "Lc, k- 1 NI PiltA4 b
Address:
\ ZIG
Ld A u
Date Called:
Special Instructions:
�-
Date Wan d:
1C 1i_ I 0 ecs
a.
/(,.,.
Requester:
Phone No
L12 S -5 1 -(`-5 7
Approved per applicable codes. El Corrections required prior to approval.
COMMENTS:
,1 A ) P
Inspector:
Date:
$60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Receipt No.:
Date:
INSPECT' I N NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (20,6)431 -3670
INSPECTION RECORD
Retain a copy with permit
Pro fM/T /2 -
TYpe�g41 Inspection: /� �2i
S : - -L £' c.. ;i 1 a v. a Y ,
/ i5 ) `)
!
5
Date Called.
r:t--1-A
Special Instructions:
•
Date Wanted:
/// 7^ dG
a.t
p.m.
Requester:
_ . .
Phone No
405 sii -/-337
Approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
OLA)J liSr. ��0 ,J4 ( 5u ;it
S : - -L £' c.. ;i 1 a v. a Y ,
( () IAA (. °f4 -1-)) r � I �. � ✓ T vc, &kf
i h (3 le') t IA i--A -- �i i' 1 .-t P, ..0(
r:t--1-A
,....
_ . .
Inspec>�r:
Date:
r J— „`j
A.
El $60.00 REINSPECTION FEE EQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter B d., Suite 100. CaIL to schedule reinspection.
Receipt No.:
'Date:
1
September 9, 2008
Bruce Robertson
1115 NW 51St
Seattle, WA 98107
•
City of Tub ila
•
Jim Haggerton, Mayor
apartment of Community ,''evelopment Jack Pace, Director
RE: Letter of Incomplete Application # 1
Development Permit Application PG08 -246
Hart Residence — 13215 — 40th Avenue S
Dear Mr. Robertson,
This letter is to inform you that your permit application received at the City of Tukwila Permit Center on
September 5, 2008 is determined to be incomplete. Before your application can continue the plan review
process the following items from the following department need to be addressed:
Building Department: Allen Johannessen at 206 433 -7163 if you have any questions
concerning the attached comments.
Please address the comment above in an itemized format with applicable revised plans, specifications,
and /or other documentation. The City requires that two (2) sets of revised plans, specifications and/or
other documentation be resubmitted with the appropriate revision block.
In order to better expedite your resubmittal a `Revision Submittal Sheet' must accompany every
resubmittal. I have enclosed one for your convenience. Revisions must be made in person and will not
be accepted through the mail or by a messenger service.
If you have any questions, please contact me at the Permit Center at (206) 431 -3670.
Sincerely,
Brenda Holt
Permit Coordinator
Enclosures
File: PG08 -246
P:\Permit Center\Incomplete Letters\2008\PG08 -246 Incomplete Ltr # 1.DOC
jem
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665
• •
Tukwila ',Building Division
Allen Johannessen, Plan Examiner
Determination of Completeness Memo
Date: September 9, 2008
Project Name: Hart Residence
Permit #: PG08 -246
Plan Review: Allen Johannessen, Plans Examiner
The Building Division has deemed the subject permit application incomplete. To assist the applicant in
expediting the Department plan review process, please forward the following comments.
(GENERAL NOTE)
PLAN SUBMITTALS: (Min. size 1 1x17 to maximum size of 24x36; all sheets shall be the same size).
(If applicable) Structural Drawings and structural calculations sheets shall be original signed wet stamped,
not copied.)
1. The permit application indicated to re -plumb two bathrooms. Only one bathroom is shown on the plan. If
an additional bathroom is to be added, a building permit shall be required or a revision to the existing
building permit may be accepted complete with revised plans.
2. Provide schematics for the plumbing of the two bathrooms that identifies pipes, pipe sizes and points of
connection.
Should there be questions concerning the above requirements, contact the Building Division at 206 - 431 -3670.
No further comments at this time.
• •
PERMIT COORD COPY
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: PG08 -246 DATE: 09 -05 -08
PROJECT NAME: HART RESIDENCE
SITE ADDRESS: 13215 40 AVE S
X Original Plan Submittal
Response to Correction Letter # Revision # After Permit Issued
Response to Incomplete Letter #
DEPARTMENTS:
: AMA
Public Works
s q -4 -o
Fire Prevention
Structural
Planning Division
n Permit Coordinator
n
III;
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
Incomplete
DUE DATE: 09 -09 -08
Not Applicable
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED: __ � LETTER OF COMPLETENESS LEp:
Departments determined incomplete: Bldg Ldl Fire ❑ Ping ❑ PW ❑ Staff Initials:
TUESITHURS ROUTING:
Please Route
Structural Review Required
No further Review Required
r
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS:
DUE DATE: 1 0-07 -08
Approved n Approved with Conditions n Not Approved (attach comments) n
Notation:
REVIEWER'S INITIALS: DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
Documents/routing slip.doc
2 -28 -02
•
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: http: //www.ci.tukwila.wa.us
Steve Lancaster, Director
Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through
the mail, fad etc.
Date: Plan ChecWPermit Number: 176_,c)p____YC
Response to Incomplete Letter # t'
❑ Response to Correction Letter #
❑ Revision # after Permit is Issued
❑ Revision requested by a City Building Inspector or Plans Examiner
Project Name:
Project Address:
Contact Person: Phone Number:
Summary of Revision: %J
/ CeAorhl�'Ze C�PrheA Za `• _ G f
Sheet Number(s):
"Cloud" or highlight all areas of revision including date of revision
Received at the City of Tukwila Permit Center by:
❑ Entered in Permits Plus on
lapplicationslforms- applications on Iinelrevision submittal
Created: 8 -13 -2004
Untitled Page
•
General /Specialty Contractor
A business registered as a construction contractor with Lai 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.
Business and Licensing Information
Name
Phone
Address
Suite /Apt.
City
State
Zip
FISCHER PLUMBING CO
INC, THE
2067834129
1115NW51STST
SEATTLE
WA
98107
County KING
Business Type CORPORATION
Parent
Company
UBI No.
Status
License No.
License Type
Effective Date
Expiration Date
Suspend Date
Previous
License
Next License
Associated
License
Specialty 1
Specialty 2
601058759
ACTIVE
FISCHPC131 R1
CONSTRUCTION
CONTRACTOR
12/21/1987
2/22/2010
PLUMBC *236J9
FISCHL *987D1
PLUMBING
UNUSED
Business Owner Information
Name
Role
Effective Date
Expiration Date
ROBERTSON, BRUCE D
Cancel
Date
01/01/1980
Bond
Amount
MILLER, DARYL J
4
01/01/1980
YL1243047
HARRELL, DON
Until Cancelled
01/01/1980
01/01/1980
Bond Information
Bond
Bond
Company
Name
Bond
Account
Number
Effective
Date
Expiration
Date
Cancel
Date
Impaired
Date
Bond
Amount
Received
Date
4
OLD
SURETY REPUBLIC
CO
YL1243047
12/27/2001
Until Cancelled
$6,000.00
01/08/2002
3
WESTERN
SURETY
CO
68722727
04/27/1998
Until
Cancelled
12/27/2001
$4,000.00
2
AMERICAN
STATES
INS CO
EX613211
04/29/198804/29
/1998
$4,000.00
1
CBIC
603576
04/29/198704/29 /1988
Insurance Information
Page 1 of 2
Insurance
Company Name
Policy Number
Effective
Date
Expiration
Date
Cancel
Date
Impaired
Date
Amount
Received
Date
https: // fortress. wa. gov /lni/bbip/Detail.aspx ?License= FISCHPC 131 R 1
10/06/2008