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HomeMy WebLinkAbout18414 CHAMPIONS DR_BLD1104_2026 RESIDENTIAL MECHANICAL PERMIT APPLICATION t�N Department of Community & Economic Development City of Arlington • 18204 59th Ave NE • Arlington, WA 98223 • Phone (360) 403-3551 THIS APPLICATION IS TO BE USED WHEN APPLYING FOR NEW MECHANICAL INSTALLATION AND OR GAS PIPING FOR EXISTING RESIDENCES. PLEASE FILL OUT ALL PAGES OF THIS APPLICATION AND INCLUDE ALL INFORMATION. Project Address:Stafford furnace Project Description:replace furnace like and kind Owner: Linda Stafford Address. 18414 Champions Dr City: Arlington StateWa Zip Code: 98223 Phone. 360-403-3153 Email-NA Applicant: Paragon Heating and Home Comfort Solutions Address: PO Box 798 City. Marysville State WA Zip Code: 98270 Phone. 360-658-9500 Email: info@paragonheating.com CONTRACTOR INFORMATION Contractor Name:Paragon Heating and Home Comfort Solutions Address: PO Box 798 City: Marysville StatelNa Zip Code: 98270 License Number: PARAGHC8632A Expiration: 5/1/2018 P hone: 360-658-9500 Emal I:info@paragonheating.com STAFF USE ONLY Permit #: Accepted by: Date: 6/16LP Page 1 of 2 Y. RESIDENTIAL MECHANICAL PERMIT APPLICATION SING Department of Community& Economic Development City of Arlington • 18204 59th Ave NE• Arlington, WA 98223• Phone(360) 403-3551 SELECT ALL PROPOSED APPLIANCES Furnace (80+) Model #TG8SO40A08MP11A AFUE80% ❑ Heat Pump Model # AFUE HSPE ❑ AC Unit Model # SEER ❑ Freestanding Stove ❑ Fire Place Insert ❑ Outdoor BBQ ❑ Gas Piping ❑ Solid-Fuel Appliance ❑ Other Gas Piping Information Not Applicable: ❑ Pipe Material: Pipe Size: Distance from Meter to Furthest Appliance: Total BTU's of all Appliances: • New gas piping requires a pressure test hooking to any appliance • Sediment traps (drips) are required on all gas lines • Gas lines are required to be supported/secured every 6 to 8 feet • Proper Combustion air and venting required for all appliances • A shut-off valve is required within 6 feet of all appliances Applicant Signature: Date: 08/01/2016 Applicant Printed Name: JEANA BRENNAN I hereby certify that the above information is correct and that the construction, installation for the above mentioned property will be in accordance with the applicable laws of the City of Arlington and the State of Washington. 6/16LP Page 2 of 2 CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT _ Address:18414 Champions Drive Permit#: 1104 Parcel#:00874400010200 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:Paragon Heating and Home Comfort Name:Paragon Heating Name:S'I AFFORD FAMILY TRUST Solutions g g Address: 1706 W WREN WOOD AVE Address:P.O.Box 798 Address:P.O.Box 798 City,State Zip:FRESNO,CA 93711 City,State Zip:Marysville,WA 98270 City,State Zip:Marysville,WA 98270 Phone: Phone:360-658-9500 Phone:360-058-9500 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:Paragon Heating Name: Address:P.O.Box 798 Address: City,State,Zip:Marysville,WA 98270 City,State,Lip: Phone:360-658-9500 Phone: LIC#:PARAGHC8632A EXP: 5/01/2018 LIC JOB DESCRIPTION PERMIT TYPE: Residential Mechanical CODE YEAR: 2015 STORIES: 2 CONST.TYPE: DWELLING UNITS: ] OCC GROUP: BUILDINGS: OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY,NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL.A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBCI 10/IRC110. Sales tax relating to construction an construction materials in the City of Arlin• reported on your sales tax return form n ded i fArl gton#3101. Signature Print Name Date c case y Date CONDITIONS Duct testing is required per the 2015 Washington State Energy Code R402.4.1.2. Adhere to installation of model#TG8SO40A08MP1 IA AFUE 80% THIS PERMIT AUTHORIZS ONLY THE WORK NOTED THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC,)WILL REQUIRE SEPARATE PERMISSION PERMIT FEES Date Description Fee Amount 8/2/2016 Furnace $25.00 8/2/2016 Mechanical Permit Base Fee $25.00 Total Due: $50.00 Total Payment: $50.00 Balance Due: $0.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of inspection being requested,and whether you prefer morning or afternoon CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address:18414 Champions Drive Permit#:1104 Parcel#:00874400010200 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:STAFFORD FAMILY TRUST Namc:Paragon Heating and Home Comfort Name:Paragon Heating Solutions Address: 1706 W WRENWOOD AVE Address:P.O.Box 798 Address:P.O.Box 798 City,State Zip:FRESNO,CA 93711 City,State Zip:Marysville,WA 98270 City,State Zip:Marysville,WA 98270 Phone: Phone:360-658-9500 Phone:360-658-9500 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:Paragon Heating Name: Address:P.O.Box 798 Address: City,State,Zip:Marysville,WA 98270 City,State,Zip: Phone:360-658-9500 Phone: LIC#:PARAGHC8632A EXP: 5/01/2018 LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Mechanical CODE YEAR: 2015 STORIES: 2 CONST.TYPE: DWELLING UNITS: ] OCC GROUP: BUILDINGS: OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. iBCI10/IRCI10. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlin reported on your sales tax return form and coded City of Arlington#3101. !f/�f n Z I/^ Signature Print Name Date c case y Date 1Fi CONDITIONS Duct testing is required per the 2015 Washington State Energy Code R402.4.1.2. Adhere to installation of model #TG8SO4OAO8MP11A AFUE 80% THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION, PERMIT FEES Date Description Fee Amount 8/2/2016 Furnace $25.00 8/2/2016 Mechanical Permit Base Fee $25.00 Total Due: $50.00 Total Payment: $50.00 Balance Due: $0.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon 8/1/2016 L98-793 I Coleman I TG8SO40A08MP11 I Johnstone Supply MJOHNSTONE i Request Account I Sign In I Contact Us Resources I Find a Store . SUPPLY O PRODUCT KNOWLEDGE SERVICE View Mfr.List HVAC HVACR Hydronics Motors Refrigeration Supplies Testing, Thermostats Ventilation Equipment Parts &Plumbing Tools&Training &IAQ Home> HVAC Equipment> Residential Unitary> Gas Furnaces> 80%AFUE Efficiency> Single-Stage> Multi-Position> Enlarge Image 80% AFUE Multi-Position Gas Furnaces TG8S Series, Single-Stage, 33" Height AFUE:80.0%;BtuH Input:40,000;BtuH Output:32,000;Nom.CFM:800;Min. Circuit Amps:4.5;Vent Size:4";Width:14-1/2";Height:33";Depth:29-1/2" Wt.Lbs.:89; Order#:L98-793 Catalog Page#:699 Mfg.#:TG8SO4OAO8MP11 Shipping Weight:94.00 Brand:Coleman Country of Origin:UNITED STATES My Johnstone Supply Price' rr In to View Pricing AVAILABILITY Store Status Login above to see availability Overvi Specifications Compliance& Warranty 8 Notes Manufacturer ............. Product Specifications AFUE 80.0% BtuH Input 40000 BtuH Output 32,000 Depth 29-1/2" Height 33" Min.Circuit Amps 4.5 Nom.CFM 800 Vent Size 4" Width 14-1/2" Wt. Lbs. 89 Shipping Weight 94.00 Shipping Width 16.00 Shipping Length 32.00 Shipping Height 37.00 Johnstone Info Contractor Resources Programs Help Center Opportunities Management About Johnstone Tax Credits Johnstone University Contact Us Career Board of Directors Supply eCatalog NATE Site Overview Opportunities Executive Staff Sales Policy Manufacturer Listing Radius Marketing Website-How To Ownership Corporate Management Press Releases Credit Application Contractor Promotions Opportunities Regional Management SIDS (FillablePDF) Vendor Collateral Mobile Site Johnstone Mobile App Terms of Use Privacy Statement Employee Network Login Store Content Manager Copyright©2016 Johnstone Supply.All rights reserved. This site is optimized for IE7 or later,Firefox,Chrome and Safari https://www.johnstonesupply.com/storefront/product-view.ep?p[D=L98-793 1/1 BUILDING INSPECTION REPORT — MECHANICAL (RESIDENTIAL) Permit No. 1104 Address: 18414 Champions Drive Contractor: Paragon Heating and Home Comfort Solution Owner: Linda Stafford Date: 8/30/2016 ® APPROVAL ❑ PARTIAL APPROVAL ❑ CORRECTION ❑ OTHER APPLIANCE: Gas Furnace CO DETECTOR: ❑ HEAT PUMP/AC UNIT: ❑ GAS PIPING: © DISCONNECT: ❑ DRIP LEG: ® SEISMIC: ❑ VENTING: ® 3" PAD: ❑ ACCESS: ® INSULATION/PROTECTION: ❑ SHUT-OFF VALVE: nx DUCTS: N/A L&I: Yes Date: 8/30/2016 Inspector: Kevin Olander CITY OF ARLINGTON 238 N.OLYMPIC AVE-ARLINGTON,WA.99223 PHONE;(360)403-3551 BUILDING PEI MM Address:18414 Champions Drive Permit M: 1104 Parcel#:00874400010200 Valuation:0,00 OWNER _ APPLICANT CONTRACTOR Name:STAFFORD FAMILY TRUST Name:Paragon Heating and Home Comfon Name:paragon Heating Solutions Address:1706 W WRENWOOD AVE Address:P.O.Box 79$ Addres:P.O.Box 798 City,State Zip:FRESNO,CA 93711 City,State Zip:Mosysv111e,WA M70 City, Zip:Mmysville,WA 99270 Phone: Phone:360.658-9500 Phone:360-659-9500 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name Paragon heating! Nam: Address:P.O.Box 798 Adds: City.State,Zip:Maryeville,WA 9SZ70 City,State,Zip: Phone:360-658-9500 Phone: LIC#:PARAGHC8632A EXP: 5/012019 LIC it: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Mechanical CODCYEAR: 2015 STORIES: 2 CONST.TYPE: DWELLING UNITS, 1 OCCGROUP: BUILDINGS: OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY W ITI I CITY AND STATE LAWS RF.OUI.A'rING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27, THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBCI IORRCI10. Sales tax relating to construction an construction materials in the City of Arlin reponed on your sales tax return form ckd i At gton 43101- - S ignslure Print Name hate Y Dale CONDITIONS Duct testing is required per the 2015 Washington State Energy Code R402.4.1.2. Adhere to installation of model#TG8SO4OAO8MP 11 A AFUE 80% THIS PERMIT AUTHORIZE ONLY THE WORK NOTED MIS PERMIT COVERS WORK TO BL DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS.SIDEWALKS.DRIVEWAYS.MARQUEES,ETC.)WILL REQUIRE.SEPARATE PERMISSION. PERIVLIT FEES _ Nis Description Foe Amount 8/2/2016 Furnace $25.00 8/2/2016 Mechanical Permit Base Fee $25.00 Total Due: $50.00 Total Payment: $50.00 Balance Due: SO.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for sit Inspection please leave the following informedon: Permit Number,Type of Inspection being requested,and whether you prerer morning or afternoon CITY OF ARLINGTON 238 N. OLYMPIC AVE - ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:18414 Champions Drive Permit#:1104 Parcel#:00874400010200 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:STAFFORD FAMILY TRUST Name:Paragon Heating and Home Comfort Name:Paragon Heating Solutions Address: 1706 W WRENWOOD AVE Address:P.O.Box 798 Address:P.O.Box 798 City,State Zip:FRESNO,CA 93711 City,State Zip:Marysville,WA 98270 City,State Zip:Marysville,WA 98270 Phone: Phone:360-658-9500 Phone:360-658-9500 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:Paragon Heating Name: Address:P.O.Box 798 Address: City,State,Zip:Marysville,WA 98270 City,State,Zip: Phone:360-658-9500 Phone: LIC#:PARAGHC8632A EXP: 5/01/2018 LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Mechanical CODE YEAR: 2015 STORIES: 2 CONST.TYPE: DWELLING UNITS: 1 OCC GROUP: BUILDINGS: OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBCI 10/IRCI 10, SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlin reported on your sales tax return form and coded City of Arlington#3101. ew Signature Print Name Date kAOr a ease y Date K� CONDITIONS Duct testing is required per the 2015 Washington State Energy Code R402.4.1.2. Adhere to installation of model #TG8SO4OAO8MP11A AFUE 80% THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 8/2/2016 Furnace $25.00 8/2/2016 Mechanical Permit Base Fee $25 00 Total Due: S50.00 Total Payment: $50.00 Balance Due: $0.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon RESIDENTIAL MECHANICAL PERMIT APPLICATION f�lJ�i�yt �j Department of Community& Economic Development City of Arlington • 18204 59th Ave NE• Arlington, WA 98223 • Phone(360) 403-3551 THIS APPLICATION IS TO BE USED WHEN APPLYING FOR NEW MECHANICAL INSTALLATION AND OR GAS PIPING FOR EXISTING RESIDENCES. PLEASE FILL OUT ALL PAGES OF THIS APPLICATION AND INCLUDE ALL INFORMATION. Project Address:Stafford furnace Project Description:replace furnace like and kind Owner: Linda Stafford Address: 18414 Champions Dr City:Arlington StateWa Zip Code: 98223 Phone: 360-403-3153 Emai I:NA Applicant: Paragon Heating and Home Comfort Solutions Address:PO Box 798 City: Marysville State WA Zip Code: 98270 Phone: 360-658-9500 Email: infoCa paragonheating.com CONTRACTOR INFORMATION Contractor Name•Paragon Heating and Home Comfort Solutions Address:PO Box 798 City: Marysville StateWa Zip Code: 98270 License Number:PARAGHC8632A Expiration: 5/1/2018 Phone:360-658-9500 Email:info@paragonheating.com STAFF USE ON Received Permit #: —]I Accepted by: &L Date: AUG 01 2016 6/16LP Page 1 of 2 RESIDENTIAL MECHANICAL PERMIT APPLICATION Department of Community& Economic Development City of Arlington • 18204 59th Ave NE• Arlington, WA 98223• Phone(360) 403-3551 SELECT ALL PROPOSED APPLIANCES Furnace (80+) Model #TG8SO4OAO8MP11A AFUE80% ❑ Heat Pump Model # AFUE HSPE ❑ AC Unit Model # SEER ❑ Freestanding Stove Uj Fire Place Insert ❑ Outdoor BBQ ❑ Gas Piping Solid-Fuel Appliance Other Gas Piping Information Not Applicable: Ej Pipe Material: Pipe Size: Distance from Meter to Furthest Appliance: Total BTU's of all Appliances: • New gas piping requires a pressure test hooking to any appliance • Sediment traps (drips) are required on all gas lines • Gas lines are required to be supported/secured every 6 to 8 feet • Proper Combustion air and venting required for all appliances • A shut-off valve is required within 6 feet of all appliances Applicant Signature: � Date: 08/01/2016 Applicant Printed Name: JEANA BRENNAN I hereby certify that the above information is correct and that the construction, installation for the above mentioned property will be in accordance with the applicable laws of the City of Arlington and the State of Washington. 6/16LP Page 2 of 2 8/1/2016 "- 1 L98-7931 Coleman I TG8SO40AOBMP11 1 Johnstone Sv-'' ) ,. JOHNS"TONE Request Account i Sign In I Contact Us I Resources I Find a Store p . SUPPLY PRODUCT KNOWLEDGE SERVICE View Mr.List ti A HVACR Hytlrronics Motors Refrigeration supj%es Testing, fherrnostals Vents( #i��n quipment Paris &Pkirnbing Tan(.s&Training &)AQ Home> HVAC Equipment> Residential Unitary> Gas Furnaces> 80%AFUE Efficiency> Single-Stage> Multi-Position> Enlarge Image 80%AFUE Multi-Position Gas Furnaces TG8S Series, Single-Stage, 33" Height AFUE:80.0%;BtuH Input:40,000;BtuH Output 32,000:Nom.CFM:800;Min. Circuit Amps:4.5;Vent Size:4";Width:14-1/2";Height:33":Depth:29-1/2"; WL Lbs.:89; Order#:L98-793 Catalog Page#:do Mfg.#:TGBSO40AOBMP11 Shipping Weight:94.00 Brand:man Country of Origin:UNITED STATES My Johnstone Supply Pfice. AVAILABILITY Store Status Login above to see availability Ova rview Specifications Compliance& Warranty$ Notes Manufacturer Product Specifications AFUE 80.0% BtuH Input 40000 BtuH Output 32,000 Depth 29-112" Height 33" Min.Circuit Amps 4.5 Nom.CFM 800 Vent Size 4" Width 14-112" Wt.Lbs. 89 Shipping Weight 94.00 Shipping Width 16.00 Shipping Length 32.00 Shipping Height 37.00 Johnstone Info Contractor Resources Programs Help Center Opportunities Management About Johnstone Tax Credits Johnstone University Contact Us Career Board of Directors Supply sCatelog NATE Site Overview Opportunities Executive Staff Sales Policy , Manufacturer Listing Radius Marketing Website-How To Ownership Corporate Management Press Releases Credit Application Contractor Promotions Opportunities Regional Management SDS (FIIlablePDF) Vendor Collateral Mobile Site Johnstone Mobile App Terms of Use Privacy Statement Employee Network Login Store Content Manager Copyright®2016 Johnstone Supply.All rights reserved This site is optimized for IE7 or later,Firefox,Chrome and Safari https://www.johnstonesupply.com/storefront/product-view.ep?MD=L98-793 1/1 8/2/2016 Paragon Htg/Hm Cmft Sltns LLC r Search L&I l Lrlrx ri+ Mic 1.&1 Sage i k� Health �;I�irns Ka Insumnce Workplace'Flights 'I-rac:ras R Licensing Washington State Department of " Labor & Industries Paragon Htg/Hm Cmft Sltns LLC Owner or tradesperson PO Box 798 MARYSVILLE,WA 98270 Principals 425-252-1807 Brennan,Jeana Anne SNOHOMISH County Ingham,PARTNERIMEMBER BRENNAN, SCOTT MATTHEW, PARTNER/MEMBER Doing business as Paragon Htg/Hm Cmft Sltns LLC WA UBI No. Business type 603 395 569 Limited Liability Company Governing persons JEANA BRENNAN SCOTT BRENNAN; License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. PARAGHC8632A Effective—expiration 05/01/2014—05/01/2018 Bond RLI Ins Co $12,000.00 Bond account no. LSM0614502 Received by L&I Effective date 05/01/2014 05/01/2014 Expiration date Until Canceled Insurance Truck Ins Exchange $2,000,000.00 Policy no. 605833231 Received by L&I Effective date 03/21/2016 05/01/2014 Expiration date 05/01/2017 Savings No savings accounts during the previous 6 year period. hftps://secure.ini.wa.gov/verify/Detail.aspx?UBI=603395569&LIC=PARAGHC8632A&SAW= 1/2 8/2/2016 Paragon Htg/Hm Cmft Sltns LLC Lawsuits against the bond or savings No lawsuits against the bond or savings accot- during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. 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. L&I Account ID Account is current. 307,488-00 Doing business as PARAGON HEATING&HOME COMFORT Estimated workers reported Quarter 2 of Year 2016"1 to 3 Workers" L&I account representative T2/LINDA ALGUIRE(360)902-4678-Email:POTH235&ni.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. https://secure.ini.wa.gov/verify/Detail.aspx?UBI=603395569&LIC=PARAGHC8632A&SAW= 2/2 Permit#: 1104 Permit Date: 08/02/16 Permit Type: RESIDENTIAL MECHANICAL Project Name: Linda Stafford Applicant Name: Paragon Heating and Home Comfort Solutions Applicant Address: P.O. Box 798 Applicant, City, State, Zip: Marysville,WA 98270 Contact: Jeana Brennan Phone: 360-658-9500 Email: info@paragonheating.com Scope of Work: Replace Furnace Valuation: 0.00 Square Feet: 0 Number of Stories: 2 Construction Type: Occupancy Group: ID Code: Permit Issued: 08/02/2016 Permit Expires: 02/02/2017 Form Permit Type: Status: LASERFICHE Assigned To: Kristin Foster Property Parcel# Address Legal Description Owner Name Owner Phone Zoning STAFFORD 116 Common Wall 00874400010200 18414 CHAMPIONS DR FAMILY TRUST Single Family Residence Contractors Contractor Primary Contact Phone Address Contractor Type License License# Paragon Heating Jeana Brennan 360-658-9500 P.O.Box 798 CONSTRUCTION UBI 603 395 569 CONTRACTOR Paragon Heating Jeana Brennan 360-658-9500 P.O.Box 798 CONSTRUCTION Labor CONTRACTOR Industri&es PARAGHC8632A Inspections Date Inspection Type Description Scheduled Date Completed Date Inspector Status 08/31/2016 R00.FURNACE 08/30/2016 BUILDING Approved FINAL Fees Fee Description Notes Amount Forced Air Heat fee per Btu $25.00 Mechanical Base Permit Fee $25.00 Total $50.00 Attached Letters Date Letter Description 08/02/2016 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 08/02/2016 JEANABRENNAN 60699836 cc $50.00 Outstanding Balance $0.00 Notes Date Note Created By: 08/02/2016 Model#TG8S040A08MPIlAAFUE 80%. Kristin Foster Uploaded Files Date File Name 08/31/2016 1819586-18414 Champions Drive.docx 08/02/2016 1765638-1104 Issued Permit.pdf 08/02/2016 1765166-1104 Application.pdf 08/02/2016 1765167-1104 Specs.pdf