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Home My WebLink About6210 206TH ST NE_BLD1618_2026 VY RESIDENTIAL PLUMBING PERMIT APPLICATION i� 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 PLUMBING INSTALLATION FOR EXISTING RESIDENCES. PLEASE FILL OUT ALL PAGES OF THIS APPLICATION AND INCLUDE ALL INFORMATION. Project Address 62I0 AOG n S l N. E AtZLAk Zrt" i cJ N- Project Description. PLlt�__- !'C,77— Owner: l rZ�Jly -K Address: G),Ip Ao6Th �7 N,f- City:IqR1S,,4ro,j State.W/�- Zip Code: 992,20 Phone: 360 y3.5-0G 5-6) Email: Applicant: � 5 (�� N&4& ! Address: City: State: Zip Code: Phone: Email: CONTRACTOR INFORMATION Contractor Name: /�(�,�l�� SE,`J ion S ✓� s Address: //42,7 09P6 r 2T-> �;vt7e 3 City: 6_y6z ee, �_ State.4 Zip Code: 99a0 License Number: S,,�J rcg5S Z y3g(l - Expiration: / -Zo -20 t Phone: /Z5 - ZGs Z 22 Z- Email: STAFF USE ON �- ----�� Received Permit#: _! Accepted by: - Date AUG 23 2017 REV 2015 Page 1 of 2 RESIDENTIAL PLUMBING PERMIT APPLICATION �llNG Department of Community& Economic Development City of Arlington • 18204 59th Ave NE -Arlington, WA 98223 • Phone (360)403-3551 Plumbing Section (check all that apply) (Check all that apply and indicate the number of fixtures proposed) Q1 Bath/Shower Combo (4.0) x U Sink (1.5) x Q Shower (2.0) x Lavatory (1.0) x QI Clothes Washer(4.0) x Q` Water Closet (2.5) x ❑l Dishwasher(1.5) x Di Water Heater x []I Hose Bibb (2.5) x Water Heater Model# Q1 Other(list) x Proposed Water Piping Size: Proposed Piping Material: Proposed DWV Material: Proposed DWV Size: • All hose bibs required to be equipped with Atmospheric Vacuum Breakers per ASSE 1019 • All water supplies at 80psi or greater shall have Pressure Reducing Valves (PRV) • Cross-Connection-Control may be required Applicant Signature - Date: -�,3 --2d t 7 I hereby certify that the above inf ation 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. REV 2015 Page 2 of 2 CITY OF ARLINGTON r , { o 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:6210 206th Street NE Permit#:1618 Parcel#:00875200007200 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:MOIR ROBERT A&KITTINGER Name:Homage Senior Services Name:Homage Senior Services BARBARAJ Address:6210 206TH ST N E Address:11627 Airport Rd,Suite B Address: 11627 Airport Rd,Suite B City,State Zip:ARLINGTON,WA 98223 City,State Zip:Everett,WA 98204 City,State Zip:Everett,WA 98204 Phone: Phone:425-265-2222 Phone:425-265-2222 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name:Homage Senior Services Address: Address: 11627 Airport Rd,Suite B City,State,Zip: City,State,Zip:Everett,WA 98204 Phone: Phone:425-265-2222 LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Plumbing CODE YEAR: 2015 STORIES: 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. IBC110/IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Ariingto mu p rted n or sales tax return form ,an oded City of Arlin gto 01. Signature Print Name Date &-elclMedWyV Date CONDITIONS Approved as submitted. 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 8/23/2017 Plumbing Permit Base Fee $25.00 8/23/2017 Processing/Technology Fee $25.00 8/23/2017 Water Heater $25.00 Total Due: $75.00 Total Payment: $75 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 42 PHONE; (360)403-3551 BUILDING PERMIT Address:6210 206th Street NE Permit#:1618 Parcel#:00875200007200 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:MOIR ROBERT A&KITTINGER Name:Homage Senior Services Name:Homage Senior Services BARBARAJ Address:6210 206TH ST N E Address:11627 Airport Rd,Suite B Address: 11627 Airport Rd,Suite B City,State Zip:ARLINGTON,WA 98223 City,State Zip:Everett,WA 98204 City,State Zip:Everett,WA 98204 Phone: Phone:425-265-2222 Phone:425-265-2222 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name:Homage Senior Services Address: Address: 11627 Airport Rd,Suite B City,State,Zip: City,State,Zip:Everett,WA 98204 Phone: Phone:425-265-2222 LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Plumbing CODE YEAR: 2015 STORIES: 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. IBCI10/IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City ofArlingto mu rted n ur sales tax return form � aded City of Arlington 0I D&7J :j-oSr-rJ 4L 2—orl Signature Print Name Date el ed y Date CONDITIONS Approved as submitted. 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 8/23/2017 Plumbing Permit Base Fee $25.00 8/23/2017 Processing/Technology Fee $25.00 8/23/2017 Water Heater $25.00 Total Due: $75.00 Total Payment: $75.00 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 �� q ' � • ... m o RESIDENTIAL PLUMBING y PERMIT APPLICATION �lING 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 PLUMBING INSTALLATION FOR EXISTING RESIDENCES. PLEASE FILL OUT ALL PAGES OF THIS APPLICATION AND INCLUDE ALL INFORMATION. Project Address: 6),10 906 n 5 % A-)E Project Description: Owner: C3f13Rf►- I�,Ll �r Address: 6, 10 ;2-o6717 �7 N r City: R� rp ) StateW-Zip Code: g Z Phone: 3Go y3.5-061td Email: Applicant: Address: City: State: Zip Code- Phone: Email: CONTRACTOR INFORMATION Contractor Name: /`f�f'l ,� SE1.l tot S ✓ZS Address: 6 City: C 2�� State:1�f Zip Code: �g�0 License Number: S,6�0 ra55 z L13C Expiration: / -Zo -zo 1 Phone: /Z5 - 2_G3 Z 22 Z Email: STAFF USE ON ' eceived Permit#: 1 1D 1 1?) Accepted by: - - - Date A U G 2 3 2017 REV 2015 Page 1 of 2 Y RESIDENTIAL PLUMBING PERMIT APPLICATION lI` Department of Community& Economic Development City of Arlington • 18204 59th Ave NE •Arlington, WA 98223 • Phone (360)403-3551 Plumbing Section (check all that apply) (Check all that apply and indicate the number of fixtures proposed) ❑; Bath/Shower Combo (4.0) x Sink (1.5) x ❑ Shower(2.0) x Lavatory (1.0) x ❑ Clothes Washer(4.0) x Water Closet (2.5) x �! Dishwasher (1.5) x LJ1 Water Heater x Hose Bibb (2.5) x Water Heater Model# F-J Other (list) x Proposed Water Piping Size: Proposed Piping Material: Proposed DWV Material: Proposed DWV Size: • All hose bibs required to be equipped with Atmospheric Vacuum Breakers per ASSE 1019 • All water supplies at 80psi or greater shall have Pressure Reducing Valves (PRV) • Cross-Connection-Control may be required I Applicant Signature/ N _`�, - _ '- - - - Date: L 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 applicabl&laws of the City of Arlington and the State of Washington. REV 2015 Page 2 of 2 8/23/2017 ^ SENIOR SERVICES/SNOHOMISH CNTY Search L&I \-7,tndr'( 1 L Ip %It I&I Sat ty rR Heaith &insurancp: Plnrkpiar,�-,,Rifjhts Trades < Licensing Alft Washington State Department of " Labor & Industries SENIOR SERVICES/SNOHOMISH CNTY Owner or tradesperson 11627 Airport RD. LEE,JAMES CHOA MING Suite B EVERETT,WA 98204-8714 Principals 425-355-1112 LEE,JAMES CHOA MING,PRESIDENT SNOHOMISH County RESSEQUIE,RICHARD SCOTT,VICE PRESIDENT PIKE,CHARLENE ADELLE,SECRETARY BOGUE-GARZA,JULIE ANNE,TREASURER WHEELER,CAROL EILEEN,AGENT LEMIRE,JOAN (End:01/01/1980) HENRY,LILLIAN E (End:01/01/1980) DANA,CONNIE (End:01/20/2012) DEKLYEN,RANDY (End:01120/2012) HARRIS,JEAN (End:01/20/2012) TREMAINE,DAVID (End:01/20/2012) SALISBURY,PAM (End:01/20/2012) MANN,HAROLD (End:01/2012012) SEATON,MARYLOU (End:01/20/2012) EARLING,DAVID ORRIN,PRESIDENT (End:12/24/2015) WHITE,RICHARD ANDREW,VICE PRESIDENT (End:12/24/2015) SHOCKEY, REID HENRY,SECRETARY (End:12/24/2015) WHITFIELD,DONALD PANKHURST,TREASURER (End:12/24/2015) WA UBI No. Business type 600 095 929 Corporation License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Help us irnprove https://secure.Ini.wa.gov/verify/Detaii.aspx?UBI=600095929&LIC=SENIOSS243OH&SAW= 1/3 1 I 8/23/2017 SENIOR SERVICES/SNOHOMISH CNTY Construction Contractor Active. i Meets current requirements. License specialties GENERAL License no. SENIOSS243OH Effective—expiration 09/08/1976—01/20/2018 Bond American States Insurance Co $12,000.00 Bond account no. 325221593 Received by L&I Effective date 05/07/2012 04/20/2012 Expiration date Until Canceled Bond history Insurance American Alternative Ins Corp $5,000,000.00 Policy no. N1A2RL000001308 Received by L&I Effective date 05/26/2016 06/01/2016 Expiration date 06/0112018 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts 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. 337,370-00 Doing business as SENIOR SRVS OF SNOHOMISH Estimated workers reported Quarter 2 of Year 2017"Greater than 100 Workers" L&I account contact TO/(360)902-4715 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 No inspections during the previous 6 year period. https://secure.ini.wa.gov/verify/Detail.aspx?UBI=600095929&LIC=SENIOSS243OH&SAW= 2/3 i Permit#: 1618 Permit Date: 08/23/17 Permit Type: RESIDENTIAL PLUMBING Project Nam e Kittinger Applicant Nam a Hom Te Senior Services Applicant Address: 11627 Airport Rd, Suite B Applicant, City, State, Zip: Everett,WA98204 Contact: Steven McGraw Phone: 425-265-2222 Em41: mlr@homTe.org Scope of Work: Replacing Gas HWT Valuation: 0.00 Square Feet: 0 Num ber of Stories: 0 Construction Type: O xupancy G ioup: ID Code: Permit Issued: 08/23/2017 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: BUILDING Property Parcel# Address L egal Description 0 wner Nam e Caner Phone Zoning M OIR ROBERT A& 00875200007200 6 210 206TH ST NE KITTINGER Residence Single Dam iy -Detached BARBARA J Contractors Contractor P rim ay Contact P hone A ddress C ontractor Type L icense License# Hom�ge Senior Services S teven M oGraw 4 25-265-2222 11627 Airport Rd, CONSTRUCTION Labor and SENIOSS2430H Suite B CONTRACTOR Industries Inspections Date I nspection Type D escription S cheduled Date C om Iieted Date I nspector S tatus 08/30/2017 R00.WATER 08/29/2017 B UILDING C om Iieted HEATER FINAL Fees Fee D escription N otes A m cant Plum ling Base P erm i Fee $ 25.00 Processing/Technology $25.00 Wder Heater(Tank) $25.00 Total $75.00 Attached Letters Date Letter D escription 08/23/2017 Building Perm t Paym Bits Date Paid By D escription P aym eit Type A ccepted By A m wnt 08/23/2017 Daniel Justin 6 6042331 c c $75.00 O ttstanding Balance $0.00 Uploaded Files Date File Nam e 08/23/2017 2549484-1618 Application.pdf 08/23/2017 2549485-1618 Issued Perm i.pdf