HomeMy WebLinkAbout19007 59th Dr NE_056384_2026 C: I -F"SK C3 F= A FR L— 1 1,%1[3-F"P4
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Owner; SUBERT & WALKER 19007 59TH AVE NE ARLINGTON 9822,:-;
Value of Work: $1, 400. 00 Tax 10 Phoneg 360. 435. 3066
Describe Works INSTALL PRO RPB�::,
Proposed Use: MANUFACTURING
Legal Description:
Job Address: 19007 59TH AVE #A
Contractor' s Name Type Address License#
ZUIDERWES CONSTRUCTION LLC PLB 20606 101ST AVE Nf-,_ ZUIDECL9&IBI
P E R M I T F E E S
Equipment and Fixtures Number Fee Total Charge
------ ----------------------
PLUMBING FIXTURES 2 $10. 00 $20. 00
S U B T 0 T A L. . . . . .
TOTALS Fee
Fimturf- $20. 00
Plumb Permit $25. 00
SIGNATURE-.I joh.;A
TOTAL FEE. . . . $45. 00 1 HEREBY CERTIFY THAT I 4AVE READ
AND EXAMINED THIS APPLICATION AND
PAYMENTS. . . . . . . . . . . . . . . . . . $0. 00 KNOW THE SAME TO BE TRUE AND COR
RECT ALL PROVISIONS OF LAWS AND
TOTAL DUE. . . . . . . . . . . . . . . . . $45. 00 ORDINANCES GOVERNING THIS TYPE OF
WORK WILL BE COMPLIED WITH WHETHER
DATE RECEIPT # SPECFmIED HEREII OR NOT.
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BUILDING OFFICIAL
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7� o PERMIT APPLICATION
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4 Department of Community Development
City of Arlington • 238 N Olympic Ave. •Arlington, WA 98223 • Phone (360)403 3431 • FAX (360)403 3447
THIS APPLICATION MUST BE ACCOMPANIED BY EIGHT(8) SETS OF CONSTRUCTION DRAWINGS, AND EIGHT
(8) SETS OF FIXTURE SPECIFICATIONS(CUT SHEETS). CALCULATIONS ARE REQUIRED FOR GREASE
INTERCEPTOR IF APPLICABLE 'RECEI VEL)
Type of Permit: ( ) Commercial A Commercial Addition/Alteration MAR 17 2005
Project Address: �9 !Y Parcel ID#: 1
_ I DIIVG pEpl-
Lot#: Subdivision:
Project Description:�N�� AGrn J �' lC /MS�J ezJ�'1 c�..l��6`7�iS &LM
Owner: �P � ��� Phone Number: svc
Address: n City: State: Zip Code:
Contact Person: �( _ A /(), - Phone Number: ���� >
Cell Phone: S-7J��"�(� �4('�'J;W
Addresses�W6n 0(�St IV • ALI' City: ,4 State: Zip Code:
Please List quantity of fixtures Below:
WATER CLOSET BATH TUB SHOWERS
LAVATORIES CLOTHES WASHER LAUNDRY TUBS
FLOOR DRAINS FLOOR SINKS SINKS
URINALS SUMPS DISHWASHERS
WATER HEATERS ROOF DRAINS WATER PIPING
DWV ALTERIREPAIR LAWN SPRINKLERS DRINKING FOUNTAINS
_ MISC PLUMB FIXTURE GREASE INTERCEPTOR GREASE TRAP
Contractor: Phone Number:
Address: '�� ���� �L�" ALL City: n�� State: Zip Code:
Contractor's License Number: 6ci Expiration:
I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above-
described property will be in accordance with the laws, rules and regulation of the State of Washington.
Applicants Signature Date
JITR 9. AJA1 &T-,��m�
Print Applicants Name
Forms/PLUMB-1
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License Information
License ZUIDECL961 B1
Licensee Name ZUIDERWEG CONSTRUCTION LLC
Licensee Type CONSTRUCTION CONTRACTOR
602355896 Verify Workers Comp Premium
UBI Status
Ind. Ins. Account
Id
Business Type LIMITED LIABILITY COMPANY
Address 1 20606 101 ST AVE NE
Address 2
City ARLINGTON
County SNOHOMISH
State WA
Zip 98223
Phone 3604353891
Status ACTIVE
Specialty 1 PLUMBING
Specialty 2 SHEET METAL
Effective Date 1/21/2004
Expiration Date 1/21/2006
Suspend Date
Separation Date
Parent Company
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https://fortress.wa.gov/lni/bbip/Detail.aspx?License=ZUIDECL961 B 1 3/17/2005
Look Up a Contractor, Electrician or Plumber License Detail Page 2 of 2
Business Owner Information
Effective Expiration
Name Role Date Date
ANDREWS, JAN
M PARTNER/MEMBER 01/21/2004
Bond Information
Bond Bond
Company Account Effective Expiration Cancel Impaired Bond Received
Bond Name Number Date Date Date Date Amount Date
DEVELOPERS
SURETY Ft Until
#1 INDEM CO 898743C 01/21/2004 Cancelled $6,000.00 01/21/2004
Savings Information
No Matching Information
Insurance Information
Company Policy Effective Expiration Cancel Impaired Received
Insurance Name Number Date Date Date Date Amount Date
THE
NORTHERN
INSURANCE
#2 COMPANY SCP42943200 01/20/2005 01/20/2006 $1,000,000.00 12/30/2004
NORTHERN
INS CO OF
#1 NY SCP01145231 01/21/2004 01/21/2005 $300,000.00 01/21/2004
Summons/Complaints Information
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