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Home My WebLink About19417 63rd Ave NE_056752_2026 CJ F- I IV"-I-(:)tq CG CI tV:Ei'T Ft U C—IF I Cl M 1z>E FZ'M I VT F>E. Ft 1-1 1 T 1N1 C] a _ (6 tLli---- £.A "7 :;5 c'_ Owner: GOHL, STEVE. 117,31,17 160"}H T SL ARLINGTON 9 t 22`j Value of Work: $500. 00 Ta:-, ID: Phone: :360-794--6061 Describe Work: INSTALL TANKLESS HOT WATER TANK Proposed Use: Legal Description: Job Address: 1'3417 63RD AVE NE . Contractor's Name Type Address License# PLUME1STAR INC PLB 2431 101ST AVE NE PLUMBI*957KG P E R M I T F E E S Equipment and Fixtures Number Fee Total Charge WATER HEATER - - - - - - - - 1 $15. Est► $15. 00 GAS PIPING 1-5 OUTLETS 1 $6. 00 $6, 00 S U B T O T A L. . . . . . 521.00 TOTALS Fee Equipment $21. 00 Mech Permit $24. 00 IGHA'CURE TOTAL FEE. . . . . . . . . . . . . . . . . $45. 00 HEREBY ' - 3TIF'Y THAT I HAVE READ AN LN EXAMINED THIS APPLICATION AND PAYMENTS. . . . . . . . . . . . . . . . . . $0. 00 KN THE SAME TO BE TRUE AND C;OR- RE 'I ALL PRYVISI,3 S OF LAWS AND TOTAL DUE:. . . . . . . . . . . . . . . . . 545. 00 OR` I ANC:ES VEEZ I�G 1 IS TYPE OF W �F K WILL -O IED ITH WHETHER K DATE RECEIPT # [. I '1 AL III �1 1 .�� i - - - - - - r � i i ii i i i i J � -I I� I � � � I I �' � - � i � � I � � � � � � I �� I • City of Arlington REQUEST FOR REVIEW FORM NAME: r1 l BP #: 05- DATE: �/�� RETURN THIS FORM BY: PROJECT SUMMARY: l 2 RESPONDING DEPARTMENTS TOM C., FIRE DAVE A. BUILDING KAREN L., UTILITIES KERRY W., BUILDING DERYL T., UTILITIES SCOTT B., BUILDING BILL B., NATURAL RESOURCE YVONNE P., PLANNING GREGG E., ENGINEERING CWA., CONSULTANT SHERRI PHELPS, BUS LIC JIM T., CONSULTANT SUBMITTAL INFORMATION IS ATTACHED. Please review the information and return this form and your comments in memo form. If you have no comments, please return the form with the"No Comments" box checked. PLEASE MARK ONE BOX, SIGN, DATE, AND RETURN THIS FORM TO LINDA. O COMMENTS FOR THIS REVIEW ARE IN ATTACHED,MEM079,9 �1� Ll NO COMMENTS FOR THIS REVIEW, OKAY TO ISSUE PERMIT Ll COMMENTS ` ) REVIEWED BY DATE d `�.`w� OMMERCIAL MEC IANICAL UG7 PERMIT APPLICATION Department of Community Development City of Arlington• 238 N Olympic Ave. •Arlington,WA 98223• Phone (360)403 3431 • FAX(360)403 3447 a ivTii ivlUS!6t i�%[.iuivrrF►niicu S Y EiGHT(8) SETS OF CONSTRUCTION;BRA WINGS, AND THREE (3) SETS OF WASHINGTON STATE ENERGY CODE APPLICATIONS. Type of Permit: ( ) Residential Apartment (,ICommercial Project Address: vI 4.t l.-1 � � �� Parcel ID#: Lot#: Subdivision: Project Description: ��-16<< `' d �r � --� k f s' k� Owner: Slo t< 419bt%1 Phone Number: -Uo -794 6.6 Address: City: State: Zip(;one: Contact Person: Kif Phone Number: 36a- 4/7` - )FI C7 Cell Phone: Fax: E-mail: Address: 1 ?A/01 704 !T City: l i kt%" State: Zip Code: 99Z3 Please List Quantity of Fixtures Below: CLOTHES DRYER FURNACE UP TO 100K BTU GAS OUTLETS FURNACE OVER 100K FLR FURN INSTALURELOCATE SUSPENDED HTRIUNIT HTR1 APPL VENT/OTHER APPLIANCE REPAIR BOILER UP TO 3 HP BOILER UP TO 4-15 HP BOLIER UP TO 16-30 HP BOILER UP TO 31-50 HP BOILER 51 HP AND UP AIR AHNDLING UP TO 1 OK CFM AIRHANDLING OVER 10K CFM EVAL COOLER VENTILATION FANS OTHER VENTILATION SYSTEM VENT HOOD DOMESTIC INCINERATOR COWIND INCINERATOR ALL OTHER UNITS FREESTANDING STOVE FIREPLACE INSERT Contractor: ��'►� .r (121P Phone Number: E22-Z67 � �-/ 1 /D l City: [ Sik 6l'r State: L 4- Zip Code: � 5� Address: y r•l�nb I G-1 'C S Expiration: -Z —2/1y. Contractor's License Number: xP 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. .,::r - ID Applicants Signature Date Print Applicants Name 4'; r9 COA PERMIT CENTER 00 Forms/MECH-1 'I�' 1 � I 1 1 � � � � � 1 1 1 1 1 r l � �. I= 1 � L T r .� � 1 1 ■ �1 1 1 - 1 � ' � 1 ti •_ _ _ _ �- I r 1 � 1 r � _ .. L 1 1 � - I 1 � i� 1 _ _ �r i � �� - I - - , . _ 1 1 1 .5 - I - 1 1 1 '. 1 _ � 1 Look Up a Contractor, Electrician or Plumber License Detail Page 1 of 2 Topic Index Contact Info ' Search liflll +1 r Horr.a Safety Claims 8 Insurance Workplace Rights Trades $ Licensing Find a Law or Rule Get a Form or Publication Look Up a Contractor, Electrician or Plumber Printer Friendly Version General/Specialty Contractor A business registered as a construction contractor with L£tl 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 PLUMBI"957KS Licensee Name PLUMBSTAR INC Licensee Type CONSTRUCTION CONTRACTOR UBI 602495239 Verify Workers—Camp Prem-um Status Ind. Ins. Account Id Business Type CORPORATION Address 1 2431 101 ST AVE NE Address 2 City LAKE STEVENS County SNOHOMISH State WA Zip 98258 Phone 2067796665 Status ACTIVE Specialty 1 GENERAL Specialty 2 UNUSED Effective Date 5/10/2005 Expiration Date 5/10/2007 Suspend Date Separation Date Parent Company Previous License P_L.UMBS*9.b2M1. Next License Associated License https://fortress.wa.gov/lni/bbip/detail.aspx?License=PLUMBI*957KS 11/17/2005 Look Up a Contractor, Electrician or Plumber License Detail Page 2 of 2 Business Owner Information Effective Expiration Name Role Date Date CARR, TIMOTHY P JR PRESIDENT 05/10/2005 VICE CARR, STEPHANIE PRESIDENT 05/10/2005 Bond Information Bond Bond Company Account Effective Expiration Cancel Impaired Bond Received Bond Name I Number Date Date Date Date Amount Date WESTERN SURETY Until #1 CO 69901610 04/29/2005 Cancelled $12,000.00 05/10/2005 Savings Information No Matching Information Insurance Information Company Policy Effective Expiration Cancel Impaired Received Insurance Name Number Date Date Date Date Amount Date FARMERS INS #1 EXCHANGE 602316092 07/15/2004 07/15/2006 $4,000,000.00 07/20/2005 Summons/Complaints Information No Matching Information Start a New Search Printer Friendly Version About Lrxl I Find a job at LEd I Information en espahol I Site Feedback 1-800-547-8367 �� 0 Washington State Dept. of Labor and Industries. Use of this site is subject to the laws of the state of Washington. Access Agreement I Privacy and security statement I Intended use/external content policy visit access.wa.gov Staff only link https://fortress.wa.gov/lni/bbip/detail.aspx?License=PLUMBI*957KS 11/17/2005 0 *..OMMERCIAL MELAANICAL ,,� o PERMIT APPLICATION 11 N G� 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 THREE (3) SETS OF WASHINGTON STATE ENERGY CODE APPLICATIONS. Type of Permit: ( ) Residential Apartment ( Commercial Project Address: V� Parcel ID#: Lot#: Subdivision: Project Description: << C>` "� Cat'��C�'pt�i�� lcrvr k�?SS L��1�'•' ` � Owner: � %� c7�► Phone Number: Address: City: State: Zip Code: Contact Person: (ri %e� —Phone Number: Cell Phone: Fax: (( E-mail: Address: City:C 1► 14" State: .) Zip Code: zZ� �T Please List Quantity of Fixtures Below: CLOTHES DRYER FURNACE UP TO 100K BTU GAS OUTLETS FURNACE OVER 100K FLR FURN INSTALLIRELOCATE SUSPENDED HTRIUNIT HTR\ APPL VENT/OTHER APPLIANCE REPAIR BOILER UP TO 3 HP BOILER UP TO 4-15 HP BOLIER UP TO 16-30 HP BOILER UP TO 31-50 HP BOILER 51 HP AND UP AIR AHNDLING UP TO 1 OK CFM AIRHANDLING OVER 10K CFM EVAL COOLER VENTILATION FANS OTHER VENTILATION SYSTEM VENT HOOD DOMESTIC INCINERATOR COM/IND INCINERATOR ALL OTHER UNITS FREESTANDING STOVE FIREPLACE INSERT Contractor:--77 l^.L�`4 �i ° 9�� Phone Number: -_72- 76 Address: -b ,v City: Stater Zip Code: S� Contractor's License Number:�I�AI^^�S 9 -7 'C S Expiration: 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 (_ p (% r, J e� RECEIVED Print Applicants Name NOV 14 200F V) COA PERMIT CENTER Forms/MECH-1