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20040009FROM :YELM SEWER DEPT. FAX N0. :360-458-(3166 Apr. 15 2005 04:45PM P1 ®~ TM~ A,~ °-~ F.~-X TRANSMISSION a ~- ~.~~~ CITY OF YELM "" ° ' °'°" P 0. B0~ 479 - 93 J Nl' ROAD NE J ` r, YELIVX, WA 98597 `` ~Lr ~ ~" 360-458-8411 ~~~~ ~~ ~.?~ ~~ (~ FAX ~36Q-458-8166 TO : C~-Y~ - ~ W (_" ~ DATE: `-1 r l ~ -- US FAQ#: ~ ~~ - g~ ~~_ PAGES: ~ ,including this Cover sheet From: ~~~N D`(' ~ s~t~~Z~ Subject: }.-~o u SC ~ - l~ ~-} L 5 C ~~, COM114ENTS: t.~ bT l 3~ 3 0 ~ ~JLc~1 ,~., 3~3 3JL.o ~ 1 ~~~ 3 0~ ~oz~Q~2C~ N,w : C~~-0~5 ~~~~ 5 a ~._ 6 ~~ -rz_c~- N , ~ , d ~ ~ 0 35~ . ~ ~ . '"* If you do~not receive all copies or any copy is not legible, please call (360) 458-6411 as snon as possible. ~_, ~~ st~ A~~'~YL ~:~ •J ,:, . s 'v ~~ . '41 ~'_GLI~ ~.c~i . 5CC x`41 ^'~nll.~i 'I IIY il! ~ G f !/l~ ~ } !1 Ll ~' ~ ~ ~ \ ` ~ ~tl n 5 . f „_ i :' L G' ~ Q''' [ a' L 0~?~c: ^ G`` ^ F~Gi~i~~C~ Yc,S \~ C~~ ~0!T~!i-~~:~ ~~~, ~;:1 ~: •!'~~~ ~ ~ ti ~~ ~~~~ ~r ham! ~ ~ rN:~ ~~1~!~ _ ^ C 2S~=Q~c ~c E'':~C~v ee ~~ll~Ti~iilC ~l V MGC.~4ili('+"~ Q ~~ s, Cpl_!-~~1~~ L~Su.~~!!0~. CG -~-~= _~_! .,:~r'J~ ~^.~ Vii,' ,-! I ~ti_!! ~y----.--..~ [i ~i~Ci__C ^ aver C =~; ~o~_ ~_~~ 5~~~ OEr'r ~i a` YELM City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 Applicant: Name: Eric Holm Address: 16102 70th Ave E Property Information: Site Address: 307 Solberg St. Assessor Parcel No. 59710001000 Contractor Information: Name: Owner Address: 16102 70th Ave. E Contractor License No: Project Information: Project: Longmire Estates, lot 10 Description of Work: SFR Sq. Ft. per floor: (1st) 852 (2nd) 295 Heat Type (Electric, Gas, Other): GAS Fees: Item Building Permit 50-100k Building Plan Review Mechanical Permit Plumbing Permit Sewer ERU Sewer Inspection (SFD) Sewer Deposit Water ERU Water Meter (SFD) Water Deposit Traffic Facilities Charge State Building Fee TOTAL FEES: Applicant's Affadavit: City: Puyallup Subdivision: Longmire Estates Contact: Holm, Eric City: Puyallup Expires: (3rd) 0 Garage 360 Item Fee Base Amt Unit Fee Unit Rate ----------- 874.75 ----------- 643.75 ----------- 231.00 ----------- 7.0000 370.65 0.00 0.00 0.0000 65.25 0.00 0.00 0.0000 90.00 20.00 70.00 7.0000 5,269.00 0.00 5,269.00 5,269.0000 145.00 145.00 0.00 0.0000 50.00 50.00 0.00 0.0000 1,500.00 0.00 1,500.00 1,500.0000 300.00 300.00 0.00 0.0000 40.00 40.00 0.00 0.0000 757.50 0.00 757.50 750.0000 4.50 4.50 0.00 0.0000 $9,466.65 Phone: 253-531-6873 State: WA Zip 98375 Lot: 10 Phone: 253-531-6873 State: WA Zip: Business License: Basement 0 No. Units Unit Desc 33.0000 $1,000 0.0000 0.0000 . 10.0000 Fixture 1.0000 ERU 0.0000 0.0000 1.0000 ERU 0.0000 0.0000 1.0100 Peak PM Trip 0.0000 I certify that I have read and examined the information contained within the application and know the same to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of Yelm regulations including those governing zoning and land subdivision, and in addition, all covenants, easements and restrictions of record. If applying as a contractor, I futher certify that I am currently registered in the State of Washington. _ Signature Date ~~/~ o~ Firm Permit No: BL®-04-0009-YL Issue Date: Not Issued (Work must be started within 180 days) Receipt No: LOTS/a I ~ooy- ~~ ~ ~ _~ _ _ a3 . o o , R~aR '~ _ ', _. sET ~~GrC G~ R ;p} lr~ ` 7; s'a 3 T ',TEIEPI3~~H~' ~ ,.~ n ~! ~ ~ ~ Tv T~UIVIStOT~{ {{ ~ p ~ 1 ~ ('~) ~ ELFcT'RlL 'c \-/ ~ ii _ , ~ ,, ~WA~e~, ~`t~1.1-a SEwe~` ~ ~ S i i. 3 i }} ~ v ~ ~ ~ I sTF~. ~. ~ I Z I ~ ~ i ®( :~ ~~ _ _ oue e ' ~ -- h _ ~ ~ ~_~_ ~3 ----------___.__ ~~-sQ 3~~ , ~ A ~ 3yv 5~~~= ~~.~~t~ ~¢ THFp City of Yelm ~ ~ 9~ Community Development Department °' ~ Building Division 5 1~ Phone: (360) 458-8407 Y E L 1VY Fax: (360) 458-3144 Applicant: Name: Eric Holm Address: 16102 70th Ave E Project Information: Project: Longmire Estates, lot 10 Description of Work: SFR Model # 1147 Site Address: 307 Solberg St. Fees: Item Acct Code - --------------------------- Building Permit 50-100k ------------- 001-322-10-00 Building Plan Review 001-345-83-00 Mechanical Permit 001-322-10-00 Plumbing Permit 001-322-10-00 Sewer ERU 412-343-50-01 Sewer Inspection (SFD) 412-343-80-00 Sewer Deposit 402-389-01-00 Water ERU 404-343-80-34 Water Meter (SFD) 401-343-80-01 Water Deposit 402-389-00-00 Traffic Facilities Charge 120-344-85-00 State Building Fee 001-386-00-00 TOTAL FEES: Item Fee 874.75 370.65 65.25 90.00 5,269.00 145.00 50.00 1,500.00 300.00 40.00 757.50 4.50 $9,466.65 City: Puyallup Permit Fees Schedule Permit No: BLD-04-0009-YL Phone: 253-531-6873 State: WA Zip 98375 Assessor Parcel No. 59710001000 Base Amt 643.75 0.00 0.00 20.00 0.00 145.00 50.00 0.00 300.00 40.00 0.00 4.50 Unit Fee Unit Rate 231.00 7.0000 0.00 0.0000 0.00 0.0000 70.00 7.0000 5,269.00 5,269.0000 0.00 0.0000 0.00 0.0000 1,500.00 1,500.0000 0.00 0.0000 0.00 0.0000 757.50 750.0000 0.00 0.0000 No. Units Unit Desc ----------- 33.0000 ------------- $1,000 0.0000 0.0000 10.0000 Fixture 1.0000 ERU 0.0000 0.0000 1.0000 ERU 0.0000 0.0000 1.0100 Peak PM Trip 0.0000 0 0 City ofYelm BLD-04-~~o9-YL Details File ID Address Project Name /Description BLD-04-0009-YL 307 Solberg St. Longmire Estates, lot 10 Sec: Twn: Rnge SFR Zoning: AssessorlD: 59710001000 ReceivedBy: Gc Contact Information: Applicant: Eric Holm Dyyner; Eric Holm Engineer/Architect: Surveyor: Fees: Item Building Permit 50-1 Building Plan Review Mechanical Permit Plumbing Permit Sewer ERU Sewer Inspection (S Sewer Deposit Water ERU Water Meter (SFD) Water Deposit Traffic Facilities C State Building Fee Total Fees Amt Paid: $ 0.0 0 Workflow: Item Application Received Building Plan Review Final Inspection Application Approved ProjectValue: $ 83 , 00 0 Permit Management Appl. Date CaselD: 2/3/04 64 StatUS: ACTIVE General Contractor: owner Mechanical Contractor: Heritage Heating Plumbing Contractor: sunset Plumbing Tot Amt Base Amt Var Amt $874.75 $370.65 $65.25 $90.00 $5,269.00 $145.00 _$50.00 $1,500.00 $300.00 $40.00 $757.50 $4.50 $9,466.65 $643.75 $231.00 $0.00 $0.00 $0.00 $0.00 $20.00 $70.00 $0.00 $5,269.0 $145.00 $0.00 $50.00 $0.00 $0.00 $1,500.0 $300.00 $0.00 $40.00 $0.00 $0.00 $757.50 $4.50 $0.00 Date Paid: 12 / 3 0 / 18 9 9 Receipt # Status Due Date Complete Sign-Off By Complete 02/04/04 02/04/04 n/a Complete 02/04/04 02/04/04 Gary Carlson Pending 03/05/04 Complete 02/04/04 02/04/04 Gary Carlson Fee Status: activity Log: Action Log Date Message -------- -------- -------------------------------------------------- NEw 02/03/04 GC Received application. File ID 'BLD-04-0009-YL', Case# = 64 SIGNOFF 02/04/04 Item 'Application Approved' sign-off by Gary Carlson on 02/04/04 SIGNOFF 02/04/04 Item 'Building Plan Review' sign-off by Gary Carlson on 02/04/04 Var Qty Var Rate Comments ------- ---------- -------- 33.00 7.0000 10.00 7.0000 1.00 5,269.0000 1.00 1,500.0000 1.01 750.0000 Report Produced By Permits Dashboard(tm) Wednesday, February 04, 2004 Page 1 ****ZERO DOLLARS & 00 CENTS }750 sst 30750 ~~ ~~, ~~ ~~4'i9 -- _ .r ,, ~ _ .~.. ~;. ~`;.~A 9597 ~z~~ 02/11!04 30750 MISCELLANEOUS RECEIPT JANINE .00 CHECK none ****NINE THOUSAND FOUR HUNDRED SIXTY SIX DOLLARS & 65 CENTS }RTHWES^1 HOUSING/HOLM, ERIC 02/11/04 30751 9,466.65 CHECK 2935 BOX 219 JMNER WA 9839@ ~` ~RMIT BLD 04-0009-YL CTE LOT 10 307 SOLBERG ST MISCELLANEOUS RECEIPT JANINE ~RMIT 874.75, PLAN RW 370.65, MECH 65.25, PLUMB 90.00, SWR ERU 5269.00 SIR INSP 145.00, CON DEP 90.00, WTR ERU 1500.00, MTR 300,FAC 757.50, BC4.50 -z,. ~: :;_. `~~ ~ ~~_ ~.~~479 `~ ~.~~.. '~ 9597 :~ _ '~ ****NINE THOUSAND FIVE HUNDRED TWENTY NINE DOLLARS & 65 CENTS )RTHWEST HOUSING/DREWETT,MEG 02/11/04 30752 9,529.65 CHECK 2935 ~ BOX 219 JMNER 4^~A 98390 ERMIT BLLD-04-0008-YL LTE 309 SOLBERG ST LOT 9 MISCELLANEOUS RECEIPT JANINE ~RMIT919.79, PLN RW 388.61, MECH 65.25,-PLUMB 90, SWR ERU5269.0@, SGdR INP 45,CON DEP 90, t^7TR ERU 1500, MTR 300, FAC 757.50, BC 4.50 CITY OF YELM RESlAE~iTlAL SL11Lb1NG PERMIT APPl,lCATlON FORM Project Address: StJi7d1V1Slon:I.nnami rv Moarlnwa 0 ~] New Construction 0 Re•M ~ Plumbing ~ Mechanical Protect DescriptionJScope of Work: Protect Value: Building Area (sq. ft) 1~` f=loor QS~ y~_ Parcel n:2~7ta~~~~n{~ ~ ~~~ta~?n4np i_Otn~_ 10 Zoning;Be~idential adsl / Re-Roof / Additlorl 0 Home Occupation Slgn d Mobile /Manufactured Home Placement ^ Other iL1gIP f Ami 1 ~+ rlwp 1 I.lAg .. 2"0 Floor,o~ Garage ,ten Deck Building Area (sq. ft) t~` ~loor~,2 2n° Floor~_ Garage ~,b8,_ Deck_ _ . _. Basement N/A Carport N A Patio N A # Bedrooms ~ 8athroomsZ, Heating:~TH1=R or ELECTRIC (Circle One) Are there any environmentally sensitive areas located on the parcel? _ completed environmental checklist must accompany permit application. li yes, a BUICDI~lG_'C1WNEf~_NAINE:_ F.rir ,rj~lm ADDRESS ~„~ n~ _ 711,r>, n,fa ~ CITY p,,,;,Ailup STATE~„j,p, ZIPg837~ TELEPHONE~~_czt~u~~ :AFjCH_iTECrIENCjN~E_R' utJnL~~rG ~ x;1 ~ LICI=NSE # NnRTxunoSC~nt ADDRESS p _ ~ _ Rnx ~ t 4~ CITY S ,mnar STATE wA ZIP gR'24(1 TEI_EPHONE,z ~_R~ ~ gg ~ENERA~'.GOt~l7~tACTOR nwnPr jh„i ls3er TELEPHONE ADDRESS same CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE # PLUMBING,CONTFtACTOR StlncaY P1 ~mhing TELEP!-IONE3fiQ~-Apt ADDRESS_F_~2_......~...2t20.$..._ ._,_._._._......-, CITY Ye1m STATE taA ZIP 9,R5~tZ7 FAX CpNTRACTOR'S LICENSE #_st>'xsF~*n44flp EXP DAT~~CITY LICENSE # MECHANICAI.CONTHACI'OR}tPr;ragp HPAr_1_p~TELEPHONE ~~~,~~~ ~~t} ADDRESS AOQj parifit Ava_ CITY Tacoma STATE taA ZIP Q.R!~~~ FAX CONTRACTOR'S LICENSE n xz-uTTFT t.~~n~ E=XP DATE ITY LICENSE x d~- Copy of mitigation agreement with Yelm Community Schools, if applicable. 1 hereby certiry that the above lnformatlon IS correct and that the construction on, and the occupancy acrd the use of the above described property will be in accordance with the {aws, rules and regulations vt the State of Wa~drfRgton and thef~ity of Yelm. /(_J /7~ Applicant's Signature Owner /Contractor /Owner' - gent /Contractor's Agent ~~~ ~ Date (Please circle one.) bC7Uyn vi•~'l bin lly0 Gl C+Y'7 V, ~y~. ~~^~: !'. 'qr ~f vi 4.F[ .j. a.v.:. (~w•~U.iU ...I JOJ.•J V..~: ~1 1G• J OCr10^ X00 d~y~ J ~_ataur uatK 4x,50 l=fNt~ ~enCe ~.+~ Sbroc.:=t~ .v, DArY. ~rewvf ~i, ~~~n s~T ~~ G~QPrG~ ~, ~ 0 siD~ ~A-s~X~aT ~ . Yr^b~811flH~ Q ~ ~~ ~ ~ E'l.Ec7'R1G ~ ~ I G, ~~s L..O'~' ~ ~ O ~I W A~ eR ~l'7 7" ~ S s~w~ W ~ No c~sE ~f f' P ° L F .. . ~ z s~~P Y f~ N 1C I ~ ~ Q G - to-~-off ~M~ ~ ~ F.,Y. ~L~'/. ~ ... 3y6 .sa, ~ ~~~ F R~' C .cy~ D 'Po~cN l~~ 00 F~Oar ~'~~~ ' ~s" =~ ' ~~ " ~ o - 00 U rIG I1Y __._ ~ ~ - ~ ,., Er4S,E.N .EiYT ~~ = ~ :,. ~-x ~~~ ~3--C o; ~~i m~ ~~ MM ~~ ~ N --~ ~- ~ X i ~ ~" ~ o ~ ~ '" Q ~ 4 .~Yt O ~ //~^ vJ Q ;;~. ~ I .~ r c ~ ~ `y-., ~ E o '~ " _ ~ I U ~,::; ~ -. ~ °' ~ O -~~.~ir_, s ~ N ?C i m O ~ 0 z ~ ~ Loans Closed: Building Permits: Final Inspection: Total Weeks in Construction: GO 81T - LONGMIRE MEADOWS, Group # 2 Yelm, WA David Dixon -Construction Supervisor BRANT, April D./Jeremy Lot # 15 508 Van Trump 9902 132°d St Ct E. Apt B 1147-2 Yelm, WA 98497 Puyallup, WA 98373 (3) Appraisal: BRIDGES, Term ~L-of=#'1"3 301 Solberg St. 16`_ 112t" St E #11 1147-2~ Yelm, WA 98497 ~--- Tacoma, WA 98445 (3) Appraisal: FERNANDEZ, Israel/Shaneen Lot # 1810 Ashwood Downs Ln #212 1147-2 Yelm, WA 98497 Olympia, WA 98504 (3) Appraisal: KNIFFEN~ Le C Lot 1 303 Solberg St. 30911 ls~ Ave S. #126 ~ ~1~40-2 ~ Yelm, WA 98597 Federal Way, WA 98090 (6) Appraisal: ~ 1 ~~~~. Lc7i>iit~ Li 1 ~rri ~ ,ot # 16 ~ 10 V an Trump 8537 Thuja Ave SE ,1.340-2 Yelm, ~V:-; 98597 Yelm; WA 98597 (7) Appraisal: WILLIAIVIS, Caroline Lot # 14 506 Van Trump 1.915 Ashwood Downs Lane SE #136 1240-2 Yelm, WA 98597 Olympia, WA 98501 (5) Appraisal: Revised: October 8, 200 ~, ~I 0 ~I v I1~ r /Jn' ` V \ t~_. w 4 C ~, C' f H ~ C ~ w. 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N 13R Look Up a Contractor, Electrician or Plumber License Detail Page 1 of 2 Topic Index ~ Contact Info Search ~ Home Safety ~, Claims $ Insurance '~ Workplace Kti~Ftts ~ Trades £t t.isensi~n~ F i Find a Law or Rule Get a Form or Publication Look Up a Contractor, Electrician or Plumber ., ~~.~.~~~,.~.~~~~. ~~ ~. _F.. , ~.~..m ._~... _.._ _ _ _~,, ,n~~~.e d~...,~..,.~,~. General/Specialty Contractor A business registered as a construction contractor with LEI 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. ~ ~.._____ . ~~ .. ~n,~~,..,.,,.~....~~. ~ .~~ ..,~ o~..~,~.~~a,. ~~License Information ~ .~ License AFFORPC963JA Licensee Name A AFFORDABLE PLUMBING CO Licensee Type CONSTRUCTION CONTRACTOR UBI 602023443 Verify Contractor Premium Status Ind. Ins. Account Id Business Type INDIVIDUAL Address 1 8540 WILLIAM PL SE Address 2 City YELM County THURSTON State WA Zip 98597 Phone 3604589362 Status ACTIVE 1 Specialty 1 PLUMBING Specialty 2 UNUSED Effective Date r 4/1/2004 Expiration Date 4/1 /2006 j Suspend Date Separation Date ;~ Parent Company Previous License ~ Next License ' Associated License o BusinessPOwner Information Name Role Effective Date ~ f ~TWIGGS, JEFFERY A OWNER 04/01 /2004 '~ __ _ _ ,.w u ~ nr _.~, , ,, .r. _..~ ~a. ,~, rou~.~ ~,~,,~.,~~~ https://fortress.wa.gov/lni/bbip/detail.aspx?License=AFFORPC963JA 7/26/2004 Look Up a Contractor, Electrician or Plumber License Detail d ~ Bond Information Page 2 of 2 Bond Bond Company Account Effective Expiration Cancel Impaired Bond Received Bond Name Number Date Date Date Date Amount Date OHIO CAS #1 INS CO 3740460 04/01/2004 $6,000.00 04/01/2004 `Savings Information No Matching Information Insurance Information Company Effective Expiration Cancel Impaired Received :.Insurance Name Policy Number Date Date Date Date Amount Date OHIO CAS #1 INS CO BH00553193440 04/01/2004 04/01/2005 $1,000,000.00 04/01/2004 Unsatisfied Summons/Complaints Information No Matching Information Swart a. New Search. About L~tl ~ Find a job at Lt31 ~ Informacion en espanol ~ Site Feedback 1-800-547-8367 ~'"-'' Ohl washu7gton State Dept, of Labor and Industries. Use of this site is subject to the laws of the ~~ "~~ ~ ~ ~3' ~~~~~ state of Washington. '--~ Access A,reement ~ Privacy and security statement j Intended use/external content policy ( Visit acCeSS.wa.QOv Staff only (ink https://fortress.wa.gov/lni/bbip/detail.aspx?License=AFFORPC963JA 7/26/2004 Look Up a Contractor, Electrician or Plumber License Detail Page 1 of 3 Topic Index ~ Contact Info Search ,. ~„ n_~„ k_ ~~_ __ .~w~~,.m,. ,_ . Home Safety Clatms Ei Insurance ~ V'lorkplace Righfs Trades fit Licerasia~g Find a Law or Rule ( ' Get a Form or Publication 3 Look Up a Contractor, Electrician or Plumber A~_e~_ ..~~~e~ P_ y ~__ . .~ .a~a~~-0~ ,~~e~,,,w~~~..m~ ~.,~ ~ ~~~_..~,~ General/Specialty Contractor ~~' ~" A business registered as a construction contractor with Lltl 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. _, a. -_ ~~ .~~ License Information ~~~ ~ ~ ~~ License HERITE1136O4 Licensee Name HERITAGE ENTERPRISES INC ~ Licensee Type CONSTRUCTION CONTRACTOR 3 UBI 600638777 Verify Contractor Premium Status j Ind. Ins. Account Id 50766200 Business Type CORPORATION Address 1 9001 PACIFIC AVE Address 2 City TACOMA County PIERCE State WA Zip 98444 Phone 2539222211 Status ACTIVE ' Specialty 1 GENERAL Specialty 2 UNUSED Effective Date 9/24/1987 Expiration Date 10/26/2005 Suspend Date Separation Date Parent Company ' Previous License Next License Associated License Business Owner Information ~~.~ Name Role Effective Date ~BLAKESLEE,JIM N 01/01/1980 s https://fortress.wa.gov/lni/bbip/detail.aspx?License=HERITEI13604 7/26/2004 Loolc Up a Contractor, Electrician or Plumber License Detail Page 2 of 3 a ~ BLAKESLEE, JOEL P 01 /01 / 1980 BLAKESLEE, JIM N 01 /01 /1980 BLAKESLEE, JOEL P 01 /01 /1980 .. ,~ a . ~~ ~ .. ~,.,~ ~ ~. s ~ ~ ~ a . ~...~~, _. Bond Information = Bond Company Bond Account Effective Expiration Cancel Impaired Bond Received Bond Name Number Date Date .Date Date Amount Date GREAT AMER #5 INS CO OF NY 79028651097 02/01/2003 $6,000.00 02/10/2003I~ INDEMNITY INS CO OF N #4 AMERICA CWACG1097 10/17/2001 02/01/2003 $12,000.00 02/10/2003 INDEMNITY f INS CO OF N #3 AMERICA CWACG1097 10/26/1999 10/17/2001 $6,000.00 07/12/2001 OH 10 ~ CASAULTYINS #2 CO 29171679 09/23/1990 09/23/1994 $6,000.00 , t DEPENDABLE #1 _w INS CO INC _ m... 43460WA1048 ~ ~v ~~~~,~w 09/23/1987 09/23/1990 ~..~ .~. .. ~ ~ ~a ~.~ ~we~~ $4,000.00 .. ,n.,_,.~ ~.~__. _. __ Savings Information Bank Assignment of Branch Savings Effective Release Assignment Impaired Recei~ Savings Bank Name Location Number Date Date Type Date Amount Datf PIERCE COMMERCIAL Until #4 BANK 1214001941 10/13/1999 Cancelled Bond $6,000.00 7/10/2 Until #3 KEY BANK 47102820135067 10/22/1997 Cancelled Bond $6,000.00 COLUMBIA Until #2 BANK 4000114142 02/12/1997 Cancelled Bond $4,000.00 KEY BANK Until #1 OF WA TACOMA 103413060088 06/26/1995 Cancelled Bond $4,000.00 Insurance Information e Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Receiv Date FIRST SPECIALTY #15 INS CORP PGL89770 12/01/2003 12/01/2004 $1,000,000.00 11/26/2 FIRST SPECIALTY #14 INS CORP PGL50715 12/01 /2002 12/01 /2003 $1,000,000.00 12/12/2 FEDERATED MUTUAL INS !#13 CO 9280318 10/26/2002 10/26/2003 02/09/2003 $1,000,000.00 11/06/2 FEDERATED #12 INS CO 9280318 10/26/2001 10/26/2002 09/19/2 https://fortress.wa.gov/lni/bbip/detail.aspx?License=HERITEI 13604 7/26/2004 Look Up a Contractor, Electrician or Plumber License Detail e Page 3 of 3 FEDERATED '#11 INS 9280318 10/26/2000 10/26/2001 FEDERATED #10 INS 9280318 10/26/1998 10/26/2000 FIREMAN'S #9 FUND MZG80628352 10/26/1995 10/26/1998 FIREMAN'S #8 FUND INS CO MZG80571791 10/26/1994 10/26/1995 AMERICAN AUTOMOBILE #7 INS CO MZG80571791 10/28/1993 10/23/1994 AMERICAN AUTOMOBILE #6 INS CO 239754101 10/26/1992 10/26/1993 FIREMANS `#5 FUND INS CO 823MZG80455239 10/26/1990 10/26/1991 FIREMANS #4 FUND 823MZG80391131 10/26/1989 10/26/1990 FIREMANS #3 FUND INS CO 823MZG80329955 10/26/1988 10/26/1989 UNIGARD SECURITY #2 INS CO GL801832 02/08/1988 02/08/1989 THE OHIO CASUALTY #1 INS BL050073687 09/23/1987 09/23/1988 'Unsatisfied Summons/Complaints Information No Matching Information Start a...New Search. About L&I (Find a jab at Lftl (lnformacion en espanol (Site Feedback ( 1-800-547-8367 ~ '] ~~wa~~9~ingtOn JJashington State Dept. of Labor and ind4~stries. Ilse of this site is suhject to the laws of the ~-~ state of Washingtar7. ~~~~- ~"~ t~ccess AgreemenC ( Privacy and security statement ~ Intended uselexternal content potJcV ~ Visit access.wa.gov Staff onto link https://fortress.wa.gov/lni/bbip/detail.aspx?License=HERITEI 13604 7/26/2004