HomeMy WebLinkAboutHousing Repair Application File Example CITY OF *j
Y`-; l �i HOUSING REPAIR ASSISTANCE PROGRAM APPLICATION
WASHINGTON
Housing Repair Program -
Community Services Division For more information
City of Auburn Call: (253)931-3099
25 West Main
Auburn,WA 98001
HOUSEHOLD INFORMATION
Name of Applicant: Date of application:
(/ /2.0 I z
Home Phone: Work Phone:
253-2-`13-d Oq
Name of Property Owner: a `Igo ifs
1-1 P50 eo
Street Address: City/Zip
W 1 31 Th Sf SA S acku r jv LJ 14-, 1300
Type of ownership verification (deed, tax bill, etc):
Attach copy of proof of ownership.
IN •- ► A • ' • + ' 'r ING
In what year was this home built? ( c(3 Z How long have you lived in this home?
•— tI2 �r'
Type of Structure (i.e., Single Family; Townhouse; Condo; Mobile Home;
Manufactured Home): tt4 v F w c-+vrt) El O(M o f in019a
Is this home on a septic system? S ❑Yes ►2 No
DEMOGRAPHIC INFORMATION
Is anybody who lives in
Age: 5'( SEX: [M OF Female headed Household ['Yes yNo the home disabled?
14 Yes.❑ No
Ethnicity Age of Head of Household Number Living in
❑ Native American/Alaskan Native 12 Under 60 Household
❑Asian/Pacific Islander U 60-74
❑African American/Black ❑ 75 and over Adults
Hispanic
Lyi Caucasian r ®Children 1
REPAIRS x
Type of Housing Repair Requested:
❑ Emergency Home Repairs ❑Accessibility ❑ General Repairs ❑ Code Compliance n Weatherization
Please describe the repairs that you want this grant to fund: (-4 Q f pvtM c) 16 No 1' (o r k erFP31,01
(> (-(e,irr F- -4- D NI c- ('A)6 n►e LS cs � ��� �-( i 115 Fro("'PSE
Oa 00s" or 45Z7 "° y4�•o'*-f ! %NS�e�-� Ho+ t,J�,- �-�r He* k '.
(� �eQ Jv4-e='�? Ict1g teed/ /V w ro
MEMBERS OF THE HOUSEHOLD
Names and ages of all living in dwelling: {use additional paper if necessary}
Name: kkl-(-- w1 H 5 i)SQov Birthdate: it(o) Age: �t
Name: Veborva'k i-(eA^ Sfl ?Sow Birthdate: t2"�1``fci Age: 12—
Name: Birthdate: Age:
Name: Birthdate: Age:
Name: Birthdate: Age:
Name: Birthdate: Age:
INCOME VERIFICATION
18 and older: Please attach documentation of ALL sources of income for all members
of the household who are 18 years and older,including most recent Federal Tax Return,
paychecks for the last two months, OR statements of monthly unemployment benefits,
Social Security,retirement or private pensions. $
Assets for the entire household: Please attach copies of two most recent statements
of the applicant's banking,savings and/or investment account(s),particularly showing
deposits made. It is not necessary to disclose social security numbers or bank account
numbers. The statement must contain the name and address of the applicant.
Proof of Home Ownership: Documents proving home ownership can include
property tax assessments, deeds,mortgages,promissory notes,or real estate contracts. $
For mobile homes please include copies of the title or registration certificate.
INCOME LIMITS
If your GROSS income(before taxes)is less than the amount shown for the family size listed on the left,
you may qualify for the Home Repair Program.(2011 Income Guidelines for HUD Programs)
Household Size Annual Income Monthly Income
1 Person $30,400 $2,533
2 Person $34,750 $2,896
3 Person $39,100 $3,258
4 Person $43,400 $3,617
5 Person $46,900 $3,908
6 Person $50,350 $4,196
7 Person $53,850 $4,488
8 Person $57,300 $4,775
' TERMS AND CONDITIONS OF RANT
Initials Your initials acknowledge that you understand and agree to the following:
*/ Auburn's Housing Repair Program is a voluntary program. The applicant is not obligated to
�7 accept the assistance offered and may reject the grant. Eligible applicants will be taken on a first-
come,first-serve basis,according to the priority system established by the City
Should a project be determined to not be feasible due to a lack of funding or failure to meet any of
the program's eligibility criteria or the applicant refuses the assistance offered;the applicant
understands the City retains the right to reject the application.
Auburn's Housing Repair Grant has a term of 180 days(6 months)and may be extended to no
\ktj more than 18 months. Following the termination of the grant,the applicant is not eligible for
� another Housing Repair Grant for another 18 months. In other words, an applicant is eligible for
only one grant every three(3)years.
With the prior-approval of the Program Administrator, additional work may be added to the grant
provided that(1)the work is an eligible activity, (2)the-total amount expended does not exceed
ok..0
the original grant award, and(3)the amended term of the grant is no more than a total of eighteen
(18)months from the approval date of the application.
��5 The grant applicant agrees to allow the City, or its designee,inspect the property.
The grant applicant agrees that the property will meet the City of Auburn's Building Codes and
1/4(42 Housing Quality Standards.All rehabilitation work(improvements)must comply with currently
approved building codes
The applicant agrees to notify the Auburn's Housing Repair Program of any material change in
JY"\, I the Applicant's financial condition,ownership of property or other circumstances that may affect
the Applicant's eligibility for a Housing Repair Grant.
AGREEMENT
I/We, the undersigned, hereby certify that the above statements are correct and accurate at the time of execution of this
application and understand that any persons giving false information will be subject to a penalty of perjury. It is hereby
acknowledged that a minimum Housing Code inspection is required before I/We receive approval for a repair grant or loan,
and that additional inspections may be required to determine cost estimates of eligible repairs. I/We also authorize the City
of Auburn to confirm the above information by securing verification of income from the issuing sources(s) and/or employers,
and verification of ownership from title reports or motor vehicle ownership records.
I/We, authorize the City or its representative to inspect my property before and after the work is done. The City of Auburn
will issue payment once contracted tasks have been completed and satisfaction of the job(s) have been reached between
contracted parties involved.
Your Signature Date //— Za—Z a r Z
If you have any questions,please call the City of Auburn,Home Repair Program at(253)931-3099.
FOR OFFICE USE ONLY
Approved Rejected Approval/Rejection Date:
❑Major Repair ❑ Minor Repair Priority: 10 2 f 3❑ 4
��r!Aro1
Grant Amount: Program Administrator: fki �L llll�
Comments:
•
Duanna Richards
From: Jeff Tate
Sent: Friday, April 05, 2013 2:30 PM
To: Duanna Richards; Michael Hursh
Subject: RE: Simpson Housing Home Repair
Just got off the phone with Will Simpson. He told me that he went to Home Depot and they took the shower/tub back
and gave him a new one. He said that he and his friend installed it and it now looks good and works fine.
He also told me that he was being kicked out of his unit by First Commercial Mortgage. He wanted to know if we could
help him because it is a predatory tactic that they are using to get rid of him. He said that he was thinking of calling AG's
office. I told him that I wasn't aware of any resources that the city could tap into to help him.
From: Jeff Tate
Sent: Thursday, April 04, 2013 3:04 PM
To: Duanna Richards; Michael Hursh
Subject: FW: Simpson Housing Home Repair
FYI—this is what I sent Will Simpson
From: Jeff Tate
Sent: Thursday, April 04, 2013 3:02 PM
To: 'mddwhs@yahoo.com'
Subject: Simpson Housing Home Repair
Mr. Simpson,
My name is Jeff Tate. I am the Director of Planning and Development for the City of Auburn. Duanna Richards works in
my Department under my supervision. Duanna has forwarded to me a number of emails you have sent her regarding
your interactions with CIR Construction. I am sorry that things have not proceeded in a way that you're pleased about.
Given the circumstances of how things have gone thus far, I have instructed Duanna to send me any emails or phone
calls that she receives from you so that I can respond. I am now your primary point of contact for all items related to
this issue. I want you to know this because it has been my direction to Duanna that she not respond.
Additionally, because CIR is under contract to the City(as opposed to them having a contract with you) I have instructed
CIR to direct all correspondence to me and to allow me to respond to all inquiries.
CIR forwarded me the email that they sent you at 10:58 am on March 29, 2013 in which Josette made a request to you
to schedule a time to replace the broken shower/tub unit. She also forwarded me your response sent at 9:48 pm on
March 30, 2013 in which you threaten legal action. CIR also provided me with information regarding the results of the
Washington State Department of Labor and Industries inspection. I am confused by the fact that the inspection
occurred on March 27th yet Josette emailed you 2 days later with a request to schedule the L&I inspection. The
individual who installs the hot water heater is the one who should call for an inspection so I'm confused as to who called
for the premature inspection. Nonetheless, I would like the record to be clear that the City has not made any
statements about the quality of work performed by CIR and,other than a failed inspection that was called in
prematurely, I am unaware of any State position that speaks to their work.
At this point,we have two options for moving forward:
1
L f'
Duanna Richards
From: Jeff Tate
Sent: Wednesday, April 03, 2013 6:26 AM
To: Duanna Richards
Subject: Re: Broken Bathtub photos ,More .
Michael and I are meeting with Dan Heid today. I will report back.
Sent from my iPhone
On Apr 3, 2013, at 4:22 AM, "Duanna Richards" <drichardsna,auburnwa.gov>wrote:
Thought you should see this. I haven't responded. What do you suggest?
Sent from my iPhone
Begin forwarded message:
From: will Simpson<mddwhs@v ahoo.com>
Date: April 3, 2013, 7:35:22 PM GMT+09:00
To: Duanna Richards <drichards(a,auburnwa.aov>
Subject: Re: Broken Bathtub photos ,More.
Reply-To: will simpson<mddwhs(&,vahoo.com>
I have not heard another word from you MRS. RICHARDS ? We are still with out
the most basic of amenities Shower,bath ? This is wrong .It's been a month or
more . I am going to have to take a different direction. at this point,WOW? WILL
SIMPSON
From: Duanna Richards<drichards(c auburnwa.aov>
To: 'will Simpson' <mddwhs5.vahoo.com>
Sent: Thursday, March 14, 2013 8:10 AM
Subject: RE: Broken Bathtub photos ,More .
Thanks for the photos and information, Will. I know Jo will do the right thing
regarding the tub; she already told me that she would. She still has to come out
for the L & I inspection on the hot water heater so she will be out there when
they're scheduled to come through. That will give them an opportunity to look at
the leak on the hot water heater and take care of that as well.
I don't go out on inspections any more, but one of our Building officials will
come do the final evaluation and you can show him any issues you're concerned
about at that time.
Duanna Richards
Neighborhood Programs Mgr./Sister City Liaison
City of Auburn
25 West Main Street
Auburn WA 98001
Desk: 253-931-3099
Fax: 253-931-3053
i
Duanna Richards
From: Jeff Tate
Sent: Monday, April 01, 2013 11:00 AM
To: 'josette59@comcast.net
Cc: Duanna Richards
Subject: RE: Tub Install
Josette,
In the event that Mr. Simpson emails or calls you again, please forward all inquiries to me. Since the City of Auburn
holds the contract with CIR (as opposed to a contract between you and Mr.Simpson) I would like all interactions with
Mr. Simpson to be with the City since he has threatened legal action. If you are contacted by Mr.Simpson simply tell
him that the City has instructed you, as our contractor,to no longer interact with him and that he should contact me
directly. Additionally, please do not set up any inspections or visit the property.
I will be meeting with the City Attorney on Wednesday to discuss the facts of this case.
Let me know if you have any questions. Thank you and I'm sorry that this is happening.
Please acknowledge receipt of this email.
Sincerely,
Jeff Tate
Interim Director of Planning and Development
City of Auburn
253-804-5036
From: Duanna Richards
Sent: Saturday, March 30, 2013 1:39 PM
To: Jeff Tate
Subject: Fwd: Tub Install
Here's an FYI . . . now I understand Will Simpsons game. I wonder if this has been his objective all along.
Notice he didn't respond to Jo's request for a time to do the install.
Sent from my iPhone
Begin forwarded message: •
From: Josette Marcellino <iosette59(&,,comcast.net>
Date: March 30, 2013, 9:57:04 AM PDT
To: "kkennedv(a,auburnwa.gov" <kkennedv@auburnwa.gov>
Cc: Duanna Richards<drichards(aiauburnwa.gov>
Subject: Fwd: Tub Install
How lovely. I have not responded.
Josette
i
Duanna Richards -
From: Josette59@comcast.net
Sent: Monday, May 13, 2013 6:05 AM
To: Duanna Richards
Cc: Jeff Tate
Subject: William Simpson
Attachments: Will S Invoice.docx
Hi Duanna and Jeff:
Hope you guys have a great day! I have attached an Invoice for the work performed at William Simpson's
property. As I stated previously in an email to Mr Tate last Monday I am a small company and truly need to be
paid for this work. I understand there were some issues with this job that to date we have not been allowed the
opportunity to correct. I am still sitting on an open permit that has cost me additional money. The receipts for
the shower stalls alone have been submitted to you(Mr. Tate)and with the cost of the new hot water heater and
permits (Which in fact were $160) most of the costs for this job has been materials which Mr. Simpson is using
and enjoying.
Please if you can find it in your hearts to pay us or it would be more then appreciated.
Thank You,
Josette Marcellino
C.I.R. Construction LLC
i
Duanna Richards
From: Josette59@comcast.net
Sent: Monday, May 13, 2013 9:03 AM
To: Duanna Richards
Subject: Re: Patricia George Exterior Paint and Back Steps Bid and Photos
Hi Duanna:
Just an FYI, I spoke to Mat Jackson, Building Inspector at L and I this morning regarding Will Simpson's
Permit. I did not want that hanging over our heads as we can be fined$200 for not taking care of it in a timely
manner. Mr Jackson stated he would note the file that the work was being performed under the Housing Repair
Program through the city of Auburn and that after several attempts by both us and the city Mr. Simpson was
being uncooperative regarding the inspection. This hopefully covers us in the event of any problems that may
or may not arise down the road.
Josette
From: "Duanna Richards" <drichards@auburnwa.aov>
To: "Josette Marcellino" <iosette59@comcast.net>
Sent: Monday,May 13, 2013 8:28:51 AM
Subject: RE: Patricia George Exterior Paint and Back Steps Bid and Photos
Hi Josette,
I'll let Patricia know since I need to find out if she's interested in having her paint job be one of the projects for
the Community Service Day. I will need to do an additional contract for the back steps since it wasn't included
in the initial one. If the cost to do the steps was brought down a little so the total doesn't go over$500,
including the taxes, I can give the job to you without bidding it out. It doesn't matter to me,but I wanted to
make sure you knew that before I proceed with sending the bids out.
Hope you had a wonderful Mother's Day and have a great day today!
Duanna
253-931-3099
From: Josette Marcellino [mailto:iosette59@comcast.netj
Sent: Monday, May 13, 2013 8:15 AM
To: Duanna Richards
Subject: Re: Patricia George Exterior Paint and Back Steps Bid and Photos
i
Duanna Richards
From: Josette59@comcast.net
Sent: Tuesday, April 30, 2013 8:57 AM
To: Duanna Richards
Subject: Re: UPDATED Contract for Patricia George
Thank you. Any word on when we will be paid for the Will Simpson job? I still have that permit hanging out
there that will cost us additional fees in about a week or so.
Josette
From: "Duanna Richards" <drichards@auburnwa.gov>
To: "Josette59@comcast.net" <Josette59@comcast.net>
Sent: Tuesday, April 30, 2013 8:48:58 AM
Subject: RE: UPDATED Contract for Patricia George
This is exactly what I needed! I'll get an updated Contract to you today.
Duanna
253-931-3099
From: Josette59@comcast.net [mailto:Josette59@comcast.net]
Sent: Tuesday,April 30, 2013 8:47 AM
To: Duanna Richards
Subject: Re: UPDATED Contract for Patricia George
Hi Duanna:
Attached is a new itemized bid for Patricia George. I have added the $200 for the kitchen light fixture
replacement as well as adjusted the sales tax.
Josette
From: "Duanna Richards" <drichards 2i auburnwa.aov>
To: "Josette59@comcast.net" <Josette59@comcast.net>
1
41.
Dwelling
Client # assigned: Mlte
House
Home Repair Eligibility Review 1/Mobile
Condo
Townhouse
Client Name li ll`t t lyli pi/AA)
Application tax assessment deed /note
/
✓ title/registration )aycheck stubs
Ff Complete Incomplete _/tax statement " bank statement
p p
SS award letter pension
OTHER: ✓�-�
Monthly Income of Household
Name Verification Amount
•
\hchiiI,O,J6 kaWIC 1.i4ctOclak5 ti )7\i1111&14)
0- 1, . , 6ui orr , I ,rt,
� ,o A,0 1 if0,Ct Total: 1'150.6 kitagl
I DEMOGRAPHICS
PLEASE CHECK ONE: Hispanic/Latino
—/ Not Hispanic/Latino Number of:
PLEASE CHECK ALL THAT APPLY f Adults Children Disabled
^/ White Asian Black/African American Senior `Head of Household( /F)
Native Hawaiian/Other Pacific Islander
American Indian/Alaskan Native
English primary language:
Asian Black/African Latino If not,what is?
Other Multi Racial Other Info:
Eligibility Status (to be completed by Home Repair/Human Services Mgr.)
Approved Conditionally Approved for Health and Safety
Denied—Explanation
Comments
Authorized by: QU I ° l,VI/ Date: i P . 9\Q 11
Claim&Account Center llttps://secure.lni.wa.p^onac/default.aspx?viewID=37&ViewClaimGu...
WOitagi nad.S r of
Topic Index I Contact Info I Search
Home Safety Claims ft insurance Workplace Rights Trades&Licensing
Claim&Account Center A`LEH Secured My profile Logged in as:william simpson I Log off o Help
F;, Welcome Payment summary
dry;, Claim information
i Send information to Lftl Claim number AN79644 Injury date 4/15/2010
w Claim payments Enter Claim# Worker name WILLIAM SIMPSON
E Claim payments& IAN79644 Employer name BIG SKY ROOFING LLC
benefits Attending doctor ROBERTSON JOHN W MD
0 Payment summary Get Claim ; Claim manager NATHAN W HUNT 360-902-6635
0 Calculations Claim manager fax (360)-902-4567
Medical bills&payments Monthly wage amount $2,288.00 Time-Loss Notification/Worker Verification form
Claim costs Monthly time-loss rate $1,498.06 received within the last 60 days
Self insured information Daily time-loss rate $49.94
Off work or returning to work? Update work status(oo tOnrinel
Learn how time-loss rate and monthly wage were calculated
Page 1 of 3 «Previous 1 2 3 Next» Jump to page I Go J
Order Amount Mailing
Payment Type From Thru Type Paid Date Recipient
Time Loss 11-09-2012 11-22-2012 D
$653.84 Pending Worker
Time Loss 10-26-2012 11-08-2012 D 594.29 11-08-2012 Worker
Time Loss 10-12-2012 10-25-2012 D
$594.29 10-25-2012 'Worker
Time Loss 09-28-2012 10-11-2012 D $594.29 10-11-2012 Worker
Time Loss 09-14-2012 09-27-2012 D $594.29 09-27-2012 Worker
Time Loss 08-31-2012 09-13-2012 D $594.29 09-13-2012 Worker
Time Loss 08-17-2012 08-30-2012 D $594.29 08-31-2012 Worker
Time Loss 08-03-2012 08-16-2012 D $594.29 08-16-2012 Worker
Time Loss 07-20-2012 08-02-2012 D $594.29 08-02-2012 Worker
Time Loss 07-06-2012 07-19-2012 D $594.29 07-19-2012 Worker
Time Loss 06-21-2012 07-05-2012 I $623.25 07-05-2012 Worker
Time Loss 06-07-2012 06-20-2012 I $506.10 06-20-2012 Worker
Time Loss 05-24-2012 06-06-2012 I $674.80 06-06-2012 Worker
Time Loss 05-10-2012 05-23-2012 I $674.80 05-23-2012 Worker
Time Loss 04-26-2012 05-09-2012 I $674.80 05-09-2012 Worker
Time Loss 04-12-2012 04-25-2012 I $674.80 04-25-2012 Worker
Time Loss 03-29-2012 04-11-2012 I $674.80 04-11-2012 Worker
Time Loss 03-15-2012 03-28-2012 I $674.80 03-28-2012 Worker
Time Loss 03-01-2012 03-14-2012 I $674.80 03-14-2012 Worker
Time Loss 02-16-2012 02-29-2012 I $674.80 02-29-2012 Worker
Time Loss 02-02-2012 02-15-2012 I $674.80 02-15-2012 Worker
Time Loss 01-19-2012 02-01-2012 I $674.80 02-01-2012 Worker
Time Loss 01-05-2012 01-18-2012 I $674.80 01-18-2012 Worker
Time Loss 12-22-2011 01-04-2012 I $674.80 01-04-2012 Worker
Time Loss 12-08-2011 12-21-2011 I $759.22 12-21-2011 Worker
Time Loss 11-24-2011 12-07-2011 I $759.22 12-07-2011 Worker
Time Loss 11-10-2011 11-23-2011 I $759.22 11-23-2011 Worker
Time Loss 10-27-2011 11-09-2011 I $759.22 11-09-2011 Worker
Time Loss 10-13-2011 10-26-2011 I $759.22 10-26-2011 Worker
Time Loss 09-29-2011 10-12-2011 I $759.22 10-12-2011 Worker
Page 1 of 3 «Previous 1 2 3 Next» Jump to page I Go I
1 of 3 11/15/2012 12:12 PM
•
View Deposit Transaction History - NOW Account - Bank 420 Page 1 of 4
rr.
Simpson William H HomeStreet Bank
NOW Account
Ledger balance: 0.03 Today's activity: 0.00
Current balance: 0.03 Total Holds: 0.00
Account available 0.03 Float: 0.00
balance:
Total accessible balance: 0.03 Unused PRA:
Closingbalance: 0.03 Related available 0.00
balance:
Last statement: 11/05/2012
1 - 150 Next > Transactions from 01/01/2012 to 12/05/2012
Date Check Amount Description Status Balance
12/03/2012 0.00 216 -Telephone Inquiry 0.00
12/03/2012 13.99 235 - Debit Card 0.00
Purchase
11/30/2012 0.00 216 -Telephone Inquiry 0.00
11/30/2012 5.26 235- Debit Card 0.00
Purchase
11/29/2012 0.00 216 -Telephone Inquiry 0.00
11/29/2012 100.00 918 -ATM Withdrawal 0.00
11/29/2012 114.33 736 -Ach Credit 0.00
11/28/2012 0.00 216 - Telephone Inquiry 0.00
11/28/2012 0.00 216 -Telephone Inquiry 0.00
11/26/2012 0.00 216 - Telephone Inquiry 0.00
11/26/2012 0.00 216 -Telephone Inquiry 0.00
11/26/2012 7.88 235 - Debit Card 0.00
Purchase
11/26/2012 1.31 235 - Debit Card 0.00
Purchase
11/26/2012 650.00 950 - Withdrawal 0.00
11/26/2012 653.84 750 - Deposit 0.00
11/26/2012 1 653.84 580 - Float 0.00
11/23/2012 0.00 216 -Telephone Inquiry 0.00
11/21/2012 0.00 216 - Telephone Inquiry 0.00
11/21/2012 2.63 235 - Debit Card 0.00
Purchase
11/21/2012 10.00 750 - Deposit 0.00
11/19/2012 0.00 216 - Telephone Inquiry 0.00
11/19/2012 0.00 216 - Telephone Inquiry 0.00
11/16/2012 0.00 216 -Telephone Inquiry 0.00
11/16/2012 140.00 918 -ATM Withdrawal 0.00
11/16/2012 141.89 736 -Ach Credit 0.00
11/15/2012 0.00 216 -Telephone Inquiry 0.00
11/14/2012 0.00 216 - Telephone Inquiry 0.00
11/13/2012 0.00 260 -ATM Balance 0.00
Inquiry
11/13/20121� 0.00 216 - Telephone Inquiry(y 0.00
1 170 e/2012 FEDERAL WAY OFF0.00 216 -Telephone Inquiry 0.00
253-838-0 00
11/13/2012 33525 Pacific IQg y 21t0 -Telp,ph,prigdrww, 0.00
11/13/2012 suite A 1.31 235 - Deice GelsdtEcct.com 0.00
Federal Way,WA 98003
FDIC Q
View Deposit Transaction History - Account- Bank 420 Page 2 of 4
Purchase
11/13/2012 1.31 235 - Debit Card 0.00
Purchase
11/09/2012 0.00 216 -Telephone Inquiry 0.00
11/08/2012 3.00 750 - Deposit 0.00
11/07/2012 0.00 216 - Telephone Inquiry 0.00
11/05/2012 0.01 761 - Interest Credit 0.00
10/30/2012 0.00 260 -ATM Balance 0.00
Inquiry
10/30/2012 0.00 216 -Telephone Inquiry 0.00
10/30/2012 60.00 918 -ATM Withdrawal 0.00
10/30/2012 54.46 736 -Ach Credit 0.00
10/29/2012 0.00 216 -Telephone Inquiry 0.00
10/29/2012 0.00 216 -Telephone Inquiry 0.00
10/29/2012 0.00 216 -Telephone Inquiry 0.00
10/29/2012 0.00 216 - Telephone Inquiry 0.00
10/26/2012 0.00 216 - Telephone Inquiry 0.00
10/26/2012 15.00 235- Debit Card 0.00
Purchase
10/25/2012 0.00 216 -Telephone Inquiry 0.00
10/25/2012 10.00 750 - Deposit 0.00
10/23/2012 0.00 216 -Telephone Inquiry 0.00
10/23/2012 0.00 216 - Telephone Inquiry 0.00
10/23/2012 1.31 235 - Debit Card 0.00
Purchase
10/22/2012 0.00 260 -ATM Balance 0.00
Inquiry
10/22/2012 0.00 216 -Telephone Inquiry 0.00
10/22/2012 0.00 216 -Telephone Inquiry 0.00
10/22/2012 3.94 235 - Pos Purchase 0.00
10/22/2012 300.00 918 -ATM Withdrawal 0.00
10/18/2012 0.00 216 -Telephone Inquiry 0.00
10/17/2012 0.00 216 -Telephone Inquiry 0.00
10/17/2012 2.63 235 - Pos Purchase 0.00
10/17/2012 244.78 736 -Ach Credit 0.00
10/16/2012 1.31 235 - Pos Purchase 0.00
10/15/2012 0.00 216 - Telephone Inquiry 0.00
10/15/2012 0.00 216 - Telephone Inquiry 0.00
10/15/2012 0.00 216 - Telephone Inquiry 0.00
10/15/2012 20.00 235 - Pos Purchase 0.00
10/12/2012 0.00 216 -Telephone Inquiry 0.00
10/12/2012 500.00 950 -Withdrawal 0.00
10/12/2012 594.29 750 - Deposit 0.00
10/12/2012 1 594.29 580 - Float 0.00
10/11/2012 0.00 216 -Telephone Inquiry 0.00
10/10/2012 0.00 216 -Telephone Inquiry 0.00
10/10/2012 2.18 235 - Pos Purchase 0.00
10/08/2012 0.00 260 -ATM Balance 0.00
Inquiry
10/08/2012 0.00 216 -Telephone Inquiry 0.00
10/08/2012 80.00 918 -ATM Withdrawal 0.00
10/08/2012 20.00 918 -ATM Withdrawal 0.00
10/08/2012 20.00 918 -ATM Withdrawal 0.00
10/05/2012 1.31 235 - Pos Purchase 0.00
https://insight.metavante.org/opstopb1/OpstopServlet/ViewTransactionHistoryDeposit 12/5/2012
View Deposit Transaction History - r Account - Bank 420 Page 3 of 4
10/04/2012 0.00 216 -Telephone Inquiry 0.00
10/04/2012 1.31 235 - Pos Purchase 0.00
10/04/2012 1.30 235 - Pos Purchase 0.00
10/03/2012 0.00 216 -Telephone Inquiry 0.00
10/02/2012 0.00 216 -Telephone Inquiry 0.00
10/02/2012 53.10 235 - Pos Purchase 0.00
10/02/2012 2.63 235 - Pos Purchase 0.00
10/02/2012 88.68 736 -Ach Credit 0.00
10/01/2012 0.00 216 -Telephone Inquiry 0.00
10/01/2012 0.00 216 -Telephone Inquiry 0.00
10/01/2012 0.00 216 -Telephone Inquiry 0.00
09/28/2012 0.97 235 - Pos Purchase 0.00
09/28/2012 500.00 950 -Withdrawal 0.00
09/28/2012 594.29 750 - Deposit 0.00
09/28/2012 1 594.29 580 - Float 0.00
09/27/2012 0.00 216 -Telephone Inquiry 0.00
09/27/2012 1.31 235 - Pos Purchase 0.00
09/26/2012 0.00 216 -Telephone Inquiry 0.00
09/25/2012 0.00 216 -Telephone Inquiry 0.00
09/24/2012 0.00 216 -Telephone Inquiry 0.00
09/24/2012 1.31 235 - Pos Purchase 0.00
09/20/2012 0.00 216 -Telephone Inquiry 0.00
09/20/2012 0.00 216 -Telephone Inquiry 0.00
09/20/2012 0.00 216 -Telephone Inquiry 0.00
09/20/2012 40.00 918 -ATM Withdrawal 0.00
09/20/2012 20.00 918 -ATM Withdrawal 0.00
09/19/2012 0.00 216 -Telephone Inquiry 0.00
09/19/2012 0.00 216 -Telephone Inquiry 0.00
09/19/2012 60.00 918 -ATM Withdrawal 0.00
09/19/2012 238.59 736 -Ach Credit 0.00
09/18/2012 0.00 216 -Telephone Inquiry 0.00
09/18/2012 0.00 216 -Telephone Inquiry 0.00
09/17/2012 0.00 216 -Telephone Inquiry 0.00
09/17/2012 0.00 216 -Telephone Inquiry 0.00
09/17/2012 30.00 831 - Nsf Return Item Force 0.00
Fee Post
09/17/2012 53.10 640 - Return Item 0.00
09/14/2012 53.10 941 -Ach Debit 0.00
09/14/2012 0.26 750 - Deposit 0.00
09/13/2012 0.00 216 -Telephone Inquiry 0.00
09/13/2012 30.00 831 - Nsf Return Item Force 0.00
Fee Post
09/13/2012 2003 1,395.26 630 - Nsf Returned Item 0.00
09/12/2012 2003 1,395.26 800 - Check 0.00
09/11/2012 0.00 216 -Telephone Inquiry 0.00
09/11/2012 30.00 831 - Nsf Return Item Force 0.00
Fee Post
09/11/2012 53.10 640 - Return Item 0.00
09/10/2012 53.10 941 -Ach Debit 0.00
09/10/2012 30.00 831 - Nsf Return Item Force 0.00
Fee Post
09/10/2012 2003 1,395.26 630 - Nsf Returned Item 0.00
09/07/2012 0.00 216 -Telephone Inquiry 0.00
09/07/2012 2003 1,395.26 800 - Check 0.00
https://insight.metavante.org/opstopb1/OpstopServlet/ViewTransactionHistoryDeposit 12/5/2012
View Deposit Transaction History unt - Bank 420 Page 4 of 4
09/07/2012 60.00 950 -Withdrawal 0.00
09/06/2012 0.00 216 -Telephone Inquiry 0.00
09/05/2012 0.00 216 - Telephone Inquiry 0.00
09/05/2012 1.71 227 - Debit Card 0.00
Purchase
09/04/2012 0.00 216 -Telephone Inquiry 0.00
09/04/2012 0.00 216 -Telephone Inquiry 0.00
09/04/2012 20.00 235 - Debit Card 0.00
Purchase
09/04/2012 1.31 235 - Debit Card 0.00
Purchase
09/04/2012 6.93 227 - Debit Card 0.00
Purchase
08/31/2012 0.00 216 -Telephone Inquiry 0.00
08/31/2012 0.00 216 -Telephone Inquiry 0.00
08/31/2012 0.00 216 -Telephone Inquiry 0.00
08/31/2012 0.00 216 -Telephone Inquiry 0.00
08/31/2012 0.00 216 - Telephone Inquiry 0.00
08/31/2012 1.31 235- Debit Card 0.00
Purchase
08/31/2012 2.00 227 - Debit Card 0.00
Purchase
08/31/2012 500.00 950 -Withdrawal 0.00
08/31/2012 594.29 750 - Deposit 0.00
08/31/2012 1 594.29 580 - Float 0.00
08/28/2012 0.00 216 - Telephone Inquiry 0.00
08/27/2012 16.10 230 - Debit Card With 0.00
Cash
https://insight.metavante.org/opstopb1/OpstopServlet/ViewTransactionHistoryDeposit 12/5/2012
-* Dept of Administration
CITY OF T *RN Duanna Richards, Programs
Neighborhoodg
Manager
25 West Main Street, Auburn, WA 98001
WASHINGTON phone: 253-931-3099
email: drichards@auburnwa.gov
HOUSING REPAIR EVALUATION REPORT
Date of initial evaluation: !Xi Ja,,OI \
Evaluated by: - aA,34QAAYVIAa
Client's Name: William Simpson
Address: 707 37th St SE. #55
City: Auburn Zip: 98002
Home Phone: 253-293-0404 Work Phone:
Concerns: His heat Dump isn't working; needs the hot water heater
inspected for repair or replacement and the bathtubs need to be replaced.
ITEM OR LOCATION Condition Description of Problem
Foundation Good Fair Poor
Roofing
Plumbing ✓ t, 0 &AS
Electrical
Flooring
Furnace/Hot Water ✓ Kakv il` s a to-I\oV VA/4-
Windows/Doors '1 4.0 ,
Appliances
Deck/Porch/Steps
General Condition
Page 1 of 2
AUBURN * MORE THAN YOU IMAGINED
Assessment (circle one) 1. GOOD J 2. FAIR 3. FURTHER INSPECTION
Reviewed with client on 61\/__q_j_4$2
Client Signature.
Evaluator's Signature
g
Evaluator's Recommendations: l J_45 , 1 /teuteLovh, eatio ad.
_r_eptv_.4) jor refria6o 4qtyyt/t ieg 410,14t--
I � hlzctb 3 (cw (N- ker
11
'Cc he s!4 lit
REVIEW OF WORK COMPLETED � C ct�/���yS- ck.�rt i 5
Crr .
Date: — --do/
S� rjGio
C•Gv e� e'G_ �
f 1... M�t�,�✓ T� .
Work performed:- Otis 4 l S"Acw e'• 6:2 `i vr� c c� �-ii T e e-,4 >‘' h r
Gin I'/e. [cc- V-ec ace Uet
Work completed (check one): APPROVED NOT APPROVED
Comments: I ,,
61g I/ "-c,(3 s %c h C 1'14, Li j C�Fer u 0-11. /4". (71-‘ 6„C S 51GeJC
Evaluator: 7`6, 2-17
Contractor:,
L
Client: \M \NI),uY\
\ -
Page 2 of 2 Housing Repair Evaluation Report