HomeMy WebLinkAboutPermit D05-222 - WADE RESIDENCE - RESIDENCE DEMOLITIONThis record contains information which is exempt from public disclosure
pursuant to the Washington State Public Records Act, Chapter 42.56 RCW
as identified on the Digital Records Exemption Log shown below.
D05 -222
Wade Residence
5016 South 118th Street
RECORDS DIGITAL D- ) EXEMPTION LOG
THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION
Page # tode Exemption = Brief Explanatory DeSctiptiop �t�tutel ule
The Privacy Act of 1974 evinces Congress' intent that
Personal Information —
social security numbers are a private concern. As
such, individuals' social security numbers are
Social Security Numbers
redacted to protect those individuals' privacy pursuant
5 U.S.C. sec.
DR1
Generally — 5 U.S.C. sec.
to 5 U.S.C. sec. 552(a), and are also exempt from
552(a); RCW
552(a); RCW
disclosure under section 42.56.070(1) of the
42.56.070(1)
42.56.070(1)
Washington State Public Records Act, which exempts
under the PRA records or information exempt or
prohibited from disclosure under any other statute.
Redactions contain Credit card numbers, debit card
Personal Information —
numbers, electronic check numbers, credit expiration
16
DR2
Financial Information —
dates, or bank or other financial account numbers,
RCW
RCW 42.56.230(4 5)
which are exempt from disclosure pursuant to RCW
42.56.230(5)
42.56.230(5), except when disclosure is expressly
required by or governed by other law.
WADE RESIDENCE
5016 S 118 ST
D05 -222
-1
City oY Tukwila
Department of Commui:ity Developmet :t
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206 - 431 -3665
Web site: ci.tukwila.wa.its
DEVELOPMENT PERMIT
Parcel No.: 3348400788
Address: 5016 S 118 ST TUKW
Suite No:
Tenant:
Name: WADE RESIDENCE
Address: 5016 S 118 ST, TUKWILA WA
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
Contractoi
BURNS G H
11772 1/2 EMPIRE WAY S, SEATTLE WA
ROBERT WADE
10024 S 46 ST, PHOENIX AZ
COBBLESTONE COMPANY, THE
PO BOX 77219, SEATTLE, WA
License No: COBBLC *033BM
Permit Number:
Issue Date:
Permit Expires On:
Phone:
Steven M. Mullet, Mayor
Steve Lancaster, Director
DOS -222
06/29/2005
12/26/2005
Phone: 480 - 221 -3769
Phone: 206 - 365 -6595
Expiration Date: 11 /10/2005
DESCRIPTION OF WORK:
DEMOLITION OF EXISTING 850 SQ FT SINGLE FAMILY RESIDENCE.
Value of Construction: $3,000.00 Fees Collected: $174.55
Type of Fire Protection: NONE International Building Code Edition: 2003
Type of Construction: Occupancy per IBC: 0022
Public Works Activities:
Channelization / Striping: N
Curb Cut / Access / Sidewalk / CSS: N
Fire Loop Hydrant: N
Flood Control Zone: N
Hauling: N
Land Altering: N
Landscape Irrigation: N
Moving Oversize Load: N
Sanitary Side Sewer: N
Sewer Main Extension: N
Storm Drainage: N
Street Use: N
Water Main Extension: N
Water Meter: N
Number: 0 Size (Inches): 0
Start Time: End Time:
Volumes: Cut 0 c.y. Fill 0 c.y.
Start Time: End Time:
Private: Public:
Profit: N Non - Profit: N
Private: Public:
doc: IBC - Permit 005 -222 Printed: 06 -29 -2005
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City oY 'Tukwila
Department of Comn:uitity Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206 - 431 -3670
Fax: 206 - 431 -3665
Web site: ci.tulnvila.wa.us
! ,--\ 11
Permit Number:
Issue Date:
Permit Expires On:
Steven M. Mullet, Mayor
Steve Lancaster, Director ;
DOS -222
06/29/2005
12/26/2005
I
Permit Center Authorized Signature: . 4 wt A Date: -- L
} I hereby certify that I have read and examined this permit and know the same to be true and correct. All provisions of law and
ordinances governing this work will be complied with, whether specified herein or not.
. The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or local laws
j regulating constru ion r t e performance' f�tntork. am authorized to sign and obtain this development permit.
i
Signature: '� Date: V ��
Print Name:
This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is
suspended or abandoned for a period of 180 days from the last inspection.
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doc: IBC - Permit D05 -222 Printed: 06 -29 -2005
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
PERMIT CONDITIONS
Parcel No.: 3348400788 Permit Number: DOS -222
Address: 5016 S 118 ST TUKW Status: ISSUED
Suite No: Applied Date: 06/29/2005
Tenant: WADE RESIDENCE Issue Date: 06/29/2005
1: ** *BUILDING DEPARTMENT CONDITIONS * **
2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the
Building Official.
3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to
start of any construction. These documents shall be maintained and made available until final inspection approval is
granted.
4: All construction shall be done in conformance with the approved plans and the requirements of the International
Building Code or International Residential Code, International Mechanical Code, Washington State Energy Code.
5: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary
sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other
excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of
this requirement.
6: Removal of septic tanks require approval and compliance with permit and inspection requirements through the
Seattle /King County Department of Public Health (206/296- 4722).
7: All construction noise to be in compliance with Chapter 8.22 of the City of Tukwila Municipal Code. A copy can be
obtained at City Hall in the office of the City Clerk.
8: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of,
any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits
presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila
shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the
Building Official from requiring the correction of errors in the construction documents and other data.
* *continued on next page **
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doc: Conditions D05 -222 Printed: 06 -29 -2005
INN �
City of Tukwila
Department of Community Development / 6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
I hereby certify that I have read these conditions and will comply with them as outlined. All provisions of law and ordinances
governing this work will be complied with, whether specified herein or not.
4
The granting of this permit does not presume to give authority to violate or cancel the provision of any other work or local laws
regulating construction or the performance of work.
a
y .
Signature: Date:
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doc: Conditions D05 -222 Printed: 06 -29 -2005
a
ILA, w , CITY OF T UKWI LA
y Community Development Department
Public Works Department
f Permit Center
i905 6300 Southcenter Blvd., Suite 100
` Tukwila, WA 98188
Applications and plans must be complete in order to be accepted for plan review.
Applications will not be accepted through the mail or by fax.
* *Please Print **
SITE `LOCATION
Site Address: o 2 0 l
+� O S
rimg t-o Assessor s i ax ivo.: -:;p J
Suite Number: Floor:
Tenant Name:
Property Owners Name:
New Tenant: El .... Yes ❑ ..No
(_ _
VC
ZU �V ti_L
Mailing Address:
e-1 6 fL" '2 Q
O eWl f K Y�C <ZC
City Slate Zip
CONTACT: PERSON:
Name: (::2 e t'1-
e
W C L-Q
Day Telephone:_ k6) ' 2 - 1 — - 3 _?
Mailing Address: (C$& s • Lt S��- �� l' 6tdP. dy l X Z a s�� �
City State Zip
E -Mail Address: Fax Number:
GENERAL. CONTRACTOR INFORMATION ' (Mechanical.Contractor information on b ack :page)
Company Name: Vl/
Mailing Address: . 6 .
/� City State � Zip
Contact Person: S �n ' V l C f A- Gn i W Day Telephone:
E -Mail Address: { � n Fax Number:
Contractor Registration Number: (� �� ! C' �i� Qr .3 . r \ Expiration Date:
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
ARCHITECT' OF RECORD All plans must be wet stamped by Architect Yof Record
Company Name:
Mailing Address: ` 0
Contact
E -Mail Address:
City State Zip
Day Telephone:
Fax Number:
ENGINEER OF RECORD: All plans'must be wet stamped by Engineer of Record`
Company
Mailing A
Contact P
E -Mail Address:
q: \permits plus \ice changesXpermit application (7 -2004)
Revised: 60.05
bh
Pap 1
City State Zip
Day Telephone:
Fax Number:
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BUILDING PERMIT, INFORMti PION 206=431 -3670
Valuation of Project (contractor's bid price): $ -_1_2 v 6
Scope of Work (please provide detailed information):
i Will there be new rack storage? ❑ .. Yes
ce.. No If "yes ", see Handout No. for requirements.
Provide All Building Areas in Square Footage Below
PLANNING DIVISION:
Single- family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): 00 Floor area of principal dwelling: �tSO Floor area for accessory dwelling:
*Provide documentation that shows that the rinci al owner lives in one of the dwellings as his or her primary residence.
P p
Number of Parking Stalls Provided: Standard Compact: Hand* ap:
Will there be a change in use? ❑ .... Yes .No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
[I.. Sprinklers ❑ ..Automatic Fire Alarm O ..None ❑ . Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ .. Yes ❑ ..No
If' yes ", attach list of materials and storage locations on a separate 8 - 112 x 11 paper indicating quantities and Material Safety Data Sheets
Existing Building Valuation: $ Cam
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gMpermits plus\icc changes \permit application (7.2004)
Revised 6.8.05 Page 2
Existing
Interior.
Remodel .
Addition to
Existing
Structure
New
Type of
Construction
per IBC
Type of
Occupancy per
IBC
1" Floor
2" Floor
3' Floor.
Floors : thru
Basement
Accessory Structure*
Attached Garage
Detached Garage .
Attached Carport .
Detached Carport
Covered Deck
Uncovered Deck
PLANNING DIVISION:
Single- family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches)
*For an Accessory dwelling, provide the following:
Lot Area (sq ft): 00 Floor area of principal dwelling: �tSO Floor area for accessory dwelling:
*Provide documentation that shows that the rinci al owner lives in one of the dwellings as his or her primary residence.
P p
Number of Parking Stalls Provided: Standard Compact: Hand* ap:
Will there be a change in use? ❑ .... Yes .No If "yes ", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
[I.. Sprinklers ❑ ..Automatic Fire Alarm O ..None ❑ . Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ .. Yes ❑ ..No
If' yes ", attach list of materials and storage locations on a separate 8 - 112 x 11 paper indicating quantities and Material Safety Data Sheets
Existing Building Valuation: $ Cam
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gMpermits plus\icc changes \permit application (7.2004)
Revised 6.8.05 Page 2
PUBLIC WORKS PERMIT INFORMATION - 206433 -0179
Scope of Work (please provide detailed
Call before you Dig: 1- 800 - 424 -5555
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
Water District
❑ ...Tukwila ❑... Water District # 125 ❑ .. Highline ❑ ...Renton
❑ ...Water Availability Provided
Sewer District
❑ ... Tukwila E] ... VaIVue ❑ .. Renton ❑...Seattle
❑ ...Sewer Use Certificate E3 ... Sewer Availability Provided ❑ -Approved Septic Plans Provided
❑ ...Septic System - For onsite septic system, provide 2 copies of a current septic design approval by King County Health Department.
Submitted with Application (mark boxes which apply):
❑ ...Civil Plans (Maximum Paper Size — 22" x 34 ")
❑ ... Technical Information Report (Storm Drainage) ❑ .. Geotechnical Report ... Traffic Impact Analysis
❑ ...Bond ❑ .. Insurance ❑ .. Easement(s) ❑ .. Maintenance Agreement(s) ❑ ...Hold Harmless
Proposed Activities (mark boxes that a
❑ ...Right -of -way Use - Nonprofit for less than 72 hours
❑ ...Right -of -way Use - No Disturbance
❑ ...Construction/Excavation/Fill - Right -of -way
Non Right -of -way _
❑ ...Total Cut cubic yards
❑ ...Total Fill cubic yards
❑ ... Sanitary Side Sewer
❑ ...Cap or Remove Utilities
❑ ...Frontage Improvements
❑ ...Traffic Control
❑ ...Backflow Prevention - Fire Protection
Irrigation
Domestic Water
❑ :. Right -of -way Use - Profit for less than 72 hours
❑ .. Right -of -way Use — Potential Disturbance
❑ .. Work in Flood Zone
❑ .. Storm Drainage
❑ .. Abandon Septic Tank ❑ .. Grease Interceptor i
❑ .. Curb Cut ❑ .. Channelization
❑ .. Pavement Cut ❑ .. Trench Excavation
❑ .. Looped Fire Line ❑ .. Utility Undergrounding f
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❑ ...Permanent Water Meter Size... WO#
❑ ...Temporary Water Meter Size.. WO#
❑ ... Water Only Meter Size............ WO# ❑...Deduct Water Meter Size "
❑ ... Sewer Main Extension ............ Public Private
❑ ... Water Main Extension .............Public Private
FINANCE INFORMATION
Fire Line Size at Property Line Number of Public Fire Hydrant(s)
❑ ... Water ❑ ...Sewer ❑ ...Sewage Treatment
Monthly Service Billing to:
Name: Day Telephone:
Mailing Address: -
City State Zip
Water Meter RefundBilline:
Name: Day Telephone:
Mailing Address:
City State - Zip
q:%%permits plus \ice changes \permit application (7 -2004)
Revised: 6.9.05 Page 3
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MECHANICAL PERMIT. INFORMATION - 206- 431- 3670
MECHANICAL CONTRACTOR INFORMATION
Company Name:
Mailing Address
! City State Zip
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
Contractor Registration Number: Expiration Date:
* *An original or notarized copy of current Washington State Contractor License must be presented at the time of permit issuance **
Valuation of Project (contractor's bid price): $
Scope of Work (please provide detailed information):
Use: Residential: New ....
Commercial: New .... ❑
Fuel Type Electric ..... ❑ Gas....❑
Replacement..... ❑
Replacement..... ❑
Other:
Indicate type of mechanical work being installed and the quantity below:
Unit Type.
Qty
Unit Type:
Qty
Unit Type:
Qty
Boiler /Corn pressor:
Q
Furnace <IOOK BTU
Air Handling Unit >10,000
Fire Damper
0 -3 HP /100,000 BTU
CFM
Furnace >IOOK BTU
Evaporator Cooler
Diffuser
3 -15 HP /500,000 BTU
Floor Furnace
Ventilation Fan Connected
Thermostat
15 -30 HP/ 1,000,000 BTU
to Single Duct
Suspended /Wall /Floor
Ventilation System
Wood/Gas Stove
30 -50 HP /1,750,000 BTU
Mounted Heater
Appliance Vent
Hood and Duct
Water Heater
50+ HP /1,750,000 BTU
Repair or Addition to
Incinerator - Domestic
Emergency
Heat/Refrig/Cooling
Generator
System
Air Handling Unit
Incinerator — Comm/Ind
Other Mechanical
<I0,000 CFM
Equipment
; PERMIT APPLICATION NOTES = Applicable'16 0 permits in this application .
Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject
to possible revision by the Permit Center to comply with current fee schedules.
Expiration of Plan Review — Applications for which no permit is issued within 180 days following the date of application shall expire by limitation.
The Building Official may grant one or more extensions of time for additional periods not exceeding 90 days each. The extension shall be requested
in writing and justifiable cause demonstrated. Section 105.3.2 International Building Code (current edition).
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER
PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT.
BUILDING OWN RAUTHOZED AGENT:
Signature: � �� ai , W e Date: � /
Print Name: 'e W - U J ACC �e Day Telephone: e leS L) —0
Mailing Address: lbo? Is. �� S r tUi,l' 04
City State Zip
Date Application Accepted: Date Application Expires: Staff Initials:
GG ,
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gA\permits plusUcc changeslpermit application (7.204)
Revised 6.8.05 Page 4
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O .."A Y Cit of Tukwila
6300 Southcenter BL, Suite 100 / Tukwila, WA 98188 / (206) 431 -3670
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I
Parcel No::
Address:
Suite No:
' Applicant:
3348400788
5016 S 118 ST TUKW
ROBERT WADE DEMO
RECEIPT
Permit Number:
Status:
Applied Date:
Issue Date:
D05 -222
PENDING
06/29/2005
i
i Receipt No.:
I
R05 -00940
Payment Amount:
174.55
t Initia{s:
LAW
Payment Date:
06/29/2005 11:14 AM
User ID:
I
1630
Balance:
$0.00
Payee: GEORGE BURNS
i
i .TRANSACTION LIST:
Type Method Description Amount
-- - - - - -- -- - - - - -- --------------------- - - - - -- ------ - - - - --
Payment Check 1173 174.55
i
ACCOUNT ITEM LIST:
Description Account Code Current Pmts
------------------------ - - - - -- ---------- - - - - -- ------ - - - - --
BUILDING - NONRES 000/322.100 103.06
PLAN CHECK - NONRES 000/345.830 66.99
STATE BUILDING SURCHARGE 000/386.904 4.50
i Total: 174.55
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doc: Receipt Printed: 06 -29 -2005
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INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431- 670
Project:
.
Type of Inspection:
T---,
Ad ss: � � r, (
Date Called:
Special Instructions: )
t
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Date Wanted
Req eter:
�
Phone N6'
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
Inspector y
$58.00 REINSPECTION F& REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
Receipt No.: Date: ::1
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INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PER O.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206).431 -3670
P I I
ox
Type 91 Inspe lion:
S� n
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Address: O ,
( �S
Date Called: �
---
Special Instructions:
1
Date Wanted:
a.m.
P.m.
/
4
Requester:
4 vaq - A l t oc- 4
P
Poone No:
Approved per applicable codes. Corrections required prior to approval.
LAMENTS:
4 $5 .00 REINSPECTION FEE SQUIRED. P 'or to inspection, fee must be
id at 6300 Southcenter Bl ., Suite 10 . Call to sechedule reinspection.
Receipt No.: Date:
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INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Project:
cri es I" Pr1 e
Type of Inspect
& Y ii &&
Address*
ym 6 .5 11 � .S-e'
Date Called:
oq s'
Special Instructions:,
Date Wanted:/o`/`p.3
j P.
cli J! ) hG(�l r pr► a 'r
Requester:
e ve.-i
Phone No:
Inspector: f+ Date: ` C
(� 0 3 v
$58.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to sechedule reinspection.
Receipt No.: Date:
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���Approved per applicable codes. Corrections required prior to approval.
G & N Septic Tank Service
37201 Military Road 19
Auburn, Washington 98001
(253) 838 -1028 or (253) 927 -2860
www.gnseptic.com
DATE ° �� / 20
� `
ADDRESS
CITY l�.I I � a_l f �=- STATE � �
DESCRIPTION OF SERVICES, ETC.
AMOUNT
�i. �i -
TOTAL
SALES TAX
TOTAL AMT.
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FA
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If this account is not paid as agreed, I agree to pay in addition to the
foregoing, a reasonable attorney's fee, or if this account is placed in the
hands of a collection agency, I acknowledge that you will be damaged
thereby to the extent of the collection charge against you and 1 therefor t
agree to pay you, as liquidated damages, an amount equal to the amount i
charged you on said collection by said collection agency, not exceeding
50% fifty percent of the amount unpaid thereon, and also a reasonable '
attorney's fee.
Customer '
Phone Number
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r General/Specialty Contractor ........... �. y_.._r....... �. ��_,_.._ �...r ..........,_,�_...�_.�.....__.. _.._._._..... �...._. �....._ _._._�__A..._._..,.......�._._�
A business registered as a construction contractor with LEH 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
COBBLC "033BM
Licensee Name
COBBLESTONE COMPANY, THE
Licensee Type
CONSTRUCTION CONTRACTOR
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UBI
601758979 Verify Workers Comp Premium
Status
Ind. Ins. Account
Id
Business Type
CORPORATION
Address 1
PO BOX 77219
Address 2
= City
SEATTLE
County
KING
State
WA
Zip
98177
j Phone
2063656595
Status
ACTIVE i
Specialty 1
CONCRETE
Specialty 2
EXCAVATION /GRADING
Effective Date
1/14/1997
Expiration Date
11/10/2005
Suspend Date
Separation Date
Parent Company
Previous License
C0BBLC066CZ
Next License
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