HomeMy WebLinkAboutPermit 6305 - Jan West Homes / Brigadoon - Single Family Residence DemolitionTYPE OF CONST.: N/A UBC EDITION (year) 1988
SETBACKS: N - S - E-
W_
(through
public Works
FIRE PROTECTION:
❑Sprinklers ❑ Detectors L] N/A
UTILITY PERMITS REQUIRED? ❑x Yes ❑ No
ZONING:
BAR /LAND USE CONDITIONS? ❑ Yes
a) No
CONDITIONS (other than those noted on or attached to permit/plans)
WA. ST. CONTRACTOR'S LICENSE # RODARI225D9
EXP. DATE 3/91
ARCHITECT
ESM, Inc.
MI AI
ADDRESS
941 Powell Street S.W., suite 100, Renton, WA
- -•p -- v •► 'i --
Jan Wes Homes
.irel..
343 -5237
ADDRESS 1420 Fifth Avenue, Suite 2200, Seattle, WA
ZIP 98101
CONTRACTOR Rodarte Construction, Inc.
PHONE 939 -0532
ADDRESS 2118 A Street S . E. , Auburn, WA
ZIP
98002
WA. ST. CONTRACTOR'S LICENSE # RODARI225D9
EXP. DATE 3/91
ARCHITECT
ESM, Inc.
PHONE
228-5628
ADDRESS
941 Powell Street S.W., suite 100, Renton, WA
ZIP
9805
CITY OF TUKWILA
Dept. of Community Development- Building Division
6300 Southcenter Boulevard, Tukwila WA 98188
(206) 431 -3670
BUILDING
PERMIT NO. CQ 3 c S"
DATE ISSUED:
SIT
PROJECT NAME/TENANT Brigadoon - Jan Wes Homes ASSESSOR ACCOUNT # 115720 - 0200 -03
TYPE OF ❑ New Building Li Addition Li Tenant Improvement (commercial) (x) Demolition (building) LI Grading/Fill
WORK: ❑ Rack Storage ❑ Reroof ❑ Remodel (residential) ❑ Other:
DESCRIBE WORK TO BE DONE:
c'O[)F (701 PI IANCF=
USE
FLOOR4
TOTAL
SQUARE
FEET
APPROVED FOR
ISSUANCE BY:
CERTIFICATE OF
OCCUPANCY NO.
OCC.
LOAD
I 1-- 1-I -90
14949 57 Av S
Demolition of one single family residence.
SQUARE
FEET
11
I hereby certify that I have read and examined this permit and know the same to be true and correct. All provisions of lay
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 regulating
construction or the performance of work. I am authorized to sign for and obtain this building permit.
SIGNATURE: ,ii',% ,,�/ DATE: /f f'/ 70
OCC.
LOAD
SQUARE
FEET
PRINT NAME: C l of N k J p COMPANY:
BUILDIN PERMIT
(POST WITH INSPECTION CARD AND PLANS
IN A CONSPICUOUS LOCATION)
OCC.
LOAD
BUILDING PERMIT: FEE
PLAN CHECK:FEE.
BUILDING SURCHARGE."
OTHERt ::.
TOTAL
30.00
I pLAN CHECK NO.:
90 -463
i
SQUARE
FEET
OCC.
LOAD
BUILDING
OFFICIAL
DATE ISSUED:
SQUARE
FEET
DATE: /4
OCC.
LOAD
C
TOTAL
SQUARE FEET
5,000.00
gcrt 0 4
TOTAL
OCC. LOAD
This per it 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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CONSULTANT: Data Sent - Date Approved
BUILDING -
initial review
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( RO 0)
DATE NOTIFIED
F IRE
O PLANNING
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FIRE PROTECTION: ( j Sprinklers fl Detectors P(N/A
FIRE DEPT. LETTER DATED: /V e- INSPECTOR: Sf Z.
INIT:
ZO I<<: - • - TIND SE • EDIT • S? Yes v •
REFERENCE FILE NOS.:
INIT:
MINIMUM SETBACKS: N- S- E- W-
k. U B L I C
WORKS
I I -14 ,14
11 � l
UTILITY PERMITS REQUIRED? Q� Yes l f No
PUBLIC WORKS LETTER DATED: j 1 0, Arlo
WIT'
TOTAL
SQUARE FEET
O OTHER
INIT:
BUILDING -
final review
o
ll -I4- 10
1-1 �, 0
TYPE OF CONSTRUCTION: UBC EDITION (year):
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PERMIT NO.
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DATE NOTIFIED
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PERMIT EXPIRES
2nd NOTIFICATION
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AMOUNT OWING
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3RD NOTIFICATION
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PLAN CHECK
NUMBER
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REVIEW COMPLETED
� BUILDINGIPERMIT
APPLICATION TRACKING
INSTRUCTIONS TO STAFF
• Contacts with applicants or requests for information should be summarized in writing by staff so that
any time the status of the project may be ascertained.
• Plan corrections shall be completed and approved prior to sending on to the next department.
• Any conditions or requirements for the permit shall be noted on the plans or summarized concisely
in the form of a formal letter or memo, which will be attached to the permit.
• Please fill out your section of the tracking chart completely. Where information requested is not
applicable, so note by using "N /A ".
BUILDING SQUARE FOOTAGE/OCCUPANCY INFORMATION
(to be filled out by Plan Checker)
DEPARTMENTAL REVIEW
"X" in box Indicates which departments need to review the project.
CITY OF TUKWILA
Department of Community Development - Building Division
6300 Southcenter Boulevard, Tukwila WA 98188
(206) 431 -3670
PLAN CHECK q NUMBER n-f.)
AF'F'! I(CA TION Alt/ k; 1 ilf
F I I I F f) OUT f 1 1 1 Y
SUITE #
VALUE OF CONSTRUCTION - $
5 000
SITE ADDRESS
PROJECT NAME/TENANT
r1 9(000 ()C f- JA ii LO2d Funk()
TYPE OF Li New Building Li Addition L. Tenant Improvement (commercial)
WORK: 0 Rack Storage 0 Reroof 0 Remodel (residential) 0 Othe
DESCRIBE WORK TO BE DONE: Rernova\ o r / '' h 0 '-t5 nck a I l =o1/4A-rCia -f-c oi^S
ASSESSOR ACCOUNT #
/157x06 ,2 U0 - (
Demolition (building)
BUILDING USE (office, warehouse, etc.)
NATURE OF BUSINESS:
WILL THERE BE A CHANGE IN USE? U No U Yes IF YES, EXPLAIN:
SQUARE FOOTAGE - Building:
Tenant Space:
Area of Construction:
WILL THERE BE STORAGE OR USE OF FLAMMABLE, COMBUSTIBLE OR HAZARDOUS MATERIALS IN THE
BUILDING? 0 No 0 Yes IF YES, EXPLAIN:
PROPERTY OWNER �, PHONE
`� 00 Sea lf1 . izI P9C9/ v1
ADDRESS c 7
(tr E . ons\- cu( \-I of (PHONE sC _as c�-
F1 ;\_ 4-c-06600 iz I 9 v0�-
WA. ST. CONTRACTOR'S LI CENSE # r. 9 0, J goon p b9 EXP. DATES /c
ARCHITECT c c. PHONE c Ei '._,s — zo a
ADDRESS F - I "" � >l '� `= s(,) A.4* I DC) lZIP °1 gas
CONTRACTOR
ADDRESS 1
BUILDING OWNER SIGNyj U0Wr� �,c,�ST 1,/Z -- /,
OR �K mil`
AUTHORIZED PRINT NAME 79/W � ' D � Y _ It /
AGENT ADDRESS 2 /,/ /9 sT
DATE APPLICATION ACCEPTED
CONTACT PERSON j" - 94J/( A) /d4f T -
BUILDIN:a PERMIT
APPLICATION
DESCRIPTION
BUILDING PERMIT >'FEE
PLAN CHECK FEE < < ><
BUILDING :SURCHARGE
OTHER:
AMO.UNT: RCPT. *:
TOTAL: >«
}E7K1kM.1
...............
( H
APPLICATION SUBMITTAL In order to ensure that your application is accepted for plan review, please make sure to fill
out the application completely and follow the plan submittal checklist on the reverse side of this form. Handouts
are available at the Building counter which provide more detailed information on application and plan submittal
requirements. Application and plans mist be c' mp!ctt: !t: crdor to be accepted for p■ei fevIuw.
VALUATION OF CONSTRUCTION Valuation for new construction and additions are calculated by the Department of
Community Development prior to application submittal. Contact the Permit Coordinator at 431 -3670 prior to
submitting application. In all cases, a valuation amount should be entered by the applicant. This figure will be
reviewed and is subject to possible revision by the Building Division to comply with current fee schedules.
BUILDING OWNER / AUTHORIZED AGENT If the applicant is other than the owner, registered architectengineer, or
contractor licensed by the State of Washington, a notarized letter from the property owner authorizing the agent
to submit this permit application and obtain the permit will be required as part of this submittal.
EXPIRATION OF PLAN REVIEW Applications for which no permit is issued within 180 days following the date of
application shall expire by limitations. The building official may extend the time for action by the applicant for a
period not exceeding 180 days upon written request by the applicant as defined in Section 304(d) of the Uniform
Building Code (current edition). No application shall be extended more than once.
If you have any questions about our process or plan submittal requirements, please
contact the Department of Community Development Building Division at 431 -3670.
DATE APPLICATION EXPIRES
- c - c,1
DATE
/0/D*
PHONE 9: 3 7_ ��- `; ?.
CITY /ZI PA /ege c 7 e
PHONE
COMMERCIAL
NEW CONMER AL BU LDINOa/ADOIY1
Complatsd bulldog pmt appifali on i
Assessor A000unlNumber
Two lets (2) of Iha foliowfn�
$p.oiffoations
............. ...............
:RACK'STO AGE:.:
mp sled. bugdinp permit'+ •
iuor Account.Number
ntirfa: wtia±► rahitrs well t�1li
omions ol:�M
s.floof p
•.:Roof plan : `: >'::'
• Bulldog elevations: (oft vivo
• Building aoos- saotion<
• Structural fronsing plans
Washington. State Energy .Code
Coinpiralod utility pamtit
Six : (6) s of sits pions showing
i>tih o�ou7cns
......... ...............................
Sauobural C wet en stamped .':
a pinagr (rN ab►apb and owl
RESIDENTIAL
I N+3 L•FAMILY DWfEL1J G>RIAQDIZfOti
SSlBMITTAL CHECKLIST
Mont. 11Dr: A00r':iiild `Celia
y pqa d s to r ur
lyy work /s b br►'darar,:
Welk is :l .
!R $AAL... T 1MP OVEM
PROJECT: r',- { °. - itato/i -- 1L.. -, /. S "4
PERMIT NO. 6 c"cr.),5
SITE ADDRESS: e.--7 G 7 C.,
f
DATE CALLED:
TYPE OF INSPECTION: �-�", , 1 ' � , a
DATE WANTED:
•.m.
2 --- 47-- .,-- `- 2 y D. m,
REQUESTER:
SPECIAL INSTRUCTIONS:
PHONE NO.:
INSPECTION RESULTS /COMMENTS: --- - -._.
—..__ /
r
U G�i'. �l,C,�Q.c%L
✓ /
_ f
INSPECTOR: . �, ,E' .4—.-4,-74—,
�
DATE:
Z.-�
�
..
CITY OF TUKWILA
Dept. of Community Development - Building Division
Phone: (206) 431 -3670
INSPECTI64 RECORD
6300 Southcenter Boulevard — #100
Tukwila Washington 98188
CITY OF TUKWILA
6200 SOUTHCENTER BOULEVARD, TUKWILA, WASHINGTON 98188
Plan Check #90 -463: Brigadoon - Jan Wes Homes
14949 57 Av S
THE FOLLOWING COMMENTS APPLY TO AND BECOME PART OF THE APPROVED
PLANS UNDER TUKWILA BUILDING PERMIT NUMBER Co 30S .
1. No changes will be made to the plans unless approved by
the Architect and the Tukwila Building Division.
2. All permits, inspection records, and approved plans shall
be posted at the job site prior to the start of any
demolition.'
PHONE # (206) 433.1800 Gary L. VanDusen, Mayor
Validity of Permit. The issuance of a permit or approval
of plans, specifications and computations shall not be
construed to be a permit for , or an approval of, any
violation of any of the provisions of this code or of any
other ordinance of the jurisdiction. No permit presuming
to give authority or violate or cancel the provisions of
this code shall be valid.
"X"
REQUIRED INSPECTIONS
PHONE
DATE
APPROVED
INSPECT.
INITIALS
DATE(S)
CORRECTION NOTICE ISSUED
1 Footings
431 -3670
2 Foundation
431 -3670
3 Slab and /or Slab Insulation
431 -3670
4 Shear Wall Nailing
431 -3670
5 Roof Sheathing Nailing
431 -3670
6 Masonry Chimney
431 -3670
7 Framing
431 -3670
8 Insulation
431 -3670
9 Suspended Ceiling
431 -3670
10 Wall Board Fastening
431 -3670
11
12
13
14 FIRE FINAL lnsp:
575 -4407
15 PLANNING FINAL
431 -3670
X
16 PUBLIC WORKS FINAL
431 -3670
X
17 BUILDING FINAL
431 -3670
IINRPFCTOR CC)MMFNT .SF(TI<)N ON RFVFR.SF)
CITY OF TUKWILA
Department of Community Development - Building Division
6200 Southcenter Boulevard, Tukwila WA 98188
(206) 431 -3670
SITE ADDRESS:
1
14949 57 Av S
OTHER AGENCIES:
BUILD'1G PERMIT
INSPECTION RECORD
(Post with Building Permit in conspicuous place)
SUITE NO.:
BUILDING
PERMIT NO. � p
DATE ISSUED: I i ` 1. Q
PROJECT:
Brigadoon - Jan Wes Homes
CALL FOR INSPECTIONS AT LEAST 24 HOURS IN ADVANCE
INSPECTION PROCEDURES AND REQUIREMENTS
All approved plans and permits shall be maintained available on the site in the same location.
1. FOOTING - When survey stakes and forms are set and rebar is tied in place.
2. FOUNDATION - When forms and rebar are in place.
3. SLAB - If structural slab or if underslab insulation is required.
4. SHEARWALL NAILING - Prior to cover.
5. ROOF SHEATHING NAILING - Prior to cover.
G. MASONRY CHIMNEY - Approximately midpoint.
7. FRAMING - After rough -in inspections such as mechanical, plumbing, gas piping, electrical and fire stopping is in place.
3. INSULATION - After framing approval, but before installation of wallboard. Baffles must be installed to keep attic
ventilation points clear.
9. SUSPENDED CEILING - Fasten diffusers, lights and seismic bracing.
10. WALL BOARD FASTENING - Prior to taping (see UBC Chap. 47 and Table 47G).
11.
12.
13.
14. FINAL FIRE INSPECTION - Contact Fire Department for their requirements.
15. FINAL PLANNING INSPECTION - Contact Planning Department for their requirements.
16. FINAL PUBLIC WORKS INSPECTION - Contact Public Works Department for their requirements.
17. FINAL BUILDING INSPECTION - When all work, corrections, reports and other inspections are complete.
Plumbing (including gas piping) — King County Health Department — 296 -4732
Electrical — Washington State Department of Labor and Industries — 277 -7272
A preconstruction meeting with the Building Inspector may be scheduled prior to starting the job by
contacting the Department of Community Development, Building Division at 431 -3670. Although not
required, a Meeting of this type can often eliminate problems, delays and misunderstandings as the
project progresses.
05/17/90
w
October 10, 1990
Dear Sirs:
Jan - Wes Homes, Inc.
941 Powell Avenue S.W.
Suite 100
Renton, Wa. 98055
RE: Proposed Demolition of Two Single Family Structures at
14949 57th Avenue South /14951 57th Avenue South
Per our phone conversation on 10/5/90 you have requested the
demolition of two (2) single- family structures at 14949 57th Avenue
South (Rockwell 3/4" water meter, Account No. 02 -0170) and 14951 57th
Avenue South (Rockwell 3/4" water meter, Account No. 02 -0190. You
are requested to contact Duane Griffin, Building Official at 431 -3675
to obtain the necessary demolition permit application forms.
Also, for the abandonment of these two water meters and services you
will apply for and obtain the following two permits by calling Denise
Millard, Permit Coordinator at 431 -3672:
1. Water Meter /Service Line Abandonment at 14949 57th Avenue South
(Permit Fee = $25.00)
2. Water Meter /Service Line Abandonment at 14951 57th Avenue South
(Permit Fee = $25.00)
As the first order of business and as part of this abandonment
the Developer shall call Dave Grage, Tukwila City Shops, at
433 -1863, to have the City's water meter removed.
The abandonment of these water meters shall be per the
requirements of the City's inspector and the service lines shall
abandoned at their connection to the main in 57th Avenue South.
The Developer shall work with Dave Grage and the City's inspector
to have these service lines field located and capped per the
City's Development Standards and the requirements of the City's
inspector.
If you have
433- 0179.
Sincerely,
.or
Phil Fraser, Senior: Engineer
Public Works Department
xc: Dave Grage
4u Greg Villanueva
Permit Coordinator
Finance Department
Building Official
Development File: Brigadoon - Jan Wes Homes
Stuart Lee Scheuerman - ESM, Inc.
PF /amc :7 :Brig2
any questions regarding this matter please call me
at
"X"
REQUIRED INSPECTIONS
1 Footings
2 Foundation
3 Slab and/or Slab Insulation
4 Shear Wall Nailing
5 Roof Sheathing Nailing
6 Masonry Chimney
7 Framing
8 Insulation
9 Suspended Ceiling
10 Wall Board Fastening
11
12
13
14 FIRE FINAL Inep:
15 PLANNING FINAL
y 16 PUBLIC WORKS FINAL
X 17 BUILDING FINAL
PLAN CHECK
UMBER
THE FOLLOWING COMMENTS APPLY TO AND BECOME PART OF THE APPROVED PLANS UNDER
TUKWILA BUILDING PERMIT NUMBER
O
0
O
O
14
1s
16
17
PROJECT: 1 3 ( I
21
a400n
No changes will be made to the plans unless approved by the
Architect and the Tukwila Building Division,
Plumbing permit shall be obtained through the King County Health
Department and plumbing will be inspected by that agency,
including all gas piping (296-4732).
Electrical permit shall be obtained through the Washington State
Division of Labor and Industries and all electrical work will be
inspected by that agency (872- 6363).
All mechanical work shall be under separate permit through the
C' ty of Tukwila.
All permits, inspection records, and approved plans shall be
posted at the job site prior to the start of any - pemotCrIdl4
When special inspection is required either the owner, architect or
engineer shall notify the Tukwila Building Division of appointment
of the inspection agencies prior to the first building inspection.
Copies of all special inspection reports shall be submitted to the
Building Division in a timely manner. Reports shall contain
address, project name and permit number of the project being
inspected.
O 7 All structural concrete to be special inspected (Sec. 306, UBC),
O 8 All structural welding to be done by W.A.8.0. certified welder and
special inspected (Sec. 306, UGC).
I All high - strength bolting to be special inspected (Sec. 306, UBC).
10 Any new ceiling grid and light fixture installation is required to
meet lateral bracing requirements for Seismic Zone 3.
11 Partition walls attached to ceiling grid must be laterally braced
if over eight (8) feet in length.
12 Readily accessible access to roof mounted equipment is required.
l3 Engineereed truss drawings and calculations shall be on site and
available to the building inspector for inspection purposes.
Documents shall bear the seal and signature of a Washington State
Professional Engineer.
Any exposed insulations backing material to have Flame Spread
Rating of 23 or less, and material shall bear identification
showing the fire performance rating thereof.
Subgrade preparation including drainage, excavation, compaction,
and fill requirements shall conform strictly with recommendations
given in the soils report prior to final inspection (see attacned
procedure,).
A statement from the roofing contractor verifying fire retardancy
of roo4 Wi11 be required prior to final inspection (see attached
procedure).
All construction to be done in conformance with approved plans and
requirements of the Uniform Building Code (1988 Edition), Uniform
Mechanical Code (1988 Edition), Washignton State Energy Code (1989
Edition), and Washington Stair Regulations for Barrier Free
Facility (1989 Edition).
All food preparation establishments must have King County Health
Department sign -off prior to opening or doing any food processing.
Arrangements for final Health Department inspection should be made
by calling King County Health Department, 296 -4787, at least three
working days prior to desire inspection date. On work requiring
Health Department approval, it is the contractor's responsibility
to have a set of plans approved by that agency on the job site.
Fire retardant treated wood shall have a flame spread of not over
25. All materials shall bear identification showing the fire
performance rating thereof. Such identification shall be issued
by an approved agency having a service for inspection at the
factory.
20 Notify the City of Tukwila Building Division prior to placing any
concrete. This procedure is in addition to any requirements for
special inspection.
All spray applied fireproofing as required by U.B.C. Standard No.
43 -0, shall be special inspected.
All wood to remain in placed concrete shall be treated wood.
All structural masonry shall be special inspected per U.B.C.
ection 306 (a) 7,
Validity of Permit. The issuance of a permit or approval of
plans, specifications and computations shall not be construed to
be a permit for , or an approval of, any violation of any of the
provisions of this code or of any other ordinance of the
jurisdiction. No permit presuming to give authority or violate or
cancel the provisions of this code shall be valid.
y
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A CIVIL ENGINEERING, LAND SURVEY, AND PROJECT MANAGEMENT CONSULTING FIRM
November 8, 1990
City of Tukwila
6200 Southcenter Boulevard
Tukwila, WA 98188
RE: Brigadoon - 57th Avenue South
Demolition Permit for Building Nos. 14949 and 14951
To whom it may concern:
I spoke with Dave Koperski of The King County Environmental Health Service
Department on November 8, he stated that there are no requirements for
abandonment of the septic system.
He would recommend that the tanks be pumped then filled. He does not need to
witness anything that is done.
Sincerely,
ESM, INC.
STUA E - CHEUERMAN .
Projec an - . er
s15:ss2
941 Powell Avenue S,W; Suite 100 • Renton, Washington, 98055
206) 228 -5628
KNOW ALL BY THESE PRESENTS:
n
That we, RODARTE CONSTRUCTION, INC.
LICENSE OR PERMIT BOND
PLANET INSURANCE COMPANY, a WISCONSIN
to transact surety business in the State of WASHINGTON
CITY OF TUKWILA
RELIANCE .URANCE COMPANY
PHILADELPHIA, PENNSYLVANIA
UNITED PACIFIC INSURANCE COMPANY
FEDERAL WAY, WASHINGTON
PLANET INSURANCE COMPANY
FEDERAL WAY, WASHINGTON
BOND NO. p 1461435
as Principal(s), and
corporation authorized
, as Surety, are held and firmly bound unto
TWO THOUSAND AND NO /100 , as Obligee, in the penal sum of
2,000.00 ) DOLLARS, lawful money of the United States of America, for the payment of which,
well and truly to be made, we bind ourselves, our heirs, legal representatives, successors and assigns, jointly and severally,
firmly by these presents.
WHEREAS, Principal has applied to the Obligee for a license or permit to do business as
REMOVE AND DISPOSE OF RESIDENCE LOCATED AT 14949 - 57th St. South, Tukwila, WA.98188
NOW THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, That if the said Principal(s) shall comply with all
applicable Ordinances, Rules and Regulations, and any Amendments thereto, then this obligation shall be void, otherwise
to remain in full force and effect.
PROVIDED, HOWEVER, That this bond shall continue in force until:
ig 1 November 6, , 19 91 , or until the expiration date of any Continuation Certificate executed
by Surety, at its sole option.
OR
❑ 2. Cancelled by Surety giving days written notice to Obligee and Principal of its intention to termi-
nate its liability hereunder.
SIGNED AND SEALED this 6th day of November , 19 90
BD -7305 (5/87)
RODARTE CONSTRUCTION, INC.
Principal
INSURANCE COMPANY
By
Mary A. Dons, Attorney -In -Fact
P LA1.TI IN9VRANCIE CC"- 14PA1STY
HEAD OFFICE, MADISON, WISCONSIN
.- POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, That the PLANET INSURANCE COMPANY, a corporation duly organized under the laws of the State
of Wisconsin, does hereby make, constitute and appoint
MARY A. DOBBS of SEATTLE, WASHINGTON
its true and lawful Attorney -in -Fact, to make, execute, seal and deliver for and on its behalf, and as its act and deed
ANY AND ALL BONDS AND UNDERTAKINGS OF SURETYSHIP
and to bind the PLANET INSURANCE COMPANY thereby as fully and to the same extent as if such bonds and undertakings and other writings
obligatory in the nature thereof were signed by an Executive Officer of the PLANET INSURANCE COMPANY and sealed and attested by one other of
such officers, and hereby ratifies and confirms all that its said Attorney(s) -in -Fact may do in pursuance hereof.
This Power of Attorney is granted under and by authority of Article VII of the By -Laws of PLANET INSURANCE COMPANY which became
effective September 21, 1981, which provisions are now in full force and effect, reading as follows:
ARTICLE VII — EXECUTION OF BONDS AND UNDERTAKINGS
1. The Board of Directors, the President, the Chairman of the Board, any Senior Vice President, any Vice President or Assistant Vice President
or other officer designated by the Board of Directors shall have power and authority to (a) appoint Attorneys -in -Fact and to authorize them to execute
on behalf of the Company, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof, and
(b) to remove any such Attorney -in -Fact at any time and revoke the power and authority given to him.
2. Attorneys -in -Fact shall have power and authority, subject to the terms and limitations of the power of attorney issued to them, to execute and
deliver on behalf of the Company, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof.
The corporate seal is not necessary for the validity of any bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory
in the nature thereof,
3. Attorneys -in -Fact shall have power and authority to execute affidavits required to be attached to bonds, recognizances, contracts of indemnity
or other conditional or obligatory undertakings and they shall also have power and authority to certify the financial statement of the Company and to
copies of the By -Laws of the Company or any article or section thereof.
This power of attorney is signed and sealed by facsimile under and by authority of the following Resolution adopted by the Board of Directors of
PLANET INSURANCE COMPANY at a meeting held on the 29th day of March, 1982, at which a quorum was present, and said Resolution has not been
amended or repealed:
"Resolved, that the signatures of such directors and officers and the seal of the Company may be affixed to any such power of attorney
or any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimile signatures or facsimile
seal shall be valid and binding upon the Company and any such power so executed and certified by facsimile signatures and facsimile seal
shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached."
IN WITNESS WHEREOF, the PLANET INSURANCE COMPANY has caused these presents to be signed by its Vice President, and its corporate seal to
be hereto affixed, this 17th day of September 19 86
STATE OF Washington
COUNTY OF King
On this
BOP -1431 1182
17th
day of September
PLANET INSURANCE COMPANY
Vice President
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said Company this
,19 86 , personally appeared Charles B. Schmalz
to me known to be the Vice - President of the PLANET INSURANCE COMPANY, and acknowledged that he executed and attested the foregoing
instrument and affixed the seal of said corporation thereto, and that Article VII, Section 1, 2, and 3 of the By -Laws of said Company, and the Resolution,
set forth therein, are still in full force.
rql
My Commission Expires: May 15 ,19 90 �4; Notary Public in and for State of,/ Washing - n
Residing at Tacoma
I, Lawrence W. Carlstrom , Assistant Secretary of the PLANET INSURANCE COMPANY, do hereby certify that the
above and foregoing is a true and correct copy of • Power of Attorney executed by said PLANET INSURANCr COMPANY, which is still in full force
and effect.
Assistant Secretor
6th day of
November
Lawrence W. Carlstrom
19 90
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PRODUCER
HURLEY ATKINS & STEWART
1800 NINTH AVE #1500
SEATTLE WA 98101
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
EXTEND OR ALTER THE COVERAGE AFFORDED
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K,..f 4 3' �.� 98UE
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DATE
/06 /90
ONLY AND CONFERS
CERTIFICATE DOES NOT AMEND,
BY THE POLICIES BELOW
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER TRANSCONTINENTAL INSURANCE CO.
COMPANY B
LETTER TRANSPORTATION INSURANCE CO.
INSURED
RODARTE CONSTRUCTION INC
2118 A ST S E
AUBURN, WA 98002
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
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BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM /00/YY
POLICY EXPIRATION
DATE (MM /DO/YY
ALL LIMITS IN THOUSANDS
A
GENERAL
LIABILITY
COMMERCIAL GENERAL LIABILITY
406805094
03/24/90
03/24/91
GENERAL AGGREGATE
f 2,000
PRODUCTS- COMP /OPSAGGR
• 1,000
,,•
k) `}
X +V
CLAIMS MAD jOCCUR.
OWNER'S &CONTRACTOR'S PROT.
WA STOP GAP
PERSONAL &ADVERTISING INJURY
$ 1, 000
EACH OCCURRENCE
$ 1,000
X
FIRE DAMAGE (Any ono fire)
S 50
MEDICAL EXPENSE/Any one person
B
AUTOMOBILE
LIABILITY 206805095
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
GARAGE LIABILITY
03
03/24/91
//
COMBINED
LIMIT
; �� • {4 �,s,.`,••. #:
1,000
BODILY
I NJURY
Per person)
X
BODILY
NJURY
Per ace)
;,ts` „Ysr {f # >f;
fI {rrXfr.: :r ,
X
PROPERTY
DAMAGE
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$ :t�!�::;•:
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EXCESS
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OTHERTHANUMBRELLAFORM
F Ft ;� >'t ` %<r,#
M
STATUTORY
EACH
: OCCUR.
AGGREGATE
$
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WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
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” ':
$
(EACH
f
(DISEASE•POLICY LIMIT)
$
(DISEASE -EACH EMPLOYEE
OTH.
DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES /SPECIAL ITEMS
RE: RESIDENCE, 14949 57TH ST. SO., TUKWILA, WA 98188
THE CERTIFICATE HOLDER IS ADDED AS AN ADDITIONAL INSURED BUT ONLY AS RESPECTS
THEIR INTEREST IN THE NAMED INSURED'S OPERATIONS ON THE ABOVE DESCRIBED PROJECT
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CITY OF TUKWILA
6200 SOUTHCENTER BLVD
TUKWILA, WA 98188
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n SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
,' MAIL WRITTEN NOTICETOTHE CERTIFICATE HOLDER NAMED TOTHE
4 : $
?:r LEFT, BUTFAILURETO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
:$ AUTHORIZE TENTATIVE
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EXIST. WATEP METER (TYP,)
EXIST. SIDEWALK
EXIST. 8" CIP WATER MAIN
'EXIST. WATER VALVE (TYP.)
EXIST. FIRE HYDRANT (TYP.)
EXIST. TELEPHONE M.H. (TYP.)
1 EXIST. POWER VAULT (TYP.)
N EXIST. TELEPHONE RISER (TYP.)
*EXIST. STREET LIGHT (TYP.)
- EXIST. STORM
'--- EXIST. STORM DRAIN (TYP.)
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EXIST. CATCH BASIN (TYP.)
STORM DRAIN M.H. (TYP.)
EXIST. JERSEY BARRIER
J .- ---- EXIST. 8" CIP WATER MAIN
EXIST. SANITARY SEWER M.H. (TYP.)
I understand that the Plan Check approvals are
object to errors c,nd omissions and approval of
..ans does not autnorizr' the violation of any
.. ():Jted code or oiC1inar' e. Rec ipt of con
tractor's copy of appro' d plhns acknowledges#
By
D ate .. I- .= -•-.f -_.... -.--
Permit No.
RECEIVED
CITY OF TUKWILA
Nov 9 dal„
PERMIT CENTCR
DWG. NAME HOUSES
DESIGNED BY: • S.S.
JOB NO. 491 —02
DRAWN BY: E.R. /B.A.C.
CHECKED BY: L.T.P.
DATE- 10-18— 90
• DATE OF
PRINT
OF
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