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HomeMy WebLinkAboutPermit D10-006 - MACY'S - LOGISTICSMACY'S LOGISTICS 17000 SOUTHCENTER PY EXPIRED I1 -17 -10 D10-006 Cit;f Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite # 100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Inspection Request Line: 206 - 431 -2451 Web site: http: / /www.ci.tukwila.wa.us DEVELOPMENT PERMIT Parcel No.: 2623049076 Address: 17000 SOUTHCENTER PY TUKW Suite No: Permit Number: D 10 -006 Issue Date: 01/27/2010 Permit Expires On: 07/26/2010 Tenant: Name: MACY'S LOGISTICS Address: 17000 SOUTHCENTER PY , TUKWILA WA Owner: Name: FEDERATED DEPT STORES INC Address: ATTN: TAX DEPARTMENT - SHF , 7 W 7TH ST 45202 Phone: Contact Person: Name: MIKE SORENSEN Address: 1100 SW 7 ST , RENTON WA 98057 Phone: 206 818 -4488 Contractor: Name: NORTH WEST HANDLING SYSTEMS INC Address: 1100 S.W. 7TH STEET , RENTON, WA 98055 Phone: 206 255 -0500 Contractor License No: NORTHWH275JF Expiration Date: 10/09/2011 DESCRIPTION OF WORK: REMODEL OF (9) EXISTING DOCK LEVELER PITS TO FIT LARGER DOCK LEVELERS. PLEASE SEE ATTACHED ENGINEERING FOR DETAILS REGARDING REBAR, CONCRETE, ETC. Value of Construction: $13,500.00 Fees Collected: $945.78 Type of Fire Protection: SPRINKLERS International Building Code Edition: 2006 Type of Construction: Occupancy per IBC: 0025 * *continued on next page ** doc: IBC -10/06 D10 -006 Printed: 01 -27 -2010 City oftukwila Department of Community Development 6300 Southcenter Boulevard, Suite # 100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Inspection Request Line: 206- 431 -2451 Web site: http: / /wwwci.tukwila.wa.us Permit Number: D10-006 Issue Date: 01/27/2010 Permit Expires On: 07/26/2010 Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Fire Loop Hydrant: N Number: 0 Size (Inches): 0 Flood Control Zone: Hauling: N Start Time: End Time: Land Altering: Volumes: Cut 0 c.y. Fill 0 c.y. Landscape Irrigation: Moving Oversize Load: Start Time: End Time: Sanitary Side Sewer: Sewer Main Extension: Private: Public: Storm Drainage: Street Use: Profit: N Non - Profit: N Water Main Extension: Private: Public: Water Meter: Permit Center Authorized Signature: N Date: 041 k,(2 I hereby certify that I have read and ex d this permit and know the same to be true and correct. All provisions of law and ordinances governing this work will be complied wi hether 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 performanc f work. I am authorized to sign and obtain this development permit. Signature: Date: (/.---7/.?:,(C) Print Name: 44 S 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. doc: IBC -10/06 D10 -006 Printed: 01 -27 -2010 Parcel No.: 2623049076 Address: Suite No: Tenant: • City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: http://www.ci.tukwila.wa.us 17000 SOUTHCENTER PY TUKW MACY'S LOGISTICS PERMIT CONDITIONS Permit Number: Status: Applied Date: Issue Date: D10-006 ISSUED 01/14/2010 01/27/2010 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: The special inspections and verifications for concrete construction shall be required. 5: When special inspection is required, either the owner or the registered design professional in responsible charge, shall employ a special inspection agency and notify the Building Official of the appointment prior to the first building inspection. The special inspector shall furnish inspection reports to the Building Official m a timely manner. 6: A final report documenting required special inspections and correction of any discrepancies noted in the inspections shall be submitted to the Building Official. The final inspection report shall be prepared by the approved special inspection agency and shall be submitted to the Building Official prior to and as a condition of final inspection approval. 7: 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. 8: Notify the City of Tukwila Building Division prior to placing any concrete. This procedure is in addition to any requirements for special inspection. 9: 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. 10: 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 ** doc: Cond -10/06 D10-006 Printed: 01 -27 -2010 • City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Fax: 206 - 431 -3665 Web site: http: / /www.ci.tukwila.wa.us 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. 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. Signature: Print Name: /1(162 !'CMG �,I, J 7 Date: / 42- 7/0/0 doc: Cond -10/06 D10 -006 Printed: 01 -27 -2010 CITY OF TUKWILA Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA .98188 http://www.ci.tukwila.wa.us Building Permit No. echanical Permit No. Plumbing /Gas Permit No. Public Works Permit No. Project No. For o� f IQ 6. use only) 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 King Co Assessor's Tax No.: 2.--(4219014 " 1,01 LO Site Address: 11 000 sD u.•/t Ce.1t1.e r- P&irIC h" Suite Number: Floor: / Tenant Name: Ma C i 1s AZ. oo i S"'7 C S New Tenant: ❑ Yes ❑ .. No Property Owners Name: isle. t li `�' 7 . 4a i I k1et iJ i`�Y r 1-o n, - jif r1 / r 4 S Mailing Address: 'c9 6. ya'1 S7 5'74. ..?'9-17 ././€4+/ yo irk /1 Y I 0 ! 6 5 ty State Zip CONTACT PERSON - who do Name: //1 ik 5ramson Mailing Address: 1 ( 00 5. U/ , ? e c E -Mail Address: Vfl SO re'1Son e V)wA s CUs. -, Day Telephone: .O6 " - Li/ gs City Latel- 9805 7 State Zip Fax Number: io?-S' r3ag -- 6 g 171, GENERAL CONTRACTOR INFORMATION — (Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5)) Company Name: N0 r'fiet 1444-S 4 11 91 Mailing Address: /100 5-(A/, 76 S r. Contact Person: X S. 7`p_0415 , ,1 r- E -Mail Address: L/1150C4v) h &, 61,5 . Contractor Registration Number: 4ie- F es- 7 City State Zip Day Telephone: 6 -g /g- `�y a8 Fax Number: i-1„7-.5- c).---K" [} ?'' ; Expiration Date: ARCHITECT OF RECORD - plans must be et s roped by Architect Company Name: Mailing Address: Contact Pers • E -Mail Address: City Day Telephone: Fax Number: State Zip ENGINEER OF RECORD - All plans mus ped by Engineer' of Record Company Name: 1 Lei C s A. s tP �n,Ue"./` Mailing Address: W /9- (4/ • �s � �ct c4 , * o V Contact Person: (3— (17 6794 .44 -, E -Mail Address. H:\ Applications \Forms - Applications On Line\2009 Applications \1 -2009 - Permit Application.doc Revised: 1 -2009 bh City p Day Telephone: 8'/ 8 Fax Number: 2 f 8 C� 9(ao y State Zip a`% �Slo aYv 38/ 3 Page 1 of 6 BUILDING PERMIT INFORMATION — 206-431-3670 Valuation of Project (contractor's bid price): $ / 3, _Soo Existing Building Valuation: $ Scope of Work (please provide detailed information): R5- �.y►7tec�,2_ f d � £.X /If j-(�j do (k: /�,vel r ,If -.r �, / / /4 9e/^ CIDCk‹. (--0 v� C i s . l%e,C sue.. s:3�ie. a 4-cf.d .Q lv i t1 e '/' + y y -P �, 2-�4G (!i r oy q t-d /"iL7 rrLlu ,r eG !1 G r- eje-- ) e-* - -. Will there be new rack storage? ❑ Yes No If yes, a separate permit and plan submittal will be required. Provide All Building Areas in re Footage 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): Floor area of principal dwelling: Floor area of accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Compact: Handicap: Will there be a change in use? ❑ Yes L+7 No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: Liz Sprinklers ❑ Automatic Fire Alarm ❑ None ❑ Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes Tr No If "yes', attach list of materials and storage locations on a separate 8 -1/2 "x 11" paper including quantities and Material Safety Data Sheets. SEPTIC SYSTEM ❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. H:\ApplicationsTo ms- Applications On Line \2009 Applications \1 -2009 - Permit Application.doc Revised: 1 -2009 bh Page 2 of 6 Existing Interior Remodel Addition to Existing Structure New 'type of ' Construction per IBC Type of Occupancy per IBC 1st Floor .oaf 2M1 Floor 3'a Floor Floors ttuu Basement Accessory Structure* Attached Gate Detached Gatage 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): Floor area of principal dwelling: Floor area of accessory dwelling: *Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence. Number of Parking Stalls Provided: Standard: Compact: Handicap: Will there be a change in use? ❑ Yes L+7 No If "yes ", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: Liz Sprinklers ❑ Automatic Fire Alarm ❑ None ❑ Other (specify) Will there be storage or use of flammable, combustible or hazardous materials in the building? ❑ Yes Tr No If "yes', attach list of materials and storage locations on a separate 8 -1/2 "x 11" paper including quantities and Material Safety Data Sheets. SEPTIC SYSTEM ❑ On -site Septic System — For on -site septic system, provide 2 copies of a current septic design approved by King County Health Department. H:\ApplicationsTo ms- Applications On Line \2009 Applications \1 -2009 - Permit Application.doc Revised: 1 -2009 bh Page 2 of 6 PERMIT APPLICATION NOTES — Applicable to all p his 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. Building and Mechanical Permit 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). Plumbing Permit The Building Official may grant one extension of time for an additional period not exceeding 180 days. The extension shall be requested in writing and justifiable cause demonstrated. Section 103.4.3 Uniform Plumbing Code (current edition). +!2 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 OWNER OR AUTHORIZED Signature: Print Name: --icy,- Ca- .4P-pt G.✓1 Mailing Address: % 00 — (AO • 7-' " ST Date: / /g//00/ Day Telephone: 6 ' (e el'O r City State Zip Date Application Accepted: Date Application Expires: Staff Initials: H:\Applications\Foans- Applications On Line\2009 Applications \1 -2009 - Permit Application.doc Revised: 1 -2009 bh Page 6 of 6 Parcel No.: 2623049076 Address: Suite No: Applicant: MACY'S LOGISTICS City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 - 431 -3665 Web site: http://www.ci.tukwila.wa.us 17000 SOUTHCENTER PY TURIN RECEIPT Permit Number: Status: Applied Date: Issue Date: D10-006 ISSUED 01/14/2010 01/27/2010 Receipt No.: Initials: User ID: Payee: R10 -00862 JEM 1165 Payment Amount: $63.00 Payment Date: 05/17/2010 03:03 PM Balance: $0.00 MICHAEL J.SORENSON TRANSACTION LIST: Type Method Descriptio Amount Payment Check Authorization No. ACCOUNT ITEM LIST: Description 6549 63.00 Account Code Current Pmts PLAN CHECK - NONRES 000.345.830 Total: $63.00 63.00 PAYMENT RECEIVED doc: Receipt -06 Printed: 05 -17 -2010 Parcel No.: 2623049076 Address: Suite No: Applicant: MACY'S LOGISTICS City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite # 100 Tukwila, Washington 98188 Phone: 206-431-3670 Fax: 206 - 431 -3665 Web site: http://www.ci.tukwila.wa.us 17000 SOUTHCENTER PY TURIN RECEIPT Permit Number: Status: Applied Date: Issue Date: D10-006 ISSUED 01/14/2010 01/27/2010 Receipt No.: Initials: User ID: Payee: R10 -00178 JEM 1165 Payment Amount: $63.00 Payment Date: 02/03/2010 10:01 AM Balance: $0.00 MICHAEL J SORENSON TRANSACTION LIST: Type Method Descriptio Amount Payment Check Authorization No. ACCOUNT ITEM LIST: Description 6524 63.00 Account Code Current Pmts PLAN CHECK - NONRES 000.345.830 Total: $63.00 63.00 PAYMENT RECEIVED doc: Receiot -06 Printed: 02 -03 -2010 • • City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 - 431 -3665 Web site: http://www.ci.tukwila.wa.us Parcel No.: 2623049076 Address: 17000 SOUTHCENTER PY TUKW Suite No: Applicant: MACY'S LOGISTICS RECEIPT Permit Number: D10-006 Status: APPROVED Applied Date: 01/14/2010 Issue Date: Receipt No.: R10 -00133 Initials: JEM User ID: 1165 Payment Amount: $714.90 Payment Date: 01/27/2010 10:31 AM Balance: $0.00 Payee: MICHAEL J SORENSON TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA - Authorization No. 053113 ACCOUNT ITEM LIST: Description 714.90 Account Code Current Pmts BUILDING - NONRES STATE BUILDING SURCHARGE 000.322.100 710.40 640.237.114 4.50 Total: $714.90 PAYMENr RECEIVED doc: Receipt -06 Printed: 01 -27 -2010 City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -431 -3670 Fax: 206 - 431 -3665 Web site: http://www.ci.tukwila.wa.us RECEIPT Parcel No.: 2623049076 Permit Number: D10-006 Address: 17000 SOUTHCENTER PY TUKW Status: PENDING Suite No: Applied Date: 01/14/2010 Applicant: MACY'S LOGISTICS Issue Date: Receipt No.: R10 -00047 Payment Amount: $230.88 Initials: JEM Payment Date: 01/14/2010 08:44 AM User ID: 1165 Balance: $714.90 Payee: MICHAEL J. SORENSEN TRANSACTION LIST: Type Method Descriptio Amount Payment Check 6519 230.88 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts PLAN CHECK - NONRES 000.345.830 230.88 Total: $230.88 PAYMENT RECEIVED doc: Receiot -06 Printed: 01 -14 -2010 r INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION le-- 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 Project: LAAA 6� S L der ST.: 5 Type of Inspect'on: , iF :nett jj U . 19. A� Address: 117 DOO Sc . ptIcw Date Called: Special Instructions: 0 `eJ prs J : te Wanted � s�( -"l p.m. Requester: Phone No: 2-d C- 30Q --6 `Pi/ ElApproved per applicable codes. Corrections required prior to approval. COMMENTS: 3-i;.N..1 Ins _,,-D vi rte& - x,' Cy1 P 6.:4% C a t■-1 S (' k: ay.) C t --c �,tkr -O&� t J - g9V t 6 t't. 0 u'1�/� 1 iv k k sp ctdi1 Date: ZIr�1 $60.10 REINSPECTION FEE • EOUIRE Prior to inspection, fee must be pal. at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: !Date: INSPECTION NO. INSPECTION RECORD Retain a copy with permit 0/0 -4)6'6 PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 1�- Project: 7 // 2/ Type of Inspection: iw.S -t A `. \-e A ,S 0 e C. I A T 1J e. '. Address: / 7G'eo _S,;r 4(oc,( ✓ Die Called: �' ` Special Instructions: Date Wanted: ,� /s 3 :3f =`� , ��% mom. m. Requester: Phone No: ❑ Approved per applicable codes. Corrections required prior to approval. - COMMENTS: (i 3 (0J-es) kA-so LAeJeJ - iw.S -t A `. \-e A ,S 0 e C. I A T 1J e. '. V A'A 'P 1.�4 1 •f l? r ( /.�..icT' ` e)( \21t-ij e • ..1 )\. 1(.1i, i-t— A (-,,,,...,A k i.,-_,-.0 .c r C, ' ,f,..)`,‘ ,-.-'.'--\ , I, Date: -(d n $60.00 REINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: 'Date: INSPECTION RECORD Retain a copy with permit INSPECT! NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670 0/d — 646° Project: ,4.1,4'r c/ 4 7 /S11 /(7 S Type of Inspection: , 3rr'i 4 /- (),/ ('/p _ Address: /706.5,1)../mfA,/,e-, 747 Date C lied: r' e ktou c. s1.5 0 atGG Special Instructions: Date Wanted: C,2- - ./ -- / © p.m. Requester: i r __ `. Al r G. i-,J r_./ C' 1A' Phone No: 3 -.?;. 5-5' - 5'5'9 y 0 Approved per applicable codes. Corrections required prior to approval. / COMMENTS: te d ,1 4 p 10 di V 0 A, . 1- e ' is e /C L-£ U P.A ef,i- ..--- 1i/)!' 0 �or 5peei I,JL'Jo, e �.%.A AC o-4. e iU% i r __ `. Al r G. i-,J r_./ C' 1A' 7 I _ t Lie 1 - A)----1-7-A- t n 10 A l..-f (iriorf q q) 1/3,,A, '" i C J:' 1: e ,-,.. pi: i t I • -t-7) pRR ��. //��� QQQ .mil V t , • //� �, "* GV Inspe or: 61),...A Date: Z r I 0 $60.00 REINSPECTION FEE REQUIRE ' . Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. Receipt No.: Date: OTTO ROSENAU & ASSOCIATES, INC. Geotechnical Engineering, Construction Inspection & Materials Testing Job Number: 10 -0080 CONCRETE REPORT Report Number: RC114153 Permit Number: D 10 -006 Project: Macy's Distribution Address: 17000 Southcenter Pkwy, Tukwila Inspector(s): Zack Ring Description /Location: Resteel Verified: Yes Client: NW Handling Systems Address: 1100 SW 7th Street, Renton Date: 2/8/2010 R"CEiyeD FEB 2 5 2010 OOP Inspected reinforcing steel and concrete placement for loading dock extension infills. Concrete was placed at the following south side loading docks 7, 8, 9, 22, 23, 24, 25, 26, 27. Concrete and reinforcing steel was placed per permit documents revision 1 dated 1/28/2010. 2/8/2010 Zack Ring (Grade 60) Mfg: Cascade Placement Data Supplier: Mix Number: Slump Spec: W/C Ratio Spec: Air Spec: Total Yards: Placed Via: Consolidated: Miles 02500 4t1" .54 n/a 9.75 Chute Yes Required Strength: 2500 psi Sampling and Testing Data ASTM C 172, C 31 Time Made Cast Samples: 1-4 11:45 am Design p Actual ❑ Batch Weights /Cubic Yard 470# 1520# 1860# 7/8" Slag (lbs): Cement (lbs/type): Fine Agg. (lbs): Coarse Agg. (lbs/size): Coarse Agg. (lbs/size): Coarse Agg. (Ibs /size): Fly Ash (lbs): Water (lbs or gal): Admixtures (specify): Cubic Water Slump Yards Added C 143 9.75 0 gal. 4" 258# 14 oz. POLYHEED 997 Air % Conc.Temp Ambient Truck Ticket C 231 C 1064 Temp No. No. n/a 65 °F 56 °F M091 233389 Weather: Cloudy Slump Range: Air % Range: Date Samples Picked Up: 2/9/2010 Initial Curing Method: ASTM C31, Exclude C31- 12.1.5 Initial Curing Temp: ASTM C31, Exclude C31- 10.1.2 Comments Concrete ticket did not arrive with batch weights, I called batch plant for weights. Corner embed plates were installed per plans. REINFORCING / PLACEMENT: Conforms 5 Does Not Conform COMPRESSIVE TEST RESULTS Specimen Test Number Date 1 2/15/10 = Discarded Tested in general accordance to: Field Cure Age Size Area Weight Max Load Strength Fracture Type (Days) (in.) (Sq.ln.) (Lbs.) (Lbs.) (psi) (other than cone) Copies to: Client 5 Engineer Building Dept ❑ Owner ❑ Contractor Batch Plant ❑ Architect ❑ Others 7 4 x8 12.59 8.8 56,830 4510 ASTMC39 ASTMC617 ❑ ASTMC1231 Technical Responsibility: 0 5 alter Hansen, Project Manager This report applies only to the items tested or reported and is the exclusive property of Otto Rosenau & Associates, Inc. Reproduction of this report except in full, without written permission from our firm is strictly prohibited. 6747 M.L. King Way S., Seattle, Washington 98118 — Phone (206) 725 -4600 or 1- 888 - OTTO -4 -US — Fax (206) 723 -2221 Form No.: ADMIN -62 -04 (Rev 09/06) Page 1 of 1 BY G. OHANIAN RAdK DEOIdN & ENd4INEERINt do. DATE . 2 -8 -10 412 W. BROADWAY. #204 dLENDALE, dA. 91204 SUBJECT. TEL:(818)240 -3810 F®%:(81A)240 -3A13 MACY'S LOGISTIC:5 immwrirrme 17000 SC'UTHCENTER PKWY, TUKWILA, WA. SHEET NO. JOB NO. RD -14601 NO SPECIAL INSPECTION 011 TESTING IS REQUIRED FOR TM1S PROJECT. EXPIRES /t 6 ; Z0 39Cd FILE COPY .- e.. Pk Aft. FR 0 9 2010 PERMIT CENTER — REVIEWED FOR CODE COMPLIANCE Pp FVE FEB 1 1 2010 S City of Tukwila BUILDING DIVISION REVISION . . I 0 -00to N9IS3U >i3d8 ETBE- OPZ -8t8 9Z :EZ 0t0Z /L0 /Z0 By OHANIAN DATE. 1 -10 -10 SUBJECT RAdK DEOI(N & ENC4INEERINGI do. 412 WEpiT BROADWAY, QUITE #204 dLENDALE, dA. 91204 TEL:(818)240 -3810 FAX:(818)240 -3813 SHEET NO. 1 OF 3 JOB NO RD -14601 DOCK LEVELER PIT DITAILS FOR: MACY'S LOGISTICS 17000 SOUTHCENTER PARKWAY TUKWILA, WA. 98188 r- A A EXPIRES 12 -26 -11 EXISTING BUILDING WALL BJ DOCK LEVELER PIT - PLAN VIEW STRUCTURAL NOTES: 1) CONCRETE TO ATTAIN A 28 DAY COMPRESSIVE STRENGTH OF 2500 PSI. 2) REINFORCING SHALL CONFORM TO A5TM A -615 GRADE 40 OR 60. 3) FINAL CONCRETE SURFACES SHALL HAVE A FINISH SIMILAR TO EXISTING SURFACES. 4) PROVIDE A 3" MIN. COVER TO ALL REBAR 5) FOR DIMENSIONS, CURB ANGLES AND INSERT BUMPERS SEE MANUFACTURE'S DRAWING AND SPECIFICATIONS _RE W Fr ED FO CODE COMPLIMNICE wEp.b FEB 0 2 ?Ulii it B City oL jila uILDI� iu►siori RECEIVED JAN 2 8 2010 PERMIT GENTEF REVISION N0,1 bLO OOlo G. OHANIAN DATE. 1 -10 -10 SUBJECT RACK DEOI(N & EN(INEERIN(i CO. 412 WET BROADWAY, QUITE #204 dLENDALE, dA. 91204 TEL:(818)240 -3810 FAX:(818)240 -3813 SHEET NO. 2 JOB NO.. RD -14601 EXISTING FUR. SLAB N 11-11 II; 1 =J 11= .11 iF PIT WALL PIT FLOOR CURB ANGLE PER MANUFACTURER'S RECOMMENDATIONS •4 REBAR, CONTINUOUS, TYP. 5 -•4 REBARS E.U1 O 11 =11 IIIE IL?. 911. = 11.=11=11.= 11.=.11=11.=,11 =.11.= .11 =.11� .11= 11= .11 =11 .11.=11 =.11 J =�.1 SECTION ,4 CURB ANGLE PER MANUFACTURER'S RECOMMENDATIONS NEW PIT WALL •4 REBAR, CONTINUOUS, TYP. 5 - "4 REBARS ElU_ EXISTING FLR SLAB 6" TIN E B. NEW PIT FLOOR &LB W /1/2" SLOPE EXISTING BUILDING WALL SECTION 5 , BY. G. OHANIAN DATE. 1 -10 -10 SUBJECT RAdK DENI(N Sc EN(4INEERINd do. 412 W= T BROADWAY, BUITE #204 LENDALE, dA. 91204 TEL:(818)240 -3810 FAX:(818)240 -3813 SHEET NO 3 JOB NO RD -14601 EXISTING WALL .II:ll �I 11:1111 11 =11 i:IL 11 1 :111111 1=1W- :11=11 1111111: 1etITIL 11.1111i�11. 1:t-11-11-11-11-11 L 11=11. ILJI�F=11 =11aI1 11:11 =11=11: : 11.1L 11:'1.11.j4 - IL -II:: =11=9: 11 - . =11: _l ILA I*110 4 =11.* 1JI: 11.11.11. 11. =11.= 4ir11:0 i1 =11: I1==11=11 =:11 ='.1 =1=1 =1 =11 =11 =11= ':11 =11 =11= x.11 =11= 11 =11 �Ilill. �lli�llill- Hx11- 11o11o11=-1Lo11.-11,oil 71. =11 1. =1L= 1=1aa 11 =11 11:�� II I=ll I:„11 5 - 04 REBARS E.W. NEW PIT FLOOR SLAB CURB ANGLE PER - MANUFACTURER'S RECOMMENDATIONS TOP VIEW m 2 er G. OHANIAN DATE. 1-10 -10 SUBJECT RAdK DEOI(N & ENOINEERIN(t do. 412 WEJIT BROADWAY, QUITE #204 LENDALE, dA. 91204 TEL:(818)240 -3810 FAX:(818)240 -3813 SHEET NO. 1 OF 3 JOB NO.. RD -14601 DOCK LEVELER PIT DITAILS FOR: MACY'S LOGISTICS 17000 SOUTHCENTER TUKWILA, WA. 98188 REVIE MPL A CE CODE CO APPROVED JAN 4 0 2010 City of BUILDIN SEPARATE PERMIT PARKvfUIRED FOR: Mechanical Electrical umbing Gas Piping City of Tukwila BUILDING DIVISION REVISIONS No changes shall be made to the scope of work without prior approval of Tukwila Building Division. NOTE: Revisions will require a new plan submittal and may include additional plan review fees. I FILE C Permit No., D[ V -0C109 OnrAyitupproval is subject to errors and omission Approval of construction documents does not authoria n of any adopted code or ordinance. Receil d Field Copy and conditions is acknowledge( DOCK LEVELER PIT - PLAN VIEW STRUCTURAL NOTES: 1) CONCRETE TO ATTAIN A 28 DAY COMPRESSIVE STRENGTH OF 4500 PSI. 2) REINFORCING SHALL CONFORM TO ASTM A -615 GRADE 40 OR 60. 3) FINAL CONCRETE SURFACES 51-IALL HAVE A FINISH SIMILAR TO EXISTING SURFACES. 4) PROVIDE A 3" MIN. COVER TO ALL REBAR. By Date: W.)-Z ,?-oto City Of lUkwita BUILDING DIVISION CITMEALA JAN 1 2010 PERMIT CENTER BY - G. GHANIAN DATE. 1 -10 -10 SUBJECT RACK DENI(N & EN(INEERIN(4 CO. 412 WET BROADWAY, QUITE #204 LENDALE, dA. 91204 TEL:(818)240 -3810 FAX:(818)240 -3813 SHEET NO 2 JOB NO.. RD -14601 3 "x3 "x1 /4" CURB ANGLE W/5 /8 " +ANCN. 912" O.G. 6" LONG NEW PIT WALL EXISTING FLR SLAB 6" MIN 57115. "4 REBAR, CONTINUOUS, TYP. "4 REBARS 9 9 "o.c. E.W. C7C= 1T. ="1C 11:11.11..1 =11= JI =1== 1 =11 Olt ��111 A p =1u '11 =11=II-11=11=11= 11=IL— :1111 #11 #11 #11=1117411.=11:11011: Il [II=11mIl :11 =11r= X11.= 11=. 11 11.= 11 .= 11.= 11.= 11= 11= 11= 1h-- .11. =1 IIr =11.-' 11 -1 Z °1 EA„. unl. u. NEW PIT FLOOR SLB W /I/2" SLOPE EXISTING BUILDING WALL ''i1SECTION EXISTING FLR SLAB (IT-1—r! E B. 3 "x3 "xI /4" CURB ANGLE W/5 /8 ".ANCN. 9I2" O.C. 6" LONG NEW PIT FLO NEW PIT WALL OR SLB— "4 REBAR, CONTINUOUS, TYP. "4 REBARS 9 9 "o.c. E.W. /'11SECTION A BY G. OHANIAN DATE. 1 -10 -10 SUBJECT RAdK DE$IGIN & ENdINEERIN( do. 412 WET BROADWAY, QUITE #204 LENDALE, dA. 91204 TEL:(818)240 -3810 FAX:(818)240 -3813 SHEET NO 3 JOB NO.. RD -14601 EXISTING WALL I 1 : 1L II IOW 3 "x3 "x1/4" CURB ANGLE W/5 /8 " *ANCH. eI2" O.C. 6" LONG TOF VIEW ro z Shuttle - Saulizide I 0 tne 1:10;1 0:Woe I:4;1 ID) Intel rig OE MEE FES V V 4 CA-5 r wwwc 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 9 11' 345444,44 04949 04001,10043. 000 01 0079 10031441.0134444130330 e 0 • 69 0 • es 0 • ee 0 O ee 0 a 09 0 e ee 0 371 30 a a o • Fur:17n- 0 08 0 a ee REVIEWED FOR CODE COMPLIANCE ApPnovED 2010 sf . W E5- 9 0 0 Ault.) 1,&lobi 3• :: 0L0 .311 317 331 346 440 371 437 311 441 341 .1' 34115 30 at 410 Egilik V. 330 4.4.• 307 II 130 EF1E - (MI iai IEEE OE 34501 34451 r— .. 07104330 z 17 coo 41. A:4-e. c 1 kt Lj 430 401 441072 IELE IFEE 374 • * Eal, 44. 317 MON lc 440 30 MI 04* 374 34037733 401 307 0403 INo 53' restriction I 303 441 276 437 4117 431 333 313 37.5 KM KM KM EISE K1E 306 307 !No 5Y restriclion I 3) () I irr'hen cde.--. e ,i--fd A s c•e4A-4.0 RECEIVED art OF TUKWILA JAN 1"Z010 1734043 11113720091223 PI4 PERMIT CENTER oo.... City of Tukwila s c ci,„..fer pc, BUILDING DIVISION OTTO ROSENAU & ASSOCIATES, INC. Geotechnical Engineering, Construction Inspection & Materials Testing Job Number: 10 -0080 CONCRETE REPORT Report Number: RC114153 Permit Number: D 10 -006 Project: Macy's Distribution Address: 17000 Southcenter Pkwy, Tukwila Inspector(s): Zack Ring ix' )4 RECEIVED MAR 2 3 2010 Client: NW Handling Systems Address: 1100 SW 7th Street, Renton Date: 2/8/2010 COMMUNITY DEVELOPMENT Description /Location: Inspected reinforcing steel and concrete placement for loading dock extension infills. Concrete was placed at the following south side loading docks 7, 8, 9, 22, 23, 24, 25, 26, 27. Concrete and reinforcing steel was placed per permit documents revision 1 dated 1/28/2010. Resteel Verified: Yes 2/8/2010 Zack Ring (Grade 60) Mfg: Cascade Placement Data Supplier: Mix Number: Slump Spec: W/C Ratio Spec: Air Spec: Total Yards: Placed Via: Consolidated: Required Strength: Miles 02500 4±1" .54 n/a 9.75 Chute Yes 2500 psi Sampling and Testing Data ASTM C 172, C 31 Time Cubic Made Yards Cast Samples: 1-4 11:45 am Design Cement (lbs/type): Fine Agg. (lbs): Coarse Agg. (lbs/size): Coarse Agg. (lbs/size): Coarse Agg. (lbs/size): Fly Ash (Ibs): Water (lbs or gal): Admixtures (specify): Water Slump Added C 143 Actual ❑ Batch Weights /Cubic Yard 470# 1520# 1860# 7/8" Slag (lbs): 258# 14 oz. POLYHEED 997 Air% C 231 9.75 0 gal. 4" n/a Conc.Temp C 1064 65 °F Ambient Temp 56 °F Truck Ticket No. No. M091 233389 Weather: Cloudy Slump Range: Air % Range: Date Samples Picked Up: 2/9/2010 Initial Curing Method: ASTM C31, Exclude C31- 12.1.5 Initial Curing Temp: ASTM C31, Exclude C31- 10.1.2 Comments Concrete ticket did not arrive with batch weights, I called batch plant for weights. Corner embed plates were installed per plans. REINFORCING / PLACEMENT: Conforms Does Not Conform ❑ Specimen Test Number Date Field Age Cure (Days) COMPRESSIVE TEST RESULTS 1 2/15/10 2 3/8/10 3 3/8/10 4 3/8/10 7 28 Size (in.) 4x8 4x8 28 4x8 28 4x8 Area Weight Max Load Strength Fracture Type (Sq.ln.) (Lbs.) (Lbs.) (psi) (other than cone) 12.59 8.8 56,830 4510 12.58 8.83 76,270 6060 12.58 8.85 83,030 6600 12.58 8.79 75,540 6010 5 5 = Discarded Tested in general accordance to: ASTMC39 Copies to: © Client 0 Engineer 0 Building Dept ❑ Owner ❑ Contractor 0 Batch Plant ❑ Architect ❑ Others ASTMC617 ❑ ASTMC1231 Technical Responsibility: ansen, Project Manager This report applies only to the items tested or reported and is the exclusive property of Otto Rosenau & Associates, Inc. Reproduction of this report except in full, without written permission from our firm is strictly prohibited. 6747 M.L. King Way S., Seattle, Washington 98118 - Phone (206) 725 -4600 or 1- 888- OTTO -4 -US - Fax (206) 723 -2221 Form No.: ADMIN -62 -04 (Rev 09/06) Page 1 of 1 10 -01 -2010 Department of Community Development MIKE SORENSEN 1100 SW 7 ST RENTON WA 98057 RE: Permit No. D10 -006 17000 SOUTHCENTER PY TUKW Dear Permit Holder: Jim Haggerton, Mayor Jack Pace, Director In reviewing our current records, the above noted permit has not received a final inspection by the City of Tukwila Building Division. Per the International Building Code, International Mechanical Code, Uniform Plumbing Code and /or the National Electric Code, every permit issued by the Building Division under the provisions of these codes shall expire by limitation and become null and void if the building or work authorized by such permit has not begun within 180 days from the issuance date of such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work has begun for a period of 180 days. Your permit will expire on 11/17/2010. Based on the above, you are hereby advised to: 1) Call the City of Tukwila Inspection Request Line at 206 - 431 -2451 to schedule for the next or final inspection. Each inspection creates a new 180 day period, , provided the inspection shows progress. -or- 2) Submit a written request for permit extension to the Permit Center at least seven (7) days before it is due to expire. Address your extension request to the Building Official and state your reason(s) for the need to extend your permit. The. Building Code does allow the Building Official to approve one extension of up to 180 days. If it is determined that your extension request is granted, you will be notified by mail. In the event you do not call for an inspection and/or receive an extension prior to 11/17/2010, your permit will become null and void and any further work on the project will require a new permit and associated fees. Thank you for your cooperation in this matter. Sincerely, Bill Rambo Permit Technician File: Permit File No. D10 -006 6300 Southcenter Boulevard, Suite #100 0 Tukwila, Washington 98188 o Phone: 206- 431 -3670 0 Fax: 206- 431 -3665 PERMIT COORD COPY. PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D10 -006 DATE: 02/09/10 PROJECT NAME: MACY'S LOGISTICS SITE ADDRESS: 17000 SOUTHCENTER PY Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # X Revision # 2 after Permit Issued DEPARTMENTS: ?.,4-1 B�ITding hision Public Works Fire Prevention Structural n Planning Division ❑ Permit Coordinator n DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Comments: Incomplete n DUE DATE: 02/11/10 Not Applicable ❑ Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES /THURS ROUTING: Building Please Route ❑ REVIEWER'S INITIALS: Structural Review Required ❑ No further Review Required Kr- DATE: APPROVALS OR CORRECTIONS: Approved Notation: REVIEWER'S INITIALS: Approved with Conditions n DUE DATE: 03/11/10 Not Approved (attach comments) ❑ DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents/routing slip.doc 2 -28 -02 • ?EMITCOORD(OPYS PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D10 -006 DATE: 01 -27 -10 PROJECT NAME: MACY'S LOGISTICS SITE ADDRESS: 17000 SOUTHCENTER PY Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # X Revision # 1 after Permit Issued DEPARTMENTS: 1 ding 'vision Public Works Fire Prevention Structural Planning Division n ❑ Permit Coordinator n DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Comments: Incomplete U DUE DATE: 02-02-10 Not Applicable u Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES /THURS ROUTING: Building Please Route ❑ Structural Review Required ❑ REVIEWER'S INITIALS: No further Review Required DATE: APPROVALS OR CORRECTIONS: Approved Approved with Conditions Notation: REVIEWER'S INITIALS: DUE DATE: 03-02-10 Not Approved (attach comments) DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents/routing slip.doc 2 -28 -02 • PERMIT COORD COPIIO PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D10 -006 DATE: 01 -14 -10 PROJECT NAME: MACYS LOGISTICS SITE ADDRESS: 17000 SOUTHCENTER PY X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # after Permit Issued DEPARTM NTS: ding Division W PP��('� Wor ks' M N /A— \-(O Fire Prevention Structural Stec AJ/A Planning Division Permit Coordinator n DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Comments: Incomplete E DUE DATE: 01-19-10 Not Applicable n Permit Center Use Only INCOMPLETE LETTER MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: LETTER OF COMPLETENESS MAILED: TUES /THURS ROUTING: Building Please Route RI Structural Review Required _ No further Review Required n REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: Approved Notation: REVIEWER'S INITIALS: Approved with Conditions DUE DATE: 02-16-10 Not Approved (attach comments) U DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents/routing slip.doc 2 -28 -02 PROJECT NAME: SITE ADDRESS: KL`�Y-1 W(Sl4i-(lff., PERMIT NO: I) 0 --006 '' ORIGINAL ISSUE DATE: pG 2,1 L (,p REVISION LOG REVISION NO. DATE RECEIVED REVISION NO. DATE RECEIVED STAFF INITIALS ISSUED DATE STAFF INITI S l Dl 11, ,0 a 0 k0 Received by: .0 Summary of Revision: 116- 1� KA f t , 4 , Summary of Revision: rfth) Received by: 1 k e SO REVISION NO. DATE RECEIVED STAFF INITIALS STAFF INITIALS ISSUED DATE STAFF INITIALS m Ot Summary of Revision: a 4-tlw Received by: t , 4 , Summary of Revision: rfth) i G _ � tick, P V Received by: 1 C f yN, lease print) REVISION NO. DATE RECEIVED STAFF INITIALS ISSUED DATE STAFF INITIALS Summary of Revision: Received by: ease print) REVISION NO. DATE RECEIVED STAFF INITIALS ISSUED DATE STAFF INITIALS Summary of Revision: Received by: ease print) REVISION NO. DATE RECEIVED STAFF INITIALS ISSUED DATE STAFF INITIALS Summary of Revision: Received by: (please print) REVISION NO. DATE RECEIVED STAFF INITIALS ISSUED DATE STAFF INITIALS Summary of Revision: Received by: City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Web site: http: / /www.ci.tukwila.wa.us iE vIStUN BMaItwrh Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Date: °' / W P-0 /0 Plan Check/Permit Number: ipl 0 - d 0,6 ❑ Response to Incomplete Letter # ❑ Response to Correction Letter # Revision # 2- after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner ( Project Name: a G y f // Project Address: / 7 0 00 ;� e,� ce—er �4 ,- w Contact Person: ,ice ‘ � SG�-e...sGi-, Phone Number: ?-06-(1>, Summary of Revision: i v t S ell Q 0.4-e4 Gtz-4 I FEB 0 °'E AW CENTER Sheet Number(s): "Cloud" or highlight all areas of revision including date of revision Received at the City of Tukwila Permit Center by: lL' Entered in Permits Plus on H:Wpplications\Forms- Applications On Line \2009-08 Revision Submittal.doc Created: 8 -13 -2004 Revised: 8 -2009 City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206- 431 -3670 Fax: 206 - 431 -3665 Web site: http://www.citukwila.wa.us Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through the mail, fax, etc. Date: l /?.7 /?OIO Plan ChecWPermit Number: DSO -o-6 ❑ Response to Incomplete Letter # ❑ Response to Correction Letter # Er Revision # / after Permit is Issued ❑ Revision requested by a City Building Inspector or Plans Examiner Project Name: /14 i CI C I S t (9,5113'711 _ S Project Address: 170900 STo 4.J-4.1 Geer /2r k w Contact Person: ,Mike. S C'2MSor, Phone Number: ;06 -g'/8 - y�i rV Summary of Revision: Q &lit eer ,OG/ ees, j Cam,, reds.,, rev i9vd Qrt1nfe%';iv . Was 514.6rn i cAeott D!'Igi�►ui�� Lid S / f- n Ler ec,�, ✓ ,/ c/ JAN 272010 PERMIT cENTEA Sheet Number(s): "Cloud" or highlight all areas of revision including date of revision Received at the City of Tukwila Permit Center by: ,� V Entered in Permits Plus on 0 MA\, 0 \applications \forms- applications on line\revision submittal Created: 8 -13 -2004 Revised: Untitled Page • General /Specialty Contractor A business registered as a construction contractor with LEtI 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. Business and Licensing Information Name NORTH WEST HANDLING UBI No. 600051641 SYS INC Phone 4252550500 Status ACTIVE Address 1100 SW 7TH ST License No. NORTHWH275JF Suite /Apt. License Type CONSTRUCTION CONTRACTOR City RENTON Effective Date 4/6/1973 State WA Expiration 10/9/2011 Date Zip 980552939 Suspend Date County KING Specialty 1 GENERAL Business Type Corporation Specialty 2 UNUSED Parent Company Business Owner Information Name Role Effective Date Expiration Date FRANCK, JAMES J Cancel Date 01/01/1980 Bond Amount THOMAS, KEVIN A 6 01/01/1980 815103354822BCM KOSTY, CLARK R Until Cancelled 01/01/1980 Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 6 TRAVS 815103354822BCM 10/01/2001 Until Cancelled $12,000.0010/09 /2001 5 TRAVELERS CASUALTY Et SURETY 8151033548228CM10 /01/200010/01/2001 $6,000.00 01/04/2001 4 UNITED PACIFIC U2160121 10/01/199710/01 /2000 $6,000.00 3 UNITED PACIFIC INS CO U2160121 10/01/199310/01 /1997 $4,000.00 2 FIDELITY a DEPOSIT CO 30132992 04/06/198810/01 /1993 $4,000.00 1 GREAT AMERICAN INS CO 9740689 04/06/198104/06 /1988 Insurance Information Page 1 of 2 Insurance) Company Name Policy Number Effective Expiration Cancel Impaired Amount Received https: // fortress .wa.gov /lni/bbip/Detail.aspx 01/27/2010