Loading...
HomeMy WebLinkAboutPermit D10-172 - LOKEN RESIDENCE - REROOFThis 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. D10 -172 Loken Residence 14253 55th Avenue South RECORDS DIGITAL D- ) EXEMPTION LOG THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION Page # tode Exemption = 8rlef Explanatory DeSclriptiop �t�tutel ule The Privacy Act of 1974 evinces Congress' intent that social security numbers are a private concern. As such, individuals' social security Personal Information — numbers are redacted to protect those Social Security Numbers individuals' privacy pursuant to 5 U.S.C. sec. 5 U.S.C. sec. DR1 Generally — 5 U.S.C. sec. 552(a), and are also exempt from disclosure 552(a); RCW 552(a); RCW under section 42.56.070(1) of the Washington 42.56.070(1) 42.56.070(1) 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 numbers, electronic check numbers, credit Personal Information — expiration dates, or bank or other financial RCW 14 DR2 Financial Information — account numbers, which are exempt from 42.56.230(5) RCW 42.56.230(4 5) disclosure pursuant to RCW 42.56.230(5), except when disclosure is expressly required by or governed by other law. LOKEN RESIDENCE 14253 55 AV S CANCELLED 08/12/10 D10 -172 VILA d�2 906'' z City aftukwila 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.: 0761000190 Address: 14253 55 AV S TUKW Suite No: DEVELOPMENT PERMIT Permit Number: D 10 -172 Issue Date: 07/09/2010 Permit Expires On: 01/05/2011 Tenant: Name: LOKEN RESIDENCE Address: 14253 55 AV S , TUKVVILA WA Owner: Name: LOKEN DAVID W +DEBBIE S Address: 14253 55TH AVE S , TUKWILA WA 98168 Phone: Contact Person: Name: GREG HANSEL Address: 16234 15 AV SW , BURIEN WA 98166 Phone: 206 - 227 -1472 Contractor: Name: HANSEL CONSTRUCTION INC. Address: 11037 19 AV SW , SEATTLE WA 98146 Phone: 206 - 246 -5680 Contractor License No: HANSECI042BH Expiration Date: 10/06/2010 DESCRIPTION OF WORK: REROOF 2100 SQ FT SINGLE FAMILY RESIDENCE. RESHEATH WITH OSB. Value of Construction: Type of Fire Protection: Type of Construction: $3,200.00 V -B Fees Collected: $275.43 International Building Code Edition: 2006 Occupancy per IBC: 0022 * *continued on next page ** doc: IBC -7/07 D10 -172 Printed: 07 -09 -2010 City "Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 - 431 -3670 Inspectio n Req uest Line: 206 - 431 -2451 Web site: http: / /www.ci.tukwila.wa.us Permit Number: D10 -172 Issue Date: 07/09/2010 Permit Expires On: 01/05/2011 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: Storm Drainage: Street Use: Water Main Extension: Water Meter: Permit Center Authorized Signature: Private: Profit: N Private: N Public: Non - Profit: N Public: Date: 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 thi permit does not p sume to give authority to violate or cancel the provisions of any other state or local laws regulating construction or t ;� ,• erformance oYw $rk. I am aut rized to sign and obtain this development permit. Signature: Print Name: Date: 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 -7/07 D10 -172 Printed: 07 -09 -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.: 0761000190 Address: 14253 55 AV S TUKW Suite No: Tenant: LOKEN RESIDENCE PERMIT CONDITIONS Permit Number: D10 -172 Status: ISSUED Applied Date: 07/07 /2010 Issue Date: 07/09/2010 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: 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: 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. 7: 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 -172 Printed: 07 -09 -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 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 construction or the performance of work. Signature: Print Name: l 444( Date: / °( ordinances governing or local laws regulating doc: Cond -10/06 D10 -172 Printed: 07 -09 -2010 CITY OF TUKWIL• Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci. tukw ila.wa.us 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 ** //_�� C King Co Assessor's Tax No.: 0 76,./ 000 / i a Site Address: //25 � `"5�h / t) `7 . T40/ /tom Suite Number: Tenant Name: Property Owners Name: David 9- 13e L4e Mailing Address: 5ei171 t✓ Floor: New Tenant: ❑ Yes ❑..No City State Zip CONTACT .PERSO who do we contact when :your permit'is ready to' issued ;' : Name: %4a 15'x! CO)1 StvaC MC • Day Telephone: 20b-- Mailing Address: /613 ( /S set) (Jr/ lAJ 9ff/ ro City State Zip E -Mail Address: /I CA/11 Ce- CCM .S 7 4 e)271Cd 7 • 4' Fax Number: I-90h CZ7cPICD GENERAL CONTRACTOR INFOR1ViA;TION° ; r (Contractor Information for Mechanical.(pg 4) for Plumbing and Gas Company Name: 1`1/(,� 1/1Sd CC)/ S ±1 /7/1.c, J Mailing Address: I (� 234' 1 S *1 5k) 6 L1 YI (°_/') WA. 9 / 6 Nay) s City State Zip 1 Day Telephone: 0-0 6v ' L) 7 /41 7/- E -Mail Address: M C(571_ S 7 (bilir.iS ri Fax Number: (, /�i ^- / t✓ 56.f C� _ Expiration Date: / e, 1 " /C: Contact Person: Contractor Registration Number: RA J5iE i. /1Y�� / H ::ARCHITECT OF.RE.CORD - hill plans must' be: wet' stamped by At-diked cif Record. • Company Name: Mailing Address: City • Contact Person: Day Telephone: Fax E -Mail Address: ENGINEER OF RECORD - Alt :pl"a'ds ".in st be wet stamped by Engidetr.o Record Company Name: Mailing Address: City Contact Person: Day Telephone: E -Mail Address: Fax Number: H:\ApplicationsTorms- Applications On Line\2009 Applications \I -2009 - Permit Application.doc Revised: 1 -2009 bh State Zip State Zip Page 1 of 6 Valuation of Project (contractor's bid price): $ �O O 1 O Scope of Work (please provide detailed information): C7�L Existing Building Valuation: $ Ctr //Liz— Will there be new rack storage? ❑ Yes �j .. No If yes, a separate permit and plan submittal will be required. 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): 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 ❑ No If "yes ", explain: FIRE PROTECTION /HAZARDOUS MATERIALS: ❑ Sprinklers ❑ Automatic Fire Alarm ❑ 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 -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:1ApplicationslForms- Applications On Linet2009 Applications11-2009 - 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 . ' '-' 15t Floor 9-4 TD 2nd .Floor 3rd Eloor .,Floors . Basement'. .Accessory. Structure' ^ At ached'Garace D'etaehedGarage•: - :' Attached- Caiport -•.. •Detached, Carport . • a s ' - 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 ❑ No If "yes ", explain: FIRE PROTECTION /HAZARDOUS MATERIALS: ❑ Sprinklers ❑ Automatic Fire Alarm ❑ 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 -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:1ApplicationslForms- Applications On Linet2009 Applications11-2009 - Permit Application.doc Revised: 1 -2009 bh Page 2 of 6 • PERMIT APPLICATION NOTES - Applicable to: all pe "rmi<ts ><nahisrappl>icatiolr 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). 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 OW ER OR AUTHORIZED AG r T: Signature: %� Print Name- - /S /1iSe-/ Date: 7-7—/ g).23/. / �/ Day Telephone: .266 L7- 5--.Le- Mailing 0 Address: 7 � ! A / L ? StJ /(J T/r J ) `7 e /h6 City State Zip Date Application Accepted: �_7-f0 Date Application Expires: -7 -11 Sta#1 Initials: Staff H:\ Applications\Forms- Applications On Line \2009 Applications \I -2009 - Permit Application.doc Revised: 1.2009 bh Page 6 of 6 PLUMBING AND GAS PIPIN ERIVIIT INFORMATION'- }2:06=431 PLUMBING AND GAS PIPING CONTRACTOR INFORMATION Company Name: Mailing Address: State zip Contact Person: E -Mail Address: Contractor Registration Number: Expiration Date: City Day Telephone: Fax Number: Valuation of Project (contractor's bid price): $ Scope of Work (please provide detailed information): Building Use (per Int'I Building Code): Occupancy (per Int'l Building Code): Utility Purveyor: Water: Sewer: Indicate type of plumbing fixtures and /or gas piping outlets being installed and the quantity below: Fixture Type: Qty Fixture Type: Qty Fixture Type: Qty Fixture Type: Qty Bathtub or combination bath/shower Bidet Clothes washer, domestic Dental unit, cuspidor Dishwasher, domestic, with independent drain Drinking fountain or water cooler (per head) Food -waste grinder, commercial Floor Drain Shower, single head trap Lavatory Wash fountain Receptor, indirect waste Sinks Urinals Water Closet Building sewer and each trailer park sewer Rain water system — per drain (inside building) Water heater and /or vent Industrial waste treatment interceptor, including trap and vent, except for kitchen type grease interceptors Each grease trap (connected to not more than 4 fixtures - <750 gallon capacity) Grease interceptor for commercial kitchen ( >750 gallon capacity) Repair or alteration of water piping and /or water treatment equipment Repair or alteration of drainage or vent piping Medical gas piping system serving 1 -5 inlets /outlets for a specific gas Each additional medical gas inlets/outlets greater than 5 Backflow protective device other than atmospheric -type vacuum breakers 2 inch (51 mm) diameter or smaller Backflow protective device other than atmospheric -type vacuum breakers over 2 inch (51 mm) diameter Each lawn sprinkler system on any one meter including backflow protection devices Atmospheric -type vacuum breakers not included in lawn sprinkler backflow protections (1 -5) Atmospheric -type vacuum breakers not included in lawn sprinkler backflow protections over 5 Gas piping outlets H WpplicationsJ'orms- Applications On- Line12009 Applications11.2009 Permit Application.doc Revised: 1 -2009 bh Page 5 of 6 wqs City of Tukwila yDepartment 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.: 0761000190 Address: 14253 55 AV S TUKW Suite No: Applicant: LOKEN RESIDENCE RECEIPT Permit Number: D10 -172 Status: PENDING Applied Date: 07/07/2010 Issue Date: Receipt No.: R10 -01254 Payment Amount: $275.43 Initials: WER Payment Date: 07/07 /2010 02:31 PM User ID: 1655 Balance: $0.00 Payee: HANSEL CONSTRUCTION TRANSACTION LIST: Type Method Descriptio Amount Payment Cash Authorization No. ACCOUNT ITEM LIST: Description 275.43 Account Code Current Pmts BUILDING - RES PLAN CHECK - RES STATE BUILDING SURCHARGE 000.322.100 000.345.830 640.237.114 Total: $275.43 164.20 106.73 4.50 doc: Receiot -06 Printed: 07 -07 -2010 Scope of Work: Re -roof at 14253 55th Ave. S., Tukwila, WA Tearing off 21 squares of cedar shake. Resheeting with 7/16 osb using 10d 3" nails over g/" skip sheeting, 6" on edges and 12" on field. Laying 30 Ib. felt and roofing with 21 squares of Pabco Premier 40 yr. - Pewter Gray. Cost for the job: $3,200 Contractor: Hansel Construction, Inc. FILE COPY Permit No. Plan review approval is subject to errors and omissions. Approval of construction documents does not authorize lh„ violation of any adopted code or ordinance. Receipt r/. approved l°i s Copy an. • nditions is acknowledged• By Date: City Of Tukwila BUILDING DIVISION b(O' tlZ REVISIONS No changes shall be made to the scope of work without prior approval of Tukwila Building Division. NOT'=: r?,vis!ons will require a new plan submitt ^! ' ude a ddtional plan rvi',,, . Y REVIEWED FOR - CODE COMPLIANCE APPMVED JUL 0 8 2010 Al— w City of Tukwila BUILDING DIVIfl RECEIVED JUL 07 2010 PERMIT CENTER City of Tukwila Jim Haggerton, Mayor Department of Community Development Jack Pace, Director September 8, 2010 Greg Hansel Hansel Construction, Inc. 11037 19 Ave SW Seattle, WA 98146 RE: Request for Refund Development Permit D10 -172 Loken Reroof —14253 55 Ave S Dear Mr. Hansel, This letter is in response to your request for cancellation of and refund for the above referenced project. The Building Official has reviewed your letter and approved both the cancellation and a full refund. Enclosed is a check in the amount of two hundred seventy -five dollars and forty - three cents ($275.43). If you have any questions you can contact us in the Permit Center at 206 431 -3670. Sincerely, ifekM shall it Te ician File: Permit No. D10 -172 Encl W: \Pennit Centcr\Refimds\Refimds\D10 -172 Pennit Refund.doc 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 - 431 -3670 • Fax: 206 - 431 -3665 CITY OF TUKWILA, WA 98188 -2544 ACCOUNTS PAYABLE CHECK NO. INVOICE NUMBER .: �` : GATE - ., P.O. NUMBER, - - -. • ... \• . a DESCRIPTION' ' • . - -1• `d' V. - .r, ••''' -. ": , ,^ ;..• 9 T.. -.. "AMOUNT. '.. 090710303 08/17/2010 *' *' * *• "275.43 BLDG PERMITS - RES. 275.43 PLEASE DETACH BEFORE DEPOSITING THE:F.A;;CE,OF,,' THIS 'DOCUMENT `HASA'COLOREW,BACKGROUND 'NOPA WHITE,BACKGROUND , PAY TO THE ORDER .OF CITY OF-TUKWILA 6200 Southcenter Boulevard Tukwila WA 98188 -2544 PAYABLE THROUGH . U 9. BANK 151 Andover Park East `... . Tukwila,. WA 88188 19-10 1250 "1-,V ,L vENDORS%1"� �a NUNIBFF3 . DATE, "", CHECK r r NUMBER • ri ''' '; t CNECICrAM0UN7S.F:'t, :«era « -lu+w 012594 .: 09/07/2010 .. *' *' * *• "275.43 Two Hundred Seventy Five Dollars and Forty Three Cents HANSEL CONSTRUCTION INC 11037 - 19TH AVE SW SEATTLE, WA 981.46 • ti :,;THE.BACK.OF;, THIS, DO CUMENT:HAS?AN!'ART,IFICIAL'• WATERMARK= ;HOLD AT .:ANANGL'`EtSOVIEW TO: FROM: DATE: SUBJECT: MEMORANDUM Laurie Anderson Jennifer Marshall 08/17/2010 Loken Reroof, 14253 55 Av S Permit Number D10 -172 Please draw a check in the amount of $275.43 (two hundred seventy -five dollars and forty -three cents) to be payable to Hansel Construction, Incorporated at 11037 19 Ave SW, Seattle WA 98146. The scope of the work ended up not involving the structural diaphragm of the roof and consequently no permit was needed. The permit has been cancelled and the Building Official has directed a 100% refund of the plan review and building permit fees. The account numbers and refund amounts are as follows: 000.322.100 (Building Permit, Residential) for the amount of $164.20 000.345.830 (Plan Check, Residential) for the amount of $106.73 640.237.114 (Washington State Surcharge) for the amount of $4.50 Please forward the check to me and I will forward it on to the applicant. Thank you! August 10, 2010 City of Tukwila Community Development Attn: Bob Benedicto 6300 Southcenter Blvd. #100 Tukwila, WA 98188 RE: Permit No. D10 -172 Loken Residence 14253 55th Ave S, Tukwila, WA Mr. Benedicto: Upon inquiring of a permit with the building department, we were told a roof permit was necessary for this project. Apparently because the structural diaphragm of the roof did not change this permit was not necessary. We are requesting a full refund of all fees at this time. Please either reimburse David Loken directly or Hansel Construction, Inc. Thanks for your time. Greg Hansel Hansel Construction, Inc. cc: Loken's (JA 74A" og/OD /D 2'lS.* • • PLAN K VIEW /ROUTING SLIP ACTIVITY NUMBER: D10 -172 DATE: 07 -07 -10 PROJECT NAME: LOKEN RESIDENCE SITE ADDRESS: 14253 55 AV S X Original Plan Submittal Response to Incomplete Letter # _ Response to Correction Letter # Revision # After Permit Issued DEPARTMENTS: ilding Division mi Public Works n AIM NA- lit 0 Fire Preve tion Structural Planning Division Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Comments: Incomplete DUE DATE: 07-08-10 Not Applicable Permit Center Use Only INCOMPLETE LETTER MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: LETTER OF COMPLETENESS MAILED: TUES /THURS ROUTING: Please Route lg Structural Review Required n No further Review Required REVIEWER'S INITIALS: DATE: n APPROVALS OR CORRECTIONS: DUE DATE: 08-05-10 Approved n Approved with Conditions 14 Not Approved (attach comments) n Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: Documents /routing slip.doc 2-28-02 Contractors or Tradespeople Pr ter Friendly Page • General /Specialty Contractor A business registered as a construction contractor with L &I 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 HANSEL CONSTRUCTION INC UBI No. 601663704 Phone 2062465680 Status Active Address 16234 15Th Ave Sw License No. HANSECI042BH Suite /Apt. License Type Construction Contractor City Burien Effective Date 1/8/1996 State WA Expiration Date 10/6/2010 Zip 98166 Suspend Date County King Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Other Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status HANSEC'174NP HANSEL CONSTRUCTION Construction Contractor General Unused 8/17/1983 8/15/1996 Archived Business Owner Information Name Role Effective Date Expiration Date HANSEL, GREG A Payment 01/01/1980 09 -2- 21402 -6KNT UNITED RENTALS NORTHWEST INC InterPlead: No HANSERL, DENISE M Date: 06/08/2009 Amount: $1,820.41 Bond(s): 5E5202 01/01/1980 Dismissed HANSEL, DENISEM Agent 01/01/1980 Bond Information Page 1 of 1 Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 6 CBIC SE5202 09/27/2002 Until Cancelled $12,000.00 10/02/2002 Assignment of Savings Information No records found for the previous 6 year period Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date CBIC INSSE5202 09/27/2003 09/27/2010 $1,000,000.00 09/21/2009 Summons /Complaint Information Cause County Complaint Judgment Status Payment Paid By 09 -2- 21402 -6KNT UNITED RENTALS NORTHWEST INC InterPlead: No KING Date: 06/08/2009 Amount: $1,820.41 Bond(s): 5E5202 Date: Amount: $0.00 Dismissed Date: Amount: Warrant Information No unsatisfied warrants on file within prior 6 year period https: // fortress .wa.gov /lni/bbip /Print.aspx 07/09/2010