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HomeMy WebLinkAboutPermit D11-125 - HOLADAY PARKS - FLOOD DAMAGE REPAIRHOLADAY PARKS 4600 S 134 PL D11 -125 Parcel No.: Address: Suite No: Project Name: City olkukwila 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 4600 S 134 PL TUKW HOLADAY PARKS DEVELOPMENT PERMIT Permit Number: Issue Date: Permit Expires On: D11 -125 05/04/2011 10/31/2011 Owner: Name: Address: Contact Person: Name: NATHANIEL BROWN Address: 980 S HARNEY ST , SEATTLE WA 98108 Contractor: Name: CHARTER CONST INC Address: 980 S HARNEY ST , SEATTLE WA 98108 Contractor License No: CHARTCI171PM Phone: 206 - 382 -1900 Phone: 206 - 382 -1900 Expiration Date: 10/23/2012 DESCRIPTION OF WORK: FLOOD DAMAGE REPAIR. PERMIT ISSUED OVER THE COUNTER PER JIM DUNAWAY. FRAMING, INSULATION, GYPSUM WALLBOARD, CARPET AND SPRINKLER MAIN. Value of Construction: $150,000.00 Type of Fire Protection: SPRINKLERS Type of Construction: V -B Electrical Service Provided by: Fees Collected: International Building Code Edition: Occupancy per IBC: $1,888.90 2009 0008 * *continued on next page ** doc: IBC -7/10 D11 -125 Printed: 05 -04 -2011 Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Fire Loop Hydrant: Flood Control Zone: Hauling: Land Altering: Landscape Irrigation: Moving Oversize Load: N N Number: 0 Size (Inches): 0 Start Time: Volumes: Cut 0 c.y. Start Time: Sanitary Side Sewer: Sewer Main Extension: Private: Storm Drainage: Street Use: Profit: N Water Main Extension: Private: Water Meter: N Permit Center Authorized Signature: I hereby certify that I have read and governing this work will be complie exam with, End Time: Fill 0 c.y. End Time: Public: Non - Profit: N Public: Date: V7 ed this permit and know the same to be true and correct. All provisions of law and ordinances whether specified herein or not. The granting of this permit does not pr • - to give authority to violate or cancel the provisions of any other state or local laws regulating construction or the performance of work. am authorized to sign and obtain this development permit and agree to the conditions attached to this permit. Signature: Date: 5/4///!/) Print Name: This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection. PERMIT CONDITIONS: 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 mechanical work shall be inspected and approved under a separate permit issued by the City of Tukwila Permit Center (206/431- 3670). 4: 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. 5: Insulating materials, where exposed as installed in buildings of any type of construction, shall have a flame spread index of not more than 25 and a smoke development index of not more than 450. Where facings are installed in concealed spaces in buildings of Type III, IV, or V construction, the flame spread and smoke - developed limitations do not apply to facings, that are installed behind and in substantial contact with the unexposed surface of the ceiling, wall or floor finish. doc: IBC -7/10 D11-125 Printed: 05 -04 -2011 6: All construction shall be done in confor with the approved plans and the requirem of the International Building Code or International Residential International Mechanical Code, Washingt to Energy Code. 7: All construction noise to be in compliance with Chapter 8.22 of the City of Tukwila Municipal Code. A copy can be obtained at City Hall in the office of the City Clerk. 8: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building Department (206- 431 - 3670). 9: 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. doc: IBC -7/10 D11-125 Printed: 05 -04 -2011 CITY OF TUKWILA Community Develoilrhent Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.ci.tukwila.wa.us Building PeiOTlo. Mechanical Permit No. Plumbing/Gas Permit No. Public Works Permit No. Project No. (For office 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 Site Address: i' 44::74; S/ 341 lL Tenant Name: 1/a // ,,e Pr& Property Owners Name: 1�sl.Q.' Mailing Address: yl4:2o s /3 4'jPL King Co Assessor's Tax No.: Suite Number: New Tenant: ❑ Yes Floor: / s4 Tw�lv,l� City State Zip CONTACT PERSON — who do we contact when your permit is ready to be issued Name: /(�, �, ,,; ( J0 fire,,,"., Day Telephone: '?a 5'3:) Mailing Address: S'o54,. -114 /4014 _ — E -Mail Address: /1 c,4c foCd .c City State Fax Number: 2 ©(-- Z— o445° IP /08 Zip GENERAL CONTRACTOR INFORMATION — (Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5)) Company Name: Mailing Address: 71 a 564 L.2,4 //4 r� e7 Contact Person: /ticf.Zi,_,,; E -Mail Address: n.c it. 10 • (,e ,r Contractor Registration Number: 5.C.674/4 City 4 4( 5Wo 6 State Zip Day Telephone: Z a, t! ---,limey -43it, Fax Number: 2 d 3P2- a3/SG Expiration Date: ARCHITECT OF RECORD — All plans must be stamped by Architect of Record Company Name: Mailing Address: City Day Telephone: Fax Number: Contact Person: E -Mail Address: State Zip ENGINEER OF RECORD — All plans must be stamped by Engineer of Record Company Name: Mailing Address: City Day Telephone: Fax Number: Contact Person: E -Mail Address: H:\Applications\Forms- Applications On Line\2010 Applications \7 -2010 - Permit Application.doc Revised: 7 -2010 bh State Zip Page 1 of 6 BUILDING PERMIT INFORMATION — 206 - 431 -3670 Valuation of Project (contractor's bid p $ 450.1 O0C1 Scope of Work (please provide detailed information): r�. ;,. 41,e, 2 ,,.�.�;,, . i pet } sfo :,t Existing ilding Valuation: $ Will there be new rack storage? ❑ ....Yes ..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: ta 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 Saf 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 'Npplications\Forms- Applications On Li ne12010 Applications17 -2010 - Permit Application.doc Revised_ 7 -2010 bh Page 2 of 6 Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of . Occupancy per IBC lm Floor 2nd Floor 3rd Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck PLANNING DIVISION: Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq ft): 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: ta 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 Saf 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 'Npplications\Forms- Applications On Li ne12010 Applications17 -2010 - Permit Application.doc Revised_ 7 -2010 bh Page 2 of 6 PLUMBING AND GAS PIPING PERI. INFORMATION — 206 - 431 -3670 PLUMBING AND GAS PIPING CONTRACTOR INFORMATION Company Name: Mailing Address: City State Zip Contact Person: Day Telephone: E -Mail Address: Fax Number: Contractor Registration Number: Expiration Date: Valuation of Plumbing work (contractor's bid price): $ Valuation of Gas Piping work (contractor's bid price): $ Scope of Work (please provide detailed information): Building Use (per Int'l Building Code): Occupancy (per Int'I 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.\Applications\Forms- Applications On Line\2010 Applications \7 -2010 - Perrnit Application.doc Revised. 7 -2010 bh Page 5 of 6 PERMIT APPLICATION NOTES likable to all permits in this application • Value of Construction - In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject to possible revision by the Permit Center to comply with current fee schedules. Expiration of Plan Review - Applications for which no permit is issued within 180 days following the date of application shall expire by limitation. 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). 1 HEREBY CERTIFY THAT 1 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 AGENT: Signature: Print Name: Al �.�'�- .�: tt / Mailing Address: Q S. J -,. q/ Sf, Date Application Accepted: Date: 5/170) Day Telephone: 10,4- 9',14' —7750 City State Zip Date Application Expires: Staff Initials: 11 'Applications.Forms- Applications On Line12010 Applications\7 -2010 - Permit Application.doc Revised: 7 -2010 bh Page 6 of 6 • City Of Tukwila Permit Center 6300 Southcenter Boulevard, Suite, 100 Tukwila, WA 98188 (206 431 -3670) 1 Application # �s ALTERNATE PLAN SUBMITTAL AUTHORIZATION FOR LIMITED SCOPE OF WORK I.B.C.& I.R.C. Section 104.1 Project name /h2Li( // y Y -1I"✓� 2;00- \(?/-MR72 - ()O,✓s�22lenv'/ Address O I �✓� S y� o /.� y � Description of work /� /OOLI Related reference number CRF -A1/- /39 The above project permit applicant, due to the limited scope of work is authorized to submit reduced plan requirements described below. 1. Complete permit application required: (Note, all application must include; 1) property assessor number, 2) copy of contractors license or completed owner waiver form.) Building Mechanical Other e (7%RJ 9 — P2/64/el e s 2. Minimum plan and /or specification requirement: Site plan Floor plan Elevations Foundation Cross sections Roof plan W.S.E.C. Compliance Narrative )( Structural calculations (stamped by Washington State licensed engineer ) Specific required information idAni/n/( rata, 7J.$ z,t4 A.1 ,of,s7)/4f C'ovriv ,v4 L Z-ALS, C l —ice Ai _5 RZc°g zi, 3. Other special instructions: Authoriza on by, TBD36/96 -form 12 Date / (Authorization void 30 days fter tiAe date issued.) 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: hup://www.ci.tukwila.wa.us Parcel No.: Address: 4600 S 134 PL TUKW Suite No: Applicant: HOLADAY PARKS RECEIPT Permit Number: D11 -125 Status: PENDING Applied Date: 05/04/2011 Issue Date: Receipt No.: R11 -00890 Initials: User ID: Payee: JEM 1165 Payment Amount: $1,888.90 Payment Date: 05/04/2011 01:01 PM Balance: $0.00 CHARTER CONSTRUCTION TRANSACTION LIST: Type Method Descriptio Amount Payment Check 24899 1,888.90 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts BUILDING - NONRES 000.322.100 STATE BUILDING SURCHARGE 640.237.114 Total: $1,888.90 1,884.40 4.50 doc: Receiot -06 Printed: 05 -04 -2011 INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (L (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 b / / - /�S Project: T Type off 1 spection: N N / — (Pc t 0 C3:). .--k.li (t — (N.-T( iSN/ a J la, S'49■ \F°/ A) f Approved per applicable codes. ElCorrections required prior to approval. COMMENTS: CD �- q A ;,,,� 6 — (Pc t 0 C3:). .--k.li (t — (N.-T( iSN/ a J la, S'49■ \F°/ A) f / ---" Inspey (:r: Date r3 t 1 r'1'l C REIN pai. ECTION FEE REQUIRED. \rjor to next inspection. fee must be t 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. REIN pai. ECTION FEE REQUIRED. \rjor to next inspection. fee must be t 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. niEK .<�-.•o�aY,a., .v- '1777i'r 'J ; ".'•.F•r�.-- ..�:--.. _.7.: . -.. ..�•,�y.,-•irpw:'..:_.:.�,.- • r[Gp INSPECTION RECORD. Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION e" 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit,lrispection Request Line (206) 431 -2451 Project: hies /d e1 ?ii Rk5 Type of Inspection: c ci4 // .2"ili.r7 /4 /aV Address: A/600 S /3 5/ ,)t' Date Called: / c- p /7/M,6,:,/� /'P ✓„�. - /j/(�.G ,/,) ? ,-= i•�S. —�1G Special Instructions: Date Wanted: ,5'- ..2 6 — // 6.1..„n p.m. Requester: Phone No: c 3,92 -1 '3av ElApproved per applicable codes. DCorrections required prior to approval. COOMMENTS:,2 4. 6,7 /iJ ./9// S /1-1, .4/1/ S i?i 5 CAo 1?,..4,1 % cr ��// A/o% ' 7C� Or` / - /4P / c- p /7/M,6,:,/� /'P ✓„�. - /j/(�.G ,/,) ? ,-= i•�S. —�1G '/ r,X -)i ✓rS — /---7", .ti�1 SfiP�,O A, ejsAiy tspeci: � I etc , Date: L `_ // �� INSPECTION FEE REQUIRED. Prior to next inspection. fee must be id at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. r. • INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION '1- 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 - 3670.• Permit Inspection Request Line (206) 431 -2451 Project: .eIVOZ 49 044i )f/R * s Type of Inspection: feivet7f st. A' Address: Y60 0 S / ?L/"'L Date Called: Special Instructions: Date Wanted: /Cg —/ / my P.m. Requester: Phone No: Cad G -81/4 = 6 ,9.2 v ❑ Approved per applicable codes. a Corrections required prior to approval. . COMMENTS: p /t s '.dG . ,G F r, P ,[a. 6 &c F fit/ - L./ r,/,'171,t/ 5- '7 -1/ .C2-• / 2 e ,)--0° c Aare 0,7, f 7 L � - , - . 4 4 - 1 1 / --------N \. Inspector. Date: 2Lc .`s ca_st S -/ g ' v PECTION FEE REQUIR D. Prior.t6next inspection. fee must be id at 6300 Southcenter Blv .. Suite 100. Call to schedule reinspection. OTTO ROSENAU & ASSOCIATES, INC. Geotechnical Engineering, Construction Inspection & Materials Testing RECEIVED Job Number: 11 -0253 CONCRETE REPORT Report Number: RC73974 Permit Number: Project: Holaday Parks Address: 4600 S 134th Place, Tukwila Inspector(s): Rick Hardy Description /Location: Resteel Verified: Yes Client: Charter Construction, Inc. Address: 980 S. Harney Street, Seattle Date: 5/18/2011 JUN 2 7 2011 I COMMUNITY DEVELOPMENT Infill, with #4 reinforcing steel with barlock connections, as per details dated 17 May 2011 by Robb A Dibble, engineer of record, Dibble Engineers, Inc. 5/18/2011 Rick Hardy (Grade 60) Mfg: Nucor Placement Data Supplier: Mix Number: Slump Spec: W/C Ratio Spec: Air Spec: Total Yards: Placed Via: Consolidated: Required Strength: Stoneway 6000 3" 0.433 2 Wheelbarrow Yes 4000 psi at 28 days. Sampling and Testing Data Time ASTM C 172, C 31 Made Cast Samples: 1 -4 2:10 pm Cubic Yards Design Cement (lbs/type): Fine Agg. (lbs): Coarse Agg. (lbs/size): Coarse Agg. (lbs/size): Coarse Agg. (Ibs /size): Fly Ash (Ibs): Water (lbs or gal): Admixtures (specify): Water Slump Added C 143 1.00 0 gal. 3" Actual ❑ 564# Type: I/11 1393# 1914# 3/4" Batch Weights /Cubic Yard 250# Air% C 231 Conc.Temp C 1064 N/A 65 °F Slag (Ibs): Ambient Temp 68 °F Truck Ticket No. No. 456 268721 Weather: Inside Date Samples Picked Up: 5/19/2011 Specimen Number Test Date Field Cure 1 5/25/11 2 6/15/11 3 6/15/11 4 6/15/11 = Discarded Tested in general accordance to: Copies to: Client 51 Engineer Building Dept ❑ Owner ❑ Contractor Batch Plant ❑ Architect ❑ Others Age (Days) 7 4x8 12.63 9.2 28 4x8 12.63 9.08 28 4 x 8 12.63 9.11 Slump Range: 3" +/- 1" Air % Range: Initial Curing Method: ASTM C31, Exclude C31- 12.1.5 Initial Curing Temp: ASTM C31, Exclude C31- 10.1.2 Comments REINFORCING / PLACEMENT: Conforms In Does Not Conform ❑ COMPRESSIVE TEST RESULTS Size Area Weight Max Load Strength Fracture Type (in.) (Sq.ln.) (Lbs.) (Lbs.) (psi) (other than cone) 28 4 x 8 12.63 9.01 67,720 5360 87,080 6900 90,150 7140 88,260 6990 ASTMC39 p ASTMC617 ❑ ASTMC1231 Technical Responsibility: 2 Jeff Rabe, 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 OTTO ROSENAU & ASSOCIATES, INC. 400 Geotechnical Engineering, Construction Inspection & Materials Testing CONCRETE REPORT Report Number: RC73974 Permit Number: D11 -125 Job Number: 11 -0253 Project: Holaday Parks Address: 4600 S 134th Place, Tukwila Inspector(s): Rick Hardy Client: Charter Construction, Inc. Address: 980 S. Harney Street, Seattle Date: 5/18/2011 Description /Location: Infill, with #4 reinforcing steel with barlock connections, as per details dated 17 May 2011 by Robb A Dibble, engineer of record, Dibble Engineers, Inc. Resteel Verified: Yes 5/18/2011 Rick Hardy (Grade 60) Mfg: Nucor Placement Data Supplier: Mix Number: Slump Spec: W/C Ratio Spec: Air Spec: Total Yards: Placed Via: Consolidated: Stoneway 6000 3" 0.433 2 Wheelbarrow Yes Required Strength: 4000 psi at 28 days. Sampling and Testing Data Time ASTM C 172, C 31 Made Cast Samples: 1-4 2:10 pm Cubic Yards Design Cement (Ibs /type): Fine Agg. (Ibs): Coarse Agg. (Ibs /size): Coarse Agg. (Ibs /size): Coarse Agg. (Ibs /size): Fly Ash (Ibs): Water (Ibs or gal): Admixtures (specify): Water Slump Added C 143 1.00 0 gal. 3" Actual ❑ 564# Type: 1/1I 1393# 1914# 3/4" Batch Weights /Cubic Yard 250# Air % C 231 N/A Conc.Temp C 1064 65 °F Slag (Ibs): Ambient Temp 68 °F Truck Ticket No. No. 456 268721 Weather: Inside Date Samples Picked Up: 5/19/2011 Specimen Number Test Date Slump Range: 3" +/- 1" Air % Range: Initial Curing Method: ASTM C31, Exclude C31- 12.1.5 Initial Curing Temp: ASTM C31, Exclude C31- 10.1.2 Comments Field Age Cure (Days) REINFORCING / PLACEMENT: Conforms COMPRESSIVE TEST RESULTS Size (in.) Does Not Conform ❑ Area Weight Max Load Strength Fracture Type (Lbs.) (psi) (other than cone) 67,720 5360 (Sq.ln.) (Lbs.) 1 5/25/11 * = Discarded Tested in general accordance to: Copies to: Client n Engineer Building Dept ❑ Owner ❑ Contractor Batch Plant ❑ Architect ❑ Others 7 4 x 8 12.63 9.2 ASTMC39 D ASTMC617 ❑ ASTMC 1231 Technical Responsibility: P ject 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 Contractors or Tradespeople Per Friendly Page 1 General /Specialty Contractor A business registered as a construction contractor with LEO 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 CHARTER CONST INC UBI No. 600479166 Phone 2063821900 Status Active Address 980 S Harney Street License No. CHARTCI171PM Suite /Apt. License Type Construction Contractor City Seattle Effective Date 10/14/1983 State WA Expiration Date 10/23/2012 Zip 981082744 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 TELESGI179JD TELESIS GROUP INC, THE Construction Contractor General Unused 4/4/1983 4/4/1984 Archived Business Owner Information Name Role Effective Date Expiration Date SALADINO, PETER CARROLL President 02/17/2011 Amount COSENTINO, PATRICK Vice President 02/17/2011 GPL982931400 JACKSON, ERIC Vice President 02/17/2011 FIRMANI, FRANK President 10/14/1983 02/17/2011 SALADINO, PETER C Vice President 10/14/1983 02/17/2011 Bond Information Page 1 of 2 Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 6 TRAVELERS CAS & SURETY CO 081S103572915BCM 07/22/2001 Until Cancelled $12,000.00 10/18/2001 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 26 CTOEADFASTINS GPL982931400 11/01/2010 11/01/2011 $1,000,000.00 10/29/2010 25 FIRST MERCURY INS CO FMWA0004122 11/01/2009 11/01/2010 $1,000,000.00 10/30/2009 24 FIRST MERCURY INS CO fmwa000412 11/01/2008 11/01/2009 $1,000,000.00 10/31/2008 23 FIRST MERCURY INS CO FMFL003259 11/01/2007 11/01/2008 $1,000,000.00 10/30/2007 22 NS ST MERCURY FMFL002201 11/01/2006 11/01/2007 $1,000,000.0011 /01/2006 21 INTERSTATE FIRE & CAS SGL1000005 11/01/2005 11/01/2006 $1,000,000.00 11/01/2005 20 INTERSTATE FIRE & CAS CO PGL1000057 11/01/2004 11/01/2005 $1,000,000.00 11/01/2004 19 CO EVANSTON INS 03GLP1005005 10/01/2003 10/01/2005 $1,000,000.00 09/29/2004 https://fortress.wa.gov/lni/bbip/Print.aspx 05/04/2011