HomeMy WebLinkAboutPermit D11-271 - SINGH RESIDENCE - DEMOLITIONThis record contains information which is exempt from public disclosure
pursuant to the Washington State Public Records Act, Chapter 42.56 RCW
as identified on the Digital Records Exemption Log shown below.
D11 -271
Singh Residence
4642 South 146th Street
RECORDS DIGITAL D- ) EXEMPTIO
THE ABOVE MENTIONED PERMIT FILE INCLUDES THE FOLLOWING REDACTED INFORMATION
F,age # Code
Exemption � � �� Brief Explsnatoty Description, Statute /Rule
The Privacy Act of 1974 evinces Congress' intent that
Personal Information —
social security numbers are a private concern. As
such, individuals' social security numbers are
Social Security Numbers
redacted to protect those individuals' privacy pursuant
5 U.S.C. sec.
DR1
Generally — 5 U.S.C. sec.
to 5 U.S.C. sec. 552(a), and are also exempt from
552(a); RCW
552(a); RCW
disclosure under section 42.56.070(1) of the
42.56.070(1)
42.56.070(1)
Washington State Public Records Act, which exempts
under the PRA records or information exempt or
prohibited from disclosure under any other statute.
Redactions contain Credit card numbers, debit card
Personal Information —
numbers, electronic check numbers, credit expiration
18
DR2
Financial Information —
dates, or bank or other financial account numbers,
RCW
RCW 42.56.230(4 5)
which are exempt from disclosure pursuant to RCW
42.56.230(5)
42.56.230(5), except when disclosure is expressly
required by or governed by other law.
SINGH DEMOLITION
4642 S 146 ST
D11-271
City 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.TukwilaWA.gov
Parcel No.: 0040000575
Address: 4642 S 146 ST TUKW
Suite No:
Project Name: SINGH DEMOLITION
DEVELOPMENT PERMIT
Permit Number: D11 -271
Issue Date: 11/10/2011
Permit Expires On: 05/08/2012
Owner:
Name: OLSEN ROBERT J
Address: C/O BECU TRUST CO ATTN LINDA , 12770 GATEWAY DR MS1017 1 98168
Contact Person:
Name: GARY SINGH
Address: 4224 S 148 ST , TUKWILA WA 98168
Contractor:
Name: CLARK BULLDOZING
Address: 255 SW 154TH #6 , BURIEN WA 98166
Contractor License No: CLARKB *221J4
Phone: 206 - 244 -1900
Phone: 206 242 -5360
Expiration Date: 07/14/2012
DESCRIPTION OF WORK:
DEMOLITION OF 1480 SQ FT HOUSE. PUBLIC WORKS ACTIVITIES INCLUDE EROSION CONTROL & SEPTIC
ABANDONMENT.
Value of Construction: $2,000.00 Fees Collected: $212.40
Type of Fire Protection: International Building Code Edition: 2009
Type of Construction: V -B Occupancy per IBC: 0022
Electrical Service Provided by: SEATTLE CITY LIGHT
* *continued on next page **
doc: IBC -7/10
D11-271 Printed: 11 -10 -2011
Public Works Activities:
Channelization / Striping: N
Curb Cut / Access / Sidewalk / CSS: N
Fire Loop Hydrant: N Number: 0
Flood Control Zone:
Hauling:
Land Altering:
Landscape Irrigation:
Moving Oversize Load:
N
Start Time:
Volumes: Cut 0 c.y.
Size (Inches): 0
End Time:
Fill 0 c.y.
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:
N
Permit Center Authorized Signature: U, C,c■( (-/l/ 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 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 and obtain this development permit and agree to the conditions attached
to this permit.
Signature:
Print Name:
„.2(4
Date: / / (o
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 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: 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.
5: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the City of Tukwila
Building Department (206- 431 - 3670).
6: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building
doc: IBC -7/10
D11-271 Printed: 11 -10 -2011
Department (206- 431 - 3670).
• •
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.
doc: IBC -7/10
D11 -271 Printed: 11 -10 -2011
CITY OF TUKA
Community Develgffnent Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http: / /www. Tu kwi IaWA. gov
Building Pet. No. N '— )-7 1
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: 40q Z S C ` Y--
Tenant Name: 1 12 • \la C a 1,-t-
Property Owners Name:
Mailing Address: y 22-1
lkdk
King Co Assessor's Tax No.:
Suite Number: Floor:
New Tenant: ❑ Yes ❑.. No
t -Vs, a
City State
Ri tog
Zip
CONTACT PERSON - who do we contact when your permit is ready to be issued
Name: , nn __ 1p.A
Mailing Address: F'� v►.,`
Day Telephone: 2.4 lD - 2-4 4 '41 0 0
City State Zip
E -Mail Address: 964-4-:n 2'k-t^i4 2' e Cel,,epot , taj Fax Number: 2.0, Cq U17) Q g
GENERAL CONTRACTOR INFORMATION -
(Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5))
Company Name:
Mailing Address:
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
Contractor Registration Number: Expiration Date:
State
Zip
ARCHITECT OF RECORD - All plans must be stamped by Architect of Record
Company Name:
Mailing Address:
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
State
Zip
ENGINEER OF RECORD - All plans must be stamped by Engineer of Record
Company Name:
Mailing Address:
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
State
Zip
H:\Applications'Ponns- Applications On Line\2010 Applications\7 -2010 - Permit Application.doc
Revised: May 2011
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Page 1 of 6
BUILDING PERMIT INFORMATION — 206 - 431 -3670
Valuation of Project (contractor's bid pi c : $ t 0 Existing ilding Valuation: $
Scope of Work (please provide detailed information): De w,-.1 On! 0 4,11A-)->L, Ili ff
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:
❑ 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:\Applications\Forms- Applications On Line \2010 Applications17 -2010 - Permit Application doc
Revised: May 2011
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Page 2 of 6
Existing
Interior Remodel
Addition to
Existing
Structure
New
Type of
Construction per
IBC
Type of
Occupancy per
IBC
1" Floor
2nd Floor
Pi 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:
❑ 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:\Applications\Forms- Applications On Line \2010 Applications17 -2010 - Permit Application doc
Revised: May 2011
bh
Page 2 of 6
PERMIT APPLICATION NOTES — illicable 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).
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 GENT:
Signature:
Print Name:
Date:
Day Telephone:
Mailing Address:
City
I Date Application Accepted: 9_0_0
State
Zip
Date Application Expires:
Staff Initial
H:\Applications \Forms- Applications On Line\2010 Applications \7 -2010 - Permit Application doc
Revised: May 2011
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Page 6 of 6
1
•
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.TukwilaWA.gov
Parcel No.: 0040000575
Address: 4642 S 146 ST TUKW
Suite No:
Applicant: SINGH DEMOLITION
RECEIPT
Permit Number: D11 -271
Status: PENDING
Applied Date: 08/08/2011
Issue Date:
Receipt No.: R11 -01703
Payment Amount: $212.40
Initials: WER Payment Date: 08/08/2011 10:23 AM
User ID: 1655 Balance: $0.00
Payee: SUDHU HOMES
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 2947 212.40
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
BUILDING - NONRES
PLAN CHECK - NONRES
STATE BUILDING SURCHARGE
000.322.100
000.345.830
640.237.114
Total: $212.40
126.00
81.90
4.50
doc: Receiot -06 Printed: 08 -08 -2011
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
01 I
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila: WA 98188 (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
Project:
Type of Inspection: 3 tat
Address:
� (04t f4
Special Instructions:
Date Called:
Date Wanted:,. 4
Requester:
Phone No: ` f 'i c2
Approved per applicable codes. a Corrections required prior to approval.
COMMENTS:
CAD t kfk
Insp =ctor:
111=it•l■1i
}
Date 6, (4,
n REINSPECTION FEE REQUIRED. Prior next inspection. fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
'i ''/ // '
D11 -271
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila: WA 98188 ,vt, (206) 431 -3670
Permit Inspection Request Line (206) 431 -2451
Project: •
7A2 y v/NCi
Type of I,ection: ik e' (' 's7`"`""' -
/- d - Jie AA 0
Address:
/ ,Z.• _ST. /4/6P
Date Called:
Spe is Instructions:
Date W�ntg�� / ,/ `p,�,
Requester:
Phone No:
Approved per applicable codes. Corrections required prior to approval: " —
COMMENTS:
k K -FILL - ,fk,rU[ t(P vile d✓e
r,iploJ��
Inspe 1:o
Date:
1/ //o f,/
REI SPECTION FEE R QUIREDfPrior to next inspection, fee must be
pa' at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
ti
IY
PRIOR TO COMMENCING WITH
DEMOLITION
A "pre -demo inspection" is required.
Contractors shall provide documentation that
an "asbestos survey" has been completed. If
needed, abatement procedures per "Puget
Sound Clean Air Agency" shall be completed
and documentation of compliance shall be
provided at time of final inspection.
4 -: I- ,TE PERM T
REQUIRED FOR
RrMechanical
L Electrical
l 'tumbing
IjoGas Piping
C'c.y of Tukwila
.: xi ?; DIVISioN`
4 -17zik-c4 A-tevioe. 148.1)
a� v
`Ar'
"1-1 �-{,�i�i.P' C cC-"IN1neC -jcl, e_
.t
c_ --Clove_ et t c C�L LR•�
A.z") c-1 n X c )-C
G .
kL 0
PLANNING A' P" . VED
No changes can be r>e to these
plans without applrovalUfrom the l
Planning Divisgon j DCD
Approved By:
Date: __5144_
. Yec
j�e.sn q�r
Perm PermIt No.
rrjiiavr approval is sub ect to errors and omissions.
1' of construction do ments does not authorize
1 ;;o; l a' any adopts a code or ordinance. Receipt
�,. 'proved Fiala Copy and . • ons is acknowledged:
eY
Date:
6
(Ho 1(
City Of, kwila
BUILDING DIVISION
f
:4V
REVISION �'�'1'J`
'o r'h nrc:_� shad be made to the scope
p
' of Florio without prior approval of
Tukwila Building Division.
PJBT71: Revisions will require a new plan submittal
and ' - sip additional- plan -rel iew -fee&.
REVIEWED FOR
CODE COMPLIANCE
APPROVED
AUG 9 2 2011
City of Tukwila
BUILDING DIVISION
1)‘1,-- 27 1
1
RD
RECEIVED
AUG 08 2011
PERMIT CENTER
May 14, 2012
City of Tukwila Jim Haggerton, Mayor
Department of Community Development Jack Pace, Director
Gurdip Singh
4224 S 148 Street
Tukwila, WA 98168
RE: Request for Extension
Development Permit No. D11 -271
Singh Demolition — 4642 S 146 St
Dear Mr. Singh,
This letter is in response to your written request for an extension to Permit Number D11-271.
The Building Official has reviewed your letter and considered your request to extend the above
referenced permit. The City of Tukwila Building Division will be extending your permit an
additional 180 days from the date of expiration, through November, 5, 2012.
If you should have any questions, please contact our office at (206) 431 -3670.
Sincerely,
File: Permit No. D11 -271
W:\Pennit Center\Extension Letters \Pennits\2011\D11 -271 Permit Extension.doc
6300 Southcenter Boulevard, Suite #100 0 Tukwila, Washington 98188 a Phone: 206 - 431 -3670 C Fax: 206 - 431 -3665
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LCustomer Transaction Summary 1
05/04/2012 15:58 2062481744
Customer Information
ACCT, NO : All
Date Type
WATER DIST 125
King County Water District 4125
Read Date
Reading
Location Information
SERVICE ID : 30110
4642 146TH ST S
TUKWILA, WA 98168-
Transaction
Usage Prior Balance Amount
PAGE 01/01
Balance
01/16/2009 Payment
02/19/2009 Adjustment
02/20/2009 Charge 02/17/2009
03/16/2009 Payment
04/20/2009 Charge 04/15/2009
05/18/2009 .Payment
06/19/2009 Charge 06/16/2009
07/16/2009 Payment
08/20/2009 Charge 08/18/2009
09/14/2009 Payment
10/20/2009 Charge 10/16/2009
11/13/2009 Payment
12/21/2009 Charge 12/16/2009
01/19/2010 Payment
02/19/2010 Charge 02/18/2010
03/17/2010 Payment
04/20 /2010 Charge 0445/2010
05/1.7/2010 Payment
06/21/2010 Charge 06/17/2010
07/16/2010 Payment
08/20/2010 Charge 08/18/2010
09/17/2010 Payment
10/20/2010 Charge 10/15/2010
11/16/2010 Payment
12/20/2010 Charge 12/15/2010
01/18/2011 Payment
02/18/2011 Charge 02/16/2011
03/17/2011 Payment
04/20/2011 Charge 04/18/2011
05/17/2011 Payment
06/20/2011 Charge 06/16/2011
07/12/2011 L Charge 07/12/2011
07/14/2011 Payment
07/22/2011 Payment
08/01/2011 Mist
08/01/2011 Charge 08/01/2011
08/11/2011 Payment
26.10 -26.10 0.00
-3 0.00 -7.80 -7.80
1349 -7.80 23.50 15.70
15.70 -15.70 0,00
1349 0.00 23.50 23.50
23,50 -23.50 0.00
1349 0.00 23.50 23.50
23.50 -23.50 0.00
1349 0.00 23.50 23.50
23.50 -23.50 0.00
1349 0.00 23.50 23.50
23.50 -23.50 0.00
1349 0.00 23.50 23.50
23,50 -23.50 0.00
1349 .0.00 23.50 23.50
23.50 -23,50 0.00
1349 0.00 23.50 23.50
23.50 -23.50 0.00
1349 0.00 23.50 23.50
23.50 -23.50 0.00
1349 0.00 23.50 23.50
23.50 -23.50 0.00
1349 0.00 23,50 23.50
23.50 -23.50 0.00
1349 0.00 23.50 23.50
23.50 -23.50 0.00
1349 0.00 25.00 25.00
25.00 -25.00 0.00
1349 0.00 25.00 25.00
25.00 -25.00 0.00
1349 0.00 25.00 25.00
1349 25.00 10.83 35.83
35.83 -25.00 10,83
10.83 -10.83 0.00
0.00 10.00 10.00
1350 1 10.00 11.13 21.13
HEmva / DC�{� L� g// M011
Ex 1 Mc i�2 - 6% X
21.13 -21.13 0.00
05/04/2012 03:20:52 PM F = First Bill L = Final Bill U = Unclosed Transaction
Page
04 -02 -2012
City
J fTHI i V a
Jim Haggerton, Mayor
Department of Community Development
GARY SINGH
4224 S 148 ST
TUKWILA WA 98168
RE: Permit No. D11 -271
SINGH DEMOLITION
4642 S 146 ST TUKW
Dear Permit Holder:
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 05/08/2012.
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 05/08/2012, 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,
J nm r Marshall
Pe Technician
File: Permit File No. D11 -271
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone 206 -431 -3670 • Fax 206 - 431 -3665
• •
PE 1-
PLAN REVIEW /ROUTING SLIP
ACTIVITY NUMBER: D11 -271
DATE: 08 -08 -11
PROJECT NAME: SINGH DEMOLITION
SITE ADDRESS: 4642 S 146 ST
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter #
Revision # After Permit Issued
DEPARTMENT :
ding Division
Public or
i�lr+n �1I O1?' 11
Fire Prevention
Structural
94 Ap 0-1q-t1
Planning Division
❑ Permit Coordinator
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete
Comments:
Incomplete
DUE DATE: 08 -09 -11
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 II Structural Review Required ❑ No further Review Required
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS:
Approved Approved with Conditions
Notation:
REVIEWER'S INITIALS:
DUE DATE: 09-06-11
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
Contractors or Tradespeople inter Friendly Page
•
General /Specialty Contractor
A business registered as a construction contractor with LEd 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 CLARK BULLDOZING UBI No. 600257275
Phone 2062425360 Status Active
Address 255 Sw 154Th #6 License No. CLARKB *221J4
Suite /Apt. License Type Construction Contractor
City Burien Effective Date 4/24/1978
State WA Expiration Date 7/14/2012
Zip 98166 Suspend Date
County King Specialty 1 Excavation, Grading And Land Clearing
Business Type Individual Specialty 2 Unused
Parent Company
Business Owner Information
Name
Role
Effective Date
Expiration Date
CLARK, TRACY J
Owner
01/01/1980
Bond Information No records found for the previous 6 year period
Assignment of Savings Information
Page 1 of 1
Savings
Assignment of Savings Account Number
Effective Date
Release Date
Assignment Type
Impaired Date
Amount
Received Date
5
4/24/1978
Until
Released
Bond
Insurance Information
Insurance
Company Name
Policy Number
Effective Date
Expiration Date
Cancel Date
Impaired Date
Amount
Received Date
18
Ctolantic Cas lns
L065007030 -4
06/11/2011
06/11/2012
$1,000,000.00
06/10/2011
17
ATLANTIC CAS
INS CO
L0650070303
06/11/2007
06/11/2011
$1,000,000.00
06/10/2010
16
ATLANTIC CAS
INS CO
L65004958
06/09/2006
06/09/2007
$1,000,000.00
06/19/2006
15
AMERICAN
STATES INS CO
01CG3536053
05/17/2005
05/17/2006
$1,000,000.00
03/24/2005
Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period
Warrant Information No unsatisfied warrants on file within prior 6 year period
https://fortress.wa.gov/lni/bbip/Print.aspx
11/10/2011