HomeMy WebLinkAboutPermit M10-036 - FINDLAY RESIDENCEFINDLAY RESIDENCE
13765 MACADAM RD S
M10 -036
Parcel No.: 3229200040
Address:
Suite No:
Citylef 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
13765 MACADAM RD S TUKW
MECHANICAL PERMIT
Permit Number:
Issue Date:
Permit Expires On:
M10-036
03/23/2010
09/19/2010
Tenant:
Name:
Address:
Owner:
Name:
Address:
FINDLAY RESIDENCE
13765 MACADAM RD S , TUKWILA WA
CLENNA BRYAN
7703 39TH AVE S , SEATTLE WA
Contact Person:
Name: JEFF STONEHILL
Address: 3016 36 SW , SEATTLE WA
Contractor:
Name: KLIEMANN BROTHERS HEATING AND AI
Address: 5518 163RD ST E , PUYALLUP WA
Contractor License No: KLIEMBH021BT
Phone:
Phone: 206 226 -3225
Phone: 253 - 537 -0655
Expiration Date: 01/27/2012
DESCRIPTION OF WORK:
INSTALL NEW 60,000 BTU 80% SINGLE STAGE GAS FURNACE TO REPLACE EXISTING.
Value of Mechanical: $2,200.00
Type of Fire Protection:
Fees Collected: $173.50
International Mechanical Code Edition: 2006
EQUIPMENT TYPE AND OUANTITY
Furnace: <100K BTU
>100K BTU
Floor Furnace
Suspended/Wall/Floor Mounted Heater
Appliance Vent
Repair or Addition to Heat/Refrig /Cooling System....
Air Handling Unit <10,000 CFM
>10,000 CFM
Evaporator Cooler
Ventilation Fan connected to single duct
Ventilation System
Hood and Duct
Incinerator: Domestic
C ommercial/Industrial
1
0
0
0
0
0
0
0
0
0
0
0
0
0
Boiler Compressor:
0 -3 HP /100,000 BTU 0
3 -15 HP /500,000 BTU 0
15 -30 HP /1,000,000 BTU.. 0
30 -50 HP /1,750,000 BTU.. 0
50+ HP /1,750,000 BTU 0
Fire Damper 0
Diffuser 0
Thermostat 0
Wood/Gas Stove 0
Water Heater 0
Emergency Generator 0
Other Mechanical Equipment0
* *continued on next page **
doc: IMC -10/06
M10 -036
Printed: 03 -23 -2010
•
City of 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
Permit Number: M10 -036
Issue Date: 03/23/2010
Permit Expires On: 09/19/2010
Permit Center Authorized Signature:
\ "U V CAkdkik Date: V VA4
ed this permit and know the same to be true and correct. All provisions of law and ordinances
hether specified herein or not.
I hereby certify that I have read and ez
governing this work will be complied
The granting of this permit does not presuiC e to give authority to violate or cancel the provisions of any other state or local laws regulating
construction or the perform ce of work. I authorized to sign and obtain this mechanical permit.
Signature: Date: 3/2-5/6
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.
doc: IMC -10/06
M10 -036 Printed: 03 -23 -2010
Parcel No.: 3229200040
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
13765 MACADAM RD S TUKW
FINDLAY RESIDENCE
PERMIT CONDITIONS
Permit Number:
Status:
Applied Date:
Issue Date:
M10 -036
ISSUED
03/23/2010
03/23/2010
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: Manufacturers installation instructions shall be available on the job site at the time of inspection.
5: Except for direct -vent appliances that obtain all combustion air directly from the outdoors; fuel -fired appliances
shall not be located in, or obtain combustion air from, any of the following rooms or spaces: Sleeping rooms,
bathrooms, toilet rooms, storage closets, surgical rooms.
6: Equipment and appliances having an ignition source and located in hazardous locations and public garages, PRIVATE
GARAGES, repair garages, automotive motor -fuel dispensing facilities and parking garages shall be elevated such that
the source of ignition is not less than 18 inches above the floor surface on which the equipment or appliance rests.
7: Water heaters shall be anchored or strapped to resist horizontal displacement due to earthquake motion. Strapping shall
be at points within the upper one -third and lower one -third of the water heater's vertical dimension. A minimum
distance of 4- inches shall be maintained above the controls with the strapping.
8: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the Cityof Tukwila
Permit Center.
9: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building
Department (206- 431 - 3670).
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
M10 -036 Printed: 03 -23 -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:
5(-0-ytekdi
Date:
ordinances governing
or local laws regulating
doc: Cond -10/06 M10 -036
Printed: 03 -23 -2010
CITY OF TUKWIL,..
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.citukwila.wa.us
avc - Fd&v g '.
Building Permit No.
Mechanical Permit No. / V ` ` C;(1 `.
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 **
y� nKing Co Assessor's Tax No.:
Site Address: / 3 765 / S! Ctc2O..�d m4 L J . Suite Number: Floor:
New Tenant: ❑ Yes ❑ .. No
Property Owners Name:
Mailing Address:
Tenant Name:
City
State
Zip
CONTACT PERSON who do we contact when your permit is ready to be issued
Name: t—
Mailing Address (S)(' 6
E -Mail Address:
D y T .z 2,2,6 ai u,
-36-,,do S a Cpl easy, vta
City
Fax Number:
State Zip
GENERAL CONTRACTOR INFORMATION
(Contractor Information for Mechanical (pg 4) for Plumbing and Gas Piping (pg 5))
Company Name:
Mailing Address:
City
Day Telephone:
Fax Number:
Expiration Date:
Contact Person:
E -Mail Address:
Contractor Registration Number:
State
Zip
ARCHITECT OF RECORD'- All plans must be wet stamped by Archlteet of Record
Company Name: -
Mailing Address:
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
State
Zip
ENGINEER OF RECORD - All plats must be wet stamped by Engineer of Record"
Company Name:
Mailing Address:
City
Contact Person: Day Telephone:
E -Mail Address: Fax Number:
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State
Zip
Page ] of 6
BUILDING PERMIT INFORM.I'ION - 206-431-3670
Valuation of Project (contractor's bid price): $ Existing Building Valuation: $
Scope of Work (please provide detailed information):
Will there be new rack storage? ❑ Yes
0.. 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: I landicap:
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.
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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
lat Floor
rd 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: I landicap:
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.
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Page 2 of 6
TION _ 206- 431 -3670
MECHANICAL SONTRACTOR INFORMATION
Company Name: fie i i IA h ms
Mailing Address: 47O O 3 /(6ci— 44. ,. . "rLPets$44i(,k wM ql lic16
�� ' SoKe k\ I I City State Zip
Contact Person: Day Telephone: e.266 2:26— *.'2...2.6.--
E -Mail Address: 44-e) we kf (( e-e CQait. YIQ." Fax Number:
Contractor Registration Number: K L. j j`il 6 ((O 2 1 5 ( Expiration Date: (/27/2e/2
Valuation of Mechanical work (contractor's bid price): $ 2)2,00
Ob
Scope of Work (please provide detailed information):
sf 41/i) ((9, MO bra- L 10% s
0e918,.c.Q_ ) 5 I�CLVt
Use: Residential: New .... ❑ Replacement ....A
Commercial: New .... ❑ Replacement .... ❑
Fuel Type: Electric ❑ Gas.... Other:
Indicate type of mechanical work being installed and the quantity below:
Unit Type:
Qty
Unit Type:
Qty
Unit Type:
Qty
Boiler /Compressor:
Qty
Furnace <100K BTU
/
1
Air Handling Unit >10,000
CFM
Fire Damper
0 -3 HP /100,000 BTU
Fumace>100K BTU
Evaporator Cooler
Diffuser
3 -15 HP /500,000 BTU
Floor Furnace
Ventilation Fan Connected
to Single Duct
Thermostat
15 -30 HP /1,000,000 BTU
Suspended/Wall/Floor
Mounted Heater
Ventilation System
Wood/Gas Stove
30 -50 HP /1,750,000 BTU
Appliance Vent
Hood and Duct
Emergency
Generator
50+ HP /1,750,000 BTU
Repair or Addition to
Heat/Refrig/Cooling
System
Incinerator - Domestic
Other Mechanical
Equipment
Air Handling Unit
<10,000 CFM
Incinerator — Comm/Ind
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Page 4 of 6
Scope of Work (please provide detailed information):
CaII before you Dig: 1- 800 - 424 -5555
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
Water District
❑ ...Tukwila ❑ ...Water District #125
❑...Water Availability Provided
Sewer District
❑ ...Tukwila
❑ ...Sewer Use Certifica
Septic System:
❑ On -site Septic System — on -site septic system, provide 2 copies of a curre /septic design approved by King County Health Department.
❑ .. Highline
❑ ...Valley View ❑ .. Renton
❑ ...Sewer Availability Provided
❑ .. Renton
❑ .. Seattle
Submitted with A lication m : ,, boxes which apply):
❑ ...Civil Plans (Maximum Pape " ize — 22" x 34 ")
❑ ...Technical Information Report ( "; Drainage)
❑ ...Bond ❑ .. Insurance ❑ .. Easement(s)
Proposed Activities (mark boxes that appl
❑ ...Right -of -way Use - Nonprofit for less th. ,Y hours ❑ .. Right -of -way Use - Profit for less than 72 hours
❑ ...Right -of -way Use - No Disturbance ❑ ,. Right -of -way Use — Potential Disturbance
❑ ...Construction/Excavation/Fill - Right -of -way
Non Right -of -wa
❑ otechnical Report ❑ ...Traffic Impact Analysis
❑ sly aintenance Agreement(s) ❑...Hold Harmless — (SAO)
❑ ...Hold Harmless — (ROW)
❑ ...Total Cut
❑ ...Total Fill
cubic yards
cubic yards
❑ ...Sanitary Side Sewer
❑ ...Cap or Remove Utilities
❑ ...Frontage Improvements
❑ ...Traffic Control
❑ ...Backflow Prevention - Fire Protection
Irrigation
Domestic Water
❑ ...Permanent Water Meter Size...
❑ ...Temporary Water Meter Size ..
❑ ...Water Only Meter Size
❑ ...Sewer Main Extension P . lic ❑
❑ ...Water Main Extension blic ❑
FINANCE INFORMATION
❑ .. Work in Flood Zone
❑ .. Storm Drainage
A don S'tb_ is Tank
b Cut
avement Cut
Looped Fire Lin
WO #
WO #
WO #
Private ❑
Private ❑
❑ .. Grease Interceptor
❑ .. Channelization
❑ .. Trench Excavation
❑ .. Utility Undergrounding
...Deduct Water Meter Size
Fire Line Size at Property Li Number of Public Fire Hydrant(s)
❑...Water /. ..Sewer ❑...Sewage Treatment
Monthly Service Billing to:
Name:
Mailing Address:
Day Telephone:
Water Meter Refund/Billing:
Name:
Mailing Address:
City
State
Zip
Day Telephone:
City
State Zip
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Page 3of6
PERMIT APPLICATION NOTES — Applicable 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 OW . R OR AU • ' ZE t E T:
Signature:
Date: 3//6
Print Name: '1-4'- -0 Sftt- {� (( Day Telephone:
Mailing Address: '6,6.* 56 l Q) 3e& W 4 qg ( 2_6
City
State
Zip
Date Application Accepted:
Date Application Expires:
Staff Initials: Ar_
H: Wpplications\Forms- Applications On Line\2009 Applications \I -2009 - Permit Application.doc
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Page 6 of 6
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 Project (contractor's bid price): $
Scope of Work (please provide detailed information):
Building Use (per Int'l Bu • ing Code):
Occupancy (per Int'l Buildin Code):
Utility Purveyor: Water:
Sewer:
Indicate type of plumbing fixtures an ;:,.r gas piping outlets b - + -g installed and the quantity below:
Fixture Type:
Qty
Fiztu `' 'ype:
?ity
Fixture Type: - :-'
:Qty
• Fixture Type:
Qty
Bathtub or combination
bath/shower
Bidet ,
Clothes washer, domestic
Dental unit, cuspidor
Dishwasher, domestic,
with independent drain
Drinking faun`:; or
water cooler (pe _ F d)
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 1-p,,, er and/or vent
',3
Industrial waste treatment
interceptor, including trap
and vent, except for kitchen
pe grease interceptors
Each grease trap
(connected to not more
than 4 fixtures - <750
gallon capacity)
Grease interceptor for
commercial kitchen (>750
gallon capacity)
:: pair or alteration of
ater piping and/or water
treatment equipment
't; •air or alteration of
dr. �, age 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
Backflo 1- •rotective device
other than : ospheric -type
vacuum bre. "!•-rs over 2
inch (51 mm) :'.meter
Each lawn sprinkler
system on any one meter
including backflow
protection devices
Atmospheric -type vac
breakers not include •
lawn sprinkler bac . • w
protections (1 -5)
Atmospheric -type
vacuum breakers not
included in lawn
sprinkler backflow
protections over 5
Gas piping outlets
H:1Applications \Forms- Appkications On- Line\2009 Applications\1-2009 Permit Application.doc
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Page 5 of 6
•
City of Tukwila
1
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.: 3229200040
Address: 13765 MACADAM RD S TUKW
Suite No:
Applicant: FINDLAY RESIDENCE
RECEIPT
Permit Number: M10 -036
Status: APPROVED
Applied Date: 03/23/2010
Issue Date:
Receipt No.: R10 -00514
Payment Amount: $173.50
Initials: JEM Payment Date: 03/23/2010 01:00 PM
User D3: 1165 Balance: $0.00
Payee: JEFF STONEHILL CONSTRUCTION
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 1306 173.50
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
MECHANICAL - RES
000.322.102.00.00 173.50
Total: $173.50
PAYENT
RE0Fi ED
doc: Receiot -06 Printed: 03 -23 -2010
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
/&tra —0310
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila, WA 98188
PERMIT NO.
(2
(206)431 -3670
Pn
d 1 Ak
keS.Lk(.G
Type of Inspecti n:
e_
A 4
Address:
t d' A
Dat Iled;
Ak�
Special Ins uctions:
Date Wanted:
a.m.
Requester:
Phone No:
Approved per applicable codes. El Corrections required prior to approval.
COMMENTS:
L■1),1 1 e ()- j,,es Ak
tow j to
Inspeytor:
Date:
� J
cy
LI $60.0 SPECTION 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
INSPECTION NO. PERMIT 1�0�
.Mid ■ O3(
CITY OF TUKWILA BUILDING DIVISION
e.
6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206)431 -3670
Proje t: 1y^' � /
(/� �+ tr "lam
Type of ns•
+i ' ► e d • f
Address:
Dat- Called: R 0,, 7trx. _
Special Instructions:
,t
Date Wanted: a.m.
Requester:
Phone No
Z.6,—Z2(--322S Cti
ElApproved per applicable codes.
Corrections required prior to approval.
COMMENTS:
t-,,b t- 1 0 r .per (FA •U s r
Ae—eK C-JcIAA-&6'T — lt7
Inspecto
Date:. (3 (
ri $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:
- ._.. . _ — ... .s. , m,,.,.._ `. �. 1.
Contractors or Tradespeople Pier Friendly Page
General /Specialty Contractor
A business registered as a construction contractor with LEI 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 Ktiemann Brothers Htg & A/C In UBI No. 601849453
Phone 2535370655 Status Active
Address 4703 116Th St E License No. KLIEMBH021BT
Suite /Apt. License Type Construction Contractor
City Tacoma Effective Date 1/30/1998
State Wa Expiration Date 1/27/2012
Zip 98446 Suspend Date
County Pierce Specialty 1 General
Business Type Corporation Specialty 2 Unused
Parent Company
Business Owner Information
Name
Role
Effective Date
Expiration Date
Ktiemann, Herb
&Nbsp;
01/01/1980
Bond Amount
Kliemann, Tom
&Nbsp;
01/01/1980
RSB763469
Ktiemann, Chris
&Nbsp;
01/01/1980
01/01/1980
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
4
RLI INS CO
RSB763469
01/27/2005
Until Cancelled
$12,000.0001
/13 /2005
3
DEVELOPERS SURETY
& INDEM CO
447697C
01/27/2002
Until Cancelled
03/17/2005
$12,000.0012/31
/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
11
TRUCK INS
EXCHANGE
600604774
07/15/2008
07/15/2010
$2,000,000.00
07/14/2009
10
TRUCK INS
EXCHANGE
600604774
07/15/2005
07/16/2008
$1,000,000.00
07/05/2007
9
NATIONAL FIRE
& MARINE INS
CO
72LP162481
07/22/2004
07/22/2005
07/15/2005
$1,000,000.0007
/25/2005
8
TRUCK INS
EXCHANGE
600604774
07/15/2004
07/15/2005
$1,000,000.00
07 /27/2004
7
CEOXINGTON INS
5207430
07/22/2003
07/22/2004
$1,000,000.0007
/28/2003
6
OOHIO CAS INS
BK052973582
07/15/2002
Until Cancelled
$1,000,000.00
07/26/2002
5
AMERICAN
STATES INS CO
01CG125370
01/27/2002
Until Cancelled
02/05/2002
4
AMERICAN
STATES INS CO
010E3339464
01/27/2001
Until Cancelled
01/17/2001
Summons /Complaint Information No unsatisfied complaints on file within prior 6 year period
Infractions /Citations Information
Infraction / Citation
Date
RCW Code
Type
Status
Violation Amount
F39952
7/28/2005
43.22.435 RCW
FAS INFRACTION
Satisfied
$200.00
https://fortress.wa.gov/lni/bbip/Print.aspx
03/23/2010