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HomeMy WebLinkAboutPermit MI97-0194 - ANGEL LEE - DEMOLITIONCity of Tukwila ( - (206) 431 -3670 Community Development / Public Works • 6300 Southcenter Boulevard, Suite 100 • Tukwila, Washington 98188 MISCELLANEOUS PERMIT WARNING: IF CONSTRUCTION BEGINS BEFORE APPEAL PERIOD EXPIRES, APPLICANT IS PROCEEDING AT THEIR OWN RISK. Parcel No: Address: Suite No: Location: Category: Type: Zoning: Const Type: Gas /Elec.: Units: Setbacks: Water: Wetlands: 004300 -0306 15420 35 AV S DEMO MISCPERM RC DEMO 001 North: 125 .0 South: Sewer: Slopes: Permit No: Status: Issued: Expires: MI97 -0194 ISSUED 12/04/1997 06/02/1998 Occupancy: DWELLING UBC: 1994 Fire Protection: N/A .0 East: .0 West: .0 VAL °VUE Y Streams: Contractor License No: BUILDBI0668BC OCCUPANT ANGEL LEE INC 15420 35 AV S, TUKWILA WA OWNER LEE HARVEY C 15420 35TH SO, SEATTLE WA 98188 CONTACT FRED THACKER Phone: 206 772 -5386 13001 MLK JR WY S, SEATTL WA 98178 CONTRACTOR BUILDING BUSTERS 3001 MARTIN LUTHER KING WAY, SEATTLE, WA 98178 4********************** *** * * * * * * * * ** * * * * * * * * * * * * * * * * ** *sir * * * ** k * * * * **** *sir * * * * * * * ** ** Permit Description: DEMOLITION OF 1200 SF EXISTING SINGLE FAMILY RESIDENCE AND EXISTING 200 SF DETACHED GARAGE AND ABANDONMENT OF SEPTIC SYSTEM. 4*************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Construction Valuation: $ 5,000.00 PUBLIC WORKS PERMITS: *(Water Meter Permits Listed Separate) Eng. Appr: Curb Cut /Access /Sidewalk /CSS: N Fire Loop Hydrant: N No: Size(in): .00 Flood Control Zone: N Hauling: N Start Time: Land Altering: N Cut: Landscape Irrigation: N Moving Oversized Load: N Start Time: End Time: Sanitary Side Sewer: N No: Sewer Main Extension: N Private: Public: Storm Drainage: N Street Use: N Water Main Extension: N Private: Public: 4*************************************************** * * * * * * * * * * * * * * * * * * * ** * * * * * * * *** TOTAL DEVELOPMENT PERMIT FEES: $ 46.50 4********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * *I* * * ** * * * **- * * * * * * * * * * * * * * * * * * ** *tilt * * * ** * * * ** End Time: Fill: Permit Center Authorized Signature: 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 provision of any other state or local laws regulating construction or the performance of work. I,a -rrr, jpthori zed to sign for and obtain this development ue -rm`1 Signature:: Print Name: )7e'c, frJd 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. CITY OF TUKWILA Addess: :Sul te .: Tenant MISCPERM Par ce1 # :.0043001-0306 Permit No: Status: ISSUED: App lied :. 71./0;;/,1997 Issued: 12/0411997 • k- A*• kAA• k* k** kk•**• k* is* h,*•**" M` Ak* k*. k. k. kA*.**. k * ***.**k* **** *•k• **•* *4k•*-k *. **N•k•kAk•N4A'k *•*4*•fkk' Permit. Conditions 1 ;Temporary erosion :control measures shall be•impl.emented•as the f ire ,t 'Order of bus ines� to ;pry vent, sedimentation oft site.: Or into., exist;ing:;,t rm drama fa i l it`ies. •ALL ' CONSTRUCTION ACTIV:ITY- ASSOCIATED WITH ,TH,I "S DEMOLITION SHALL BE LIMITED 'TO W:ITHI,N;;10' OF THE BUILDING EXTERIOR: LL; 3 APPLICANT SHA CONTACT WD4 .REGARDING CAPPING ,OF .THE WATER `'LINE,', AND VALVUE DISTRICT' @; (2.11'6) "242 3`236 ''REGARDI,N,(3 CAPPING OF SANITARY.<$;IL E ':,EWER:: • No Chang . wi l' -1 b`e•� made.• to 0.:e- "..cope of wiirk, unl es.. ;appro've'd by Tirk.w'i „l :a Building ,Divisi,ont: Al ;1 pe.,:m;4ts, inspection r~eciprds, and approved pl;ans'shal1'`'b,e available b' the ,job site`' r�ior to 'the start of any c6n7 str~uction,•,''`'Tf ese ,documents ar�e.,to be maintained 'and ,:a41,1,-; ab 1 eAiiittr final inspection approval is granted. • Comp,,i wi th the requierements',`of TMC '16.04, Demo l itianrRe;1ttc • atia 'of Structures °and Article 87:''.of the llniform Fi;r•e'`,C "ode..5 Remove all',weed.s,,, con.cr�e''te', stone : ".'foundatio•ns, flat ‘con- cr ejte concrete patio.',.,.masonry 'wc l l�",' g rage floors`, drive ways •and si�,mi lar ., s,tr�uctur�eS,-'and ai.,l i:a :o re. rn;iscei laneous, . . . mat :erk`;i a 1 . Y Proper :i:y _ ca'p r sanitary sewer • and . °wa ter connet: tion , pro'perl:y.fi ;ii" art otherwise protect "all basement';'"':-:, .c.ellrar,s,; s;epti'c tanks,,=• wells and other erc.avations Va l i,tizi ty o: Per,n►i t, The 'issuance 'af a pe-riii i t `.or` appr•ovatl o plan °s ,spe,;icati"ons, :,and computations "• hal i not .Lie con' strue;d ;to';be :a R'e,r`mit for, or are. app"ro+va1 .of:, "any 61.41 or of • any'ta;f the pr ov,isions of the ,bui ]ding code or: :of any pt,her.0d,i:rlance oi'` .the iuriscii +:tiara. No per...mit' pre sum irtg< to give • authority'' to violate or cancel of this code shall, be v l id :. • CITY OF TUKWILA Permit Centel 6300 Southcenter Boulevard, Suite 100 Tukwila, WA 98188 (206) 431 -3670 Project Number: Permit Number: d Miscellaneous Permit Application Application and plans must be complete In order to be accepted for plan review. Applications will not be accepted through the mall or facsimile. Project Name/Te ant: K,tiGG� x,6'5 Vie- Val f onstruction: GOO Site A r s: ��� �' p v� �, City at /Zip: 7ti'4'rl a City ,/ Tax Parcel Number: aO 5/304 —03(0, Pro A *er: V L Ph 4/ 3 go// Street Address: City State /Zip: Fax #: Contact Perso I C t2+ City /State /Zip: Phon2e:1-/3- ?G // Street Addre s: t P4a ,►j City State /Zip: Fax #: -5I o- (pc/0S Contr tor: t 0 u i L a l' r-t &dt-x_,C 1_Thl C-- Phone. 77 - 6 - - 6 6. Street dress: 5 00 ✓LIL/C. l/u o c. S � /� State » Fax #:772 - 5 3 ? 6 Architect: /� IN ( Phone: Street Address: City State /Zip: Fax #: Engineer: / 1 /A- Phone: </ Street Address: City State /Zip: Fax It: MISCELLANEOUS PERMIT REVIEW .'AND,'APPROVAL- REQUESTEDi :(TO BE FILLED OUT BY APPLICANT): Description of work to be done: t Gtl�u- c( Ur malt c E 5t'P j-i L 1 —/vice L . •4UU S C t't / • 6 * i Will there be storage of flammable /combustible hazardous material in the building? El yes ®- riv"""---- Attach list of materials and stora • e location on se • arate 8 1/2 X 11 • a • er indicatln • uantities & Material Safet Data Sheets ■ Above Ground Tanks ■ Antennas /Satellite Dishes ■ Bulkhead /Docks ■ Commercial Reroof El Demolition ❑ Fence ❑ Mechanical ❑ Manufactured Housing - Replacement only ❑ Parking Lots ❑ Retaining Walls El Temporary Pedestrian Protection /Exit Systems ❑ Temporary Facilities ❑ Tree Cutting APPLICANT;REQUESTFOR MISCELLANEOUS PUBLIC WORKS PERMITS ❑ Channelization /Striping ❑ Flood Control Zone El Landscape Irrigation ❑ Storm Drainage ❑ Water Meter /Exempt # Size(s): ❑ Water Meter /Permanent # Size(s)' El Water Meter Temp # Size(s : Est. quantity' gal Schedule: ❑ Miscellaneous O't710 1P "� I 10 Moving Oversized Load/Hauling Cl Curb cut/Access /Sidewalk ❑ Fire Loop /Hydrant (main to vault) #: Size(s): ❑ Land Altering: 0 Cut cubic yards 0 Fill cubic yards 0 sq. ft.grading/clearing ❑ Sanitary Side Sewer #: El Sewer Main Extension 0 Private 0 Public ❑ Street Use ❑ Water Main Extension 0 Private 0 Deduct O Public O Water Only MONTHLYSERVICE,BILLINGS TO: ;: ' Name: Phone: Address: City /State /Zip: 0 Water 0 Sewer 0 Metro 0 Standby WATER METER DEPOSIT /REFUND BILLING: Name: Phone: Address: City /State /Zip: 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 schedule¢,�1 O inn Expiration of Plan Review - Applications for which no permit is issued within 180 days following the date of applicatldn shall expire by limitation. The building official may extend the time for action by the applicant for a period ngtoKoirn 180 days upon written request by the applicant as defined in Section 107.4 of the Uniform Building Code (catifittfit1149brickajplication shall be extended more than once. Date n applicati accepted: iI• -1� Date application expires..> C Ap Heatlon en by: (Initials) ALL MISCELLANEOUS PE' APPLICATIONS MUST BE SUBMI D WITH THE FOLLOWING: ➢ ALL DRAWINGS SHALL BE AT A LEGIBLE SCALE AND NEATLY DRAWN ➢ BUILDING SITE PLANS AND UTILITY PLANS ARE TO BE COMBINED ➢ ARCHITECTURAL DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED ARCHITECT ➢ STRUCTURAL CALCULATIONS AND DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED STRUCTURAL ENGINEER ➢ CIVIL/SITE PLAN DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED CIVIL ENGINEER (P.E.) SUBMIT APPLICATION AND REQUIRED CHECKLISTS FOR PERMIT REVIEW ➢ Above Ground Tanks/Water Tanks= Supported, directly upon.grade exceeding 5,000 gallons.and a ratio of height to diameter:or-.width: which exceeds 2:1" Submit checklist No:: M- Antennas /Satellite Dishes ; Submit checklist'" Awnings /Canopies - No:signage. Commercial Tenant Improvement Permit ° . . Bulkhead/Dock. Submit checklist , No:,: M= 10;. Commercial Reroof Submit checklist.' No: ; M-6' Demolition Submit checklist`, , , No iM3a, Fences - Over 6 feet in Height Submit' checklist, 'No: M -9: Land Altering/Grading /Preloads Loading 'Docks Submit checklist ., No: M -2 Commercial,Tenantlmprovement: Permit..'Submit checklist` No :1H -1.7 Mechanical (Residential & Commercial) Miscellaneous :Public >Worke,Permits "Submit checklist; Nor . M -8, 'Residential +only..» H =6,, H16 Submitchecklist: ' •. Manufactured Housing;(RED INSIGNIA ONLY): Moving Oversized;Load/Hauling: ❑ Parking Lots Submit checklist No:: M -5 Submit checklist No: M -5 Submit checklist. No: , M -4 Residential'Reroof - Exempt with following excePtion::Ifloof structure to be.repaired or replaced Residential Building Permit Submit checklist No:. M -6r • Retaining Walls - Over 4 feet in height Submit checklist ; : No: M -1 Temporary Facilities .Submit checklist; No; M -7.': Temporary' Pedestrian Protection /Exit'Systems • Tree Cutting. Submit checklist ;No: M -4..', Submit checklist No: M =2 ❑ Copy of Washington State Department of Labor and Industries Valid Contractor's License. If not available at the time of application, a copy of this license will be required before the permit is issued, unless the homeowner will be the builder OR submit Form H -4, "Affidavit in Lieu of Contractor Registration ". Building Owner /Authorized Agent If the applicant is other than ,the owner, registered ' architect/engineer,.,or contractor.licensed .:. by the State of Washington, a notarized letter from the property owner authorizing the agent to submit this permit application and obtain the permit will be required as part of this submittal. 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 O OR RIZED AGENT: Signature,----- 1_,..7- tL I Date: /// ?/?/7 ,7e_ _ 55- a x #:772._ :3 F-, Print name: F a,ED "%l ACLE It- Phone Address: 23001 rtr'.zsi u,�/44(ry , y Cit /Stale /Zi P � W 77 MISCPMT.17fr 7/11196 * 4 A4ck# A•.* it* OAAlk*Afid•AstAi4k !c R•,4+l1 401,0fislh4,•A•fi*0 khA•kA44,*r•14fi CITY OF TUKWILA W( -7-0161 _klfiAAk. TI'tANSMIT. • kkAsikdkAAi hAAst il# A, 14Afifi •kk *A0.4∎0 **#Afi•*.Aka•1 0,*11 gth• Aso ***/%k.A;A'A41■14,.*IcA***•A TItANSMIT Number R9700GE37 ':Amount: 46.50 12/04/97 10:37 ,;.'Pa.vment Method: 'CASH Notation: f3U].{. )) 1t .OUSTERS Inuit: WA13 Permit. Noe MI97 -0194. Type: MIECPEPM MISCELLANEOUS PERMIT.... Parcel No 004300 -0306 Site Address: 15420 .75 .AV S Total' Fes: ,, 7h.i s Payment: . '$b . 0 1otxl .ALL pinta a, 13alancea ,' •k• * AAA•m:A10,,4-A.4Ar *Ai4k.k#* *s1 #Jr#•kfi.Ah #slfiiir A• *44*A.hfi.Ak,d Account; Cade p0.0/5224.0.0.,' . 000/3136.904 : Descr i p t; i.0 •3pTLp]:NG Nf1NRE,5 ;iTnTE HUII:I?ING SUIiC14nioc: r� kkslrl kki** 11444•hhh *til•hk•hk *#kk *Ak *kh'h *4**kA4 *.At k :sr .k* *. 1•CV OF 1 UI W1L �1A -- `( IRA M11 k% 4k #• • A• hh:k:k.lhl*1rkk.k3 * *tkk•kh•k•A 1`'11A0 iMIT i4umbPr a`.�70OLt7 Amoun ;: :;,a49. :20 2,04/97 .11n0Q .pa:ylnot t :.NNe,thodn ,C1 )tCIi 'Not ation. AJAX (4.11.tT ORI :C'Iiit'i P.. Perin it . No: 141,97.-0194 Type: parcel Pin.: 00430Q-0306' Site 'Address: 15420 •`3 Ay 5. Total Fees: 1J•.1592,.70 . This Payment 5,546.20 Total ALL Pnitsx 5.592.70 ri cllanGe: .Q0 k ;*. * ;44,4 tk tai h A:A.k jk 0: r1 /04 01 * is tl IV sl * d' i tl A. 4r';t 04. A`$ st iF4 44 y4 •A 4r 0 k ;ii, 1 k• d' 1‘r4 ak lt,l •A...: Account Cade` Desor ipt ion Amount 00Q/386..90$. ,. BU;) :L,.DTNG fOPIU /DEI'Ual:'C.: 51;546.20 INSPECTION RE(ORD Retain a copy wi& permit IN6eF,Li70N O. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 981 PERMIT NO. 06 431 -3670 Project: A Type of inspe- ion: �-- Add ress: Date called:..— Special in= ru tions: Date wanted: /2...../s17 a.m. `r Requester: Phone No.: Lliti,LApproved per applicable codes. Corrections required prior to approval. COMMENTS: Inspector: ADate:j2 —A<S l 1- $42. ' 0 = INSPECTION EE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. INSPECTION NO. INSPECTION R'ORD Retain a copy wi ,aermit CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 (206) 431 -3670 Pe • T lion //''�� YPepjV Date ca ed: t� Li , AcIcj�a¢ 1 5 /^ 5 1`71 %'j' Special instructions' /all t(Siio (fl-i- Vwvi Y.,Y ao wR' v_k 0 L. Date want . 5 a. m. Requester. Pho 3....(055-69 i/. Approved per applicable codes. Corrections required prior to approval. C MMENTS: • Inspector: �� ' j� ,6" Date:, J 1 r.„9 7 $42.00 REINSPE N FEE REQUIRED. Prior to Inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. INSPECTION NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila, WA 98188 ... e - �'•+�++tiwvtl�w.ttmLMMiar.�t'�RR[Y �lP,���i7j�' INSPECTION RE ORD Retain a copy wiOermit )91M-3171/ PERMIT NO. (206) 431 -3670 Project: A . (J T� n 11 Le C .1. -2)(2 7 Type of inspection: CT , L.1./ t.e.., ,1 ,.;:- . r.1,Y -.,. Address: /5'-' O .`� A v S . Date called: 1:,, / _ 7 ,� r / Special instructions: 7/72---" ��J -hone Date wanted: a.m� 'Requester: No.: _ Approved per applicable codes. Corrections required prior to approval. COMMENTS: le /toe f ' ,1_ e,S -c 6'cA $42.0 EINSPECTION FEE REQUIRED. Prior to inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. 1 i-71 yfrer V` CITY OF TUKWILA APPROVED Ao DEC 0 3 199 AS Pdif l c A 0 9 fSS ) 5142 -o 3 5'- Ave E o, IA)C1/ 4e aer Z S-6 Aver" FILE * PY 1 unc �;: ' ..: f t' . . sut : ::1 t. c... ::1 omi JIor plan?, c:coc not authorize violation c; .., adopted codo or ROOM, pt of contractor's copy ci_approvor •. Dato Perm(t No. pr ,�. eye ki mH.en. mkt %MAI1. RECEIVED VED NOV 0 3 1997 TUKWILA e -UBLIC WORKS //iJii 9 Y/ Agency U:te. Ont.' Pt.TGE..7 SOUND AIR POLLUTION CONTROL AGENCY 110 Mon Steel, Suite 500, Seattle, WA 9g1C1-2033 rciariC2, kri....Zic TO PERFORM: Date Received 11J. J . AgencY Ute Only 1997 A t'rottLctrioe: 2. 0 'Asbestos Removta 2. f3 Asbestos Renton:1 Demolition, No AsImtos Removal Mae MY: pormaarrasha0a4Wanalillailillailatal... atoraart.am.a B. Prol.,..triy 07r;f:r: •••■•••• P. rty Owner'.s 1V1,•i1ing A.ddress: 11111111••••1111.10■111 Al-'1 L. Inc. ?O Box 68925 C. Mito Contractor: wataaaaKatl• r'1-645.i:4411.7(.1..t.i14.T. ',ILL NE row, ,v1=4411,17.70 CZ-4 Walker Szecialty Constracaor, IState: WA MaiIinzt Address: City: FO 13ex 469 Snohomish Ia. 93291-0469 D. Sire Addr,=: 15420 35 Ave South Project Mazager or Con.tzct Person: Chy: Sea-T2.0 V/A Zit,: 98 i 48 al " I ?hone () Ast>.4tos Survey or No. of 0 Ma'1Pro.snmeti: Stracrures: -crirN:.rr: Beniarain T. Cook Dat.: Survey was Cenducle-d: l' F. Dzi N0. si Inforrnatioc: Strozares: Contractor: Daidtr.0,* A:SU.sters, C. 1 Sart 10/18/97 C9Ordered Demolition (attach c.opy of Ordx) F(206) 7721,5556 1.....441:81.5.....41/1:4/(40.14aaa*Iaaaraaaaralal addaaantiaaliatiaiaLraaidal.10.11. W,3.$ AS'OeSTO4Foar.d? 7/30/97 0 If No, Attach Survey J&J970219- Expiriciox C.-.rtif:c.i.tletl. No.; BI.R-'0L.n.:.i•ELLL?./lzL9.L.. Thdizin3 Fire (List Firt.:1)._ demoiilion contractor blow) aoasaaaaawarwaaaaasagoas., C. 4i..sig.:sees ...?rofJet No. of &-.o.J.cm.r.ts: IL formation: (see back if> 1) Stz,..rt I Con....pletion Da: 10/13/97 p :caw: 10/17/97 Day61..., Hours: 71=-3:30rIn -fatal Ouaatiry to be Removed 240 Linear Ft. 300 Squart: F. Thermal System Insulaion: TE Boil,•,.-,AFum= Ia, U Due: ms. °Pipe ins. I Will all asbeszs athrial b. I =oyez! by _project compleiion? I Li Fiecpr0011•42: 0 Paints 0 ?las-cu. Corailgs r Smfacing Mae]: Misc.:pfiat'1.19. Cement Sd. Cement Pipe Ei:kori.^.3 Ntat'1 L..:Rool5ng Mat'l Ott= VC/1.nd o tit/ au 2.1aaalheaaa..abas 1, ,•• 0 No WU«. 'Ima.-..loYan.takaamas.alraammardwaaialaa...railaati ..bestos/Dt:malic;:-...a Catgories: Wahins! ;04. I. Owae.r-Ocr:upsagi Rosidnlial Asbestos Removal :Project 0 CA7inet--0,:z.:piz:ti Residential Asbdsto..; Re.alovel D4ra1.:::.n Project Owtax-Occeoted uu Cemeiirica *Proit.a.14.o • 1 - as Odle: Decaol.l.:er.ul With No Asbestos Removzi Proleor 3. 10 - 2.59 fee. or 4:3- 159 vac::: off for mdon:..) 4. 2 6 0 - 999 lineal. or 1::-C• - 4,999 5g2tlartt 5. - 9,999 linear feal or 5 000 - 49.999 ..;.ovazse fe,:t 6. U 10,000 - 49,999 iintar feet or .50.,0130 - 99..999 sounre feet 7. LI 50,000 - 99,999 'linear Pet or 100,000 - 149,999 s feet 3. U IC0.000+ linear fr or 1.50..000+ seilare 970 Ey Mbet.,-tos Projt.et OMThmemency Dennoliziera Project TrCi Alternate Means of Complianco for Eriable.—.1thrids or 0 Demolitions 11. U AIL-ante Means of Cormaiiwca for 3:..siNtStelS Palled NON-REI7UNDA21.7. S25 S150 Days 10 1".:ays • arramaran-arar-raaam.waballia 10 Da. -s 10 Days 10 Days 10 Days Prior 10-Day R.eview Period Con-it Proi= $300 $750 S2,000 S5,000 Zee Fee Tyvic Project Fee Proi•ct IS10,000 TwiCo •,„ I. I do itc..^galy c=tify thrt the czczzinacl in Cris t:otiii:-...±011. Ind supplcr4=1 ±ta c s •tz-t cf Icy z..:w' rac v.4d eornp. I .ths.11 not cause x allow *ay prej,:et r tk.-nciicAl .Ltrritie; to b.jn until the x,..i.i4cyritze wits ..1e4 hs c.114w.d, ,• ...//1/1/77 1. I ,1.■ ,s/ 1/1 11!•_11,.. Y.. Compl4ane.-.2 Min 1991 UKWL r ©' d itj1L�l The Yag„ t,S i:;d Air �0:1:COi Control Agency ('SAfC_ . :'4a Lds advance 2L1"0- before Faf, k.C"'s. 01 "(' ^. • 43 • V coi meric s an asbestos project involving materials : i I" to or •72.0 3ti: in size t ' +ri 10 Linear fiends! 43 SCitl::ieiie''ufr::llt1' Ur all u :n r ' projects (regardless of 3..Sbastos conwat) involving strtic : s with a p' .oj Led roof arc'a 120 Sq'aaa:e fees (R�51Iarort DI, Arricie 4). All asut` erns and dezaolidon notif C.:uione and inotiaa on parr, 'tr^r.-,r-an¢ =at w PS.- tPC.4. oL Agcy form No.: 66-•160 ( :"`Y:sed 7f95) and No. 66 -173 (Revised 7/95) rvuly. A . . r,:ri --.r, t,^ i v. r e *, SUCSr•: a!'� C °r, ^.O�ItIn" t"t'71I�� 11' ✓Ci VITi1' t'`. -. ?3S ij C� ?TT ..tl:i'..., t •- •.C�4. C :10'utC7.'t,,�'J7„Q''1 �,775`::�t'1Cilf� 12.'x' S�.'1_. •i:�•�... -., :C nl %or.?At Reffolatiop. DL ta,yC+2 s• ► Ave �. i t't..�'' j'C f>t 154-2o 3- e 5. Stu- flu ��:..t1n 13'l�, tr:,lU -. YL •!�."".+C'7�✓. � VAN . .+4r -Taz. i( J) J, /j ekfc/`�,/� L Dv.racilrla:1 Cana °r.; zs:: MlziligAdii ss: ,300/ ML.'. \Ji 5. P o= C2.00772 - 5� City: pt;- � Scar: VIA HD: 817 6' ••• •.•� "W 'IfJi:lrJi"' -••_ •li•W- r'^r_'"h +1T %.=-/' 1i 2..- saiiLVJ7ib41ii:3':TIZt ,XWML:b z_oCri7a - A 38'6,: Cuozrzcze s Job ;i: t' " t f 5 ... •. s. w, rN S'" ' y •...•„� : R r r. r Q 1r� t w •....�,. v x"1.:.1../ i3 l i � i'T �1 .� s• + .::G.JaL�t~: ..::a ri.?r. �?�u:��t � � It•l4i roi'. J�J_SiY.� { .J..•t.r ��, "i"lr� A T1tJiV , The PSAPCA nc:iiccz:o form mast be � w sami: a norificaaior. for an :isc,:.:,-u:s project, a combined ku;,zstG:a or dc:mlidicu project and a dexcciidon piojC:L:'t w afe:'3o GSbestOS r.:.~t 0v$.i i tth 4 price: tz ..+'..:'ivbv a coY:lli ° e noti1'icatic with the apprcpr:re project f . PSA CA. will IVriew die for ant re r 3 celery to the asbestos andfor dG> sGeiidon c:,nvacrt: by mail in 3 to 5 days. 'Me rella ::t'tl� Co .y will be your validated coalma :cu. S".L'S I. C rci:: the appropiiate .*'ioLi.carior' box On the t. p of the loan to .'li:.:;It "•`. '.:1$ :ype of zetii',G.+r cii being stib and eater the legal own."'. ^J isafrx.- a.-d0u iY -.:3 on ta.. Step 2. Ens:.': the: asbestos Goan-am-or i::iorminon in Box L and he demolition mc acme ifor:.:atici1 i:i Box ! (above). Step 3. Eater the 31;+. '.:+d -i. To: all :2061..4:zic.,as in :Bo:: C. "zap .rY rx.1 u- st:::Ly:,'.rd p.cojixts. �, 4'+:.•. Ent:: tine '���. Y n .K. . .1 ire laooii3 :.i d. ;: t acop'i or C. li"r�'J 11C for to`,,e St.:.-11 4. �C.. .W ..$ wS ::��i t�L') Ua.:Jr.Ti:...:i 1uG ta:a �.4 'o :,:� L. 3:: :,..i � 7'ti•".il. +..�I"'`' i y '_C'47:7i ;1jllii71.V :c i1.1: -s• /. * {y y. 1 n1 + y l q +'►r S:41? :.I."+'3 S. a.-ca t:".. '...r-ita rreG vi : t/, i.+.1. tiaf'J:1 1iHt7 .1.1 'Lon `.w' . and ch -Ic 3: the '.�J� l L'1 "i•''" ie box. i the '..�rariii ,'./L.• is i ,T • •'YJ Ere ' •... .� . a (a lc :i E i' dwa: .`. r �:aiC 1'::"t vr,..7 .1t :=•Cli �:i : City C•:. :;.t.,:e Zf,�1 t;i iii• `.r L v" •. .. 3S'ml.. 6. Enter S!.Dis 1. Q.t.:::.•." one piQ ec: Cate; ory iri .{Stile v I - ti. The prof t...•.: fed for e::t:oo 1 1 - 6 i'nc1 dez th thx.: demicKdonifee. J✓.."GC1i oo p:ojecta sxit.5 .lei asb+:," to i /1170111 rag hz..i 10 lizaa :a ric or -•r.... p<ie fee: :Is zc_::ir. � No. In a:iaoc 'ta 1:::.fai::`J7 •a �'!!`•it1�'.t i r• a ' .':L' �i ^,i ^•,t_ "-f_ : :7_ S aVo,j t Yx.s f_ : care-pry v�!i'!y I✓ b1- af1.1r 1 - at:-•scas or I c t: nuu tcs p : o5u`�t axy ....z =4. t by e1 ii :'erI:iV t =gay #7. i U":est ., I a 7.:•x::5' (C'S lr v.r,bLe ; ?..r 'i y l Z���• r:l j'✓... i t ra?rri =.rtrt s t'.:•'r° � i..iY �r •:iF.:'[, �i� FiLti i11Jt f 1 ' `.C; �r,-.w': :i "�• "•°S ::t'i ;1` -i}il G' , •:. t a 1Icr7. ••'r. , ¢ +r•,L: S ' 1 i "Y .� `.: �: ••r.•;t .y y' ,., n• +• m j . " �. .._ ,. `r {� ^ti l% ur..+rYJ i � �. �� •v Ii '';j,il f'1°iL{'�ll;,s4lly. i- �•r i.r.•trt;•w:WS !i? ; t"A'!',r," .t r`rn Y�''�ii; :i.::�i4 �� '':� .�y.`.,..N .�,, •'fir 1 " -� . v.r'• " 4• a v •h w : {:...te.w r:,. lc C'1 p. ^`• ,.=. �b ' �� . l =_ aT� 1, f :'; iU :,:.i _t..,� �.. '�Ii i'..::,'•'`i7,. T:".,:;'.5'+ ':,. Jt._,Iu....+.•.. r:7_ •;-. or no.._ iiP?:la. i ", • C• !_:, 7 `C..'.."' a iatio:1 of :acs u i i.:iry rr: n't J:. a± f::' ii »±..::i: r.:: . "' with .` ega! •:t:ii:: l.::c.:.Cn: w.0.S(b) L: for '- # t Cf II:a7l:Lion '7:'i+6 r..:iv: es be1.: I.yw tats aaUiie t/�/ :'r:r = .ill :l ,�^ u g ,T"f 'li L. 7 5. St:Cp 3. ?l ':: -er•ify the ;:t •i:�.iz"` and c et =:: ci he ilifor " 'off'ii` i by `ai g snd c;• ,a'tti'c 1:o'C{is.:L:G`'it b ` .. f oFCpI r y �;,u;` Lb :�Zx:�:. MartrintoYy aillmdnzo2::ia :o ci noldfimdor d. rec,:i.zd fcr'.'•haritg%:.' ' that 1.:1- erse the project t ::r. or f C1±s11g! th typta of a.be itos ra:.s:ri,T• to b : venlove;d Ind work sr-ne;i:aic eyz s. silo ftx.A ; .. _:ti waz...s if tla : I:o .szr,.. . a...., irec�.fo: w:,:� sc:t.•..r a ,,.-., r•.w J is parr;pr.nog in u:ts Agexcy work scheduLt fax p:ogxstx. A twctity -rive dcliar prcce ;;ing fee is tY.T.PliS E r4Lattliarite5=11t5. For technical a~sist nce. con=t Tom Hudson at (r'OS) 629 -405S. /.:ay Van (204639-4035 or 5:7,, 4054. Forirquiii conc,:rning notifcalon and am=dirent eciotaC Aixa Morgan (206) S.Liti.� vets.:�'c.. c3• �c�." ; ;:c•ris:.17:`75.*; r2 :- TUKWILA I-Ul3LIC WORKS • •••••00•••••• 1, • .1 •• LICATION # - • • . Ann Fli.T.,171•16/■■ SEATAC te : • APPLICATION FOP ,.:1TY BUSINESS LICE'N'411,,::?':: 17900 111TERNATIO:.'A;.. 3 OULEVARD SUITE 401 ;;;•.' , WA 98188 (206) 241-:-..1(.;•;! FAX (206) 241-3999 TDr C"...;(;) 241-009 ;;; • v.. • •••••,....nmeyrevemrw.mometa oramonsomesamoust•smonvi••• •••• •• • •• I.T.1■7•■ ant •Al0111•1118•WIITOW4■••111.....V.101•••••••••••111000004041... .a01•Wst Mary The City of SeaTac Ord. #10-103g requires that each bustnr“. 'perating wtthin the City limits must obtMh7businoss registration from the City Finance Department. Each year, all current busincr,r ,r. lre required to renew by January 31".0.Iitlfio following year. Failure to pay fees by January 31' will result in penalties as listed In addition, if you change your busliiesi'address, nature of business, ownership, or if you discontinue businass activity within SenT.1,:, please notify tho Finance Department at (20(3) 241-9100. This validated form is proct of tpplication only and is not a licoii V. in business. 0110/1.0,0,0•411ILTT, •••••••mnromr.Leammusaot • te • • • Am- eT".",•••• 114.111124•P•re•■•••Moly.m rosamoludramismaloornmarsoms, • •••," ••• • r••••••■,,,,,,t,mirn...rtt vcr•vervrannoursamwasev •••••• • • ...• r• • ...,••••el.00 For 6100,00,0001100 • ININMY•011111.000•04•11.1•111•Mwor BUSINESS NAME: 12 2 L. j • SUStNESS ADDRESS: 7//. CITY: ,rtiZe. STATE: /4./4 • ZIP: 711 / 7 ) (1/ MAILING ADDRESS (i( different from above): BUSINESS PHONE: /02 - 6:-•:-S.7. C,<-: NO. OF EMPLOYEES: ,i2 r.:3 IS Business currently licensed with SeaTac'?: 1 If yas, under what name?: t.L.(1— i Data Businr.-15 r,ponod: In City Limits?: U•B.I. # (;•( __,.„..f.. (' 7 (.7 / ".."-. _____....::.....,.......—• ----..........,„.......—; ' NATURE OF BUSINESS J. 1/.,44%,A II ' PLEASE DESCRIBE: .65NTRACT OFT .,...S.t.u.i.J.L.A.',.....1iff(k_kc• ••••• et 4......trerinn . . aumrsan.aervvr. ta,:rtr, •••. • , ./ 4 CCHECK ONE: ( ) INDIVIDUAL PROPRIETOP List Owners, Parioers, or Officers: NAME(S): -Ai(' `..1.:- 2,.._11_/:,/ (-1 ••/•••■•' " — • •—■••■■••••ftaamanondowine•sino.cotoom Anon. worn., c••■«••••••SZI2sawm.marefsesr. / • /1 0/11 or 1 • HOME OCCUPATION: ( "WES (e..) If yes, you must complete a Home Occupation questionnaire ) PARTNERSHIP (44-GeRPORATION ADDRESS: 1„ ( , • I / CITY: (7-6. e. STATE: ef'• •,11 ZIP' ("2"4:772,1 PHONE: ?2L j? .0.0I•a•• 0 00■0100•440 mum, .40.0.•■• VIDA.110•••••0M1000n0 •04;i O. • • • • • or • •••• •••••••••• •,/ APPLICANT SIGN,A,TURE: 'I ...1R.IN:.__NLvr_ELIIr1-,F: C . ..:-, . 4,s '../:;s,g1.,;.,4 4..c.•:'.‘„....- . 14/ .d:-% ..C./2 -,..._,..„C.rE: i ,4. . 1 EMERGENCY INFORMA1 ION FOR IN CITY BUSINESSI* : t ;:,.: PENALTIES FOR APPLICA.TIONIMACMIWALS MADE AFTER JAN, •-t) & Police Dailtn. C.):t1:.9 INAME: PHONE: t I 1 TO 15 DAYS 16 TO 30 DAYS ---- ; 31 fik)V5 t& +RFS 15.00 Til-aeNS 20.00 ...)1 gm r• •• • • • j �. 1^ iJ 1 i'-:: .J...1 lriie ��jtJ4'J1. J:'�' . ..:1+i iz=G114 �:..z..*:,; :_ .ra ...iiir?...d•: L l.•. »:14,......d..,t 17.::lilQii =., J ,..,. .. ..:• , : ", ' '• r ■•:1' .:.�'I .�. tl( r•,. nil f ly J1; cc [("''( Cryry (( �•' //'' C {{y^ t i; • : i' I i x • kj,1;'' :'V '11J�i1.711 ER'I ICElcil'/Ir SER '4Cr I.:5 !' xtcci� .'t';•q`J. • !! �i.1 `�.i E �.� i :1\ 11 kw' V.,,.+' S J ",1 1 li � 1'.. E (5,.. i, i v Gu..) .;' .. .i..r ti1;p y j: L yl UNIFIED BUSINESS ID M: 601 508 915 BUSINESS ID >r: 001 It EXPIRES : 12-31-1997 01:. iVA 1UNGTON ORGANIZATION "r'E DOMESTIC PROFit CORPORATION. BUILDING BUSTERS, INC. 1300 5TH AVE 1/35OO SEATTLE WA 98101 1 ( DOMESTIC PROFIT CORPORAT771:1 RENEWED BY AUTHORITY OF i'GRETARY OF STATE !S t� . • The :above entity Is bean it uadthe bitsindas rot, ii...!f idiotic or listed OPPAId1I•(I'N1'Or11 :rl'13iNG • OUSItiti ' r" n I•':'•1('',d$DNISIUN1' . \J! h 1.y.-."i ••L,/.► P.U.nox5 3.1 •bLYA1PiAAVAOW10'740:•I 1' :�N'JS;Id•101•• •,t,' •I' .I.tN'✓ .. 3cor,rP..A...,.p- t�Jil.i:L v' • • F �j st,.t . •i .: '.' ( 1 , .f:A. ! Rf ,. ' ...:'�T• (g44..' 'x7S•. 'y9x::1J.!...:;.•� � ,V. x` 1,0 " ' J ...r7.�`(,.vAr> ; %x e...•,:ci�1T7v «`�' , 1 ..'T' lii t' -i�t- '•...'J.i •i�. /.r , J. �C'ya^+rti�,St... �jr' J {Ja P.� A ........Jl.•:.1.�.� .�.. 1�..)....�t'. • •J "}� .•.<. e'w•� 1"' 1�.��..:•7:....7.... )L;�.'w:.:'t •d �nm:Jp �': • aECEIVOweD. NOV 0 3 199 TUKWILA 71 i1�1 1?' ►A/rinve� i ..... ..,..,,.,i.. +.•.•�.irw.x..re.., w..r»...wer- .ur+dri n�mr.a -r;r Per Cu+ (cord. CDC/ PLAN REVIEW / ROUTING SLIP ACTIVITY NUMBER Mi91-0194 An3I Lee inc PROJECT NAME D PARTMENT: ING DIVISION Q \ \'l.\'Clel PUBLIC WORKS DATE 11.34)7 FW PREVENTION ❑ P G DIVISION jV Ii � -1,�� sTRUC ❑ PERMIT COORDINATOR II DETERMINATION OF COMPLETENESS: (T,Th) • COMPLETE COMMENTS I DUE DATE I I. Lia. 97 NOT COMPLETE ❑ NOT APPLICABLE ❑ TUES /THURS ROUTING: PLEASE ROUTE fl NO FURTHER REVIEW REQUIRED ❑ ROUTED BY STAFF ❑ (If routed by staff, make copy to master file & enter Sierra.) REVIEWERS INITIAL DATE t APPROVALS OR CORRECTIONS: (ten days) DUE DATE I I' 148 q APPROVED I 1 APPROVED W/ CONDITIONS ❑. NOT APPROVED (attach comments) ❑ REVIEWERS INITIAL CORRECTION DETERMINATION: DATE DUE DATE APPROVED 11 APPROVED W/ CONDITIONS ❑ NOT APPROVED (attach comments) U REVIEWERS INITIAL DATE (CardRcsdoo of occupancy required. ) PLAN REVIEW / ROUTING SLIP ACTIVITY NUMBER mZcil -0194 DATE I 1'3'97 PROJECT NArvIE DEPARTMENT: BUILDING DIVISION PUBLIC WORKS Ls An5eI Lee inc FIRE PREVENTION C STRUCTURAL El PLANNING DIVISION 0 PERMIT COORDINATOR Q DETERMINATION OF COMPLETENESS: (T,Th) COMPLETE COMMENTS NOT COMPLETE DUE DATE I I, Lk 97 NOT APPLICABLE 0 TUES /THURS ROUTING: PLEASE ROUTE 11 NO FURTHER REVIEW REQUIRED ROUTED BY STAFF n (If route y staff, make copy to master file & enter Sierra.) REVIEWERS INITIAL DATE f( qi APPROVALS OR CORRECTIONS: (ten days) APPROVED El APPROVED W/ CONDITIONS REVIEWERS INITIAL DATE DUE DATE I I' 118 q7 NOT APPROVED (attach comments) Q CORRECTION DETERMINATION: APPROVED Q REVIEWERS INITIAL DUE DATE APPROVED W/ CONDITIONS I 1 NOT APPROVED (attach comments) 0 DATE (Ceidficadon of occupancy reauiicd. ) t 44ktn b!+ Yfn�Mx^ �rf i�t .�- r�h+ara�•ewinrv.. Ivo wow•tnv.4... ..,40M n.q.. .VYlMxA1.0 •. 7.0. 2 ^i,!JY.!,(45,14rthIMtN.85h0(gt. nil PLAN REVIEW / ROUTING SLIP ACTIVITY NUMBER mi..97 -0194 DATE PROJECT NAME DEPARTMENT: BUILDING DIVISION PUBLIC WORKS L An3I Lee Inc. II•3'97 FIRE PREVENTION U PLANNING DIVISION a STRUCTURAL p PERMIT COORDINATOR 0 DETERMINATION OF COMPLETENESS: (T,Th) COMPLETE n NOT COMPLETE COMMENTS DUEDATE 14- 97 NOT APPLICABLE TUES /THURS ROUTING: PLEASE ROUTE fl NO FURTHER REVIEW REQU ROUTED BY STAFF U (If routed by staff, make copy to master file & enter Sierra.) REVIEWERS INITIAL ec)o DATE //—'1-2 APPROVALS OR CORRECTIONS: (ten days) APPROVED REVIEWERS INITIAL DUEDATE I I' APPROVED W/ CONDITIONS NOT NOT APPROVED (attach comments) 0 DATE CORRECTION DETERMINATION: DUE DATE APPROVED El APPROVED W/ CONDITIONS p NOT APPROVED (attach comments) REVIEWERS INITIAL DATE (Certifica ioa of occuoancr required. ) .km..4., 104 .ubvAKU +n UkSVFr.4'nh yyyy...rr•s s�rrwNM.+. r..t tw.» xv. av�..'. w<. aNwo.. r�n�.urn.�!�wr.a..�/y�+.Io-s,a.. r,.n n.m.:.w� »a..w- .- .......- PLAN REVIEW / ROUTING SLIP ACTIVITY NUMBER MZ9"019y DATE PROJECT NAME A DEPARTMENT: BUILDING DIVISION El PUBLIC WORKS II•3-g7 • FIRE PREVENTION — PLANNING DIVISION r STRUCTURAL Ej PERMIT COORDINATOR ❑ DETERMINATION OF COMPLETENESS: (T,Th) COMPLETE El NOT COMPLETE COMMENTS DUEDATE l 97 NOT APPLICABLE TUES/THURS ROUTING: PLEASE ROUTE �x NO FURTHER REVIEW REQUIRED El ROUTED BY STAFF (If routed by staff, make copy to master file & enter Sierra.) REVIEWERS INITIAL AT DATE t u' / R • APPROVALS OR CORRECTIONS: (tea days) APPROVED DUEDATE lI CI 7 APPROVED W/ CONDITIONS I 1. NOT APPROVED (attach comments) 0 REVIEWERS INITIALS DATE " 'T CORRECTION DETERMINATION: APPROVED I I APPROVED W/ CONDITIONS REVIEWERS INITIAL. DATE DUE DATE NOT APPROVED (attach comments) Q (Certification of occupancy required. ) PLAN REVIEW / ROUTING SLIP DEPARTMENT: BUILDING DIVISION FIRE PREVENTION n PLANNING DIVISION El PUBLIC WORKS III STRUCTURAL E PERMIT COORDINATOR El DETERMINATION OF COMPLETENESS: (T,Th) COMPLETE [ NOT COMPLETE COMMENTS DUE D A T E i f Lt. -/ 7 NOT APPLICABLE fl •.•JO • IL u + - _ _ ;r TUES /TRURS ROUTING: PLEASE ROUTE 1 NO FURTHER RE REQUIRED Li ROUTED BY STAFF l_J (If routed by staff, make copy to master file & enter Sierra.) REVIEWERS INITIAL DATE APPROVALS OR CORRECTIONS: (ten days) DUE DATE I I' tB-q7 APPROVED n APPROVED W/ CONDITIONS g NOT APPROVED (attach comments) Q ' No p W /KT, ES Rho.' REVIEWERS INITIAL .i t ca./ DATE CORRECTION DETERMINATION: DUE DATE APPROVED n APPROVED W/ CONDITIONS REVIEWERS IMTiAL DATE NOT APPROVED (attach comments) 0 (Cecnficarion of occupancy required. ) w.l City of Tukwila. John W Rants, Mayor Department of Community Development Steve Lancaster, Director December 24, '1997 .Art Dumpis Angel Lee, Inc 3211 South 154th PO Box 68925 Seattle, WA 98168 RE: Permit Refund Dear Mr. Dumpis: Per your letter dated December 17, 1997, requesting the refund of your bond posted for Permit No, MI97 -0194, enclosed is a check in the amount of $5,546.20. This final activity will close out the permit file. If you should have any questions, please contact me at (206)431 -3671. Brenda Holt Permit Technician CITY OF TUKWILA TREASURER'S CHECK 6200 SOUTHCENTER BLVD. PH. 206. 933 -180C TUKWILA, WA 98188 gy, to- tdoo„/v ? .�- iktrt/*and Inc, Likud BANK TUKWILA.ANOOVER PARK BRANCH 181 ANDOVER PARK E, P.O. BOX 08923 SEATTLE, WABHINOTON 08188.0923 U.S. O NK,QJ P WABHINOTONt,NATIOONAL PBBOCIATIO /QJ , - n.c,A . / 1 r 1' AC', ..1. k An IA .'1 aztt (9- la4157 9331 19 -10 30 1250 . $16,5 y: I CID .6.40grnr e - CITY OF TUKWILA di) I I Ti / 0 - /Tl/� A N A r--,.l • City of Tukwila Department of Community Development Steve Lancaster, Director John W. Rants, Mayor. MEMORANDUM LAURIE ANDERSON, FINANCE FROM: BRENDA HOLT, PERMIT CENTER DATE: DECEMBER 18, 1997 SUBJECT: RELEASE BOND /DEPOSIT Please release the $5,546.20 bond /deposit to ANGEL LEE, INC. The demolition work for Permit No. M197 -0194 was signed off by the building inspector on December 15, 1997. The original transaction was Receipt #R9700687 for $5,546.20 . Please return the check to the permit center and I will forward it to the applicant. Thank youl At uilding Official / Date 7 Angel Lee, Inc. dba Angel: Lee, Inc. 15420 = 35 Ave. So. Seattle, WA 98168 DEC :I . 1997 COMN,,,441TY DEVELOPMENT City of Tukwila Building Division 6300 Southcenter Blvd., #100 Tukwila, WA 98188 Attn: Kelsey, Wendy Permit #: MI97 -0194 This is regarding the bonds deposit for $5,546.20. As, the work has been approved by inspector from City of Tukwila, we like to get the deposit check back. Copy of inspection record and bonds receipt is provided. Any question, please call: 206-243-8011 Art Dumpis. Please mail check to: Angel Lee, Inc. 3211 s 154th PO box 68925 Seattle, WA 98168, ���� a •IGA•6 ell . on 0.... Donne - e...■t.. WA Aa•aa 1I n • 12/04/1997. 10:'4 DEPARTMENT OF'LA :. •.i, 1 .8 CERTIFIES THAT, THE PERSON e, •.i;; ■fir 7 ;vj7� 4;1, r wwl j. • , 4 nE'} r try• Jai t'r4-4* BUILDING PAGE' :02 t, fl^• � Ih�l STATE OF WASHINGTON