HomeMy WebLinkAboutPermit MI98-0191 - CITY OF TUKWILA - CITY HALL - REROOFCITY OF TUKWILA MI98-0191
City 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: 359700 -0282
Address: 6200 SOUTHCENTER BL
Suite No:
Location:
Category: NSFR
Type: MISCPERM
Zoning: 0
Const Type:
Gas /Elec.:
Units: 001
Setbacks: North:
Water: N/A
Wetlands:
Permit. No:
Status:
Issued:
Expires:
MI98 -0191
ISSUED
10/07/1998
04/05/1999
Occupancy: OFFICE
UBC: 1997
Fire Protection:
.0 South: .0 East: .0 West: .0
Sewer: N/A
Slopes: Y Streams: 2
Contractor License No: MIKESRI044BK
OCCUPANT CITY OF TUKWILA
6200 SOUTHCENTER BL, TUKWILA WA 98188
OWNER CITY OF TUKWILA
6200 SOUTHCENTER BLVD, TUKWILA WA 98188
CONTACT AL SPENCER Phone: 206- 433 -1865
CITY OF TUKWILA, 6200 SOUTHCENTER BL, TUKWILA WA 98188
CONTRACTOR MIKE'S ROOFING INC Phone: 425 - 771 -7534
12828 AVONDALE WY, EVERETT WA 98204
k **•k** k**•k* * * ***•k k******• k*************** ** *•k * *****•k * **•***********•** k** k *•k* **** * * * *•k
Permit Description:
ROOF REPLACEMENT.
* k** k*•k•k k* ** ***•k k **** * *•k* **•k* ** **** * ** **** **** k *•k* *** k * * ** *•k* **** **•k * ** *** * **•k * * ** k
Construction Valuation: $ 74,560.00
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: End Time:
Land Altering: N Cut: Fill:
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:
*** A************ k*** k******•*****• k*************• k* k* k• k****** * * *•kk * *•k *•k * * *•k *•k * **•k * * * **
TOTAL DEVELOPMENT PERMIT FEES: $ 735.50
k k*•k ***•k•k *** * ***** *•k k k•k* k* ****•k k *•k* k•k * * ** *** ** **•k*** k*** •k**** **•k**** ***•k*** * * * * * * * **
Permit Center Authorized Signature:_ �" Date:_3/ !?
I hereby certify that I have read an' 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 permi
cancel the provision of
or the performance
development per
Signature:
roes not presume to give authority to violate or
iy other state or local laws regulating construction
¥k. I am authorized to sign for and obtain this
Print
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.
Fate:
City 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: 359700 -0282
Address: 6200 SOUTHCENTER BL
Suite No:
Location:
Category: NSFR
Type: MISCPERM
Zoning: 0
Const Type:
Gas /Elec.:
Units: 001
Setbacks: North:
Water: N/A
Wetlands:
Permit No:
Status:
Issued:
Expires:
MI98 -0191
ISSUED
10/07/1998
04/05/1999
Occupancy: OFFICE
UBC: 1997
Fire Protection:
.0 South: .0 East: .0 West: .0
Sewer: N/A
Slopes: Y Streams: 2
Contractor License No: MIKESRI044BK
OCCUPANT CITY OF TUKWILA
6200 SOUTHCENTER BL, TUKWILA WA 98188
OWNER CITY OF TUKWILA
6200 SOUTHCENTER BLVD, TUKWILA WA 98188
CONTACT AL SPENCER Phone: 206 - 433 -1865
CITY OF TUKWILA, 6200 SOUTHCENTER BL, TUKWILA WA 98188
CONTRACTOR MIKE'S ROOFING INC Phone: 425 - 771 -7534
12828 AVONDALE WY, EVERETT WA 98204
************************** * * * * * * * * * * * * * * * * ** * * * * * * * * * * * ** *tilt * * * * * * * * * * * * * * * * * * * * * * * **
Permit Description:
ROOF REPLACEMENT.
***************************************************** * * * * * ** ** * * * * * * * * * * * * * * * * * * * * **
Construction Valuation: $ 74,560.00
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:
k**************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
TOTAL DEVELOPMENT PERMIT FEES: $ 735.50
k****************************************,*********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
End Time:
Fill:
Permit Center Authorized Signature:
Date: j6,-q--ye
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
cancel the provisio
or the performanc
development per
Signature:
it does not presume to give authority to violate or
any other state or local laws regulating construction
work. I_ ni authorized to sign for and obtain this
Date: ld'`7- /mod'/
Print Name: __�/�_,',.,isti
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 T'IKWILA
Permit Center
6300 Southcenter Boulevard, Suite 100
Tukwila, WA 98188
(206) 431 -3670
Miscellaneous Permit Application
Application and plans must be complete in order to be accepted for plan review.
Applications will not be accepted through the mail or facsimile.
Project Name/Tenant:
�,'11�, /%h) (? /7 Y / -I /-P- i
Valu ,'of
»
Construction.
,-�
45
-
ri ,
Site Address: City State /Zip:
_ 6.�?(.3 6 cS a,r lA c ev-ier 1 ,H k brrA. ledrw.ba
Tax Parcel
,:- C) 6
Number:
7ta,-OZ7.-
y 7 - ,/ ,5 tE,,.5-
Property Owner: /7 / r/ 6 F TC/ A' j 4 !4
Street Address: City State /Zip:
/ 47/6)() .7TAI7 .eL /Jfp) -1i'1 4'y 7--eWf<.0 / -/9
Fax #:
(7(10' 6 -
-/ -,_-37c1.,
40--
Contact Person: A
Phone:
0 Sewer
0 Metro
0 Standby
Street Address: City State /Zip:
Fax #:
Contractor: i �� '
p".) /,ti'% 5 /�COc/ii.n= TN C »)�k (o,VX)
Phone:
y� -4'-
'7
- 7573
Street Address: City State /Zip:
Y =2 & /l 9 / /) ,!�J` _`f.7,, 9 ,�/
Fax #:
«'T ;
-� ° 8c
1�'
Architect:
Phone:
Street Address: City State /Zip:
Fax #:
Engineer:
Phone:
Street Address: City State /Zip:
Fax #:
MISCELLANEOUS PERMIT REVIEW AND APPROVAL REQUESTED: (TO BE FILLED OUT BY APPLICANT) .
Description of work to be done:
< I- / '�
Z1? (' y7 A/ / _
Will there be storage of flammable /combustible hazardous material in the building? ❑ yes —erno
Attach list of materials and storage location on separate 8 1/2 X 11 paper indicating quantities & Material Safety Data Sheets
❑ Above Ground Tanks ❑ Antennas /Satellite Dishes ❑ Bulkhead /Docks 211 Commercial Reroof
❑ Demolition ❑ Fence ❑ Mechanical ❑ Manufactured Housing - Replacement only
❑ Parking Lots ❑ Retaining Walls ❑ Temporary Pedestrian Protection /Exit Systems
❑ Ternporary Facilities ❑ Tree Cutting
APPL'ICANTREQUEST FOR MISCELLANEOUS :PUBLIC.WORK &PERMITS`?`
❑ Channelization /Striping
❑ Flood Control Zone
❑ Landscape Irrigation
❑ Storm Drainage
❑ Water Meter /Exempt #
❑ Water Meter /Permanent #
❑ Water Meter Temp #
❑ Miscellaneous
❑ 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 #: ❑ Sewer Main Extension 0 Private 0 Public
❑ Street Use ❑ Water Main Extension 0 Private 0 Public
0 Deduct 0 Water Only
Size(s):
Size(s):
Size(s): Est. quantity:
❑ Moving Oversized Load /Hauling
gal Schedule:
MONTHLY SERVICE BILLINGS TO:
Name:
Phone:
Address:
City /State /Zip:
0 Water
0 Sewer
0 Metro
0 Standby
WATER METER DEPOSIT /REFUND BILLING:
Name:
IPhone:
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 schedules.
Expiration of Plan Review - Applications for which no permit is issued within 180 days following the date of application shall
expire by limitation. The building official may extend the time for action by the applicant for a period not exceeding 180 days
upon written request by the applicant as defined in Section 107.4 of the Uniform Building Code (current edition). No application
shall be extended more than once.
Date application accepted:
Date application expires:
Applica n taken by: (initials)
ALL MISCELLANEOUS PE IT APPLICATIONS MUST BE SUB ED WITH THE FOLLOWING:
➢y ALL DRA'OONGS 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
➢ CIVIUSITE PLAN DRAWINGS REQUIRE STAMP BY WASHINGTON LICENSED CIVIL ENGINEER
(P.E.)
El
SUBMIT APPLICATION AND REQUIRED CHECKLISTS FOR
PERMIT REVIEW
Submit checklist No: M -9
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
0
Antennas /Satellite Dishes
Submit checklist No: M -1
o
Awnings /Canopies - No signage
Commercial Tenant Irnprovement
Permit
Bulkhead/Dock
Submit checklist No: M -10
Commercial Reroof
Submit checklist No: M -6
El
Demolition
Submit checklist No: M -3', M -3a
EI
Fences - Over 6 feet in Height
Submit checklist No: M -9
in
Land Altering/Grading/Preloads
Submit checklist No: M -2
0
Loading Docks
Commercial Tenant Improvement
Permit. Submit checklist No H -17
0
Mechanical (Residential & Commercial)
Submit checklist No. M -8,
Residential only - H -6, H -16
El
Miscellaneous Public Works Permits •
Submit checklist No: H -9
El
Manufactured Housing (RED INSIGNIA ONLY)
Submit checklist No: M -5
Moving Oversized Load /Hauling
Submit checklist No: M-5
0
Parking Lots
Submit checklist No: M -4
0
Residential Reroof - Exempt with following exception: If roof structure
to be repaired or replaced
Residential Building Permit
Submit checklist No: M -6
Retaining Walls - Over 4 feet in height
Submit checklist 'No:: M -1
in
Temporary Facilities
Submit checklist No: M -7
0
Temporary Pedestrian Protection/Exit Systems
Submit checklist No: M -4
El
Tree Cutting
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 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 X ENT:.- -
Signatur/ .. " /i-'
Date:
Print name:---' < <,
�•-.� 7-,e, �r (�7 i? �= �'
Phone:
h-tr- /7/- '753 9 1
Fax #:1/25 -
t_141k- 2/ 4.5—
Address:
I s s - Vic- )f)/_1 / /; e g- /),9 /
_ City/ to a / Zip:
City/State/Zip: /a? , `78 2c7 9
CITY OF T"'ICWILA
Permit Center
6300 Southcenter Boulevard, Suite 100
Tukwila, WA 98188
(206) 431 -3670
M -6
Submittal Checklist
Miscellaneous Permits
REROOFS
• RESIDENTIAL REROOF: Single- family structures are exempt from reroof permitting.unless roof structure is to
be repaired or replaced, in which case a Residential Building Permit is required.
COMMERCIAL REROOF:
If roof structure is to be repaired or replaced, a commercial building permit will be
required.
Document Requirements
Narrative describing existing roof, material being removed, and material being installed
Any roofing material documentation available is requested for review of application
Note: A certification letter is required prior to final inspection and sign -off of the permit
%Rc`_'aI7DUwY (, )c157/NI G
600a D 17 >N -65:5'
in 37,49 64- ,,,),„40s/ 7/ 5A/ /iN GZ65
12»r9 7cR/4 5 /54 /9 ye R /u/, -.id. e p
4 l?cH/ 7c 4•T € f9,,o.eo U C1 •
CITY OF TUKWILA
REROOF CONDITIONS
e A vd- 3-- / S - „ 2d oD
Permit No: M798-0191
Project Name: CITY OF TUKWILA
Address: 6200 SOUTHCENTER BL
Suite:
*•,*k• k*****• k**• A****• k• Ak• k** *`kk. * **, *•k. * *K kkk;*****• k**A * ******•k ***•k**•k•k *•k•k*
THE FOLL.OWING CONDITION'S WILL .: rAPPLY To RE -Roof ;PERMITS
■
1. All re -roof ing.pt o5ect5 will <:be, accomplished, in compliance with
Appenitx Chapter 15 of the Uniform 'Elui.ldiny 'Code (llf3C) ,
2. Inspections:
New roof coverings shall not be applied without, firs'
obtaining' a pre. roofing; inspection from the Bui;iding„
Division and written approval,fronr the Building” Inspector.
The ..:pre-roofing ..inspection shall pay particular- attention to
evidence of ''accumulation of water." -,Where extensive, ponding
of water• is apparent, an analysis "af:; the roof, str-ucture for
compliance with Section 1506, -UBCY shal 1 be made-and
corrective .. measures; isuch as relocation of roof :drains. or
scuppers, res1oping of'.'the' roof or.,.structural�.�. changes oshai l
be accompl i'shed. An inspection .covering the above :listed
ed
topics prepared by a qual,i fied special, inspector, as {r.;
deterinined by the BuildingfOff,icial, may be_�aceep,ted,,in' lieu
f ;`the` pre..- inspection by the 'Building . inspector
final inspection and approval, shall "be. >abtained f,rom' the
„Building Division when the re-roofing i,s comp,l etey: /,,A a
c'onditlan of, the. final itispectiort for., roofs .that .require a
fire retardant roof covering under. the pro,v.is ions. of Table
15::A,'•1994" UBC, the 'r'oof installer shall. p'rovlde` the
inspector with a written.tatement indicating:, the fol lowing
(or something similar) ;
I HAVE INSTALLED A ROOF MEMBRANE ASSEMBLY', INCLUDING INSULATION IF
APPLICABLE, CONSISTING OF :'(f1ANUFACTUfER)- ,,°.-SF'E I(=ICATION 1# _ , DATA
'S
SHEET ENCLOSED, WHICH MEETS OR EXCE:EDS' THC'�''REQt1IREMENTS FOR�CLASS A
OR CLASS B ROOFS. THIS ROOF WAS INSTALLED AT (ADDRESS) , UNDER CITY
OF TUKWILA PERMIT NO.
(The statement shall include the name of the roofing, company
installed the roof, signature of installer and date.)
CITY OF TUKWILA
REROOF CONDITIONS
Permit No: MI98-0191
Project Name: CITY OF TUKWILA
Address: 6200 SOUTHCEt1TER BL
Suite:
•,
THE FOLLOWING coNRIpows:,w1LIJApny TO,?,E-ROOF..PERMITS.
. ..
1 All re-:roofing ,p6lects will...pp_acomplishedin COppance with
Appendix ."Chapter 15 of the Uniform Bullding7;;Code (UBC).
.. ,, . ,. .,.
4.. InsPections:,.,
-,
A:.Newiroof coverings shell not be applied withopOIrSXA
iiobtalning.'a pre-root ingi:inspection from the.,.Buif4'ing4.:„'.
,.-
DfVisAon and wrftten aWoval::.'from the BuildAngi'n-spOtor.
,•
-.:- comPliancia wi..h zlef...tion 146,, OB(..,,,,..,0011 be mt441.11i
. , "
The pre..7:roofing. inspeCton sna1 .1,pay particular,Ottentl,bn to
';..:' evidence ofjaCcuMOla0on of,::WAte'.-Mhere extenslye,p0Oing
of water ts'apparent.:,an',,analySiS-64the roof"struciuriOor
cor'.rect)ve measyressuch as relocation of roof AralnsrAlt
;" %clippers, r.esloptng'of::the',rodf'or structural!ch:ing4s,:shall
;,.', be aCcdmplfShed,,/,An.rinspeCOOn'-coering the aboVe'F.AitItid
.- to0ct Orepared-liYa qualifiedali.inspedtoe ia
tl, ,./
,,;;,,..determined by the Building :Offlciel, 60 be accepted prilleu
'10f the pre-Inspection by 01678611dinginspetor,, NY/
\
B.Okfinal inSpection and apOroiial!spa1 1.,0e_obtained -90 the
l`spilding Division when the re':-.rlopfihp-JS:complete./Is a'
'On.ditidn..pf the final 1nspectidiVY6r„croofOlat.,0itore a
fi"re.,,retadant roof covering under.,.,the PrdNiont'f Table
4994.'OBC, the'roofJnstal 1e shall.ira00:Aie
inspector with a writtenatement indictingth'e following
( or s 640 0,i rig similar
I HAVE INSTALLED A ROCIMEMBRANE 'ASSEMBLY; INCLUDINGINSULATION IF '
APPLICABLE, CONSISTING'OFOAN4FCTOUR4::q5P.X0f14.7ATION # _ ,* DATA
SHEET ENCLOSED, WHICH MEEtS'''bitRKtERD,$1-,T1-jfRtOOIREMENTS FOR CLASS A .
OR CLASS B ROOFS. THIS ROOF WAS INSTALLED AT (ADDRESS)! UNDER CITY
OF TUKWILA PERMIT NO. . '.
The statement shall include the name of the roofing company that
installed the roof, signature of installer and date.) "
•
INSPECTION NO.
INSP.Fr.CTION:RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 98188
PERMIT NO.
(206)431 -3670
1
Pro ect: ��%C ��
(
Type T e of I ection:
Address: /
Date called
Spec' I i�6lr ��s:
/ F" /fJ?
/^ ,/ iR
Date wanted:
ii ....-• .-•
a.m.
P.m.
Requester: he
Phone:
Approved per applicable codes. ci Corrections required prior to approval.
COMMENTS:
$47.00 REINSPECT! + REQU ED. Prior to inspection, fee must be paid
at 6300 Southcenter : , Suite 100. Call to schedule reinspection.
1 Receipt No: Date:
IINSPECTION RECORD
Retain a copy with permit
INSPECTION NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 98188
PERMIT NO.
(206)431 -3670
Project:, //
4 `"
Type of Insp
ion:
r�U
e
aQ
-1/4
[
Address:
"
Date called: '"
Special instructions:
Date wanted:
..
40_
.
Requester:
Phone:
Approved per applicable codes. ,Corrections required prior to approval.
COMMENTS:
,fe
Are
Inspector:
Date:
j $47.00 REINSPECTIONr E REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. CaII to schedule reinspection.
Receipt No: 1 Date:
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila, WA 9818
PERMIT NO.
(206)431 -3670
Projec I` fir,, Gil) 4d
Type of sec an:
;;-,- _ c
Address: _ s m,r.,,
�_ n'e
Date calllee + 10
Special instructions: t i'�l�Lf 9 �,
aob -q 14 -� a03
4�
Date wanted: � 15 DO�
Requete
Phone: I ' 3q.
0 Approved per applicable codes. g Corrections required prior to approval.
COMMENTS:
l--1.6 1,^../s 4-2%50 qC.. _, ?-2 5 .P/ 1-1-,
"Val r' -PIh $ u//Ar-L, 1- 4.,4 S
^s -,/CJ f ./54 - /00e,L, .--Avv 114AYh
e 7&,, ea l ! C- f4
t.,,,,f -Y 1'.‘ % e
Inspector: Date:
4.-t. 3 e0
0 $47.00 REINSPECTION E REQUIRED. Prior to inspection, fee must be paid
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
1 Receipt No: 1 Date:
CITY OT, TOKMItA.. 14A .., • •TR MISHIT . .
TRANSMI T Number' : 10700043 :Amount.* 735.50'10/07/0 104+.
Pvmert MethO.d* CHECK Notkti,on* 'Mt RE ' S ROOFING Itijt*„01.1.1
••• .• ••••■•• oa, •••• • we ■•••, •••• •••• •• !.•• ow: .•
l'ermi t ilo 11198-0191 Type: MISCPERli MISCELLANEOUS 1)ER.MIT
Parcel No 353702E12
te Addresa: 6200 SOU'fliCENTER
Total Fees: ' 73'5..50
This • Payment; 735.50 Total LL Pmtsi : 735..50 • .
ance: .00
Account Code Descri p tjon Amount
000/322.100 BUN...DINO RES , : 73100
000/386.904 sTivrE GE 4..50
. .
• •" -. • .„ ,
• . , • ' • •
. • • • . • ' , ' • .
' ' • • .
A.4.1 C'.1 A,14 pi 't1.14
FROM : MIKE'S ROOFING, INC.
PHONE NO. : 2063488215
DE:•I'AR'FMENI' OF l.AIU.)R AND INDUSTRIES
Oct. 07 1998 11:03RM P1
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL
• ' ); ' :REGTAT ,.40 .•... EXP . DATE
£SRro 4.4B t";o 6 /p;8;/,.1,9r9'
MIKE'S ROOFING INC
12828 AVONDALE WAY
EVERETT WA 98204 -6229
fa25452.(XK) t:uu7)
Dett ch And T)iApiny (;crtlfleote
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL
RSGIST. # EXP. DATE
CCO1 EFFECTIVE DATE044BR 01//12//1996
MIRE'S ROOFING INC
12 82 8 ' 'AV'ONDALE WAY
EVERETT. WA 98204 -6229 .
Si nut
Ut e
L sued by DEPARTMENT OF LABOR AND INDUSTRIES
Please Remove
And Sign
Identification
Card Before
Placing In
Billfold.