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HomeMy WebLinkAboutPermit D12-247 - SUNWOOD CONDO - ROOF REPAIRSUNWOOD CONDOS ROOF REPAIR 15209 SUNWOOD BL D12 -247 City okukwila 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 DEVELOPMENT PERMIT Parcel No.: 8141400000 Address: 15209 SUNWOOD BL TUKW Suite No: Project Name: SUNWOOD CONDO - ROOF REPAIR Permit Number: D12 -247 Issue Date: 08/08/2012 Permit Expires On: 02/04/2013 Owner: Name: SUNWOOD CONDOMINIUMS Address: C/O SUHRCO RESIDENTIAL PROP , 10655 NE 4TH ST STE 711 98004 Contact Person: Name: TIM LONG Address: PO BOX 65181 , SHORELINE WA 98155 Contractor: Name: CONSOLIDATED GTR & SHT MTL LLC Address: 16751 BURKE AV N , SHORELINE WA 98133 Contractor License No: CONSOGS902RN Lender: Name: Address: Phone: 425 - 780 -0400 Phone: Expiration Date: 12/15/2012 DESCRIPTION OF WORK: BUILDUP CURB FOR EXISTING SKYLIGHT Value of Construction: $1,986.00 Fees Collected: $212.40 Type of Fire Protection: International Building Code Edition: 2009 Type of Construction: V -B Occupancy per IBC: 0021 Electrical Service Provided by: PUGET SOUND ENERGY * *continued on next page ** doc: IBC -7/10 D12 -247 Printed: 08 -08 -2012 Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Fire Loop Hydrant: N Number: 0 Flood Control Zone: Hauling: N Start Time: Land Altering: Volumes: Cut 0 c.y. Landscape Irrigation: Moving Oversize Load: Start Time: End Time: Sanitary Side Sewer: Sewer Main Extension: Private: Public: Storm Drainage: Street Use: Profit: N Non - Profit: N Size (Inches): 0 End Time: Fill 0 c.y. Water Main Extension: Private: Public: Water Meter: Permit Center Authorized Signature: Date: 6 -/c r( 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. w , Signature: (MY' "t 1$1, Date: 8/1)/ Z Print Name: 7 714"i 4 0A-)� 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: All construction shall be done in conformance with the approved plans and the requirements of the International Building Code or International Residential Code, International Mechanical Code, Washington State Energy Code. 5: 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. 6: All construction noise to be in compliance with Chapter 8.22 of the City of Tukwila Municipal Code. A copy can be doc: IBC -7/10 D12 -247 Printed: 08 -08 -2012 obtained at City Hall in the office of the Citrk. • 7: Prior to final inspection for this building permit, a copy of the roof membrane manufacturer's warranty certificate shall be provided to the building inspector. 8: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building Department (206- 431 - 3670). 9: VALIDITY OF PERMIT: The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the building code or of any other ordinances of the City of Tukwila. Permits presuming to give authority to violate or cancel the provisions of the code or other ordinances of the City of Tukwila shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the Building Official from requiring the correction of errors in the construction documents and other data. 10: ** *FIRE DEPARTMENT CONDITIONS * ** 11: The attached set of building plans have been reviewed by the Fire Prevention Bureau and are acceptable with the following concerns: 12: Application of roof coverings with the use of an open -flame devices requires a separate permit from the Tukwila Fire Department located at 444 Andover Park East, Tukwila, Washington, 98188; telephone - (206)575 -4407. There shall be not less than one multi- purpose portable fire extinguisher with a minimum 2 -A 20 -B:C rating on the roof being covered or repaired. (IFC 105.6.24, 1417.3) 13: Contact The Tukwila Fire Prevention Bureau to witness all required inspections and tests. (City Ordinances #2327 and #2328) 14: Any overlooked hazardous condition and/or violation of the adopted Fire or Building Codes does not imply approval of such condition or violation. 15: These plans were reviewed by Inspector 511. If you have any questions, please call Tukwila Fire Prevention Bureau at (206)575 -4407. doc: IBC -7/10 D12 -247 Printed: 08 -08 -2012 CITY OF TUKYI Community Develop t Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http: / /www.TukwilaWA.gov Building Pe t No. (01--- 2' Project No. Date Application Accepted: Date Application Expires: (For office use only) CONSTRUCTION PERMIT APPLICATION 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 / J 3S cu Y1 %(/a0 / /Vi( -! 1(Al �' c 81 er -� King Co Assessor's Tax No.: Site Address: /S`2 SG�>1G ✓Ot�G� ‘04,p4 1�,�,d'�tc Suite Number: Floor: Tenant Name: So., n ( ,)J o h d o c New Tenant: ❑ Yes ® .. No PROPERTY OWNER Name: S'Gt, rl too 04 GQ yva riy , Address: is-2Y6— St,n (voa t &Al va( City: lk A 1,1)3457 State:., Ja Zip: CONTACT PERSON — person receiving all project communication Name: I) Th /6 4 •1 Address;q) ail K5,-/s i Address: , ) 44, 65-/ :v Phone: Fax Fax 6/-7 „.... %2 Sb City: -46 ,re 6.4. Q State: ti)4., Zipcorr Phone: 4/26 -7e 0- 6e66, Fax: 26 77y_ /2 q 6 Email: , GENERAL CONTRACTOR INFORMATION Company Name:t- 6 I ), l�e J liv�#y r.tqpC� -44 Gl /�� �1 •1 Address;q) ail K5,-/s i City: S40 Ye /,/n C State: ‘,L)ct. Zip:gpJd . Phone: Fax Fax 6/-7 „.... %2 Sb Contr R e g � NN oo . 0 GS,y,Qa e Exp 7 — ' — J 2 ✓ J2 . Tukwila Business License No.: Az c _ 6 v 39 y,Q H:Wpplications\Forms- Applications On Line\2012 Applications\Permit Application Revised - 2- 7- 12.docx Revised: February 2012 bh ARCHITECT OF RECORD Name: Address: Company Name: Architect Name: Address: City: State: Zip: Phone: Fax: Email: ENGINEER OF RECORD Name: Address: Company Name: Engineer Name: Address: City: State: Zip: Phone: Fax: Email: LENDER/BOND ISSUED (required for projects $5,000 or greater per RCW 19.27.095) Name: Address: City: State: Zip: Page 1 of 4 BUILDING PERMIT INFORMATION — 206 - 431 -3670 Valuation of Project (contractor's bid price: $ / g ‘6° Existing ding Valuation: $ Describe the scope of work (please provide detailed information): et�,�'f� •[,� Jt'3 G LA. Y,� �e , - 4e._3( A7 )),A, 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 11): 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\2012 Applications\Permit Application Revised - 2- 7- 12.docx Revised: February 2012 bh Page 2 of 4 v Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC lst Floor sky %4 Gc 1 D f A r 2nd Floor 3rd Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck PLANNING DIVISION: Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq 11): 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\2012 Applications\Permit Application Revised - 2- 7- 12.docx Revised: February 2012 bh Page 2 of 4 v PERMIT APPLICATION NOTES — • • 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 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). 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�� A -T RIZED AGENT: Signature: Print Name: /7r‘ Mailing Address: /20 A2,04 b'/ g) H: Applications \Forms- Applications On Line\2012 Applications\Permit Application Revised - 2- 7- 12.docx Revised: February 2012 bh Date: %A7 / ,v ���. Day Telephone: 246 - 2004/74 Wet, ciswr- City State Zip Page 4 of 4 PUBLIC WORKS PERMIT INFWTION — 206 - 433 -0179 Scope of Work (please provide detailed information): Call before you Dig: 811 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 Certificate ❑... Highline ❑ ...Valley View 0... Renton ❑ ...Sewer Availability Provided 0... Renton 0... Seattle 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. Submitted with Application (mark boxes which apply): ❑ .. Civil Plans (Maximum Paper Size — 22" x 34 ") ❑ .. Technical Information Report (Storm Drainage) ❑ .. Bond 0... Insurance 0... Easement(s) Proposed Activities (mark boxes that applv): ❑ .. Right -of -way Use - Nonprofit for less than 72 hours El.. Right -of -way Use - No Disturbance ❑ .. Construction/Excavation /Fill - Right -of -way ❑ Non Right -of -way ❑ ❑ .. Total Cut cubic yards ❑ .. Total Fill cubic yards El.. Sanitary Side Sewer El.. Cap or Remove Utilities El.. Frontage Improvements ❑ .. Traffic Control ❑ .. Backflow Prevention - Fire Protection Irrigation Domestic Water ❑ .. Permanent Water Meter Size (1) El.. Temporary Water Meter Size (1) ❑ .. Water Only Meter Size ❑ ... Geotechnical Report 0... Maintenance Agreement(s) ❑ .. Traffic Impact Analysis El.. Hold Harmless — (SAO) ❑ .. Hold Harmless — (ROW) 0... Right-of-way Use - Profit for less than 72 hours 0... Right-of-way Use — Potential Disturbance 0... Work in Flood Zone O ... Storm Drainage 0... Abandon Septic Tank 0... Curb Cut El... Pavement Cut 0... Looped Fire Line ❑ .. Sewer Main Extension Public ❑ .. Water Main Extension Public If >> WO # WO # WO # Private ❑ Private ❑ ❑...Grease Interceptor ❑ ... Channelization ❑...Trench Excavation 0... Utility Undergrounding (2) >> WO # (3) (2) >> WO # (3) ❑ .. Deduct Water Meter Size >> WO # WO# FINANCE INFORMATION Fire Line Size at Property Line Number of Public Fire Hydrant(s) ❑ .. Water El.. Sewer ❑ .. Sewage Treatment Monthly Service Billing to: Name: Day Telephone: Mailing Address: Water Meter Refund/Billing: Name: Mailing Address: City State Zip Day Telephone: City State Zip H:Wpplications\Forms- Applications On Line\2012 Applications'Permit Application Revised - 2- 7- 12.docx Revised: February 2012 bh Page 3 of 4 fib City of Tukwila Department of Community Development 6300 Southcenter Boulevard, Suite #100 Tukwila, Washington 98188 Phone: 206 -43 1 -3670 Fax: 206 -431 -3665 Web site: http: / /www.Tukwila WA .gov RECEIPT Parcel No.: Permit Number: D 12 -247 Address: 15209 SUNWOOD BL TUKW Status: PENDING Suite No: Applied Date: 07/27/2012 Applicant: SUNWOOD CONDO - ROOF REPAIR Issue Date: Receipt No.: R12 -02212 Initials: User ID: WER 1655 Payment Amount: $212.40 Payment Date: 07/27/2012 09:27 AM Balance: $0.00 Payee: CONSOLIDATED GUTTER & SHEET TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd VISA Authorization No. 012652 ACCOUNT ITEM LIST: Description 212.40 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: 07 -27 -2012 INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300'Southcenter Blvd., #100, Tukwila. WA 98188 C =- s), (206) 431 -367' Permit Inspection Request Line (206) 431 -2451 b/2 y7 Project: SL /,vc, oUC. ed,o)o Type of Inspection: /.17vA L,. Address: f 52_09 Si/AMA/0C O t? L Date Called: Special Instructions: Date Wanted:. /p — h/— /Z 4m p.m. Requester: Phone No: 4 /2-S — 7Se- 04'00 }Approved per applicable codes. El Corrections required prior to approval. / COMMENTS: rN'►t Clew.? (6 f Fi .iAt, C )ector Date: , EINSPECTION FEE REQUIRED. Prior to next inspection, fee must be IITY at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. _ .1._ INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431 -3670 Permit Inspection Request Line (206) 431 -2451 6/2 -24/7 Project: �Ci ? /A/latl L) 0()AiD0 Type of Inspection: /;)/`)(l /---• -.SM' /)I 'f //V 4 - /-----/2/9/Pik Address: /5,20.9 ,Sz/ ialc JZ 1:' /._ Date Called: Special Instructions: Date Wanted:. a`m.. Requester: Phone No: LL25- 7AO-:c /e)( Approved per applicable codes. Corrections required prior to approval. •.0 COMMENTS: �r/ J / f ' ,204, .S 0/IM, -, --A j:4. 2) /::-/2/4.44,4 ,4 AA.e)h✓1/f 7 ( 1 N. Inspkctor. n RFFINSPECTION FEE REQUIRED. prior to next inspection. fee must`be paid /at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. /em*, Date: el-- Consolidated Gutter & Sheet Metal, LLC PO Box 65181, Shoreline WA 98155 (206) 408 -1848 Customer File #: 1487 Date: 6/18/2012 (Cut tourer` MaillligfAddmss. ( Raise & Re- Install 8'x8' Skylight Steve Gregory (Sunwood Condos) Consolidated GSM offers to fumish all materials and perform all labor as described be Terms and Conditions as set forth on the reverse side hereof: REVISIONS No changes shall he made to the scope mirk wltrlotai prior approval of Tuk,,vila Building Division. NOT:: G :ovisicns will require a new plan submittal firma; may in;;lude additional plan review fees. J eflase tf work /LE COPY Load roof materials. Remove existing 8'x8' Skylight. Build up skylight frame approximately 4 & 1/2". Inspect sub -deck for necessary replacement of wood components to accept new Replace 1/2" CDX plywood at $52.00 per sheet (All materials & labor included) Any unforeseen woodwork will be performed at $65.00 per man hr. plus actual material costs u pon homeowner approval Our jobsite will be left in a dean orderly manner with a watertight seal at the end of each dalo Raise approx. 2' of outside roof curb. Permit N N O. Fabricate and install custom metal for approx. of outside roof curb. 2' Install crickets on two sides of skylight to alleviate standing water. Re -flash around skylight box with smooth torchdown. Apply Kamac reflective coating on patched area. Re-set skylight on raised curb. iPh°asetll Wor1th? _4 Perform final inspection. (JoilLocation; Sunwood Condo 15209 IP oq saILOptions Raise & Re -Seal Skylight $1,691. Pl0,1 r view approval is subject to errors and omissions. of construction documents does not authr)te f►,- ,:;ration of any adopted code or ordinance. Recei.pt of improved Field i py and conditions is acknowledvd: By F 8 11 I Trim out inside of skylight well with 1x8 MDF • $295.00 + tax & peerprm'l!itr�f e�tt t ,ir Ilan^ The preceding proposal options are subject to our Standard Terms and Conditions on the reverA�5i98 +88f.�6y�ON deviations from the work described above will be performed only upon the direction of the Customer, and Customer agrees to pay Consolidated's standard charges for such work. Estimated starting date of shall be subject to availability of materials, manpower and weather conditions. This proposal is good for 20 days from the date first written above, and shall automatically lapse if not accepted in writing by Customer by that time. Our Terms are 1/3 at contract • ' • • • - - • completion. By: , Consolidated Customer hereby agrees to accept this foregoing Proposal this Customer Signature REVIEWED FOR C 8CO APPROVED nn II AUG 0 3 2012 C1� mat City of Tukwila BUILDING DIVISION d Date: b1X- 1.14-7 SEPARATE PERMIT REQUIRED FOR: f IRIlAarhapicaj_, 20 arElectrical r r I i1 g as Piping "". J of Tukwila EIVED JUL 27 2012 PERMIT GETTER FILE COPY Permit No. AUTHORIZATION FOR ALTERNATE PLAN SUBMITTAL (LIMITED SCOPE OF WORK) IBC & IRC Section 104.1 Date: 7 -- / Permit /Application Number: b 0:—;--)-1 7 Address: / 2 _ 2 c7 Tukwila, WA 981 860 Description of Work: r P��G>'. --, )016 The above project permit applicant, due to the limited scope of work, is authorized to submit reduced plan requirements described below: 1. Complete permit application(s): KBuilding ❑ Mechanical ❑ Plumbing /Gas Piping ❑ Electrical ❑ Other 2. Plan and /or Specification (minimum): ❑ Site Plan ❑ Floor Plan ❑ Elevations ❑ Foundation ❑ Cross Sections ❑ Roof Plan Narrative ❑ Narrative WSEC Compliance ❑ Structural Calcs 3. Required Inspections (only completed when to be issued over the counter): 'Framing ❑ Glazing IEinal ❑ Other: 4. Other Special Instructions: ROOPEriNglar CODE COMPLIANCE, PAPINVIVED l' AUG 0 3 2012 Date: (Authorization void 30 days after date) RECEIVED JUL 27 7017 6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone: 206 431-36TERAARGENTER City of Tukwila 7w:vermit Center\ Templates \Forms\Autta.for - Reduced Plan Submittal.docx BUILDING DIVISION �� TCOORD COPY PLAN REVIEW /ROUTING SLIP ACTIVITY NUMBER: D12 -247 DATE: 07 -27 -12 PROJECT NAME: SUNWOOD CONDOS - ROOF REPAIR SITE ADDRESS: 15209 SUNWOOD BL X Original Plan Submittal Response to Correction Letter # Response to Incomplete Letter # Revision # After Permit Issued DEPARTMENTS: 6uilding''Divi� n 11;I`�� Public Works Yn AV i,)— Fire Prevention Structural Planning Division Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Comments: Incomplete n DUE DATE: 07 -31 -12 Not Applicable Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials: TUES /THURS ROUTING: Please Route Structural Review Required nNo further Review Required REVIEWER'S IN1TIALS: DATE: n APPROVALS OR CORRECTIONS: Approved Notation: Approved with Conditions DUE DATE: 08-28-12 Not Approved (attach comments) REVIEWER'S INITIALS: 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 *ter Friendly Page • General /Specialty Contractor A business registered as a construction contractor with L &I 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 Phone Address Suite /Apt. City State Zip County Business Type Parent Company CONSOLIDATED GTR & SHT MTL LLC 2063009138 16751 Burke Ave North Shoreline WA 98133 King Limited Liability Company UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 603054384 Active CONSOGS902RN Construction Contractor 12/15/2010 12/15/2012 General Unused Other Associated Licenses License L Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status NORTHCG964QQNORTHWEST CUSTOM GUTTERS Construction Contractor Metal Fabrication Unused 11/18/2004 2/5/2011 Expired Business Owner Information Name Role Effective Date Expiration Date KEENE, BRIAN A Agent 12/15/2010 Amount KEENE, BRIAN A Partner /Member 12/15/2010 FMWA00193902 Bond Information Page .1 of 1 Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 1 UNITED STATES FIRE INSURANCE COMPANY 615978760 11/29/2010 Until Cancelled $12,000.00 12/15/2010 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 3 First Mercury Ins Co FMWA00193902 12/01/2011 12/01/2012 $1,000,000.00 12/05/2011 2 First Mercury Ins Co FMWA00193902 12/02/2011 12/02/2012 $1,000,000.00 11/30/2011 1 FIRST MERCURY INS CO FMWA001939 12/01/2010 12/01/2011 $1,000,000.0012 /15/2010 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 08/08/2012