HomeMy WebLinkAboutPermit D13-107 - PHAN RESIDENCE - GARAGE AND SHEDS DEMOLITIONPHAN DEMOLITION
4237 S 160 ST
D13-107
City oiR'ukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-43 1-3670
Inspection Request Line: 206-431-2451
Web site: http://www.TukwilaWA.gov
Parcel No.: 5379800040
Address: 4237 S 160 ST TUKW
Suite No:
Project Name: PHAN DEMOLITION
DEVELOPMENT PERMIT
Permit Number: D13-107
Issue Date: 08/28/2013
Permit Expires On: 02/24/2014
Owner:
Name: LANDFAIR LLC
Address: 2415 62ND AVE SE , MERCER ISLAND WA 98040
Contact Person:
Name: HAN PHAN, PE
Address: 5130 S 166 LN , SEATAC WA 98188
Phone: 206 229-6422
Contractor:
Name: PEACEFIELD CONSTRUCTION CO Phone: 206-249-1665
Address: 10606 DES MOINES MEMORIAL DR S , SEATTLE WA 98168
Contractor License No: PEACECC888KN Expiration Date: 05/15/2014
Lender:
Name:
Address:
DESCRIPTION OF WORK:
DEMOLITION OF 720 GARAGE AND (3) SHEDS WHICH ARE 162 SF, 173 SF, AND 547 SF.
Value of Construction: $5,000.00 Fees Collected: $306.95
Type of Fire Protection: UNKNOWN International Building Code Edition: 2009
Type of Construction: VB Occupancy per IBC: 0026
Electrical Service Provided by: PUGET SOUND ENERGY
**continued on next page**
doc: IBC -7/10
D13-107 Printed: 08-28-2013
Public Works Activities:
Channelization / Striping: N
Curb Cut / Access / Sidewalk / CSS: N
Fire Loop Hydrant:
Flood Control Zone:
Hauling: N Start Time: End Time:
Land Altering: Volumes: Cut 0 c.y. Fill 0 c.y.
Landscape Irrigation:
Moving Oversize Load: Start Time: End Time:
N Number: 0
Size (Inches): 0
Sanitary Side Sewer:
Sewer Main Extension: Private: Public:
Storm Drainage:
Street Use: Profit: N Non -Profit: N
Water Main Extension: Private: Public:
Water Meter: N
Permit Center Authorized Signature:
Date: 9—'4-1'3
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 am authorized to sign and obtain this development permit and ag ee to the conditions attached
to this permit.
Signature -
Print Name v `-
`A' - Date:
71-Yvt =14
This permit shall become null and void if the work is not commenced within 180 days from the date of issuance, or if the work is suspended
or abandoned for a period of 180 days from the last inspection.
PERMIT CONDITIONS:
1: ***BUILDING DEPARTMENT CONDITIONS***
2: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the
Building Official.
3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to
start of any construction. These documents shall be maintained and made available until final inspection approval is
granted.
4: Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary
sewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other
excavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of
this requirement.
5: 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
doc: IBC -7/10
D13-107 Printed: 08-28-2013
Building Official from requiring the correctioi rrors in the construction documents and ottata.
doc: IBC -7/10
D13-107 Printed: 08-28-2013
CITY OF TUKWILA
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
hnp://www.TukwilaWA.gov
Building. Permit No.
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
Site Address: 4237-S. 160th Street
Tenant Name:
PROPERTY OWNER
Name: Han Phan, PE
Name: Landfair, LLC
City: SeaTac State: WA Zip: 98188
Address: 2415 -62nd Ave SE
Email: pbg.engr@yahoo.com
City: Mercer Island State: WA
Zip:98188
CONTACT PERSON — person receiving all project
communication
Name: Han Phan, PE
Address: 5130 S. 166th Lane
City: SeaTac State: WA Zip: 98188
Phone: (206) 229-6422 Fax:
Email: pbg.engr@yahoo.com
GENERAL CONTRACTOR INFORMATION
Company Name: TBD
Address:
Company Name:
Address:
Architect Name:
Engineer Name:
City:
State:
Address:
Zip:
Phone:
Fax:
Phone: /
Fax:
Contr Reg No.:
Email:
Exp Date:
/
Tukwila Business License No.:
Email:
H:WppIicatats'Forns-Applications On Lme\2011 Apphcatiors\Permit Application Revised. 8-9-1I.docx
Revised: August 2011
bh
King Co Assessor's Tax No.: 5379800040
Suite Number: Floor:
New Tenant: ❑ Yes ❑..No
ARCHITECT OF RECORD
Name:
Address:
Company Name:
Architect Name:
Engineer Name:
Address:
Address:
City:
State:
Zip:
Phone: /
Fax:
State:
Email:
Phone:
/
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): $ 5,000
Describe the scope of work (please provide detailed information):
Demolition existing 3 existing sheds and 1 existing garage
Will there be new rack storage? ❑ Yes
Existing Building Valuation: $
m.. No If yes, a separate permit and plan submittal will be required.
Provide All Building Areas in Square Footage Below
Existing
Interior Remodel
Addition to
Existing
Structure
New
Type of
Construction per
IBC
Type of
Occupancy per
IBC
1St Floor
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 ft): Floor area of principal dwelling: Floor area of accessory dwelling:
*Provide documentation that shows that the principal owner lives in one of the dwellings as his or her primary residence.
Number of Parking Stalls Provided: Standard:
Compact: Handicap:
Will there be a change in use? 0 Yes 0 No If "yes", explain:
FIRE PROTECTION/HAZARDOUS MATERIALS:
0 Sprinklers 0 Automatic Fire Alarm 0 None 0 Other (specify)
Will there be storage or use of flammable, combustible or hazardous materials in the building? 0 Yes 0 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
0 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''oms-Applications On Lmet2011 ApplicationstPermit Application Revised - 8-9-11.docx
Revised: August 2011
bh
Page 2 of 4
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 OWNER AUTHO D AGEN C�
Signature:
i
Date: 04/01/2013
Print Name: Han Phan Day Telephone: (206) 229-6422
Mailing Address: 5130 S. 166th Lane SeaTac WA 98188
City State Zip
H:\Apphcauotts\Forms-Applications On Line \2011 Applications\Permit Application Revised - 8-9-I I.docx
Revised: August 2011
bh
Page 4 of 4
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.TukwilaWA.gov
Parcel No.: 5379800040
Address: 4237 S 160 ST TUKW
Suite No:
Applicant: PHAN DEMOLITION
RECEIPT
Permit Number: D13-107
Status: APPROVED
Applied Date: 04/01/2013
Issue Date:
Receipt No.: R13-02497
Payment Amount: $187.80
Initials: WER Payment Date: 08/28/2013 04:03 PM
User ID: 1655 Balance: $0.00
Payee: PEACEFIELD CONSTRUCTION CO
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Credit Crd VISA
Authorization No. 170139
ACCOUNT ITEM LIST:
Description
187.80
Account Code Current Pmts
BUILDING - NONRES
STATE BUILDING SURCHARGE
000.322.100 183.30
640.237.114 4.50
Total: $187.80
Printed: 08-28-2013
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Fax: 206-431-3665
Web site: http://www.TukwilaWA.gov
Parcel No.: 5379800040
Address: 4237 S 160 ST TUKW
Suite No:
Applicant: PHAN DEMOLITION
RECEIPT
Permit Number: D13-107
Status: PENDING
Applied Date: 04/01/2013
Issue Date:
Receipt No.: R13-01176
Payment Amount: $119.15
Initials: JEM Payment Date: 04/01/2013 11:31 AM
User ID: 1165 Balance: $187.80
Payee: PHAN BUSINESS GROUP LLC
TRANSACTION LIST:
Type Method Descriptio Amount
Payment Check 1066 119.15
Authorization No.
ACCOUNT ITEM LIST:
Description
Account Code Current Pmts
PLAN CHECK - NONRES
000.345.830 119.15
Total: $119.15
Printer • Od_M-9(113
INSPECTION RECORD
Retain a copy with permit
INSPECTION NO. - PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-367
Permit Inspection Request Line (206) 431-2451
D13-10-7
Project:
etttkN. DEry-‘0
Type of Inspection:.
F I IQ AL -
Address:
WA -31 S I hO'
Date Called:
Special Instructions:
t,100-
_ ATE 4 ice. .NJ
Date Wanted: 2
9I (2-- (3
(.1._) -
Requester:
Phone No:
a...0(0zy5- (G&S
Approved per applicable codes.. Corrections required prior to approval.
COMMENTS:
Ze\uJ p<, Rop,A 4
1Z,rt`AN( -1b �-1P Ill tv A
n •ecto
r
REIN PECTION. FEE RE
.paid : t 6300 Southcenter
12.— 13
UIRED. Prior to nixt inspection. fee must be
lvd.. Suite 100. Call to schedule reinspection.
�kf
INSPECTION RECORD
Retain a copy with permit
.ii3- 107
INSPECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 - to_ (206) 431-3670
Permit Inspection Request Line (206) 431-2451 r=
Projec .
rr"erf\f ,...)G". e--AIO
Typ f ection:
.2--. 0 k --AA CO pre_—
Address: `i.
4237 11 01--,1
Date Called:
Special Instructions:
/'
Date Wanted: _rig3a.m.
Requester:
Phone Nq: --2-4 ( (40(0—S
Approved per applicable codes.
ElCorrections required prior to approval.
Li
COMMENTS:
- UJ- '`- Q V e.R ALS ,. 0'1J ()A%
p1‘A , A-10 p( L)A6Q.LriThAiot
Ins
I I REINSPECTION FEE REQUIRE
Date ,' 1 _ (3
aor to next inspection, fee must be
paid at 6300"Southcenter Blvd. Suite 100. Callao schedule reinspection.
1
ETCRtt
FIN ,,: 429.'.C.
1,..1-4FY E4 r
A`.1 -i OLE
1 19
—i.+i—� r 19
8+00
• W
SEPtAT E PERMIT
REQUIRED POR:
._.. P ce
c anicaL___
IR Electrical
Plumbing
Gas Piping
City of Tukwila
BUILDING DIVISION
n
8.160TFI MEET- ' __
+`
POINT OF ACCESS FOR DEMOUTION
It: 0..:o-. _. 4
REVISIONS
No changes shall be made to the scope
of work without prior approval of -
Tukwila -.Building
fTukwila-Building Division.
NOTE: Revisions will require a new plan submittal
and may incude additional pian review fess.
DOSING HOUSE
TO REMAIN
LOT1
(18,060 SQ. Fr)
�✓r
i
•r
EX SHED
TO BE DEMOUSHED
(APPROX. 162 SF)
LOT 4
(7,750 SQ. FT)
11,
EX SHED
-70 BE DEMOUSHED
(APPROX. 547 SF)
LOT:3
(7,75 SQ: FT) . .
" EX GARAGE- {
TO 3E DEMOLISHED
(AFPROX 720 SF)
I EX SHED—
TO BE DEMOUSHED
(APPROX. 173 SF)
LOT 2.
(7,750 SQ. FT)
HORIZONTAL GRAPHIC SCALE
20 10 0 10 20
N0.
1 inch = 20 ft.
DATE
BY
REVISION DESCRIPTION
JOB NO
812500
ISSUE DATE
4-01-2013
DESIGNED BY.
H. H. PHAN
DRAWN BY
CHECKED BY:
H. H. PHAN
PROJ. MNGR
LEGEND
CONTACTS
PROPERTY UNE
ADJACENT PROPERTY UNE
— ROAD CENTERUNE/ROW CENTERLINE
ROW UNE
— PROPOSED EASEMENT UNE
LEGAL DESCRIPTION
BEGINNING ON THE NORTH UNE OF SECTION 27, TOWNSHIP 23 NORTH. RANGE 4 EAST, W.M.,DISTANT
NORTH 8959'10' WEST, 2156.10 FEET FROM THE NORTHEAST CORNER OF SMD SECTION 27;
THENCE SOUTH 001550 EAST 305.40 FEET; THENCE NORTH 89'5910• WEST 150 FEET; THENCE
NORTH 0015'50' WEST 305.40 FEET TO 111E NOR1H UNE OF SAID SECTION 27; THENCE ALONG SAID
NOR1H UNE SOUTH 8959'10' EAST TO THE POINT OF BEGINNING
EXCEPT 1HE NORTH 30 FEE THEREOF FOR ROAD PURPOSES.
SITUATE IN THE aTY OF TUKWILA, COUNTY OF KING, STATE OF WASHINGTON
TAX PARCEL NUMBER
5379800040
APPLICANT:
OWNER
2415 — 62ND AVE SE
MERCER ISLAND. WA 98040
(206) 339-5973
CONTACT: CAO HUYNH
UTILITIES
CML ENGINEER:
PB0, LLC
5130 S. 166111 LANE
SEATAC, WA 98188
(206) 446-1292
CONTACT: HAN PHAN, P.E.
SURVEYOR
SITE SURVEY & MAPPING INC.
10115 — 214TH AVE NE
REDMOND, WA 98053
(253) 298-4412
CONTACT: THOMAS WOLDENDORP, P.LS.
WATER
HIGHUNE WATER DISTRICT
23828 -30TH AVE SOUTH
KENT. WA 98032
(206) 592-8924
SEWER
VALLEY VIEW SEWER DISTRICT
3460 S. 1481H STREET, SUITE 100
SEATTLE, WA 98168
(206) 242-3236
POWER:
PUGET SOUND ENERGY
1-888-321-7779
FILE COPY
Permit No. _ Z ' rl O N.
Plan review approval is subject to errors and omissions.
Approval of construction documents does not autho ,e
It* violation of any adopted code or ordinance. Receipt
of approved Field Copy and conditions is acknowledged:
By 7 ill yv
Date: (?� 2 t ?�
City Of Tukwila
BUILDING DIVISION
GAS: TELEPHONE:
PUGET SOUND ENERGY QWEST
1-888-321-7779 1-500-526-3557
CABLE:
COMCAST
1-866-771-2281
•
REVIEWED FOR
CODE COMPLIANCE
APPROVED
APR 10 2013
J
tF
City of Tu la
BUILDING VISION
RECEIVED
CITY OF TUKWILA
APR 0 1 2013
PERMIT CENTER
Land Planning • Civil Engineering
5130 South 166th Lane
SeaTac, WA 98188
T (206) 229-6422
LANDFAIR 2 SHORT PLAT
4237 - S. 160TH STREET
TUKWILA, WA 98188
CALL 48 HOURS
BEFORE YOU DIG
1-800-424-5555
REFERENCE
SHEET NO.
DM1
•
SITE PLAN - DEMOLITION
SHEET
1
OF
1
SHEETS
August 29, 2013
Han Phan, PE
5130 S 166 Lane
Seatac, WA 98188
City of Tukwila Jim Haggerton, Mayor
Department of Community Development Jack Pace, Director
RE: Request for Extension
Permit D13-107
Phan Demolition — 4237 S 160 St
Dear Mr. Phan,
This letter is in response to your written request for extension to permit D13-107. The Building Official
has reviewed your letter and considered your request to extend the above referenced permit. The City of
Tukwila Building Division does not need to extend the permit per your request at this time due to the fact
that an inspection was requested and performed today, August 29, 2013. This inspection automatically
extends the permit 180 days. The new expiration date is February 25, 2014.
If you should have any questions, please contact our office at (206) 431-3670.
File: Permit No. D13-107
W:V'ermit Center\Extension Letters\Denials\Permits\2013\D13-107 Extension Denial.docx
6300 Southcenter Boulevard, Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665
August 20, 2013
Department of Community Development
City of Tukwila
6300 Southcenter Boulevard, Suite #100
Tukwila, WA 98168
Subject: Permit Application No. D13-107
Phan Demolition
4237 — S. 160th Street
To whom it may concern:
This letter is written in requesting an extension for Demo Permit D13-107.
RECENED
BfTf t3: T ICWILA
AUG 22 2013'
J5Pirr t t
The owner is working on finding a contractor that can do this work. As you know, this is a very busy time of the year
for construction and finding the contractors that can do the work with a reasonable price is very difficult.
Furthermore, the owner is in the process of finding a partnership to complete this development project.
Please feel free to contact me if you have questions regarding to the subject above.
Han Phan, P.E.
Project Manager
PBG, LLC
/04 -JAW/
/Bo d
vied
S/g�zae3.
\Pak aLdck��R ��z�lp
w 0,5r�J� �
nu.) �k,k
08-01-2013
•
City of Tukwila
•
Jim Ha Berton. Mayor
Department of Community Development Jack Pace. Director
HAN PHAN, PE
5130 S 166 LN
SEATAC WA 98188
RE: Permit Application No. D13-107
PHAN DEMOLITION
4237 S 160 ST TUKW
Dear Permit Applicant:
In reviewing our current application files, it appears that your permit applied for on 04/01/2013, has not been
issued by the City of Tukwila Permit Center. Per the International Building Code, International Mechanical Code,
Uniform Plumbing Code and/or National Electrical Code every permit application not issued within 180 days
from the date of application shall expire and become null and void. Your permit application will expire on
09/28/2013.
If you still plan to pursue your project, a written request for extension of your application must be submitted to the
Permit Center at least seven (7) days before it is due to expire. Address your extension request to the Building
Official and state your reason(s) for the need to extend your permit application. If it is determined that an
extension is granted, your application will be extended for an addtional 90 days from the expiration date and you
will be notified by mail.
In the event that we do not receive your written request for extension or request was denied, your permit
application will expire, become null and void and your project will require a new permit application, plans and
specifications, and associated fees.
Thank you for your cooperation in this matter.
Sincerely,
7D,AZ
Bill Rambo
Permit Technician
File: Permit File No. D13-107
6300 Southcenter Boulevard. Suite 11100 • Tukwila, Washington 98188 • Phone 206-431-3670 . Fax 206-431-3665
*EMIT COORD COPY*
PLAN REVIEW/ROUTING SLIP
ACTIVITY NUMBER: D13-107 DATE: 04/01/13
PROJECT NAME: PHAN DEMOLITION
SITE ADDRESS: 4237 S 160 ST
X Original Plan Submittal Response to Incomplete Letter #
Response to Correction Letter #
Revision # after Permit Issued
DEPARTMENTS:
�s AVCd
Building Division E.
Public Work
ArW\ NSA— x-13
Fire Prevention ig
Structural
Planning Division
❑ Permit Coordinator ❑
DETERMINATION OF COMPLETENESS: (Tues., Thurs.)
Complete �J
Incomplete ❑
DUE DATE: 04/02/13
Not Applicable
Comments:
Permit Center Use Only
INCOMPLETE LETTER MAILED:
Departments determined incomplete: Bldg 0 Fire 0 Ping 0 PW 0 Staff Initials:
LETTER OF COMPLETENESS MAILED:
TUES/THURS ROUTING:
Please Routeif
REVIEWER'S INITIALS: DATE:
Structural Review Required ❑ No further Review Required ❑
APPROVALS OR CORRECTIONS:
DUE DATE: 04/30/13
Approved ❑ Approved with Conditions k Not Approved (attach comments) ❑
Notation:
REVIEWER'S INITIALS:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections:
Bldg 0 Fire 0
Ping ❑ PW ❑
Staff Initials:
Contractors or Tradespeople Pri r 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 PEACEFIELD CONSTRUCTION CO UBI No. 603203999
Phone 2062491665 Status Active
Address 10606 Des Moines Memorial Dr S License No. PEACECC888KN
Suite/Apt. License Type Construction Contractor
City Seattle Effective Date 5/15/2012
State WA Expiration Date 5/15/2014
Zip 98168 Suspend Date
County King Specialty 1 General
Business Type Corporation Specialty 2 Unused
Parent Company
Other Associated Licenses
License
Name
Type
Specialty
1
Specialty
2
Effective
Date
Expiration
Date
Status
AFFORRP907KS
AFFORDABLE ROOTER
PLUS
Construction
Contractor
General
Unused
5/10/2010
5/10/2012
Expired
PEACECC044BP
PEACEFIELD
CONSTRUCTION CO
Construction
Contractor
General
Unused
1/17/1996
2/15/2010
Expired
Business Owner Information
Name
Role
Effective Date
Expiration Date
AMEN, DAVID A
President
05/15/2012
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
American Contractors
Indem CO
100195508
05/11/2012
Until Cancelled
$12,000.00
05/15/2012
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
2
Security
National
Insurance
46-10163467
11/02/2012
11/02/2013
$1,000,000.00
11/05/2012
1
Covigatorslns
4610152927
11/02/2011
11/02/2012
$1,000,000.00
05/15/2012
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
Infractions/Citations Information No records found for the previous 6 year period
https://fortress.wa. gov/lni/bbip/Print.aspx
08/28/2013