The URL can be used to link to this page

Home My WebLink AboutPermit D13-195 - SEGALE PROPERTIES - HOUSE DEMOLITIONSEGALE PROPERTIES HOME DEMOLITION 18115 57 AV S D13-195 City of.ukwila • 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.: 3523049034 Address: 18115 57 AV S TUKW Suite No: Project Name: SEGALE PROPERTIES - HOUSE DEMOLITION Permit Number: D13-195 Issue Date: 06/27/2013 Permit Expires On: 12/24/2013 Owner: Name: SEGALE PROPERTIES LLC Address: PO BOX 88028 , TUKVVILA WA 98028 Contact Person: Name: DAINA MERENESS Address: PO BOX 88028 , TUKWILA WA 98138 Contractor: Name: SEGALE PROPERTIES LLC Address: PO BOX 88028 , TUKWILA WA 98138 Contractor License No: SEGALPL902CQ Lender: Name: SELF FUNDED - SEGALE PROPERTIES Address: Phone: 206-575-2000 Phone: 206-575-2000 Expiration Date: 04/01/2014 DESCRIPTION OF WORK: DEMOLISH AND REMOVE STRUCTURES AND FOUNDATIONS OF A 3690 SQ FT HOME AND 780 SQ FT DETACHED GARAGE BUILT IN 1965. ALL UTILITIES WILL BE TERMINATED AND CAPPED. REGRADE TO MATCH GRADING PLANS FOR SOUTH TUKVVILA PROJECT (PLEASE SEE PLANS SUBMITTED FOR PW10-064) PUMP AND REMOVE SEPTIC TANK. HIGHLINE WATER DIST. Value of Construction: $13,000.00 Fees Collected: $809.07 Type of Fire Protection: NONE International Building Code Edition: 2009 Type of Construction: V -B Occupancy per IBC: 434 Electrical Service Provided by: PUGET SOUND ENERGY **continued on next page** doc: IBC -7/10 D13-195 Printed: 06-27-2013 Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Fire Loop Hydrant: N Number: 0 Flood Control Zone: N Hauling: N Start Time: End Time: Land Altering: N Volumes: Cut 0 c.y. Fill 0 c.y. Landscape Irrigation: N Moving Oversize Load: N Start Time: End Time: Size (Inches): 0 Sanitary Side Sewer: N Sewer Main Extension: N Private: Storm Drainage: N Street Use: N Profit: N Water Main Extension: N Private: Water Meter: N Permit Center Authorized Signature: Date: I hereby certify that I have read and examined t s 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 pe Public: Non -Profit: N Public: Signature: Print Name: Date: /.2. "7/3 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: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the City of Tukwila Building Department (206-431-3670). 6: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building doc: IBC -7/10 D13-195 Printed: 06-27-2013 Department (206-431-3670). 7: 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. 8: ***PUBLIC WORKS DEPARTMENT CONDITIONS*** 9: Contractor shall notify Public Works Inspector Mr. Dave Stuckle at (206)433-0179 of commencement and completion of work at least 24 hours in advance. 10: Temporary erosion control measures shall be implemented as the first order of business to prevent sedimentation off-site or into existing drainage facilities. 11: Any septic tanks in the area shall be pumped empty and removed or filled with sand. A copy of the documentation from the business that performed the pumping shall be provided to the Public Works Inspector. doc: IBC -7/10 D13-195 Printed: 06-27-2013 • • CITY OF TUKWILA Community Development Department Public Works Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Building Permit No. ( Project No. Date Application Accepted: ( _ l 3 Date Application Expires: 1)--'1--'t5 (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: Tenant Name: King Co Assessor's Tax No.: 352304-9034 18115 - 57th Avenue S, Tukwila, WA 98188 Suite Number: PROPERTY ,OWNER Name: Daina Mereness Name: Segale Properties LLC Address: P.O. Box 88028 Address: P.O. Box 88028 City: Tukwila State: WA City: Tukwila State: WA Zip: 98138 CONTACT PERSON — person receiving all project communication Name: Daina Mereness Address: P.O. Box 88028 Address: P.O. Box 88028 Phone: (206) 575-2000 Fax: (206) 575-1837 City: Tukwila State: WA Zip: 98138 Phone: (206) 575-2000 Fax: (206) 575-1837 Email: dmereness@hotmail.com GENERAL CONTRACTOR INFORMATION Company Name: Segale Properties LLC Address: P.O. Box 88028 City: Tukwila State: WA Zip: 98138 Phone: (206) 575-2000 Fax: (206) 575-1837 Contr Reg No.: SEGALPL902CQ Exp Date: 04/01/2014 Tukwila Business License No.: BUS -0101320 H.Applications\Fonns-Applications On Line N.2011 Applicattons\Permn Application Revised - 8.9.1 I .docx Revised: August 2011 bh Floor: New Tenant: 0 Yes ..No ARCHITECT OF RECORD Name: )// &fi//eCJ Company Name: Address: Architect Name: City: State: Address: City: State: Zip: Phone: Fax: Email: ENGINEER OF RECORD Name: )// &fi//eCJ Company Name: Address: Engineer Name: City: State: Address: City: State: Zip: Phone: Fax: Email: LENDER/BOND ISSUED (required for projects $5,000 or greater per RCW/1'9.27.095�),/ Name: )// &fi//eCJ 1 k Ice,/ ,4 i Address: City: State: Zip: Page 1 of 4 BUILDING PERMIT INFORMATI— 206-431-3670 Valuation of Project (contractor's bid price): $ 13,000 Existing Building Valuation: $ 0 Describe the scope of work (please provide detailed information): Demolish and remove structures and foundations of 3690 -square -foot home and 780 -square -foot detached garage built in 1965. All utilities will be terminated and capped. Regrade to match grading plans for the Tukwila South project (please see plans submitted for PW 10-064). Will there be new rack storage? ❑ Yes m.. No If yes, a separate permit and plan submittal will be required. Provide All Building Areas in Square Footage Below PLANNING DIVISION: Single family building footprint (area of the foundation of all structures, plus any decks over 18 inches and overhangs greater than 18 inches) *For an Accessory dwelling, provide the following: Lot Area (sq ft): 801,910 Floor area of principal dwelling: 3,690 Floor area of accessory dwelling: 780 *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 0 No If "yes", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ Sprinklers ❑ Automatic Fire Alarm ❑ 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 ❑ On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health Department. H:Wpplications\Foms-Applications On Line\2011 Appltcattons\Permn Application Revised - 8-9-11.docx Revised: August 2011 bh Page 2 of 4 Existing Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC 1st lion! " 2,790 2"d Floor' 3`' Floor Floors thni'�'- Basement 900 Accessory Structure* Attached Garage Detached Garage 780 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): 801,910 Floor area of principal dwelling: 3,690 Floor area of accessory dwelling: 780 *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 0 No If "yes", explain: FIRE PROTECTION/HAZARDOUS MATERIALS: ❑ Sprinklers ❑ Automatic Fire Alarm ❑ 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 ❑ On-site Septic System — For on-site septic system, provide 2 copies of a current septic design approved by King County Health Department. H:Wpplications\Foms-Applications On Line\2011 Appltcattons\Permn Application Revised - 8-9-11.docx Revised: August 2011 bh Page 2 of 4 PUBLIC WORKS PERMIT INFO ATION — 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 0 ...Water Availability Provided Sewer District ❑ ...Tukwila ❑ ...Sewer Use Certificate ❑...Valley View ❑...Sewer Availability Provided m .. Highline ❑ .. Renton ❑ .. Renton ❑ .. Seattle Septic System: m 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): 0 ...Civil Plans (Maximum Paper Size — 22" x 34") ❑ ...Technical Information Report (Storm Drainage) ❑ ...Bond 0 .. Insurance 0 .. Easement(s) 0 .. Geotechnical Report 0 .. Maintenance Agreement(s) ❑...Traffic Impact Analysis ❑ ...Hold Harmless — (SAO) ❑ ...Hold Harmless — (ROW) Proposed Activities (mark boxes that apply): ❑ ...Right-of-way Use - Nonprofit for less than 72 hours 0 .. Right-of-way Use - Profit for less than 72 hours ❑ ...Right-of-way Use - No Disturbance 0 .. Right-of-way Use — Potential Disturbance ❑ ...Construction/Excavation/Fill - Right-of-way 0 Non Right-of-way 0 ❑ ...Total Cut cubic yards 0 .. Work in Flood Zone ❑ ...Total Fill cubic yards ❑ .. Storm Drainage 0 ...Sanitary Side Sewer ❑ .. Abandon Septic Tank 0 .. Grease Interceptor m ...Cap or Remove Utilities ❑ .. Curb Cut ❑ .. Channelization 0 ...Frontage Improvements ❑ .. Pavement Cut ❑ .. Trench Excavation ❑ ...Traffic Control 0 .. Looped Fire Line ❑ .. Utility Undergrounding 0 ...Backflow Prevention - Fire Protection Irrigation Domestic Water ❑ ...Permanent Water Meter Size... WO # 0 ...Temporary Water Meter Size.. WO # ❑ ...Water Only Meter Size WO # 0 ...Deduct Water Meter Size 0 ...Sewer Main Extension Public 0 Private 0 ❑ ...Water Main Extension Public 0 Private 0 FINANCE INFORMATION Fire Line Size at Property Line Number of Public Fire Hydrant(s) 0 ...Water 0 ...Sewer 0 ...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 \2011 Applications\Permit Application Revised - 6-9-11.docx Revised: August 2011 bh Page 3 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 HA READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY THE S OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNER Signature: Date: 06/03/2013 Print Name: Mark A. S T Day Telephone: (206) 575-2000 Mailing Address: P.O. Box Tukwila WA 98138 City State Zip H:Wpphcattons\Forms-Applications On Line \2011 Applications\Permit Application Revised - 8.9.11.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: 206-431-3670 Fax: 206-431-3665 Web site: http://www.TukwilaWA.gov RECEIPT Parcel No.: 3523049034 Permit Number: D13-195 Address: 18115 57 AV S TUKW Status: APPROVED Suite No: Applied Date: 06/03/2013 Applicant: SEGALE PROPERTIES - HOUSE DEMOLITION Issue Date: Receipt No.: R13-01993 Initials: User ID: TLS 1670 Payment Amount: $250.00 Payment Date: 06/27/2013 08:15 AM Balance: $0.00 Payee: SEGALE PROPERTIES TRANSACTION LIST: Type Method Descriptio Amount Payment Check 634883 250.00 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts PW BASE APPLICATION FEE 000.322.100 250.00 Total: $250.00 ,.Inn• Dcnnink_fla o.inro,l• na_17_)n1z • 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 RECEIPT ParcelNo.: 3523049034 Permit Number: D13-195 Address: 18115 57 AV S TUKW Status: PENDING Suite No: Applied Date: 06/03/2013 Applicant: SEGALE PROPERTY HOUSE DEMOLITION Issue Date: Receipt No.: R13-01788 Initials: WER User ID: 1655 Payment Amount: $559.07 Payment Date: 06/03/2013 04:33 PM Balance: $0.00 Payee: SEGALE PROPERTIES LLC TRANSACTION LIST: Type Method Descriptio Amount Payment Check 2140 559.07 Authorization No. ACCOUNT ITEM LIST: Description Account Code Current Pmts BUILDING - NONRES PLAN CHECK - NONRES STATE BUILDING SURCHARGE 000.322.100 000.345.830 640.237.114 Total: $559.07 336.10 218.47 4.50 printed. OR -03-2013 z, INSPECTION NO. INSPECTION RECORD Retain a copy with permit PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-367 Permit Inspection Request Line (206) 431-2451 Project: eGo AIX- . �ic Q Type gfanspection: i--T0A1..., Address: IStI 5-7 ilv 5 Date Called: Special Instructions: Date Wanted: CI-- 2-13 a�To. p.m. Requester: Phone c)-0%-3C.L—.1017 '.Approved per applicable codes. Corrections required prior to approval. nsp or: ce>r, k&-4* --Zo - t—j n ' EIJISPECTION FEE REdUIRED. Prior to next inspection. fee must be ROI at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 it. (206) 431-3670 Permit Inspection Request Line (206) 431-2451 .D13-175 Project: C\I.�-1-1&is€ Typ f Inspection: R.- bvvl 0 Address: c �v Date Called: Date Special Instructions: Date ant �_ .. � m. P•m. Req ester: Ph?o_ne,Wo ZD(Z. tglApproved per applicable codes. 0 Corrections required prior to approval. COMMENTS: • Dat 3 D. - REI SPECTION FEE RE UIRED. Prior next inspection. fee must be paid at 6300 Southcente Blvd., Suite 1. 0. Call to schedule reinspection. kt- —Fri A -ecif INSPECTION NO. INSPECTION RECORD Retain a copy with permit ) 3- /9'$ PERMIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 5outhcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 431-2451 Project:Type (.41,Je -damn i1 /1-r o of Inspe tion: ' k'L -) r4. ddre4 :Date / g )/S .7 4ve S Called: 09//y fi3 Special Instructions: Cai' ( /5ill."' y r0 a " S p , Date Wanted: (' 9 /ac,// 3 a.m. p.m. Request r y Phone No: ?(-)( 3% aota ElApproved per applicable codes. EJ Corrections required prior to approval. COMMENTS: Inspector: 05 Date: f (70f f 3 REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit D(3115- INSPECTION NO. PERMIT NO. CITY. OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98.1'88 (206) 431-3670 Permit Inspection Request Line (206) 431-2451 Project: Type of Aspectiorii A Byre s. ' ate Called `ii /3 S�eci I Instructions: 444 �X 4 i I 1 Y"li`1 1P ae Z Date Wanted.. 1.3 L C7/ a.m. P.m. Requeser.: i Phone NJ*�,� j C.! �/ c�. - 4 --GrD i Approved per applicable codes. Corrections required prior to approval. COMMENTS: Si Inspector: 05 Date: q /c f 3 F-7 REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. "Tr"' st Abatement S July 11, 2013 Barry Bennett Segale Properties P.O. Box 88028 Tukwila, WA 98138 "It's Not What We Do, It's How We Do It RE: Letter of Completion House Structure Abatement 18115 Southcenter Parkway Tukwila, WA 98188 Dear Barry, i3-1�� This letter will serve as our notice of completion of the asbestos abatement for the above mentioned address per proposal # 2013-7320. Northwest Abatement Services, Inc. performed the following: _ Northwest Abatement Services, Inc. removed and disposed of the identified asbestos containing materials in the structure per the asbestos survey. Asbestos containing materials were removed using certified personnel and according to all the state and local codes. The structure is abated and ready for demolition — please see attached the asbestos permits from Puget Sound Clean Air Agency and Dept. of Labor & Industries, copy of our clearance air sample, and a waste manifest associated with the asbestos debris removed from the site. If you have any questions or require further information, please call us (253) 588-0440. Sincerely, Chris Eckholm Project Manager Northwest Abatement Services, Inc. P.O. Box 39246.9822 32` 1Ave. S. • Laleood, WA 98499 • (253) 588-0440 • Fax (253) 588-0198.1-800-588-0340 Website: wwwnwalieimioom • Cornmaxr#NORTHAS066RN 3673'!7 /9[,13?) PRIOR TO COMMENCING WITH DEMOLOTO®N A "pre -demo inspection" is required. Contractors shall provide documentation that an "asbestos survey" has been completed!. Of needed, abatement procedures per "Puget / Sound! Clean Air gency" shall be completed) and documentation of compliance shall be provided at time of final inspection. '352-3065034 s3� I`,3•3 230001.0_1-"' 1 Acess C 4C) 2:Wi timg [:Duty 422 CEIVED OF TLJKWiL( IBJ U 0 3 20131; CEN COMMENTS: VICINITY MAP The information included on this map has been compiled by King County staff from a variety of sources and is subject to change without notice. King County makes no representations or warranties, express or implied, as to accuracy, completeness, timeliness, or rights to the use of such information. This document is not intended for use as a survey product. King County shall not be liable for any general, special, indirect, incidental, or consequential damages including, but not limited to, lost revenues or lost profits resulting from the use or misuse of the information contaird on this map. Any sale of this map or information on this map is prohibited except by written permission of King County. Chang County Date: 6/3/2013 Source: King County iMAP - Property Information (http://www.metrokc.gov/GISAMAP) iMAP a • CC: 2330 9L^sg County COMMENTS: PARCEL 352304-9034 The information included on this map has been compiled by King County staff from a variety of sources and is subject to change without notice. King County makes no representatiois or warranties, express or implied, as to accuracy, completeness, timeliness, or rights to the use of such information. This document is not intended for use as a survey product. King County shall not be liable for any general, special, indirect, incidental, or consequential damages including, but not limited to, lost revenues or lost profits resulting from the use or misuse of the information contained on this map. Any sale of this map or information on this map is prohibited except by written permission of King County. Date: 6/3/2013 Source: King County iMAP - Property Information (http://www.metrokc.gov/GIS/iMAP) La King County • • NOTICE TO CONTRACTOR CONSTRUCTION CONTRACTOR'S RESPONSIBILITY' Before bidding or starting any construction work, you are required to obtain a written asbestos report from the building owner or owner's agent. The report must be based on a survey by an accredited AHERA building inspector unless the building owner assumes materials in the structure are asbestos or has other convincing documents showing asbestos is not present in the work area. A building owner may know asbestos has been removed during prior work or that a new building has been constructed using materials certified to be asbestos free. If you discover suspect asbestos materials, you must report them to the building owner within 24 hours. Asbestos materials may be found in enclosed structures or between other materials, where they are not accessible before work. State law specifies a minimum $250 per day fine for failure to obtain the asbestos report. This fine can be applied to both the contractor and building owner. Additional fines may be applied if workers are exposed to airborne asbestos. Washington State Department of Labor & Industries regulations & policy with regards to asbestos removal. A Copy of the asbestos report must be made available to the building inspector prior to the first inspection. In addition, if asbestos has been found, confirmation of the completed abatement work must be provided to the building inspector. Inspection scheduling will not be accepted until this documentation is received by the building inspector. s � PERMIT COORD COPY PLAN REVIEW/ROUTING SLIP ACTIVITY NUMBER: D13-195 DATE: 06-03-13 PROJECT NAME: SEGALE PROPERTIES - HOUSE DEMOLITION SITE ADDRESS: 18115 57 AV S X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # After Permit Issued DEPARTMENTS: „ 1 Ing Dlvls on ire Prev/ntlon si Structural Public Works M� (-(3—c3 Planning Division Permit Coordinator DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete Comments: Incomplete DUE DATE: 06-04-13 Not Applicable Permit Center Use Only INCOMPLETE ` ` ` ' '•a°" INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg 0 Fire 0 Ping 0 PW 0 Staff Initials: TUES/THURS ROUTING: Please Route 'NCStructural Review Required ❑ No further Review Required REVIEWER'S INITIALS: DATE: APPROVALS OR CORRECTIONS: DUE DATE: 07-02-13 Approved ❑ Approved with Conditions Not Approved (attach comments) ❑ Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg 0 Fire 0 Ping 0 PW 0 Staff Initials: Documents/routing slip.doc 2-28-02 Contractors or Tradespeople PrOr Friendly Page • General/Specialty Contractor A business registered as a construction contractor with LaI 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 SEGALE PROPERITIES LLC 2065752000 Po Box 88028 Tukwila WA 981382028 King Limited Liability Company UBI No. Status License No. License Type Effective Date Expiration Date Suspend Date Specialty 1 Specialty 2 602023533 Active SEGALPL902CQ Construction Contractor 2/18/2010 4/1/2014 General Unused Other Associated Licenses License Name Type Specialty 1 Specialty 2 Effective Date Expiration Date Status LAPIALP055MZ LA PIANTA LIMITED PARTNERSHIP Construction Contractor General Unused 7/9/1995 4/1/2001 Archived SEGALBP151M5 SEGALE BUSINESS PARK Construction Contractor General Unused 7/25/1985 7/9/1995 Archived LAPIAL'008J8 LA PIANTA LLC Construction Contractor General Unused 4/28/2000 4/1/2010 Inactive Business Owner Information Name Role Effective Date Expiration Date SEGALE, MARIO A Agent 02/18/2010 Amount SEGALE, MARIO A Partner/Member 02/18/2010 13DLS31006 Bond Information Page 1 of 2 Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date 1 SAFECO INS CO OF AM 6115146 02/18/2010 Until Cancelled Bond Amount $12,000.00 Received Date 03/28/2002 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 5 Alaska National Insurance Co 13DLS31006 04/01/2013 04/01/2014 $1,000,000.00 03/28/2013 4 Alaska National Insurance Co 12DLS31006 04/01/2012 04/01/2013 $1,000,000.00 03/30/2012 3 Alaska National Ins Co 11DLS31006 04/01/2011 04/01/2012 $1,000,000.00 03/29/2011 2 ALASKA NATIONAL INSURANCE COMP 10DLS31006 04/01/2010 04/01/2011 $1,000,000.00 03/31/2010 1 ALASKA NATIONAL INSURANCE COMP 09DLS31006 02/18/2010 04/01/2010 $1,000,000.00 03/31/2009 Summons/Complaint Information No unsatisfied complaints on file within prior 6 year period https://fortress.wa.gov/lni/bbip/Print.aspx 06/27/2013