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HomeMy WebLinkAboutPermit D13-304 - TONGUE RESIDENCE - DEMOLITIONTONGUE DEMOLITION 13906 51 AV S D13-304 City o0Tukwila 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 Parcel No.: 1670400005 Address: 13906 51 AV S TUKW Suite No: Project Name: TONGUE DEMOLITION DEVELOPMENT PERMIT Permit Number: D13-304 Issue Date: 10/15/2013 Permit Expires On: 04/13/2014 Owner: Name: TONGUE ROY+HARRIET LIVNG TR Address: 100 ANDOVER PARK W STE 150 PMB 115 , TUKWILA, WA 98188 Contact Person: Name: BRYCE TINGLEY Address: PO BOX 2403 , BUCKLEY, WA 98321 Phone: 360 829-1490 Contractor: Name: E R PROPERTIES INC Phone: (253)735-4100 Address: 1402 LAKE TAPPS PARKWAY #104-5 , AUBURN, WA 98092 Contractor License No: ERPROI*060P6 Expiration Date: 10/22/2015 Lender: Name: Address: DESCRIPTION OF WORK: DEMOLITION OF 520 SF SFR AND 160 SF DECK @ 13912 51st Ave S. Public Works activities include: SEPTIC ABANDONMENT, WATE SERVICE CAPPING AND EROSION CONTROL. Value of Construction: $10,000.00 Fees Collected: $762.90 Type of Fire Protection: International Building Code Edition: 2012 Type of Construction: VB Occupancy per IBC: 0022 Electrical Service Provided by: SEATTLE CITY LIGHT **continued on next page** doc: IBC -7/10 D13-304 Printed: 10-15-2013 Public Works Activities: Channelization / Striping: N Curb Cut / Access / Sidewalk / CSS: N Fire Loop Hydrant: N Number: 0 Size (Inches): 0 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: Sanitary Side Sewer: Y 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: [ 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 joverning this work will be complied with, whether specified herein or not. rhe 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 :o this permit. Signature: ?rint Name: ✓`C/f/:� ( rye Phis 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 )r abandoned for a period of 180 days from the last inspection. Date: L -/2 PERMIT CONDITIONS: 1: ***BUILDING DEPARTMENT CONDITIONS*** 3: No changes shall be made to the approved plans unless approved by the design professional in responsible charge and the 3uilding Official. 3: All permits, inspection records, and approved plans shall be at the job site and available to the inspectors prior to ;tart of any construction. These documents shall be maintained and made available until final inspection approval is ;ranted. Remove all demolition rubble and loose miscellaneous material from lot or parcel of ground, properly cap the sanitary ;ewer connections, and properly fill or otherwise protect all basements, cellars, septic tanks, wells, and other ?xcavations. Final inspection approval will be determined by the building inspector based on satisfactory completion of his requirement. 3: All plumbing and gas piping work shall be inspected and approved under a separate permit issued by the City of Tukwila 3uilding Department (206-431-3670). 3: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila Building Inc: IBC -7/10 D13-304 Printed: 10-15-2013 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: The applicant must notify the City Project Inspector at (206)433-0179 upon commencement and completion of work at least 24 hours in advance. All inspection requests for utility work must also be made 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: From October 1 through April 30, cover any slopes and stockpiles that are 311 IV or steeper and have a vertical rise of 10 feet or more and will be unworked for greater than 12 hours. During this time period, cover or mulch other disturbed areas, if they will be unworked more than 2 days. Covered material must be stockpiled on site at the beginning of this period. Inspect and maintain this stabilization weekly and immediately before, during and following storms. 12: From May 1 through September 30, inspect and maintain temporary erosion prevention and sediment at least monthly. All disturbed areas of the site shall be permanently stabilized prior to final construction approval. 13: The site shall have permanent erosion control measures in place as soon as possible after final grading has been completed and prior to the Final Inspection. 14: CONTRACTOR SHALL CHASE THE SEWER PIPE TO ESTABLISH SEPTIC TANK LOCATION SINCE IT WAS NOT SHOWN ON PLAN.The existing septic tank 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 City Utilities Inspector. Septic tank removal or abandonment shall be accomplished in accordance with King County Board of Health Code 13.04.054. Within 30 days applicant or contractor shall report the septic tank removal or abandonment to the King County Health officer, phone number 206-296-4932. 15: Sewer and water utilities shall be plugged at the mains if they are to be abandoned. If they will be used again in the near future for a new building, they shall be capped at the property line and at the water meter respectively. 16: Any material spilled onto any street shall be cleaned up immediately. doc: IBC -7/10 D13-304 Printed: 10-15-2013 CITY OF TUALA 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: 0 13 Date Application Expires: O Z� I (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: / 3 vl 06 S tive - Tenant Name: King Co Assessor's Tax No.: 41 V 1 7 0 bO Suite Number: Floor: New Tenant: ❑ Yes ..No PROPERTY OWNER Name: pot? t T ki'!'f2 lj_ (73 -ii -ware L'v'N�i ss:� Addre�) U ,9il/) over PAk k C i s `. / C }/ City: .4 kW , /19 State: IA/f9 , Zip:1 pi pg CONTACT PERSON — person receiving all project communicationti (.4: Name: 131't�.c,Q. (TWl`� Address: p o R _ 02 v(0 3 1 City: /��,c,�. I State: r A IA , Zip: 6'(3a I 1l/ Phone 0 _ iz p� ,, /q� x 36 rJ sgal ,. i'-kt� i _! V Email: /10 v �7rv1G 0 G E& Pr0A?r / S, /tie GENERAL CONTRACTOR INFORMATION Company Name: b 2 Pr f�.Pr; f Address: �Dr1 3o) a q /03 City: r2 ck r State: //� Zip:af(�oZ mit 1 1/" i Phone%rD✓12,Gt--/c(gbaxg60—bay — /u� / Contr Reg No.: E /�l K O /GE©Qx Date: Tukwila Business License No.: -1 , �ntv. omfo H:\Applications\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 INFORMATIO206-431-3670 • Valuation of Project (contractor's bid price): $ /�% v Existing Building Valuation: $ Describe t scope of work (please prov, . e detailed information): e ✓Yld (%.� -QJCf S 71: A S 7t -r- la 1bi-, Pf' ,vdait/ (3hrof /mss ittpr 520j074,c eeD/Yr isfivX/ 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 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:Wpplications\Forms-Applications On Line \2012 Applications\Permit Application Revised - 2-7-12.docx Revised: February 2012 bh Page 2 of 4 Existin: Interior Remodel Addition to Existing Structure New Type of Construction per IBC Type of Occupancy per IBC 1st Floor w 2nd Floor 3rd Floor Floors thru Basement Accessory Structure* Attached Garage Detached Garage Attached Carport Detached Carport Covered Deck Uncovered Deck WI 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:Wpplications\Forms-Applications On Line \2012 Applications\Permit Application Revised - 2-7-12.docx Revised: February 2012 bh Page 2 of 4 r PUBLIC WORKS PERMIT IN TION — 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 0 ...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: 0 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 apply): ❑ .. Right-of-way Use - Nonprofit for less than 72 hours ❑ .. Right-of-way Use - No Disturbance ❑ .. Construction/Excavation/Fill - Right-of-way 0 Non Right-of-way 0 ❑ .. Total Cut ❑ .. Total Fill cubic yards cubic yards ❑ .. Sanitary Side Sewer ❑ .. Cap or Remove Utilities ❑ .. Frontage Improvements ❑ .. Traffic Control 0 .. Backflow Prevention - Fire Protection Irrigation Domestic Water ❑ .. Permanent Water Meter Size (1) ❑ .. Temporary Water Meter Size (1) ❑ .. Water Only Meter Size 0... Geotechnical Report 0...Maintenance Agreement(s) ❑ .. Traffic Impact Analysis ❑ .. Hold Harmless — (SAO) ❑ .. Hold Harmless — (ROW) ❑ ... Right-of-way Use - Profit for less than 72 hours ❑... Right-of-way Use — Potential Disturbance 0... Work in Flood Zone 0... Storm Drainage Abandon Septic Tank .s.‘9... Curb Cut 0...Pavement Cut 0...Looped Fire Line ❑ .. Sewer Main Extension Public ❑ .. Water Main Extension Public 0 0 ❑...Grease Interceptor 0... Channelization ❑...Trench Excavation ❑... Utility Undergrounding WO # (2) " WO # (3) " WO # WO# (2) " WO # (3) " WO# WO # ❑ .. Deduct Water Meter Size " Private 0 Private ❑ 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:Wppbcatrons\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx Revised: February 2012 hF 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 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 AUTHOR 17- ,D GENT: Signature: Date: Print Name: (� ril C. e tQ Day Telephone: 366 '/ok q- P -f q 0 Rad i‘p W/9• gr3a City 7 State Zip Mailing Address: Po 80y, y '^ 6l V 3 H:Wpplications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx Revised: February 2012 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 Parcel No.: 1670400005 Address: 13906 51 AV S TUKW Suite No: Applicant: TONGUE DEMOLITION RECEIPT Permit Number: D13-304 Status: APPROVED Applied Date: 09/27/2013 Issue Date: Receipt No.: R13-02887 Initials: User ID: JEM 1165 Payment Amount: $576.80 Payment Date: 10/15/2013 03:32 PM Balance: $0.00 Payee: BRYCE K TINGLEY, ER PROPRTIES CONSTRUCTION TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd MC Authorization No. 554655 ACCOUNT ITEM LIST: Description 576.80 Account:Code Current Pmts BUILDING - NONRES PW BASE APPLICATION FEE PW PERMIT/INSPECTION FEE PW PLAN REVIEW STATE BUILDING SURCHARGE 000.322.100 000.322.100 000.342.400 000.345.830 640.237.114 Total: $576.80 286.30 250.00 18.00 18.00 4.50 • 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.Qov RECEIPT Parcel No.: 1670400005 Permit Number: D13-304 Address: 13906 51 AV S TUKW Status: PENDING Suite No: Applied Date: 09/27/2013 Applicant: TONGUE DEMOLITION Issue Date: Receipt No.: R13-02757 Initials: User ID: JEM 1165 Payment Amount: $186.10 Payment Date: 09/27/2013 12:53 PM Balance: $290.80 Payee: BARRY K TINGLEY, ER PROPERTY CONSTRUCTION TRANSACTION LIST: Type Method Descriptio Amount Payment Credit Crd MC Authorization No. 648477 ACCOUNT ITEM LIST: Description 186.10 Account Code Current Pmts PLAN CHECK - NONRES 000.345:830 186.10 Total: $186.10 Printpri • f19-77-2011 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 -30.1 Pr �/L! 6 U F J E/'\ C% TYp,,e fIQ cotltion: J • , o . n to t Address: TT nq OP St AVE - Date Called: • Special Instructions: • Date Wanted: r-11. /3 • a.m. Requester: Phone No: -1613 - O 2- Approved°per applicable codes. EJ Corrections required priorto_approval. COMMENTS: of Mit \ Hwy E e. ii h'r 001 • ( Date: 10 —11 —1? 'DEIN PECTION FEE R C UIRED. Prior o next inspection, fee must be t 6300 Southcenter Blvd., Suite 1 0. Call to schedule reinspection. INSPECTION RECORD Retain a copy with permit INSPECTION NO. PERMIT NO. �I) A'33oy CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670 Permit Inspection Request Line (206) 431-2451 Project: NG2 — .C�fi-,C) Typ of Inspection: pry.(b71�!at - ; 0'7v Address: /3�i6)G�'/41/ 5 Date Called: Special Instructions: Date Wanted: /0—ie /3 ` r- Requester: Phone No• pproved per applicable codes. EJ Corrections required prior to approval.' 1'1' COMMENTS: Inst€ct. r: Date: / 3 /3 INSPECTION FEEEQUIRED. Prior to 'ext inspection. fee must be paid at 6300 Southce ter Blvd.. Suite 100. Call to schedule reinspection. - COMMENTS: 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 P/3- y Project:Type ).-7 l.(f Ilia of Inspection: on:_ • Db6// it� Ad ress: (UU /3t,6 S'/ IP( -S Date Called: l v liG // 3 Special Instructions: Date Wanted: o /I -7//3 p. Requester: riire Phone No: i ,x6 793-e47 Approved per applicable codes. Corrections required prior to approval. 75> ^ ((40+-le�T M? - �r nGLt�9 (2) c(/tett•e-K ISG - Ft is C �,ar - rill...-tP %, Inspector: .05 Date: re) f17 it 3 REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection. REVISIONS No changes shall be made to the osco Pe of work without prior approval Tukwila Building Division. NOTE: Revisions will require a new plan submfl ' and may incude additional plan review f.' SEPARATEFQR T REQUIREpimectl'ED Dn' cai Electrical Plumbing Gas Piping City of Tukwila BUILDING DIVISION tu 1- N t 35.0' FILE COPY Permit No. D (71— \ Plan review approval is sublect to encs and omissions. Approval of construction documents does not auti r nzs the volatipn of any adopted code or ordinance. Receipt of approved Feld end , /:admovAedged City Of Tukwila BUILDING DIVISION PLANNING APPROVED • No changes tan be madeto these plans without approval from the Planning Division of DCD Approved By:, `A PA'i \r40\, Date: 24.0 b 1390G p Ci N N 24.0 SEWEI 21.0 0 m 6 O N Site Plan 0' 10' 20' 33.0' '13910 133.0 — — — T82.0 O N EXISTING POWER POLE r Nbl • 139Th ST 34.0 Ib I Lt DEMO EXISTING BUILDING 7 13912 Lou9-Tt p dv of cie- lIC S 1C—l0 Tv 36- p E�� 40.0 I 'D13-3�1 PARCEL NO -167040-0005 cs REVIEWED FOR CODE COMPLIANCE APPROVED OCT 0 4 2013 K City o T kwila BUILD1N IVISION APP OVER OCT 03 2013 City of Tukwila PUBLIC Works RECEIVE, OCT 012013 TUKWiw PUBLIC WORKS LEGAL DESC - TRACT 1 IN BLOCK 1 OF COLEGROVE'S ACRE TRACTS, AN ADDITION TO THE. CITY OF SEATTLE, AS PER PLAT RECORDED IN VOLUME 11 OF PLATS, PAGE 85, RECORDS OF KING COUNTY; EXCEPT THE WEST 2 FEET THEREOF; AND EXCEPT THE NORTH 38.6 FEETOF THE WEST 150 FEET. THEREOF; TOGETHER WITH THE WEST 55 FEET OF THE EAST 1/2 OF LOT 2 IN BLOCK 1 OF COLEGROVE'S ACRE TRACTS, AN ADDITION TO THE CITY OF SEATTLE, AS PER PLAT RECORDED IN VOLUME 11 OF PLATS, PAGE 85, RECORDS OF. KING COUNTY; SITUATE IN THE CITY OF TUKWILA, COUNTY OF KING, STATE OF RECEIVED CITY OF TUKWILA SEP 2 7 2013 PERMIT CENTER r PERMIT COORD COPY4111( PLAN REVIEW/ROUTING SLIP ACTIVITY NUMBER: D13- 04 DATE: 09/27/13 PROJECT NAME: EMOLITION SITE ADDRESS: 13906 51 AV S X Original Plan Submittal Response to Incomplete Letter # Response to Correction Letter # Revision # after Permit Issued DEPARTME TS: Building Division in SSS hwL I o•0;1/ Public Works AWL n//4 to -1-13 Fire Prevention Structural Ai 01 13 Planni g Division ❑ Permit Coordinator ❑ DETERMINATION OF COMPLETENESS: (Tues., Thurs.) Complete r_. Incomplete DUE DATE: 10/01/13 Not Applicable Comments: Permit Center Use Only INCOMPLETE LETTER MAILED: LETTER OF COMPLETENESS MAILED: Departments determined incomplete: Bldg ❑ Fire 0 Ping 0 PW 0 Staff Initials: TUES/THURSSRROUTING: Please Route TK REVIEWER'S INITIALS: DATE: Structural Review Required ❑ No further Review Required ❑ APPROVALS OR CORRECTIONS: Approved ❑ Notation: REVIEWER'S INITIALS: Approved with Conditions DUE DATE: 10/29/13 Not Approved (attach comments) ❑ DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg 0 Fire 0 Ping ❑ PW 0 Staff Initials: 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 E R PROPERTIES INC UBI No. 601579987 Phone 3608291490 Status Active Address Po Box 2403 License No. ERPROI`060P6 Suite/Apt. License Type Construction Contractor City Buckley Effective Date 10/26/1994 State WA Expiration Date 10/22/2015 Zip 98321 Suspend Date County Pierce Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Business Owner Information Name Role Effective Date Expiration Date TINGLEY, BRYCE KIRK President 10/26/1994 Bond Amount TINGLEY, CHRISTINE MARIE Vice President 10/26/1994 CLB2712203 Bond Information Page 1 of 2 Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 5 PLATTE RIVER INS CO CLB2712203 11/10/2010 Until Cancelled $12,000.00 11/30/2010 4 CBIC P02279 11/10/2001 Until Cancelled 11/10/2010 $12,000.00 10/08/2001 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 15 Starr Surplus Lines Insurance SLPG GL01253 01 11/30/2012 11/30/2013 $1,000,000.00 11/20/2012 14 Starr Surplus Lines Insurance SLPGGL01253 00 11/30/2011 11/30/2012 51,000,000.00 11/30/2011 13 Benchmark Insurance Co BIC5005044 08/27/2011 08/27/2012 51,000,000.00 08/26/2011 12 COBENCHMARK INS BIC5003682 08/27/2010 08/27/2011 $1,000,000.0009/24/2010 11 FIRST MERCURY INS CO fmwa000953 12/11/2009 12/11/2010 $1,000,000.0012/11/2009 10 Berkley Regional Ins Co CGL0013327 12/11/2008 12/11/2009 $1,000,000.00 02/23/2009 9 BERKLEY REGIONAL SPEC INS CO CCL0006867 09/30/2007 09/30/2009 $1,000,000.0009/26/2008 Summons/Complaint Information Cause County Complaint Judgment Status Payment Paid By 10-2-28513- OSEA STONEWAY ROOFING SUPPLY INC KING Date: 08/09/2010 Amount: $4,195.89 Bond(s): P02279 Date: 09/07/2010 Amount: $5,674.39 Closed/Satisfied Date: 02/16/2011 Amount: $5,674.39 Contractor https://fortress.wa.gov/lni/bbip/Print.aspx 10/15/2013