HomeMy WebLinkAboutPermit D14-0061 - MAI RESIDENCE - DECKMAI RESIDENCE
13335 37 AVE S
D14-0061
Parcel No:
Address:
Project Name:
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Inspection Request Line: 206-438-9350
Web site: http://www.TukwilaWA.gov
7358600280
13335 37 AVE S
MAI RESIDENCE
DEVELOPMENT PERMIT
Permit Number: D14-0061
Issue Date: 3/3/2014
Permit Expires On: 8/30/2014
Owner:
Name:
Address:
MAI TUYEN M+DUONG HUY QUOC
13335 37TH AVE S, TUKWILA, WA,
98168
Contact Person:
Name: MIKE ARNOLD
Address:
Contractor:
Name:
Address:
License No:
Lender:
Name:
Address:
4320 S 131ST PL SUITE 100, SEATTLE,
WA, 98168
BELFOR USA GROUP
Phone: (206) 305-5267
Phone: (206) 632-0800
3826 WOODLAND PARK AVE N ,
SEATTLE, WA, 98103
BELFOUG990B1 Expiration Date: 12/20/2014
,,,
DESCRIPTION OF WORK:
REMOVE AND REPLACE DECK COVER, SIDING, RAILING, INSTALL NEW SLIDER, WINDOW AND PAINT.
Project Valuation:
$11,549.00
Fees Collected: $557.86
Type of Fire Protection: Sprinklers:
Fire Alarm:
Type of Construction: VB Occupancy per IBC: R-3
Electrical Service Provided by: TUKWILA FIRE SERVICE Water District: 125
Sewer District: VALLEY VIEW SEWER SERVICE
Current Codes adopted by the City of Tukwila:
Internations Building Code Edition:
International Residential Code Edition:
International Mechanical Code Edition:
Uniform Plumbing Code Edition:
2012
2012
2012
2012
International Fuel Gas Code:
WA Cities Electrical Code:
WA State Energy Code:
2012
2012
2012
Public Works Activities:
Channelization/Striping:
Curb Cut/Access/Sidewalk:
Fire Loop Hydrant:
Flood Control Zone:
Hauling/Oversize Load:
Land Altering:
Landscape Irrigation:
Sanitary Side Sewer:
Sewer Main Extension:
Storm Drainage:
Street Use:
Water Main Extension:
Water Meter:
Volumes: Cut: 0 Fill: 0
Number: 0
No
Permit Center Authorized Signature:
Date: 01I1
I hearby certify that I have read and — ed this permit and know the same to be true and correct. All
provisions of law and ordinances gov- 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.
Signature: f`U� //JJ
Print Name: ,4f4% ,4,ar>
Date: 3! -2,/ 1`�
This permit shall become null and void if the work is not commenced within 180 days for 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 PERMIT CONDITIONS***
2: Work shall be installed in accordance with the approved construction documents, and any changes made
during construction that are not in accordance with the approved construction documents shall be
resubmitted for approval.
3: All permits, inspection record card and approved construction documents shall be kept at the site of work
and shall be open to inspection by the Building Inspector until final inspection approval is granted.
4: All construction shall be done in conformance with the Washington State Building Code and the
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 obtained at City Hall in the office of the City Clerk.
7: All electrical work shall be inspected and approved under a separate permit issued by the City of Tukwila
Permit Center.
8: 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.
PERMIT INSPECTIONS REQUIRED
Permit Inspection Line: (206) 438-9350
1700 BUILDING FINAL**
0409 FRAMING
0606 GLAZING
0401 ROOF SHEATHING
CITY OF TUKI. ,A
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Blvd., Suite 100
Tukwila, WA 98188
http://www.TukwilaWA.gov
Building Permit No. DJt(-O0ip
Project No.
Date Application Accepted:
0-d-P (7 V
Date Application Expires: O1l;-( 77 (l
(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: 13335 37�- tf S
Tenant Name.
King Co Assessor's Tax No.: 7 36'( o- o2-ift7
Suite Number: Floor:
PROPERTY OWNER
Name: I U Li [n
41/4k Ai
Address: 3335
3-I- A J L
City:, - \ ;),,
State: ,w,t
Zip:
r1(.,ii'
CONTACT PERSON - person receiving all project
communication
Name: , l. Amotx7
Address: Lt320 5 13, 5,), L lop
1
City: State: , Zip: d irl G r
Phone: aoc,305--_7 Fax:
Email-• m.-4.• ..1.C,t.„ova®tn 124,1Pw-.4.w.
GENERAL CONTRACTOR INFORMATION
Company Name: 1 n _ ? i V_ Lor
Address: N320 .So 1311'"Q11ut- I S✓`o. -k-(00
City: 5e4-
Zip:��
State: W Q-
�
Phone: PO 6-C32.:Fax: 0)04-5 0-0W
Contr Reg No.:3EL F60 & i566T Exp Date: t,, /l Li
Tukwila Business License No.: V 1 �� 0 `0�1lir
New Tenant: ❑ Yes ❑ .. No
ARCHITECT OF RECORD
Company Name:
Architect Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
ENGINEER OF RECORD
Company Name:
Seam 1:o-:5,76.s . S5;„ear-5
Engineer Name: -Tack.
f ej.5t. t
Address: 1 $ OZ A 544+ ' SS
City: State: VV A Zip: /$ovZ
Phone: Z-06-6Z1-lLS'b Fax: ZS3 cs4 - loe
Email: „,bt.v.ot f-%Sp<vfio✓" gHSi'1. coo"
LENDER/BOND ISSUED (required for projects $5,000 or
greater per RCW 19.27.095)
Name:
Address:
City: State: Zip:
H:\Applications\Fonns-Applications On Line\2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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Page 1 of 4
BUILDING PERMIT INFORMATI - 206-431-3670
Valuation of Project (contractor's bid price): $ 11) 519 t/o Existing Building Valuation: $ Z i j Dt V
Describe the scope of work (please provide detailed information): Te.whouc, ^AA- b.+k-- Cowl"- 6 t.,'
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
Existing
Interior Remodel
Addition to
Existing
Structure
New
Type of
Construction per
IBC
Type of
Occupancy per
IBC
1m Floor
66a
2"d Floor
3 b
3rd Floor
Floors thru
Basement
Accessory Structure*
Attached Garage
`t )
�/
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? ❑ 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
PUBLIC WORKS PERMIT INF( IATION — 206-433-0179
Scope of Work (please provide detailed information):
Ca11 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 ❑ ... Renton
❑ ... Sewer Availability Provided
❑... Renton
❑... 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 Aaalication (mark boxes which aaalv):
❑ .. Civil Plans (Maximum Paper Size — 22" x 34")
❑ .. Technical Information Report (Storm Drainage) ❑... Geotechnical Report 0 .. Traffic Impact Analysis
❑ .. Bond ❑... Insurance ❑... Easement(s) ❑... Maintenance Agreement(s) ❑ .. Hold Harmless — (SAO)
❑ .. Hold Harmless — (ROW)
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 ❑
Non Right-of-way ❑
❑ .. Total Cut cubic yards
❑ .. Total Fill cubic yards
❑ .. Sanitary Side Sewer
❑ .. Cap or Remove Utilities
❑ .. Frontage Improvements
❑ .. Traffic Control
❑ .. Backflow Prevention - Fire Protection
Irrigation
Domestic Water
0...Right-of-way Use - Profit for less than 72 hours
❑ ... Right-of-way Use — Potential Disturbance
❑... Work in Flood Zone
❑... Storm Drainage
0... Abandon Septic Tank
❑... Curb Cut
0...Pavement Cut
❑... Looped Fire Line
0... Grease Interceptor
❑... Channelization
❑ ... Trench Excavation
❑... Utility Undergrounding
❑ .. Permanent Water Meter Size (1) " WO # (2) " WO # (3) " WO #
❑ .. Temporary Water Meter Size (1) " WO # (2) " WO # (3) " WO #
❑ .. Water Only Meter Size 1, WO # ❑ .. Deduct Water Meter Size "
❑ .. 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)
❑ .. Water ❑ .. 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:\Applications\Forms-Applications On Line \2012 Applications\Permit Application Revised - 2-7-12.docx
Revised: February 2012
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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 AUTHORIZED AGENT:
Signature:
Date: Z IZt 1
Print Name: t\kA cL_ , r, Day Telephone: 34S- SZ6 ?
Mailing Address: 437_0 5 131 — Q )Sod— /bo
City
'i?W
State Zip
H: Applications\Forms-Applications On Line\2012 Applications\Permit Application Revised - 2-7-I2.docx
Revised: February 2012
bh
Page 4 of 4
DESCRIPTIONS
Cash Register Receipt
City of Tukwila
ACCOUNT
QUANTITY
PAID
$557.86
D14-0061
Address: 13335 37 AVE S
Api
7358600280
$557.
DEVELOPMENT
$541.58
PERMIT FEE
R000.322.100.00.00
$325.50
PLAN CHECK FEE
R000.345.830.00.00
$211.58
WASHINGTON STATE SURCHARGE
B640.237.114
$4.50
TECHNOLOGY FEE
$16.28
TECHNOLOGY FEE
TOTAL FEES PAID BY RECEIPT: R1322
R000.322.900.04.00
$16.28
$557.86
Date Paid: Tuesday, February 25, 2014
Paid By: BELFOR USA GROUP
Pay Method: CHECK 5694
Printed: Tuesday, February 25, 2014 10:36 AM 1 of 1
SYSTEMS
INSPECTION RECORD
Retain a copy with permit
INS T . t PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 iouthcenter Blvd., #100, Tukwila. WA 98188 ' (206) 431-3670
Permit Inspection Request Line (206) 431-2451 ,
Pro t:
NeS
Type of Inspection:
rkFteAtk3
cg
Ate.
dress:
37i�US
Date Called:
S�ecia Instructions: ,
-Date Wanted:
[m
Requester:
Phone No:
IAApproved per applicable codes.
aCorrections required prior to approval.
COMMENTS:
i-R:ctnoIt.1cc, ck/Ect.
Pe, r1/46_ rawt:lC
Fe r ,�1.-,. C G nit 1 l F I� - �t ►41
In
Date:
— 2 1
RE ECTION FEE REQUIRE Prior to ne inspection, fee must be
pat. t 6300 Southcenter Blvd., uite 100. Cat to schedule reinspection.
INSPECTION RECORD
IN P T NRetain a copy with permit .
PERMIT N0.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
Project, ^
S
Type oft"' { 4
Ant• S 5
-1 Pru
Date filled:
Special Instructions:
date ted:
j�
p.m.
Requester:
Phone No:
DApproved per applicable codes.
ElCorrections required prior to approval.
COMMENTS:
l' 1 t .) A t .J AT "(Da
NSPECTION 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
1)14 6(42?
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd, #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
4-‘
Pro ect;
i c� (- �o tcS
Type of Inspection:
IZi+U(...
Li Ad s :
51 mA
Date {kd:
i06
lt5weiflet-{ie;i%
Special Instructions:
ADD EG 2.
Date4ante e^ Ili (ma•
J
Req ter:
IQ PIAf
Phi N�oS I Z7 --OS3 e
fgApproved per applicable codes.
EJCorrections required prior to approval.
COMMENTS:
1� ItSA6-kic94)1.(1to 11:
i
or:
vAtilIl
SPECTION FEE REQUIIi D. Prior to next inspection, fee must be
at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
Date:
INSPI:t:TE0I NO.
INSPECTION RECORD
Retain a copy with permit
�14_p°0 i
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
Project: ,
Type Inspects
Address:3 -s 3 7 AVE.
Date tl
Rz of � T
Specia�lnstructions: - t�
t Nta r�7 +� i� a'%[f�
�/. �� ��� �b
U,,Je/' S� I
n e t4J •S C ALA--
Date Wanted: �G /1-{r
•�t ....
q l �T
a.m.
Requester:
7"'
Phone No:
Approved per applicable codes.Corrections required prior to approval.
COMMENTS:
d
Dater
REINSPE • N FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection.
16'
ALLEY
FILE COPY
EXISTING EXTERIOR DECK.
1-REMOVE / REPLACE FIRE
I DAMAGED ROOF PER PLAN
115.49' N89'59'00'E
EXISTING
UDRIVEWAY
EXISTING
SFR
115.49' N89'59'00'E
37th AVE S
TUYEN MAI RESIDENCE
FIRE DAMAGED ROOF REPAIR IN LIKE KIND TO CURRENT
CODES, NO PROPOSED IMPERVIOUS ALTERATIONS
LEGAL:
PARCEL#: 735860-0280
LOT 17, BLOCK 4, ROBBINS ORCHARD ADD TO RIVERTON
PP ACT 39973615 MOBILE HOME
APPROXIMATE LOT AREAS:
LOT AREA = 5,774 sf
HOUSE FOOTPRINT =1,432 sf
DRIVEWAY = 719 sf
REAR PATIO = 400 sf
TOTAL DEVELOPMENT AREA . 2,551 sf
MAXIMUM ALLOWED
. 2,275 st
REVIEWED FOR
CODE COMPLIANCE
APPROVED
FEB 2 5 2014
City of Tukwila
BUILDING DIVISION
491
RECEIVED
CITY OF TUKWII_ A
FEB 2.1 2014
PERMIT CENTEe
NOTE: EVERY EFFORT HAS BEEN MADE TO AVOID INACCURACY IN THE PREPARATION OF THIS PLAN. HOWEVER, THE DESIGNER CANNOT GUARANTEE AGAIJST HUMAN ERROR. IT IS THE 6BLIGATION OF THE BUILDER TO CHECK ALL
INFORMATION, DIMENSIONS, AND DETAILS ON THE JOB AND BE RESPONSIBLE FOR THE SAME.
THIS SITE PLAN WAS DERIVED FROM ONLINE RECORDS AND DATA FROM KING COUNTY ASSESSOR'S MAPS (IF AVAILABLE); A LAND SURVEY IS RECOMMENDED IF ACCURATE DATA IS REQUIRED BY GOVERNING JURISDICTION.
1802 'A' ST. SE 2223
AUBURN, WA 98002
PNONE: (206) 621-I636
FAX: (253) 932-4988
NOTE MOOD All OMITS
MOM T! ADM
MMUS AND .eCErATIONs
TROMP ARE ANDSW.
MUM TR PROPERTY OF
THE ER IN/Mt. NO FART
TOW ROLL OE
AD'*TW almbit
o1STREutID TO onus,
110.9 MUM OR
C M ESE USED NImWf TIIE
FRO* MITTEN WOW OF
MD AFFNoIfiATE
COIR MATON T) TR
ENGIS®l. VISUAL WrfAOT
NI157 nv MOVE ROLL
ACTIME MORO CF
ACCPfMKE OF TIME
RESTRICT NS.
REVISIONS
JOB INFO
TUYEN MAI
RESIDENCE
TUKWILA, WA. % 8
PROJECT TYPE
FIRE DAMREPAI
DRAWN BY: KJI
SCALE PER PLANS
DATE 02/08/14
JOB * 20142310
SITE
City of Tukwila
Department of Community Development
9/2/2014
MIKE ARNOLD
4320 S 131ST PL SUITE 100
SEATTLE, WA 98168
RE: Permit No. D14-0061
MAI RESIDENCE
13335 37TH AVE S
Dear Permit Holder:
Jim Haggerton, Mayor
Jack Pace, Director
In reviewing our current records, the above noted permit has not received a final inspection by the City of Tukwila Building
Division. Per the International Building Code, International Mechanical Code, Uniform Plumbing Code and/or the National
Electric Code, every permit issued by the Building Division under the provisions of these codes shall expire by limitation and
become null and void if the building or work authorized by such permit has not begun within 180 days from the issuance date of
such permit, or if the building or work authorized by such permit is suspended or abandoned at any time after the work has begun
for a period of 180 days. Your permit will expire on 10/6/2014.
Based on the above, you are hereby advised to:
1) Call the City of Tukwila Inspection Request Line at 206-438-9350 to schedule for the next or final inspection. Each
inspection creates a new 180 day period, provided the inspection shows progress.
2) Submit a written request for permit extension 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.
The Building Code does allow the Building Official to approve one extension of up to 180 days. If it is determined that your
extension request is granted, you will be notified by mail.
In the event you do not call for an inspection and/or receive an extension prior to 10/6/2014, your permit will become null and void
and any further work on the project will require a new permit and associated fees.
Thank you for your cooperation in this matter.
Sincerely,
er Marshall
t Technician
File`N6: D14-0061
6300 Southcenter Boulevard Suite #100 • Tukwila, Washington 98188 • Phone 206-431-3670 • Fax 206-431-3665
PERMIT COORD COPY
PLAN REVIEW/ROUTING SLIP
PERMIT NUMBER: D14-0061
PROJECT NAME: MAI RESIDENCE
SITE ADDRESS: 13335 37 AVE S
X Original Plan Submittal
Response to Correction Letter #
DATE: 02/21/14
Revision #
Revision #
before Permit Issued
after Permit Issued
DEPARTMENTS:
kL
Building Division
S I
Public Wo s
M 'I 41°
Fire Prevention Planning Division
Structural
Permit Coordinator II
PRELIMINARY REVIEW:
Not Applicable ❑
(no approval/review required)
REVIEWER'S INITIALS:
DATE: 02/25/14
Structural Review Required
DATE:
APPROVALS OR CORRECTIONS:
Approved
Corrections Required
(corrections entered in Reviews)
Approved with Conditions
Denied
(ie: Zoning Issues)
DUE DATE: 03/25/14
Notation:
REVIEWER'S INITIALS:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
12/18/2013
BELFOR USA GROUP INC
Page 1 of 5
C) Washington State Department of
Labor & Industries
BELFOR USA GROUP INC
Owner or tradesperson
YELLON, SHELDON
Principals
YELLON, SHELDON
CIOLINO, JOSEPH
JOHNSON, JEFFERY L (End: 10/30/2008)
DAVIS, MARK W (End: 10/30/2008)
Doing business as
BELFOR USA GROUP INC
WA UBI No.
602 089 710
185 OAKLAND AVENUE
BIRMINGHAM, MI48009
206-632-0800
Business type
Corporation
Governing persons
JEFFERYJOHNSON
License
Verify the contractor's active registration / license / certification (depending on trade) and any past violations.
Construction Contractor Active.
Meets current requirements.
License specialties
GENERAL
License no.
BELFOUG99OBJ
Effective — expiration
01 /11 /2001 —12/20/2014
Bond
HARTFORD FIRE INS CO
Bond account no.
35BSBBZ7167
$12,000.00
Received by L&I Effective date
11/16/2003 01/01/2004
Insurance
National Union Fire Ins of PA
Policy no.
GL4522683
$2,000,000.00
Received by L&I Effective date
06/28/2013 07/01/2013
Expiration date
07/01/2014
https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602089710&LIC=BELFOUG99OBJ&SAW= 03/07/2014