HomeMy WebLinkAboutPermit D14-0199 - 17686 BUILDING - TENANT IMPROVEMENTVACANT TENANT
17686 SOUTHCENTER PKWY
D14-0199
Parcel No:
Address:
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
DEVELOPMENT PERMIT
3523049005 Permit Number: D14-0199
17686 SOUTHCENTER PKWY
Project Name: VACANT TENANT SPACE
Issue Date: 7/21/2014
Permit Expires On: 1/17/2015
Owner:
Name:
Address:
Contact Person:
Name:
Address:
Contractor:
Name:
Address:
License No:
Lender:
Name:
Address:
KIR TUKWILA 050 LLC/KIMCO
3333 NEW HYDE PARK STE 100
PROPERTY TAX DEPARTMENT, NEW
HYDE PARK, WA, 11042
JEFF WASSERMAN
5628 AIRPORT WAY S #112 , SEATTLE,
WA, 98108
ECLIPSE DEMOLITION LLC
32226 44 PL SW , FEDERAL WAY, WA,
98023
ECLIPSL937D1
Phone: (206) 420-2242
Phone: (253) 815-6869
Expiration Date: 3/23/2015
DESCRIPTION OF WORK:
CONVERSION OF AN EXISTING MERCANTILE/SOTRAGE SPACE INTO A NEW BUSINESS TENANT. DEMO OF AN
EXISTING BATHROOM AND INTERIOR FINISHES AND CONSTRUCTION OF NEW INTERIOR PARTITIONS, DOORS,
DESKS AND FINISHES AS WELL AS NEW CEILING AND LIGHTS.
Project Valuation: $35,000.00
Type of Fire Protection:
Sprinklers: YES
Fire Alarm: YES
Type of Construction: IIB
Electrical Service Provided by: TUKWILA FIRE SERVICE
Fees Collected: $1,285.28
Occupancy per IBC: M
Water District: HIGHLINE,TUKWILA
Sewer District: TUKWILA SEWER SERVICE
Current Codes adopted by the City of Tukwila:
International 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: cn I it I I 1
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 = resume to give authority to violate or cancel the provisions of any other
state or to I s regulating co stru ion or the performance of work. I am authorized to sign and obtain this
develop ent rmit an fi ag: to t' conditidns attached to this permit.
Signatur
Print Name:
'4zy5-1PPu1nv1n.Ni
Date: ' t( - I
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 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).
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.
9: Prior to permit issuance for new structure, the demolition permit must receive final inspection approval.
17: The attached set of building plans have been reviewed by the Fire Prevention Bureau and are acceptable
with the following concerns:
12: The total number of fire extinguishers required for an ordinary hazard occupancy with Class A fire hazards is
calculated at one extinguisher for each 1,500 sq. ft. of area. The extinguisher(s) should be of the "All
Purpose" (2A, 20B:C) dry chemical type. Travel distance to any fire extinguisher must be 75' or Tess. (IFC
906.3) (NFPA 10, 5.4)
10: Portable fire extinguishers, not housed in cabinets, shall be installed on the hangers or brackets supplied.
Hangers or brackets shall be securely anchored to the mounting surface in accordance with the
manufacturer's installation instructions. Portable fire extinguishers having a gross weight not exceeding 40
pounds (18 kg) shall be installed so that its top is not more than 5 feet (1524 mm) above the floor. Hand-
held portable fire extinguishers having a gross weight exceeding 40 pounds (18 kg) shall be installed so that
its top is not more than 3.5 feet (1067 mm) above the floor. The clearance between the floor and the
bottom of the installed hand-held extinguishers shall not be less than 4 inches (102 mm). (IFC 906.7 and IFC
906.9)
11: Extinguishers shall be located in conspicuous locations where they will be readily accessible and
immediately available for use. These locations shall be along normal paths of travel, unless the fire code
official determines that the hazard posed indicates the need for placement away from normal paths of
travel. (IFC 906.5)
13: Maintain fire extinguisher coverage throughout.
19: Maintain coverage and operability of portable fire extinguishers, sprinkler systems and fire alarm systems
during demolition and construction.
14: All new sprinkler systems and all modifications to existing sprinkler systems shall have fire department
review and approval of drawings prior to installation or modification. New sprinkler systems and all
modifications to sprinkler systems involving more than 50 heads shall have the written approval of Factory
Mutual or any fire protection engineer licensed by the State of Washington and approved by the Fire
Marshal prior to submittal to the Tukwila Fire Prevention Bureau. No sprinkler work shall commence
without approved drawings. (City Ordinance No. 2436).
16: All new fire alarm systems or modifications to existing systems shall have the written approval of The
Tukwila Fire Prevention Bureau. No work shall commence until a fire department permit has been
obtained. (City Ordinance #2437) (IFC 901.2)
22: Per Tukwila Municipal Code a fire watch is required any time a fire sprinkler or fire alarm system is
impaired. The fire watch shall be maintained until the system is restored. Contact the Tukwila Fire
Prevention Bureau at 206-575-4407 for detailed fire watch requirements.
18: Accumulation of combustible waste material is prohibited during the demolition phase of this project.
Remove and properly dispose of all waste material prior to the close of the working day and as often
throughout the day as needed.
15: Contact The Tukwila Fire Prevention Bureau to witness all required inspections and tests. (City Ordinances
#2436 and #2437)
20: Any overlooked hazardous condition and/or violation of the adopted Fire or Building Codes does not imply
approval of such condition or violation.
21: These plans were reviewed by Inspector 511. If you have any questions, please call Tukwila Fire Prevention
Bureau at (206)575-4407.
PERMIT INSPECTIONS REQUIRED
Permit Inspection Line: (206) 438-9350
1700 BUILDING FINAL**
1400 FIRE FINAL
0502 LATH & GYPSUM
0101 PRE -CONSTRUCTION
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. ( ( o/q 9
Project No.
Date Application Accepted: 404, / f/ y
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: 17686 Southcenter Parkway
Tenant Name: Vacant Tenant Space
PROPERTY OWNER
Name: Kimco Realty
Address: 3635 Factoria Blvd. S.E.
City: Bellevue State: WA
zip: 98006
CONTACT PERSON — person receiving all project
communication
Name: Jeff Wasserman
Address: 5628 Airport Way S, #112
City: Seattle State: WA Zip: 98108
Phone: (206) 420-2242 Fax: (206) 260-9595
Email: jwasserman@jjwarch.com
GENERAL CONTRACTOR INFORMATION
Company Name: NIA
Address: N/A
City: N/A State: N/A Zip:
Phone: Fax:
Contr Reg No.: Exp Date:
Tukwila Business License No.:
King Co Assessor's Tax No.:
Suite Number: 68 Floor:
New Tenant: ❑ Yes J .. No
ARCHITECT OF RECORD
Company Name: JJW Architects and Planners
Architect Name: Jeff Wasserman
Address: 5628 Airport Way S, #112
City: Seattle State: WA Zip: 98108
Phone: (206) 420-2242 Fax: (206) 260-9595
Email: jasserman@jjwarch.com
ENGINEER OF RECORD
Company Name: N/A
Engineer Name: N/A
Address: N/A
City: N/A
State: N/A
Zip:
Phone:
Fax:
Email: N/A
LENDER/BOND ISSUED (required for projects $5,000 or
greater per RCW 19.27.095)
Name: N/A
Address: N/A
City: N/A State: N/A Zip:
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Revised: August 2011
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Page 1 of 4
BUILDING PERMIT INFORMATION — 206-431-3670
Valuation of Project (contractor's bid price): $ 35,000
Existing Building Valuation: $
Describe the scope of work (please provide detailed information):
The scope of this project is the conversion of an existing Merchantile/Storage space into a new Business tenant at Southcenter Mall.
This consists of the demolition of an existing bathroom and interior finishes and construction of new interior partitions, doors,
desks and finishes as well as new ceiling and lights. Relocation of any mechanical diffusers, electrical junction boxes, and fire
sprinkler heads is not included as part of this scope of work but is shown for coordination purposes.
Will there be new rack storage? ❑ Yes
Z.. 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
la Floor
24,913
24,913
IIBNB
M
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 It): 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 Ill 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\Forms-Applications On Line12011 Applications\Permit Application Revised - 8-9-11.docx
Revised: August 2011
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Page 2 of 4
PUBLIC WORKS PERMIT INFOktMMATION - 206-433-0179
Scope of Work (please provide detailed information):
No new sewer or water service to be provided. Cap any removed plumbing fixtures at their source. Trenching in the existing
concrete slab for future electircal/data outlets.
Ca11 before you Dig: 811
Please refer to Public Works Bulletin #1 for fees and estimate sheet.
Water District
21...Tukwila 0... Water District #125
0 ...Water Availability Provided
Sewer District
(%' ...Tukwila
❑ ...Sewer Use Certificate
❑ .. Highline
❑ ... Valley View 0 .. 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.
ubmitted with Application (mark boxes which apply):
DI ...Civil Plans (Maximum Paper Size — 22" x 34")
❑ ...Technical Information Report (Storm Drainage) ❑ .. Geotechnical Report
❑ ...Bond ❑ .. Insurance 0 .. Easement(s) 0 .. Maintenance Agreement(s)
Proposed Activities (mark boxes that apply):
❑ ...Right-of-way Use - Nonprofit for less than 72 hours
❑ ...Right-of-way Use - No Disturbance
0 ...Construction/Excavation/Fill - Right-of-way 0
Non Right-of-way 0
❑ ...Total Cut
❑ ...Total Fill
❑ ...Sanitary Side Sewer
0 ...Cap or Remove Utilities
❑ ...Frontage Improvements
❑ ...Traffic Control
❑ ...Backflow Prevention - Fire Protection
Irrigation
Domestic Water
cubic yards
cubic yards
❑...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
❑ .. Work in Flood Zone
❑ .. Storm Drainage
❑ .. Abandon Septic Tank
❑ .. Curb Cut
❑ .. Pavement Cut
❑ .. Looped Fire Line
❑ ...Permanent Water Meter Size...
0 ...Temporary Water Meter Size ..
0 ...Water Only Meter Size
0 ...Sewer Main Extension Public 0
0 ...Water Main Extension Public 0
❑ .. Grease Interceptor
❑ .. Channelization
21.. Trench Excavation
❑ .. Utility Undergrounding
WO #
WO #
WO # 0 ...Deduct Water Meter Size
Private 0
Private 0
FINANCE INFORMATION
Fire Line Size at Property Line
Number of Public Fire Hydrant(s)
❑ ...Water 0 ...Sewer 0 ...Sewage Treatment
Monthly Service Billing to:
Name:
Day Telephone:
Mailing Address:
City State Zip
Water Meter Refund/Billing:
Name:
Mailing Address:
Day Telephone:
City
State
Zip
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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.
BUIL
Signature
Print Name:
Mailing Address
rHORIZED AGENT:
asserman
5628 Airport Way S. Suite #112
Date: 04/13/2014
Day Telephone: (206) 420-2242
Seattle WA 98118
City State Zip
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Revised: August 2011
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Page 4 of 4
DESCRIPTIONS
PermitTRAK
Cash Register Receipt
City of Tukwila
ACCOUNT
QUANTITY PAID
$507.39
014-0199 Address: 17686 SOUTHCENTER PKWY
Ape: 3523049005
$507.39
DEVELOPMENT
$469.72
PERMIT FEE
R000.322.100.00.00
0.00
$465.22
WASHINGTON STATE SURCHARGE
B640.237.114
0.00
$4.50
TECHNOLOGY FEE
$37.67
TECHNOLOGY FEE
TOTAL FEES PAID BY RECEIPT: R2640
R000.322.900.04.00
0.00
$37.67
$507.39
Date Paid: Monday, July 21, 2014
Paid By: ECLIPSE DEMOLITION LLC
Pay Method: CREDIT CARD 094715
Printed: Monday, July 21, 2014 12:48 PM 1 of 1
SYSTEMS
Receipt Number
DESCRIPTIONS
PermitTRAK
D14-0199 Address: 17686 SOUTHCENTER PKWY
ACCOUNT
Apn: 3523049005
QUANTITY I PAID
$777.89
DEVELOPMENT
PERMIT FEE
PLAN CHECK FEE
TOTAL FEES PAID BY RECEIPT: R2470
R000.322.100.00.00
R000.345.830.00.00
0.00
0.00
$777.89
$288.18
$489.71
$777.89
Date Paid: Thursday, June 26, 2014
Paid By: KIMCO REALTY
Pay Method: CHECK 1001444
Printed: Thursday, June 26, 2014 11:31 AM 1 of 1
INSPECTION NO.
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
Project/7. ly
Type of Inspection.;
Address:�t 8 tP
1i �� Pw
tt
Date Called:
Special Instructions:
Date Wanted-
2-9 ` I l
a• •
�i
Requeste�rJ:
Phone No:
proved per applicable codes. ❑ Corrections required prior to approval.
COMMENTS:
Vb r flA'T) ( VM,
-) -) C LIP•n
%Y A
/
rcJ�
ti
\I AC A► T 'F{k'
e Dat•,
to -
SPECTION
REQUIREDrior to nt inspection, fee mst be
at 6300 Southcenter Blvd.. Su a 100. 11 to schedule reinspection.
F E
INSPECTION RECORD
Retain a copy with permit
INSP CTI 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
.D, Li -ore
project:
Type atinspe tip:
Afdrets a L S
P
Lf
Date Called:
Special Instructions:
!
(
Date Wanted:._ 7_f `�l
p.m.
Requester:
Phon No:
approved per applicable codes.
Corrections required prior to approval.
COMMENTS:
nspe r:
27--/4"
R INSPECTION FEE FfEQUIRED. Prior to next inspection, fee must be
id at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
INSP T 0 NO.
INSPECTION RECORD
Retain a copy with permi�li �069
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 431-2451
Pro_7, C' 4 �NAit ai
t1l/ff''��
e pect s�
/�
A
((jj��/ c
��tpV IJ J�
ate Called:
Special Instructions:
riCJuvr "r (-r
' .
Date W d:
' a.m.
Request r:
Ph ne t9/c
C.J,9
Approved per applicable codes. Corrections required prior to approval.
COMMENTS:
/JO OA./5/i _
j4f') �/sWF� 0 QA(,d0
1
nspect
REINSP
pai
Dat
Z
ON FEE REQUI D. Prior to ne t inspection, fee mtlst be
6300 Southcenter Bl ., Suite 100. Ca Ito schedule reinspection.
INSPECTION RECORD
Retain a copy with permit
PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-36 0
Permit Inspection Request Line (206) 431-2451
Project: �"'
\lati` i't
-el
Type inspection'
/� A ...�--
rre -CA/ S i
Addilss: /
I el �� k, Sc ��
Date Called:
Sp cia nstru Lions:
/
'Date Wanted: / // AIM'
J
i 1 (4 p.m.
Requester:
itnr: 4 ,0 24
Approved per applicable codes.
QCorrections required prior to approval.
COMMENTS:
Ins or:
Date
9
Q REINS EP CTIOQUIRED. 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
INSPECTION NUMBER
PERMIT NUMBERS
CITY OF TUKVV/LA FIRE DEPARTMENT
444 Andover Park East, Tukwila, Wa. 98188 206-575-4407
Project:
uA 1
'" at+
--
Type of Inspection:
t �Q040
S . C.., eK
l
Contact Person:
/'�T`e.�
Address: "7 l�j?:6,
Suite #:
Special Instructions:
Phone No.:
proved per applicable codes.
I —I Corrections required prior to approval.
COMMENTS:
Needs Shift Inspection:
Sprinklers:
Fire Alarm:
Hood & Duct:
Monitor:
Pre -Fire:
Permits:
Occupancy Type:
Inspector:/ v/
S— Z_
Date: /'/c9 7//
Hrs.:
(
I I $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from
the City of Tukwila Finance Department. Call to schedule a reinspection.
Billing Address
Attn:
Address:
City:
Word/Inspection Record Form.Doc
Company Name:
State:
6/11/10
Zip:
:.o.,T.F.D. Form F.P. 113
PERMIT COORD COPY
PLAN REVIEW/ROUTING SLIP
PERMIT NUMBER: D14-0199 DATE: 06/26/14
PROJECT NAME: VACANT TENAT SPACE
SITE ADDRESS: 17686 SOUTHCENTER PKWY
X Original Plan Submittal
Response to Correction Letter #
Revision # before Permit Issued
Revision # after Permit Issued
DEPARTMENTS:
b0-7` 9
Building Division m
't[61ic V '
Fire Prevention
Structural
C/ 0'1'v1'1'1
Cp'-
Planning Division
Permit Coordinator
PRELIMINARY REVIEW:
Not Applicable ❑
(no approval/review required)
DATE: 07/01/14
Structural Review Required
REVIEWER'S INITIALS: DATE:
APPROVALS OR CORRECTIONS:
Approved
Corrections Required
(corrections entered in Reviews
Notation:
Approved with Conditions
Denied
(ie: Zoning Issues)
LA) o
140 v
DUE DATE: 07/29/14
REVIEWER'S INITIALS:
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
12/18/2013
ECLIPSE DEMOLITION LLC
Page 1 of 3
Cie Washington State Department of
Labor & Industries
ECLIPSE DEMOLITION LLC
Owner or tradesperson
PROTZMAN, CRYSTAL LYNN
Principals
PROTZMAN, CRYSTAL
LYNN, PARTNER/MEMBER
PROTZMAN, MICHAEL
BRIAN, PARTNER/MEMBER
Doing business as
ECLIPSE DEMOLITION LLC
32226 44TH PL SW
FEDERAL WAY, WA 98023
253-815-6869
KING County
License
Verify the contractor's active registration / license / certification (depending on trade) and any past violations.
Construction Contractor Active.
Meets current requirements.
License specialties
Demolition and Salvage
License no.
ECLIPDL937D1
Effective — expiration
03/21/2007— 03/23/2015
Bond
Wesco Insurance Co
Bond account no.
46WB016395
Received by L&I
02/11/2013
Bond history
Insurance
Scottsdale Indemnity Co
Policy no.
CPS1926613
Received by L&I
03/12/2014
$6,000.00
Effective date
03/19/2013
Expiration date
Until Canceled
$2,000,000.00
Effective date
03/19/2014
Expiration date
03/19/2015
https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602693491&LIC=ECLIPDL937D1&SAW= 07/21/2014