HomeMy WebLinkAboutPermit PG15-0029 - SCHOOL EMPLOYEES CREDIT UNION - BREAK ROOMSCHOOL EMPLOYEES
CREDIT UNION
5200 SOUTHCENTER
BLVD 100
PG15-0029
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
PLUMBING/GAS PIPING PERMIT
Parcel No: 1157200013 Permit Number: PG15-0029
Address: 5200 SOUTHCENTER BLVD 100 Issue Date: 5/8/2015
Permit Expires On: 11/4/2015
Project Name: SCHOOL EMPLOYEES CREDIT UNION
Owner:
Name:
GROW INVESTMENTS LLC
Address:
5200 SOUTHCENTER BLVD #140 ,
TUKWILA, WA, 98188
Contact Person:
Name:
CHE FORTALEZA
Phone: (206) 682-0884
Address:
502 SECOND AVE, SUITE 2800,
SEATTLE, WA, 98104
Contractor:
Name:
FERGUSON CONSTRUCTION INC
Phone: (206) 767-3810
Address:
13810 SE EASTGATE WAY SUITE 110,
BELLEVUE, WA, 98005-4417
License No:
FERGUCIOOOLA
Expiration Date:
Lender:
Name:
Address:
DESCRIPTION OF WORK:
DEMOLISH EXISTING SINGLE OCCUPANT TOILET ROOM AND TWO BREAK ROOM SINKS. INSTALL THREE NEW
BREAK ROOM SINKS, ONE UNDERCOUNTER RESIDENTIAL DISHWASHER, THREE INSTANTANEOUS WATER
HEATERS, ONE ICE MAKER, AND TWO REFRIGERATOR WATER BOXES TO CONNECT TO EXISTING DOMESTIC
WATER, SANITARY WASTE AND SANITARY VENT SYSTEM IN BUILDING.
Valuation of Work: $5,000.00 Fees Collected: $272.36
Water District: 125
Sewer District: TUKWILA SEWER SERVICE
Current Codes adopted by the City of Tukwila:
International Building Code Edition:
2012
National Electrical Code:
2014
International Residential Code Edition:
2012
WA Cities Electrical Code:
2014
International Mechanical Code Edition:
2012
WAC 296-46B:
2014
Uniform Plumbing Code Edition:
2012
WA State Energy Code:
2012
International Fuel Gas Code:
2012
Permit Center Authorized Signature: Date:
I hearby certify that I have read and examined this permit and know the same to be true and correct. All
provisions of law and ordinances governing this work will be complied with, whether specified herein or not.
The granting of this permit does not presume to give authority to violate or cancel the provisions of any other
state or local laws regulating construction or the performance of work. I am authorized to sign and obtain this
development per it and as ree o th onditions attached to this permit.
Signature Date:
Print Name:_Td Wl
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: ***PLUMBING/GAS PIPING PERMIT CONDITIONS***
2: No changes shall be made to applicable plans and specifications unless prior approval is obtained from the
Tukwila Building Division.
3: All permits, inspection records and applicable plans shall be maintained at the job and available to the
plumbing inspector.
4: All plumbing and gas piping systems shall be installed in compliance with the Uniform Plumbing Code and
the Fuel Gas Code.
5: No portion of any plumbing system or gas piping shall be concealed until inspected and approved.
6: All plumbing and gas piping systems shall be tested and approved as required by the Plumbing Code and
Fuel Gas Code. Tests shall be conducted in the presence of the Plumbing Inspector. It shall be the duty of
the holder of the permit to make sure that the work will stand the test prescribed before giving notification
that the work is ready for inspection.
7: No water, soil, or waste pipe shall be installed or permitted outside of a building or in an exterior wall
unless, adequate provision is made to protect such pipe from freezing. All hot and cold water pipes
installed outside the conditioned space shall be insulated to minimum R-3.
8: Plastic and copper piping running through framing members to within one (1) inch of the exposed framing
shall be protected by steel nail plates not less than 18 guage.
9: Piping through concrete or masonry walls shall not be subject to any load from building construction. No
plumbing piping shall be directly embedded in concrete or masonry.
10: All pipes penetrating floor/ceiling assemblies and fire -resistance rated walls or partitions shall be protected
in accordance with the requirements of the building code.
11: Piping in the ground shall be laid on a firm bed for its entire length. Trenches shall be backfilled in thin
layers to twelve inches above the top of the piping with clean earth, which shall not contain stones,
boulders, cinderfill, frozen earth, or construction debris.
12: The issuance of a permit or approval of plans and specifications shall not be construed to be a permit for, or
an approval of, any violation of any of the provisions of the Plumbing Code or Fuel Gas Code or any other
ordinance of the jurisdiction.
13: The applicant agrees that he or she will hire a licensed plumber to perform the work outlined in this permit.
14: All new plumbing fixtures installed in new construction and all remodeling involving replacement of
plumbing fixtures in all residential, hotel, motel, school, industrial, commercial use or other occupancies
that use significant quantities of water shall comply with Washington States Water Efficiency ad
Conservation Standards in accordance with RCW 19.27.170 and the 2006 Uniform Plumbing Code Section
402 of Washington State Amendments
PERMIT INSPECTIONS REQUIRED
Permit Inspection Line: (206) 438-9350
1900 PLUMBING FINAL
8005 ROUGH -IN PLUMBING
, 1
CITY OF YVKWl
Community Development Department
Permit Center
6300 Soutlicenter Blvd.. Suite 100
Tuktvik WA 98188
htt J1www.TukwilaWA. ov
Plumbing/Gas Permit No.
Project No. Q
Date Application Accepted:
Date Application Expires: A!,
use
PLUMBING / GAS PIPING 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
King Co Assessor's Tax No.- 11572000130020
Site Address: 5200 Southcenter Blvd. Suite Number: 100, 200 Floor: 1,2
Tenant Name: School Employee's Credit Union New Tenant: ® .....Yes ❑..No
PROPERTY OWNER
Name: School Employee's Credit Union
Address: 5200 Southcenter Blvd.
City: Tukwila State: WA Zip: 98188
CONTACT PERSON — person receiving all project
communication
Name: Che Fortaleza, CR architecture + design
Address: 506 2nd Ave Suite 2800
City: Seattle State: WA Zip: 98104
Phone: (206) 682-0884 Fax: (800) 469-4949
Email: c.fortaleza@cr-architects.com
Valuation of Project (contractor's bid price): $ 5,000
Scope of Work (please provide detailed information):
PLUMBING CONTRACTOR INFORMATION
Company Name: TBD
Address:
City: State: Zip:
Phone: Fax:
Contr Reg No.: Exp Date:
Tukwila Business License No.:
Demolish existing single occupant toilet room and two break room sinks. Install three new break room sinks, one
undercounter residential dishwasher, three instantaneous water heaters, one ice maker, and two refrigerator water
boxes to connect to existing domestic water, sanitary waste and sanitary vent system in building.
Building Use (per Int'l Building Code):
Office
Occupancy (per Int'l Building Code): Business
Utility Purveyor: Water: City of Tukwila
Sewer: City of Tukwila
H:1Applications\Fomrs-Applications On Line\2011 Applications\Plumbing Permit Application Revised 8-9-1 i.docx
Revised: August 2011
bb
Page 1 of 2
Indicate type of plumbing fixtures and/or gas piping outlets being installed and the quantity u-,ow.
Fixture Type
7Qty
Bathtub or combination
0
bath/shower
Dishwasher, domestic with
1
independent drain
Shower, single head trap
0
Sinks
3
Rain water system — per
0
drain (inside building)
Grease interceptor for
0
commercial kitchen (>750
gallon capacity)
Each additional medical
0
gas inlets/outlets greater
than 5
Atmospheric -type vacuum
breakers not included in
0
lawn sprinkler back -flow
protections (1-5)
Fixture Type
Qty
Bidet
0
Drinking fountain or water
0
cooler(per head)
0
—Lavatory
Urinal
0
Water beater and/or vent
3
Repair or alteration of
1
water piping and/or water
treatment equipment
Backflow protective device
other than atmospheric-
0
type vacuum breakers 2
inch (51 nun) diameter or
smaller
Atmospheric -type vacuum
breakers not included in
0
lawn sprinkler back -flow
protections over 5
PERMIT APPLICATION NOTES -
Fixture Type
Qty
Clothes washer,
0
domestic
Food -waste grinder,
0
commercial
Wash fountain
0
Water closet
0
Industrial waste
0
treatment interceptor,
including trap and vent,
except for kitchen type
ease interceptors
Repair or alteration of
1
drainage or vent piping
Backflow protective
device other than
0
atmospheric -type
vacuum breakers over 2
inch 51 mm diameter
Gras piping outlets
0
Fixture Type
Qty
Dental unit, cuspidor
0
Floor drain
0
Receptor, indirect waste
0
Building sewer and each
trailer park sewer
0
Each grease trap
0
(connected to not more
than 4 fixtures - <750
gallon capacity
Medical gas piping
0
system serving 1-5
inlets/outlets for a specific
as
Each lawn sprinkler
0
system on any one meter
including backflow
protection devices
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 extension of time for an additional period not to exceed 180 days. The extension shall be requested in writing
and justifiable cause demonstrated. Section 103.4.3 International Plumbing 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 OWIiER OR AUTHORIZED AGENT:
Signature:
Date: 03/09/2015
Print Name: Che Fortaleza, CR architecture (authorized agent) Day Telephone: (206) 682-0884
Mailing Address: 506 Second Avenue Suite 2800 Seattle WA 98104
City state; Zip
H:1Applications\Fomu-Applications OnLine\2011 Applications\PlumbingPeunitApplication Revised 8-9-Il.donc
Revisal• August 2011 Page 2 of 2
bh
DESCRIPTIONSACCOUNT QUANTITY
PermitTRAK
PAID
$261.50
D15-0062 Address: 5200 SOUTHCENTER BLVD 100 Apn: 1157200013
$66.50
DEVELOPMENT
$66.50
ADDITIONAL PLAN REVIEW
R000.345.830.00.00
1.00
$66.50
EL15-0216 Address: 5200 SOUTHCENTER BLVD 100 Apn: 1157200013
$65.00
ELECTRICAL
$65.00
ADDITIONAL PLAN REVIEW
R000.345.830.00.00
1.00
$65.00
M15-0025 Address: 5200 SOUTHCENTER BLVD 100 Apn: 1157200013
$65.00
MECHANICAL
$65.00
ADDITIONAL PLAN REVIEW
R000.345.830.00.00
1.00
$65.00
PG15-0029 Address: 5200 SOUTHCENTER BLVD 100 Apn: 1157200013
$65.00
PLUMBING
$65.00
ADDITIONAL PLAN REVIEW R000.345.830.00.00 1.00
TOTAL+
$65.00
1
Date Paid: Thursday, June 04, 2015
Paid By: SCHOOL EMPLOYEES CREDIT UNION
Pay Method: ACCOUNT
Printed: Thursday, June 04, 2015 1:11 PM 1 of 1
SYSTEMS
DESCRIPTIONS
PermitTRAK
ACCOUNT QUANTITY
PAID
$216.48
PG15-0029 Address: 5200 SOUTHCENTER BLVD 100 Apn: 1157200013
$216.48
PLUMBING
$206.00
PERMIT ISSUANCE BASE FEE
R000.322.100.00.00
0.00
$29.00
PERMIT FEE
R000.322.100.00.00
0.00
$177.00
TECHNOLOGY FEE
$10.48
TECHNOLOGY FEE
TOTAL4'
R000.322.900.04.00 0.00
$10.48
$216.48
Date Paid: Friday, May 08, 2015
Paid By: SCHOOL EMPLOYEES CREDIT UNION
Pay Method: CHECK 0002184880
Printed: Friday, May 08, 2015 11:38 AM 1 of 1
SYSTEMS
Date Paid: Monday, March 09, 2015
Paid By: SCHOOL EMPLOYEES CREDIT UNION
Pay Method: CHECK 2180208
Printed: Monday, March 09, 2015 3:50 PM 1 of 1
SYSTEMS
U
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) 438-9350
Project: c� � � L�
Type of Inspection: I
Address:
s20o 'S0A1'n' k �)"
Date Called:
Special Instructions: r1n
FM t
Date Wanted: a.m.
tlbw p.m.
Requester:
Phone No:
El REINSPECTION FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
A
INSPECTION RECORD
Retain a copy with permit bZ`j
IN ECTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 438-9350
Project:
(2ae � k -f 1n t cA
Ty
If Inspection.
��61
Address:
j�ZQO 5°v �.4c,� 61vJ
Date Called:
Special Instructions:
Date Wanted: a.m.
-3 -! p.m.
Requester:
Phone No:
11 Approved per applicable codes. 0 Corrections required prior to approval.
F] 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
INSPECTION NO, PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd.., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 438-9350
Project: %
Type of Inspectio
Address: f _ M
Date Called:
Special Instructions: 9
i�
Date Wanted: a.m.
7'",z- /3 p.m.
Requester:
Phone No:
�&pproved per applicable codes. L, Corrections required prior to approval.
Inspecto Date:
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�5-�
PECTION NO. PERMIT NO.
CITY OF" TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 438-9350
Project-
Tvp of Inspection:
Address: A
Date Called:
Special Instructions: ^^
'CIA
Date Wanted: a.m.
7 —Z Z " /s p.m.
Requester:
Phone No:
Approved per applicable codes. Corrections required prior to approval.
COMMENTS: �
A GC
c
Inspector: Date:
7-2, b
REINSPEZ'T-10N FEE REQUIRED. Prior to next inspection. fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
E.
INSPECTION RECORD
Z' Retain a copy with permit ��
IN ION NO, PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 438-9350
Proje
Type o Inspection:
R,
Address:
-X� (Vrd
Date Called:
Special Instructions:
Date W ted: a.m.
p.m.
Request
Phone Now:
—1Z c( ? ( f
Inspector DatAC
REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
b
r�
p INSPECTION RECORD �02�
l Retain a copy with permit f S~
IN5nCTION NO. PERMIT NO.
CITY OF TUKWILA BUILDING DIVISION
6300 Southcenter Blvd., #100, Tukwila. WA 98188 (206) 431-3670
Permit Inspection Request Line (206) 438-9350
Project:
i- � PKT
��C
Type of Ins �ectio
Address:
ub c �Jd
Date Ca d:
Special Instructions:
44
'r
Date Wanted• _ a.m.
p.m.
Requester:
Phone No:
Inspector: JDate:/
REINSPECTION FEE REQUIRED. Prior to next inspection, fee must be
paid at 6300 Southcenter Blvd., Suite 100. Call to schedule reinspection.
METRIZ
E N G I N E E R S
May 18, 2015
Plans Reviewer
City of Tukwila
Community Development Department
Public Works Department
Permit Center
6300 Southcenter Boulevard Suite 100
Tukwila, WA 98188
RE: PERMIT RESUBMITTALS
For: SECU Tenant Improvements
Building Permit #D15-0062
Mechanical Permit #M15-0025
Plumbing Permit #PG15-0029
To Whom It May Concern:
RECEIVED
CITY OF TUKWILA
MAY 19 2015
?ERMIT CENTER
As a result of the bid process, the following mechanical and plumbing revisions have been made to the
SECU Tenant Improvements Permit Set dated 03/06/2015:
Sheet M-002
1. The Exhaust Fan Schedule was updated with a revised fan selection.
Sheet M-004
1. VAV balancing notes were removed from the Test & Balance specifications.
Sheet M-701
1. Revised Flag Note #2 to include the replacement of all fire sprinkler heads.
Sheet M-702
1. Revised Flag Note #2 to include the replacement of all fire sprinkler heads.
Should you have any questions or concerns, please feel free to call me at 206-920-9240.
Regards,
Scott A. Miller, PE
Principal
1131 SW 7`h Street, Suite 110 Renton, WA 98057 Office: 425 336 2822 Fax: 425 336 2802
PERI","T C 0R0 COPY
PLAN REVIEW/ROUTING SLIP
PERMIT NUMBER: PG15-0029 DATE: 05/19/15
PROJECT NAME: SCHOOL EMPLOYEES CREDIT UNION
SITE ADDRESS: 5200 SOUTHCENTER BLVD
Original Plan Submittal Revision # before Permit Issued
Response to Correction Letter # X Revision # 1 after Permit Issued
DEPARTMENTS:
M "Q-
Building Division
Public Works
PRELIMINARY REVIEW:
Not Applicable ❑
(no approvaUreview required)
REVIEWER'S INITIALS:
APPROVALS OR CORRECTIONS:
Approved ❑
Corrections Required ❑
(corrections entered in Reviews)
Notation:
REVIEWER'S INITIALS:
Fire Prevention ❑
Structural ❑
Planning Division ❑
Permit Coordinator ❑
DATE: 5/21/2015
Structural Review Required ❑
DATE:
DUE DATE: 6/18/2015
Approved with Conditions ❑
Denied ❑
(ie: Zoning Issues)
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
12/18/2013
PLANPAEVIEOW/ROUTING SLIP
PERMIT NUMBER: PG15-0029 DATE: 03/09/15
PROJECT NAME: SCHOOL EMPLOYEES CREDIT UNION
SITE ADDRESS: 5200 SOUTHCENTER BLVD - SUITE 100
X Original Plan Submittal Revision # before Permit Issued
Response to Correction Letter #,
Revision # after Permit Issued
DEPARTMENTS:
Building Division Fire Prevention ❑
Ptib4ic Works Structural ❑
PRELIMINARY REVIEW:
Not Applicable ❑
(no approval/review required)
REVIEWER'S INITIALS:
APPROVALS OR CORRECTIONS:
Approved
a
Corrections Required ❑
(corrections entered in Reviews)
Notation:
REVIEWER'S INITIALS:
Planning Division ❑
Permit Coordinator R
DATE: 03/12/15
Structural Review Required ❑
DATE:
DUE DATE: 04/09/15
Approved with Conditions
Denied ❑
(ie: Zoning Issues)
DATE:
Permit Center Use Only
CORRECTION LETTER MAILED:
Departments issued corrections: Bldg ❑ Fire ❑ Ping ❑ PW ❑ Staff Initials:
12/18/2013
PROJECT NAME: S • v • l� PERMIT NO:
SITE ADDRESS: QI ORIGINAL ISSUE DATE: I5'
REVISION LOG
REVISION
NO.
DATE RECEIVED
STAFF
INITIALS
ISSUED DATE
4SYlff"F
ITLS
ai
s
Summary of Revision: Q
/`
Received b
l
REVISION
NO.
DATE RECEIVED
STAFF
INITIALS
ISSUED DATE
STAFF
INITIALS
Summary of Revision:
Received b
/ (please print)
REVISION
NO.
DATE RECEIVED
STAFF
INITIALS
ISSUED DATE
STAFF
INITIALS
Summary of Revision:
Received by:
(please print)
REVISION
NO.
DATE RECEIVED
STAFF
INITIALS
ISSUED DATE
STAFF
INITIALS
Summary of Revision:
Received by:
(please print)
REVISION
NO.
DATE RECEIVED
STAFF
INITIALS
ISSUED DATE
STAFF
INITIALS
Summary of Revision:
Received by:
(please print)
REVISION
NO.
DATE RECEIVED
STAFF
INITIALS
ISSUED DATE
STAFF
INITIALS
Summary of Revision:
Received by:
(please print)
City of Tukwila
Department of Community Development
6300 Southcenter Boulevard, Suite #100
Tukwila, Washington 98188
Phone: 206-431-3670
Web site: hqp://www.TukwilaWA.gov
REVISION
SUBMITTAL
Revision submittals must be submitted in person at the Permit Center. Revisions will not be accepted through
the mail, fax, etc.
Date: 05/18/2015
7 Response to Incomplete Letter #
Plan Check/Permit Number: PG15-0029
Response to Correction Letter #
✓ Revision # ' after Permit is Issued
Revision requested by a City Building Inspector or Plans Examiner
Project Name: SECU Tenant Improvements
Project Address: 5200 Southcenter Blvd. Tukwila, WA 98188
Contact Person. Che Fortaleza Phone Number:
Summary of Revision:
Revisions as a result of the bidding process. See attached narrative.
Sheet Number(s): Listed on attached narrative.
"Cloud" or highlight all areas of revision including date of revisi
Received at the City of Tukwila Permit Center by:
ZS -. Entered in Permits Plus on
(206)682-0884
CM K)F FUN WkA
MAY.!1.9 aI'
PEftA1rrCEMMA
H:\Applications\Forms-Applications On Line\2010 Applications\7-2010- Revision Submittal.doc
Revised: May 201 1
ITT FERGUSON CONSTRUCTION
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VACURA, TODD M BELLEVUE, WA98005-4417
425-974-8400
Principals KING County
VACURA, TODD M, PRESIDENT
JANSSEN, CHRIS L, SECRETARY
BENNETT, GARY J, TREASURER
COLIN, GENE J, CHIEF EXECUTIVE
OFFICER
PRESCOTT,LARRY
(End: 01/01/1980)
BENNETT, GARY J, VICE PRESIDENT
(End: 04/30/2012)
EASTON, MARGO, VICE PRESIDENT
(End: 05/05/2004)
LUNSFORD, LARRY JR, VICE PRESIDENT
(End: 05/09/2002)
RAFTERY, CHRIS, VICE PRESIDENT
(End: 05/09/2002)
SURINA, DON, VICE PRESIDENT
(End: 05/09/2002)
HALL, JAY L, TREASURER
(End: 05/09/2002)
BALBO, TOM C, VICE PRESIDENT
(End: 10/11 /2011)
Doing business as
FERGUSON CONSTRUCTION INC
WA UBI No. Business type
578 023 619 Corporation
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.
FERGUCIOOOLA
Effective — expiration
06/01 /2000— 06101 /2016
Bond
........_.......
TRAVELERS CAS & STY CO OF AMER $12,000.00
Bond account no.
968384
https:Hsecure.lni.wa.gov/verify/Detail.aspx?UBI=578023619&LIC=FERGUCIOOOLA&SAW= 5/8/2015