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Home My WebLink About18306 59TH DR NE BLDG 5_BLD20120099_2026 vl c� > \ C Y V N c -ca m m Cl) c : W a. z d ` CD U (D iL c CL O c a? ® ® ® ® ® Z a 3 a co O Q W `o o H W O 4 �i O W cu Z \ ® ® w ov �, E m m e m w W c� a) 'ca _Z o o l g � W C Z v I 3 0 H J .. cn cuCD LZ ` o € y m CL Q U O a c aw .r o wJ Z U) m �Q • N > 4 O Q I— u �. o 9 Q p O C�1 O +r 1 u d J cc V ` CS) OMCM U) G > z a. O c � �a � Q) � = Ct p N � c °o o O \ C Y O j CYa. W I 0 v coo o ° �� am Q a Z " 0 CD U C� (q LL S Z Q O `o E +� ® ® ® ® ® ® O o V co Q w o K3 n W00 Q Z J c :IL 0 ffi � c rn w p U ia Z E C m .- W c 1 m ( � .� H Z v I L.L ❑ V) UD wo ❑ Z C; O I Q Z ai v I 3 0 E C� m a 0 0 0 ❑ a, a � Z �, o C? J —� a � as � \ �O > 0 c I � L o C �o > c O Q d o 0 1 �:� O o o o y, V a J N cc � m c z a O c2mm m cr "o o �' P4~ ® > I I I c LLLL � � � 0 ® ® ®'xp 0 ® CITY OF ARLINGTON e 238 N.OLYMPIC AVE.-ARLINGTON,WA 98223 PHONE:(360)403-3551 BUILDING PERMIT Address:18306 59TH DR NE#BLDG 5,ARLINGTON Permit#:BLD20120099 Parcel#: Valuation:$20,000.00 OWNER APPLICANT CONTRACTOR UNIVERSAL AEROSPACE ANDGAR CORPORATION ANDGAR CORPORATION 18640 59TH DR NE TOM BAJEMA TOM BAJEMA ARLINGTON,WA 98223 PO BOX 2708 PO BOX 2708 FERNDALE,WA 98248 FERNDALE,WA 98248 Lie 4:ANDGAC"19102 Exp:7/11/2013 `PLtTINIB1NG CONTRACTOR MECHANICAL CONTRACTOR UNIVERSAL AEROSPACE 18640 59TH DR NE ARLINGTON,WA 98223 Lie#: Exp: Lie#: Exp: JOB DESCRIPTION Mechanical Improvements PERMIT TYPE: Commercial PERMIT GROUP: Mechanical/Solar STORIES: 0 CONST TYPE: DWELLING UNITS: 0 OCC GROUP: CODE: OCC LOAD: PERM11T APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED.IBC110/IRC110. SALFS TAX NOTICE: Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form and dcd Cit f Arlington 43101. r ��lG Bnv,fC 03Z-71Z Signature Print Name Date Released Q61e ARCHIVE APPLICANT ASSESSOR OTHER BLD20120099 CONDMONS THIS PERMIT AUTHORIZES ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY.ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS, SIDEWALKS,DRIVEWAYS, MARQUEES, ETC.)WILL REQUIRE SEPARATE PERMISSION. • None PFR W f FFN Date Description Fee Amount Paid Balance Due 3/23/2012 Mechanical Permit Fee $210.00 $0.00 $210.00 3/23/2012 Building Plan Check Fee(QT -1) $300.00 $0.00 $300.00 Total Due: $510.00 $0.00 $510.00 CALL IUR INSPECTIONS BUILDING NG1 ,M�INC,/PARI�CS/UIII,ITIFS/FINAL(360)435-0674 FIRE(360)403-3607 When calling for an inspection please leave the following information: Permit Number,Job Site Address,Type of Inspection being requested,Contact Name and Phone Number,Date Prefereed,and whether you prefer morning or afternoon. • C-Equipment-Mechanical BLD20120099 (PT-LIVE) - PermitTrax by Bitco Software Page 1 of 1 BUILDING PERMIT PERMIT M BLD20120099 OWNER: UNIVERSAL AEROSPACE STATUS: APPLIED ADDRESS: 18306 59TH DR NE#BLDG 5,ARLING... BALANCE: $0.00 rot!*, ISSUED: CREATED: 3/21/2012 44 SCREENS: Select Screen._ FUNCTIONS: Select Permit Function... MECHANICAL/SOLAR REVIEWS PRINT ADD NEW SUMMARY REVIE.. DESCRIPTION ASSIGNE.. DUE DATE LAST (#) REQ? DO.. ASSIGN REMOVE 2000 C-Building I CYOUNG 3/28/2012 0 Y N Assign Remove 2008 C-Community Development I ARUSKO 3/28/2012 0 Y N Assign Remove https:Hcoapermits.arlington.local/PermitTrax/Module_Permits/Permits Permit/Permit Reviews.as... 3/21/2012 y' a .� COMMERCIAL MECHANICAL SUBMITTAL REQUIREMENTS Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington, WA 98223 • Phone(360)403 3551 • FAX(360)403 3418 THIS APPLICATION MUST BE ACCOMPANIED BY TWO(2)SETS OF CONSTRUCTION DRAWING$,AND ONE(1) SET OF WASHINGTON STATE ENERGY CODE APPLICATIONS. Type of Permit: 0 Residential Apartment ✓� Commercial Valuation: /20 Od d Project Address 16306 59TH DR NE BLDG 5 Parcel ID#: Lot#: Subdivision: — Project Description: TENANT IMPROVEMENT Owner: UNIVERSAL AEROSPACE Phone Number: Address: 1864059THDRNE City, ARLINGTON State: WA Zip Code: 98223 Contact Person:TOM BAJEMA Phone Number: 360-366-9900 EXT 104 Cell Phone: 360-815-5845 Fax: 360-366-5600 E-mail: TOMB@ANDGAR,COM Address: PO Box 2706 City: FERNDALE State: WA Zip Code: 98248 Please List Quantity of Fixtures Below: FURNACE UP TO 100K BTU CLOTHES DRYER GAS OUTLETS FURNACE OVER 100K FLR FURN INSTALURELOCATE — SUSPENDED HTRlUNIT HTP' BOILER UP TO 3 HP APPLIANCE REPAIR �^ APPLIANCE VENT/OTHER BOILER UP TO 4-15 HP TYPE I OR II HOOD VENTILATION EQUIPMENT BOLIER UP TO 16-30 HP _!_ AIR AHNDLING UP TO 1 OK CFM VENTILATION FANS BOILER UP TO 31-50 HP AIRHANDLING OVER 10K CFM OTHER VENTILATION SYSTEM BOLIER UP TO 51 HP AND UP INCINERATOR (AST)TANK STORAGE/PIPING ALL OTHER UNITS _L HEAT PUMP (UST)TANK STORAGE/PIPING Contractor: ANDGAR CORPORATION _ Phone NUmber: 360-366-9900 AddreSS' PO Box 2708 City: FERNDALE State: WA Zip Code: 98248 Contractor's License Number: ANDGAC"19102 Expiration:JULY2012 • Provide applicable WSEC Worksheet(s)and appliance cut sheet(s)along with application • Provide applicable NFPA or other Reference Standard Material along with application I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above- described property will be in accordance with the laws, rules and regulation of the State of Washington, 3-21.2012 Applicar,g Signature Date TOM BAJEMA RECEIVED Print Applicants Name FOR STAFF USE ONLY MAN L 1 LU1L �LD o�D I a 00°I -61-- -45� COA PERMIT CENTER Permit# Accepted By Amount Received Receipt# Date Received 2 / _ r - n _ , .A rir -- i � � � � '_ 1 ti l i _ ' r l I � ' J � r ■ r ti' i• ♦J . .- r ,1 — — 1 061 rA R 1' r L r — • » r 1 V �t� l -�� l oft f r _ r COMMERCIAL MECHANICAL SUBMITTAL REQUIREMENTS 4 Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington, WA 98223 • Phone(360)403 355-1 • FAX (360)403 3418 If gas piping will be installed, this form is required in addition to a Commercial Mechanical Permit Application Pipe Material: Inlet Pressure: '7 G. Pressure Drop: Specific Gravity: Pressure Piping Schematic Show Pipe Size(s) and Ler gth(s) from meter to all appliances. ❑ Scale or Not to Scale i o,NP NOTE: any interior pressure regulators —� must be indicated DOTE: drip legs/sediment i traps are IV required at all appliances unless integrated in the listed appliance RECEIVED MAR 21 2012 04A PERMIT CENTER .. j . + � {,r..1�, ' � COMMERCIAL MECHANICAL SUBMITTAL REQUIREMENTS Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington, WA 98223 • Phone(360)403 3551 • FAX(360)403 3418 WHEN A MECHANICAL PERMIT IS REQUIRED The City of Arlington requires a mechanical permit before mechanical equipment is installed, altered, or replaced. Examples are installations or alterations of gas piping, replacement of any HVAC equipment, Heat Pumps, Exhaust Systems, Paint Booths, Above-ground and Under-ground tanks with piping, etc. The City of Arlington does not require a permit to replace an existing gas clothes dryer, stovetop ranges, ovens, or gas log if there is no gas piping installed or altered. MECHANICAL PLAN REVIEW IS REQUIRED FOR THE FOLLOWING PROJECTS 1. New Commercial Buildings. 5. All hoods (Type I and II). 2. Complete HVAC systems and AC units, heat 6. All Commercial gas piping. pumps, rooftop units or exhaust fans. 7. Any penetrations of fire resistive construction 3. Relocation of 10 or more diffusers. 8. All spray booths 4. Addition of fan coil units. SUBMIT TWO (2)COPIES OF THE FOLLOWING FOR MECHANICAL PLAN REVIEW: Q Mechanical plans or drawings. (Minimum plan size is 18" X 24" scale, '/" scale for details.) ❑✓ Reflected ceiling plan showing and identifying ductwork, equipment, piping, supply diffusers, return air grilles and fire dampers. ❑ Roof plan showing equipment, ductwork, vents, roof access and equipment screening. ❑ List of equipment and schedule. ❑ Engineered structural gravity and/or lateral force calculations for ALL rooftop units. 0 A Commissioning Plan shall be submitted with the following: A detailed explanation of the original design intent Equipment and systems to be tested, including the extent of tests Functions to be tested, i.e. calibration, economizers, etc. Conditions under which test shall be performed, i.e. winter or summer design, full outside air, etc. Measureable criteria for acceptable performance ✓❑ Washington State Non-Residential Energy Code Forms. Structural Information: Please note that engineered structural gravity loads calculations are required for all rooftop units. If the unit is 440 lbs. or larger engineered structural lateral force calculations are also required. All Natural Gas Fuel Gas Piping is covered under the 2009 International Fuel Gas Code, Liquefied Petroleum Gas installations are covered by NFPA 54 (National Fuel Gas Code) and NFPA 58 (Liquefied Petroleum Gas Code). Gas water heater replacements require a permit and are regulated by the Uniform Plumbing Code 1 ■ i� - -� - 'rye■ l� �~� {qh �r n1tir.-V ■••f�: - 1 1 1 1 Rr 7 . :1 a1.ti oil A r G' •: . / �� r S 1 1 1 r I . .fx V .7. ivy L t ■ ■ ■ c rr r 1 I I 2009 Washington State F^orgy Code Compliance Forms for Nonresidential end Multifamily Residential 2009 Washington State Energy Code Compliance Forms for Nonresidential and Multifamily Residential Revised February 2011 Project Info Project Address 9th DR NE s Date 3/21/2012 ARLINGTON,WA 98223 For Building Dept. Use RECEIVED Applicant Name: ANDGAR CORP./CO TOM BAJEMA Applicant Address: PO BOX 2708 FERNDALE WA 98248 MAR 21 2012 Applicant Phone: 360-36-9900 Project Description INSTALLATION OF NEW HVAC SYSTEM FOR TENANT IMPROVEMENT Briefly describe mechanical OWNQ o-ob {"I system type and features. ❑' Includes Plans Drawings must contain notes requireing compliance with commissioning requirements-Section 1416 Compliance Option Simple System Complex System O Systems Analysis (See Decision Flowchart(over)for qualifications.Use separate MECH-SUM for simple&complex Equipment Schedules The following information is required to be incorporated with the mechanical equipment schedules on the plans. For projects without plans,fill in the required information below. Cooling Equipment Schedule Equip. Equip Capacity2 OSA CFM SEER Econmizer Heat ID Type Brand Name' Model No.' Btu/h or Econo? or EER IPLV3 Option or Recovery Exceptions Y/N AHU-1 TRANE TAM7A0C60H51SA 58500 ECONO 13 N HP-1 TRANE 4TWR3060 Heating Equipment Schedule Equip. Equip Capacit/ OSA cfm Heat ID Type Brand Name' Model No.' Btu/h or Econo? Input Btuh Output Btuh Efficiency4 Recovery Y/N AHU-1 TRANE TAM7A0C60H51SA 56000 ECONO COP 3.6 N HP-1 TRAM 4TWR3060 " IT -1 woAs 30 30, voo 2yGoo &2' t! ezn•r uU 5 HS uou 3 dF00 LR a"/o Fan Equipment Schedule Equip. Equip ID Type Brand Name' Model No.' CFM SP, HP/BHP Flow Controls Location of Service 'If available. 2 As tested according to Table 14-1A through 14-1 G. 3 If required. 4 COP, HSPF,Combustion Efficiency,or AFUE,as applicable. 5 Flow control types:variable air volume(VAV),constant volume(CV),or variable speed(VS). 6 Exception number from Section r-->, t� �. � � 'fir •r i �. .�, � �i 1� A. � � � � 2009 Washin ton State F^prgy Code Compliance Forms for Nonresidential and Multifamily Residential Mechanical Summn • 2009 Washington State Energy Code Compliance Forms for Nonresidential and Multifamily Residential Revised February 2011 All Systems: ❑ No humidification? ❑No Reheat? System Description If Heating/Cooling ❑ Constant vol? ❑Split system? ❑-84,000 Btuh? ❑Economizer See Section 1421 for full description of or Cooling Only: ❑ Air rnnled'? ❑ ParkanPd sys? ❑<=155 non Rtuh? included? Simple System qualifications. ❑Coolina Can<=15 Btuh/ftz? ❑Heating Cap.>0&<=10 Btuh If If Heating Only: [I <1onn rfm? ❑<30%outside air?❑ Heating Cap.<=10 Btuh/ft2? Decision Flowchart Use this flowchart to determine if project qualifies for Simple System Option. If not,either the Complex System or Systems Analysis Options must be used. START Cot <=15 ,or RECEIVED Humidification Heat/Cool Eq.with o MAR 21 2012 � or Reheat? Cap<=10 stufiW? Yes \ -. Yes COA PERMIT CENTER No Heating/Cooling <onstant Cooled, No System Type or Cooling Only Vol Heating Only Yes Reference Section 1421 Total <1000 CFM Serving —No-- N cfm? Single Roo Ys Yes <Package Unit Split System N <30%OSA =135'000 No— <=84,000 Btuh N Btuh Yes Yes Yes eatin alifies No Cap<=10 Yes Econo -- No— Economizer N tuh/ ncludedl Exception (s lion 1,433) Yes r Yes Simple System Allowed i (section 1420) Use Complex —► Systems (section 1430) Complex Systems Refer to MECH-COMP Mechanical Complex Systems for assistance in determining which Complex P Y Systems requirements are applicable to this project. r-. � 1 1 l . � • I 2009 Washington State energy Code Compliance Forms for Nonresidential and Multifamily Residential Mechanical Permit PIRs Checklist MECH-CHK-, 2009 Washington State Energy Code Compliance Forms for Nonresidential and Multifamily Residential Revised February 2011 Project Address Date The following information is necessary to check a mechanical permit application for compliance with the mechanical requirements in the Washington State Nonresidential Energy Code. Applicability Code Location Building Department (yes,no,na) I Section Component Information Required on Plans Notes HVAC REQUIREMENTS(Sections 1401-1424) 1411 Equipment Performance yes 1411 1 Minimum efficiency Equipment schedule with type,capacity,efficiency Q E'V '�`,�r N.A. 1411.1 Combustion htg Indicate intermittent ignition,flue/draft damper&jacket loss N.A. 1411.1 Air-cooled chiller Provide total air and water chiller capacity AK 2 1 LU I L N.A. 1411.21 Water-cooled chiller Full-load and NPLV values adjusted for any non-standard conditions Yes 1411.4 Pkg.elec htg.&clg. List heat pumps on schedule tVV 1 Mnini a %F—r � 1411.5 Unenclosed Heat Indicate radiant heat system and occupancy controls 1412 HVAC Controls Yes 1412.1 Temperature zones Indicate locations on plans Yes 1412.2 Deadband control Indicate 5 degree deadband minimum N.A. 1412.3 Humidity control Indicate humidistat Yes 1412.4 Setback and Shutoff Indicate thermostat with 7 day program capability&required setback N.A. 1412.4.1 Dampers Indicate damper location,leakage rate,control type,&max.leakage N.A. 1412.4.2 Optimum Start Indicate optimum start controls Yes 1412.5 Heat pump control Indicate heat pump thermostant&outdoor lockout on schedule 01511l 1412.6 Combustion heating Indicate modulating or staged control Yes 14127 Balancing Indicate balancing features on plans N.A. 1412.8 Ventilation Control Indicate demand control ventilation for high-occupancy areas N.A. 1412.9 Loading Dock& Indicate enclosed loading dock&parking garage ventilation system Garage Ventilation activation and control method. N.A. 1422 Thermostat interlock Indicate thermostat interlock on plans N.A. 1432.2.1 Temperature Reset Indicate temperature reset method 1413 Air/Water Economizers Yes 1412.1 Single zone systems Indicate multiple cooling stage control capability. Yes 1413.1 Air Econo Operation Indicate 100%capability on schedule N.A. 1413.1 Wtr Econo Operation Indicate 100%capacity at 45 degF db&40 deg F wb N.A. 1413.2 Wtr Econo Document Indicate max.OSA condition for design clg load&equipment performance data. Yes 1413.3 Integrated operation Indicate capability for partial cooling N.A. 1413.4 Humidification Indicate direct evap or fog atomization w/air economizer 1414 Ducting Systems Yes 1414.1 Duct sealing Indicate duct design pressures,sealing,and testing requirements Yes 1414.1.2 Low press.duct test Indicate applicable low pressure duct systems shall be leak tested No 1414.1.3 High press.duct test Indicate high pressure duct systems shall be leak tested,and identify the location of this ductwork on plans Yes 1414.2 Duct insulation Indicate R-value of insulation on duct 1415 Piping Systems N.A. 14151 Piping insulation Indicate R-value of insulation on piping 1141e Completion Requirements Yes 1416 3.2 System Balancing Indicate air and water system balancing requirements Yes 1416.3.3 Functional Testing Provide sequence of operations and test procedures. Yes 1416.3.4 Documentation Indicate O&M manuals,record drawings,staff training Yes 1416.3.5 Comm. Report Indicate requirements for final commissioning report Yes 1416.4 1 Compliance Chklist Submit to building official upon substantial completion. Yes::: Mechanical Summary Form Completed and attached. Equipment schedule with types,input/output, efficiency,cfm,hp,economizer 1 � �I 2009 Washington State r-nergy Code Compliance Forms for Nonresidential arld Multifamily Residential Mechanical Permit FWs Checklist Continued IF MECH-CHK 2009 Washington State Energy Code Compliance Forms for Nonresidential and Multifamily Residential Revised Febn,ary 2011 Project Address Date The following information is necessary to check a mechanical permit application for compliance with the mechanical requirements in the Washington State Nonresidential Energy Code. Applicability SCode Location Building Department (yes,no.r ection Com onent Information Reauired on Plans Notes SERVICE WATER HEATING AND HEATED POOLS(Sections 1440-1454) 1440 Service water htg. 1441 Elec.water heater Indicate R-10 insulation under tank 1442 Shut-off controls Indicate automatic shut-off of circulators or heat trace 1443 Pipe Insulation Indicate R-value of insulation on piping 1444 Pump Energy Indicate method of pump energy management(Sec 1438) 1445 Heat Recovery Indicate preheat capacity as%of peak service water demand. 1460 Heated Pools 1452 Heat Pump COP Indicate minimum COP of 4 0 1452 Heater Efficiency Indicate pool heater efficiency 1453 Pool heater controls Indicate switch and 65 degree control 1454 Pool covers Indicate vapor retardant cover 1454 Pools 90+degrees Indicate R-12 pool cover 1455 1 Heat Recovery I Indicate method and capacity of exhaust air temperature reduction COLD STORAGE (Sections 1460-1465) 1460 Cold Storage 1463 Evaporators Indicate motor type and speed control 1464 Condensors Indicate condenser cooling type,design wb temp and control 1465 Compressors Indicate design minimum condensing temp and control. If"no"is indicated for any item in Sections 1401-1424 or 1440-1465 , provide explanation: RECEIVE® MAR 21 2012 COA PERMIT CENTER _, (� ) 1 �� l.' Page 1 of 2 Washington State Depaftent of Labor & Industries Contractors or Tradespeople Detail Return to List > Start a New Search > Q Printer friendly Verify Workers' Comm Premium Status Check for Dept. of Revenue Account About 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 ANDGAR CORPORATION UBI No. 600100192 Phone No. (360)366-9900 Status Active Address Po Box 2708 License No. ANDGAC*1 9102 Suite/Apt. City Ferndale License Type A) Construction Contractor State WA Effective Date 9/22/1981 Zip 98248 Expiration Date 7/11/2013 County Whatcom Suspend Date J.4 Business Type Corporation Specialty 1 b General Parent Company Specialty 2 Unused Other Associated Licenses License Name Type Specialty Specialty Effective Expiration Status 1 2 Date Date ANDGAIL960M9 ANDGAR II LLC Construction General Unused 7/29/2004 7/29/2012 Active Contractor VANSSM*270NA VANS SHEET Construction General Unused 8/1/1973 8/1/1981 Archived METAL INC Contractor U Business Owner Information a Hide All Name Role Effective Date Expiration Date WROEGEIVG® VAN LOO,GARY J President 01/01/1980 MCLLEMA,ANDREW Vice President 01/01/1980 MAR 2 1 2012 Bond Information i C®A PERMIT�ZndCENTE�R,�q Bond Company Bond Account Effective Expiration Cancel Impaired Bond Received ��j�+�u�� / Name Number Date Date Date Date Amount Date htt s:Hfortress.wa. ov/lni/bbi /Result.as x 3/21/201�Z P g P P i I I i Page 2 of 2 4 WESTERN 929334221 07/11/2004 Until $12,000.00 05/20/2004 SURETY CO Cancelled Assignment of Savings Information No records found for the previous 6 year period B Insurance Information l; Insurance Company Policy Number Effective Expiration Cancel Impaired Amount Received Name Date Date Date Date Date American 19 Economy 001C1216044- 04;01/2012 04/01/2013 $1,000,000.00 03/17/2012 Insurance Co AMERICAN 18 ECONOMY 01 C12160443 04/01/2011 04/01/2012 $1,000,000.00 03/29/2011 INSURANCE CO AMERICAN 17 ECONOMY 01 C12160442 04/01/2010 04/01/2011 $1,000,000.00 03/29/2010 INSURANCE AMERICAN 16 ECONOMY 01 C121 60441 04/01/2009 04/01/2010 1 $1,000,000.00 05/12/2009 INSURANCE 15 AMERICAN 01CG165309-6 07/11/2008 07/11/2009 $1,000,000.00 07/10/2008 STATES INS 14 AMERICAN OICG16530930 07/11/2006 07/11/2008 $1,000,000.00 06/28/2007 STATES INS CO 13 AMERICAN 01CG16530930 07/11/2005 07/11/2006 $1,000,000.00 07/08/2005 STATES INS CO B summons'Complaint Information 1D No unsatisfied complaints on file within prior 6 year period 9 Warrant Information No unsatisfied warrants on file within prior 6 year period Amu C)Washington State Dept. of labor& Industries. Use of this site is subject to the laws of the state of Washington. A&Aashington", M'bIR��r!avrnnm�1Qt✓•91p https:Hfortress.wa.gov/lni/bbip/Result.aspx 3/21/2012 s� t. M 0 ^G y < y y �rt a c* y a� a � s A T1, 0 M y a z ooac Zinn DODZxo �vi �Z D A tmlf ap zOC O mnOc Or��nD�`Zmmzy i cpzazS�zZOZ vzx113s ?o DO�p D OD vaOD OO Z iIZ mN 3cmimnOy 3a < �n mp� pm �a L o C �c o D x a tt Z� O'i Z.O m�D v0 y 3 0 Z O A o v m n N m< g a rn N� n3M� zoaNx ozOz p H N 2 p 2 C m N rn o o w p x z T. D D D > D D D D D o 3 0 3 a y k C N --I� 2 DD Oz D > `LCsv"'i ZN m z 3 z oc a o92 m M < o z a v > r L1m �c0 �Lzzpm -z1 m ? 0 rn D x OnpCv+ N x O A°C G) O H Z N D D 3 � m 3 m u 2 v v 3 m y o C O L N C7 w C) m�W V Z � �a \JT�`Mm I.Vc. rn L n Z Lj.J l_� r+ m 61 'V 0 LL_ -- � � Y = n _ IIIIIII �� T rn m m UNIVERSA[ AEROSPACE ANDGAR CORPORATION A (,a S S -i N N z o I I I I I I 18306 59th Ave NE BLDG 5 HVAC ® Arlington, WA 98223 Tennant Improvement ��C) N o 3'�