HomeMy WebLinkAbout23-322 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE RESULTED ❑ CASE 23-322 z
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 28
TRIBAL UNITS 02 STRUCK' BUILDING
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑
cawsloN 01 - 09 - 2023 0035 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SE ROYAL HILLS DR BLOCK NO. e✓ 3000
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 1 5 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2063591508 30
6� LAST NAME ZUBIK FIRSTNAME VITALIY MIDDLE 1 2 31
INITIAL
STREET ❑ 35816 10TH AVE SW CITY FEDERAL WAY ST WA ZIP 98023 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 1 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10� Pi aT�S� B60317Y sTATe WAvIN# 1GCGG29V461151091
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR. O 0 33
12❑ VIN#' VIN#'
2006 CHEV EXPRES VN I FROM 34
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO u BLIN TOWED BY GOVT.VEHICLE
13 A DAMAGE YES NO YES[:] NO✓
REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14❑ LIABILI INSURANCE❑ INSURANCE CO 3
IN EFFECT &POLICY# 9TOP
VE— CHARGE 36
LEGALLY Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 7
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2062283295
16❑
LAST NAME ABDULLANI FIRST NAME IKRA MIDDLE A
INITIAL
17 STREET NEW ADDREs�' 3000 SE ROYAL HILLS DR#39D CITY RENTON ST WA ZIP 98058 37
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t— l NO❑
19 DRIVER # STATE SEX F M .C.B. 01 01 199 4 39
INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ TATE 41
IN#LICENSE V 1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO I 9TOP 5
VE""LE ❑ Nu
CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YESs e
7TH
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26MAN 11462 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED25942
COLLISION REPORT III III III III III 111
1591972 CASE# 23-322
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
PM USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Please see subsequent narrative pages
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J.THIELMAN 01-12-23 02:43 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.THIELMAN 11462 111812023 4:19:03 AM
BADGE OR ID# 11462 OR]# WA0171300 TIME POLICE DISPATCHED; ?2:37 AM TIME POLICE ARRIVED:12:42 AM
PART I PAGE IT]OF 4�
REPORT NO. ED25942 CASE# 23-322 OF COLLISION
01/09/23 00:35
OF CbLLI510N
NARRATIVE
Case Number 23-322
On 01/09/2023 at approximately 0037 hours, Renton units were toned out to a possible shooting at
3000 SE Royal Hills DR #39D within the City of Renton, King County, Washington.
While en route, dispatch relayed an unknown suspect fired a round into their bedroom. We later
learned it was not a bullet, but a vehicle backing into the building at a slow speed.
I arrived and saw WA/Lic B60317Y rested against building #39. It appeared the vehicle rolled
backwards at a slow speed and struck the window of unit#D. There was no obvious structural
damage.
I contacted the driver/owner of the vehicle/unit one, Vitaliy Zubik, who stated he was working on his
vehicle and he apparently forgot to put it in park. This caused the vehicle to slowly roll backwards out
of it's parking spot and into unit#39. There was minor cosmetic damage to the vehicle. Zubik was
provided a business card.
I spoke with the resident of unit#39, Ikra Abdullani, who stated she initially thought it was gunfire due
to the crashing noise but then saw the vehicle resting against her apartment window. The window
glass was broken but again, there did not appear to be any structural damage. I provided her a
business card and case number to provide to the apartment complex.
Based on the damage, I believe unit one was the proximate cause of the collision by failing to ensure
the vehicle was in park, causing it to slowly back into building #39.
1 certify (declare) under the penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed J.Thielman/11462
01/11/2023 2335 Hours Renton, WA.
PAGE 3 OF 4
REPORT NO. ED25942 CASE# ' 23-322 DATE AND TIME 01/09/23 00:35
OF COLLISION
*NOT TO SCALE*
BUILDING#39
CONCRETE WALKWAY
,N
WINDOW OF UNIT#D
A
UNIT`ONE
PAGE 4 OF 4