HomeMy WebLinkAbout25-8762 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG41001OLCERA
COLLISION REPORT 1591971
INTERSTATE CITY STREET FIRE CASE# 25-8762 2
❑ ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAI-ANG 4200 3
HIT&RUN ❑ CODING
❑ COUNTY RD PRIVATE WAY ❑✓ INVOLVED
2 1 TOTAL#OF OBJECT 1 28
TRIBAL UNITS 02 STRUCK BUILDING
RESERVATION 1 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eDCL s on' 10 - IN
09 - 2025 1415 17 �.[� S 8 W e OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
108TH AVE SE BLOCK NO. e 17033 .�
4a❑ MILE POST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 1❑ 50 00 FEET e✓ S 8 W e SE 172ND ST
0 1 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4253300886 30
5 LAST NAME MUK11TE FIRST NAME BRENDA MIDDLE M 1 2 31
INITIAL
STREET ❑ 2211 SMITHERS AVE S CITY; RENTON ST I WA ZIP; 980554208 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEflIGAL TRANSPORTED 3
INTERLOCKYEs NOW INTERLOCKm No�/ YES NO✓
8❑ DRIVER # STATE WA SEXI F MMDDYY' 01 - 01 - 1990 32
-NJUR
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASSY 1 [NATURE of INJURIES 2
LICENSE, CTG4333 STATE WA VIN#; 1HGCR2F58FA007817 3
10 F1 as ATP tt
TRAILER
11 0 0 STATE TRAILER STATE PLATE# PLATE# 5 ROM
TRLR zRLR. 1 5 33
12 VIN#' VIN#
FROM TO
VEH.YEAR 201S MAKE yOND MODEL ACCOR STYLE SD VEHICLE TOWED[n TO ZBLIN TOWEDBY GOVT VEHICLE m 34
13� DAMAGE YES II_II NO YESII_I) NO✓
REGISTERED OWNER INFO BRENDA MUKHTE 2211 THERS AVE S RENTON WA 98055 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE / INSURANCE CO PERMANENT GENERAL 53-WA-8902118 3QIN
4
EFFECT &POLICY# 9VEn" CHARGE 5 36
Lemur YES❑NO❑ CITATION# t a 8
15❑ STANDING 7 e
MOTOR PEDAL-:. PROPERTY DAM THR OLD MET PHONE
UNIT 02 PEDESTRIAN ✓ D:4255287070
VEHICLE CYCLE PROPSOWNE YES✓ NO
16❑
LAST NAME RENTON FIRST NAME COTTAGES OF MIDDLE
INITIAL
STREET ❑
17 ❑ 17033 108TH AVE SE CITY RENTON ST, WA ZIP 98056 37
NEW ADDRE SS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES No INTERLOCK YES Na YES NO
19 DRIVER'S
# STATE SEX U MMDDYY � 39
20❑ ON DUTY STATUS AIRBAG RESTR EJECT HELMET INJURY NATURE OF INJURIES 40USE CLASSLICENSE
❑
21 PLATE# T-1- VIN# 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
vemae ❑ ,.I—I CITATION# CHARGE to BOTTOM
EEGnEEY YES NC
25 a s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
WA0171300
26
D.NELSON 12421
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG41001
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8762
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE
SEXi D.O.B. —
MMDDYYYY
PASSENGERQ WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ; HELMET NJURY NATURE OF INJURIES
POS. ' USE GLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. —
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES
POS. USE O'SS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. I USE CLASS
NARRATIVE
25-8762 ACC
On 10/9/2025 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the
City of Renton. I was dispatched to a report of a single vehicle collision into a building at 17033 108th
Ave SE Renton/King/WA. An employee at a memory care facility called to report that the vehicle had
struck the building and there was structural damage. No injuries were reported.
I arrived on scene and located the black 2015 Honda Accord WA/CTG4333 had drove over a parking
barrier and sidewalk and had collided with the north wall of a building. There was obvious structural
damage to the wall and damage to the front bumper of the Honda. The driver, Brenda M Mukiite
DOB: 1/1/1990, said that she pulled into the parking space and when her front wheel touched the
parking barrier it scared her, and she hit the gas. This caused the vehicle to collide with the building.
The area where Brenda hit the building was a patient's room, it was not occupied at the time of the
collision.
I provided Brenda and management at the Cottages of Renton Memory Care Facility an exchange of
information form.
RRFA personnel responded and evaluated the building.
Nothing further.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
D. Nelson #191 10/9/2025 Renton WA
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
D.NELSON 10-10-25 03:05 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1012412025 7:42:19 AM
BADGE OR ID# 12421 ORI# WA0171300 TIME POLICE DISPATCHED 1 2:18 PM TIME POLICE ARRIVED i 2:Y8 Pry
PAST B a Da-3mx-attar(txIMR) PAGE 2�OF F3
REPORT NO. EG41001 CASE# 25-8762 DATE AND TIME 10/09/25 14:15
OF COLLISION
s y£1 x
r
4
{ tS
} 3
a
r
n
J
st s
t s
ss
} tx u
t
ttt
'���x st n 1,, ttlits �>l1h sxs s�4 t
h� }
A
s.
'
t.
I
rt �
u
x t
PAGE 3 OF 3