HomeMy WebLinkAbout25-9509 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG45851oc� RA
COLLISION REPORT 1591971
CASE# 25-9509 2
INTERSTATE CITY STREET FIRE I
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCAL-A`NG 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E
eDLLISION' 11 - 02 - 2025 1124 17 =.�� S WE IN
OF 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SUNSET BLVD N BLOCK NO. e 352 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 775 00 FEET e✓ S 8 W e NE 3RD ST
2 0 29
MOTOR PEDAL- DAMAG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES No �/ D:2067195695 0 1 30
5 LAST NAME FOSNAUGH FIRST NAME KEVIN MIDDLE D 1 1 2 31
INITIAL
STREET ❑ 25090 JONES AVE NE CITY; RENTON ST WA ZIP; 98056 2
NEW ADDRESS
7❑ CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES NO✓ INTERLOCKVEs NO✓ YES F NO✓
8 DCIENSE# STATE WA SEXI M MMDDYY' 08 - 25 - 1960 1 2 32
-NJUR
9 ON DUTY STATUS' AIRBAG 3 RESTR 4 EJECT 1 N USEET 2 CLASSY 1 [NATURE of INJURIES 2
LICENSE, CJK1730 STATE WA VIN#; 3KPA24ADIPE573658 3
10 Fq I PI ATP tt
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# ROM To
TRLR TRLR 1 1 5 33
12 3 0 VIN#' vIN#
FROM TO
VEH.YEAR 2023 MAKE KIA MODEL RIO STYLE P4 VEHICLE TOWED[n TO ZBLIN TOWEDBY GOVT VEHICLE 1 $ 34
13 DAMAGE YES II_II NO YESII_I) NO✓
REGISTERED OWNER INFO KEVIN FOSNAUGH 21090 JONES AVE NE RENTON WA 98056 D:2067195695 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
4 LIABILITY INSURANCE INSURANCE CO 2 3 4
14 ViKING INSURANCE 4 70644 98 7
IN EFFECT &POLICY# 4TOP
VEnicLE CHARGE t 5 36
LEcgiL.� YES❑NO❑ CITATION# 7 0 80TTOM
15❑ STANDING 7 e
MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR YES�/ THR NO D:2062256306
16�
LAST NAME TRAN FIRST NAME KIM LOAN MIDDLE V
INITIAL
17F1 STREET ❑
❑ 20230 127TH PL SE CITY' KENT ST, WA ZIP 98031 q 37
NEW ADORE SS
1g❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCKYES No✓ INTERLOCK YES NO✓ YES NO✓
19 DRIVER'S STATE WA SEX F D.OS. 11 27 1978 � 39
LICENSE# MMDDYY —
20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H ET 2 INJ 6Y 1 NATURE OF INJURIES 40
21 LICENSLATE E CSJ8330 TATE WA VIN# WBY43HD04SFU47947 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 202$ MAKE BMW MODEL/4 STYLE p4 VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO✓ VES NO✓
REGISTERED OWNER INFO KIM LOAN TRAN 20230127TH PL SE KENT WA 98031 D:2062256306 VEHICLE NO.2
SHADFY DAGEAREA
LIABILITY INSURANCE INSURANCE CO AMICA 95114625ZM
IN EFFECT &POLICY# 9TOP
vew1— ❑ ,J—I CITATION11 CHARGE t080TTOM
LEGALLY YES N
25 a e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
RAYMOND WATSON 13127 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG45851
COLLISION REPORT III III III III III 111
1591972 CASE# 25-9509
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 INJURY 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 CLASS ----�
: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
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.
RAYMOND WATSON 11-06-25 02:55 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
J.TRADER 4553 1 111612025 3:44:22 PM
BADGE OR ID# 13127 ORI# WA0171300 TIME POLICE DISPATCHED 11:28 Aryl TIME POLICE ARRIVED i 11:32 AM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EG45851 CASE# 25-9509 DATE OF COLLI r�510NN + 11/02/25 11:24
L1
NARRATIVE
25-9509
This report is a summary of events that occurred and is not an exact sequencing of events.
Statements have been paraphrased and summarized.
On 11/02/2025 at approximately 1128 hours, myself, Officer R. Watson, was dispatched to a accident
with no injuries and non-blocking, at 352 Sunset BLVD N, within the City Limits of Renton, County of
King, State of Washington.
Dispatch notes stated that there were two vehicles involved, non-blocking, and that there were no
injuries.
When I arrived on scene, I saw two vehicles in the parking lot of the address with damage.
Unit#1 driven by Kevin D. Fosnaugh (DOB 08/25/1960) verified by WA DOL photo, stated he was
driving a Gray 2023 Kia Rio, WA plate #CJK1730. There were two other passengers in the vehicle,
but they were not identified. Kevin said that he was traveling south bound on Sunset BLVD N, when
he attempted to merge into the left lane and collided with unit#2 who had come out of the Houser
Way Bypass tunnel. He said she was in his blind spot. Kevin and his other occupants all stated they
had no injuries and declined aid. When I asked for Kevin's license, registration and insurance he was
able to provide all documentation. Unit#1 had slight damage to the left front of the vehicle, no airbag
deployment and he was able to drive the vehicle from the scene.
Unit#2 driven by Kim Loan V. Tran (DOB 11/27/1978) verified by WA DOL photo, stated she was
driving a White 2025 BMW 14, WA plate #CSJ8330. There were no other occupants in the vehicle.
Kim Loan said that she came out of the Houser Way Bypass tunnel south bound and unit#1 turned
into her vehicle. Kim Loan said she had no injuries and declined aid. Unit#2 had moderate right side
damage, no airbag deployment and was able to be driven from the scene.
An exchange of information was completed and provided to each party.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer R. Watson #13127 11/06/2025 1453 hours, Renton, King County,
WA.
PAGE 3 OF 4
REPORT NO. EG45851 CASE# 25-9509 DATE AND TIME 11/02/25 11:24
OF COLLISION
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