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HomeMy WebLinkAbout25-80969 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 SASE 25-80969 2 INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 2 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 02 RESERVATION STRUCK z 3 DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# cowsloN 12 - 1-- 2025 0855 17 ❑.= S IN 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ PARK AVE N BLOCK NO. e✓ 400 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e N 4TH ST OF,1 29 MOTOR ✓ PEDAL- DAMAGE THRESHOLD MET PHONE UNITS VEHICLE ❑ CYCLE ❑ YEs �/No D:4255457079 0 1 30 6 LAST NAME LAPERASHVILI FIRSTNAME GIORGI MIDDLE N 1 1 2 31 INITIAL STREET ❑ 4015 NE 7TH CT CITY RENTON ST WA 2jp, 980563800 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO Z/ YES R No�/ 8❑ LDRIVER # STATE WA SEX'M MID -O B 08 - 18 - 1981 1 2 32 9❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES z❑ 3 10❑ P1 ATpS� BFP2007 sTATI WAurN#' 1 HGCR2F1XHA049101 TRAILER STATE TRAILER STATE 11 3 0 PLATE# PLATE# FROM TO TRLR. TRLR. 1 5 33 12 3 0 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 7 34 13 4 2017 HOND ACCOR SD DAMAGE YES NO YES[:] No REGISTERED OWNER INFO IRINA LAPERASHVIL14015 NE7THCT RENTON WA 98056 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 ABILI INSURANCE U INSURANCE CO SAFECO H2483369 4 IN EFFECT &POLICY# TOPVE—LE CHARGE36 LEGALLv Yes❑NO CITATION# <1�3 OTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM NO OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ : OWNFR ❑ YES 1/ NO D:2063000134 a 16 LAST NAME STEWART FIRST NAME ANITA MIDDLE I M INITIAL 17❑ STREET ❑', 2408 NE 13TH ST CITY' RENTON ST WA ZIP 980562796 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38 INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES t l NOF,/ 19 LDIIVER # STATE WA ]SEX IF M .C... 05 _ O6 _ 1962 El 39 HELMET {NJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS' A{RBAG,4 RESTR 4 EJECT '1 USE 2 CLASS 1 ❑ 21❑ LICENSE I CMU8348 TATE WA VIN# 7FARS6H82SE014828 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2025 MAKE HOND MODEL CR-V STYLE SD VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES�/ NO BANKERS TOWING YES NO REGISTERED OWNER INFO ANITA STEWART 2408 NE 13TH ST RENTON WA 98056 VEHICLE NO.2 SHADE IN DAGAAGED AREA 2 4 LIABILITY INSURANCE INSU&PORGY#E CO PROGRESSIVE 45914685IN 1GQVE""LE ❑ ,J� CITATION# CHARGE LEGALLY YES N`L J 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 D.NELSON 12421 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG72207 COLLISION REPORT III III III III III 111 1591972 CASE# 25-80969 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. D.NELSON 12-24-25 08:01 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOSS 1953 1/26/2026 2:36:30 PM BADGE OR ID# 12421 ORI# WA0171300 TIME POLICE DISPATCHED 8:87 AM TIME POLICE ARRIVED]9:03 AM PART B PAGE IT]OF 4� REPORT NO. EG72207 CASE# 25-80969 FC LNaoy L isI©�ON O 12/23/25 08:55 F cu NARRATIVE 25-80969 ACC On 12/23/2025 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 two-vehicle collision that had occurred in the intersection of N 4th St and Park Ave N Renton/King/WA. No injuries were initially reported, and one lane was blocked. I arrived on scene and Officer Chang advised there were no injuries, and both parties declined aid. Both vehicles were blocking one westbound lane of NE 4th St. The driver of the 2017 Honda Accord WA/BFP2007, was identified by his WADL as Giorgi Laperashvili DOB: 8/18/1981. Giorgi advised that he was driving south on Park Ave N in the #2 lane with a green light, as he entered the intersection Unit 2 ran the red light and he struck her. There was damage to the front bumper of the Honda, and it was drivable. Giorgi declined a tow. The driver of the 2025 Honda CRV WA/CMU8348, was identified by her WADL as Anita M Stewart DOB: 5/6/1962. Anita said that she was driving west on N 4th St in the #3 lane, she said that she entered the intersection with a green light and was struck by Unit 1. There was damage to the passenger side mid-section of the Honda. There was side airbag deployment only and Anita did not want medical attention. Bankers Towing was called to remove the Honda from the scene. Neither vehicle had dash cameras, and no independent witnesses were on scene when I arrived. There are no traffic cameras that cover this intersection. I was not able to determine who had the green light to enter the intersection. 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 12/23/2025 Renton WA PAGE 3 OF 4 REPORT NO. EG72207 CASE# 25-80969 DATE AND TIME 12/23/25 08:55 OF COLLISION ,r 4 1 4) Ito S { t 3 r i 4}r } t .. 8"'t t r{ PAGE 4 OF 4