HomeMy WebLinkAboutBill of Sale & Cost Data.xlsmPROJECT SET-UP/UPDATE FORM
CED Staff Use Only
Project Information
Project Status
Project Contacts
City Contacts
Civil Plan Reviewer
Planner
Construction Inspector
Project Description
Additional Permits:
Project Totals by Discipline
City PW File #
Staff Use Only
PLR-
Project Name:
CED Plan # (LUA):
Project Address:
Parcel #(s):
Street Intersection:
Project Description:
File Status:
Project Phase:
Project Description:
Street Lighting Permit #:
Other Aliases
Erosion/Sediment Control
Water
Sewer
Stormwater
Traffic & Lighting
Roadway
Subtotal of Improvements
Intake Accepted By
Project Name
##-######
Site Address
Parcel Number
Street Intersection
0
0
0
0
0
0
0
CED Permit # (U):
Construction Contacts
Building Permit #:
City Project Numbers
Consulting Engineer
Owner
Contractor
Developer
WTR-
WWP-
SWP-
TRO-
TED-
Project Type:
N/A
N/A
N/A
N/A
N/A
Date:
########
Firm Name
Project Owner
(Water - mains, valves, hydrants)
(Wastewater/Sanitary Sewer mains)
(Surfacewater Improvements)
(Signalization, channelization, lighting)
(Roadway, drainage, offsite improvements)
Return Address:
City Clerk’s Office
City of Renton
1055 South Grady Way
Renton, WA 98057
BILL OF SALE
Please make no mark in the margin space - Reserved for County Auditor's Use Only
By
Its
BILL OF SALE
Page 2
Project File Number: LUA##-######, U########, PLR-
BILL OF SALE
Project File Number: LUA##-######, U########, PLR-
EXHIBIT A
Legal Description
TYPE OF DOCUMENT:
GRANTOR(S):
GRANTEE:
ABBREVIATED LEGAL
DESCRIPTION:
ASSESSOR TAX PARCEL I.D. NUMBERS:
NAME OF PROJECT:
ADDRESS OF PROJECT:
PROJECT FILE NUMBERS:
LEGAL DESCRIPTION:
PERSONAL PROPERTY DESCRIPTION:
Reference Number(s) of Documents assigned or released:
Additional reference #’s on page _____ of document
The Grantor, as named above, for, and in consideration of mutual benefits, hereby grants, bargains, sells and delivers to the Grantee, as named above, the following described personal
property as described in Exhibit B of this document.
By this conveyance, Grantor will warrant and defend the sale hereby made unto the Grantee against all and every person or persons, whomsoever, lawfully claiming or to claim the same.
This conveyance shall bind the heirs, executors, administrators and assigns forever.
IN WITNESS WHEREOF, said Grantor(s) has caused this instrument to be executed this ________ day of _______________________ 20 _____ .
Notary Seal must be within box
Notary Seal must be within box
Notary Seal must be within box
INDIVIDUAL FORM OF ACKNOWLEDGEMENT
STATE OF WASHINGTON
COUNTY OF KING
I certify that I know or have satisfactory evidence that ___________________
__________________________________________ signed this instrument and
acknowledged it to be his/her/their free and volumtary act for the uses and purposes
mentioned in this instrument.
Notary Public in and for the State of Washington
Notary (Print): ___________________________________________________
My appointment expires: __________________________________________
Dated: _________________________________________________________
REPRESENTATIVE FORM OF ACKNOWLEDGEMENT
STATE OF WASHINGTON
COUNTY OF KING
I certify that I know or have satisfactory evidence that ___________________
__________________________________________ signed this instrument, on
oath stated that he/she/they was/were authorized to execute the instrument
and acknowledge it as the ______________________________ and
__________________________ of _______________________ to be free and
voluntary act of such party/parties for the uses and purposes mentioned in the
instrument.
Notary Public in and for the State of Washington
Notary (Print): ___________________________________________________
My appointment expires: __________________________________________
Dated: _________________________________________________________
CORPORATE FORM OF ACKNOWLEDGEMENT
STATE OF WASHINGTON
COUNTY OF KING
On this ____ day of ____________ , 20 _____ , before me personally appeared
_______________________________________________ to me known
to be _____________________________________ of the corporation that
executed the within instrument, and acknowledge the said instrument to be the free
and voluntary act and deed of said corporation, for the uses and purposes therin
mentioned, and each on oath stated that he/she was authorized to execute said
instrument and that the seal affixed is the corporate seal of said corporation.
Notary Public in and for the State of Washington
Notary (Print): ___________________________________________________
My appointment expires: __________________________________________
Dated: _________________________________________________________
Bill of Sale
Project Owner
Additional Project Owner
City of Renton, a Municipal Corporation
Abbreviated Legal
Parcel Number
Project Name
Site Address
LUA##-######, U########, PLR-
See Attached Exhibit A of this Document
See Attached Exhibit B of this Document
By
Its
) SS
)
) SS
)
) SS
)
Return Address:
City Clerk’s Office
City of Renton
1055 South Grady Way
Renton, WA 98057
EXHIBIT "B"
Contributary Assets
PROJECT NAME:
CONSTRUCTION PERMIT NO.
PROJECT FILE NUMBER:
Per the request of the City of Renton the following information is furnished concerning final costs for improvements installed and turned over to the City for the referenced project.
ROADWAY, STREET LIGHTS AND SIGNALS
DESCRIPTION
Curb and Gutter
Sidewalk
Asphalt Concrete Pavement
Monument Case and Cover
Traffic Signs - Complete System
Number of Luminaires and Poles
STORMWATER SYSTEM IMPROVEMENTS
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
STORMWATER FACILITIES
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
WATER SYSTEM IMPROVEMENTS
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
SANITARY SEWER SYSTEM IMPROVEMENTS
QTY
0
0
0
0
0
0
0
0
0
0
0
0
UNIT
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
UNIT
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
UNIT
L.F.
L.F.
L.F.
L.F.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
EA.
UNIT
L.F.
L.F.
L.F.
L.F.
L.F.
L.F.
EA.
EA.
EA.
EA.
EA.
LS
SIZE
8"
12"
15"
18"
24"
30"
36"
48"
60"
72"
8"
12"
15"
18"
24"
30"
36"
42"
48"
6"
8"
12"
15"
18"
24"
30"
36"
48"
54"
60"
72"
6"
8"
12"
15"
18"
24"
30"
36"
48"
54"
60"
72"
6"
8"
12"
15"
18"
24"
30"
36"
48"
54"
60"
72"
6"
8"
12"
15"
18"
24"
30"
36"
48"
54"
60"
72"
48"
48"
48"
54"
60"
72"
96"
ITEM
Detention Pond
Detention Tank
Detention Vault
Infiltration Pond
Infiltration Tank
Infiltration Vault
Infiltration Trenches
Basic Biofiltration Swale
Wet Biofiltration Swale
Wetpond
Wetvault
Sand Filter
Sand Filter Vault
Linear Sand Filter
StormFilter
Rain Garden
Other: 0
Other: 0
Other: 0
Other: 0
Other: 0
Other: 0
Other: 0
Other: 0
Other: 0
Other: 0
Other: 0
Other: 0
Other: 0
Other: 0
Other: 0
SIZE
4"
6"
8"
10"
6"
4"
6"
8"
10"
12"
6"
2"
1"
3"
4"
6"
8" - 10"
SIZE
8"
12"
8"
12"
4"
6"
48"
54"
60"
72"
96"
Project Name
########
##-######
QTY
0
0
0
0
0
0
TYPE
CMP
CMP
CMP
CMP
CMP
CMP
CMP
CMP
CMP
CMP
Concrete
Concrete
Concrete
Concrete
Concrete
Concrete
Concrete
Concrete
Concrete
LCPE
LCPE
LCPE
LCPE
LCPE
LCPE
LCPE
LCPE
LCPE
LCPE
LCPE
LCPE
HDPE
HDPE
HDPE
HDPE
HDPE
HDPE
HDPE
HDPE
HDPE
HDPE
HDPE
HDPE
PPE
PPE
PPE
PPE
PPE
PPE
PPE
PPE
PPE
PPE
PPE
PPE
DI
DI
DI
DI
DI
DI
DI
DI
DI
DI
DI
DI
TYPE 1
TYPE 1L
TYPE 2
TYPE 2
TYPE 2
TYPE 2
TYPE 2
TYPE
DI
DI
DI
DI
DI
TYPE
PVC
PVC
DI
DI
PVC
PVC
Diameter
Diameter
Diameter
Diameter
Diameter
UNIT
L.F.
S.Y.
S.Y.
EA.
L.S.
EA.
DESCRIPTION
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Storm Drainage Pipe
Catch Basin
Catch Basin
Catch Basin
Catch Basin
Catch Basin
Catch Basin
Catch Basin
ITEM
Water Main Pipe and Fittings
Water Main Pipe and Fittings
Water Main Pipe and Fittings
Water Main Pipe and Fittings
Water Main Pipe and Fittings
Gate Valve Assembly
Gate Valve Assembly
Gate Valve Assembly
Gate Valve Assembly
Gate Valve Assembly
Fire Hydrant Assembly
Permanent Blow-Off Assembly
Air Vac Assembly
Air Vac Assembly
Large Water Meter Assembly
Large Water Meter Assembly
Large Water Meter Assembly
Pressure Reducing Valve St
DESCRIPTION
Sewer Main
Sewer Main
Sewer Main
Sewer Main
Side Sewer Laterals
Side Sewer Laterals
Manhole
Manhole
Manhole
Manhole
Manhole
Lift Station
(City Staff Use Only)
City Project Numbers:
WTR -
WWP -
SWP -
TRO -
TED -
Subtotal
Sales Tax
Grand Total Roadway, Street Lights and Signals
Subtotal
Sales Tax
Grand Total Stormwater System Improvements
Subtotal
Sales Tax
Grand Total Stormwater System Improvements
Subtotal
Sales Tax
Grand Total Water System Improvements
Subtotal
Sales Tax
Grand Total Sanitary Sewer System Improvements
N/A
N/A
N/A
N/A
N/A
TOTAL COST
0
0
0
0
0
0
0
0
0
TOTAL COST
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TOTAL COST
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TOTAL COST
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TOTAL COST
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
SW Facilities?
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
COR Water Service?
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
COR Sewer Service?
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
UNIT COST
14.75
39.5
28.7142857142857
250
0
0
UNIT COST
19
29
35
41
56
78
130
190
270
350
42
48
78
48
78
125
150
175
205
60
72
84
96
108
120
132
144
156
168
180
192
42
42
74
106
138
221
276
331
386
441
496
551
84
89
95
100
106
111
119
154
226
332
439
545
61
84
106
129
152
175
198
220
243
266
289
311
1500
1750
2300
2500
2800
6000
14000
UNIT COST
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
UNIT COST
50
56
60
70
80
500
700
800
1000
1200
4000
1800
2000
1500
8000
9000
10000
20000
UNIT COST
105
120
115
130
80
95
6000
6500
7500
8500
14000
0