HomeMy WebLinkAboutSouthport Office_Bill of Sale & Cost Data_to be signed.pdfTYPE OF DOCUMENT:
GRANTOR(S):
GRANTEE:
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
By By
Its Its
See Attached 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 _____ .
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
Bill of Sale
Office at Southport, LLC
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.
City of Renton, a Municipal Corporation
ABBREVIATED LEGAL
DESCRIPTION:
" New Lot B" City of Renton lot lin adjustment no. LUA14-001514 (Southport
lot line adjustment) Recording No. 20141223900010 (Being a portion of SW
qtr str 05-23-05 and of nw qtr nw qtrstr 08-23-05)
ASSESSOR TAX PARCEL I.D. NUMBERS: 082305-9216
Southport Office
1083 Lake Washington Blvd N
U15005273, PLR-3837
See Attached Exhibit A of this Document
Page 1 of 4
INDIVIDUAL FORM OF ACKNOWLEDGEMENT
Notary Seal must be within box STATE OF WASHINGTON ) SS
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
Notary Seal must be within box STATE OF WASHINGTON ) SS
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
Notary Seal must be within box STATE OF WASHINGTON ) SS
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 File Number: U15005273, PLR-3837
Page 2 of 4
" New Lot B" City of Renton lot lin adjustment no. LUA14-001514 (Southport lot line adjustment) Recording No.
20141223900010 (Being a portion of SW qtr str 05-23-05 and of nw qtr nw qtrstr 08-23-05)
BILL OF SALE
EXHIBIT A
Legal Description
Project File Number: U15005273, PLR-3837
Page 3 of 4
WTR - 3837
WWP - 3837
SWP - 3837
TRO - N/A
TED - 3837
PROJECT NAME:
CONSTRUCTION PERMIT NO.
PROJECT FILE NUMBER:
Page 3
WATER SYSTEM IMPROVEMENTS
QTY UNIT SIZE TYPE TOTAL COST
70 L.F.6"DI Water Main Pipe and Fittings 3,920.00$
3 EA.6"Fire Hydrant Assembly 12,000.00$
1 EA.6"Large Water Meter Assembly 10,000.00$
Subtotal 25,920.00$
Sales Tax 2,592.00$
Grand Total Water System Improvements 28,512.00$
SANITARY SEWER SYSTEM IMPROVEMENTS
QTY UNIT SIZE TYPE TOTAL COST
359 L.F.12"C900 Sewer Main 64,620.00$
4 EA.48"Diameter Manhole 24,000.00$
Subtotal 88,620.00$
Sales Tax 8,862.00$
Grand Total Sanitary Sewer System Improvements 97,482.00$
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.
ITEM
DESCRIPTION
(City Staff Use Only)
EXHIBIT "B"
Contributary Assets
City Project Numbers:
Southport Office
U15005273
0
Return Address:
City Clerk’s Office
City of Renton
1055 South Grady Way
Renton, WA 98057
Page 4 of 4