HomeMy WebLinkAboutBOS 20170328000258 . �
.
Return Address:
City Clerk's Office
City of Renton
]O55 South Grady Way
Renton,WA 98057
20170328000258
CITY OF RENTON BS 76.00
PAGE-001 OF 004
03/28/2017 10:31
KING COUNTY, WA
BILL OF SALE
I'lease nuzke rto�na�•k ii��the mcrrk�iit sE�acc-Reserved for(.btrnty.�uditor's L�se(7nlv
TYPE OF DOCUMENT: Bill of Sale
GRANTOR(S): Park 09 LLC
GRANTEE: City of Renton,a Municipal Corporation
ABBREVIATED LEGAL
DESCRIPTION: [,oc�atvp LOT 7,BLK 10 OF RENTON FARM PLAT
ASSESSOR TAX PARCEL I.D.NUMBERS: 7224000850&7224000855
NAME OF PROJECT: My Dental Office Building
ADDRESS OF PROJECT: 525 Park Ave N
PROJECT FILE NUMBERS: LUA15-000729,U15007909,PLR-3880
LEGAL DESCRIPTION: See Attached Exhibit A of this Document
PERSONAL PROPERTY DESCRiPTION: See Attached k,xhibit B of this Document
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.
�N WIT'NE WHERE F,said Grantor(s)has caused this instrument to be executed this /s day of
'` 20 t
BY '�s�."�/�`-- By
�
Its �L-7.r•!%v 1/` Its
,
BILL OF SALE
Page 2
Project File Number:LUA15-000729,U15007909,PLR-3880
INDIVIDUAL FORM OFACXNOWLEDGEMENT
Notary Seal must be within box STATE OF WASHINGT�N )SS
``\���\�\\\11����+ COUNTYOFKING �
�.�� gPN�� � ���i� I certify that I know or have satisfactory evidence that \�� �'1'�a�►
_ `��..�����u,�i
_ _`�,M�Ss��ti�������,�� signed this instrument and
� _v0 �OTq�Ff��i�� a�knowledged it to be his/her/their free and volumtary act for the uses and purposes
� � s � � -� m� rr�ntioned in this instrument.
i --1 ' ,p � rn s �
� ��1:� � G@L�G _ � �`
� ��'-"C..�-.L-
��ij���a,,�9��1g`��..'����'Votary Pubhc m and f r he State of WashmgtQn ,
I/'1�1���$��G����_ MY appoPntment ex 5 201d-+r�. �=1.(,/^C.�.f
Dated: � —(.�—��']
REPRESENTATIVE FORM OFACKA�OWLEDGEMENT
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 inshument,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 appoi�tment 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
instnunent and that the seal at�ixed 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:LUA15-000729,U15007909,PLR-3880
EXHIBIT A
Legal Description
LOT 6 AND LOT 7,ALL IN BLOCK 10,RENTON FARM PLAT,AS PER PLAT RECORDED IN VOLUME 10 OF
PLATS,PAGE 97,RECORDS OF KING COUNTY AUDITOR:SITUATE IN THE CITY OF RENTON,COUNTY
OF KING,SATE OF WASHINGTON.
.
(City Stat'f Lse Onlv)
Return Address: CSty R'ojecx Numbers: _
City Clerk's Office �- ��
City of Renton �- �
1055 South Grady Way �- ��
Renton,WA 98057 �- WA
1ID- 3880
EXHIBIT "B"
Contributary Assets
PROJECT NAME: My Dental Office Building
CONSTRUCTION PERMIT NO. 15007909
PROJECT FILE NUMBER: 15-000729
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, STR�T IJGI-{fSAND 9GNAL�
D�P110N Q1Y UNIT TOTALaOST
Sidewalk 26 S.Y. $ 1,027.00
Asphalt Concrete Pavement 148 S Y $ 4,249 7]
�btotal $ 5,276.71
�les Tax $ 501.29
Grand Total Roadway, Street �ghtsand 9gnals $ 5,778.00
STORM WAl�2 SYST�BVI I M PROVBVI B�1T�
Q�' UNIT 9ZE TYPE D�PoP11pN TOTALO�S'T
1 EE1• 48" TYPE 1 Catch Basin $ 1,500.00
�btotal $ 1,500.00
�les Tax $ 142.50
Grand Total �ormwater 9,rstem Improvements $ 1,642.50
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