16-10615143vti:�o� State of Washington UBI
Business Licensing Service 4.a — L)
a PO Box 9034 1
fix ^, oYrs Olympia, WA 98507-9034 Owner name +Gjr
1-800-451-7985
Vehicle Transport/Disposal Addendum
(To apply for an endorsement as 'a Registered Tow Truck Operator, Vehicle Transporter,
Hulk Hauler, Wrecker and/or Motor Vehicle Salvage Processor)
This addendum form may only be submitted as an attachment to the Business License Application.
Licenses requested All applicants
LReg.w Truck Operator (244) ❑ Hulk Hauler (247) ❑ Motor Vehicle Wrecker (250)
Transporter (242) ❑ Motor Vehicle Salvage Processor (254)
ck Operator additional information
1. If you maintain additional secured vehicle storage/impound areas away from this location, please see the instruction
sheet.
2. You must attach all of the following lists and completed documents to this application (see instruction sheet for
d scriptions):
Names & addresses of all employees who serve as tow truck drivers
Proof of Registered Tow Truck Operator liability insurance
Registered Tow Truck Operator bond
Fee schedule
® Washington State Patrol Tow Truck -Business -Operator -Equipment Inspection Report
Vehicle Transporter additional information
The transporter plates/license cannot be used to transport vehicles owned or registered to the licensee or business, unless
you are a tow truck operator. (RCW 46.76.065)
Is your transport business available to the general public? ......................... -- ....... .................. ❑ Yes ❑ No
As a licensed transporter, will you provide towing services for pay?......................................................................... ❑ Yes ❑ No
If you answered "yes" to the previous question, will you also hold a Registered Tow Truck (RTTO) license? ........... ❑ Yes ❑ No
How many sets of Vehicle Transporter license plates do you need? . ($2 per set)
Hulk Hauler, Wrecker, and Motor Vehicle salvage Processor additional information
1. How many sets of plates do you need? (first set is $5 each, additional sets are $2)
Hulk Hauler Wrecker Motor Vehicle Salvage Processor
2. Hulk Hauler, Wrecker, and Motor Vehicle Salvage Processor applicants must attach a completed Personal/Criminal
History Statement.
3. Motor Vehicle Salvage Processor and Wrecker applicants only
You must also complete a State Environmental Policy Act (SEPA) checklist, present it to the local zoning official for review (see
Vehicle Transport/Disposal Certification and Approval), and then attach the completed checklist to this application. A blank checklist is
enclosed.
4. Wrecker applicants only, attach the following completed form (blank form provided)
❑ Bond of Motor Vehicle Wrecker
If you have additional (branch) Motor Vehicle Wrecker business locations in the same county as this business location, please see the
instructions sheet for information about registering the other locations.
All business types EXCEPT Vehicle Transporter complete reverse side ...
BLS-700-183 (6/28/16) Page 1 of 2
5TAI State of Washington uBl
2 Business Licensing Service 60`
PO Box 9034
s -- �n' owner name
Olympia, WA 98507-9034 E
1-800-451-7985O '
Vehicle Transport/Disposal Certification and Approval
(To apply for an endorsement as a Registered Tow Truck Operator,
Hulk Hauler, Wrecker and/or Motor Vehicle Salvage Processor)
This addendum form may only be submitted as an attachment to the Business License Application.
Business site identification Certifications below apply to the following business location
Business firm name Business telephone number
Business physical location addr s Shest oKroule Do not use PO do07 tuber
City r County State Zipgcoyde
6.1 Cl/ o0
Zoning certification
This section must be completed and signed by the local zoning authority before submitting the application to the Business Licensing
Service. Zoning Officer. Check either "yes" or "no" for each option, then sign.
1. Applicant is applying as a Registered Tow Truck Operator................................................................................. X Yes []No
2. Applicant is applying as a Hulk Hauler.......--............................................................................................... ❑ Yes W No
If "yes" is checked for #1 or #2 above, my signature below certifies that this Registered Tow Truck Operator or Hulk Hauler
applicant's place of business is in compliance with all applicable local land use ordinances.
3. Applicant is applying as a Motor Vehicle Wrecker............................................................................................... ❑ Yes ® No
4. Applicant is applying as a Motor Vehicle Salvage Processor............................................................................. ❑ Yes ,K No
If "yes" is checked for:=3 or #4 above, my signature below certifies that the environmental impact from this proposed land use for
a Motor Vehicle Wrecker or Motor Vehicle Salvage Processor business appears insignificant, pursuant to Chapter 43.21 RCW, the
state Environmental Policy, WAC 197-11-305, WAC 197-11-820, and WAC 197-11-800(14)(i). A completed State Environmental
Policy Act (SEPA) checklist must be attached.
iur oral o lal Title of local zoning official Phone number I Date fig
n
Col.ur�ln c a► of t ns- ear 2bv3 r 7
Inspecting Officer approval Hulk Hauler, Wrecker, and/or Motor Vehicle Salvage Processor applicants only
Before submitting your Business License Application, you must arrange for law enforcement to do a site inspection, review your entire
application, and sign this form. Contact the Washington State Patrol or the local Chief of Police (if business is located in a city with a
population of more than 5,000). Out-of-state Hulk Hauler and Motor Vehicle Salvage Processor applicants must contact their local law
enforcement officials. Inspecting Officer. Check either "yes" or "no" for each option, then sign.
1. Applicant is applying as a Hulk Hauler.................................................................................. ❑ Yes ❑ No
2. Applicant is applying as a Motor Vehicle Salvage Processor............................................................................. ❑ Yes ❑ No
If "yes" is checked for #1 or #2 above, my signature below certifies that: this Hulk Hauler or Motor Vehicle Salvage Processor
applicant is located at the address shown in section B above, and has suitable equipment for the safe and lawful transport
of vehicle salvage on the public highways; each vehicle equipped for lifting or transporting vehicles or hulks operated by the
applicant on highways of this state permanently displays, with letters and numerals at least three inches high, the business name,
complete address of place of business, and current business telephone number; and that I assume responsibility for enforcement
of the applicable laws.
3. Applicant is applying as a Motor Vehicle Wrecker... ................... ❑ Yes ❑ No
If "yes" is checked for #3 above, my signature below certifies that: this Motor Vehicle Wrecker applicant is located at the address
shown in section E above, as defined by RCW 46.80.010; each vehicle equipped for lifting or transporting vehicles or hulks
operated by the applicant on highways of this state permanently displays, with letters and numerals at least three inches high, the
business name, complete address of place of business, and current business telephone number; and that I assume responsibility
for enforcement of the applicable laws.
Signature of inspecting officer
Title of inspecting officer I Phone number I Badge number I Date signed
For tax assistance or to request this document in an alternate format, please call 1-800-647-7706. Teletype (TTY) users may use the Washington Relay Service by calling 711.
BLS-700-183 (6/28/16) Page 2 of 2
Instructions for completing the
Vehicle Transport/Disposal Addendum and Certification and Approval
to obtain a license as a Registered Tow Truck Operator, Motor Vehicle Transporter,
Hulk Hauler, Motor Vehicle Wrecker and/or Motor Vehicle Salvage Processor
Application procedure
1. Review the Endorsement and Fee Description Sheets
for general business registrations and vehicle -related
businesses.
2. Select those endorsements that apply to your
business activities at this location. You may apply
for all endorsements and related license plates
necessary for all vehicle business activities occurring
at the same location with a single application, but
each different business location requires a
separate application.
3. Write the names and fees for each endorsement you
require in Section 2 on page one of the Business
License Application.
4. Complete the appropriate sections of the Vehicle
Transport/Disposal Addendum and Vehicle Transport/
Disposal Certification and Approval (if applicable).
5. Submit the completed Business License Application,
Vehicle Transport/Disposal Addendum and Vehicle
Transport/Disposal Certification and Approval (if
applicable), other documentation as described in
these instructions,
and fee payment to:
State of Washington
Business Licensing Service
PO Box 9034
Olympia Washington 98507-9034
For more information, contact:
Phone: (360) 705-6744
FAX: (360) 705-6699
TTY: (360) 705-6718
Complete these sections on
Complete these sec -
the Vehicle
tions on the Vehicle
Transport/Disposal
Transport/Disposal
If you are applying for a license as a:
Addendum Form
Certification and
Approval
A
B
C
D
A
B
C
Registered Tow Truck Operator (RTTO)
X
X
X
X
Vehicle Transporter
X
X
Hulk Hauler
X
X
X
X
X
Motor Vehicle Wrecker
X
X
X
X
X
Motor Vehicle Salvage Processor
X
X
X
X
X
If you wish to register:
For each physical location being registered you must
RTTO Branch Storage Sites
complete a separate application consisting of a Business
and/or
License Application and the combined RTTO/Motor
Motor Vehicle Wrecker Branch Sites
Vehicle Wrecker Branch Addendum form. Instructions for
completing that form are included with it.
For tax assistance or to request this document in an alternate format, please call 1-800-647-7706. Teletype (TTY) users may use the Washington Relay Service by calling 711.
BLS-700-1 BB (10/26/16) Page 1 of 3
Vehicle Transport/Disposal Addendum
Instructions
Below are instructions for completing each section
of the Vehicle TransporVDisposalAddendum form. If you
have questions about completing the form or if you have
questions about any of the endorsement requirements
please contact the Vehicle Services' Dealers Division at
(360) 664-6466.
Section B: Tow Truck Operator additional information
If you operate additional impound areas away
from this place of business, you must register each
location separately by submitting a Business License
Application and a Vehicle Transport/Disposal Branch
Site Addendum for each location. You do not need to
complete the Vehicle Transport/Disposal Addendum
form if you only wish to register for branch site
endorsements.
You must attach the following to the Vehicle
Transport/Disposal Addendum:
• Driver List: The names of all employees who will
serve as tow truck drivers at this location.
• Insurance: Proof that the business carries the
following insurance:
• $100,000 liability for bodily injury or property
damage; and
• $50,000 on -hook or cargo
• $50,000 garage keeper
• Bond: A properly executed Registered Tow Truck
Operator surety bond in the amount of $5,000. Each
separate business location must have its own bond.
The name of the principal on the bond must reflect
exactly both the business owner name (sole proprietor
name, all partners, or the corporate name) and the
business firm name.
All bonds must be signed by the Attorney -in -Fact
for the bonding company, and by the applicant (the
individual, if a sole proprietor; all partners, if a general
or limited liability partnership; or by an authorized
corporate officer or member, if a corporation or
limited liability company). Incorrect bonds delay
endorsement approval. A blank bond form is
provided for you in the application package.
• Fee Schedule: A declaration of the fees you charge
for the various tow truck services. (The form is
provided.)
• Inspection Report: You must arrange to have all
your business facilities and equipment inspected
by the Washington State Patrol before submitting
the application. Attach the completed State Patrol
Inspection Report form. Remember to include $50
with the total application payment for each truck
permit. (The completed inspection is sent to you
by the inspecting officer.)
Section C: Vehicle Transporter additional information
Answer the questions listed on the addendum and
indicate how many sets of Transporter license plates you
will need in your business. Remember to include $3 in
your total payment for each set of plates you request.
Section D: Hulk Hauler, Wrecker and Motor Vehicle
Salvage Processor additional information
1. Indicate how many sets of plates you need for each
business type.
2. All applicants for these endorsements must attach
a Personal/Criminal History Statement. (Remember to
include the correct plate fee with your total application
payment: $5 for the first set of plates of each type, and $2
for each additional set of plates of that same type.)
Note: You must submit a separate application for
other locations doing business as a Hulk Hauler, Motor
Vehicle Salvage Processor, and/or a Branch Site Vehicle
Wrecker, and list the vehicles used for each business
location on each separate application.
Motor Vehicle Salvage Processor and Wrecker
applicants must attach a completed Department of
Ecology checklist for the State Environmental Policy Act
(SEPA) for your business location (the form is provided
with the application). The completed checklist must
be presented to the local zoning official for review and
approval before the application is submitted (see section
B of Certification and Approval).
Wrecker applicants only must also attach the
Wrecker's Bond (form is provided).
The surety bond must be in the amount of $1,000.
The name of the principal on the bond must reflect exactly
both the business owner name (sole proprietor name,
partner name, or the LLC name) and the business firm
name. All bonds must be signed by the Attorney -in -Fact
for the bonding company, and by the individual, if a sole
proprietor; all partners, if a general or limited liability
partnership; or by an authorized corporate officer or
member, if a corporation or limited liability company. An
incorrect bond will delay your endorsement approval.
BLS-700-188 (10/26/16) Page 2 of 3
Vehicle Transport/Disposal Certification and
Approval (RTTO, Hulk Hauler, Wrecker and Motor
Vehicle Salvage Processor only)
Section A: Business site Identification
This section identifies for the officials who will sign the
certifications in sections B and C the business site
for which the Certification and Approval form is being
filed. List your firm name and physical location address.
Section A of the Certification and Approval form must be
completed before you submit the form to local officials for
their certifications.
Section B: Zoning certification (Registered Tow Truck
Operator, Wrecker, Hulk Hauler and/or Motor Vehicle
Salvage Processor applicants)
Note: This section of the form must be completed and
signed by the appropriate official before you submit your
application to the Business Licensing Service.
Registered Tow Truck Operator and Hulk Hauler
applicants must have the place of business certified as
complying with applicable land use ordinances by the
local zoning and/or land use authority before submitting
the application.
Motor Vehicle Wrecker and/or Motor Vehicle
Salvage Processor applicants must have completed the
State Environmental Policy Act (SEPA) checklist from
the Department of Ecology for the local zoning official to
review. The completed checklist must also be submitted to
the Business Licensing Service with the application.
Mark "yes" or "no" for all boxes in section B which
apply to you and have the local zoning official sign the
certification.
Section C: Inspecting Officer approval (Hulk Hauler,
Wrecker and/or Motor Vehicle Salvage Processor
applicants)
Note: If you are applying for any of the
endorsements listed in this section, you must contact
the Washington State Patrol (or the local Chief of
Police if you are located in a city with more than 5,000
people) before you submit your application to the
Business Licensing Service.
You must arrange with the appropriate law
enforcement office for an inspection of your
business site, and have the inspecting officer sign
the certification in section C of the Certification and
Approval.
BLS-700-168 (10/26/16) Page 3 of 3
State of Washington LIN
,: ,t b �'F OS3 — b
d a� Business Licensing Service � '-,;,yr, _
PO Box 9034 l) r �+ Owner name
'q r , Olympia, WA 98507-9034 IN �} ► �,� e'�-U
ems, 4 !
Vehicle Transport/wiiposal Branch Site Addendum
(To register a branch site of a Registered Tow Truck Operator or Motor Vehicle Wrecker)
Instructions for Completing This Form
• This form is only for businesses that are already
licensed or have applied for a principal business
location and are now registering an additional (branch)
site related to that principal location.
• This addendum must accompany a Business License
Application.
• Please print or type, using dark ink.
• For licensing and regulatory questions, call
(360) 664-6466.
Registered tow truck operator branch site
1. Write `Tow Truck Branch Site" in Section 2 on the front
page of the Business License Application form (there
is no fee for this license).
2. Complete Section A on this form, identifying the
principal business location to which the branch site
relates and enter the physical address of the branch.
This section must be completed before you contact
local approving authorities.
3. Have the local zoning office and the Washington State
Patrol complete their portions of Section B of this form.
4. Attach this form to the Business License Application
and submit with the Business License Application fee.
Principal and branch
Motor vehicle wrecker branch site
1. Write "Motor Vehicle Wrecker Branch Site" in Section 2
on the front page of the Business License Application
form (there is no fee for this license).
2. Complete Section A on this form, identifying the
principal business location to which the branch site
relates and enter the physical address of the branch
site. This section must be completed before you
contact local approving authorities.
3. Complete Section C on this form, listing vehicles you
will use at this site which are in addition to any wrecker
vehicles you have already registered. Each vehicle
listed will be issued a set of wrecker license plates.
The fee for license plates is $3 each.
4. Calculate the total amount due for wrecker license
plates and write "Wrecker Plates" and the amount due,
in section 2 , on the front page of the Business License
Application.
5. Complete and attach the State Environmental Policy
Act (SEPA) checklist for review by the local zoning
office.
6. Have the local zoning office and the appropriate law
enforcement official complete their portions of Section
D of this addendum.
7. Attach this form and the SEPA checklist to the
Business License Application and submit with the
appropriate fees.
I
Identification (All applicants)
Principal location: Enter the information for the existing principal location to which the new branch site is
1 connected. The UBI number is a 9-digit number found on the Business License. The Business ID is 3-digit
number that immediately follows the UBI number; the Location ID is 4-digit number that follows the Business ID.
Firm name Unitifed Business Identifier (UBI) Business ID Location ID
i' Th L '- —�,53w `') S -
Physical location address W8eror route (no PO Sox)
City
State Zip code
WA 1 (Aktx
2 1 Branch site: Enter the physical address of the new branch site you wish to register on this application.
Physical location address Street or route (no PO Box)
33 a-s- v�
City Coun State Zip code
&" WA 200
BLS-700-184 (9/2/15) Page 1 of 2
Registered tour truck operator branch site approvals
The approvals certified in this section are for the branch business site identified in Section A on the front of
this form.
Note: Your signature on the Business License Application certifies that this branch site has the same business name
as the principal location, and is covered by the principal location bond and insurance.
You must obtain signatures from the Local Zoning Official and a Washington State Patrol Inspection Officer.
Local Zoning & Land Use Approval
I HEREBY CERTIFY that this Reglter,�d3N perator branch secure storage site is in compliance with all applicable
land use ordinances. 4
Sin utsvaiZ ff-, Title of Zoning Official DgrSi9i1
1� . _ r► .1•n n. 1� _ _ r 1 I I I1 � 7
Washington State Patrol Inspection Approval
I HEREBY CERTIFY that this Registered Tow Truck Operator branch secure storage meets all requirements of RCW 46.55 and
WAC 308-61, and that 1 assume responsibility for enforcement of the applicable laws.
Signature of Inspecting Officer I Title of Inspecting Officer -]--Date Signed
X jl
Motor vehicle wrecker branch site description of vehicles used at the site
Make I Model 1 Year I Vehicle ID number (VIN)
Motor vehicle wrecker branch site Total approvals
The approvals certified in this section are for the branch business site identified in Section A on the front of
this form.
You must obtain a signature from the Local Zoning Official. You must also obtain a signature from the Chief of
Police (if the business is located within the city limits of a city with a population over 5,000) OR the Washington State
Patrol (if the business is located outside city limits, or within a city with a population of less than 5,000)
Local Zoning & Land Use Approval
I certify that I have reviewed the attached State Environmental Policy Act (SEPA) checklist for this Motor Vehicle
Wrecker Branch Site, and the environmental impact from this proposal appears insignificant to RCW 43.21C and
WAC 197-11-305.
Signature of Local Zoning Official
X
Title of Zoning Official
Date Signed
Inspecting Officer Approval
certify that the applicant has a Motor Vehicle Wrecker Branch Site at this address, as defined by RCW 46.80.101:
each vehicle equipped for lifting or transporting vehicles or hulks operated by the applicant on highways of this state
permanently displays, with letters and numerals at least three inches high, the business name, complete address of
the place of business, and current business telephone number; and that I assume responsibility for enforcement of the
applicable laws.
Application requires approval of the Chief of Police if the business address is within the city limits of a city of over
5,000 population. Otherwise, approval of the Washington State Patrol is required.
Signature of Inspecting Officer Title of Inspecting Officer Date Signed
X
For tax assistance or to request this document in an alternate format, please call 1-800-647-7706. Teletype (TTY) users may use the Washington Relay Service by calling 711.
BLS-700-1 e4 (9/2/15) Page 2 of 2
J. i
STATES 01P
4
�:. r I
1
secretary of state
I, HIM WYMAN, Secretary of State of the State of Washington and custodian of its
seal, hereby issue this
CERTIFICATE OF FORMATION
ABT TOWING & RECOVERY LLC
a/an WA Limited Liability Company. Charter documents are effective on the date
indicated below.
Rl�
10
-�1889
Date: 11/28/2016
UBI Number: 604-053-846
Given under my hand and the Seal of the State
of Washington at Olympia, the State Capital
Kim Wyman, Secretary of State
Date Issued: 11/28/2016
REQUEST FOR ADMINISTRATIVE DECISION
DEPARTMENT OF CommuNITY DEVELOPMF NT
CITY OF t DEC �(1 Sri 33325 8`° Avenue South
Federal Way Federal Way, WA 98003-6325
FweR-At. ANY 253-835-2607; Fax 253-835-2609
www.ci affederalwa .cam
FILE NUMBER - ! 0 Date
Applicant
PRIMARY PHONE
NAME,
1��ur fie. . � Z� ob — 6 � — 9 �� y
ALTERNATE PHONE
BUSINESS/ORGANIZATION //��
AAt r 'i,-".". _ _ .� I ite P.., FQr l.s LAC. 9 Z
31
MAILING ADDRESS V
33 ►2 � ��' ��� S
CITY STATE ZIP FAX
1-c j "' DU �
Property Address/Location
Description of Request 's l 1► * Ste- Vb8V
List/Describe Attachments.
For Staff Use
❑ Code interpretation/Clarification
❑ Critical Areas Letter/Analysis/Peer Review
❑ Request for Extension (Land Use/Plat Approval)
❑ Revisions to Approved Permit
❑ Tree Removal
❑ Zoning Compliance Letter
- No Fee
- No Fee (Actual Cost if Applicable)
- Check Current Fee Schedule
- Check Current Fee Schedule
No Fee
- Check Current Fee Schedule
iulletin #079 — January 4, 2016 Page 1 of 1 k:\IIandouts\Request for Administrative Decision
>
State of Washington UBI
. _ r Business Licensing Service } _,:. L)— OS3 J
o PO Box 9034 �L tr V Owner name
Olympia, WA 98507-9034
f -Wr
Vehicle Transpord"Posal Branch Site Addendum
(To register a branch site of a Registered Tow Truck Operator or Motor Vehicle Wrecker)
instructions for Completing This Form
• This form is only for businesses that are already
licensed or have applied for a principal business
location and are now registering an additional (branch)
site related to that principal location.
• This addendum must accompany a Business License
Application.
• Please print or type, using dark ink.
• For licensing and regulatory questions, call
(360) 664-6466.
Registered tow truck operator branch site
1. Write `Tow Truck Branch Site' in Section 2 on the front
page of the Business License Application form (there
is no fee for this license).
2. Complete Section A on this form, identifying the
principal business location to which the branch site
relates and enter the physical address of the branch.
This section must be completed before you contact
local approving authorities.
3. Have the local zoning office and the Washington State
Patrol complete their portions of Section B of this form.
4. Attach this form to the Business License Application
and submit with the Business License Application fee.
Motor vehicle wrecker branch site
1. Write "Motor Vehicle Wrecker Branch Site" in Section 2
on the front page of the Business License Application
form (there is no fee for this license).
2. Complete Section A on this form, identifying the
principal business location to which the branch site
relates and enter the physical address of the branch
site. This section must be completed before you
contact local approving authorities.
3. Complete Section C on this form, listing vehicles you
will use at this site which are in addition to any wrecker
vehicles you have already registered. Each vehicle
listed will be issued a set of wrecker license plates.
The fee for license plates is $3 each.
4. Calculate the total amount due for wrecker license
plates and write "Wrecker Plates" and the amount due,
in section 2 , on the front page of the Business License
Application.
5. Complete and attach the State Environmental Policy
Act (SEPA) checklist for review by the local zoning
office.
6. Have the local zoning office and the appropriate law
enforcement official complete their portions of Section
D of this addendum.
7. Attach this form and the SEPA checklist to the
Business License Application and submit with the
appropriate fees.
Principal and branch location identification (All applicants)
Principal location: Enter the information for the existing principal location to which the new branch site is
1 connected. The UBI number is a 9-digit number found on the Business License. The Business ID is 3-digit
number that immediately follows the UBI number; the Location ID is 4-digit number that follows the Business ID.
Firm name Unitifed Business Identifier (UBI) Business ID Location ID
AW
Physical location address of or route (no PJ BoxJ
City Cau State Zip code
2 1 Branch site: Enter the physical address of the new branch site you wish to register on this application.
Physical location address Street orrgule (no PO Box)
J 1 t� V State Tip code
city Count /p
O .ri ,rn.r� WGh U"Lij L.Uw�,II WA C, 0 V0
BLS-700-184 (9/2115) Page 1 of 2
Registered tow truck operator branch site approvals
The approvals certified in this section are for the branch business site identified in Section A on the front of
this form.
Note: Your signature on the Business License Application certifies that this branch site has the same business name
as the principal location, and is covered by the principal location bond and insurance.
You must obtain signatures from the Local Zoning Official and a Washington State Patrol Inspection Officer.
Local Zoning & Land Use Approval
HEREBY CERTIFY that this Registered Tow Truck Operator branch secure storage site is in compliance with all applicable
land use ordinances_
Washington State Patrol Inspection Approval
I HEREBY CERTIFY that this Registered Tow Truck Operator branch secure storage meets all requirements of RCW 46.55 and
WAC 308-61, and that I assume responsibility for enforcement of the applicable laws.
Signature of Inspecting Officer Title of Inspecting Officer Date Signed
X
Motor vehicle wrecker branch site description of vehicles used at the site
Make Model Year Vehicle ID number'(VIN)
Motor vehicle wrecker branch site local approvals
The approvals certified in this section are for the branch business site identified in Section A on the front of
this form.
You must obtain a signature from the Local Zoning Official. You must also obtain a signature from the Chief of
Police (if the business is located within the city limits of a city with a population over 5,000) OR the Washington State
Patrol (if the business is located outside city limits, or within a city with a population of less than 5,000)
Local Zoning & Land Use Approval
I certify that I have reviewed the attached State Environmental Policy Act (SEPA) checklist for this Motor Vehicle
Wrecker Branch Site, and the environmental impact from this proposal appears insignificant to RCW 43.21 C and
WAC 197-11-305.
Signature of Local Zoning Official
is
i itie or coning uniciai
Date Signed
Inspecting Officer Approval
I certify that the applicant has a Motor Vehicle Wrecker Branch Site at this address, as defined by RCW 46.80.101:
each vehicle equipped for lifting or transporting vehicles or hulks operated by the applicant on highways of this state
Permanently displays, with letters and numerals at least three inches high, the business name, complete address of
the place of business, and current business telephone number; and that I assume responsibility for enforcement of the
applicable laws.
Application requires approval of the Chief of Police if the business address is within the city limits of a city of over
5,000 population. Otherwise, approval of the Washington State Patrol is required.
Signature of Inspecting Officer
X
Title of Inspecting Officer
Date Signed
For tax assistance or to request this document in an alternate format please call 1-800-647-7706. Teletype (TTY) users may use the Washington Relay Service by calling 711.
BLS-700-104 (912/15) Page 2 of 2
STATES QJP
• 5TAr� O'
T of - a wU)a5 n ato n btate
x e
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Secretary of state
I, HIM WYMAN, Secretary of State of the State of Washington and custodian of its
seal, hereby issue this
CERTIFICATE OF FORMATION
ABT TOWING & RECOVERY LLC
a/an WA Limited Liability Company. Charter documents are effective on the date
indicated below.
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Date: 11/28/2016
UBI Number: 604-053-846
Given under my hand and the Seal of the State
of Washington at Olympia, the State Capital
/754';� *AO —
Kim Wyman, Secretary of State
Date Issued: 11/28/2016