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HomeMy WebLinkAbout15-102709 • Demolition City of Federal Way Community&Econ.Dev.Services Permit #: 15-102709-00-DE 33325 8th Ave S FILE Federal Way, 98003 Inspection Request Line: (253) 835-3050 Ph:(253)835-2607 Fax ecues :(253)835-2609 p q Project Name: FEDERAL WAY BOYS & GIRLS CLUB .3-ct(gG Project Address: 30835 8TH AVE S Parcel Number: 082104 9119 Project Description: Demolition of single family residence. Owner Applicant Contractor BOYS&GIRLS CLUB KING CNTY MARK HENDRICKS BAYLEY CONSTRUCTION 603 STEWART ST#300 BOYS&GIRLS CLUBS OF KING BAYLECG034JC(12/31/15) SEATTLE WA COUNTY/FEDERAL WAY 8005 28TH ST 98101 PO BOX 3134 MERCER ISLAND WA 98040 FEDERAL WAY WA 98063 Additional Permit Information Demolition Valuation 25000.00 PERMIT EXPIRES Saturday, June 3, 2017 Permit Issued on Thursday, June 4, 2015 I hereby certify that the above information is correct and that the construction on the above described property and the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington and the City of Federal Way. 44 /5//Owner or agent: k �.� Date: Il` 4 • THIS CARD IS TO AIN ON-SITE "TM OF 4144*, Construction In ection Record Federal Way INSPECTION REQUE TS: (253) 835-3050 PERMIT#: 15-102709-00-DE Address: 30835 8TH AVE S Project: BOYS & GIRLS CLUB KING CNTY FEDERAL WAY, WA 98003-4701 Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card. ❑ Final-Building(4050) Approved 7 . By4. Date G_ ((- 15 El Rough ElectricalCI Final Electrical Right of Way Approved Approved Approved By Date By Date By Date CITU OF 411111 PERMIT APPLICATION Federal Way _-,gyp 7___ JUN 0 4 2015 PERMIT NUMBER 5 .... ! _ pu TARGET DATE Cm OF FEDERAL WAY CDS SITE ADDRESS SUITE/UNIT# 30P3S RD-r floc= _�. FEOER-AL L :-Ayt L / 78003 PROJECT VALUATION ZONING ASSESSOR' T PARCEL# $ 5; oCI 0 Z 04- Y 9 , TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING 0 MECHANICAL ISIDEMOLITION 0 ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT r 0 E ILA L Li p y G o yS £ 6 i �L-S C L Q PROJECT DESCRIPTION C�t Li jj of.),A/ �/ 0 /Sfr1( LC" 64..r4/i2, h'� /( Detailed description of work to (Aft yi j 70 67C 8137 A vt. -f y�-}i )i-2 6'0 Flo} be included on this permit only q "Y 4!A /Ic n? r , NAME r PRIMARY PHONE PROPERTY OWNER �j i�S q Gl(SLS CIk�,i o ��/NG c0t,✓17. 2SY ""6Gi --�,$o/ I GADDRESSSy- b 7 E-MAIL MH CAJ,)21C f KJ 607 fIt=�..J{ �.-. , .1 OQ PG§lrlV e/ ts+_c ..0 fit. G CITY STATE ZIP SF�i nE kt `y 1 / o . _. NAME e �. .�,�.. �>..m�..,.-�_. a. ...:.�=PHONE_ LIPS ey CO r-Li rittk.cii‘v r) /Lb -CoZ/- 2y,5/ MAILING O ADbREsef CONTRACTOR 100.C.- 6— 2-8 Ty, .f�r� L1�t-M (i) r,, , . y I t Ne CITY STATE y , � U.- ZIP ` r o y,) z 3'/-- 7 7 2. FAX e 14(ea- /1 IA rim {-.. WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# g l LC ' . [r /2, / 71 / i PRIMARY PHONE " 5: .t,4'i--6.S'c / APPLICANTmAnatiG ADDRESS E-mAIL/Nicivil, ii.i c KJ J POI Of-rvC-'1'i/Ntt=. 6IL6 C TY STATE ZIP FAX A . 2si -3-2 - /50 PRIMARY PHONE (The individual to receive and E-MAILTh H Er oR i c rc.1 respond to all correspondence ..5. 4 t .../ * concerning this application) FAX i , NAME � PROJECT FINANCING 0 OWNER-FINANCED Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE (RCW 19.27.095) I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws. I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of such claim), which may be made by arty person, including the undersigned, and filed against the city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of this application. SIGNATURE: /I j % a.. DATE /3 1 / I S'~ PRINT NAME: /14 A R)Z P. H E/ C) Q 1 C K$ R1111Pt;.,A 1(1(1-Tan,lary 1 '11111 Pana 1 of 2 4-VF3anrTn„tc\Pv,-.,,it d,,v-dir at7..., • • AMMER LIS 106 Frontage Rd N Pacific,WA 98047 PO Box 1 150 Sumner,WA 98390 Phone:253-939-4375 Fax:253.939.5720 Date: 5/12/15 To:Bayley Construction From: Rick Estes Ascendent LLC Project Manager Subject:Federal Way Boys& Girls Club,30835 8th AVE S Federal Way 1 certify all asbestos containing materials identified in the hazardous materials survey performed by Argus Pacific dated 12/27/13 have been legally removed from the above addressed structure completely. Rick Estes • ' 4-44444 4- k-,-**'-' *44'44:144A4i-4,-,';-- 0 ARCUS I AV ANNINIONINE 7.z TRAINING-CONSULTING 1 I Regulated Building Materials '-r,-- --;,,-,-:- Assessment Report lvt-=*,-1;--'1::;:30835 -y Boys& Girls8th Club ofSouthg Kin CountyAvenue Federal Way, Washington , A v December 27,2013 * * X0'0 x T X4 i #�T#F� G ORGANIZATIONS WITH - t1 HEALTH i I AND � " SAFETY SOLUTIONS �r '1-1 �y . S Ulf I 0 8 ASBEST©S ,' N©R T H W E S T Asbestos NW Batch#: 30620 Pacific Hwy S.#103,Federal Way,WA 98003 (253)941-4343 PCM Chain of Custody �( Company Name: AS CrAAd _yp _____,_. __ Phone# Address: Fax Project Manager: �-- Date: Email: PM Cell/4:�... 3� Protect Location 3c,...1.6 Q- ?� s TV-LWProject# Cy ((' Number of Samples: Turn Around: Rush Samples: a Sample ID fakM ice Location (L t Y'U Y3" Start Time �,, 3 Fibers/ 7 Sample Type tr) ,l/ E' End Time t, /e,. G3 Fields /tom Pump# ia G Activity e l- Q U E A '1�� Total Time � Fibers/cc ` , Environment C ('rk-- -?�'7r1 red Start Rate Protection 'f Lit. Worker End Rate Z.— Date Decon �, Cert# Total Liters Sampled Sample ID1 C; ;l``�j{ Start Time % 3 Fibers/ �i 4` location �p� Sample Type /� =.cif. �/�Gl(� ?i�r 44'1End Time Fields Pump# �,.� ���1r1 L,\-) I Q v5 Total Time 1 1L Activity "� d Fibers/cc Environment f��F P \ i Alktkt.it ( S Start Rate Protection y'4; { Worker End Rate Date 1 ,p( Cert# Total Liters Sampled %` Decon }� Sample ID 4 I Location !f'1y /� ti. Start Time JC : (-'( Fibers; 2 Sample Type C L End Time 1 i , .3 Fields /DC p .P Pump# r1i;^. (,);i r) hrj. k t'/C7 Lid r Total Time C Fibers/cc Activity ,% Environment(LeGC4A Start Rate ) 4 Protection ('-)%b. 1 ' (L Worker End Rate 1 W Date Decon ( �1 p[- Cert# Total Liters Sampled �' Sample ID Start Time Fibers/ Location Fields Sample Type End Time Pump# Total Time Activity Fibers/cc Environment Start Rate Protection Worker End Rate Date Decon Cert# Total Liters Sampled 61c- Sampled By: �>,e_ yfi . L5_. . r Date - Yl Time Relinquished By: Date: Time. Received By: Date: /a : . Analyzed By: " �. _�. Date: }'z • • . . NORTHW ASBESTEOST ,/' S Asbestos Northwest. LLC Asbestos NW Batch#: 201510568 30620 Pacific Hwy S. J4103, Federal Way, WA 98003 Phone-4 253.941.4343 Fax# 253.941.4175 Attn: Rick Estes Date Analyzed: 5/8/2015 Ascendent Inc Samples Analyzed: 3 106 Frontage Rd N. Pacific, WA 98047 Project Location: 30835 8th Ave Federal Way, WA Project # Boys and Girls Club Sample ID 1 Start Time 7:30 Fibers/ 71/100 Location Throughout house and basement Fields Client ID B&G#16 End Time 10:00 Sample Type PN Total Time 150 Activity Remove ACM Wiring Fibers/cc 0.1161 Pump 002 Start Rate 2 Environment DampWorker Sam Ortiz End Rate 2 Date Sam led 5-8:2015 Protection 1/2 Mask Cert it Total Liters 300 p Sample ID 2 Start Time 7:34 Fibers/ Location Outside Decon Clean RoomFields 3/100 Client ID B&G#17 End Time 9:45 Sample Type OW Total Time 1 Activity Remove ACM Wiring — Fibers/cc < 0.0021 Pump 006 Start Rate 10 Environment Clean Worker End Rate 10 Date 5;8/2015 Protection 1/2 Mask Cert# Total Liters 1310 Sampled Sample ID 3 Start Time 10:00 Fibers/ Location BasementFields 2/100 Client ID B&G#18 End Time 11:30 Sample Type C1, Total Time 90 =activity Remove ACM Wiring Fibers/cc < 0.0021 Pump 006 Start Rate 14 Environment Clean Worker End Rate 14 Date 5`8/2015 Protection 1/2 Mask Cert ti Total Liters 1260 Sampled Sampled By: Dennis StaplesDate: 5/8/2015 Analyzed By:4110• Date: 5/8/2015 1 Pag- of 1 • • pscteana r.org Puget Sound Clean Air Agency Notification Case #: 201501174 This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available for inspection at all times at the asbestos project or demolition site (Reg III, 4.03(a)(6)). Fee Amount Paid $275.00 Credit Card Transaction # ATOFCFD05784 Transaction Date 03/26/15 Owner's Name Boys and Girls Club Phone (206) 621-8884 Project Street Address 30835 8th ave s City Federal Way Zip 98003 Contact Person Wade Meyer Phone (206) 621-8884 Mailing Address This project includes asbestos removal. Project Size linear feet / 800 square feet Project Start Date 04/05/15 Completion Date 05/30/15 Asbestos will be removed by a licensed asbestos abatement contractor Contractor ascendent Ilc Contractor Job # Contact rick estes Phone (253) 939-437! Mailing Address po box 1150 sumner, WA 98390 This project includes a demolition. Demolition Start Date 04/09/15 Completion Date 05/30/15 Demolition will be completed by a demolition contractor Demo Contractor ascendent Ilc Contractor Job # Contact rick estes Phone (253) 939-431 Mailing Address po box 1150 sumner, WA 98390 (1) I certify that the information I have provided is to the best of my knowledge true and accurate. (2) I understand that I must file an Amendment to this Notification if: • The type of project has changed. The project types are asbestos and demolition. • The quantity of friable asbestos to be removed meets a larger project category. • The project's start or completion date has changed. (3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Create Another Notification View History Loa Out If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. • • • Dept. of Labor & Industries, Division of Occupational Safety & Health Asbestos Project Notification Form Form ID: 98222##1499Ascen091130 Notice Date: 3/26/2015 Start Date: 4/5/2015 Completion Date: 5/30/2015 Status: Initial On Hold Site Work Hours: 700am - 330pm Site Work Days: Monday Tuesday Wednesday Thursday Friday Contractor: Ascendent LLC Job Site C.A.S.: Julio Ruiz Your email address: restes@ascendentdemo.com Contractor Phone Number: 253-273-3153 Property Owner Name: Owner's Agent: Wade Meyer Company: Federal way boys&girls club Address: 30835 8th ave s City: Federal Way State: wa Zip+4: 98003 Phone: 206-621-8884 Job Site Address: 30835 8th ave s Building Name: Abandoned house Room: all City: Federal Way Zip +4: 98003 County: King Facility Type: Age: 1950 Size: 1100 Type of activity: Demolition Quantity of Asbestos to Be Removed Indoors Quantity: 985 square feet Popcorn ceiling VAT Other:WALL TEXTURE Quantity: linear feet i Other:ROOF PEN MASTIC, DUCT SEALANT, EXTERIOR WINDOWS, Control Measures Neg. pres. enclosure Wet methods HEPA vacuum Critical barriers Manual methods Respiratory Protection 1/2 mask APR Type C pressure demand Comments: Date/Time Submitted 3/26/2015 11:26:29 AM • • . DEPARTMENT OF COMMUNITY DE\'1 i OemENTSeKvici:s Aiiimin. .4A„ 33325 5"'Avonue South Federal Way.WA 95UO3-6325 CITY OF 253-8.15-2(107;Fax 253-835-2609 Federal Way www.c11Yf1:10efulway.Conl -1,0S). BAS S. DEMOLITION PERMIT REQUIREMENTS A demolition permit is required co remove any structure or structures on a subject property.Check with the City's Planning Division to see if the proposal exceeds thresholds that trigger an environmental review, An environmental review and submittal of an environmental checklist may be required, which will extend the time period before a demolition permit can be issued. 0 Prior to submitting a demolition permit,the following items(as applicable)must be signed by the respective agency(see Demolition Permit Contact List). NOTE iv APPLICANT; Utilities shall he discunnecied and services perjnrrrted,if applicuble,prior to issuance of dee demolition permit.All applicable hems below we to be gt,nrd anti dare(by the respective agency represetttutivea'. 1.ASBESTOS ABATEMENT 6. E RICM , // (Copy of approval form and asbestos survey from Puget Sound Clean Air ( ity . b% h o an r-• , ) /// Agency provided) �- fJ-/ I (Puget Sound Energy) l� (CCiity Federal +edWay 'ud ng Ica) 2.GAS SUPPLY 7.FUEL STORAGE TANKS >V 3-> rel S (Gas to be shut off,me Pr moved and final bill paid) (Above or below grade fuel tanks, have been pumped or removed ` ice off, under Fire DepaRn^ent permit prior to any dis antle/Excavation) Puget Sound Energy) .S KyC2 /7/f).�i ya,�-f 4/1/-t> .r.r re c ,f rr r ouch yang Flre.and F stye) T(ir f e t"...�. (� �.' r) /4_4_,.? 4,r'_' iz,i r. •mac bl ) /'r c o�-c,J,' 4',....�,j' - , (. j . ,�P - 3.SEPTIC SYSTEM 8.WATER-Public Source (Check applicable box) �j� /,c (Tank to be removed or tank to be drained and filled) ��Meter to be removed and final utility bill paid �� ,-- t.tll//�� r:::Meter to remain and be protected (King County Environmental Services) (Water Supplier) **'.***OR **..** 4.SANITARY SEWER (Check applicable box) 9.WATER-Private Well (Check applicable box) a Sewer line capped at property line r Private well filled and capped c Existing sewer line to remain and be used by proposed new structure ;:i Private well to be Used for other purposes (talcehaven utility District) King County Environmental Services) 5.GARBAGE (All household garbage disposed off and final bill paid) (Waste Management/Other Company) ❑ Completed Construction Permit Application form ❑Provide the following fees: 1. Demolition Permit Fee Based on valuation,See table on pg 4 iff the construction permit application. 2.Automation Fee $6.00 3. WA State Surcharge $4.50 Bulletin 4122-luuuury I.2011 Nage 1 of 1 k.\tlanUuuts\Demolition Permit Reguiren ants • • . DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES 33325 8th Avenue South Federal Way,WA 98003-6325 CITY OF v' = 253-835-2607;Fax 253-835-2609 Fe ci e ra l W Y www.cityoffederalway.com DEMOLITION PERMIT REQUIREMENTS A demolition permit is required to remove any structure or structures on a subject property. Check with the City's Planning Division to see if the proposal exceeds thresholds that trigger an environmental review. An environmental review and submittal of an environmental checklist may be required, which will extend the time period before a demolition permit can be issued. ❑ Prior to submitting a demolition permit,the following items(as applicable)must be signed by the respective agency(see Demolition Permit Contact List). NOTE TO APPLICANT: Utilities shall be disconnected and services performed, if applicable,prior to issuance of the demolition permit.All applicable items below are to be signed and dated by the respective agency representatives. 1.ASBESTOS ABATEMENT 6. ELECTRICITY (Copy of approval form and asbestos survey from Puget Sound Clean Air (Electricity to be shut off and meter removed) Agency provided) (Puget Sound Energy) • (City of Federal Way Building Official) 2.GAS SUPPLY 7. FUEL STORAGE TANKS (G s to be shut off, meter removed and final bill paid) (Above or below grade fuel tanks, have been pumped or removed ' / 0 8 s g G S790 under Fire Department permit prior to any dismantle/excavation) (Puget Sound Energy) (South King Fire and Rescue) 3.SEPTIC SYSTEM 8.WATER- Public Source (Check applicable box) (Tank to be removed or tank to be drained and filled) o Meter to be removed and final utility bill paid o Meter to remain and be protected (King County Environmental Services) (Water Supplier) ******OR****** 4.SANITARY SEWER (Check applicable box) 9.WATER- Private Well(Check applicable box) o Sewer line capped at property line n Private well filled and capped o Existing sewer line to remain and be used by proposed new structure o Private well to be used for other purposes (Lakehaven Utility District) (King County Environmental Services) 5.GARBAGE (All household gar a d' sed off and finalfit)t bill paid) , J v1,t.1 R — l+ry eF fN+ (Waste Management/Other Company) ❑ Completed Construction Permit Application form ❑ Provide the following fees: 1.Demolition Permit Fee Based on valuation.See table on pg 4 of the construction permit application. 2.Automation Fee $6.00 3. WA State Surcharge $4.50 Bulletin#122—January 1,2011 Page 1 of 1 k:\Handouts\Demolition Permit Requirements w 4111 DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES k 33 325 8th Avenue South Federal CITY OF r Way,l� a 98003-6325 253-835-2607;Fax 253-835-2609 Federal Way tV N1,.Gtvof)ederalwm.com DEMOLITION PERMIT REQUIREMENTS A demolition permit is required to remove any structure or structures on a subject property.Check with the City's Planning Division to see if the proposal exceeds thresholds that trigger an environmental review. An environmental review and submittal of an environmental checklist may be required. which will extend the time period before a demolition permit can be issued. ❑ Prior to submitting a demolition permit,the following items(as applicable)must be signed by the respective agency(see Demolition Permit Contact List). NOTE To.4PPLICA:vT: Utilities shall be disconnected and services performed,if applicable,prior to issuance of the demolition permit.All applicable items below are to be signed and dated by the respective agency representatives. 1.ASBESTOS ABATEMENT 6. ELECTRICITY (Copy of approval form and asbestos survey from Puget Sound Clean Air (Electricity to be shut off and meter removed) Agency provided) (City of Federal Way Building Official) (Puget Sound Energy) 2.GAS SUPPLY 7.FUEL STORAGE TANKS ?j c4 $.> W r!t (Gas to be shut off, meter removed and final bill paid) (Above or below grade fuel tanks, have been pumped or removed under Fire Depart ent permit prior to any dis antle/excavation) C dp (Puget Sound Energy) 5/ y1©-F- fr 4 ,th, (H /( yI. r [� i flouts�tng Fire and R scye) .._4: . ) irke- --111;,.i..A,7.1.i_saivh 3.SEPTIC SYSTEM 8.WATER-Public Source (Check applicable box) (Tank to be removed or tank to be drained and filled) Meter to be removed and final utility bill paidi deter to remain and be protected _,X___Zddial,,---1 ) tAxig,ii . (King County Environmental Services) Wa ffiCIUCA (Nlater Supplier) ****** OR****** 4.SANITARY SEWER (Check applicable box) 9.WATER-Private Well (Check applicable box) ) Sewer line capped at property line Private well filled and capped Existin sewer line to remain and be used by proposed new structure Private well to be used for other purposes (Lakehaven Utility District) (King County Environmental Services) 5.GARBAGE (All household garbage disposed off and final bill paid) (Waste Management/Other Company) 0 Completed Construction Permit Application form 0 Provide the following fees: 1. Demolition Permit Fee Based on valuation.See table on pg 4 of the construction permit application. 2.Automation Fee $6.00 3. %VA State Surcharge $4.50 Bulletin#122-January 1,2011 Page 1 of 1 k:Uiandout;\Demolition Permit Requirements • • • DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES 33325 8th Avenue South Federal Way,WA 98003-6325 CITY OF 253-835-2607;Fax 253-835-2609 Federal Way wwwcityoffederalway.com DEMOLITION PERMIT REQUIREMENTS A demolition permit is required to remove any structure or structures on a subject property. Check with the City's Planning Division to see if the proposal exceeds thresholds that trigger an environmental review. An environmental review and submittal of an environmental checklist may be required, which will extend the time period before a demolition permit can be issued. 0 Prior to submitting a demolition permit,the following items(as applicable) must be signed by the respective agency (see attached Demolition Permit Contact List). NOTE TO APPLICANT: Utilities shall be disconnected and services performed, if applicable,prior to issuance of the demolition permit.All applicable items below are to be signed and dated by the respective agency representatives. 1.ASBESTOS ABATEMENT 6. ELECTRICITY (Copy of approval form and asbestos survey from Puget Sound Clean Air (Electricity to be shut off and meter removed) Agency provided) (Puget Sound Energy) (City of Federal Way Building Official) 2. GAS SUPPLY 7. FUEL STORAGE TANKS (Gas to be shut off, meter removed and final bill paid) (Above or below grade fuel tanks, have been pumped or removed under Fire Department permit prior to any dismantle/excavation) (Puget Sound Energy) q1-( IovrOl (South King Fire and Rescue) 3. SEPTIC SYSTEM 8.WATER- Public Source (Check applicable box) (Tank to be removed or tank to be drained and filled) o Meter to be removed and final utility bill paid eter rem ' and be protected 7//1-- King County Environmental Services) (Waterier Supp( } ******OR****** 4.SANITARY SEWER (Check applicable box) 9.WATER- Private WellCheck applicable box) PP ❑Sewer line capped at property line ❑Private well filled and capped ❑Existing sewer line to remain and be used by proposed new structure o Private well to be used for other purposes (Lakehaven Utility District) (King County Environmental Services) 5.GARBAGE (All household garbage disposed off and final bill paid) (Waste Management/Other Company) 0 Completed Construction Permit Application form 0 Provide the following fees: 1.Demolition Permit Fee Based on valuation.See table on pg 4 of the construction permit application. 2.Automation Fee $6.00 3. WA State Surcharge $4.50 Bulletin#122—January 1,2011 Page 1 of 1 k:\Handouts\Demolition Permit Requirements