22-105009City of Federal Way
Community Development DepL
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: BELMOR MHP SPACE 174
Project Address: 2101 S 324TH ST
Project Description: Onsite demolition of manufactured home
Demolition
Permit #:22-105009-00-DE
Inspection Request Line: (253) 835-3050
Parcel Number: 162104 9037
Owner
Applicant
Contractor
BELMOR MOBILE HOME PARK LP
BRE ICEAMERICAN ABATEMENT &
AMERICAN ABATEMENT & DEMO
2101 S 324TH ST
DEMO
AMERIAD833CF (2/7/23)
FEDERAL WAY WA 98003
2 AUBURN WAY
2 AUBURN WAY
AUBURN WA 98002
AUBURN WA 98002
ft
Additional Permit Inforr AWn
PERMIT EX E nday, 30 An
Permit Issued esdav, Novembe 2
1 hereby certify that the above iIrLE
rrrect and that the constr tion on the above described property
and the occupancy and the e accordance with laws, rules and regulations of the State of
City oflral Way.
L
Owner or agent: Date:
_11;k
CITY OF
Federal Way
PERMIT #: 22 105009 00
THIS CARD IS TO REMAIN ON -SITE
Construction Inspection Record
INSPECTION REQUESTS- (253) 835-3050
Address: 2101 S 324TH ST Space 174
Project: BELMOR MOBILE HOME PARK LP FEDERAL WAY WA 98003
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.
❑
SWM Precon Site Mtg (4400)
Q
Site Assessment (Erosion) (4365)
Interim Erosion Control (4370)
Approved
To be done PRIOR to breaking ground
Approved
By
Date
By
Date
By
Date
❑ Final Erosion Control (4375) 0 Final - Building (4050)
Approved Approved
By Date By Date
❑
Rough Electrical
❑
Final Electrical
❑
Right of Way
Approved
Approved
Approved
By
Date
By
Date
13y
Date
a
RECEIVED
OCT 2 7 2022
COMMUN"DEV LELE OPMEKT PERMIT APPLIGATION
[ITV OF
�� PERMIT CENTER + 33325 8-^ Avcntic South + Fcdcral Way, WA 98003-6325
Fe 253-835.2607 + FAX 253-835-2609 + pernliteenier(t�cityoffcclei'altyay com
PERMIT NUMBER — q
l TARGET DATE
): x :12U2t
SITE ADDRESS SUITE/UNIT s
1 2101 S314ihsi I 174
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL
1A00000 9037 I 6 2 1 Q_ 4 - 9 0_ ...3_ i
TYPE OF PERMIT ❑ BUILDING ❑ P1.UMOING ❑ MECIIANICAL DO DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT 1 13ehnort'IobilcFlomcPark #174
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
CONTRACTOR
APPLICANT
PROJECT CONTACT
(Tile indiuidual to receive and
respond to all correspondence
Concerning this applicationj
PROJECT FINANCING
When value is 35,000 or ntore
(RCIV 19.27095)
Onsitc dcmolitiou of manufaclurcd Lome
NA14E
PRIMARY PHONE
51aro Nnnhi—i LP
1SI./)1-1517
MAILING ADDRESS
EMAIL
1101 S sllih Si
nnb91o1LPhl ncmrl.eum
CITY
STATE
ZIP
Frderal Wa±
51•q
9A110!
NAME
PHONE
Ammcan Abirmeni and nenio
I)! 919 A710
MAILING ADDRESS
EMAIL
` 1 Aubum 1V11 N Sir 101
nlliupn.l•w com
CITY
f
STATE
ZIP
FAX
Auburn
11.1
9100,
',1 919 0619
WA STATE CONTRACTOR'S LICENSE I
EXPIRATION DATE
UBI t
A\IFRIAPA)3CF
01 a7 1013
Aol•n-.PA;
NAME
PRIMARY PHONE
Ore Ice/ AmcticAn Abalemeni and Ormo
153.919 A71P
MAILING ADDRESS
EMAIL
1 Auburn 1Va) N Sir 101
ufliuRr. J.vr com
CITY
STATE
ZIP
FAX
,5uburn
%VA
9300'
191 919 361;
NAME
PRIMARY PHONE
Srr let
153.919•9730
MAILING ADDRESS
EMAIL
I Aubun, 1V3y?I Sit 101
oriic,v,,j --
CITY
STATE
ZIP
FAX
Auharn
%VA
990o1
151919d615
NAME
51nm Nonharn 11'
0 OWNER -FINANCED
MAAIIG ADDRESS, CITY, STATE, ZIP
r1toH�
21015 )14tb SI 14drrat 1Vay, WA 911003
2i;-B18-2517
I cereM 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 ownces responsibility for compliance with local, state, or jederal laws regulating
construction or environmental laws.
I further agree to hotel harmless the City of Federal Way as to any claim (Including costs, expenses, and attorneys' fees Incurred In
the Investigation and defenst of such claim; which may be made by any person. Including the undersigned, and-Rled against the city,
but only where such claim arises out of the reliance of the citg, including Its ofj4ecra and employees, upon the accuracy of the
Informallan supplied to the city( as a part of r1iIs applicattom
SIGNATURE. LL l« _ DATE]
PRINT NAME
Bul Imin # 100 — Pebnlary 19, 2020
page 1 of 2
01 lanilauls\11crniii Application
4k
CITY OF
Federal Way
CUlllitINIT)' DEVELUPIIEN-I' DEP:\I011ENT
33325 Sl Avenuc South
Federal Way. WA 98003
253-835-2607:Fax 253-835-2609
% k IV %V Lit.bficdcral+tia�.com
DEMOLITION PERMIT REQUIREMENTS
A demolition permit is required to remove any structure on a subject property. Demolition of separate
structures may require separate permits.
❑ Address of Demolition: 2101 S 324th St Unit #174 Federal W2L WA
98003
❑ Prior to submitting a demolition permit, the following items must be signed by the respective
agency or their approvals attached. Items not applicable to your project should be marked N/A.
❑ A completedConstruct/on Perm/tApp//cat/on form is also required.
1. ASBESTOS ABATEMENT
(Provide copy of Nobte of Intent from Puget Sound Clean Air Agency
and copy of inspection report by AHERA-certified inspector)
PSCAA NoWicatior v202207 136
of Federal Way Building Official)
2. FUEL STORAGE TANKS
o Under grade tank(s) is/are present
o Above grade tank(s) are present
oTank(s) has been pumped or removed under South King Fire & Rescue
permit prior to any dismantling or excavation
NIA
(South King Fire and Rescue)
3. SEPTIC SYSTEM DECOMISSIONING
NIA
(King County Environmental Services)
4. SANITARY SEWER
NA
(Lakehaven Water & Sewer District)
5. ELECTRICITY
NA
(Puget Sound Energy/Tacoma power)
6. NATURAL GAS
(Puget Sound Energy)
7. WATER - Public Source
NA
(Lakehaven Water & Sewer District)
8. WATER - Private Well
(King County Environmental Services)
❑ Please Note: Erosion control measures must be in place d ring the demolition and through
completion of the site clean-up. .
AFplirant}
Bulletin 0122 —April 8.2021 1108c 1 01' 1 k:H landoutslDemohuon Permit Requirements
0")i
CC
,,'
wars SOUND
Clean Air Agency
Notification Case *: 202205136
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 $65.00
Credit Card Transaction # A10AAA34D285
Transaction Date
10/25/22
Owners Name
Metro Northwest Phone (253) 838-0517
Project Street Address
2101 S 324TH ST Unit #174
City
Federal Way Zip 98003
Contact Person
Aaron Borrero Phone (425) 698-7925
Mailing Address
This project Includes a demolition.
Demolition Start Date 11/14/22 Completion Date 11/21/22
Demolition will be completed by a demolition contractor
Demo Contractor American Abatement and Demo Contractor Job #
Contact Aaron Borrero Phone (253) 929-8730
Mailing Address 2 Auburn Way N, Suite 101
Auburn, WA 98002
(1) 1 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 projects 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.
If you have questions, contact us at asbestos@pscieanair.gov or 206.689.4058.
AMERICAN
■ ABATEMENT &DEMO
CERTIFIED ASBESTOS RISK ASSESSMENT AND TESTING
PROJECT NAME: BELLMORE PARK UNIT 1174
PROJECT LOCATION:2101 S. 324T" ST FEDERAL WAY. WA
DATE SAMPLED: Monday, October 17, 2022
Dear Tyler flint
American Abatement and Demo LLC appreciates the opportunity to be of service to you.
If you have any questions regarding this report, please contact Aaron Borrero, AHERA Building
Inspector, at 425-698-7925.
AARON BORRERO
AHERA BUILDING INSPECTOR
CERTIFICATION NUMBER 182411 EXP. 9/10/2022
AMERICAN
� ABATEMENT &DEMO
DEMOLITION ASBESTOS SURVEY
On October 17, 2022, AHERA Building Inspector Aaron Borrero, ofAmerican Abatement and
Demo LLC, conducted a Good Faith Demolition inspection for suspected asbestos -containing
materials, at the Bellmore Park 2101 South 324 h St Unit#174 Federal Way, WA, at the request
of Tyler Flint with Bellmore Park. Accessible areas were visited, and samples were taken of
building materials suspected to contain asbestos or lead. The asbestos samples were taken to
Asbestos Northwest to be analyzed. Lead samples were taken to NVL Labs to be analyzed.
The building in question was tested at 2101 South 324th St Unit#174 Federal Way, WA by
AHERA Building Inspector, Aaron Borrero. The building in question was in good condition and
structurally sound. Out of the 6 asbestos samples taken only 4 came back positive for asbestos.
The window caulking on windows around the unit came back positive for asbestos (samples 174-
3 and 174-4. approximately 150 linear feet chrysotile 5%).The roofing had silver seal that tested
positive (3% chrysotile) and was a double roof (samples] 74-1 and 174-2 1,200 SQ FT). These
items will have to be abated prior to demolition of structure.
PROCEDURES FOR ASBESTOS PROJECTS
It shall be unlawful for any person to cause or allow any work on an asbestos project unless it is
performed by persons trained and certified, in accordance with the standards established by the
Washington State Departemnt of Labor and Industries, the Federal Occupational Safety & Health
Administration (OSHA), or the United States Environmental Protection Agency (EPA)
(whichever agency has jurisdiction) and whose certification is current.
The certification requirment does not apply to asbestos projects conducted in an owner -occupied,
single family residence performed by the resident owner of the dwelling.
W
AMERICAN
• ' ■ ABATEMENT &DEMO
AHERA (Asbestos Hazard Emergency Response Act) regulation requires this inspection to
include the indentification of Friable and Non -Friable ACM in:
• Surfacing Materials,
• Thermal Systems Insulation, and
• Miscellaneous Materials: to delineate homogenous areas and to sample or "Presume' all
materials locations.
The number of samples required is specified in the AHERA Rue (40 CFR 763.86) as follows:
Surfacing Materials ISM):
• 3 samples per homogeneous area of less than 1000 sq. feet,
s 5 samples for greater than 1000 but less than 5000 sq. feet,
• 7 samples for greather than 5000 sq. feet
Thermal System Insulation (TSI):
• 3 samples from each homogeneous area that is not "Assumed" to be asbestos,
■ 1 sample per each patched area, and as determined by the inspector for tees, elbows, or
valves.
Suspected asbestos -containing materials within the structure were identified and classified as a
surfacing material, Thermal System Insulation (TSn, or miscellaneous materials. Surfacing
materials are those which are either spray applied or troweled -on for acoustical, decorative, or
fireproofing purposes. TSI is insulation used to inhibit heat transfer or to prevent condensation on
pipes, boilers, tanks, ducts and various other components. Miscellaneous materials include all other
materials not included in the above categories such as floor tile, roofing felt, cementitous materials,
wallboard systems and products such as caulking, mastics, and putties.
W
(_'1111,
AMERICAN
� ABATEMENT &DEMO
Field inspection, data collection, and report generations were performed according to the
following Scope of Work:
The survey was intended to identify possible asbestos -containing materials (ACM) on the
interior and exterior of the building. The inspection covered only those areas, which were
exposed and/or physically accessible to the inspector. Materials uncovered during the course of
demolition, renovation, or maintenance activities that are not identified in this inspection report
must be presumed to contain asbestos until PLM analysis proves that this material is not
asbestos -containing.
This inspection is not intended for, nor should be used as a design specification. The Asbestos in
School Hazard Amendments and Reauthorization Act (ASHARA), effective November 201h, 1990,
expanded accreditation requirements to apply to persons who work with asbestos in public and
commercial buildings as well as schools. Specifically, ASHARA expanded the Toxic Substance
Control Act (TSCA) Section 206 (a) (1) and (3) to require accreditation for any person who designs
or conducts a response action with respect to friable ACM in a building. TSCA Section 207
provides for civil penalties of $5,000 for each day of a violation for not employing accredited
individuals to design and conduct response actions. Sampling of suspected asbestos -containing
materials was conducted as prescribed in 40 CFR 763.86.
In the case of <l % asbestos is found in a material, WISHA enforcement staff must assess that the
basic asbestos work practice requirments as given in WAC 296-62-17712(2).. particularly use of
wet, non -aggressive methods and prompt clean up. Vaccuums used must be HEPA filtered.
Worker training must include asbestos awareness and hands on training as given in.WAC 296-
62-07722(5). Respiratory protection must be based on overall dust levels. A competent person
must be assigned and trained under the requirments of WAC 296-62-07728.
4
AMERICAN
� ABATEMENT &DEMO
AMERICAN
� ABATEMENT &DEMO
viay •Vauu%jn %-auin
Sample Number 174-1 Description Silver Paint
Asbestos Type + , Percent (if detected)
R
AMERICAN
■ ABATEMENT &DEMO
AMERICAN
■ ABATEMENT &DEMO
The intent of the asbestos survey is to comply with asbestos regulations required by the state of
Washington and Puget Sound Clean Air Agency. Currently, the state of Washington requires a
written "good faith inspection" for identification of asbestos -containing materials prior to any
remodeIirig or demolition work. During demolition and construction work it is the responsibility
of the owner and the contractor to make this survey document available to all concerned parties
who may be handling the building materials.
In demolitions, all asbestos is to be removed by an asbestos contractor.
These agencies regulate asbestos in these counties (Washington State):
Puget Sound Clean Air Agency (PSCAA) King, Kitsap, Snohomish
Olympic Regional Clean Air Agency (ORCAA) Jefferson, Clallam, Mason, Thurston, Pacific,
Grays Harbor
Southwest Clean Air Agency (SWCAA) Lewis, Clark, Wahkiakum, Cowlitz, Skamania
Yakima County Clean Air Authority (YCCAA) Yakima
Northwest Air Pollution Authority (NAPA) Whatcom, Skagit, Island
Douglas County Clean Air Commission, Douglas
Grant County Clean Air Authority, Grant
Tri Counties Air Pollution Control Authority, Benton, Walla Walla, Franklin
Spokane County Air Pollution Control Authority (SCAPCA) Spokane
Washington Department of Ecology (DOE) Stevens, Ferry, Okanogan, San Juan, Chelan,
Kittitas, Klickitat, Columbia, Garfield, Asotin, Adams, Lincoln, Pend Oreille
A fee must be paid, and the Notice of Intent filed, and be submitted prior to renovation or
demolition of a building.
There is a required waiting period after filing a notification before work can begin. (Mandatory
10 days for all demolition's) Calendar or working day wait is stipulated by each regulatory
agency's policy.
Further information regarding compliance may be obtained at our office.
AMERICAN
■ ABATEMENT &DEMO
It is unlawful for the owner or owner's agent to remove asbestos in excess of 10 linear feet or 48
square feet per year, per structure, unless the building is an owner -occupied, single family
private residence.
Washington State law requires asbestos that is left in place, be in good repair and maintained at
regular intervals. Maintenance should be documented.
In addition, PSCAA requires that a copy of the written asbestos survey be made available on -site
for inspection by a PSCAA Control Officer during construction and demolition work. The survey
is required to be performed in accordance with 40 CFR 763.86. These federal standards require
inspections to be conducted by an EPA Accredited Building Inspector with analysis to be
provided by an asbestos laboratory certified by the National Bureau Standards. The requirements
are described in Article I and Article 4, of PSCAA's Asbestos Control Standards. All survey
work was conducted in compliance with the above -mentioned standards.
Asbestos -Containing material are required to be removed and disposed of in accordance with
Washington State Regulations 296-155 WAC, Part S prior to any demolition, renovation, or
remodeling that would disturb these materials. Washington State Department of Labor and
Industries and PSCAA require that the abatement be performed using Certified Asbestos
Abatement Workers under the direct on -site supervision of a Certified Asbestos Supervisor in
accordance with 296-65 WAC. Also see 296-62 WAC, Part 1-1General requirements for
handling asbestos.
Asbestos inspections are non -comprehensive by nature and our assessment is limited only those
locations inspected and sampled. This survey was not designed to identify all potential concerns
or eliminate all risk associated with abatement. No warranty, express or implies, is made with
American Abatement and Demo, LLC. American Abatement and Demo LLC is not responsible
for materials which require destructive means to access, or materials which are hidden from
sight, those materials hidden behind walls, or materials which cannot be found with reasonable
diligence. Extreme caution should be used during renovation or demolition to ensure that
additional unidentified materials are not disturbed.
In the event that additional materials are discovered, the material should be sampled by an EPA
Accredited AHERA Building Inspector and analyzed to determine if it contains asbestos prior to
disturbance.
17
AMERICAN
■ ABATEMENT &DEMO
WRITTEN BY:
AARON BORRERO
AHERA BUILDING INSPECTOR
CERTIFICATION NUMBER 182411 EXP. 09/10/2022
AMERICAN ABATEMENT AND DEMO, LLC
Certificate of Completion
This is to Certify that
Aaron E. Borroro
has satisfactorily Completed
4 hours of online refresher training as an
AHERA Building Inspector
to comply with the training requirements of
TSCATitle It, 40 GFR 763 (AHERA)
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10
NORTBHW ST�
30620 Pacific Hwy S. #103.
Federal Way, WA 98003
(253) 941-4343
zy� e
TESTING f
NVLAP LAB CODE ]00993 0
Enclosed please find the analytical report for one or more samples submitted for analysis by
Polarized Light Microscopy.
The six types of asbestos fibers are chrysotile, amosite, crocidolite, tremolite, anthophyllite
and actinolite. A sample which contains more than 1% asbestos is considered positive and
is defined by the EPA as an Asbestos Containing Material (ACM).
The samples were analyzed in accordance with EPA method 600/R-93/1 16 and 600/M4-82-020
which has a detection limit of approximately 1%. The analyst used a stereomicroscope to
visually inspect the sample to determine homogeneity and material descriptions. The sample was
then viewed under a polarized light microscope to determine the presence and percentage of
asbestos and non -asbestos fibers.
After analysis is complete, all paperwork is filed together, and kept in a secure locked filing
cabinet. Asbestos Northwest ensures that the files will not be tampered with at any time and will
only be removed if the client requests reanalysis or a modification to the report. if you have any
concerns or comments, contact us at feedbackta:asbestosnw.com or fill out our survey at
as bestosn w.comis u rvey
Thank you.
-These results are only applicable to the samples enclosed with information provided by the
client. This report may not be reproduced, except in full, without the approval of the laboratory.
This report may not be used to claim product certification, approval, or endorsement by NVLAP,
N1ST, or any agency of the U.S. Government.-
n
ASBESTOS Asbestos NW Batch#(_,/
W ORTHW EST -) l � K
man Pacific Hwy S. JJ103, Federal Way, WA How
(253) 941-4343 NVLAP Lab Code: 200993-0
Bulk Samples Chain of Custody (EPA 600/R-93/116)
Name, America Abatement & Demo Date
Address 18855 SE Auburn Black Diamond RD Phone 425-698-7925
Auburn, WA 98092 E-mall Aaron5AAD-WA.com
Proiect Manager Aaron Borrero
Project Locat.- 110 r s, 32,90, � Ujv�J 7* 17H Number of Samples
Fra<rn1 iA 11111 k.IA- Turn arniinri time $ 1—
#
Sample ID
Description
Location/Comments
1
I-7y I
•-
4
/ 7L-1- Id
1
;
5
17L4 - .
,,. F v '
K , f-
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Print 5ion
Comr.)any Date Time
Sampled by:
/�a�rV3t�tw
�— f ]•�.�_
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12' oc P,41
Relinquished by:
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AA 9
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Delivered by:
Accepted by:
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JD -
Analyzed by:
ESTOS
NORTHWES Klyly L"J
TESTING f
Asbestos Northwest, LLC
NVIAP LAB CODE 200943•0
30620 Pacific Hwy S, #103, Federal Way, WA 98003
Ph: (253) 941-4343 Fax: (253) 941-4175 Batch Number: 202214288
PLM Analysis by EPA Method 600/M4-82-020 and 600/R-93/116
This report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST, or any
agency of the U.S. Government.
Attn: Aaron Borrero
American Abatement and Demo
18855 SE Auburn Black Diamond Rd
Auburn WA 98092
Location: 2101 S 324th St Unit #174 Federal Way WA
Date Received: 10/17/2022
Date Analyzed: 10/17/2022
Samples Received: 6
Samples Analyzed: 6
Client Sample
Lab Sample
Description
Matrix
% Non -Asbestos
% Asbestos Fibers
ID
ID
Fibers
and Type
174-1
1
Silver paint
Paint/binder
2% Cellulose
3% Chrysotile
2
Black asphaltic material
Asphalt/binder
5% Cellulose
None Detected
3
Silver paint
Paint/binder
2% Cellulose
3% Chrysotile
4
Black asphaltic material
Asphalt/binder
2% Cellulose
None Detected
174-2
1
Silver paint
Paint/binder
2% Cellulose
3% Chrysotile
2
Black asphaltic material
Asphalt/binder
5% Cellulose
2% Chrysotile
174-3
1
Gray soft/elastic material
Binder/filler
1 % Cellulose
5% Chrysotile
174-4
1
Gray soft/elastic material
Binder/filler
1% Cellulose
5% Chrysotile
174-5
1
1
Beige sheet vinyl
Vinyllbinder
None Detected
None Detected
Filler.
None Detected
2
Gray fibrous material with
65% Cellulose,
mastic
Mastic/binder
Synthetic fibers
174-6
1
Tan sheet vinyl
Vinyl/bi.nder
None Detected
None Detected
65% Cellulose,
None Detected
2
Gray fibrous material with
Filler,
mastic
Mastic/binder
Synthetic fibers
Report Page 1 Reviewed b : Cathy Butler 'N Fur /
Analyzed by: Dan Lafley p g Y Y