07-104361City of Federal Way go
Community Development Services
P.O. Box 9718
Federal Way, WA 98063 -9718
Ph: (253) 835 -2607 Fax: (253) 835 -2609
Demolition Permit': 07- 104361 -00 -[
Inspection Request Line: (253) 835 -3050
Project Name: DEPARTMENT OF TRANSPORTATIPNn r "r
Project Address: 1730 S 356TH ST Parcel Number: 282104 9146
Project Description: Demolition of stuctures & asbestor removal and disposal at approved landfill
Owner
Applicant
Contractor
WASHINGTON STATE DEPT OF
CORRECTION INDUSTRIES
CORRECTION INDUSTRIES
TRANSPORTATION
ENVIRONMENTAL SERVICES
ENVIRONMENTAL SERVICES
PO BOX 47338
PO BOX 41116
CIENVS•972CG (3/7/09)
OLYMPIA WA 98504
OLYMPIA WA 98504
PO BOX 41116
OLYMPIA WA 98504
Additional Permit Information
CONDITIONS:
After finial inspection is complete and approved, please contact Kari Cimmer by e-mail at
Karic *c tyoffederalway.com OR by fax at 253- 835 -2609 to receive a refund of cash bond.
PERMIT EXPIRES Thursday, August 6, 2009
n,....,... is r..: _.,.a ...: T...:.. IJ 6 7 41AA7
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
a d the City of Federal Way.
Owner or agent: Date:
Fj� ,�
THIS CARD IS T MAIN ON -SITE
p ,
CITY OF 0Community Develo nt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 07- 104361 -00 -DE
Owner: WASHINGTON STATE DEPT OF TRANSPORTATION
Address: 1730 S 356TH ST
FEDERAL WAY, WA 98003 -8304
This card is part of your required inspection documents. 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
By Date — ( a
For inspector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
CITY OF Q -.
Federal Way ��� 0 �'� .� �
�G� PERMIT SF MF CO ME EL PL E EN FP
COMMUNITY DEVELOPMENT SERVI ^
33325 D AVENUE SOUTH • 63 971 9 1 0" `�7w{ DL I C A T I O N
FEDERAL WAY, X 98063.260 �7' p� TD
253- 835.2607• FAX 253- 835.2609 V!
urt»ur.dtuaf(etiervlwny.com
The following is required - an incomplete application will not be accepted. Please print legibly (in ink) or type.
SITE ADDRESS _ 73c> J S J SUITE /UNIT #
ASSESSOR'S TAX /PARCEL # LOT SIZE (sfl
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach aepemte pagef- lengflry legd desaipff.N -
PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
�crtp EMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed d�e ti on of work included on this ermit onlyj
5�: 5 �- = r�-c ( c �L� n �; ,-��A e�� c�� r7 c s T.�zJ r=
15 / ("t c�Tztaz-%5 : C, F-=- D� -6A. -) . ✓fi-i'_
PROJECT NAME (Name of Business or Owner Last Name) (7; O t' -j-VA7-)S PO iC1-A-T? 1)1-/
PEOPLE •- •
PROPERTY
OWNER
CONTRACTOR
COPY of c-d mquimd
with each application
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME
APPLICANT NAME
G� e-;Cl cc it_-
PRIMARY PHONE
t� � s i r7r�
� 'r J {Z,�S l�vl�' i ��,•�
(36c�) 70.5
MAILING ADDRESS
4-733 S
CITY, STATE,
E -MAIL ADDRESS
TE
P w
-- /D 5
COMPANY NAME
; Ir -S
APPLICANT NAME
G� e-;Cl cc it_-
OFFICE PHONE
(36ce) S Z
-on:
MAILING ADDRESS
o c� f I 'S'
CITY, STATE, ZIP
Cx ✓7 pi t.J^ . `I �"`i
CELL PHONE
360 23 -.
- ) Yj- 7
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EIXPIRATION
TE
FAX NUMBER
(31 J g 6 C3(-,3 4c '
-- /D 5
Zd��
(3L(j
CONTRACTORM REGISTRATION NUMBER
EXPIRATION D TE
E -MAIL ADDRESS
c 1 j6/V V5 'i� -1 [ Z. C.
COMPANY NAME
APPLICANT NAME
-k--
OFFICE PHONE
(3 &)) 5"86 - cx-3
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
z� � - 1 �� 7
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
(31 J g 6 C3(-,3 4c '
NAME PRIMARY PHONE E -MAIL ADDRESS
�-�c_ lt� tU )SRI 0 6 3
NAME
Per RCW 19.27.095,
Lender information is required if project value exec )ds $5,000
MAILING ADD
STATE, ZIP
PHONE
EXISTING ASSESSED /APPRAISED VALUE $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE S
WATER SERVICE PROVIDER ❑ LAKEHAVEN HIGHLINE
SEWER SERVICE PROVIDER ❑ LAKE N ❑ HIGHLINE
PROPOSED USE
V.
WORK $.
YSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
• TACO ❑ PRIVATE (WELL)
• PRIVATE IS IC)
AREA DESGRIPTION
EXISTING
PROPOSED
TOTAL
BBQS.
S •
S . FT.
SO. FT.
BASEMENT � '
SINKS
DUCTS
TS
FIRST
CHANGE OF .USE?
o YES
ONO
.SECOND
o YES a NO
UP /SEPA /SU?
THIRD
o NO
PLATTED LOT?
o YES 'ONO
ADDITIONAL FLOORS (DESCRIBE)
DEMO PERMIT REQUIRED?
o YES
o NO
DECK (❑ COVERED OR ❑ UNCOVERED ?)
GARAGE ❑ CARPORT ❑
NUMBER OF FLOORS
°°
PROP086D
TOTAL
TOTAL ea+arwaa
TOTAL;;XOPOeeD ar'
TOTAL OF
"NEW HOMES ONLY" NUMBER OF BEDROO ESTIMATED ELLING PRICE $
Indicate number of each type of fixture to be installed or
Value of Mechanical Work $
(A COPY OF BID R ES7
AIR HANDLING UNITS
COOLERS
BBQS.
RAINWATER SYST
BOILERS
/FANS
NSERTS
COMPRESSORS
SINKS
DUCTS
TS
rA.vulaegry
a ALTERATION
BATHTUBS (or Tub /shower combat
LAV.S 15.0voom sit*.)
DISHWASHERS
RAINWATER SYST
DRINKING FOUNTAINS
SHOWERS
ELECTRIC WATER H TERS
SINKS
HOSE BIBBS
SUMPS
part'of this project. Do not include existing fixtures xtures to remain.
MUST BE INCLUDED W&H APPLICATION)
GAS PIPE OUTLETS WOODSTOVES
S WATER HEATERS MISC (Describe)
HG (Commerd�Q
T— RANGES
REFRIG. SYSTEMS
URINALS MISC (Describe)
VACUUM BREAKERS
WATER CLOSETS (Tolleq
WASHING MACHINES
I certify under penalty of perjury that the ir;formation furnished by me is true and correct to the best of -my knowledge, and further, that I
am authorized by the owner of .the above premises to perform the work for which the permit _application is made. 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 any person, including the undersigned, and filed'against the City of Federal Way, but only where such claim
arises out of the reliance of the city, including its office and empto s, upon the accuracy of the iil formation supplied to the city as a part of
this application.
NAME /TITLE �-1L` ( l7n a �' c DATE J V
(Slghature) (Title)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent )CContractor ❑ Architect ❑ Other
o NEW o ADDITION
a ALTERATION
o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY?
a YES o NO .
BASIC PLAN?
o YES
n NO
ZONING DESIGNATION
CHANGE OF .USE?
o YES
ONO
NEW ADDRESS REQUIRED?
o YES a NO
UP /SEPA /SU?
o YES
o NO
PLATTED LOT?
o YES 'ONO
DEMO PERMIT REQUIRED?
o YES
o NO
Bulletin #100 —April 2, 2007 . Page 2 of k \Handouts \Permit Application
AUG -02 -2007 13:51 From:ELECTRIC �ST REP 2533956806 To #0 586 0036 P.1/1
;
DEPART M ENT OF COMMUNITY DEYE LOrkENTSE1tvIM.
33325 8'h Avenue South
CITY pF j PO Box 9719
Federal Way WA 98063 -9718
Federal Way 253- 835 -2607; Fax 253 -835 -2609
vinvw.Ci iffcdumlwa .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 bigger 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
bc. issued.
0 Priolr to submitting a demolition permit, the following items (as gpplicablc) must be Signed by the respective
agency (see attached Demolition Permit Contact List).
NOTE ru A)pt;JCANT. Utilities shall be disconnected and services P6rformed, if applicable, prior to issuance of the demolition permit. Alt applicable
items below are to be shred acrd by the respective agency representatives.
Z. ASBESTOS ABATEMENT
(Copy of approval form and survey from Puget So nd CleaniAir
Agency provided)
o
(City of ral Way Suilrfing oflidal) I
2. GAS SUPPLY
(Gas •shut off,, er remQV aril final bill paid)
0
(Puget Sound Fltergy
3. SEPTIC SYSTEM ;
(Tank to be removed or tank to be drained and filled)
(King County Environmental Services)
4. SANITARY SEWER (Check applicable box)
o Sewer line capped at property line
o Existing sewer line to remain and be used by proposed new structure
(Sewer Dish
S.GARgAGE
(All household garbage disposed off and final brill paid)
(RST Disposal/Federal Way Disposal)
O Completed Construction Permit Application Form
6. ELECTRICITY
(7t2 to �aff er renwyed)
(Puget Sound Energy
7. FUEL STORAGE TANKS
(Above or below grade fuel tanks, have been pumped or removed
under Fire Department permit prior to any dismantle /excavation)
(Souttt King Fire and Reside)
S. WATER - Public Source (Check applicable box)
o Meter to be removed and final utility bell paid
(Met to re a be protected
071ZL. F,>t•ST
C . (Water Supplier)
Yt,*** OR *it****
9. WATER - Private Well'(Check applicable box)
o Private well filled and capped
❑ Pr'ivatc well to be used for other purposes
(ling County Environtm>ental Services)
13 Provide the following fees: I. Demolition Perm: it Fee $67.50
2. Automation Feet 5.00
3. WA State Surellarge 4.50
4. Cash Bond Depdsit 50 (Refundable upon Completed Final Inspection)
77.00
t• tillettn N UZ- January 1. 2007 Page I of I k:Wandoufs\Demolitiun Ycmtit Rcquiremants
AUG -03 -2007 13:00 P.02
DZPARTMF14T AMMUNffy DEVLLOPMENT SERVICES
33325 S* Avenue Sou;h
PO Box 9716
CITY OF lrfidaal Way WA 91063 -9718
Way 253-635 -2607; Fax 193.835.2609
�deral ;;;;... ralYederolw�t lI
DEMOLITION PERMIT REQUIREMENTS
A demolition permit is required to remove any structure or structures on d subject property. Check with the City's planning
Division to see if the proposal exceeds ��be required, t whi h w 11 extaad he time period be demolition permit can
submittal of an enviromnental chacldist may
be issued,
O Prior to submitting a demolition permit' the following items (as applicable) must be signed by the respective
agency (see attached Demolition Permit Contact List).
Nor TO APPLK.1Mr: Ulifitim Shari be disconn"ted and services ped'ormed. if aPPlicabie, prior to issuance oriht dernolitton permit Alt appftoabie
Lr
neon below are to be by the respective agency representoHves.
X1. ASB�S ADATEMENT
(Copy of approval form and asbestos survey frbm'p6gett'SdUnd Geary Air
agency provided)
(City of Federal Way Building O lda
Z. GAS SUPPLY
(Gas to be shut off, rneter removed and final 16,11 00
(Doge[ 5oun Enengy
3. SEPTIC SYSTEM
(Tank to be removed or tank. to be drained and Oiled)
(zing Cohn Environmental Ste► ce9 ::;:
4. SANITARY SEWER (Check applicable box Z, �• .
o Sewer line rapped at property line
o Exlsdng sr � re
r min and be used by proposed new structure
(Sewer DlstrIct)
5. GARBAGE
(AII h0 rbage d sod off Mal bill paid)
(PST D isposal /Federal Way &P sal)
0 Completed Co1)3trnctlon Permit Applicwtion form
6, ELECI'RMIYY
,(6(ectradty to be shut off and meter removed)
Puget pun ner9y
y. FUEL ST01tAGE TANKS or removed
(Above or below grade fuel tanks, have been Pu vation)
under Fire Department Permit prior to any i
Soot Kong Fire an
2. WATER -Public Source (Check applicable box)
o Meter to be removed and flrtal utility bill paid
XMet to rem a be proteCtad
star SUPP1160
■ *swK OR * *a *Rs
9, WATER;- PrlVate Well (Check applicable box)
❑ Private well rifled and rapped
cl Private way tc be used for other / as
(King urtN E nvlronmentai rvices)
0 provide the following fees: 2. Au omtlttlo Fee 'Fermit Fee
I WA State-Surcharge
4. Cash Bond Deposit
suliatin 0122 - January I, 2007 Naga 1 or I
oi 07: 48
360 586 0036
$67.50
a.50
50 (Refu11dabac upon Completed Flnsl Inspection)
77.00
kAHandouyukmolition Petmlt Regairemenu
9F3% P. 02
TOTAL P.02
DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
33325 8`h Avenue South
PO Box 9718
Federal Way WA 98063 -9718
253- 835 -2607; Fax 253- 835 -2609
www.cityoffederalwa v.cotn
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 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
x(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)
2. GAS SUPPLY
(Gas to be shut off, meter removed and final bill paid)
(Puget Sound Energy)
3. SEPTIC SYSTEM
Rank to be removed or tank to be drained and filled)
(King County Environmental Services)
94. SANITARY SEWER (Check applicable box)
• Sewer line capped at property line
• Existing sewer line to remain and be used by proposed new structure
(Puget Sound Energy)
7. FUEL STORAGE TANKS
(Above or below grade fuel tanks, have been pumped or removed
u to any dismantle /ex vation)
Sf "ik
outh King Fire and Rescue)
8. WATER - Public Source (Check applicable box)
❑ Meter to be removed and final utility bill paid
(Mete to rem a d be protected
UAL. F->rST
(Water Supplier)
* * * ** OR * * * * **
9. WATER - Private Well (Check applicable box)
• Private well filled and capped
• Private well to be used for other purposes
(Sewer District) (King County Environmental Services)
5. GARBAGE
(All household garbage disposed off and final bill paid)
(RST Disposal /Federal Way Disposal)
❑ Completed Construction Permit Application form
❑ Provide the following fees:
1. Demolition Permit Fee $67.50
2. Automation Fee 5.00
3. WA State Surcharge 4.50
4. Cash Bond Deposit 50 (Refundable upon Completed Final Inspection)
77.00
Bulletin tt122 - January I, 2007 Page I of I k: \Handouts\Demolition Permit Requirements
CITY OF
Federal Way
DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
33325 8`h Avenue South
PO Box 9718
Federal Way WA 98063 -9718
253- 835 -2607; Fax 253- 835 -2609
w%vw.cityoffederalway.com
DEMOLITION PERMIT CONTACT LIST
This list of agencies may assist you in expediting the demolition permit process. Refer to the demolition permit
requirements for signature blocks. All applicable signatures are required prior to permit approval.
1. Asbestos Removal: Puget Sound Clean Air Agency
110 Union Street, Suite 500
Seattle, WA 98101 -2038
206 - 343 -8800 -0R 800 -552 -3565
www.pscleanair.org
2. Electricity: Puget Sound Energy Tacoma Public Utilities
Attn: Construction Coordinator Customer Service
22828 68'h Avenue South, Suite #102 –OR– 747 Market Street
Kent, WA 98032 Tacoma, WA 98402
888- 225 -5773 253- 383 -9600 or 253- 383 -2471
3. Gas: Puget Sound Energy
805 156h Avenue NE
Bellevue, WA 98004
888 - 225 -5773
4. Telephone: Qwest Communications
801- 962 -2475 (phone) / 801 - 237 -6491 (fax)
5. Water: Lakehaven Utility District Tacoma Public Utilities
Technical Service Division Customer Service
31623 First Avenue South –OR– 747 Market Street
Federal Way, WA 98003 Tacoma, WA 98402
253- 941 -2288 253- 383 -9600 or 253 - 383 -2471
6. Garbage. Waste Management
655 Second NW
Auburn, WA 98071
253- 833 -3333 (residential) – OR – 253- 939 -9792 (commercial)
7. Sewer: Lakehaven Utility District
Technical Services Division
31623 First Avenue South
Federal Way, WA 98003
253- 941 -2288
—8. Septic: King County Environmental Services
14350 SE Eastgate Way
Bellevue, WA 98007
206 - 296 -4932
s. 9. Fire Department: South King Fire & Rescue
33325 8'h Avenue South / PO Box 9718
Federal Way, WA 98063
253- 946 -7248
Bulletin #109 —March 1, 2007 Page 1 of 1 UHandouts0emolition Permit Contact List
Notification Case #: 200702652
Page 1 of 2
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 100.00
Credit Card Transaction #. VUHFIBDOCEFE
Transaction Date 07/26/07
Owner's Name Wash St Dept of Transportation Phone (360) 705 -7358
Site Address 1730 So 356th St
Site City Federal Way Zip 98003
Contact Person David Yoon Phone (360) 705 -7301
Mailing Address PO Box 47338
Olympia, WA 98504
This project includes asbestos removal.
Project Size linear feet / 110 square feet
Project Start Date 08/06/07 Completion Date 08/06/07
Asbestos will be removed by a licensed asbestos abatement contractor
Contractor Correctional Industries Contractor Job # AWS15
Contact. Steve Williams Phone (360) 586 -0031
Mailing Address PO Box 41115
Olympia, WA 98504
This project includes a demolition.
Demolition Start Date 08/07/07 Completion Date 08/08/07
Demolition will be completed by a demolition contractor
Demo Contractor Correctional Industries Contractor Job # AW815
Contact Steve Williams Phone (360) 586 -0031
Mailing Address PO Box 41115
Olympia, WA 98504
(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 that the project's site address cannot be modified and additional structures may not be added to a
notification by Amendment.
(4) I understand the fees for this Notification are nonrefundable.
Create Angther Notification View History L_ os-0ut
https:Hsecure.pseleanair.org /Asbestos /Approved.aspx 7/26/2007