Loading...
09-100502City of Federal Way Community Development Services P.O. Box 9718 Federal Way, WA 98063 -9718 Ph: (253) 835 -2607 Fax: (253) 835 -2609 40 Demolition Permit #: 09- 100502 -00 -DE Inspection Request Line: (253) 835 -3050 Project Name: KARILEEN LLC Project Address: 326 S 376TH ST Parcel Number: 322104 9021 sl Project Description: Demolition and removal of residential structure and metal outbuilding. Own r Aaalicant Contractor KARILEEN LLC WINDWARD ENVIRONMENTAL PILCHUCK EXCAVATING LLC PORTLAND OR 200 W MERCER ST SUITE 401 PILCHEL952C5 (2.23.11) 97296 -0047 SEATTLE WA 98119 2111 S LAKE ROESIGER RD SNOHOMISH WA 98290 CONDITIONS: For release of bond, submit request to kari .cimmer @cityoffederalway.com following final inspection and approval. PERMIT EXPIRES Sunday, February 6 2011 Permit Issued on Friday, February 6, 20+09 1 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 the City of Federal Way. ., / Owner or agent: _ Date:° 4 FINALED 2 `vCA J 1 THIS CARD IS T EMAIN ON -SITE r CITY OF Community Develop ent Inspection Record Federal Wav IVR INSPECTION REQUEST PHONE # (253) 835 -3050 mv PERMIT #: Owner: Address: 09- 100502 -00 -DE 326 S 376TH ST FEDERAL WAY, WA 98003 -7444 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 L13 Y Date 2 For inspector reference only D Rough Electrical ❑ FINAL - Electrical Approved Approved By Date By Date CITY CF, 'Federal Way COM�NITY DEVELOPMENT SERVICES 33325 8n' AVENUE SOUTH • PO BOX 9718 FEDERAL WAY, WA 98063 -9718 253- 835 -2607• FAX 253 - 835 -2609 wtuto cituoffederalwaLl.com 0 PERMIT APPLICATION Oq - / 0 0. f �i I*;,- SF MF CO ME EL PL( /DE )�N FP The following is required if}formation - an incomplete application will not be accepted. �ase print legibly (in ink) or type. C PROPERTY •. • SITE ADDRESS 32IQ S -3 +• �j SUITE /UNIT # ASSESSOR'S TAR /PARCEL # ? ? Z d - i ? I LOT SIZE (1j) LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) (Attach separate page for Lengthy Le9a1 desert t-n) E PROJECT INFORMATION TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL XDEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit only) DO.101A 51t M ETA L- U AgA41t: AND el t STI NG +1016E 01'j 19A0 ____2( 12t7v10V � l.0 NCeer ` Pt 21Y210 ION S PROJECT NAME (Name of Business or Owner Last Name) lC -AR 11, Or � 1, 6/ • PEOPLE •• • PROPERTY OWNER CONTRACTOR COPY of card mquimd with each application APPLICANT PROJECT CONTACT LENDER tvewir, -- x1�,t,���, AtM.1�fi t�,ri�, G`o whfix' of PRo�i¢,�iv� U.G (so3 ) �,8. 4 - G949 LAO Bby, t4s4 1'roi -.gum, 09 V24i, 1 YhCUSI'► AU'4;0hA • r- &"' I COMPANY NAME �I Y t t, t,G Per RCW 19.27.095: Lender information is required if project value exceeds $5,000 APPLICANT NAME OFFICE PHONE (3U MAILING ADDRESS 211 t S • cs( c+c RA, nY. STATE, ZIP ah isle W4k 162AQ CELL PHONE (42.5 23I -661Z CITY OF FEDERAL WAY BUSINES LICENSE t UMBER EXPIRATION DATE FAX NUMBER cl' °/0605(p 26 OF ( ) - CONTRACTOR'S REGISTRATION NUMBER IRATION DATE E -MAIL ADDRESS ui IL S a 15 3 NAME PRIMARY PHONE E -MAIL ADDRESS KATN*r-N •4uPuC ( 206 ) 90, - 5{i/o l�►k�r►G�� wi�w�r�%nd• NAME Per RCW 19.27.095: Lender information is required if project value exceeds $5,000 MAILING ADDRESS CITY, STATE, ZIP PHONE EXISTING USE AM A %-V HOUSE PROPOSED USE 60NSFiJ VA 101 - ECol•4!CAL EXISTING ASSESSED /APPRAISED VALUE $ �S -VALUE 00'1J OF PROPOSED WORK $ . lb SPRINKLERED BUILDING? ❑ YES y NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ANO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 'PRIVATE (WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE PRIVATE (SEPTIC) PROJECT ••• AREAS AREA DESCRI EXISTING PROPOSED TOTAL S . FT. 89. FT. S . FT. BjaSEMENT WA ❑ YES o NO FIRST i D 0 b -fla►� ❑ YES SECOND -7 UP /SEPA /SU? THIRD OVA PLATTED LOT? o YES o NO ADDITIONAL FLOORS (DESCRIBE) lit f fLw2 ❑ YES o NO DECK (❑ COVERED OR ❑ UNCOVERED ?) GARAGE A CARPORT ❑ NUMBER OF FLOORS EX19TIN0 PROPOSED TOTAL TOTAL &W. SF 0 TOTAL PROPOSED SF TDTAL SF "NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL Value of Mechanical Work $ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION) AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES BBQS FANS GAS WATER HEATERS MISC (Describe) BOILERS FIREPLACE INSERTS HOODS (Commercial) COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG. SYSTEMS BATHTUBS (or Tub /Shower Combo) DISHWASHERS DRINKING FOUNTAINS ELECTRIC WATER HEATERS HOSE BIBBS LAVS (Bathroom Stnksl URINALS MISC (Describe) RAINWATER SYST VACUUM BREAKERS SHOWERS WATER CLOSETS (Toilet) SINKS WASHING MACHINES SUMPS I certify under penalty of perjury that the information 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 officers and employees, upon the accuracy of the information supplied to the city as a part of this application. NAME /TITLE /� DATE �! I Zo an (Signature) (Tale) RELATIONSHIP TO PROJECT ❑ O Agent ❑ Contractor ❑ Architect o Other Bulletin #100 — April 2, 2007 Page 2 of 4 k\Handouts\Permit Application ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR o TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑ YES ❑ NO BASIC PLAN? ❑ YES o NO ZONING DESIGNATION CHANGE OF USE? ❑ YES o NO NEW ADDRESS REQUIRED? ❑ YES ❑ NO UP /SEPA /SU? o YES o NO PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? ❑ YES o NO Bulletin #100 — April 2, 2007 Page 2 of 4 k\Handouts\Permit Application 1y : v { rr + ` Y x - ..:.•f`:.fJ a r. { :r Z f -r i • . 4YJ-r..•rv(. : ; r,.ii f�.: i Cra'"vr.'::F t.: t +' a x M°f-iy ,'4'✓-•r r:•.: : ra..v r s rSG•r 'r .. v�.r !.,r •? ::? _w. : .:- . rrr.r {r-.r 4. •w 3. nr.W . i .:u .:.:.?n . :.x .r: ..�.r? .:.:• n}.:x rT�:I.. - . %. . � : - w- t r •wv.;�.v_rrr.r :.: . rrrJin :.fn n' :vv .? +.rfr{ ::: 1r: .. �r i r. - :+.Jr .:J.r-%... . v } r' ;r ::::: n.: v:rr.+.: •:: :rJ .: x..:}�.. ,:v . vfr +SiFrriF..- .f Jv rk" x 4 . . Jf.F.fn :.'; . •:a � ffy. : {rf: _: +fz,; :' Via: ` „r r if % is vi -i{r +!�•: _ _ :rf.. i ?fi' .. ' ....• .ry::... ..�•:- •.....; .. ?:: :... ._::...:.:.....:::•.. r<. �::: r:: v::,•:::: :.i'::::.,:t.. { ::: ::• ::; :....;. ... .. .•r.. {.t :..>:: ?'�zG. /.: .n- �f.,.r .J.ru rn::i: t?;:rG:.if ti i::- .� S:r..:i_•..;x:r f Jr nfr . JGGr 1r /.ry 3ri( W r : f{•S� • : ` J JO% `a- N: iy. . �: -0fv v f :a-,';%J.iiw. L` �K 'i: �r.i.J�.�f+ . 3 y•`.. : u :Y: `G .•r{. :.+rC` .:��isriw'r TF :l v;:S.' {f•. .'YF % '{.i%-" n -t ' i t , i •�.:`.• _ . "•r ^.+.Sin., .'r;XJf :i3c2'i” "'t .ir.+{t' J+ww✓✓+�..r+Jrr�rrrGu rvJxr43 f.(�i 4r Jnf -•J f .,GJrr rrr�3ik'-:.-�•' /!%riY +�`'YVr ��.^w,Te,: r:%w. t ?a JJroM+v.xr»vw ..�nre. .- r.f.:., ::.arr /,=„vr ?� r+a.r. ..� +w. «. ......n...,.: '" .. i rir::- '%i: :S +FJr +iti ?ivra::s ?ta : :i }ro. rrJ.a. : {�i'f•�ir ..3- 1.��{iiiii:?:r l'vr +iY -illi� �:i:'Yv:+yrn . - ri iJr /����" t+v . .l.-i�.. . •r v 'Fr -- rF.s}• i ARR fM�r'• r f.r ..J . M. 4 .GG. {Ci ifiili »fir+::w.vrr:J .rf. ?. n riYF�.. f....l� _ Nrx .r+xar.�JSFiri:tnn•�Vr: =fry ?•slii w:'.:::Jf ^ }ti: ?: ir. ?a:'r•y.y:.tr<: :v:.v: -• r. :. rill `: .wrrrlk_ "ir_JJr:F.:: �rrwx.: xrxJ '?.•:iC- : :::w:: ✓xrrr:J.. {r:ri: Jfirr: r: rra �uv ::::: w.r�i:n4: :.:........... r.• ?• rat• ill +✓i ": -r. ..:{, ?yY r:_- %i''x' r .fJ N36.'4sn:f: ::vu+rrCki xkw• ••rH.i -v S<ii +mil- .tiF.iiis+v.L }! ?"r{v: r>. +f::w.v'A 'Y.ii.`;;:',"...:r. d„fcw�f . r�ruu',,. iw.•. u Instructions for completing form: This form is to be completed by any persons permanently removing a septic tank, seepage - pit, cesspool, or other on -site sewage system wastewater tanks from service. Complete and submit this report to the health officer within thirty (30) days of the abandonment. Authority: Chapter 13.04.054, the Code of King County Board of Health Titl Return Completed Form to the Following Address: ec Eastgate Public Health Center 14350 SE Eastgate Way JUN 2 0 2007 Bellevue, WA 98007 Phone (206) 296 -4932 z3 General Information (Please print): Name of Owner /Occupant of Property: VA k 1 l,;OW fil� Address: 321®S 3-4-lo t" Ave- Ftd Cj;UJ - WA., w-A I S o03 t &cd , ' �2'ZI041o2 J Telephone: So 3 r 215 it. !0 944- - M °T C+tisK^, rt a ^oey- . Date of Report- -5:j22 / a �- Wastewater Tank Data: Type of Sewage Tank: X Septic Tank Pump Tank Holding Tank — Other: Number of Compartments Pumped: Number of Gallons Pumped- Checklist Item Yes No Not Applicable Comments Se tage removed by an approved pumper?* Tank lid removed or destroyed? Tank void filled with compacted soil? *OSS Pumper Name: IJ mw, wr IG N k-- vIC.L King County Certification Number: Y7Z Reason for wastewater tank abandonment: h(A .., &10>1M'% W06') Property being served by public sewers Property being served by replacement tank Comments: ,TANK ARANPOM£T, I R AC4 r 4�o US C- ggN4 PEMt6 5t�D, !JO N WOO GQNsT12U�lD"� 7 O[.GrtJ,t✓- Signature: /�� Date: MEMO] of Wastewater Tank Abandonment: Print Date 5/12/99 Forms/sewage/form.96 APR -12 -2007 12:36 From:ELECTRIC FIRST REP 2533956806 04/1.2/2007 THU 11:00 FAX 0 217 0089 CITY OF Federal Way To:206 217 0089 P.2/2 0 IA 002/002 DePAXnWZW OF COMMUMW DEVFLOPMLW SERVICES 33325 a Avenue Soutb PO Box 9718 Fedcrsl Way WA 98063 -9718 253 - 8352607; Fax 253- 835 -2609 W Ww.eitvofft41w211way.CVm DEMOLITION PERMIT REQUIREMENTS A demolition permit is requited to remove any structure or structures on a subject propetty. Check with the City's Plarming Division to see if the proposal exceeds thresholds that trigger an environmental review. An environmental review and submittal of an environmental checklist maybe required, which will extend the time period before a demolition permit be issued. 0 Prior to submitting a demolition permit, the following items (as applicable) mist be signed by the respective agency (see attached Demolition Permit Contact List). ,wore 7o APrur wr-- U61kiea shrill he discoenested and se�vlasa perjarnrcd ijdppllmbld, prior to lssftonce of the deawlilion Perot/,. All dppJicdble flews below are to be sloedby the respective agency representatives. 1. ASBESTOS ABATEMENT (Copy of lip Mai f and ftbeog, survey from Puget Sound Clean Air 2, GAS SUPKY (Gas to be shut 4 meter remav+ed and final bill paid) Al N-A (Pugd&uid BUY 3. SSMC SYSTEM (Tank tank to be drained and filled) r� IQ,lg County Eanrironmental sel4i(es) 4. SANITARY SEWER (Check applicable box) o Sewer line capped at property line t] Existing sewer ilne� main and be used by proposed new structure (Sewer Distrid) S. GARBAGE (All houset+old garbage dsposed off and Mal big pall) (RSf vNt/reAe -MT" Bfsposal) 0 Completed Construction Permit Application form 32(,: � ca : -I Cr- S-7 - F W N `L 6.9LECTRicrrlr " A A , 7. FUEL STORAGE TANKS (Above or below glade fuel tanks, have been pumped or removed under ir Depe trnent permit prior to any disrnantWexcavation) (South Kung Etre and Rescue S. WATER - PUMICSoUrM (Check applicable box) a Meter to be removed and final vdRy tdil paid o Meter to rempllnn and be protected - (wow supper) aaaaa *ORna * *w w 9. WATER - Private Wall (CheeK applicable box) o Private well flied and capped E3 Pd"W well tD be used for other purposes A/� fang Cour*j Emnronrnentsl services) 0 Provide the following fees; I. Demolition Permit Fee $67.50 2. Automation Fes 5.00 3. WA State Sumharge 4.50 4. Cash Bond Deposit 500.00 (ReNntlable upon Conspltted Mal lmupeetlon) $577.00 Bulletin11122 - January I, 2007 Past 1 of 1 la\11 ndoutsl0emolilion renifimcquirrumts r f f • Proiect Case No. Date Received:, Puget Sound Clean Air Agency 1904 3rd Avenue Ste 105 Seattle WA 98101 -3317 D s a , e a n a i F o r g 206.689.4058 - 1.800.552.3565 ext 4058 Agency Use Only fax 206.343.4073 Agency Use Only Notice of Intent Type or print clearly y� A _ Prnipet TvnP- 1 El Friable AchPCtns Remnvai 2_ El FrinhlP A.cheatns Removal & Demolition 3. l� Demolition Only B. Property Owner: v Rr _ AR11 . Mk f usm� Phone: 503 2Sle-&7Q1 Mailing Address: C'o whik 1 >Flz .codes 66 -160 NOI Feb 8 '07 .doe ?o� 1004- Mailing Address: s 3'('�`� %' ii►G B« Sk �tC Jf City: P040 Q "61 State �� Zip: i 2 to C. Asbestos Contractor: OR/O Owner /CEO: PonnA, McNecC N Contact Person: kjAph lqik r, " WtNI)WARP 6 NV1It#Nt-tfNTAL. Mailing Address: s 3'('�`� %' ii►G B« Sk �tC Jf Phone: ?-S; •552. fv� Contractor Job No.: City: ena,Q G✓ State: W#1 Zi OD3 Fax: 2S3•9a3.4? Will nonfriable asbestos be left in place during demo? LJ Yes Ll No D. Site Address: 3 24 6.3 Moth Sf City: r—c % wo If Zip: ©0 3 Contact Person: kjAph lqik r, " WtNI)WARP 6 NV1It#Nt-tfNTAL. Local Phone: 1,7— E. W Asbestos Survey or ❑ Mat'l Presumed No. of Structures: % Dat of Asbestos Survey: V rte G Was Friable Asbestos Identified? OYes No Was Nonfriable Asbestos Identified? OYes XNo A RA Buildin Inspector: KL"t'tcd -( ,J Certification #: /oZ x 77f Ex p. Date: (< 2t> 2oc� J. d14FFJ R,..o is ro i—d Fof ro nll damnliti— n in ft F. Demolition Start Date: No. of Structures: 1. LJ Training Fire (List Fire Dept.) Information: I To k— G Rmtne 1 2 1 2. ❑ Ordered Demolition attach copy of Order Demolition Insert demolition contractor's mailing address on back. Will nonfriable asbestos be left in place during demo? LJ Yes Ll No Contractor: I If yes, list type and qty. Note disposal requirements in Step 6 (on back). G. Friable Asbestos Start Date: Completion DIte: Work Days: M T W Th F Sa Su Project Information: NA t4.,+ Hours: Will all friable asbestos El Yes materials be removed? ❑ No Total Qty. to be Removed: Linear Ft. N. 4 Square Ft. AJ'* H. Asbestos/Demolition Project Categories: Notification Period Project Demolition 1. Single - Family Residence (owner- occupied): A. Prior Notice Fee Surcharee A. r ' Asbestos Removal Project Only B. 10 Days* A. $25 B. Demolition Project (with or without asbestos removal project) B. $50 * As ,estos removal can begin upon notification; demolition must wait 10 days) Note: It the single family residence is owned by one family who has been or will be using the residence as their domicile, the above boxes 1A or 1 B may be checked. If this is not an owner - occupied residence, one of the categories listed below must be used instead. A single family residence does not include rental property, multi-family units, or an y mixed -use building. 2. All Other Demolitions (with no Asbestos removal or Nonfriable Asbestos 10 Days $50 on]. or less than 10 linear feet and/or 48 square feet of friable Asbestos Friable Asbestos Projects other than Single Family Residence): Asbestos Demo 3. ❑ >_ 10 - 259 linear feet and/or >_ 48 - 159 square feet of asbestos Prior Notice 10 Days $50 $50 4. ❑ 260 - 999 linear feet and/or 160 - 4,999 square feet of asbestos 10 Days $200 $50 5. ❑ >1,000 linear feet and/or >5,000 square feet of asbestos 10 Days $600 $50 6. ❑ Emergency Asbestos Project or ❑ Emergency Demolition Project Prior Notice $50 Emergency Fee (Single - Family Residences are exempt from emergency fee; however, property owners must provide a written emergency request) I. I certify that the information contained in this notification & supplemental data is, to the best of my knowledge, Agency Use Only accurate & complete. S Zg 09- Si nature Representing Date 66 -160 Notice of Intent Rev. 3/13/07 RDH:LSS 1 or Z The Puget Sound Clean Air Agency requires advance notification before any person commences a friable asbestos project involving materials equal to or greater in size than 10 linear feet or 48 square feet and for all demolition projects (regardless of asbestos content) involving structures with a projected roof area greater than 120 square feet (Regulation III, Article 4). All asbestos removal and demolition notifications must be submitted to the Agency on current Agency forms. Asbestos removal and demolition projects involving materials and structures below the notification threshold are still subject to all other requirements of Regulation III, Article 4. J. Demolition ?I LfiH UGK , C av Arr N'cl Contractor: �. ,, y 1*) Owner /CEO:vAep.� ��O x �+ 'I- Mailing Address: 2��� S• Lw� ��51 q " r� Phone: 3ipQ•J�QS I�CGC(% Contractor's Job #: S Ci : h ftrt, Ste Zi $ 2D Fax: GUIDELINES FOR SUBMITTING AN ASBESTOSIDEMOLITION NOTIFICATION Step 1. Check the appropriate project type in Box A. Friable asbestos includes popcorn ceiling material, sheet vinyl flooring, cement asbestos board siding, and duct insulation. Nonfriable asbestos is normally found in vinyl floor tiles, window putty and most roofing materials. Step 2. Enter property owner information in Box B. Step 3. Enter the asbestos contractor or property owner information, if the property owner is conducting a single - family residential project, in Box C. Print clearly this is your return mailing label. Step 4. Enter the site address for all notifications in Box D. For multi - structure projects, attach supplemental sheet with a site map (include an address for each site) and a list of the type and amount of friable asbestos to be removed from each structure. Step 5. Check either asbestos survey or material presumed in Box E. All demolitions require that an Asbestos Hazard Emergency Response Act ( AHERA) asbestos survey be conducted by a certified AHERA building Inspector. Step 6. Enter the project information in Box F. and check the training fire or ordered demolition box if appropriate (a copy of the official order must be attached). All asbestos must be removed prior to conducting a training fire. Additional training fire requirements are contained in Regulation I, Section 8.08. If any nonfriable asbestos materials will be left in place during demolition, check yes and list the type and quantity of material. Note: Demolition debris containing nonfriable asbestos materials must be labeled as " nonfriable asbestos - containing waste" and be deposited at an authorized waste disposal facility. Step 7. Enter asbestos project information in Box G. List types of friable asbestos material to be removed: surfacing material such as popcorn ceilings or plaster, sheet vinyl flooring, duct and pipe insulation, cement asbestos board siding or pipe, etc. Step 8. For owner- occupied Single- Family Residential projects, check BOX H1A for renovation projects or BOX H1B for demolition projects (with or without asbestos removal). Asbestos removal may be conducted after a complete notification is received, but demolition activities can only begin on the 10`h day after the notification is received. Note: If the single family residence is owned by one family who has been or will be using the residence as their domicile, boxes IA or IB may be checked. A single family residence does not include rental property, multi family units, or any mixed -use building. For Commercial asbestos projects (or projects that do not qualify as Single Family Residential); check the project category H2 - 5 that matches the amount of friable asbestos that will be removed. If a demolition is involved, include the appropriate surcharge (additional fee) in your payment. To file for an emergency asbestos or demolition project, check the appropriate box 1 — 5 and the applicable emergency box in H6. All emergency requests must be accompanied by a letter from the property owner demonstrating the need to conduct the project immediately in accordance with the requirements in Regulation III Section 4.03 (c). Step 9. Please certify the accuracy and completeness of the information provided by signing the notification in Box I. Mandatory amendments to the notification are required for changes that increase the project category, change the types of asbestos materials to be removed and changes to start date, completion date and work schedule for asbestos projects. No fee is required for work schedule changes if the contractor is participating in the Agency work schedule fax program. A $25.00 processing fee is required for all amendments. Puget Sound Clean Air Agency asbestos regulations and forms can be downloaded from the Agency web page at www.pscleanair.org. For technical assistance call (206) 689 -4058. 66-160 Notice of Intent Rev. 3113107 RDH:LSS 2 of 2 Report Date: May 17, 2007 Windward Environmental, LLC Attn: Kathleen Hurley 200 West Mercer Street, Suite 401 Seattle, Washington 98119 WBE W2F5912535 Executive Summary RE: Asbestos Survey Report — 326 South 376th Street in Federal Way, Washington Dear Ms. Hurley: On May 10, 2007 under an agreement with your organization, we performed an asbestos survey on the residential structure located at 326 S. 376th Street in Federal Way, Washington. At your request, the purpose of this survey was to ascertain the existence of asbestos containing materials in the residential structure and associated garage as well as providing characterization and quantities. This residential structure is a two -story, wooden building on a concrete block foundation. The top story of the building has been destroyed by fire. Area size of this structure was estimated at approximately 600 square feet of floor space. The structure was built during the 1900's. The exterior finishes consist of wood siding, window caulking and composite roofing. The interior finishes consist of vinyl sheeting, insulation, sheetrock, ceiling tile and mastics. The garage is metal and has a silver coated metal roof and fiberglass insulation. This survey was performed in conformance with procedures and methods outlined in applicable federal, state, and local regulations. This survey was performed by an accredited AHERA Building Inspector Ronald Coleman (1022774; Expiration Date: June 28, 2007). Investigating Protocol and Findings All samples were homogenized, collected, processed, and analyzed for content by Polarized Light Microscopy. AHERA protocol provides guidance for the number of samples of each material to be collected depending on its category and amount of material present. The goal of AHERA is to ensure statistically reliable data and it accomplishes this by requiring or suggesting a minimum number of samples to be collected, and in some cases, by using random sampling techniques to determine sampling locations. Building materials that contain asbestos fiber s (1 %) are regulated by the Occupational Safet y Puget Sound Clean Air Agency. No identified the associated garage that meet this criterion. Orion Environmental Report #071973 326 S. 376' Street in Federal Way, Washington in the amounts greater than 1 percent and Health Administration (OSHA) and material(s) associated with the house or May 17, 2007 Page 1 of 4 Suspect materials processed and found non - detect or containing < 1 % asbestos are listed in the table below: Wall System 1 (WS1) Ceiling Tile 1 (CT1) Vinyl Sheeting 1 (VS1) Tub Surround Mastic (MA1) Splash Board Mastic (MA1) Wiring ( Misc. 1) Wiring ( Misc. 6) Building Paper 2 (Misc. 2) Building Paper 3 (Misc. 3) Roofing Material 1 (RM1) Window Putty 4 (Misc. 4) Silver Coat 5 ( Misc. 5 ) Insulation 1 (Ins. 1) Insulation 2 Residential Inventory (Negative) Sheetrock 2'x 3' Ceiling Tile with Associated Brown Mastic White w/ Blue and Brown Floral Pattern Vinyl Sheeting w/White Mastic White and Yellow Tub Surround Mastic Yellow Splash Board Mastic Tube and Knob Wiring Black Wrapped Electrical Wiring Building Paper Associated w/ Wall Paper Building Paper Associated w/ Siding Multi- Layered Three Tab Roofing and Associated Slip Sheet White Window Putty Silver Roof Coating Associated w/ the Garage Pink Fiberglass Insulation w/ Paper Backing Pink Fiberglass Insulation w/ Pa Backing Associated wl Garag Negative for ACM Table Please note that should additional materials (not referenced in this report) be discovered as a result of remodeling or demolition, they are to be presumed asbestos containing unless subsequent sampling by an accredited inspector proves otherwise. Inaccessible Locations ORION Environmental Services cannot make statements as to the potential presence or absence of asbestos containing materials in inaccessible areas or areas not considered. Disclaimer ORION Environmental Services has conducted a survey for asbestos containing materials of the residential structure and associated garage located at 326 S. 376th Street in Federal Way, Washington in conformance with the requirements established by the United States Environmental Protection Agency and the Occupational Safety and Health Administration prior Orion Environmental Report #071973 326 S. 376t" Street in Federal Way, Washington [nay at, t s Page 2 of 4 to the engagement of renovation or demolition of the building. The sampling strategy and analytical method employed conform to existing and enforceable standards and methods. This Executive Summary of the investigation performed at the subject site is intended to describe asbestos containing materials with the potential of being impacted. We represent that our services were performed within the limits prescribed by applicable regulations and in a manner consistent with the level of care and skill ordinarily exercised by other professional consultants under similar circumstances. No other representation is made to the client, expressed or implied, and no warranty or guarantee is included or intended. The opinions presented herein apply to the site conditions existing at the time of our investigation, and interpretation of current regulations pertaining to asbestos containing material. Therefore, our opinions and recommendations may not apply to future conditions that may exist at the site we have not had the opportunity to evaluate. Future regulations pertaining to these materials may impose stricter restrictions on renovation or demolition work. The regulations should always be verified prior to any work involving these materials. The inspector is not held responsible or liable for any repairs or replacements with regards to this property, systems, components, or the contents therein. The acceptance of this report by the client acknowledges the client's agreement to all of the terms and conditions of the inspection contract. ORION retains active copies of reports for a period of not less than one year. Retained copies of reports, field data, field notes, laboratory test data, calculations, estimates, and other documents prepared by ORION as instruments of service, shall remain the property of ORION. Other than the Client, other agencies of the U.S. Federal Government, and the Owner, reports submitted with respect to services performed under this contract may not be extended to third parties without prior written consent. Questions concerning this Executive Summary may be addressed the undersigned. Thank you for the opportunity to serve you. I hope we can be of assistance to you on future projects. If there is anything additional I can do to expedite your operation, please do not hesitate to let me know. Orion Environmental Report #071973 ` "'ay t'' 326 S. 376 "' Street in Federal Way, Washington Page 3 of 4 Professionally Yours, ORION Environmental Services, Inc Building Inspector x0i Ron Coleman AHERA Building Inspector ORION Environmental Services W-azdTo M-M I I �11 . I I I , I Reviewer Donna McNeal AHERA Building Inspector, CEO ORION Environmental Services 0RI01 � Environmental Services Polarized Light Microscopy Test Report EPA Method 600/R.- 98/116 Client Windward Environmental Date May 17, 2007 200 W. Mercer St, Ste # 401 Page Page 1 of 3 Seattle, WA 98119 Invoice 071973 Attn: Kathleen Hurley Date Received May 10, 2007 Project Number N/A Project Name 326 South 3760' Street Federal Way, Washington Client Orion Sample Asbestos Other Number Number Stereo Scope Exam Treatment Percent Tyne Fibers 326 -01 70510 -56 Silver Coat Roofing Chloroform ND - Cellulose Homogeneous 326 -02 70510 -57 Silver Coat Roofing Chloroform ND - Cellulose Homogeneous 326 -03 70510 -58 Silver Coat Roofing Chlorofo in ND - Cellulose Homogeneous 326 -04a 70510 -59a Pink Fiberglass Insulation - ND - Fiberglass Homogeneous 326 -04b 70510 -59b Paper Insulation Backing - ND - Cellulose Assoc. w/ 326 -04a Fiberglass 326 -05 70510 -60 Black Electrical Wire - ND - - Homogeneous 326 -06a 70510 -61a Ceiling Tile - ND - Cellulose Homogeneous 326 -06b 70510 -61b Brown Mastic Chloroform ND - Cellulose Assoc. w/ 326 -06a 326 -07a 70510 -62a Joint Compound - ND - Cellulose Assoc. w/ 326 -07b 326 -07b 70510 -62b Wallboard _ ND - Cellulose Homogeneous 326 -08a 70510 -63a Joint Compound - ND - Cellulose Assoc. w/ 326 -08b 326 -08b 70510 -63b Wallboard - ND - Cellulose Homogeneous 34004 - 9t" Avenue South ♦ Suite 5 ♦ Federal Way, Washington 98003 -6740 ♦ Tacoma (253) 952 -6717 ♦ Seattle (253) 874 -8118 ♦ Facsimile (253) 927 -4714 ♦ Email Info @OrionES.net WBE W2F9219763 ORI01 Environmental Services An Environmental Compliance Consulting Firm Polarized Light Microscopy Test Report EPA Method 600/R- 98/116 Client Windward Environmental Date May 17, 2007 200 W. Mercer St, Ste # 401 Page Page 2 of 3 Seattle, WA 98119 Invoice 071973 Attn: Kathleen Hurley Date Received May 10, 2007 Project Number NIA Project Name 326 South 376d' Street Federal Way, Washington Client Orion Sample Asbestos Other Number Number Stereo Scope Exam Treatment Percent Tyne Fibers 326 -09a 70510 -64a Joint Compound - ND - Cellulose Assoc. w/ 326 -09b 326 -09b 70510 -64b Wallboard - ND - Cellulose Homogeneous 326 -10 70510 -65 Tub Surround Mastic Chloroform ND - Cellulose Homogeneous 326 -11 70510 -66 Tube & Knob Wire - ND - Cellulose Homogeneous 326 -12 70510 -67 Building Paper - ND - Cellulose Homogeneous 326 -13 70510 -68 Building Paper - ND - Cellulose Homogeneous 326 -14a 70510 -69a White w/ Blue & Brown - ND - Cellulose Floral Pattern Vinyl Sheeting w/ Felt Backing Homogeneous 326 -14b 70510 -69b White Mastic Chloroform ND - Cellulose Assoc. w/ 3626 -14a 326 -15a 70510 -70a Rust 3 -Tab Composite Ash ND - Cellulose Roofing Fiberglass Homogeneous 326 -15b 70510 -70b White 3 -Tab Composite Ash ND - Cellulose Roofing Assoc. w/ 326 -15a 34004 - 9`" Avenue South ♦ Suite 5 ♦ Federal Way, Washington 98003 -6740 ♦ Tacoma (253) 952 -6717 ♦ Seattle (253) 874 -8118 ♦ Facsimile (253) 927 -4714 ♦ Email Info@OrionES.net WBE W2F9219763 ORI09Environmental Services An Environmental Compliance Consulting Firm Polarized Light Microscopy Test Report EPA Method 600/R- 98/116 Client Windward Environmental Date May 17, 2007 200 W. Mercer St, Ste # 401 Page Page 3 of 3 Seattle, WA 98119 Invoice 071973 Attn: Kathleen Hurley Date Received May 10, 2007 Project Number N/A Project Name 326 South 3766' Street Federal Way, Washington Client Orion Sample Asbestos Other Number Number Stereo Scone Exam Treatment Percent Type Fibers 326 -15c 70510 -70c Gray 3 -Tab Composite Ash ND - Cellulose Roofing Assoc. w/ 326 -15a 326 -15d 70510 -70d Slip Sheeting Ash ND - Cellulose Assoc. w/ 326 -15a 326 -16a 70510 -71a Pink Fiberglass Insulation - ND - Fiberglass Homogeneous 326 -16b 70510 -71b Foil Insulation Backing - ND - Cellulose Assoc. w/ 326 -16aa Fiberglass 326 -17 70510 -72 Yellow Splash Board Chloroform ND - Cellulose Mastic Homogeneous 326 -18 70510 -73 White Window Putty - ND - Cellulose Homogeneous Dup: Laboratory QA/QC Duplicate; M; Mastic [(a), (b), (c), etc.]: Sample layers numbered from front to back. Comments: For layered samples, each component has been analyzed separately. ND means non - detect for asbestos fibers by EPA Method 600/R- 98 /116.Disclaimers: PLM has been known to miss asbestos in a small percentage of samples that contain asbestos. Thus, these laboratory results represent due diligence , however negative or <1 % PLM results can not be guaranteed. Per EPA guidelines samples will be archived for 30 days then will be disposed of. This report may only be reproduced in full with written approval of ORION Environmental Services Analyzed By (all" �' Reviewed By &kAQ Donna McNeal Allen Clark Laboratory Director, CEO Laboratory Analyst Leming EnvironmentaCComphance Conwiting Into the 21st Century 34004 - 9"' Avenue South ♦ Suite 5 ♦ Federal Way, Washington 98003 -6740 ♦ Tacoma (253) 952 -6717 ♦ Seattle (253) 874 -8118 ♦ Facsimile (253) 927 -4714 ♦ Email Info@OrionES.net WBE W2F9219763 AW AM 4 AM a -4 m