01-100875City of Federal Way
Community Development Services
33530 1st Way S
Federal Way, WA 98003 -6210
Ph: 253.661.4000 Fax: 253.661.4129
Project Name: BRAINARD
Project Address: 29006 MILITARY S
fX0
Demolition Permit #:01 - 100875 - 00 - DE
Project Description: DEMO - Demolish single family house damaged by fire
Inspection request line: 253.835.3050
Parcel Number: 042104 9119
Owner
Applicant
Contractor
BRAINARD COMPANY INC
CITY OF FEDERAL WAY
MIKE WERLECH CONSTRUCTION
22039 7TH AVE S #IE
33530 IST WAYS
22039 7TH AVE S SUITE 1
DES MOINES WA
FEDERAL WAY WA 98003
SEATTLE WA
98198 -6216
(206) 937 -2208
PERMIT EXPIRES September 9, 2001, IF NO WORK IS STARTED.
Permit issued on March 13, 2001
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.
Owner or agent: Date: 3 _
I Der�� c a� f���
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Mar 01 01 07:36a
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DEMOLITION PORMIT APPLICATION
CITY OF FRDERAL WAY
WILDING DIVI810N
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CITY OF FEDERAL WAY
•
DEMOLITION PERMIT APPLICATION
CITY of FEDERAL WAY
BUILDING DIVISION
33530 Final Way South
Faerol Way. WA 95003
(253) 661 -4000 - Fax (253) 661.4129
DESCRIPTION OF WORK D F— wo'—( 7 t O fJ
PRIOR TO APFUCATION
P.
191 001
name Pernik Fee 547.00
4.30
sulchniza ar+ sons $00.00
(P rm& Payins >�
NOTE= ! understand &hot the followwK ud4des dwlt be disconnected and se"ker pepfonned. Irapplfcable. prior to issuance of the demobban POMP4
AU Items ov to be signed by die prrpecti a agenry_
1. AJmw3 RELmvAL _ 6. /clwRenos
(Building OtGeid)
ELECTRICITY
(Puget Power)
x03 T4LEPHOM
(US West)
(� GAS
(Washington Natural Gaa)
S. WA=R- DIS0OWaffcTR1QUe2T
7. SEPTIC TANK PI NVW AND FILLED Wm CRUSMO ROM OR
RE4OY6Dt0R SSWEIL LINE PLUGGED AT PROPERTY LINE. (Ina MUGn
required prior to backfilling).
*l Y. TAATYa LDM cvr AT PROPGATY La96 (well sapped)_ buPeai°n required
�� /prior to baL+M1IIng.
9. ALLUMERGROVND TAMS PUb "ED AND PSMOVSDVNOrI ';=
D®pAP.TM Tr PRMAT MM TO EXCAVATION.
10. DMM QUFM UT=V CHAR0R3 PAID
INFOAMA nom FOR APPLICATION
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(Attach if lengthy.)
TAX PARCEL NO n
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ADDRESS -2,30-32 ` 1�C A y Q.
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EXPIRATION DATE
aU 6- g37- Sao �
Sipamm of Applicant Phone
° LAr Mike Wvjkafi Copy struction I =.
4522 49th Ave. S.N.
Seattle,, WA 9811
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Feb 14 01 08:18A mike Werlech construction 2069380221 T�OOp-
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DEMOLITION PERMIT APPLICATION
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Fpb 28 01 03:14p mike werlech construction 2069380227 p.l
MIKE WERLECH CONSTRUCTION, INC.
GENERAL CONTRACTOR
VIA FAX 8 PAG 459�
r'1 1
February 28, 2001
Mr. Martin Nordby
Code Compliance Officer
Department of Community Development
City of Federal Way
P.O. Box 9718
Federal Way, WA 98163 -9718
Dear Martin:
RE; 29006 Military Rd. South, Demolition Project.
We would like to update the status of the above project. The Septic
tank has been pumped, the asbestos abatement is complete, and the
utilities have been signed off.
The demolition permit application notes a "building official" for sign
off of asbestos removal. Can you please advise whom we should
contact for that?
I have enclosed copies for your review. Would you look them over
and let us know what else may be needed in order to secure the
demolition permit?
Thank you, Martin.
Sincerely,
Peggy Johnson
Project Admin.
4522 49th Avenue SW 4 Seattie, Washington 98116 • (206) 937 -2208 ♦ FAX (206) 938 -0227
Ma,r O1 01 11:59a mike werlech construction 2069380227
.
Sent-By: ; 0 206763949D Mar -1.01 9
•39AM; Page 1/1'
CROWN DELTA
Environrvimtai. Inc.
March 0l, 2001
Mike werlech Construction
4522 49`h Avenue SW
Seattle, WA 48116
Attn: Mike Werlech
RE: Asbestos Abotement Services P. 29000 Military Rand South Federal Way, WA
Dc¢u Mike,
This letter is to certify that Crown Delta Envirunmenial, Inc. has completed the asbestos
abatement work at the above - mentioned address. The asbestos materials removed at this
site were identified in a site survey pruvided by Pacific Rim LIlvirotuiiclital dated.
December 28, 2000. All work was completed in cornpliance with all total, state, and
Federal regulations.
Please feel to contact me if you have any questions regarding this protect or, when we
can be of further service.
Sincerely,
Crown Deh Environmental Inc.
Mike Correll
estimator /project Manager
309 3 CluveWhItt 021 • 5aatllt+. Washington 98 lob
(206) 763 -5232 • CROWNDE033MC • FAX (206) 7639490
P.1
Mar 01 01 07:37a mike werlech construction 2069380227 P.6
• w 0
Agency Case No. PUGET SOUND CLEAN AIR AGENCY 1 A62zd1!1Ve& Ili
110 Union Street, Suite 500
• Seattle, WA 98101 -2038 JAN 31 2001.
200 �02�6 �' www,pscleanair.org
NOTICE OF INTENT Aii<AGENCY
Agency Use Only
A. Project Type: I I. ❑ Asbestos Removal I IbLAsbestos Removal & Demolition 3. ❑ Demolition, No Asbestos Retnoval
B. /
Property Owner: `il % c> 1 L— R Phone: 7-M.,
Mailing Address: 1�� (-k 7/ -__— Ci r r%�✓+-C --GU State (,(/ zip: I
C. Asbestos
Contractor:
i,1,i:4sEP1VN7TLK1XTTY13 WILL E YOUR REMOUAANG I BEL.
Crown Delta Environmental, Inc.
Owner /CEO: Ron Bryan
�r
Completion Date: Jr�
C f
Work Days: / Sa Su
Hours: `tr - ..v1
Contractor
Mailing Address:
309 South Cloverdale Street # D -21
Phone: 206 -763 -5232
Job No.:
1001- 04
City: Seattle
Other:
State: WA
Zi : 98108
Fax: 206 - 763 -9490
D. Site d�
Address: Gt: "� 11•! G,rri r Ci : r�Ql= �(— ,/-j I Zip:Oe
Site '
Manager: , o-/( &,;;,C -g 4 Local Phone:
E. YFAsbestos Surveyor I No. of Date Asbestos Survey Was Friable Asbestos Identified? Yes UNo
❑ Mat'l Presumed Structures; was Conducted: Was Nonfriable Asbestos Identified Yes ONo
An urvey is required Be7ore all emo rtron projects Attach a copy of the survey, if nonfriabie asbestos is
AHERA Building Inspector: _ ANC ° identified or if no asbestos is identified on survey,
Certification No,: r CJOC7 `t Z 1 o Z Ex ,Date: C State:
F. Demolition Start No. of 1. Training Fire (List Fire Dept.)
Information: Date: f C 1 Structures: 7. ❑ Ordered Demolition attach copy of Order
Demolition insert demolition conrrac or's mailing address on back. Will nonfriable asbestos be left in place during demo? U Yes Ll No
Contractor: 1 t, IVS- if yes, list type and qty,
G. Asbestos Project
Information:
Start Date: G1
G l
�r
Completion Date: Jr�
C f
Work Days: / Sa Su
Hours: `tr - ..v1
Total Qt , to be Removed:
r
linear Ft. j Sl J Scare Ft.
Will all friable asbestos Yes
! materials be removed? ❑ No
Thermal System Insulation:
Boiler \Furnace Ins,
U Duct Ins. LJ Pipe Ins.
Other:
,
Surfacing Mat'l: I U -ireptoofing, LJ Paints
LJ Plaster Textured Coatin ps
Other_
$2,000
Mise. Mat'l -Cement Bd, - Cement Pipe -
Friable Flooring or Roofing Mat'l
Other:
H. Asbestos /Demolition Project Categories:
1. Single - Family Residence: (Check box A & B for asbestos removal & demolition)
A. ❑ Asbestos Removal Project
B. ❑ Demolition Project
Notification Period
o A, Prior Notice
0 B. Da s
Project Fee Schedule
$ 25 Nun - Refundable
Fee Covers Asbestos
Removal & Demolition
3 All Other Demolitions With No Asbestos Removal Project 'a
1 a s
$150
3- >_ 10 - 259 linear feet or �: 48 -159 square feet of asbestos 'see back)
0 D s
5150
4. 260 - 999 linear feet or 160 - 4,999 square feet of asbestos 1 ",
a s
S300
5. 1,000 - 9,999 linear feet or 5,000 - 49,999 square feet of asbest %`'' ,
10 Da s
5750
6. > 10,000 linear feet or > 50,000 square feet of asbestos ��' . .,t
10 DRYS
$2,000
=Emergency Asbestos Project or Emergency Demolition Pro`ec . -�1•
Prior Notice
Twice Project Fee
i. I do hereby certify that tt:e information contained in this notification & supplemental data described herein is, to the best of my Agency Use Only
knowledge, arc rate & complete.
.j
Signature Representing Diu, Hevie a By
Niget Sound Clean Air Agency Form No 66 -160 (Revised 9/7/00) AM
Mar 01 01 07:39a
FEB -14 -01 WED 08 � 44 M
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EFWTE ENV 1 RUN, HE L'th h Rx NU 0040
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lnstructinns for completing form: 'ilsis form is to be completed by any persons pennanendy removing, a
septic tank, seepage pit, cesspool, or other on -site ,;ewage system vvastcwatcr tanlcs from service.
Completc and submit this report to the health officer within thirty (30) days of tltc abandonment.
{ Authority- Chapter 13.04.054, the Code of King County Board of 14ealth, Title 13.
}Return Completed Form to the Followin ss: Date Received:
Castgnte Public health Center-
' 14350 SE Eastgate Way
Bellevue, WA 98007 hone (206) 2964493
i General Information (Please print):
i
Name of Owner /Occupant of Property:
Address: �- t�G%C� C�+ �^'� ?�- % r .�< .- ,,• � l'" C �i.,�_____ ...�
Date of Report: Z
W astewster Tank Data:
Type of Sewage Tank: Septic Tank Pump Tani: _ Holding Tank Other:
_
Number of Compartments Pumped: _ l
Number of Gallons Pumpod:
Checklist Item Yes No Not Applicable Comtncnts
Septage removed by an approycd pumper ?*
6
Tanfi licl rentoved or destroyed?
Tmik void filled with compacted soil?
*OSS Purnper Name:
King County Certification Number:
Reason for wastewater tank abandonment:
Property being served by public sewers _ Property being served by replacement tank
Catttmcni.s: � -
Signature: ,�!�'� `� Date:
Report of Wastewater Tank Abmdorincnr Print Date 5/12/99 Forms /scwage /form.96
p.7