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15-100403 • Demolition City of&FEcon. al Dev. y S Permit #: 15-100403-00-D E Community&Econ.Dev.Services 33325 8th Ave S Federal Way,WA 98003 Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050 Project Name: BELMOR PARK MHP- SPACE 122 Project Address: 2101 S 324TH ST Space 122 Parcel Number: 162104 9037 Project Description: Demolition of existing manufactured home Owner Applicant Contractor BELMOR MOBILE HOME PARK WOODCAM INDUSTRIES WOODCAM INDUSTRIES 2101 S 324TH CT 10215 66TH AVE E WOODLIG033JD(3/8/16) FEDERAL WAY WA 98003 PUYALLUP WA 98373 10215 66TH AVE E PUYALLUP WA 98373 Additional Permit Information Demolition Valuation 5000.00 CONDITIONS: PERMIT EXPIRES Thursday, January 26, 2017 Permit Issued on Tuesday, January 27, 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. Owner or agent: j r\G ' Date: /, U-) ' AiTHIS CARD IST EMAIN ON-SITE CITY OF "" Construction IiWpection Record ' Federal Way INSPECTION REQUESTS: (253) 835-3050 PERMIT#: 15-100403-00-DE Address: 2101 S 324TH ST Space 122 Project: BELMOR MOBILE HOME PARK 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. ❑ Final-Building(4050) Approved By , Date ❑ Rough Electrical Final Electrical Right of Way Approved Approved Approved By Date . By Date By Date ! • 01 CITY OFPERMIT' APPLIG& N Federal Way JAN 272015 PERMIT NUMBER I ,.7 _ 0 O 40 3 _ 1) CITY OF FEDERAL WAY TARGET DATE CDS SITE ADDRESS SUITE/UNIT# L\ 3 IO PROJECT V UATIO ZONING ASSESSO 'S T�AR�# � 6 - O $ cx ' TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICALEMOLITION 0 ENGINEERING 0 FIRE PREVENTION NAME OF PROJECT Q 1 Y11i1[' ` 4�\C PROJECT DESCRIPTION ' " c' l j �{' k rrr Detailed description work to h CAG` L>t1k of �� �� r\( Gbe included on this permit only E PRIMARY PHONE PROPERTY OWNER '/oQ `AC ING ADD ` E-MAIL ??U() 2 NAME ONE .74: u cco O. ADCDRE11Ss> EfiMAIL CONTRACTOR itc (O( / (rcL� Y 1 cNT E zit-1 � _-173--' lV�,) Vc ,WA SCONTCONTRA LICENSE PRION DATE FEDERAL WAY BUSINESS LICENSE#rXJ / () / o NAME P t.NGYYi Of \a- "� APPLICANT ri7...,AD67S L4 Q� S4(cvdr\\ccII4Jlna ,�4 ' ZI�gs1 N E \ MARY PHONE _� �cq c93 PROJECT CONTACT � � .).)" '' (The individual to receive and 317R(s i ` ` { � L(t��(��r{ ,J /1�, respond to all correspondence t V 11 k concerning this application) TATE 733-(44( /�C ��( D `JJ NAME PROJECT FINANCING OWNER-FINANCED Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE (RCW 1 9.27.095) I certify under penalty of perjury that I am the property owner or authorised 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 any 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 supplieji to the city as a_Tpar`t of this application. SIGNATURE: / C4 t/I DATE PRINT NAME: Th `'i ' C 1 q4 Bulletin#100—January 1,2013 Page 1 of 3 k:'Handouts\Permit Application 112312015 • Aoprovixi Transact-on • p Sc ieanai r,o r g P4get Sound A Agency Single-Family Notification Case #: 201500282 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 -7 VRCFBAFFCS86 Transaction Date 01/23/15 Owner's Name Green Tree Servicing LLC Phone (360) 870-265S Project Street Address 2101 S. 324th. St City Federal Way Zip 99002 Contact Person Mike Miller Phone (253) 830-5945 Mailing Address 33600 6th. ave. S. Suite 220 Federal Way, WA 98003 This project includes asbestos removal. Project Size linear feet / 1500 square feet Project Start Date 02/04/15 Completion Date 02/04/15 be removed by a licensed asbestos abatement contractor This project includes a demolition. Demoiltim Start Date 02/05/15 C:nrroletion Datii 02/28/15 Demolition ii.ill be comolcied ov a demolition contractor I certify that; ) This is a sinele-family residence project. The structure s used oy one family who owns the prepni y as their domicile. roe information I have provided is to the best of my knowledge accurate and complete. ..T understand the fee for this Notification is nonrefundable. Create Another Notjtication ylqw Histç 1.99 Out If you have questions,contact us at asbestosOpscleanair,ory ur 206.685.4058. ifsccige.pscioarisir.oriSAsixislosiAppiovimiaspx 111 vis2om www.ircwatm•upcvaavasbwwForimpatavoay.asp?Forrnio=.;,,4231SVIA,C011,117,4' Dept. of Labor & Industries, Division of Occupational Safety 84 Health Asbestos Project Notification Form Form ID: 95651##1532TAC0M176411 Notice Date: 1/23/2015 Start Date: 2:4:2015 Completion Date: 2i4:2015 Status: Initial Site Work Hours: 8:30 am - 3:30pm Site Work Days: Wednesday Contractor: TACOMA ABATEMENT CO LLC Job Site CAS.: Ray Ware Your email address: mmiller(aitaeomaabatementeem Contractor Phone Number: 253-830-5045 Property Owner Name: Owner's Agent: Company: Green Tree Servicing LLC Address: 33600 6th. Ave_ S. Suit 220 City: Federal Way State: WA Zip÷4: 98003 Phone: 360-870-2658 Job Site Address: 2101 S. 324th. St. Building, Name: Room: f'dtp.Avww,1nimagovisafetyiloacsatozhisbestatilFormiDataDtsulay.asp9FarmID-t Ott-61%M 23-tb-32TAcomi(6411 12 235 www.inmawArkvizzlacatirgnstmcormDatiOispiay.mpWormID=9.23%Z31522TAGOtitlise411 C/iy: Federal Way ' Zip+4: 913003 County: King Facility Type: Mobile Home Age: 1960 Size: 1400 Type of activity: Demolition Quantity of Asbestos to Be Removed Outdoors Indoors Quantity: 1500 square feast Sheet vinyl Roofing Quantity: linear feet Control Measures Wet methods liEPA vacuum Manual methods Respiratory Protection mask APR Comments: Date/Time Submitted 1/23/2015 12:24:08 PM filvAvww.tnima.govisAlytorictpsntortasirestsr.diermairaDisplay,asp?FaTniDszltb651%23%2315.32TAI:OM 1/6411 212 —„, • ! •.., 4, i�,. „,.: , , ,,,..,,,„ , a � TACOMA ABATEMENT COMPANY,LLC Jan. 14, 2015 4 Bill McTurnal Enterprises, LLC P.O. Box 12048 Olympia, WA 98508 1 RE: Bell More Park Unit# 122 2101 S. 324th St. Federal Way WA, 98003 Asbestos Good Faithrprises :' ,,,,,.',,,,,,,,,,,,,,t,t‘r,,,, Tacoma Abatement Company LLC conducted a limited asbestos survey dated 1- 14- 2015 at the property listed above. This is a single family manufactured home that has been selected for demolition. Asbestos samples were collected for the purpose of determining potential hazards to workers during demolition, repair and or renovation of this residential space. State laws require hazards be identified before structures or components are impacted as part of demolition activities. Suspect materials were limited to 1) sheet vinyl, 2) ceiling tiles and 3) roofing. During demolition any materials not identified in this survey will need to be tested. Unless presumed asbestos containing, any materials or components containing one A. percent>1% or greater asbestos is regulated by state, federal and local agencies. Sample #'s 1 and 6 are positive for the presents of asbestos. No other suspect materials or components were identified in association with this house. Let me know if you have any questions or if we may be of further assistance. tl Professionally Yours, ilite Tacoma Abatement Company, LLC Mike Miller , AHERA Building Inspector#BIR-NES-110413.01 Exp. 11-2.2015 Project Manager • t .. • , IA 1 ,,,,,: CI 1::-!--i ,. TACOMA�EMCNT CAMFANCI LC !'':,\'‘:,":,:" UIL Sample Results Sample ;*4 # Type Location Positive Negative Friable ft A 1 Sheet vinyl Kitchen XXXXX Yes 2 Sheet vinyl Bath # 1 XXXXX I 3 Sheet vinyl Bath#2 XXXXX 0 4 Ceiling tile Living rm. XXXXX , •' 5 Roofing Roof XXXXX , \• `' 6 Silver coat Roof XXXXX Yes ' z\\. z 7 Mastic Roof XXXXX • ar i '',,,,,, ,1-•:' A R I I 0 �l Ukffi 1 Conclusion: to Sample #'s 1 and 6 will need to be abated by a licensed asbestos I abatement contractor. i z Y. u 0 S BELM©R PARK GOLF & COUNTRY CLUB 2101 S 324TH Si'+FEDERAL WAY,WA 98003 (253)535-0517 January 20, 2015 Re: Home Demolition — Lot 122 To Whom It May Concern: Belmor Mobile Home Park gives permission to Woodland Industries to demolish the home including carport and shed(s) on lot 122. These permissions are given with the understanding that the Power, Water, & Sewer are to remain intact and the park is to be contacted before the disconnection takes place. V_____Th i ' Ben Nelson General Manager Cc: The Hynes Group Belmar Golf& Country Club,part of the Hynes Group of properties