10-104605 ;- • Demolition-
City of Federal Way
Community Development Services Permit #: 10-104605-00-DE
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: NEW LUMBER AND HARDWARE
Project Address: 30854 PACIFIC HWY S Parcel Number: 785360 0145
Project Description: Demolition of 960 square foot storage building.
Owner ADoIicant Contractor
NEW LUMBER AND HARDWARE BILL EICHHOLTZ NEW LUMBER AND HARDWARE
30854 PACIFIC HWY S 30854 PACIFIC HWY S 30854 PACIFIC HWY S
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
3A 7 Additional Permit nif` r i n
P , Z,, If A, term',, p ,,p A-3-?
Demolition Valuation 1750
CONDITIONS:
This parcel is located within a Wellhead Protection Area(Capture Zone 10) and must comply with FWRC
Chapter 19.185 and fill out a Hazardous Materials Inventory Statement,if applicable.
PERMIT EXPIRES Sunday, October 28, 2012
Permit Issued on Friday, October 29, 2010
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 �;'\/ '� UUULtA Date: /� "61 I �(0
)0 (.) 2
1111111r—c„,.,,A.,........,.: PERMIT
Federal Way ECEIVO MF CO ME P DE N FP
COMMUNITY DEVELOPMENT SERVICES A P P L I CAT I O.
25:3.835.2607•FAX 253-835-2609 T 2 9 2010
CITY OF FEDERAL WAY
SITE ADDRESS CDS SUITE/UNIT#
`i Pa(li�t C �1 l.i,lc ;
PROJECT VALUATION ZONING ASS SOR'S TAX/PARCEL#
--7 91 6- – 3 & I ct
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
]�DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT ,
Tenant Name/Homeowner Last Name) t" ` r _t-f r..- ,42,,,c,,t) 1,4.4 A ¢ dt
PROJECT DESCRIPTION
Detailed description of work to 1)-o l.(40 C0 _ k,1 S7i/(, -) Sb
be included on this permit only
NPRIMARY PHONE
PROPERTY OWNER p/lthLitat&)
hirAM
.�` MAILING ADDRESS E-MAIL
Lt q
CITY STATE ZIP
NAME - PHONE _
� ,_. .._�rs ..
MAILING ADDRESS E-MAIL •
CONTRACTOR
CITY STATE_AZIP FAX
"-WA
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME t //,_ _ -'"N
Z /
PJ t LL- C tc 1 l/�-.� PHONE #. J��/J�
APPLICANT MAILING ADDRESS II E-MAIL
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CITr?1` (,p L'� S�'A r'IC( z>pq CIO FAX
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PROJECT CONTACT NAME 1 _ /, rl /V•V PHONE (� �
(The individual to receive and 6(L� �•' (C cf t'i�-�t-T7 --2-S3,'J--� ► 13fi
respond to all correspondence MAILING ADDREESSe_ I r� t E -MAIL
concerning this application) L C f)J `,1 via CJ c ti uic-/ , ,
CITY A -/ /?{ �S,�TAlTE +LIPA /^ FAX ��,// // (f
fr-eALTERNATE CONTACT NAME:V /at J PHONE E-MAIL
iI tt ( --, I.
PROJECT FINANCING NAME
OWNER-FINANCED
Required value of 45,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
I certify 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 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 supplied to the city as apart of this application.
SIGNATURE: / % `�r.� �'" DATE
PRINT NAME: P l LL 't C V\ �1
Bulletin#100-April 14,2010 Page 1 of 3 k:\Handouts\Pelmit Application
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VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must be provided) \,
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PiPE OUTLETS OTHER(Describe) -_
AIR CONDITIONER FIREPLACE INSERTS HOODS comm<rcisi
BOILERS FURNACES HOT WATER TANKS(cas)
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Indicate ho many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATH UBS(or-rub/shower Combo) LAVS(Hondsinlm) TOILETS WATER PIPING
DISH ASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAT S SHOWERS VACUUM BREAKERS
DRIN ING FOUNTAINS SINKS(xitchen/utiiity) WATER HEATERS(Ekctric)
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EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
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AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
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EXISTIHOTOTAL
Area Totals
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ESTIMATED SELLING PRICE$ #OF BEDROOMS
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AREA DESCRIPTION Occupancy Grou s Additional Information
in Square Feet Type Stories
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ADDITION
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AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
in Square Feet Type Stories
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TENANT AREA ONLY
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Bulletin#100—April 14,2010 Page 2 of 3 k:\Handouts\Permit Application
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VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must be provided)
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
,
AIR HANDLING UNITS FANS GAS PIPE OUTLETS / OTHER(Describe) -
AIR CONDITIONER FIREPLACE INSERTS HOODS(commer6a1),
BOILERS FURNACES HOT WATER TANKS(clos)_,---"7
COMPRESSORSGAS LOG SETS _ REFRIGERATION SY:ST.' e•-' t i -------- •
DUCTING „,,,,-°"'''''''-'-------- G ING WOODSTOVE,S,'"
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Indicate ha many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
- - BATH UBS(or Tub/Shower Combo) - LAVS(Hand Sinks) TOILETS WATER PIPING
—
DISH ASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAI S . SHOWERS • VACUUM BREAKERS
—
DRIN ING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Eketric)
HOSE IBBS SUMPS WASHING MACHINES iimmmigAigtwowftogiiiiliiiim
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CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
-- ii..,_; (." /\Ji(-) $
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
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AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
FIRST FLOOR (or Mobile Home)
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Bulletin#100-April 14,2010 Page 2 of 3 k:\Handouts\Permit Application
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Approved Transaction It- C t` ` ''F"" ` wI.-! w • Page 1 of 1
•
l ,) 1o( I0
Notification Case #: 201002946
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 $75.00
Credit Card Transaction # VSHF5F1D5120
Transaction Date 10/27/10
Owner's Name new Humber Phone (253) 839 1313
Project Street Address 30854 pacific hwy s
City federal way Zip 98003
Contact Person bill Phone (253) 839 1313
Mailing Address
This project includes a demolition.
Demolition Start Date 11/30/10 Completion Date 12/30/10
Demolition will be completed by a demolition contractor
Demo Contractor Property Owner Contractor Job #
Contact Phone
Mailing Address
(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 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
the-e is no street address, I have used a building number.
(4) I understand the fees for this Notification are nonrefundable.
Create Another Notification View History Log Out
If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058.
. .
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https://secure.pscleanair.org/Asbestos/Approved.aspx 10/27/2010
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laraymago
ASBESTO-TEST, INC.
ASBESTOS SURVEY
SHED ONLY (a,
30854 PACIFIC HWY. S, FEDERAL WAY, WA 98003
Page 1 of 4
#2101005
October 11, 2010
Bill Eichholtz
30854 Pacific Hwy. South
Federal Way,WA 98003
253-839-1313
billecnew lumber-hdw r.com
On October 7,2010 Asbesto-Test personnel conducted an Asbestos survey(per
U.S.E.P.A./A.H.E.R.A.guidelines as designated and specified by Puget Sound Clean Air
Agency and Washington State)of the shed only n,30854 Pacific Hwv. South,Federal Way,
King County,Washington 98003. This survey purpose is to identify any Asbestos
Containing Materials that may be present and will require professional removal prior to
demolition.
Note: Samples of suspect Asbestos Containing Materials were taken per AHERA protocol and analyzed for the
presence of asbestos. THERE WAS NO ASBESTOS DETECTED IN ANY OF THE SAMPLES TAKEN.If there is
any additional suspect ACM located prior to or during demolition(such as,but not limited to,those materials listed
on the last page of this report),that was not discovered in this survey,the material(s)must be Presumed Asbestos
Containing Material unless tested otherwise by laboratory analysis.
NARRATIVE OF FINDINGS
BASIC CONSTRUCTION: The house is one story wood frame. The composition roofing
materials were sampled.
INTERIOR CONSTRUCTION, FINISHES, AND FLOORINGS: The interior is wood
with a dirt floor. There was no relating suspect ACM located.
CONTINUE TO PAGE 2
1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;c 206-914-5500;f 775-665-0420
g a mail Asbestotestfamsn.com;web:www.asbestotest.com
0
Page 2 of 4 October 11, 2010
CB2101005 Asbesto-Test,Inc. 425-489-4040
Shed only(a1 30854 Pacific Hwy.S, Federal Way,King County, Washington 98003
INSULATION: There is no insulation.
ELECTRICAL SYSTEM: There is no electrical system.
HEATING AND VENTILATION SYSTEM: There is no heating system.
MISC.: None.
ADDITIONAL STRUCTURES ON SITEINCLUDED IN SURVEY: None.
#of structures included in survey:,one shed
Requested by: Bill Eichholtz
Carl Dykstra
Inspector, certified A.H.E.R.A.
accred.#1067045 (Exp. June 2, 2011)
continue to page 3
fir.. ..,.
4.:,,::::,:•::-.•4
1429 Ave.D.8187,Snohomish,WA 98290 425-489-4040;c 206-914-5500;f 775-665-0420
e mail Asbestotest{a�msn.com;web:www.asbestotest.com
S
Page 3 of 4 October 11,2010
CI32I01005 Asbesto-Test,Inc. 425-489-4040
Shed only(Ii 30854 Pacific Hwy. S, Federal Way,King County, Washington 98003
ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL
THERE WAS NO ASBESTOS DETECTED IN ANY OF THE SAMPLES
1.0 composition roofing NAD cellulose,tar
fiberglass,
non-fibrous materials
2.0 roofing mastic NAD non-fibrous materials
3.0 roofing vapor barrier NAD cellulose,tar
continue to page 4
45;`>`>§1 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;c 206-914-5500;1 775-665-0420
e mail Asbestotest(almsn.com;web:www.asbestotest.com
, , ,
•
' .S
Page 4 of 4 October 11, 2010
0132101005 Asbesto-Test,Inc. 425-489-4040
Shed only(a,30854 Pacific Hwy.S, Federal Way,King County, Washinjton 98003
Some sample analyses listed may be a representative analysis of individual and separate samplings and analysis of homogenous
materials,as prescribed by A.H.E.R.A.protocol.
Samples taken are listed with their corresponding analyses.If asbestos is detected,those samples containing asbestos are listed first
and noted with the initials"ACM".
If,during demolition or renovation,any additional hidden or covered suspect materials similar to those identified in the survey are
located[may include but not limited to:sheet vinyl flooring,tile flooring,wall or ceiling texturings or paints,concrete siding or
skirting,cement pipes,cement wallboard,electrical cloth,electrical wiring insulation,thermal paper,wallboard,joint compounds,
vinyl wall coverings,spackling compounds,or any other suspect TSI(Thermal System lnsulation)jsthey are presumed Asbestos
Containing Materials unless determined to be non-asbestos by laboratory analysis.
Note:Asbesto-Test,Inc.does not guarantee approximations of quantities of ACM;,which may be listed with the analyses.It is
therefore recommended professional abatement price and/or disposal quotes be obtained by inquiring as to fees per area of specific
ACM material(i.e.square or linear foot,etc.),or by on site assessment.
Any and all materials identified as ACM and/or PACM in this report must be abated prior to disturbance,renovation,or demolition.
Analytical test method:USEPA 600/R93/116**(PLM);WAC 296-62 07753 App.J
Key: ACM signifies Asbestos Containing Material"
PACM signifies"Presumed Asbestos Containing Material"
CAB signifies"Concrete Asbestos Board"
< signifies"less than"
TSI signifies"Thermal',System Insulation"
HVAC signifies"Heating Ventilating Air-Conditioning"
NAD signifies"No Asbestos Detected'
**One percent is the USEPA regulatory limit for asbestos in bulk samples.
PLM has been known to miss asbestos in small percentages of some samples, which contain asbestos,thus negative
PLM results cannot be guaranteed. Floor tiles and wipes should be tested with SEM(scanning electron microscope)or
TEM(transmitting electron microscope), to insure analytical accuracy when asbestos is reported in small percentages.
END OF REPORT
ArLynn Hammond,Pres.
Analytical Chemist,B.Sc.
AIHA proficient
.,,......--'":—.--4...„.
b A Tr
47 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;c 206-914-5500;f 775-665-0420
e mail AsbestotestAmsn.com;web:www.asbestotest.com
l• - .
411
Project Name jue t` �i^ Applicant .(-)1� "l L(C)L(C) (r
-EZ
Project Location t Cr C J' q Tracking No.
IV. FURTHER INFORMATION
Provide the approximate quantity of fill and source of fill to be imported to the site.
Approximate Quantity of Imported Fill Source of Fill
X ts"
Check box#1 if you do not plan to store, handle, treat,use,produce,recycle, or dispose of any of the
types and quantities of hazardous material or deleterious substance listed in Section III. Check box(s)#2
through#5 (and fill in appropriate blanks)of the below table if they apply to your facility or activity.
#1 [ ] The proposed development will not store,handle,treat,use,produce,recycle,or dispose of any of
the types and quantities of hazardous materials or deleterious substances listed above.
#2 [ ] Above ground storage tanks,having a capacity of gallons will be installed.
#3 [ ] Construction vehicles will be refueled on site.
Storage within wholesale and retail facilities of hazardous materials,or other deleterious
#4 [ ] substances,will be for sale in original containers with a capacity of gallons liquid or
pounds solid.
The presence of chemical substances on this parcel is/will be for"temporary"non-routine
#5 [ ] maintenance or repair of the facility(such as paints and paint thinners)and are in individual
containers with a capacity of gallons liquid or pounds solid.
Check any of the following items that currently exist or are proposed in connection with the
development of the site.
#1 [ ] Stormwater infiltration system(e.g.,french drain,dry well,stormwater swale,etc.)
#2 [ ] Hydraulic lifts or elevator,chemical systems,or other machinery that uses hazardous materials
#3 [ ] Cathodic protection wells
#4 [ ] Water wells,monitoring wells,resource protection wells,piezometers
#5 [ ] Leak detection devices,training for employees for use of hazardous materials,self-contained
machinery,etc.
f ;
SIGNATURE I r
. ' 101 (6
Signature Date
< < ( A L/tr1
Print Name
If you have any questions about filling out this application form,please call the Department of Community
Development Services at 253-835-2607. Please be advised that an application for a development permit
lacking the required information will not be accepted.
Bulletin#056—April 10,2009 Page 3 of 3 k:\Handouts\Hazardous Materials Inventory Statement
440%,16. MAIN�/ ON-SITE
CITY OF " Construaction I e4tion Record
Federal Way INSPECTION REQUE TS: (253) 835-3050W
PERMIT#: 10-104605-00-DE Address: 30854 PACIFIC HY S
Project: NEW LUMBER AND HARDWARE FEDERAL WAY, WA
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 s 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.
0 Final-Building(4050)
Approved
By Date
1
0 Rough Electrical111 Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date