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09-101329 At 3 Demolition City of Federal Way • 410 Community Development Services • P.O.Box 9718 F- 17 r Permit #. - 1329-00-DE Federal Way,WA 98063-9718 Inspection Request Line: (253) 835-3050 Ph.(253)835-2607 Fax (253)835-2609 Project Name: FEDERAL WAY FOREIGN INVESTMENTS INC Project Address: 27614 PACIFIC HWY S Parcel Number: 720480 0188 Project Description: Demolish unsafe building per VO 08-102805. Owner Applicant Contractor RON FULLER RON FULLER FEDERAL WAY FOREIGN INVESTMENT FEDERAL WAY FOREIGN INVESTMENT FEDERAL WAY FOREIGN INVESTMENT 27614 PACIFIC HWY S 27614 PACIFIC HWY S 27614 PACIFIC HWY S FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 �::.. i -,,`A,,,.,. Addittonatp anemia formate+ i , PERMIT EXPIRES Saturday, April 9, 2011 Permit Issued on Thursday, April 9, 2009 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: l 7 L`6) � 411k,, • THIS CARD IS TG&EMAIN ON-SITE CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT #: 09-1013.29-00-DE Owner: RON FULLER Address: 27614 PACIFIC HWY S FEDERAL WAY, WA 98003-3400 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 01 .Ll Date y_tD_p4 • . i For inspector reference only ❑ Rough Electrical 0 FINAL-Electrical Approved Approved By Date By Date CITY of tl.... • I -- _ l 0 / / 3 A Federal Way PERMIT OENCOMMUNITY DEVELOPMENT SERVICESSF MF CO ME EL PL FP 33325 8TH AVENUE SOUTH•PO BOX 9718 FEDERAL WAY,WA 98063-9718 APPLICATION T° 253-835-2607.FAX 09 '' --..„,,,,....j www.cifrofedemtwau.com The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type. • PROPERTY INFORMATION SITE ADDRESS_^12 7 /(`( Y z [', kt.-/` ,.c. SUITE/UNIT# ASSESSOR'S TAX/PARCEL# 7 2 0 V 0- 4 LOT SIZE(sj � 11 L) 0 I LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) (Attach separate page for Lengthy legal description) IN PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL QI DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROD CT DESCRIPTION(Prouide detailed description of work inc ded on this permit onlu) } Je / 554dt / /� C= ()I , 7 , i PROJECT NAME(Name of Business or Owner Last Name) eL41,1 (e( i&/ /� i iAt} 'c--__. .1 PEOPLE INFORMATION �� PROPERTY NAME ( 7��/ f > PRI Y PHONE f OWNER MAIUN 8.R� u�/ ��e-,1/-cm_/ L,)` i /' r72a -ii c./ V 3 L// -?Ae) L rhr,STA E'ZIIP `/ E-MAIL AD ESS kiccietfii CONTRACTOR COM ANY NAME, APPLICANT NAME �` OFFIC PH0I ( (',/ ,c b 4-4 (/ ilt i (L, , -3/ / _RIG AD/D SS //��// / _ AT ,ZIP( i tali, _ I1' DF'FEDERA[�WAY SUSIItl I E • ` :T, ER Y y of/.I L EXPIRATION�DATE `" ` 'i- (ELL BN _ FAX NUMBER ( CONTRACTOR'S c .• ) ( t EXPIRATION DATE E-MAIL ADDRESS APPLICANT CO�bPANy pIAME ' 1{/�'/ APPL[ NT NAME OFFIC O E re 6 e„,44 .2,zr `11Kr` ''/ `SIT r y'�zIP f...../. t.'� tis? j/ -Z47/ MAILING DpppR•Ss l b' j 7 7 YY Iii.L> 0( F}��h ��j (CELL PHON ,, RELATIONSHIFTO PROJECT / / FAX NUMBER �� 0 Architect 0 Tenant ❑AgetSt ❑ Other 6,'It/41, l-- ( ( ) - PROJECT NAME ,, } CONTACT E/ 61,1 ..r.,::1", % Gk:,�/ � ^ HO / E-MAIL ADDRESS IV. LENDER NAME /Th } Per RCN,'19.27.095: (�' d�`e, Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) - • DETAILED BUILDING INFORMATION EXISTING USE ( 2,Sq �" c.1.4.,' )� PROPOSED USE So( ill EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ (.Ick SPRINKLERED BUILDING? ❑ YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO WATER SERVICE PROVIDER iLAKEHAVEN o HIGHLINE ❑ TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER o LAKEHAVEN 0 HIGHLINE Ad PRIVATE(SEPTIC) E PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. SQ.FT. SQ.FT. BASEMENT FIRST 200° SECOND THIRD ADDITIONAL FLOORS(DESCRIBE) DECK(0 COVERED OR 0 UNCOVERED?) GARAGE 0 CARPORT 0 NUMBER OF FLOORS =STEMPROPOSED TOTAL TOTAL=STEW sr TOTAL PROPOSED SF TOTAL SF **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES 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 Icommq COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG.SYSTEMS PLUMBING BATHTUBS(or Tub/Shower Combo) LAVS(sarhroomsira.4 URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS WATER CLOSETS(rogeq ELECTRIC WATER HEATERS SINKS WASHING MACHINES HOSE BIBBS SUMPS SIG1TATUR ° 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 a part of this application. SIGNATURE: .i/ h DATE 0 3 .-' Property Owner and/or Authorized Agent I , a � I�.• i a NEW a ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT BUILDING SHELL ONLY? a YES a NO BASIC PLAN? ❑YES o.NO ZONING DESIGNATION CHANGE OF USE? a YES a NO AAAA... NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES ❑NO PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES a NO Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Permit Application MAR-13-2009 13:43 Fr'orn:ELECTRIC FIRST REP 2533956886 To:A.25-38743484 P.1'1 r '\.' 0,..,, 4- 7 _ 0 t A C)f- c \-kv y-r 3 DEPARTMI':NT OF COMMuNITV DEVELOPMENT S.akVTCES ! 33325 St°Avenue South Pu Box 971K CITY OF - - (. .. . '.c)4 k ‘ I Federal Way WA 9$063-9718 Federal Way 253-835-26(77;Fax 253-U5-26091' a2,(7 . 874 . f' Q - www.cityalIederalway_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 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). Nom rtl APPLrc4Nr: Utilities shall he disconnected and cervices performed, if applicable,prior to issuance of the demolition permit,All applicable items below are to be 'rjpnd dated by the respective agency representatives. 1.ASBESTOS ABATEMENT 6.E CTRICrTY (Copy of approval form and asbestos survey from Puget Sound Peen JrA (El city be u re Agency provided) . ,; '"� °'' ( 'jr �' t -0 (Puget Sound Energy (City of Federal Way Building Official) 2.G P t •Y 7.FUEL STORAGE TANKS ( ,s to .ff, myly,,. and final bill Paid)...,,,,, (Above or below grade fuel tanks,have been pumped or removed . fit --�G�.,, i'� i under Fire Department permit prior a dismantle/excavation) l (Puget Sound Energy) � / (South King/ and Rescue) 3.SEPTIC SYSTEM 8.WATER Public Source (Check applicable box) (Tank to be removed or tank to be drained and tilled) c Mehr to be removed and final utility bill paid _/2 / (� _ n Meter to remainandbe/p (King County Environmental Services) (Water Supplier) ******OR****** 4.SANITARY SEWER (Check applicable box) 9.WATER-Private Well(Check applicable box) ❑Sewer line capped at property line n Private well filled and capped o Existing sewer line to remain a qe used by proposed new structure a Private well to be used for other u (Lakehaa�fien/Utiility District) (King County n1n�nta1 Services) . 5.GARBAGE (All household garbage clipegf,ed off a final bill paid) (Waste Management/Other Company) ❑Completed Construction Permit Application form ❑Provide the following fees; L Demolition Permit Fee Blued on valuation.Sec table on pg 4 of the construction permit application. 2.Automation Fee $6.00 3.WA State Surcharge $4.50 4.Cash Bond Deposit 120%of calculated building permit fee Refundable upon Completed Final inspection ttulletin#122-January 1,2009 Page 1 M t k:1f-fandoats\flcrnolitian Permit Requirements MAR-23-2009 12:53 P.02 • • DEPARTMENT OF COMMUNITY DEVELOPMENT SERv10E.5 33325 8`i'Avenue South ry_ FO Box 9718 CITY OF 14h ;". :rh , Federal Way WA 98063-9718 253-835-2607;Fax 253-835-2609 Federal Way 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, D 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)APPLUCANT:: Utilities shall be disconnected and services performed, tf applicable,prior to issuance of the demolition permit,All applicable items below are to be sipieei'card datedby the respective agency representatives, 1.ASBESTOS ABATEMENT 6. ELECTRICITY (Copy of approval form and asbestos survey from Puget Sound Clean Air (Electricity to be shut off and meter removed) Agency provided) (Puget Sound Energy) (City of Federal Way Building Official) 2.GAS SUPPLY 7. FUEL STORAGE TANKS (Gas to be shut off,meter removed and final bill paid) (Above or below grade fuel tanks,have been pumped or removed under Fire department permit prior to any dismantie/excavation) (Puget Sound Energy) (South King Fire and Rescue) 3.SEPTIC SYSTEM 8.WATER-Public Source (Check applicable box) (Tank to be removed or tank to be drained and filled) o Meter to be removed and final utility bill paid o Meter to remain and be protected (King County Environmental Services) (Wa&Supplier) ***s**OR ****** 4.SANITARY SEWER (Check applicable box) 9.WATER-Private Welt(Check applicable box) u Sewer line capped at property line o Private well filled and capped U Existing sewer line to remain and be used by proposed new structure o Private well to be used for other purposes ( aven Utility District) (King County Environmental Services) 5. E (Ai . ••.id e.cbage_' e.off and final bill paid) (Waste Manage ent/Other Company) C)Completed Construction Permit Application form D Provide the following fees: 1,Demolition Permit Fee i3astd on valuation.Sec Cable on pg 4 of the construction perrnit application, 2.Automation Pee $6.00 3,WA State Surcharge 54.50 4,Cash Bond Deposit 120%of calculated building permit fee Refundable upon Completed Final Inspection F3ullaain 0)22 .,rautsry 1,2009 Page!of 1 k;° andouts\t)ernolition Permit Requirement$ TOTAL P.02 M i ‘h.. DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES 33325 86 Avenue South PO Box 9718 CITY OF Federal Way WA 98063-9718 Federal 253-835-2607;Fax 253-835-2609 Waywww.cityoffederaiway.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 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. D 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 (Copy of approval form and asbestos survey from Puget Sound Clean Air (Electricity to be shut off and meter removed) Agency provided) (Puget Sound Energy) (City of Federal Way Building Official) 2.GAS SUPPLY 7. FUEL STORAGE TANKS (Gas to be shut off,meter removed and final bill paid) (Above or below grade fuel tanks, have been pumped or removed under Fire Department permit prior to any dismantle/excavation) (Puget Sound Energy) (South King Fire and Rescue) 3.SEPTIC SYSTEM 8.WATER-Public Source (Check applicable box) (Tank to be removed or tank to be drained and filled) o Meter to be removed and final utility bill paid Meter to remain and be protected ,,,15") c ?C 3,,, iiN-flElf AvFi (),,-rt LAT q i,ts-T. 'siia-f o (King County Environmental Services) (Water Supplier) ******OR****** 4.SANITARY SEWER (Check applicable box) 9.WATER-Private Well(Check applicable box) o Sewer line capped at property line o Private well filled and capped o Existing sewer line to remain be used by proposed new structure o Private well to be used for other purposes Lak2haven Utility District) (King County Environmental Services) 5.GARBAGE (All household garbage disposed off and final bill paid) (Waste Management/Other Company) D Completed Construction Permit Application form D Provide the following fees: 1.Demolition Permit Fee Based on valuation.See table on pg 4 of the construction permit application. 2.Automation Fee $6.00 3.WA State Surcharge $4.50 4.Cash Bond Deposit 120%of calculated building permit fee Refundable upon Completed Final Inspection Bulletin#122-January 1,2009 Page 1 of 1 k:\Handouts\Demolition Permit Requirements SiteMail 6.0 - mdfortowggwest fice.net - RE: Demolition Permit Requirements Page 1 of 1 Read Mail Compose Search Email Calendar Addresses Folders Settings Help Logoff From: 'Kim Cole'<KimC@pscleanair.org> Sent:Thu Mar 12 16:56 To: <mdfortow@gwestoffice.net> Priority: Normal Type:Embeded -�-- Subject: RE: Demolition Permit Requirements HTML/Text JoAnn, Reply 1 My read of the attached form indicates the City of Federal Way Building Official that reviews the form when Ron goes to get the City's demo permit will sign in the#1 spot. There isn't a signature required from my Agency. What you need is a copy of the survey that you sent me. You can not get a demolition permit from the Clean Air Reply All Agency because the demolition has already occured. You might want to attach a copy of the violation I issued and print a copy of this e-mail to attach as well. Forward Kim Cole Puget Sound Clean Air Agency X Delete 1904 3rd Ave,Ste 105 Seattle,WA 98101 Address Book 206.689.4020 kimc@pscleanair.org Print From:mdfortow@qwestoffice.net[mailto:mdfortow@gwestoffice.net] , ' Block Sender Sent:Thursday, March 12, 2009 12:59 PM To: Kim Cole View Headers Subject: Demolition Permit Requirements Hello Kim, Next Would you be so kind as to sign#1 on this form and email it back to mdfortow@gwestoffice.net(Ron Fuller's email address)or fax it back.Form is an attachment. Previous Ron Fuller Owner Federal way Foreign 27614 Pacific High South Suite A Federal Way,WA 98003 Phone Number: 253-941-2131 Fax Number:253-874-8484 Thank you JoAnn Folders User Profile Logoff 11111: / iittllAwstt ff ,nct s tamed ademail. l' id=9c fc/der nnb x&cache=7F74B3... 4/6/2009 + pscleanair.org Ph 206.343.8800 • 1-800-552-3565 • fax 206.343.7522 0 0 Asbestos Notice of Violation No , - 842502 z Violation Date: /-27—Oq Time: a:ap pi? A Case/Registration No.: Name Responsible Person, Title .,/- r + i 7Ox' itt� oon0 ail 31i5 fiao-a, 'iort ;141 rr/wri trn =if 1�r�2rakGt , 7/41.14` •r k4., r�,�' Site Address // ,r City Zip 1C�County j{'7 2:7 Li 4 i CijiC 4 i�.ry�j k'e%L (,e 1' Mailing Address + City, State 1 Zip Phon X4017 IztiN AA- Si fS 1ilnine-Si WA /8 lig- b' ea getii 113I Violation of Regulation III, Section(s): ,0o6 • $1 . ?ail XI 4.02 Failure to have an AHERA bldg. Inspector conduct an asbestos survey before performing.a renovation or demolition. ; ❑ 4.04(a) Failure to remove all ACM before any renovation or demolition project that may disturb the ACM. ❑ 4.05(b)(1) Failure to conduct an asbestos project in a controlled area clearly marked by barriers and asbestos warning signs. ❑ 4.05(b)(7) Failure to seal ACWM in leak-tight containers as soon as possible after removal but no later than the end of each work shift. ❑ 4.05(b)(8) Failure to keep absorbent/nonabsorbent ACWM saturated/coated with liquid wetting agent until sealed in teak tight containers. ( l. .L 4.• '.r,.i/.lt ....- i� fl''1...341. ti ,- ±12 �M /b�' `.. .;.d,..`. i.''t:e -''?.4i- /.' 0 077 b 1f Cft c; f4'`(s l F. �.a-Az "4-0 4- ,MI Facts Alleged to Constitute a Violation: .. L) A f-' k u..1,��/+{y� t -4- t.- ,J -'�7 N ^t o r a. . -41-4a C -n 100-fti@, ul -%I . 4/��?�1 cej r t K' eery/Chill I ..4.,-/144. !�(J(1T{,/� .\ ^.Y' .,06:44,,,i)-61-&e:11 -770 ��t�'�c � � /L'[ �I/LL4) �{ t-'�,+r id.);hi %J2� ,. '�. F�-...�17. „if,.�"1r L'V vl.q/.�/ ■ 1 ,/Iii... / ( ) O{7 /f /'� j- + !qui +.l. / -1 ,X,'�Ll,.{ Ll.+GC 1 f.N/i - 9 br� Corrective Action Order You must take the corrective action described below. ❑ Within 10 days of the date you receive this Notice of Violation, submit a written report describing the action you have taken to correct this violation and achieve compliance with Agency regulations. )4 1W You must .ir►:. -r- �_ 6.4,-At Lk#? 6adelittal .11 -) efrniA,c,f 61 rAt ,sitAvel 4,6-tl,o _,..)a.t . 0441. plzmft14.1 4,cll'.o5,.`---° ailAsti 6.t t '`;.,i'"°� 14.74. Lf,fiti (- /14,-.�} e7 p-rf[ltt rnt L� bt(.t�t7 ,.cn l 41..2.x. J e�Kt-thts 1 (,r t `r' yl'(.a � .t` aftd 111444-k t-ei,. . . ... �iu >nu4;4_ /1' �,, v4 t�rr i rhe ci 4e4 *f?.rR' d-r -e. l'. tip Ac to..rk: Issued by: • ,/ � ;fj7 rr i Datelrirrre: $ 2/ y ilyt' ifA Received by r Signing this document is not an admission of guilt print name Apr 01 09 04: 45p G&N SEPTIC TANK SERVICE 3608251637 p. 1 4111 REPORT OF WASTEWATER TANK PUBLIC HEALTH ABANDONMENT SEATTLE & KING COUNTY 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, Title 13. Return Completed Form to the Following Address: Date Received: Black River Environmental Health 900 Oaksdale Ave. SW Ste.100 Phone(206) 296-4932 Renton,WA 98057 General Information(Please print): Name of Owner/Occu ant of Property: "*_tt Address: ,9 i LP l tit�tG y F '\N y Telephone: xy77� i a1-22 Date of Report: ?! /, gt I V( Wastewater Tank Data: Type of Sewage Tank: X Septic Tank Pump Tank —Holding Tank Other: Number of Compartments Pumped: 1 Number of Gallons Pumped: / ?UCS Checklist Item Yes No Not Applicable Comments Septage removed by an approved pumper?* X Tank lid removed or destroyed? Tank void filled with compacted soil? *OSS Pumper Name: C7.f'CAEVtCT +ee p iij King County Certification Number: H 11R Reason for wastewater tank abandonment: Property being served by public sewers Property being served by replacement tank Comments: �' Signature: Date: 7 /1I!'/ - Report of Wastewater Tank Abandonment: Print Date 5/12/99 Forms/sewage/form.96 .03-05-'09 i459 FROM-Pacific Flim Env, +206-244-9096 • PACIFICENVIRONMENTAL, T-172 1'lti?1Lr'ldid'G r—b7 , PR IN . C �;L';�"1 i.l' t��4��.f>itCri?tzCnv,CUt7� A?lC!-IORAGL.. . L,,_„,,_ E March 5, 2009 Ron Fuller Federal Way Foreign investment 27614 Pacific Highway South, Suite A Federal Way, WA 98003 i.•REif 13990 e��xa�,..av+axsn,,r.5v ,ti, r , , . 1 Fra ICT.(.RI E�,IjiR f'i��frf`{�'H' I RE: CREDIT CARD RECEIPT I 6:,5�i3 eat. `fF{t;ct ER; l..�.te' Dear Mr. Fuller, ' MF2` x '00}141";?1 {�`'` i Thank,you for giving us the opportunity to serve you, - Dr-pCi cs � Enclosed is a credit card receipt for the amount of $825.00 7: 3i r MP charged on your account #**'9468. Please sign the ` photocopy of the credit card receipt on the right for our :OM; 558-Z5..00M i records and email or fax it back to us at your earliest ; '.` 1: * + **: : * �- =y 1 convenience. My email address is dle @ pecrirnenv.com and _,,, . L.,,,12 ;,;,, mi-=T`%I1 ' my fax#206-244-9096. � ,.i� ..iy j^Li i 4<<,. 1 _ ':C:,1.,..- ��N ,r f lam' If you have any questions please do not hesitate to contact ' 1''P. 1r-;SN; :". PIVOT our office at(206) 244-8965. 1 • HEREON AND,PCil? ES 1 TO bT' 717, �t 'r.`>s `' Iti rl. R4T Thank you, ialT1' THP' =SSCFR raNf �a T-� t- J Please Si.014 t-tere _c -t.,..-e:-�'-� ' -- -— 41 Dal Le Accounts Manager Pacific Rim Environmental, Inc. _._ corporate Office Anchorage office 6510 Southcenter Blvd.,Sic,#4 Phone:(907)569.8081 Seattle,llA98i S8 wmv,pttcrintenv.cottt Phone, (206) 244-8%5 Fax: (206) 244-9096 Ø3- 4-' L19 10:51 FROM-Pao.: Pim Env ..206-244-9096 • T-167 P001/015 F-667 PD -174 . . PACIFIC RIM LI\VIRONME..\-TAI INC 1VI ASBESTOS SURVEY Former Commercial Building 27614 Pacific Highway South Federal Way, WA .1 • • • • PERFORMED FOR: Ron Fuller 27614 Pacific Highway South Federal Way, WA 98003 PE ORM 0 Todd P. Carter Pacific Rim Environmental, Inc. 6510 Southcenter Boulevard Tukwila, WA 98188 PRE#: 13990 DATE PREPARED: 02/25/2009 t.t>eput ate Ottocv Anchorage Oftit e 10 sontheenterlilvcL,Ste,#41 Phone(907) 509-808 I ".;!-:rtnie 1NA 98188 WriiThi-ra• ?AC {. C N Y TROi`_�rlE_V y , INC. Ill V BULK SAMPLE ANALYSIS REPORT WENT.. Ron Fuller PRE#: 13990 Federal Way Foreign Investment REPORT#: 2009-02-236 27614 Pad Hwy South DATE RECEIVED: 2/18/2009 Federal Way, WA 98003 ANALYST: William F .Golloway DATE ANALYZED: 2/23/2009 REPORT BY: Amy Jackson REPORT DATE: 2/23/2009 SAMPLE DATE: 2/10f200c} TURNAROUND: 3-5 Days CONTACT: PAGE: 1 of 4 Attached are the results of analysis of 11 bulk samples submitted for asbestos identification: lab IU #2009-02-236 through 2009-02-246. Samples were analyzed in accordance with method EPA-600/R-93/116: "Method for the Determination of Asbestos in Bulk Building Materials". Unless otherwise noted, samples were inhomogeneous: subsamples of components were analyzed to achieve representative analysis. Separate layers of layered samples are analyzed and reported separately. Unless otherwise stated, asbestos content was quantified by calibrated visual estimation (CVES). OVES concentrations are reported in 2 to 3 percent ranges tor fiber concentrations ranging from 1-10%, and 5 percent ranges for concentrations greater than 10%. Samples in which asbestos was not observed are reported as"none detected", Limitations and Uncertainty: Factors such as sample quality; sample size, interfering matrix material, fiber size, and fiber concentration contribute to the uncertainty of asbestos concentration measurements in bulk materials. Relative errors exceeding 100% may occur in samples containing <1.10% asbestos. Relative errors are typically below 30% in samples with greater than 10%asbestos,and approach zero as the asbestos concentration approaches 100%, Asbestos fibers with diameters below approximately 0.25 micrometers are not detectable by PLM. These extremely fine fibers may occur in such products as floor tile, adhesives, and cement products. This limitation can be overcome, however, by the use of alternate analytical methods, such as Transmission Electron Microscopy (TEM). This report cannot be represented by the client to claim product endorsement by NVLAP or any agency of the U.S. Government. Test results pertain only to the samples submitted for analysis. This report shall not be reproduced except in full without written permission of the laboratory. NVLAP Accredited LAB#: 101631-0 Reports Samples submitted b PRE Reviewed — A l rovtd3-i6nyt ry Corporate Office Anchorage Office. . i}cnzitl:('estt@'Blvd .Sic 7t4 Phone (9tl7) 569-80S I �E'Eltli?,W,1'r1'-M 188 11 t1.1)itC1111'.ta?t,t U!i? PhOsle: I,210 2,FI-S965 1:10 (?iaO ...H-i}0006 3-04-.' 09 i@:28 FROM-Plikic Rim Env • +206-244-9096 T-166 P001/001 F-666 PACIFIC RIM ENVIRONMENTAL INC. R6510 Southcenter Blvd. Suite 4 E Tukwila, WA 98188 Phone (206) 244-8965 Fax: (206') 244-9096 INVOICE Date: 2/27/2009 Invoice # 33424 TO Federal Way Foreign investment 27614 Pacific Highway S. Suite#A Federal way, WA 98003 PRE Job ft Client 'Project Name/# Commercial Building 27614 Pac, Hwy , A 13990 eral AS. Net Due Upon Receipt FedWay, W 98003 Ste. Contact: Ron Fuller Description Shift,/Hours/Qty. Unit Price 1 Line Total 2/18/2009-Todd Carter-AHERA Building Inspector 4 $75.00 $300,00 Asbestos Bulk Sample Analysis-Standard TAT 11 $25.00 $275.00 — Final Report 1 $250.00 $250,00 Total: $825.00 Thank you tr your bt.nines! Ail invoices are due upon receipt, A late charge of 1.5%will bo added to any unpaid balance after 30 days. We accept Visa, MasterCard and American Express. 03-04-' 09 10:52 FROM-Pack Pini Env +2006-244-9096 411 T-167 P002/015 F-667 Table of Contents Section 1.0 Scope of Work 2 Section 2.0 Asbestos Containing Materials(ACM)Survey Narrative 4 Section 3.0 Statement of Compliance 5 Section 4.0 Cost Estimate 6 Appendix A Asbestos Sample Summary Appendix B Laboratory Analysis Data Sheets Appendix C Inspector/Laboratory Certifications FRE #1$990 This report shall not be reproduced except in full without written permission of Pacific Rim Environmental,Inc, 03-04-' 09 10: 52 FROM-Fail Rim Env, +206-244-90196 • T-167 P003/016 F-667 Section 1,0 Scope of Work 27614 Pacific Highway South, Federal Way WA Pacific Rim Environmental, inc. (PRE) performed an asbestos survey of the building site and demolition debris associated with the former commercial building located at 27614 Pacific Highway South in Federal Way, WA. The subject was a wood frame commercial building on a concrete slab. The building burned and was subsequently demolished and loaded into a roil-off box for disposal. Field inspection, data collection, and report generation were performed according to the following Scope of Work; Asbestos-Containing Materials(ACM) 1. Bulk sampling and analysis of suspect asbestos-containing materials(ACM). 2. Analysis of suspect ACM by a NVLAP accredited laboratory. 3 Quantity estimates of ACM. 4. Written report including recommendations based on the technician's observations, abatement (removal) cost estimates,sample descriptions,and sample location. 5. Statement of Compliance with W.A,C.296.62-07721 Sign-off form. This survey was intended to identify possible asbestos-containing materials (ACM) on the interior and exterior of the building. This inspection covered only those areas, which were exposed and/or physically accessible to the inspector. Materials uncovered during the course of demolition, renovation, or maintenance activities that are not identified in this inspection report must be presumed to contain asbestos until PLM analysis proves that this material is not asbestos- containing. This survey is not intended for, nor should be used as a design specification. The Asbestos in Schools Hazard Amendment and Reauthorization Act(ASHARA), effective November 20, 1990, expanded accreditation requirements to apply to persons who work with asbestos in public and commercial buildings as well as schools. Specifically, ASHARA expanded the Toxic Substances Control Act (TSCA) Section 206 (a) (1) and(3)to require accreditation for any person who designs or conducts a response action with respect to friable ACM in a building. TSCA Section 207 provides for civil penalties of $5,000 for each day of a violation for not employing accredited individuals to design and conduct response actions. Sampling of suspect asbestos-containing materials was conductec as prescribed in 40 CFR 763.86. Suspect asbestos-containing materials within the structure were identified and classified as a surfacing material,thermal system insulation, or miscellaneous materials. Surfacing materials are those,which are either spray applied or troweled- on for acoustical, decorative, or fireproofing purposes. Thermal system insulation (TSI) is insulation used to inhibit heat transfer or to prevent condensation on pipes, boilers, tanks, ducts and various other components. Miscellaneous materials include all other materials not included in the above categories such as floor tile, ceiling tile, roofing felt, cementitious materials,wallboard systems and products such as caulkings,mastics and putties. A total of eleven (11)samples were collected and submitted for PLM laboratory analysis, none(0)of these samples was found to contain greater than 1%asbestos. PRE #13990 2 This report shall not be reproduced except ir,full without mitten permission of Faciiii;Rim Environmental,Inc. 09 10: 53 PRA-Rai:10 Rim En , -206-244-9096 410 T-167 P004/315 F-667 Section 2.0 Asbestos-Containing Materials (ACM) Survey Narrative 27614 Pacific Highway South, Federal Way WA Thermal systems Insulation (TSI) No suspect thermal system insulation was identified on the subiect Property. If during the course of wall, ceiling or floor demolition, any TSI materials that are not listed in this report are uncovered, sampling must be performed prior to disturbing these materials. Surfacing Materials Suspect asbestos-containing textured drywall was observed on the ground around the building pad and inside the roll-off dumpster on-site. The material was sampled several times and no as,bestos was detected. If during the course of wall, ceiling or floor demolition, any surfacing materials that are not listed in this report are uncovered, sampling must be performed prior to disturbing these materials. Miscellaneous Materials Suspect asbestos-containing floor mastic was observed on the building pad. f he material was sampled and no asbestos was detected Suspect asbestos-containing roofing material was identified on the ground around the building pad and in the roll-off dumpster on-site. The material was sampled and no asbestos was detected. Suspect asbestos-containing floor tile was identified behind the building pad. The material was sampled and no asbestos was detected. If during the course of wall, ceiling or floor demolition, any miscellaneous materials that are not listed in this report are uncovered, sampling must be performed prior to disturbing these materials. This rwx)rt shall not te ienrrxliic excw.tt In wtnoiJt vAitten perrnis.5ivi Paci/i0 Han Environcft"ntal,inc. . . ' 0 03-04-" 09 10:56 FROM-Facie: Rim Et-A, , +206-244-9096 T-167 F010/015 F-667 Pacific Rim Environmental, Inc. BULK SAMPLE ANALYSIS REPORT ---- CUENT: 11On FUller PRE#: 13990 Federal Way Foreign investment REPORT#: 2009-02-236 27814 Pad Hwy South DATE RECEIVED: 2/18/2009 Federal Way,WA 98003 ANALYST: William F .Gollovvay DATE ANALYZED: 2/23/2009 REPORT BY : Amy Jackson i REPORT DATE: 2/23/2009 I TURNAROUND; 3-5 Days CONTACT: PAGE: 2014 .,...„— Field/Lab ID Samplei ----- Tate Number Location and Description Asbestos Type(s)I% Other Material(s) Analyzed ,_____......._ i Building pad (mastic on Layer 1 (Mastic): Layer 1: Cellulose (<1%), 2/23/09 concrete slab floor). None Detected Adhesive, Mineral 2009-02-236 Aggregate Light brown mastic (layer 1) on green-painted, light Layer 2 (Mastic): Layer 2: Cettulose (<1%), brown, brittle mastic None Detected Adhesive, Mineral, material (layer 2) on thick Aggregate, Paint gray paint (layer 3). Layer 3 (Paint): Layer 3: Cellulose (<1%), None Detected I Paint, Mineral Aggregate. I ---- . 2 Building pad (wall texture I Layer 'I (Texture mud): Layer 1: Cellulose (<1%), 2/23/09 debris on footing). None Detected Binder, Mineral Aggregate, 2009-02-237 Paint. Gray-painted, white, I chalky texture mud (layer Layer 2 (Joint Mud): Layer 2: Cellulose (10- 1) on gray or white- I Chrysotile 1-3% 15%), Binder, Mineral painted, white, chalky Aggregate, Paint, joint mud with white and brown paper (layer 2). 3 Building pad (roofing Layer 1 (Roofing): Layer 1: Cellulose (<1%), 2/23/09 debris on ground). None Detected Fiberglass (5-7%), Mineral 2009-02-238 Aggregate, Tar. Black tar roofing with red and gray gravel (layer 1) Layer 2 (Tar Paper): Layer 2: Cellulose (60- and tar paper (layer 2). None Detected 65%), Tar. — ----I ---- — — . 4 Behind building pad (tar None Detected Cellulose (60.65%), Tar, 2/23/09 paper debris on ground), Binder, Mineral Aggregate. 200g-02-239 Black tar paper material with white residue. 5 Behind building pad None Detected Cellulose (1-3%), 2/23/09 (drywall debris on Fiberglass (3-5%), Gypsum, 2009-02-240 ground). Mica, Binder. White, chalky drywall il material,with brown _ _ — — 03-04-' 09 10:57 FROM-Pacltic Rim Env, +206-244-9096 0 T-167 P011,015 F-667 Pacific Rim Environmental, Inca BULK SAMPLE ANALYSIS REPORT -____ _ __..__ DRE#:�13990 ! �_ GUEtJT: Ron Fuller REPORT#: 2009-02-236 Federal Way Foreign Investment DATE RECEIVED: 2/1$12049 27614 Pao Hwy South ANALYST: William F ,Galloway Federal Way,WA 98003 DATE ANALYZED: 2123/2009 REPORT BY: Amy Jackson REPORT DATE: 2/23/2009 TURNAROUND: 3-5 Days PAGE: 3 of 4 CONTACT: —— __ - ---- - _.. -- fiat field/Lab ID - Sample Asbestos Type(s) °� Other Material(s) Analyzed_ Humber Location and Description __,_—.__ -- Layer 1 (Tile): Layer 1: Mineral Aggregate, 2/23/09 6—�— Behind building pad (12x12 floor tile). None Detected Binder, Vinyl. 2009-02-241Layer 2; Cellulose {<1 ), Light brown and gray floor Layer 2 (Mastic): tile (layer 1)with clear, None Detected Adhesive, Mineral tacky mastic (layer 2) and Aggregate. light brown and gray floor 3: Mineral Aggregate, tile (layer 3)with clear, Layer 3 (Tile); Layer tacky mastic (layer 4). None Detected Binder, Vinyl. Note: Tiles were separate Layer 4 (Mastic): Layer 4: Cellulose (<1%), pieces and not apparently None Detected Adhesive,AeMineral layered one on top of the other. - --- ---- —. None Detected Cellulose (1.3%), Fiberglass 2/23/09 7 Dumpster (drywall (3-5%), Gypsum, Mica, debris). Binder. 2009-02-242 White, chalky drywall with brown paper and black charred paint.. ___ — ` None Detected Cellulose (60-65%), 2/23/09 debbriris).. 8 Dumpster (tar paperSynthetics (1-3%), Tar, Paint. 2009-02-243 Black tar paper rnaterial with silver paint residue. --- 9 Dumpster (GWB with Layer 1 (Texture Mud): Layer 1: Cellulose (<1%), 2/23/09 texture). None Detected Binder, Mineral Aggregate, Paint. 2049-02-244 White-painted, white., chalky texture mud (layer Layer 2 (Drywall): Layer 2: Cellulose (1-3%), 1) on white, chalky drywall None Detected Fiberglass (3.5%), Gypsum, with white-painted, brown Mica, Binder. paper (layer 2). _ �_ - . . 03-04-' 09 1058 FROM-Paci lc Rim Env, +206-244-9096 41' T-167 P012/015 F-567 Pacific Rim Environmental, Inc. BULK SAMPLE ANALYSIS REPORT _ 1---CLIENT: 11onfulter---- ...-- PRE#: 13990 Federal Way Foreign Investment REPORT#: 2009-02-236 27614 Pac Hwy South DATE RECEIVED: 2/18/2009 Federal Way,WA 98003 ANALYST: WiiliaM F' ,GOODWay DATE ANALYZED: 2/23/2009 REPORT 13Y: Amy Jackson REPORT DATE: 2/23/2009 TURNAROUND: 3-5 Days _CONTACT: _ PAGE; 4 of 4 Field/Lab ID Sample Number Location and Description Asbest % Other Mater iiii( ) Analyzed 10 Type(s)/ 1alyzed ---------, ----- 1 0 Dumpster (GWB with Layer 1 (Texture Mud): Layer 1: Cellulose (<1%), 2/23/09 texture), None Detected ,Binder, Mineral Aggregate, 2009-02-245 Paint, I White-painted, white, chalky texture mud (layer 1._ 1) on white, chalky drywall ite-paintedbrown„ Layer 2 (Drywall): None Detected -- ---- Layer 2: Cellulose (1-3%), Fiberglass (3-5%), Gypsum, with wh Mica, Binder, paper (layer 2). ------1--.1 Dumpster (GWB with Layer 1 (Texture Mud): Layer 1: Cellulose (<1%), 2123/09 I texture), None Detected Binder, Mineral Aggregate, 2009-02-246 Paint. White-painted, white, chalky texture mud (layer Layer 2 (Drywall): Layer 2; Cellulose (1-3%), 1) on white, chalky drywall None Detected Fiberglass (3-5%), Gypsum, with white-painteo, brown Mica, Binder. paper (layer 2). -- 03-04-' 09 10:54 FROM-Falk Rim Env, . -244-9096 • T-167 F'005/015 F-667 Section 4_0 Cost Estimate 27614 Pacific Highway South, Federal Way WA The following abatement costs are "best-effortestimates and are based on current industry averages. The following estimates are subject to many variables beyond the control of PRE. Such variables include, but are not limited to: project duration, contractor work schedule, hours of work allowed by the owner, contractor performance, regulatory agency interpretation of changing regulations, logistics of removal of material and miscellaneous delays. The estimate is meant only as a guideline to assist in the selection of a n abatement contractor and may not reflect the actual finai costs of asbestos removal. They do not include owner costs such as abatement project oversight and monitoring for compliance to law, and compliance to project plans and/or specifications. I nese estimates assume that adequate, professional pians and specifications are prepared. Generally, abatement costs are minimized by professional project management as weii as utilizing the same asoestos abatement contractor to remove all asbestos containing materials during a single project. It is in no way intended to serve as, or replace, a comprehensive abatement specification. Estimates include permitting, removal and disposal. No asbestos-containing materials were identified on the subject Property. PH E. 41 '.',-tnr'.ahall r-t ha rahrr-ri:!raf1 Rrca.0? r W110!)IJI 0o11111,40 0E1MISS1017 01Pacilfc Frn trvironmental. S 213- 4-" 2,9 11 E4 FROM-Facill Rim Env +706-244-3111 T-1157 P5, ø15 F-667 Section 3.0 Statement(*Compliance 27614 Pacific Highway South, Federal Way WA In accordance with W.A.C. 296-62-07721 and PSCAA Regulation Ill, Article 4, Pacific Rim Environmental, Inc. performed an asbestos survey of the building pad site and demolition deoris associated with the commercial building at 27614 Pacific Highway South in Federal Way WA. Should employees or contract personnel encounter any suspect asbestos-containing materials ACM) it is their responsibility to: 1. Contact R representative of the owner: 2. Consult the inspection report to determine whether or not the suspect material contains asbestos 3, If the suspect material does not appear in the inspection report, then that material was not sampled and must be presumed to contain asbestos until proven otherwise by sampling and PLM analysis 4. Ensure that all employees and contractors are informed and advised of the location and type of materials that contain asbestos, No asbestos-containing materials were identified at the subject property: I Hereby Attest. The inspection report has been made available to me. I will inform all suocontractors of the location and types of materials containing asbestos, I am authorized to sign on behalf of my company, Contractor Owner's : _ . Rep — Sloature, Signaturei Print Name. Pant Nam . Ttle: Date Date: — PREI 3990 This recy7t sLi rint be rCor(!duced except r uirAttiout mitten oerrm5sion(.2t PitonAn Env,ronmc;ntai,Inc_ . . • • r . .., • „, „..SPIrP,:"'N, Alt7,*, ,e''.*Ati'''*z,,,,„ '1'''.4', .. ,,...., :Et .41.kt!iek,,,,./i:‘..::1"."7.7";Ltif(t_tle,/,:riii; ';''.;,,,.,',''l,,,cr 4:01)T:q 1'..,..-'!--.'.'''':r..,•,4.11.:'li:4 iyik-1,,:,)72I,4 .:91.1.71tUt:::,,:7 41iftly..7,.,,,-:,,,,f-Ngtoi.L,11:0 i, ..',7'A;,_ Y n-: -,,A (,/ .. ,..., . ki(f ( )c. -./ ;i,. ,.... . 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'A,i,, a_,,...,;!..%.... nn -- ..t., nn n--....-111:-.),.• -<5.--,:n. ..•-7,Lff.-..,;--4. 7-4,-*,..v.,st..-tt onfi-k---,--,„vtea-frvir .;-nn'0 •,‘•,4'',"-'-i,, !•ti„. '-':'''i'fili%t A'7. - '.1',Ii 'v-M/A1114. 4?. ''''--,$, 7\ (i'41,,IC *).1r1W,,, lir,'X ',-?...oliAtils_ 1 i, -4,4001#,-:•,,z-N IR ?tn,.,. 44,\A , i.o.t,._ ...,-,-,.:.... ,.z.,4,171141 ,;:v..... . r..,,„2 lisiiicif...••,..,a.. 41144Vit; -t''''.-:ICT c.-14.4e...-- -:'''''1-Vttef.:-.7 ''t1-70-''1111(04,--:s.:"'''Ni& '-''II' p'`,.V.}u...(4,....,,,— ... i* ._... ,- % . . 110 09 10:59 FROM-Pao* Rim Env. +205-244-9096 T-157 P015/015 F-667 I 1 , 0 • , ... 0 Pa' i *17 mile. ., 1.) 3 I 4, tb ,-i 1-! 1 -.' s]. ei.„4 '•-. 0 0,) : ,,,,) .-7.;-"•, 0.. ;:i 0 1),---• ;,- --- ook 0 6' -4-, c- --, 11 ay (ID = :0 ° 0 1110144 0 4; 6 ' . ;;,••• fag c ri.c) MI I • • :1) ,.... D1 LJ Cr .t1 iii :51 Z rot. 0 V 6, 4,,,. ..Or 6Z•3 .' 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