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06-103222 ` c r City of Federal Way W Demolition Permit #: 06-103222-00-DE i Community Development Services 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: LUCKY BUSINESS CENTER Project Address: 30315 PACIFIC HWY S Parcel Number: 042104 9237 Project Description: Demolition of interior walls,drop ceilings & kitchen equipment ` Owner Applicant Contractor VC INVESTMENTS LLC LU-BOND CONSTRUCTION INC LU-BOND CONSTRUCTION INC 2101 SE 2ND PL 2828 S OTHELLO ST LUBONCI022LH 6/1/08 RENTON WA SEATTLE WA 98108 2828 S OTHELLO ST 98056-8864 SEATTLE WA 98108 Additional permit Information CONDITIONS: After final inspection is complete and approved. Please contact Kari Cimmer by e-mail at a Karic cltyoffederalway.com OR by fax at 253-835-2609 to receive a refund of cash bond. PERMIT=EXPIRES Friday, June 27, 2008 Permit Issued on Wednesday, June 28, 2006 I hereby certify that the abov- information is correct and that the construction on the above described property and the occupancy and the .twill be in accordance with the laws, rules and regulations of the State of Washington .and th- City of Federal Way. Owner or agent: , Date: zg 04 o / THIS CARD IS TO WAIN ON-SITE CITY OF A Pommuni ` p p Develo me t Inspection Record � Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 06-103222-00-DE Owner: Address: 30315 PACIFIC HWY S FEDERAL WAY, WA 98003-4124 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. 0 Final-Building(4050) Approved By (A.) Date 6. 14 C)t�► • RECEIVE b$ Federa1WayPERMIT • COMMUNITY DEVELOPMENT SERNCESN 2 8 SF MF CO ME EL PLGE>N FP 33325 8 AVENUE SOUTH•PO BOX 9718 FEDERAL WAY,WA 98069- 1 /r 2538952607.FAX 253� �� D �u�d'PLI CATI O N !` /Y� www.aiuerrcde au.oemBUILDING DEPT. The ollowi • is re,wired information-an •lete ap•iication will not be accepted. Please •rint legibly n in or 1•e. Ig PROPERTY INFORMATION c3I� - - - (- SITE ADDRESS �?��.='��---( ��--_ �� - �� :LI:, SUITE/UNIT# ASSESSOR'S TAX/PARCEL# . rJ` / - t . f LOT SIZE(sf) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) Oath aeparab Page%lengthy legal desoiptlonl ►. PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed des``cription of work included on this permit only) �CA4Du DR C' iLi'N ASN)) (fMl Tdl, C, • PROJECT NAME(Name of Business or Owner Last a e) • '• i A ark ' . .4 /' PEOPLE INFO12MATION PROPERTY . NAME ` , LL, C PHONE OWNER V . e 771.1l� • La�..L, 3 .( ) - MAILING ADDRESS CITY,STATE,ZIP 30Sir 4-1 ie.)/ y1 Fit kok r CONTRACTOR COMPANY NAME APPLICANT NAME f OFFICE,PHONE L-u - 1DOM) (ANS, jNC' - in{ x FA-N)q 0-G )3`7a -;(i)(t MAILING ADDRESS CITY, ATE,ZIP CELL PHONE I4?t . D 'EG(b 77(Z-- L�1�S feig C) 3 -`7�.3 C OF DERAL AY ESS CENSE NU BER EXPIRATI N DATE FAX NUMBER _a- , -ie _CNA-B6eI231/DK� / / ( ) - CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) 'EXPIRATION DATE APPLICANT COMPANY NAME �� APPLICANT NAME OFFICE PHONE LU'—&). 1-6A.57 f' 6 2( F ocb )3?D - 9c MAILING ADDRESS CITY, ATE, P CELL PHONE' Nis? 5 . t ai&LCv .c7. ,56-7-6-77(2, . LAM 4 64 (4�s)s-a.1 -`A—b3 R I NSHIP TO PR ECT FAX NUMBER ❑Architect Cl Tenant ❑Agent ❑ Other(Describe) ( ) . - CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS h- D 7o rt 5 � ) o3 - 9,t-t) LENDER NAME MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) ADETAILED BUMMING`INFORMATION - EXISTING USE &= .-c' -- PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE $ 371 0/j�6 VALUE OF PROPOSED WORK $�,,7 G 0 t>. C 3' SPRINKLERED BUILDING? ❑YES /O--NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES '::(NO WATER SERVICE PROVIDER EVAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER 0 4A EHAVEN . ❑ HIGHLINE ❑ PRIVATE(SEPTIC) s a. • PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. SQ.FT. SQ.FT. BASEMENT FIRST SECOND THIRD FOURTH ADDITIONAL FLOORS(DESCRIBE, DECK(COVERED?) GARAGE 0 CARPORT 0 NUMBER OF FLOORS =WINOrxorosso ronu •1?;, �.•, , **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES Indicate number of each type of fixhtre to be installed or relocated as part of this project. Do not include existing fixhires to remain. MECHANICAL Value of Mechanical Work $ AIR HANDLING UMTS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS FANS' HOODS(CommercialWOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCTS /� GAS PIPE OUTLETS PLUMBING BATHTUBS(or Tub/showorcombo) SHOWERS WATER CLOSETS(ToSeq MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAVS(Bathroom sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS DISCLAIMER/SIGNATURE BLOCK 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 m e by any person,including the undersigned,and-it led against the City of Federal Way,but only where such claim arises out of the reliance city,including itsofficers and employees,upon the accuracy of the information supplied to the city as a part of this application. j j' 1 /rl NAME/TITLE / % DATE ,r (S' ature� (Title) RELATIONSHIP O PROJECT c Owner 0 Agent 0 Contractor ❑Architect Other '��'x� � m� s„�,N.aq �s r. ,. dy �./2 V ;`7 C.. :air � vYE,,,,,,rL, t.4q,.�i3a.j�a.��1 i t��` ,,,i'1 x �,.} x:i`.;Q ' : y e1 : °ill`` kx549�?r. �ibi,�'3 �a3� if ✓��'�, ft�'�,x (Yi z�� Bulletin#100—January 1.2006 Pace 2 of 4 k�Handouts�Permit Application • DEPARTMEiOF COMMUNITY DEVELOPMENT SERVICES 33325 8`h Avenue South „..., . CITY OF ,,,,,,. PO Box 9718 swgie Federal Way WA 98063-9718 Federal Way. 25383 -2609www.cityoffederalway.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. L,iS�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.AS,L STOS ABATEMENT 6. ELECTRICITY (Copy olapproval form and asbestos survey from Puget Sound Clean Air (Electricity to be shutoff arxi meter removed) Agency1.ro 'de 1) N ,,. f,/ *—......id u/4_�L (Puget Sound Energy) (City o ederal Way Building Official) 2.GAS SUPPLY 7. FUEL STORAGE TANKS (Gas to bt;shu off,meter removed and final bill paid) (Above or below grade fuel tanks, have been pumped or removed ft /k under,Fir 2k permit prior to any dismantle/excavation) (Puget Sound Energy) N (Federal Way Fire District#39) 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 Ai//A- ❑Metngrlto r ain and be protected /`J (KingCountyEnvironmental Services) r v � (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 se7er,7o remain and be used by proposed new structure ❑PSewer re yGelto be used for other purposes (King District) (K ng County Environmental Services) 5.GARBAGE (All hoi1hol garbage disposed off and final bill paid) /4, (RST Disposal/Federal Way Disposal) ❑ Completed Construction Permit Application<form ❑Provide the following fees: 1.Demolition Permit Fee $65.50 2.Automation Fee 5.00 3. WA State Surcharge 4.50 4.Cash Bond Deposit 500.00 (Refundable upon Completed Final Inspection) - $575.00 Bulletin#122—January 1,2006 Page 1 of 1 k:\Handouts\Demolition Permit Requirements • DEPARTMENT OFIMUNITY DEVELOPMENT SERVICES 41114111t 33325 8th Avenue South PO Box 9718 CITY OF Federal Way WA 98063-9718 Federal Way 253-835-2607;Fax 253-835-2609 Way www.citvoffederalway.com DEMOLITION PERMIT CONTACT LIST This list of agencies may assist you in expediting the demolition permit process.Refer to the demolition permit requirements for signature blocks.All applicable signatures are required prior to permit approval. 1. Asbestos Removal: Puget Sound Clean Air Agency 110 Union Street,Suite 500 Seattle,WA 98101-2038 206-343-8800-OR—800-552-3565 http://www.pscleanair.org 2. Electricity: Puget Sound Energy Attn: Construction Coordinator 22828 68th Avenue South,Suite#102 Kent,WA 98032 888-225-5773 3. Gas: Puget Sound Energy 805 156th Avenue NE Bellevue,WA 98004 888-225-5773 4. Telephone: Qwest Communications 801-962-2475(phone)/801-237-6491 (fax) 5. Water: Lakehaven Utility District Tacoma Public Utilities Technical Service Division Customer Service 31623 First Avenue South —OR— 747 Market Street Federal Way,WA 98003 Tacoma,WA 98402 253-941-2288 253-383-9600 or 253-383-2471 6. Garbage: Waste Management 655 Second NW Auburn,WA 98071 253-833-3333 (residential)—OR—253-939-9792(commercial) 7. Sewer: Lakehaven Utility District Technical Services Division 31623 First Avenue South Federal Way,WA 98003 253-941-2288 8. Septic: King County Environmental Services 14350 SE Eastgate Way Bellevue,WA 98007 206-296-4932 9. Fire Department: Federal Way Fire Department#39 31617 First Avenue South Federal Way,WA 98003 253-839-6234 Bulletin#109—October 1,2004 Page 1 of 1 k:\landouts\Demolition Permit Contact List Jun 27 06 02:41p ORION ENVIRONMENTAL 2539274714 p.2 ORION Environmental Services An Environmental Compliance Consulting Firm WBE W2F5912535 Report Date: April 19, 2006 Asbestos Survey Report Mr. Renald Tong Project No.062915 Lu-Bond Construction, Inc. 2828 South Othello Street Seattle, Washington 98108 RE: Panda Theater Remodel 30315 Highway 99 Federal Way, Washington Dear Mr. Tong:. On June 27, 2006 ORION Environmental Services, Inc. performed a limited asbestos survey regarding visible materials that would be impacted during remodeling activities at the subject location. Per our discussion, components being impacted were ceiling tiles and carpeting that are being disposed_ This survey ascertains the existence of asbestos containing materials that will be impacted during the activities you described. No other building systems (wall, roofing, etc.) are being impacted as you have explained. This survey was performed in conformance with procedures and methods outlined in applicable federal, state, and local regulations. Investigating Team An AHERA Building Inspector conducted the field investigation, sample collection, analysis, and report review for this survey. All bulk samples submitted for analysis were collected in keeping with local regulatory practice. Information regarding the representative is provided below: Team Asbestos Accreditation and Experience Building Inspector • AHERA Building Inspector (ABI-R-NES-06-01) Dennis Rauschenberg Expiration Date:August 9, 2006 investigating Protocol and Findings All samples as it related to your scope of work were homogenized, collected, processed, and analyzed for content by Polarized Light Microscopy. AHERA protocol provides guidance for the number of samples of each materials to be collected depending on iVs 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. However, in every case, AHERA relies on the judgment of the inspectors who are experienced in AHERA methodology and the type of facilities being inspected. Building materials that contain asbestos fibers in the amounts greater than 1 percent (1%) is regulated by state agencies, which include the Department of Labor and Industries (L&1) and Puget Sound Clean Air Agency. \,\,.*tile ?' FIG kiln!_ +. : 1111 ? 4, . aler<t 'iV'i`,. V;Iti11111L;(111 `tE'I(I .51.1:< f n ra,l'?711:1 ! Jun 27 06 02:47p ORION ENVIRONIVItiv I AL S • • 0 ip ' ion Environmental Services 34004 91h Avenue South•Building A Suite 5 • Federal Way,Washington 98003-6740 Telephone Seattle(253)874-8118*Tacoma (253)952-6717•Facsimile(253)927-4714+email O12101416717(jaol WEE W2F5912535 Polarized Light Microscopy Test Report EPA Method 600/R-98/116 Date June 27, 2006 Client Lu-Bond Construction, Inc. Page page 2 of 2 2828 South Othello Street Invoice x62915 Seattle, Washington 98105 Date Received Tune 27, 2006 Project Number99 Federal Way, Washington Project Name Panda Theater Restaurant—30315 Highway t b Asesos Other Sample T e Fibers Client Orion Treatment percent Trumber Number Stereo Sco a Exam 60627-73 Carpet Mastic(Yellow) Chloroform ND .. Cellulose 30315-13 Homogeneous Dup: Laboratory QAIQC Duplicate;M;Mastic [(a), (b), (c), etc.1: Sample layers numbered from front to back_ samples, each component has been analyzed separately. ND means Comments: For layered guidelines, samples non-detect for asbestos fiber byEPA then disposed of D98 laimes� PLM has been known to will be archived for 30 days and miss asbestos in a small percentage of samples that contain asbestos. Thus negative PLM results cannot be guaranteed. This report may only be reproduced in full with written approval of ORION Environmental Services. /! C/1? � -- Donna McNeal 0../11145 Nelson B. Miles III Reviewed By Analyzed By Sr. Industrial Hygienist CEO Leading EngmlmmentafOrmiphiance Consulting Into the 215'Century Jun 27 06 02:47p ORION ENVIRUNIVILN I HL 4 • '-- Orion Environmental Services 34004 9'm Avenue South♦Building A Suite 5 r•Federal Way,Washington 98003-6740 4em�� ONG717(rvao! Telephone Seattle(253)874-81181 Tacoma (253)952-6717♦Facsimile(253) WBE W2F5912535 Polarized Light Microscopy Test Report EPA Method 60018-981116 June 27, 2006 Page ag Client Lu-Bond Construction, Inc. Date pe 1 2 2828 South Othello Street Invoice Page 15 Seattle, Washington 98105 Date Received June 27, 2006 Project Number Project Name Panda Theater Restaurant—30315 Highway 99 Federal Way, Washington Client Orion Sample Asbestos Other Tips Number Number Stereo Scope Exam Treatment Percent _ips Fibers 30315-1 60627-61 Ceiling Texture 6 Chrysotile - Homogeneous 30315-2 60627-62 Ceiling Texture - 2 Chrysotile - Homogeneous 30315-3 60627-63 Ceiling Texture - 8 Chrysotile - Homogeneous 30315-4 60627-64 Ceiling Texture - 4 Chrysotile - Homogeneous 30315-5 60627-65 Ceiling Texture 4 Chrysotile - Homogeneous „ 2 Chrysotile - 30315-6 60627-66 Ceiling Texture Homogeneous 30315-7 60627-67 Ceiling Texture 2 Chrysotile - Homogeneous 30315-8 60627-68 Ceiling Texture 4 Chrysotile - Homogeneous 30315-9 60627-69 Ceiling Texture - 4 Chrysotile - Homogeneous Ash ND - Cellulose 30315-10 60627-70 Ceiling Tile Fiberglass Homogeneous Ash ND - Cellulose 30315-11 60627-71 Ceiling Tile Fiberglass Homogeneous 30315-12 60627-72 Carpet Mastic(Yellow) Chloroform ND - Cellulose Homogeneous RY r w