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02-101892 jr-4 • • City of ity Services Federal Way Demolition Permit #:02 - 101892 - 00 - DE ComnnmDevelopment 33530 1st Way S Federal Way,WA 98003-6210 Ph:253.661.4000 Fax:253.661.4129 Inspection request line: 253.835.3050 Project Name: ALVIS Project Address: 955 S 356TH Parcel Number: 292104 9039 Project Description: DEMOLITION-Demolition of abandoned house on northwest corner of property Owner Applicant Contractor Brian C&Derek J Alvis Brian C&Derek J Alvis Brian C&Derek J Alvis PO BOX 1624 PO BOX 1624 PO BOX 1624 AUBURN WA 98071 AUBURN WA 98071 AUBURN WA 98071 (253)315-1738 CONDITIONS: 1.Provide to the inspector evidence that the septic tank has been properly decomissioned. PERMIT EXPIRES November 4,2002,IF NO WORK IS STARTED. Permit issued on May 8,2002 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 ws,rules and regulations of the State of Washington and the City of Federal Way. ,/ • Owner or agent: Date: 5— r 615Q _- •cEtvEO �-.Gr CONSTRUC I ION PERMIT APPLICATION •1--1 iL MAY 0 7 2002 APPLICATION NUMBER: Z- 1 e vN) FEY' t £s 2- c�-o ., ;1`fyOfEDERALWA`f APPLICATION NUMBER: - • - BUILDING DEPT, - APPLICATION NUMBER:• /\"`c% **The following is required information-Please print(in ink)or type** . Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application. i- 1=PROPERTYINFORMATION -.`-. SITE ADDRESS: Q C 3S7'T1I ASSESSOR'S TAX/PARCEL #: 2. 1 2- 1 0 4--- q 0 3 q LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): --T-4_v00R-T.4 ' 'Flier OF -r4E. SDoriiLEST 601\e3 - of T4E 00=-40451- QJ4Et7...12_ of- ›ealol-) zt / -1-01-‘+asiti? zl a40 4- E4sr, J.kt . LKu& wW-'sr- o - �r-4rr! 1-1/4.144,44.1 (SR-11) 4 "i - 1•r , .,) –I-µ . ..- ., . F' �.: ► ua. $2- 1GIA)(o can., tap. 8 LKo7 • 05 ';;K:,..4,:. 7•:.,� • �.x,,.?;.; „ ,Y< :; AIN,.PROJECT INFORMATION .:r • - TYPE OF PROJECT(This application): LI BUILDING ❑ PLUMBING ❑ MECHANICAL DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description): OP - - A_ A. •• � ,., E. IA ES— a F= 'P¢bf2.42-1"Y PROJECT NAME: }4[215,F' A F _vi,s .,.,...,.,..,,:-..,....,...-..„....,-..-.:-::,.....,--... --...._..- ,...: _' ._PEOPLE INFORMATION PROPERTY OWNER: NAME: DAYTIME PHONE: SP-IANY-J G. QL_JIS (2c3) 3(5 - 1�•3g MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): ice.D. 1(47 24'" 4JBdz t l.A- ! q--( CONTRACTOR: NAME: ��/`'� _ DAYTIME PHONE: MAILIN RESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING EVENING ONE: CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: ( ) CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE: (copy of card required) / / APPLICANT: NAME: DAYTIME P\/HONE: - MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: RELATIONSHIP TO PROJECT: FAX NUMBER ❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) - E-MAIL ADDRESS: / CONTACT PERSON FOR THIS PROJECT: p-PROPERTY OWNER CI APPLICANT ❑ CONTRACTOR bc_ge JC9€ I(•Zi k.. '`,.i 'f i: :-,::-:-:-.-...--:.:::-.:,'-:',::::/i7-;:':,;,•-111 'DETAILED"BUILDING INFORMATION.'''.::'":-7:**:•:::i.-:-. _-- EXISTING USE: IJCX-IC EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ ^ PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ -- 0 — SPRINKLERED BUILDING? ❑ YES .WNO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES xi NO WATER SERVICE PROVIDER: LAKEHAVEN ❑ HIGHLINE ■ TACOMA El PRIVATE(WELL) SEWER SERVICE PROVIDER: HAVEN [11HIGHLINE 12 PRIVATE(SEPTIC) • **NEW(RESIDENTIAL CONSTRUCTION OPiLY** l NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ .. • . : ■ PROJECT FLOOR AREAS • . •- - - .. FLOOR • EXISTING SQ.FT. • PROPOSED SQ.FT. TOTAL • rs •,x- BASEMENT' s „r*. .. .t.:,;a,,,, -7#• • FIRST SECOND THIRD )1\3 • ,(-- - . FOURTH OTHER FLOORS(DESCRIBE) DECK GARAGE HOW MANY FLOORS? TOTAL: . ■ FIXTURES _ Indicate number of each type of fixture - MECHANICAL AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S) BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S) BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( ) COMPRESSOR(S) FURNACE(S) DUCT(S) GAS • PE 0 LET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS PLUMBIN • BATHTUB(S) LAV•TOR ') • URINAL(S) WATER HEATER(S) DISHWASHER(S) RAI WATE• SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( ) INTERCEPTOR(S) SUMP(S) .'I..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 I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in the I investigation and defense of such claim),which may be made by any person,induding the undersigned,and filed against the City of Federal Way,but only where such daim arises out of the reliance of the city,including its officers and employees,upon the accuracy of the information supplied to I.• city as a part of .% application. 11 • NAME/TITLE: /�i A_A Alb DATE: • (-P • C3'2. C-PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR FOR OFFICE:USE ONLY: J.0 NEW- 3- ADDITION ❑ ALTERATION ©,REPAIR _, 0 TENANT IMPROVEMENT = CENSUSCODE: LOT SIZE: ---„,:,;;- X--_ „x , ONINGDESIGNATION BUILDINGSHELL=ONLY?; ❑YES ❑ NO COMP PLAN DESIGNATIONBASIC PLAN'-11- El YES ❑ NO SECTION , TOWNSHIP RANGE NEW ADDRESSxREQUIRED? ❑ YES ❑ NO 'RLATTED LOT? ' ❑'YES CI NO CHANGE OF USE? ❑ YES ❑;'NO COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH-PO BOX 9718-FEDERAL WAY,WA 98063-9718-253-661-4000•FAX:253-661-4129 www.cayoffedera Tway.com • WY OP r� DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES 33530 First Way South � � - PO Box 9718 VN Federal Way WA 98063-9718 253-661-4000;Fax 253-661-4129 w ww.c i.federal-way.wa.u s 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. U 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 (EI r it�s�d m ter re ved) Agency provided) 111,K (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 tJ© removed under Fire Department permit prior to any cqi(PytgbAr,AMY) dismantle/excavation) (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) ❑Meter to be removed and final utility bill paid o M ter to remain and be protected 5e-e- Gos,orrni (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 ❑Existing sewer line to remain and be used by proposed new structure u Private well to be used for other purposes (Sewer District) (King County Environmental Services) 5. GARBAGE (All household garbage disposed off and final bill paid) V I° /\//y (RST Disposal/Federal Way Disposal) c,T �qy ��Q Y 60�4aa Completed Construction Permit Application form. g m,C0Rq k'p L! 4k L:1 Provide oo� the following fees: 1. Demolition Permit Fee $52.50 2.WA State Surcharge 4.50 3. Cash Bond Deposit 500.00 (Refundable upon Completed Final Inspection) $557.00 Bulletin #122—January 11, 2002 Page 1 of 1 k:\Handouts—Revised\Demolition Permit Requirements • Puget Sound Clean Air Agency Agency l 20020060/7 110 Union Street,Suite 500,Seattle,WA 98101-2038 CASE#: (206)343-8800•Fax:(206)343-7522 ' Instructions for completing this form are on the back. 1 Please type or print clearly. Clean Air Agency Notice of Single-Family Residence Asbestos Removal ,/ Clearly print your name and address below. This will be your return Enclose $25 Check for Processing Fee mailing label. 2C--ENO �v,'- Name of Person Conducting Removal: Name: it� cvt� Address: --- '0 ' 'Y- I6'2--'4- 2 S 3, 3/5= l 3E Daytime Phone#: City, State,Zip Code: v1' t ( Evening Phone#: Z5 3. 3(5". I X36 Keep This Form Once The Agency Returns It To You! You will need it to dispose of your asbestos. . , �, Quantity to be removed: _ /2.-' 4-1)_0____ ----- QU -- square ft. .,:'r' yam, Project starting date: 4- - 30 - d 2 Completion date: 4— 30.- 0 Z ,'`.`.;6'y Is this residence scheduled for demolition? y(Yes ❑ No esti-• Site address:THIS MUST BE COMPLETED t)-5 5. -3.75--&,i-4 5rrek+ r=e24W,:/ 11241-f 9,6(x) '3 Kir36> Street City Zip code County Has material to be removed been sampled and analyzed? X Yes ❑ No If No, Please explain: - Type of material to be removed: ❑ Popcorn Ceiling ,Vinyl Flooring ❑ Cement Asbestos-Board Siding ❑ Other(specify): - Briefly describe your method of removal: I '�J..� I'a-ry s L 4L--- +' l `'" `Z I � , c��g,.-���,.., l�c<�. �� �s..��, 54� pre-C.4- as vt>�t�� ,tet G�r`�-, Asbestos disposal site: �A,tiv- LW') L.-ii ' it cloco•-2,..4--r,+--.., have read the applicable instructional brochure for removing asbestos from an owner-occupied, single-family residence. I CERTIFY THAT I AM THE OWNER OF THIS RESIDENCE AND THAT THE c ABOVE INFOR 4 .TION IS CORREC . �i1/ e /I\ ' 414 k r0 Co / _ uIA 4•Z 4- 0 2— Age116I11%Only 7(2 Signature Date B(l/44)/4/0 f og `? ��.FpT�'gy Agency,,,Le Only I (� t Reviewed by: 1,v4/>✓ ' � 1 2 A R 2 J 2002 s estos Program •.ecialist,Puget Sound Clean Air Agency Valid for Disposal Only with Approved Signature THIS IS NOT AN APPROVAL 1:White—Agency 2 Ye/low—Property Owner Permit for Disposal(signed by agency) 3.Pink—Property Owner