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15-105788 _ '' i nolit on City of Federal Way :. Community&Econ.Dev.Services Permit #: 15-105788=00-DE 33325 8th Ave S Federal Way,WA 98003 Inspection Request Line: 253 Ph:(253)835-2607 Fax (253)835-2609 p Q ( )835-3050 Project Name: KONSMO Project Address: 2019 S 330TH ST Parcel Number: 797880 0621 Project Description: Demolition of single family residence,detached garage and shed. "• `• Owner Applicant Contractor KEN KONSMO KEN KONSMO OWNER IS CONTRACTOR 13301 MUIR DR NW 13301 MUIR DR NW GIG HARBOR WA 98332 GIG HARBOR WA 98332 Additional Permit Information Demolition Valuation 1500 PERMIT EXPIRES Sunday, November 12,2017 Permit Issued on Friday, November 13, 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: /fes u�� Date: /1 /13 13 4N4 " THIS CARD IS TO REMAIN ON-SITE CITY OF "'.. ` Federal WayConstruction Inspection Record INSPECTION REQUESTS: (253)835-3050 PERMIT#: 15-105788-00-DE Address: 2019 S 330TH ST Project: KEN KONSMO FEDERAL WAY, WA 98003-6827 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 SS Date 69[21 ❑ Rough Electrical Final Electrical Right of Way Approved Approved Approved By Date By Date By Date RECEIVED - 11116, NOV 13 2015 CITY OF PERMITPPLICATION Federal W , OF FEDERAL WAY CDS 3`x13 PERMIT NUMBER /5 - / a5 781 - 2E TARGET DATE 11/11 / 16-- SITE ADDRESS SUITE/UNIT# r..J.,,,,,.., ,,_.. ..„ cs, 9„s„,_ PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# • $ / ,,Scr'1 l'— "7 ' 2 0 _ o . 2- / TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION NAME OF PROJECT K U E o PROJECT DESCRIPTION Detailed description of work to be included on this permit only c t^ t 0•f ( ( 4J) •u a I NAMEePRIMARY PHONE PROPERTY OWNER v�� i��Ae S. '-O S - 0 MAILING ADDRESS E-MAIL / 3 3 c) r At�„'.< �r. N, . . CITY 1... /� ,1( STATE r ZIP-04 1 V NAME/ J J 1 PHONE L i'�C.ti.1- (c',n--/L J.G✓C. MAIL lG ADDRESS J E-MAIL CONTRACTOR L ✓3v ..``,, 00A- )e-,--e CITY STATE ZIP FAX �j:7 (-�,4 ae'3.-‹ 14_,,,A. cf9 3 3,.2_ WA STATE CONTRACTOR'S LICENSE It EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# / / NAMEill PiLe".4 PRIMARY PHONE APPLICANT MAILING ADDRESS E-MAIL CITY STATE ZIP FAX NAME '` K PRIMARY PHONE PROJECT CONTACT C5//`�/' (The individual to receive and MAILING ADDR E-MAIL respond to all correspondence concerning this application) CITY STATE ZIP FAX NAME OWNER-FINANCED PROJECT FINANCING Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE (RCW 19.27.095) 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 aapppaart of this application. Q SIGNATURE: DATE (f (i. — PRINT (NAME: t.1V A. .4 Bulletin#100-January 1,2013 Page 1 of 3 k:\Handouts\Permit Application • • VALUE OF MECHANICAL WORK MECHANICAL PERMIT $ 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(Commercial) BOILERS FURNACES HOT WATER TANKS(Gas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES VALUE OF PLUMBING WORK PLUMBING PERMIT $ Indicate how many of each type of fixture to be installed or relocated as part of this project. t+. not include existing fixtures to remain. BATHTUBS(or Tub/Shower Combo) LAVS(Hand sinks) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe) DRAINS SHOWERS VACUUM I EAKERS DRINKING FOUNTAINS SINKS(Kitchen/utility) WATER . ATERS(Electric) HOSE BIBBS SUMPS WASH 'G MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF'EXISTING IMPROVEMENTS EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FI' SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ■ Yes ❑ No ❑Yes ❑ No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PRO••SED TOTAL FOR OFFICE USE ✓ f ,'''AFF i � / 1 /; / /F:/ 1,4',•'t',��,' ��d )74.%f i i � 40 e�/4, ii / / ,/ '9 l t ff/ r// ,sf //./r,;"�, / f '' ,''" r ,' /� .f 1;////%/ / j'/yi''i/ / FIRST FLOOR(or Mobile Home) fr 1 • �£.4%/,.v/>- y , A COVERED ENTRY GARAGE ❑ CARPORT 0 t i EXISTING PROPOSED TOTAL Area Totals ESTIMATED SELLING PRICE$ #OF BEDROOMS COMMERCIAL-NEW/ADDI ON AREA DESCRIPTION Are; Occupancy Group(s) Construction #of Additional Information in Squ• a Feet Type Stories ''/'/ „MNO <'€/ % k i / `/fF ; /'/ ( ADDITION COMMERCIAL-RE 'DEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information In Square FeetType Stories TOT1 ISti TENANT AREA ONLY ,'/ r Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application • • COMMUNITY DEVELOPMENT DEPARTMENT 33325 8h Avenue South Federal Way,WA 98003-6325 ,., CITY OF ;� �.���_;>�� 253-835-2607;Fax 253-835-2609 Federal VVay www.cityoffederalway.com DEMOLITION PERMIT REQUIREMENTS A demolition permit is required to remove any structure on a subject property. Demolition of separate structures may require separate permits. S, 330" 3 0�� �,,,�,�2 � I ?S ❑ Address of Demolition: d 0 j qj ❑ Prior to submitting a demolition permit,the following items must be signed by the respective agency or their approvals attached. Items not applicable to your project should be marked N/A. ❑ A completed Construction Permit Application form is also required. O 1b1/4) 1.ASBESTOS ABATEMENT (Providy.. y of Nods- • ntent from Puget Sound Clean Air Agency 5.ELECTRICITY and o o;�• nsp-' r on .sty AH ••-ce 'fieri inspector) i , , /1- 13/.� SC��,. As / 4* .f Federal W :uildin Official) / (Puget Sound Energy) 2. FUEL STORAGE TANKS 6.GAS SUPPLY ❑ Under grade tank(s)is/are present o Above grade tank(s)are present �/ ❑Tank(s)has been pumped or removed under South King Fire& (Puget Sound Energy) Rescue permit prior to any dismantling or excavation EI v it 4/40 itia^' l 1. SNc G`bvi !l-itic. (South King Fire and Rescue) 7.WATER-Public Source L (�—f1UTA{ irst, (Water Supplier) M 3. SEPTIC SYSTEM ! t((s- :, fro 8.WATER-Private Well (King County Environmental Services) Av l/ (King County Environmental Services) 4.SANITARY SEWER. Ali (Lakehaven Utility District) Bulletin#122—May 13,2015 Page 1 of 1 k:\I-Iandouts\Demolition Permit Requirements To: ken konsmo Page 1 of 2 2015-11-12 22:53:00(GMT) 12532760267 From: Adriana Guzman 10/16/2015 • Notification Details • pscieanair.org Puget sound Citor.. Agency tfa_ewnrmR .O rsi HiStont Create Amendment end ent 2015t 4433.-2 Single-Family Notification Details for Case #: 201504433-1 Fee Amount $25.00 Transaction Date 10/16/15 Owner's Name Ken Konsmo Phone (253) 279-6415 Project Street Address 2019 S. 330th St City Federal Way Zip 98003 Contact Person Mitch Eaden Phone (253) 229-6391 Mailing Address 13301 Muir Dr NW Gig Harbor , WA 98332 This project includes asbestos removal. Project Size linear feet / 650 square feet Project Start Date 11/04/15 Completion Date 11/06/15 Asbestos will be removed by a licensed asbestos abatement contractor Con tractor Tacoma Abatement Company,LLC Contractor lob A Contact Phone (253) 830-5945 Mailing Address 5111 S Burlington way Tacoma, WA 98409 Note: Notifications cannot be amended after the completion date. https'!secure.pscleanai r.orgAsbestos/Logi nAccountiN otificati onDetail.aspx 1/1 • 116 ORION Environmental Services 4 34004 Ninth Avenue South,Suite Al2, Federal Way,WA 98003 `9'i `''' • "°g Phone:(253)952-6717• Fax:(253)927-4714 Email:info@oriones.net•Web:www.oriones.net WBE W2F9219763 Polarized Light Microscopy Test Report EPA Method 600/R-98/116 client: Tacoma Abatement Company LLC Rpt.Date: 9/23/2015 Address: 5111 South Burlington Way,Tacoma,WA 98409 Page: 1 of 2 Attention: Pat Culver Invoice: 154950 Project Name: Ken Konsmo-Pelland Enterprises Date Rcvd: 9/21/2015 Project Number: NA „ , <fw rte. . Oz �`-y .,� � e� k �'���I�€�p � � - � .?+ � rl,.�•}!* `� ii �� i s�� �tlr x �- jfj� d cis . 7, .c��. it... .E.. .u. 4�_�:_, �,�P_�,�:�s��t.��:�.�..��'�.�a __:m�:,_�:r u .. �.�� .,..u-:�.v:E: :�;.�.,r.��.�.�.� _., _. .�. ... . _. 1 20150921-50 Felt chloroform ND cellulose 2 20150921-51 Texture ND cellulose 3-a 20150921-52 Roofing Comp ND cellulose/ fiberglass 3-b Roofing:C_Omp ND cellulose/ fiberglass 3-c Felt ND cellulose I - 2a13.Q92t 63.: Vinyl Tile 3 Chrysotile 4-b Mastic 2 Chrysotile 5-a 20150921-54. Vinyl Tile 2 Chrysolite 5-b Mastic 2 Chrysotile 5 c Vnyl:Tile <1 Chrysotile 5-d Mastic 2 Chrysolite 6 2015092155 Popcorn Ceiling Texture 2 Chrysotile cellulose 7 20150921-56 Popcorn Ceiling Texture 3 Chrysotile cellulose 8 20150921.57 Popcorn Ceiling:Texture 2 Chrysotile cellulose 9 20150921-58 Joint Compound ND cellulose 10 20150921-59 Texture ND cellulose 11 20150921-60 Texture ND cellulose 12 201-50921:-61 :Texture ND cellulose • • • • Polarized Light Microscopy Test Report (cont.) Client: Tacoma Abatement Company LLC Rpt.Date: 9/23/2015 Address: 5111 South Burlington Way,Tacoma,WA 98409 Page: 2 of 2 Attention: Pat Culver Invoice: 154950 Project Name: Ken Konsmo-Pelland Enterprises Date Rcvd: 9/21/2015 Project Number: NA a `,, Y i XI/r�r .. ,04,1141 ,--,.,7:-.. ..4t4;•4,-;•-;fs x :- , t ."•a ,= ` f k 'S �>� '�i !; �� 1: Ss toC f �� �.—�y a li y a - e� - ,, �"1,T7,- •.a i a , r sk,r :--47'''''' a ', IV.441 i.eg * 3 n •o,.1'� � ; '� 4, ; g,�?�rxt , ri r ` - ?if<tt Y �1a--�' ', ,C 'gu�.cK"' '�ii C- €+9" !€� 34n' {� r ::i 0 , .1y ° L I.A u},-, a ", t`�'' ., `. }.♦ i, xis 'r`!` .. a+ -w t a-€'j -€, ' am' © o ,,i lg, . ,�C_ '"-47n 1-e- :f _§- r t v 1144 i ei �Kyy -e { ',1`7. "� ,p v €i �'q-1t=a �� r { - .� � ,� tti i �, �+�1,1 �(t�• 1!k � i� � �r"`F'fi F ','°.:'1.10`.:' 7,' 8 ii .� lF,J i "7- t C4--' 5 L el 1.119 Y - itiAtp4 ,ra TF(� �' 1 N-flik ' t.fir/1$ { V1i rd 4!°1.4x'.- ,, - t,�t� tr J ..-.( 5y k ; y. .. ?- .4-,:,`:!:-, :.2,:_...,~,;-',.,1,,,', '' '• .:.• 7' ,x !` r x .. s:,.-,S��� dr...wi�f'__C[..4 r ���..3,z +�, �,�i°� t.L_` � . �� �.l..w�..x:,�'lL.;�. ....r;.�-._vax;Y.#^4 rt��*�x�:r�.-.,w....-.i���; 13-a 20150921-62 Vermiculite <1 Actinolite cellulose 14 Ceiling Insulation ND fiberglass 14 20150921-63 Texture ND cellulose fa 20150921,64 Laminate chloroform - ND 1111111111111 16 20150921-65 Ceiling Tile ND cellulose 17 :20150921-66 Window Blazing crush 3 Chrysotile cellulose 18 20150921-67 Vinyl Sheeting ND cellulose 19 20150921-68 Laminate chloroform ND Dup:Laboratory QA/QC Duplicate;M;Mastic((a),(b),(c),etc.]:Sample layers numbered from front to back. Comments: For layered samples,each component has been analyzed separately. ND means non-detect for asbestos fibers by EPA Method 600/R-98/116.Disclaimers: PLM has been known to miss asbestos In a small percentage of samples that contain asbestos. Thus,these laboratory results represent due diligence,however negafive or<1%PLM results can not be guaranteed. Per EPA guidelines samples will be archived for 30 days then will be disposed of. This report may only be reproduced in full with written approval of ORION Environmental Services. Analyzed By(Print) Date Reviewed By(Print) Date Dennis Rauschenberg 9/23/2015 Donna McNeal 9/23/2015 Analyzed B ignature) Time evie ed B , gnature) Time C-C-Ce4-/ 7/7i/�G/7 1 • • Bulk Sample Log/Chain of Custody • LAB: Client Company:Tacoma Abatement Company, LLC LAB Job#: Client Address: 5111 S Burlington Way Tacoma.WA 98409 #of Samples: Phone#: (253)830-5945 Job Name: M V-424514toegibef' Fax#: (253)383-1592 Job Address:Zo(9 S, 33611^ Sr FEU Report Results To: Pat Culver Type of Analysis(Check One) At Phone#: (253) 273-5809 ASBESTOS LEAD Fax Results: (253)383-1592 PCM(air) Paint 0 Son Mail Hard Copy: PLM(bulk) 0 Dust/Wipe(area?) Email Copy To: pculver@tacomaabatement.com 0 Air(volume?) 0 TCLP ‘14 REGULAR 0 RUSH Condition of Package: 4Good 0 Damaged(No Spillage) 0 Severe Damage(Spillage) Lab ID Sample ID Type Location 1 "t' �� -0MT 2 Tiest. l l N bt1H esA 3 Qooc MATA NDoSE 4 \y/-T' LAtAeittlit• �Y+� 5 VGT fbA, 6 PL +xvzN 7 PL gat I Few 8 ' PL 6t~1) Z 8+4c -. HOOSC 9 IL. L-TL/Ir)VithoN 10 -E9. JAN% _ 11 'T eaC 13e6 } 9ani T 140d.Si 12 7E3. 8Eq - gdz� 13 CkaLTAif9 Zf3Cut-AV k Q-I✓L W� 14 p -t B to 1 LST Signature/ Date Time Sampled By: Delivered By / 2((i f Received By: it0 i Analyzed By: Special: Read Abatement Sample 1# ONLY if Sample It is Greater Than .01 f/cc • • t5� ozA sa tk 15L\"\56 of- Bulk Sample Log/Chain of Custody LAB: Client Company:Tacoma Abatement Company, LLC LAB Job#: Client Address: 5111 S Burlington Way #of Samples: Tacoma,WA 98409 Phone#: (253)830-5945 Job Name:JLef4 ICAO tua:f G7J-4140 6141,PCS6 Fax#: (253)383-1592 Job Address: Report Results To: Pat Culver Type of Analysis(Check One) At Phone#: (253)273-5809 ASBESTOS LEAD Fax Results: (253)383-1592 0 PCM(air) Q Paint Q son Mail Hard COoV: PIM(bulk) Q Dust/Wipe(area?) Email Copy To: pculver@tacomaabatement.com 0 Air(volume?) O TCLP FkREGULAR Q RUSH Condition of Package: lagood El Damaged(No Spillage) 0 Severe Damage(Spillage) Lab ID Sample ID Type Location l5LAiquiRns a54 k2tt0.1 l6 fe--zN b TILE lRl`z_ I") tar4\00 (3,Avst)t, Pah.. IA.a.440 V fl 15i4 i L tUlu_ Pmts_ 5frot S 1 1 1 1 ignatu Date Time Sampled By---7 / i //c Delivered B � t�r z Received By: V15 Analyzed By: Special: Read Abatement Sample# ONLY if Sample# is Greater Than.01f/cc • • • -a ORION Environmental Services {` 34004 Ninth Avenue South,Suite Al2, Federal Way,WA 98003 `° Comp tome St on"s` On Nn4 Phone:(253)952-6717 • Fax:(253)927-4714 Email:info@oriones.net•Web:www.oriones.net WBE W2F9219763 Polarized Light Microscopy Test Report EPA Method 600/R-98/116 • Client: Tacoma Abatement Company LLC Rpt.Date: 9/21/2015 Address: 5111 South Burlington Way,Tacoma,WA 98409 Page: 1 of 1 Attention: Pat Culver Invoice: 154936 Project Name: Ken Konsmo-Pelland Enterprises Date Rcvd: 9/21/2015 Project Number: N/A • t '" --Y i? t rg • .;sL�+a��., `M.t s.��,,�..�IF'rF�.rXe4_' k •" - ' ikla 4-k rk 'f: yS: 41 "]r ;it*=75 11-1s0.10-9-7174, *,ti y�9si lc O �f 1 . - 't Aft"aeilA . F<JJAemI1 3W- 'sa'47f -_ ,S:�c � :!i-6e,ISE&A&Ak la 20150921-2 Composite Roofing ND cellulose 1t Vapor Barrier ND cellulose 2a 20150921-3 Composite Roofing ND cellulose 2b Vapor Barrier ND cellulose Dup:Laboratory QA/QC Duplicate;M;Mastic[(a),(b),(c),etc.]:Sample layers numbered from front to back. Comments: For layered samples,each component has been analyzed separately. ND means non-detect for asbestos fibers by EPA Method 600/R-98/116.Disclaimers: PLM has been known to miss asbestos In a small percentage of samples that contain asbestos.Thus,these laboratory results represent due diligence,however negative or<1%PLM results can not be guaranteed. Per EPA guidelines samples will be archived for 30 days then will be disposed of. This report may only be reproduced in full with written approval of ORION Environmental Services. Analyzed By(Print) Date Reviewed By(Print) Date Leah Barta Do McNeal A aly d By Viip 111. Time viewe Sign e) Time I • • Bulk Sample Log/Chain of Custody • LAB: /54-13..0 Client Company:Tacoma Abatement Company, LLC LAB Job#: Client Address: 5111 S Burlington Way #of Samples: Tacoma,WA 98409 Phone#: (253)830-5945 Job Name: 1415A V NSY►ao- Qe..LitruD r`wi ePS Fax#: (253)383-1592 Job Address: 7.011 S• 3361'1 St FEt Q Ik_ (AM Report Results To: Pat Culver Type of Analysis(Check One) At Phone#: (253) 273-5809 ASBESTOS LEAD Fax Results: (253)383-1592 PCM(air) 0 Paint Soil Mail Hard Copy: ( PLM(bulk) 0 Dust/Wipe(area?) Email Copy To:pculver@tacomaabatement.com 0 Air(volume?) O TC • 0 REG -0 • CE1 RUSH ' 7CSA-1 Condition of Package: OGood 0 Damaged(No Spillage) .ge Spillage) Lab ID Sample ID Type Location 1 goOF O tr t/SLAZN 3 4 5 6 7 8 9 10 11 12 13 14 Signature Date Time Sampled By: ic — Delivered By: 1 Received By: Analyzed By: Special: Read Abatement Sample# ONLY if Sample# is Greater Than.01 f/cc To: ken konsmo Page 2 of 2 2015-11-12 22:53:00(GMT) 12532760267 From: Adriana Guzman I S► ,tF M i It f I .T+e!° P 4,,,;,,,,, e ,i,r, . a i.. TACOMA, AEA1 tMENT COMPANY, LLC Notice of Asbestos Removal: November 9. 2015 Ken Konsmo 2019 S. 330th Si Federal Way, WA 98003 To: Ken. Konsmo Completion of Asbestos Removal: at the property listed above On November 6th 2015 Tacoma Abatement Company, LLC removed all asbestos containing materials identified in the survey. These materials were located in the kitchen, living, hall, three bedrooms, laundry, rec room, window putty. Per the Department of Labor and Industries WAC regulation 296-155(9) Part S and the Puget Sound Clean Air Agency revised Asbestos Regulations section 4.02 (b) a, all accessible asbestos containing materials have been removed from this property. Work practices, engineering controls along with air sampling have shown that the area is clear and ready to perform demolition_ 11`vou have any further questions please feel free to contact me, Mitch Laden Project Manager 5111 S Burlington Way, Tacoma, WA 98409 Phone: 253-830-5945; Fax: 253-383-1592