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17-101931 Demolition City of Federal nityDeelopmeay Permit #•17-101931-00-DE Community Development Dept. • 33325 8th Ave S Federal Way,WA 98003 Inspection Request Line: (253)835-3050 Ph:(253)835-2607 Fax:(253)835-2609 Project Name: CHARWOOD MHP SPACE 100 Project Address: 1660 S 333RD ST Parcel Number:797820 0081 Project Description: Demolition of manufactured home on site Owner Applicant Contractor CHARWOOD PARK LLC BERWICKS MANUFACTURED HOME BERWICKS MANUFACTURED HOME 6619 132ND AVE NE PMB 254 SERVICE INC SERVICE INC KIRKLAND,WA 98033-8627 PO BOX 1563 BERWIT*846J5 (4/25/18) PUYALLUP WA 98371 PO BOX 1563 PUYALLUP WA 98371 Additional Permit Information ' PERMIT EXPIRES Saturday,27 April,2019 Permit Issued on Thursday,April 27,2017 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: .5f/t. 7cs /7 P 6/ 0 THIS CARD IS TO REMAIN ON-SITE Construction Inspection Record Federal Way INSPECTION REQUESTS: (253)835-3050 PERMIT#: 17 101931 00 Address: 1660 S 333RD ST Space 100 Project: CHARWOOD PARK LLC FEDERAL WAY WA 98003 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 Date _ ( El Rough Electrical ❑ Final Electrical 111 Right of Way Approved Approved Approved By Date By Date By Date „,,„,tb.,.., PERMIT APPLICATION CITY OF MIT CENTER+ 33325 8th Avenue South + Federal Way,sQWA 98003-6325 Federal Way PER253-835-2607 + FAX 253-835-2609 +pern�i�dl Y tbalway.com PERMIT NUMBER . _ I 10 1 9 ( _ APR .2 7 2017 - TARGET DATE CITY OF FEDERAL WAY SITE ADDRESS COMML hi0PMENT 44 4e(Y`4_069J A d .1.- /6 i 0 J fj3,j,u-t PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING D MECHANICAL 0 DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT PROJECT DESCRIPTION 0e,w�d '©� i Imo'' gait.,-,c_. Detailed description of work to be included on this permit only NAME �jn G:� l i5 PRIMARY PHONE PROPERTY OWNER C'IA4 s Acie, L-'.) /iat.0645 l.-l..C..-. RE)6 - 22 _Y-0,J`� MAAING ADDRESS A E-MAIL C /� t S'l'A'�E ZIP NAME PHONE �' .;3 .1`Cd...4C., :5 74 kti,e 5:cvit)Cc_c. -77-4c,, ac5-- ----ee&- MAILIN ADDRESS E-MAIL CONTRACTOR reCk A n5 CITY TIE ZIP FAX N/474 './C''. , e/ WTAT CONTR OR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# RwTry6 T.5' agiar i t49 /S-11/3 NAME PRIMARY PHONE zL, - L/ feyIti/L ��)[PLv`y•-Ze 6-7,f APPLICANT MAI G ADDRE E-MAIL ” -�. Q k !�(a-5 /'iI1 43c;•L. cJ—„l H,e,i.t(!a fut CIT z/ I ,% / S XE ZIP �/r FAX NAME / PRIMARY PHONE PROJECT CONTACT (The individual to receive and MAILING ADDRESS E-MAIL respond to all correspondence concerning this application) CITY STATE ZIP FAX NAME PROJECT FINANCING ❑ OWNER-FINANCED When value is$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 Wag 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 a part of this application. SIGNATURE: G v/1 Lie/ -- C�� DATE (4 ? �CjJ PRINT NAME: (A--9 (,‘'( ( (e.c.(AA, c576/'[..A...;/rc Bulletin#100-January 29,2016 Page 1 of 2 k:AHandouts\Permit Application VALUE OF MECHANICAL WORK MECHANICAL PERMIT Indicate how many of each type jfxture 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(c...) 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.Do 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 BREAKERS DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric) HOSE BIBBS SUMPS WASHING 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 FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑Yes ❑ No ❑ Yes u No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR(or Mobile Home) SECOND FLOOR COVERED ENTRY DECK GARAGE ❑ CARPORT 0 OTHER(describe) ,/. EXISTING PROPOSED TOTAL Totals i otals **NEW HOMES ONLY** ESTIMATED SELLING PRICE$ # OF BEDROOMS COMMERCIAL—NEW/ADDITION Area in Construction #of AREA DESCRIPTION Square Feet Occupancy Group(s) IN. Stories Additional Information NEW BUILDING ADDITION COMMERCIAL—REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in Occupancy Group(s) Construction #of Additional Information Square Feet Type Stories TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application RECEIVED COMMUNITY DEVELOPMENT DEPARTMENT 33325 8`h Avenue South Federal y,WA 98003 ,,,,..4,..... CITY OF $ 253-835-2607;Fax a253-835-2609 APR 2 7 2017 www.cityoffederalway.com Federal WaCITY OF FEDERAL WAY COMMUNITY DEVELOPMENT DEMOLITION PERMIT REQUIREMENTS A demolition permit is required to remove any structure on a subject property. Demolition of separate structures may require separate permits. i Address of Demolition: ( �00 ¶ --_ "cis- 4 100 Ili 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. I/ A completed Construction Permit Application form is also required. 1.ASB . OS ABATEMENT Provi.- ,. of Notice of 'tent-from Puget Sound Clean Air Agency 5. ELECTRICITY ( aY and c inspedio• ort by AHERA-certified" Spector) , ^ V'' i -- C� t11` U N Ly A„, , _ ,--, (Puget Sound Energy/Tacoma Power) —.— of Federal Way Bui.i . Official) 2. FUEL STORAGE TANKS i 6. NATURAL GAS o Under grade tank(s)is/are present g. /A 71 Above grade tank(s)are present Tank(s)has been pumped or removed under South King Fire&Rescue (Puget Sound Energy) permit prior to any dismantling or excavation N /A (South King Fire and Rescue) 7.WATER-�Public Source w j/fok 0 SRU 7. (Lakehaven Utility District) 3.SEPTIC SYSTEM DECOMISSIONING 11 /A 8.WATER- Private Well (King County Environmental Services) /A (IGng County Environmental Services) 4.SANITARY SEWER --tir 0 S3U C,t. --@ lam) 0N9,• (Lakehaven Utility District) // L4' Please Note: Erosion control measures must be in place during the demolition and through completion of the site clean-up. 4// - 27,-- ,---• „ „..-1(' (Applicant) Bulletin#122—March 16,2017 Page 1 of 1 k:\Handouts\Demolition Permit Requirements • pscieanalr.org Puget Sound C.€-.:3n Aar Agency Single-Family Notification Case #: 201701929 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 $65.00 Credit Card Transaction# ASOFF6683EE3 Transaction Date 04/25/17 Owner's Name Davis Investors LLC. Phone (206) 775-5036 Project Street Address 1660 S.333rd St.#100 City Federalway Zip 98003 Contact Person William Berwick Phone (253)606-9323 Mailing Address P.O. Bix 1563 Puyallup,WA 98371 This project includes a demolition. Demolition Start Date 05/08/17 Completion Date 05/09/17 Demolition will be completed by a demolition contractor I certify that: (1)This is a single-family residence project. The structure is used by one family who owns the property as their domicile. (2)The information I have provided is to the best of my knowledge accurate and complete. (3)I understand the fee for this Notification is nonrefundable. Create Another Notification If you have questions,contact us at asbestos@pscleanair.org or 206.689.4058. RECEIVED APR 272017 CITY OF FEDERAL WAY COMMUNITY DEVELOPMENT Acare-, C\Ao,y-Locktvi iv\,k41) /6(00 s, 3334, jp- 63,40 , ( --.p ' b ; 10e S p /oe ryiV`40.c4-•e . cc 4 MOkiit- ( gr^^4— c.A-I.044. Q:(I &IA is 941-4696, 9�L3 M� F} 7 � 30' /1'\ :4, - © e RECEIVED APR 2 7 2017 CITY OF FEDERAL WAY COMMUNITY DEVELOPMENT 333 f- J.J. Asbestos Inspection 425-233- 1809 Asbestos Survey Report Berwick's MHS 1600 S 333rd St Federal Way, WA 98003 RECEIVED APR 2 7 2017 CITY OF FEDERAL WAY COMMUNITY DEVELOPMENT Table of Contents Introduction Page 1 Purpose General Information Description of Building Sampling Page 2 General Protocol Sampling Protocol Sampling(cont.) Page 3 Laboratory Analysis List of Homogeneous Areas Survey Results List of Homogeneous Areas Page 4 Floor Plan Page 5 Conclusion Page 6 Conclusion of Survey/Recommendations Introduction Purpose • This asbestos survey was preformed in specified demolition area to identify the presence, the location and quantity of any asbestos containing materials (ACM) within the demolition area. The reason of this survey is to fully comply with the governing asbestos regulations set by the State of Washington and with the Federal guidelines. The State of Washington requires a"good faith inspection" for the identification of ACM prior to any renovation,remodeling or demolition work. The survey is required to be preformed in accordance with 40 CFR 763.86 and WAC 192-62-07721. Both Federal and State regulations require inspections to be preformed by and EPA Accredited Building Inspector, and with analysis to be provided by an asbestos laboratory certified by the National Bureau of Standards. This Survey was performed in compliance with all the standards mentioned above. General Information • On April 17th, 2017, I Joshua Johnson, AHERA certified building Inspector of JJ Asbestos Inspection, Preformed a inspection for suspect ACM 1600 S 333rd St, Federal Way, WA. • The structure located at the above referenced property is to be scheduled for Demolition. • This inspection included all accessible areas within the projected construction area. Description of the Building • This building located at 1600 S 333rd St, Federal Way, WA is a Single Wide mobile home. This home has Wood Paneling as the main wall system throughout the house (This Home Has Water Damage Throughout). This building is scheduled for demolition. Page 1 Sampling General • The objective of sampling was to determine the quantity and location(s) of asbestos containing materials. There were 7 suspected ACM in or on the structure at the above referenced property and four samples were collected. Protocol • The asbestos building survey was adapted from the Asbestos Hazard Emergency Response Act(AHERA) Protocol outlined under 40 CFR 763. The protocol is as follows: Sampling Protocol • Put on Protective equipment(if needed) • Label each sample container with its identification number and recording number. Record sample location, and type of material sampled on a sampling data form. • Moisten area where the sample is to be extracted (Spray immediate area with water). • Extract sample using a clean knife, drill capsule, or cork-boring tool, to cutout or scrape off approximately one tablespoon of the material. Making sure to penetrate all layers of the suspect ACM. • Place sample into a container and quickly seal it. • Wipe the exterior of the container, then clean any tools used to preformed sampling, or vacuum area with a HEPA vacuum to clean all debris. • Seal the sampling location with any form useful. • Discard protective clothing, wet wipes,rags, and drop cloths into a labeled plastic waste bag. Page 2 Sampling (cont.) Laboratory Analysis • The bulk ACM samples were analyzed at Seattle Asbestos Test, LLC. Located at 19711 Scriber Lake Road, Suite D, Lynnwood, WA 98036, using polarized light microscopy(PLM)with dispersing staining in accordance with the U.S. EPA method 600/R-93-166 as specified in 40 CFR part 763. PLM quantifies asbestos concentrations at between 100% - 1% can be stated as "ND". • For those samples with asbestos concentrations between one and ten percent based on visual estimation, the EPA recommends a procedure known as point counting. Point counting is much more accurate means of quantification for samples with low concentrations of asbestos. List of all Homogenous Areas • This list will show where all samples where taken and what types of samples were taken as listed on Page 4. • Included with the list on Page 5 is a rough copy of the floor plan of the building that was inspected, Identifying where the room the samples taken were located. Results of Survey • The building located at 1600 S 333rd St, Federal Way, WA, had seven(7) suspected ACMs on or in building materials. Samples 1-7 taken, tested Negative for Asbestos content Page 3 • List of Homogeneous Areas 1600 S 333rd St, Federal Way, WA. Sample HM # Area Description Amount Contain's T e ## Asbestos Type Y/N S/T/M 1 1 Vinyl Flooring/Mastic Room 3 8-10 sqft N M 2 1 2nd Layer Flooring/Mastic Room 3 8-10 sqft N M 3 2 Putty Around Windows Exterior Throughout N M 4 3 Roofing Material Exterior Throughout N M 5 4 Celing Material Room 4 Throughout N M 6 5 Putty Around Tub Room 3 6-8 sqft N S 7 6 Vinyl Flooring/ Mastic Room 1 8-10 sqft Y M Y=Yes N= No A=Assumed S= Surfacin T-= ermanl system ulati• M= Miscellan us ,-% r / ( 4iii. ' jj \,,, / Date: Signature: Page 4 _�-%%` Conclusion Conclusions of Survey/ Recommendations • The results of this survey contain that all seven suspected ACMs tested negative for asbestos. • A copy of this report must be provided to any employee or contractor conducting renovation or demolition activities at the subject property. • Asbestos surveys are non-comprehensive by nature and subject to many limitations. These limitations are that my survey has considered risks pertaining to asbestos; this survey is limited to only those locations sampled. The survey conducted was not designated to identify all potential concerns and/or eliminate all risk associated with potential asbestos containing materials (PACM) • Evaluation of all other risks, such as hazardous substances and toxic waste in soil and ground water, structural, electrical, mechanic, gas,building settlement, moisture, or site drainage have not been include. There is No Warranty, Expressed or implied, is made. • The site visited includes a visual walkthrough of the subject area for the soul purpose of viewing and sampling PACMs. JJ Asbestos Inspection is not responsible for any materials, which require destructive methods to access, or any material that are hidden from sight. Those materials hidden behind walls or materials, which cannot be found reasonable diligence. • JJ Asbestos Inspection conducted this survey in full accordance with the accepted standards of care in the inspection profession in Washington State at the time of the study. This asbestos Survey was preformed in preparation for a demolition of the subject Structure. JJ Asbestos Inspection Joshua Johnson JJ Asbestos Inspection AHERA No: 3 508-07-02-04 Expiration Date: February 28, 2018 Page 6 List of rooms 1 2 3 4 5 Page 5 List of rooms 1 2 3 4 Page 5 .