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16-103547 - Demolition City of Federal Way Community&Econ.Dev.Services Permit #: 16-103547-00-DE 33325 8th Ave S Federal Way,WA 98003 Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050 Project Name: CHURCH OF BLESSING Project Address: 1430 S 330TH ST Parcel Number: 172104 9045 Project Description: Demolish existing metal building Owner Applicant Contractor CHURCH OF BLESSING CHURCH OF BLESSING CHURCH OF BLESSING 1430 S 330TH ST 1430 S 330TH ST 1430 S 330TH ST FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 Additional Permit Information Demolition Valuation 9000 PERMIT EXPIRES Sunday, July 22, 2018 Permit Issued on Friday, July 22, 2016 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: r`NIA- Date: 7---•2 THIS CARD IS TO REMAIN ON-SITE CITY 01. - A. Construction Inspection Record - Federal Way INSPECTION REQUESTS: (253) 835-3050 PERMIT#: 16-103547-00-DE Address: 1430 S 330TH ST Project: CHURCH OF BLESSING FEDERAL WAY, WA 98003-6302 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. O SWM Precon Site Mtg(4400) ❑ Initial Erosion Control(4365) ❑ Interim Erosion Control(4370) Approved To be done prior to breaking ground Approved By Date By Date By Date ❑ Final Erosion Control(4375) ❑ Final-Building(4050) Approved Approved By Date By Date /qtr I Rough Electrical Final Electrical ❑ Right of Way ❑ Approved ❑ Approved Approved By Date By Date By Date CEIVE® i► PERMIZSAP 2 2 PLICATION CITY OF' JUL 2016 PERMIT CENTER + 33325 8th Avenue South + Federal Way,WA 98003-6325 Federal Way CITY OF FEDERAL WA' 253-835-2607 + FAX 253-835-2609 +perrnitcenter@cityoffederalway.com CDS PERMIT NUMBER ) (a _ 1 0 S uj L j -7 - 2) [r> 11!! NNV��� TARGET DATE SITE ADDRESS # I el 3O S ` O s.-/ -2ci"1 �4,y , 1A. Qv"OO1 PROJECT VALUATer ZONING ASSESSOR'S TAX/PARCEL# $ .?• C0 -- ---- ,, 112- / q - . Of/ 3— TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT C t, r c Ae `-P sc;to if -e/ co 1 i sit. e / SII ik) Nt 4 G e chif4p0 PROJECT DESCRIPTION r Detailed description of work to I �)c M C)— be included on this permit only PRIMARY PHONE PROPERTY OWNER NAME r e h o Ze SS/, VO k 3S0 - beoe MAILINGI `ADDRESS V 5 ✓ D 0 "'I C S ' / CITYF STATE-1'C r L W/1Y i'/t/A-. Zy s 003 • C-C4 / NAME , (,/ t iv t-7PHONE^"'� MAILI DS 2,p �I / e . CONTRACTOR 190 5 33c' '‘-' E-MAIL ,atrt, CITY i , STATE ZIP FAX e-E CJS OA l t.k_i) 4 Q 00 ------ WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# / / NAME IMARY PHONE �'��.1 (re A �ZP � V- 0 1r-6 ' C d APPLICANT MAILING ADDRESS 330.-- ,i.2, . ( E-MAIL 30 5 CITY / A l 3W E ZIP O O 3 FAX NAME ! > PRIMARY PONE PROJECT CONTACT /� >e, �/1 c y� IC (2o 6) 6,X0 0 (The individual to receive and MAILING ADDRESS / E-MAIL respond to all correspondence /c/ 36 © 5 . 3� S r > r y2( concerning this application) CITY Fe d ( um 9 SATE_ ZIP dn.— FAX J NAME ttK..ff//jQ� Y r 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 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 arty 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 of this applicati SIGNATURE: Lp DATE 7_,22 —IE PRINT NAME: A ' L t ,. L )14./� Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application s • VALUE OF MECHANICAL WORK MECHANICAL PERMIT $ Indicate how many of each type offixture 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.Do not include existing fixtures to remain. BATHTUBS(or Tub/Shower combo) LAVS(Hand Sinks) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINATR 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 ❑ No RESIDENTIAL - NEW OR A nniTinN AREA DESCRIPTION(in square feet) EXISTING I PROPOSED 1 TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR(or Mobile Home) SECOND FLOOR COVERED ENTRY • DECK GARAGE ❑ CARPORT ❑ OTHER(describe) EXISTING PROPOSED TOTAL Area Totals I I I I **NEW HOMES ONLY** ESTIMATED SELLING PRICE$ #OF BEDROOMS COMMERCIAL-NEW/ADDITION Area instruction # of AREA DESCRIPTION Square Feet Occupancy Groups) I ConType Stories Additional Information NEW BUILDING ADDITION COMMERCIAL-REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area Occupancy Group(s) Construction # of Square Feet Type Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application • / )j f RECEIVEDCOMMUNITY DEVELOPMENT DEPARTMENT 33325 8th Avenue South CITY OF - JUL o 2 ���� Federal Way,WA 98003-6325 253-835-2607;Fax 253-835-2609 Federal Way CITY OF FEDERAL WAY www.cityoffederalway.com CDS DEMOLITION PERMIT REQUIREMENTS A demolition permit is required to remove any structure on a subject property. Demolition of separate structures may require separate permits. l Address of Demolition: \ 730 'NZ 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. 1.ASBESTOS ABATEMENT (Provide copy of Notice of Intent from Puget Sound Clean Air Agency 5. ELECTRICITY and copy o inspection report by AHERA-certi {,1 inspector) x,0,.1--t„ I, rJ (City of Federal Way-Mcing Official) (Puget Sound Energy) 2. FUEL STORAGE TANKS 6.GAS SUPPLY o Under grade tank(s)is/are present ❑Above grade tank(s)are present " c Tank(s)has been pumped or removed under South King Fire& (Puget Sound Energy) Rescue permit prior to any dismantling orexcavation ItlA (South King Fire nd Rescue) 7.WATER- Public Source NI A (Waterl Supplier) 3. SEPTIC SYSTEM N� A 8.WATER- Private Well (King County Environmental Services) 4 (King County Enthironmental Services) 4. SANITARY SEWER (Lakehaven Uti ty District) Bulletin#122—May 13,2015 Page 1 of 1 k:\Handouts\Demolition Permit Requirements • • pscleanair.org RECEIVED Puget Sound Liean Alt JUL 22 2016 Notification Case #: 201603419 CITY OF FEDERAL WAY 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# AROFD7F7A282 Transaction Date 07/14/16 Owner's Name Church of Blessing Phone (253)334-7149 Project Street Address 1430 S 330th St City Federal Way Zip 98003 Contact Person Alex Lukomsky Phone (253)334-7149 Mailing Address This project includes a demolition. Demolition Start Date 07/24/16 Completion Date 08/14/16 Demolition will be completed by a demolition contractor Demo Contractor Property Owner Contractor Job# Contact Phone Mailing Address (1) I certify that the information I have provided is to the best of my knowledge true and accurate. (2) I understand that I must file an Amendment to this Notification if: • The type of project has changed. The project types are asbestos and demolition. • The quantity of friable asbestos to be removed meets a larger project category. • The project's start or completion date has changed. (3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary structures, such as a detached garage or other outbuildings having the same street address. If there is no street address, I have used a building number. (4) I understand the fees for this Notification are nonrefundable. Create Another Notification If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. . • RECEIVED Asbestos Northwest, LLC - Survey Report JUL 2 2 2016 30620 Pacific Hwy S, #103, Federal Way, WA 98003 253.941.4343 CITY OF FEDERAL WAY CDS Survey Location: 1430 S 330th St Federal Way, Wa Prepared for: Church of Blessings Date: July 1st, 2016 Asbestos Northwest Batch Number: 201611008 Inspector: Dan Lafley (#15-3556) Liam Butler (#15-0775) E-mail: Danl anasbestosnw.com 1 • • Table of Contents: 1. Background and Scope of Work 2. Building information 3. Material Sampling information 4. Asbestos Containing Material 5. Conclusions Appendices Appendix A Appendix B Appendix C Page 2 of 12 • • 1. Background Information and Scope of Work On July 1st, 2016, Asbestos Northwest, LLC conducted a storage warehouse at the location of 1430 S 330th St Federal Way, WA. The survey was conducted by Liam Butler (#15-0775) and Dan Lafley (#15-3556) who are Asbestos Hazard Emergency Response Act (AHERA) certified building inspectors. The survey was conducted to determine the presence of Asbestos Containing Materials (ACMs) before the demolition of the building The survey included the interior and exterior of the building. Materials were located and sampled. They were then analyzed in-house at Asbestos Northwest. See section 3 for detailed sampling information. See appendix B for a detailed floor plan of the building including the survey area and any inaccessible areas, and appendix C for the complete laboratory report. Page 3 of 12 • • 2. Building Description The building was a single story 7,000 ft2 warehouse building with 23ft ceiling. The building shared structural elements with the adjacent church, which will not be demolished. The warehouse was occupied and being used for storage at the time of the survey. Structural System The warehouse was metal framed structure with corrugated metal walls and ceilings. The south wall was comprised of drywall. All other walls were metal or painted wood over metal. Wood walls had trace mastic running along the floor from cove base. Flooring was concrete. Mechanical system The warehouse was heated from a large metal duct, with the heating source on the roof of the church. Electrical system The electrical system was modern plastic wiring over copper. The electrical box was located in the south eastern corner of the building and contained breakers. Roofing system The roof was corrugated metal over wood. Insulation The building was insulated with modern fiberglass insulated with a plastic sheeting on both the ceiling and walls. Page 4 of 12 • • and released the form to the laboratory with the samples. Samples were analyzed in house at Asbestos Northwest. Below is a list of all materials sampled. Appendix C contains the laboratory report and analytical results for each sample Description Material Type Extent and Sample #'s and Condition Locations Plastic Sheeting and Miscellaneous Walls and ceiling of 1- Mid north wall yellow insulation Material building Friable Semi Damaged Drywall and Joint Surfacing material / Portions of the south 2- wall in SE corner Compound Miscellaneous wall Material Good Condition Non-Friable Brown and Yellow Mastic Miscellaneous Running around floor 3-West wall along floor Material of most of the Non-Friable building. -250 Linear Feet Good Condition Page 6 of 12 • • 4. Asbestos Containing Material A homogenous material is considered to be ACM (Asbestos Containing Material) if one or more samples are reported to have greater than 1% asbestos. Analysis can result in both positive and negative sample results in materials containing <10%, have very fine asbestos fibers, have been hand mixed, or have asbestos fibers tightly bound in the matrix. EPA recommends a minimum of three samples be analyzed by PLM for these types of materials. All materials that were sampled during the inspection were analyzed under PLM, EPA Method 600/R-93/116. During the inspection, the inspectors determined that none materials contained asbestos. 5. Conclusions No asbestos was found during the inspection, Page 7 of 12 0 . Appendix A — Certifications! 0 CD T^ ti .y —. C.) 0 Z —h n y —. O QI I rn n I nl'- o ' co' — eo CI Z.- Cu ' _2 �. tD Z aCo p c, cD ti `c O r+ roof — —i6 O C Z w 0vii 'CB z-5 ,i. 1 Qp 7W 0 OM. a iv `�Fic Z ,.4 74: IN III pII a. ut r •-t► (:::: . O C 1:: ::--Sk = R°yam ���a C7 °' �to �, m �' Tf (t) � s:g , ace fD —' Q, = o SQ.. c 1. 1 mom Cno S CD it-, ( cj QO n nO g. c. � a m i )1 d c. c. ., n t i �' y 0 m @N O, 2 0 .Z to N co �n i n �' " (ail v illvN IV Q a � Q N N' 0 " ?j O 1 1 1 4 I cn G a i 1 Page 8 of 12 • • r 1 Certificate of Completion This G to certify that Liam Butler has satisfactur,Iv cornp1ett. 24 hours of training as an AHERA Building Inspector n'omphance with TSCA f dfe II AHE RA d0 CF R Part 763 U S EPA Region 10 Accreditation#192 Course Date 7/24/2015 RGA cert'#15-0775 3317 aid Ave S,Suite D „,r Seattle.WA 98134.888 281 8858 www rgatrainrng tom 1900 W Nickerson St.#315 Seattle.WA 98119 A Rt' n 206.285.3373 a N SNE This certifies that Daniel J. Lafley has satisfactorily completed 4 hours of refresher training as an Asbestos Building Inspector complies with TSCA Title II/40 CFR 763(AHERAI rX Certificate# 153556 Class Date: Oct 21.2015 Instructor Expires: Oct 20,2016 EPA Provider Certificate It 1085 Page 9 of 12 • • • Appendix B — Building Layout 3 t �` .... �• 7, 142 1.0W 11 F 7 0 M fr o (n W 1� d t U .1- c..1 Page 10 of 12 • • Appendix C — Laboratory Report ASBESTOS •` �� (� NORTHWEST Asbestos NW Batch# \b. t i 25 30620 Pacific 116 S.#103.Federal Was.N A 98003 (253)941-4343 SA LAP Lab#:200993-0 Bulk Samples Chain of C stody(EPA 600/R-93/116) Namcromp:lli,: Church. 0C i Sl Date: 7/i/DI( Address: v l lA Phone tt: P11 Email:j-} U rYl'5�C 0 CSC Project Manager: RI.e.. L (,.-OVNpyw , P\1('ell`:�ZF"aj ,7l� Project Location: 142-X 5 53:551:ec 01 t".....)co..) Project -: Number of Samples; �"'1 !UM lir tiunu fluice; # Customer Sample II) Description Location/Condition i ` e\ t rlSz 0 .: tcrvl (oV IA.,-Q, 1, -1.11 , ►..k ic( tiuis�tl '�c S_ ui 3 �--A-C K\AA ) Cc�Yl V4-, c�.-1 l 4 (2. k0gtirm5 5 6 i R 9 10 11 12 13 14 15. 16 17 19 20 21 11 23 14 25l 1 1 "Client%Ail!he notified it.subcontracting is required Print Sign Company Date Time Sampled by: Relinquished by: Delivered by: �1. - lLll;�.1 5/L q,of Accepted by: Analyzed by: e,1, fro., /9-, AV- 7-5'"4o Reviewed by: Page 11 of 12 • 0 NORTHWEST 200993-0 Asbestos Northwest,LLC 30620 Pacific liwy S,#I03_Federal Way.WA 98003 Batch Number: 201611185 Ph:(2_53)941-4343 Fax:(253)941-4175 PLM Analysis by EPA Method 600/M4-82-020 and 600/R-93/116 Attn: Alex Lukomskv Date Received: 7/1/2016 Church of Blessing Date Analyzed: 711/2016 Samples Received: 3 Samples Analyzed: 3 Project: 1430 S 330th federal Way WA Client Sample %Non-Asbestos %Asbestos Fibers ID Lab Sample ID Layer Description Matrix Fibers and Type I I I White Plastic Plastic None Detected Non Detected 2 Yellow fibrous material Filler 80%Glass fibers None Detected 1 White powdery material Binder/filler. 2 1 x.ith paint and paper Paint 15%Cellulose None Detected 2 White chalky material Filler/binder. 35%Cellulose None Detected ti.ith paper Gypsum/hinder 3 3 I White mastic Mastic/binder 1%Cellulose None Detected 5%Cellulose. Brown mastic Mastic/binder None Detected Wol lastonitc 3 Brown wood Wood None Detected None Detected Aggragates Analyzed By:Cathy Butle( I17.4Pate t of 1 vi• edRv:Dan Laney --"-' \ J Page 12 of 12