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15-106433
• • Demolition City of Federal Way Community&Econ.Dev.Services Permit #. 15-106433-00-DE 33325 8th Ave S Federal Way,WA 98003 Inspection Request Line: 25 Ph:(253)835-2607 Fax:(253)835-2609 p q ( 3) 835-3050 Project Name: FOSTER Project Address: 28811 19TH AVE S Parcel Number: 422300 0020 Project Description: Complete demolition and removal of fire-damaged residence. Owner Applicant Contractor MARK FOSTER MCBRIDE CONST RESOURCES INC MCBRIDE CONST RESOURCES INC 213 N RANCHO PL 224 NICKERSON ST MCBRICR099JZ (3/25/17) EL SOBRANTE CA 94803 SEATTLE WA 98109 224 NICKERSON ST SEATTLE WA 98109 Additional Permit Information Demolition Valuation 30000 CONDITIONS: Erosion and Sediment Control Measures shall be installed and maintained in accordance with the King County Surface Water Manual,Appendix C or D,dependent on site size. The City may inspect and require additional controls dependent on erosion or risk of erosion. Upon completion of operations,all disturbed areas shall be stabilized in accordance with the King County Surface Water Manual,Appendix C or D,dependent on site size.This can be accomplished by spreading seed at manufacturer's recommended rate and straw at a rate of 2" -3" thick or alternate method listed in the manual. PERMIT EXPIRES Wednesday, December 20, 2017 Permit Issued on Monday, December 21, 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 vvilh the laws, rules and regulations of the State of Washington nd th ity of Federal Way. • Owner or agent:/IX-GI � Date: j a -24/ - l ' • THIS CARD IS TO AIN ON-SITE CITY OF `" ` Construction In ection Record Federal Way INSPECTION REQUE TS: (253) 835-3050 PERMIT #: 15-106433-00-DE Address: 28811 19TH AVE S Project: MARK FOSTER FEDERAL WAY, WA 98003-3811 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. SWM Precon Site Mtg(4400) ❑ Initial Erosion Control (4365) El Interim Erosion Control(4370) Approved To be done prior to breaking ground Approved By Date By Date By Date ❑ Final Erosion Control (4375) 0 Final-Building(4050) Approved Approved 1 /^ By Date By A_N) Date �3J/I1� El Rough Electrical Final Electrical 0Right of Way Approved Approved Approved By Date By Date _ .._.w. _.-.j y Date REmirCid • CITY Of DEC 212015 PERMIT APPLICATION Federal Way CITY OF FEDERAL WAY CDS rte^ PERMIT NUMBER J 5 - /,,.� ,,� - y TARGET DATE iZ 19(1-7 // { � � __ G,//" L `J SITE ADDRESS tltl� ��rr q d� SUITE/UNIT# ,,.�rr��,, 979 frV . Jr rf i) /ir/(9©3 PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# $ 3 er,e) 7 0 0 - J TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING El MECHANICAL DEMOLITION ❑ ENGINEERING CI FIRE PREVENTION NAME OF PROJECT 0 3 TJI )),, zA k PROJECT DESCRIPTION r ► Tort�T�t©� `�`� 2s-� Rai4.tDetailed description of work to (�f' �G� J� !`�� ij � ' l be included on this permit only NAME PRIMARY PHONE PROPERTY OWNER q -5-£f Y 7 Tae_ MAILING ADDRESS l,�,// / / E-MAIL fel go1 CITY, t tire✓p , �n4 STA E ZIP g,f 3, NAME ,,.., PHONE r„1„93...,71/Z MAILING ADDRESS 2217/ G+� �,/ _ E-MAIL Z CONTRACTOR a'/ /v` i „5- I" 57�. /ms f 146rit°►ee CITYE ZIP FAX t Crow ' 7i�g TA�, 115101 -.; m � WA STATE CONTRAC R'S LICENSE:7, \ EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# ffriC, /ate � ' - .� ei 3/ ,' 20 i-"/OY S/_ cc- NAME PRIMARY PHONE �! r14 alIt1, lE/ 2 = - 7/x.1 APPLICANT MAILING ADDRESS ^Z iV/&K,,,P i E-MAIL G 1l- 1 iit S€Ine617decbMtTt' Otfl&AA7 CITY 4471 TATE ZIP FAX i. 1�� 'Zett7 ze4'-56 7O NAME PRIMARY PHONE PROJECT CONTACT _5/Wf:: /45 e (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 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 a part of this applicati SIGNATURE: �Tr,, , / t DATE PRINT NAME: "-1 / ,5^C/10A/2 Bulletin 14100—October 26,2015 Page 1 of 3 lc:\Handouts\Permit Application • RECEIVED • DEC 212015 COMMUNITY DEVELOPMENT DEPARTMENT Am% 33325 8th Avenue South CITY OF FEDERAL WAY Federal Way,WA 98003-6325 CITY OF w^° CDS 253-835-2607;Fax 253-835-2609 Federal Way 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. ❑ Address of Demolition: Z9$1/ ,9 f✓E.- 5, GG,DrR// lvily (746/4573 0 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 r and copy inspection r port by AHERA-certified inspector) (0i of Feder ay Building Official) (Puget Sound Energy) 2. FUEL STORAGE TANKS 6. GAS SUPPLY / ❑ Under grade tank(s)is/are present u Above grade tank(s)are present ge- 1,1 /t/Lt if' ;1 Tank(s)has been pumped or removed under South King Fire& (Puget Sound Ener ) Rescue permit prior to any dismantling or excavation /144 (South King Fire and Rescue) 7.WATER- Public Source �i / - ' (Watt Supplie - 3. SEPTIC SYSTEM A8.WATER- Private Well (King County Environmental Services) (KingCountyEnvironmental Services) 4. SANITARY SEWER *t4` A4-41frl kehaven Utility District) Bulletin#122—May 13,2015 Page 1 of 1 k:\Handouts\Demolition Permit Requirements • • ORION Environmental Services 11041 34004 Ninth Avenue South,Suite Al2, Federal Way,WA 98003 Envi .tal'camplivn.o&c6nsm,m9 Phone:(253)952-6717 • Fax: (253)927-4714 Email:info@oriones_net•Web: www.oriones.net WBE W2F9219763 RECEIVED Polarized Light Microscopy Test Report EPA Method 600/R-98/116 DEC 21 2015 Client: Tacoma Abatement Company LLC CITY OF F i.A: 1.6/2015 Address: 5111 South Burlington Way,Tacoma,WA 98409 age: 1 of 2 Attention: Pat Culver Invoice: 155420 Project Name: Adair Date Rcvd: 10/16/2015 Project Number: Asbestos Orion ?Material Sample Containing Asbestos Qthei of 1 lltipl ID Description Treatment Material Type Fibers:. 1 20151016-6 Texture ND cellulose 2 20151016-7 Joint Compound ND 3 20151016-8 Texture ND cellulose • 4=a 20151016-9 Vinyl Tile ND 4-b Mastic j chloroform ND cellulose 5 201,51016-10 Vinyl Sheeting ND cellulose 6-a 20151016-11 Vinyl Sheeting ND cellulose 6-b White Mastic chloroform ND cellulose 7 20151016-12 Self Adhesive ND cellulose 8 20151016-13 Texture ND 9 20151016-14 Texture ND cellulose • 10 20151016-15 Joint Compound ND 11 20151016-16 Texture ND cellulose 127a 20151016-17 Comp Roof ND cellulose/ fiber ilass 12-b Slip Sheet ND cellulose • • Polarized Light Microscopy Test Report (cont.) Client: Tacoma Abatement Company LLC Rpt. Date: 1'7/36/2015 Address: 5111 South Burlington Way,Tacoma,WA 98409 Page: 2 of 2 Attention: Pat Culver Invoice: 155420 Project Name: Adair Date Rcvd: 10/16/2015 Project Number: _ . t Lt."' a Asbestos ,client :ry Orion Material Sample containing Asbestos Other Sample ID ::- Sample IQ _ ', bescription Treatment -, •Material Type ' Ftber Dup:Laboratory QA/QC Duplicate;M., Mastic[(a),(b),(r.),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 Donna McNeal 10/16/2015 Dennis Rauschenberg 10/16/2015 An e y(S,jg ature) c-------2__ Time Reviewed By{signature) Time • ! 0 Bulk Sample Log/ Chain of Custody LAB: 1 5 If).(1) i 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: V .e t-nit Fax#: (253)383-1592 zest t kcT Job Address: Aic c; L:A pa. tt fr AQ Type of Analysis(Check One) Report Results To: Pat Culver At Phone#: (253) 273-5809 ASBESTOS LEAD Fax Results: X253) 383 1592 0 PCM(air) p'( Paint IT�J Soil Mail Hard Copy: PLM(bulk) ❑ Dust/Wipe(area?) Email Copy To: pculver{�tacomaabatement.com 0 Air(volume?) 0 TCLP p� 0 REGULAR ( ARUSH ' ' 7.9101 / -' ‘Iih , Condition of Packages Good 0 Damaged(No Spillage) 0 Severe Damage (Spillage) • Lab ID Sample ID Type Location 1 7E'T1Q 1—'3--Jir--14-! Q.4. 3 1 E i U iLC 15\s-1-4, r Uo. 4 1f �4 41 T 5 n 1NaN G, 6 3V PO,,,,N r*1-1 • 7 5 V i` N 8 • 10 ZC Re() 11 • `p1 UQ 13.&- 12 Ph 1.- Pc(4 til (' 13 14 LL� 7` ----------Z7Z`1' L��' /p, Signatur r'1 4�Date Time � ��QQ"" Sampled By J/ (s— q:op iPVI d B Delivere Y / /U l�6 fl --- 6: 3o A yi Li Received By: V [0/ / _- g 1i T', Analyzed By: Special: : Read Abatement Sample# ONLY if Sample# is Greater Than .01 f/cc Notification Details https://secure.pscleanair.org/AsbestoslLoginAccount/NotificationDetai... • pscleanair.org Puget Sound Clean Air Agency View Account History Create Amendment 201505020-2 Notification Details for Case#: 201505020-1 Fee Amount $65.00 Transaction Date 12/01/15 Owner's Name Mark Foster Phone (925)548-7702 Project Street Address 28811 19th Ave.S. City Federal Way Zip 98003 Contact Person Jim Schunzel Phone (206)283-7121 Mailing Address 213 N.Rancho Place El Sobrante,CA 94803 This project includes a demolition. Demolition Start Date 12/16/15 Completion Date 12/23/15 Demolition will be completed by a demolition contractor Demo Contractor McBride Construction Contractor Job A Contact Jim Schunzel Phone (206)283-7121 Mailing Address 224 Nickerson St. ,WA 98109 Note:Notifications cannot be amended after the completion date. RECEIVED CITYDEC OF FEDERAL212015 WAY CDS 1 of 1 12/1/2015 2:04 PM