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07-100097 City of Federal Way • Community Development Services Demolition Permft #: 07-100097-00-DE P.O.Box 9718 Federal Way,WA 98063-9718 Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050 Project Name: OTMAR Project Address: 2101 S 324TH Space 168 Parcel Number: 162104 9037 Project Description: Demolition of fire damaged mobile home Owner Applicant Contractor STEVEN OTMAR STEVEN OTMAR STEVEN OTMAR 2101 S 324TH ST 2101 S 324TH ST 2101 S 324TH ST FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 FEDERAL WAY WA 98003 Additional Permit Information CONDITIONS: After final inspection is complete and approved,Please contact Kari Cimmer by e-mail at Kari.Cimmer@ci.federal-way.wa.us to receive a refund of cash bond. PERMIT EXPIRES Wednesday, January 7, 2009 Permit Issued on Monday, January 8, 2007 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 an e it f Federal Way. J -f Owner or agent: ,� Date: / — THIS CARD IS TO ILMAIN ON-SITE CITY of ••isol ommunity Developm it Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT #: 07-100097-00-DE Owner: STEVEN OTMAR Address: 2101 S 324TH Space 168 FEDERAL WAY, WA 98003 This card is part of your required inspection documents. 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. 0 Final-Building(4050) Approved By I1 Date ► -2r- 4), CITY OF a +� �•�� Federal Way4E -�'�� O - - - r 000 COMMUNITY DEVELOPMENT SERVICES n 8 ry00, PERMIT SF MF CO ME EL PL N 33325 8rN AVENUE SOUTH•PO BOX 9718+,i V L FEDERAL WAY,WA 98063-9718 APPLICATION TD 253-835-2607•FAX 253.835-2609 / / www.dfzioljederalwaVTY OF FEDERAL WAY BUILDING The following is requiredinformationDformattion-an incomplete application will not be accepted. Please print legibly(in ink)or type. . al PROPERTY INFORMATION • . SITE ADDRESS f 0 1 5-f 3 z ei { ( ( f SUITE/UNIT# 1.1 ASSESSOR'S TAX/PARCEL# • _ LOT SIZE(s� LEGAL DESCRIPTION (e.g.Acme Estates, Lot 1) D� �. . W C .(` rj�L e (Attach separate page for lengthy legal description) !!!!//// a PROJECT INFORMATION TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL 'DEMOLITION 0 ELECTRICAL ❑ ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlll) PROJECT NAME(Name of Business or Owner Last Name) 07&J(�`' _. NI PEOPLE INFORMATION PROPERTY NAME OWNER 5t�V e/` ' 077--k....40,1 j� PRIMARY PHONE ,x^J�/J /7 MAILING ADDRESy� ( v . 11 . 1 , L14f CITY,STAT ;'ZIP E �5-6 `O ` z f z. i 1'l / (.5-,3 . , `� (,j 1 Fl �' ){ t��L�, 7E-MAIL ADDRESS CONTRACTOR COMPANY NAME + /I APPLICANT NAME ` 'r�r✓ ,_c/9"-/ -4' t' e OFFICE PHONE MAILING ADDRESS 'L CITY,STATE,ZIP - ) � � CELL ) CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER - EXPIRATION DATE - FAX NUMBER • COPY of card required CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE ) with each application I E-MAIL ADDRESS • APPLICANT COMPANY NAME -APPLICANT NAME OFFICE PHONE -.71\)\•11e._..-• • ( ) MAILING ADDRESS - • CITY,STATE,ZIP - • CELL PHONE - RELATIONSHIP TO PROJECT ) FAX NUMBER 0 Architect ❑ Tenant ❑Agent ❑ Other ( ) PROJECT I NAME PHONE I E-MAIL ADDRESS CONTACT I ( ) LENDER NAME Per RCW 19.27.095: . J Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIPPHONE I ` ) • • • . • - ■ DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ SPRINKLERED BUILDING? ❑ YES 0 NO FIRE.SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) b. ■ PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ. FT. SQ. FT. SQ. FT. BASEMENT FIRST SECOND THIRD ADDITIONAL FLOORS(DESCRIBE) DECK(0 COVERED OR 0 UNCOVERED?) GARAGE 0 CARPORT 0 EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF NUMBER OF FLOORS **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ N FIXTURES • Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL Value of Mechanical Work $ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION) • AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES BBQS FANS GAS WATER HEATERS MISC(Describe) BOILERS FIREPLACE INSERTS HOODS(commercial) COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG.SYSTEMS PLUMBING BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS WATER CLOSETS crone) ELECTRIC WATER HEATERS SINKS WASHING MACHINES HOSE BIBBS SUMPS • • _ _ ___ _ SIGNATURE wI 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 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 of Federal Way,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 application. �' ®�► A DATE 0 r ^2� (Signature) (Title) NAME/TITLELATIONSHIP TO PROJECT 9rOwner ❑ Agent ❑ Contractor ❑ Architect 0 Other ❑NEW o ADDITION ❑ALTERATION ❑REPAIR o TENANT IMPROVEMENT BUILDING SHELL ONLY? a YES ❑NO BASIC PLAN? ❑YES o NO ZONING DESIGNATION CHANGE OF USE? a YES o NO NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? ❑YES o NO PLATTED LOT? ❑YES 0 NO DEMO PERMIT REQUIRED? ❑YES a NO • Bulletin#100—January I,2006 Page 2 of 4 k\Handouts\Permit Application • DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES 33325 8th Avenue South ��- �� (, PO Box 9718 CITY OF f r U i Federal Way WA 98063-9718 Federal 253-835-2607;Fax 253-835-2609 www.cityoffederalway.com 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. ❑ 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. j'1.ASBESTOS ABATEMENT 6. ELECTRICITY (Copy of approval form and asbestos survey from Puget Sound Clean Air (Electricity to be shut off and meter removed) Agency provided) (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 removed under Fire epartment perri it prior to any ismantle/excavation) (Puget Sound Energy) Wpel a tta,,,i- i(// i !Lz Z4--- (Federal Way Fire Distr ct# 3. SEPTIC SYSTEM 8. WATER- Public Source (Check applicable box) f'elvA-C- S' (Tank to be removed or tank to be drained) o Meter to be removed and final utility bill paid 51-rt LS Mfg rkteep o Meter main and b protected M ;) (King County Environ7rrental Services) (Water Supplier) ******OR****** 4.SANITARY SEWER (Check applicable box) 9.WATER` •rivate Well(Ckte'ck applic e box) ❑Sewer line capped at property line 0 Private well filled . a.,,=d Existing sewer line to remain and be used by proposed new structure o PrivatLJ e ya be , , ' er purposes ''a (Sewer District) (King County Enviro . ental Services) 5.GARBAGE /' (All household arbage dis d off and final bill paid)n f y) ( Disp sal/Federal Way Disposal) �� ❑ Completed Construction Permit Application form ElProvide the following fees: 1.Demolition Permit Fee $65.50F ` 2.Automation Fee 5.00- 3. WA State Surcharge 4.50"- 4. Cash Bond Deposit 500.00 (Refundable upon Completed Final Inspection) $575.00 Bulletin#122—January 1,2006 Page 1 of 1 k:\Handouts\Demolition Permit Requirements • DEPARTMENT OF( 1UNITY DEVELOPMENT SERVICES 33325 8th Avenue South PO Box 9718 CITY OF Federal Way WA 98063-9718 Federal Way 253-835-2607;Fax 253-835-2609 www.cityoffederalway.com DEMOLITION PERMIT CONTACT LIST This list of agencies may assist you in expediting the demolition permit process.Refer to the demolition permit requirements for signature blocks.All applicable signatures are required prior to permit approval. 1. Asbestos Removal: Puget Sound Clean Air Agency 110 Union Street,Suite 500 Seattle,WA 98101-2038 206-343-8800—OR—800-552-3565 http://www.pscleanair.org y (VT ('e 2. Electricity: Puget Sound Energy Attn:Construction Coordinator 22828 68th Avenue South, Suite#1025 3 3 g Kent,WA 98032 888-225-5773 f 1/1 3. Gas: Puget Sound Energy S 3 3 _ / 2 805 156a'Avenuee NE �j 8/ Bellevue,WA 98004 ` c �J � O 888-225-5773 Ax 5, 3 4. Telephone: Qwest Communications 801-962-2475 (phone)/801-237-6491 (fax) 5. Water:. Lakehaven Utility District Tacoma Public Utilities Technical Service Division Customer Service 31623 First Avenue South —OR— 747 Market Street Federal Way,WA 98003 Tacoma,WA 98402 253-941-2288 253-383-9600 or 253-383-2471 6. Garbage: Waste Management ( 8'4 D 2 ' 133 x�� A > 655 Second NW t— — e (v C7 l`t c Auburn,WA 98071 253-833-3333 (residential)—OR—253-939-9792(commercial) 7. Sewer: Lakehaven Utility District Technical Services Division 31623 First Avenue South Federal Way,WA 98003 253-941-2288 8. Septic: King County Environmental Services ( ST 14350 SE Eastgate Way Bellevue,WA 98007 206-296-4932 9. Fire Department: Federal Way Fire Department#39 31617 First Avenue South Federal Way,WA 98003 253-839-6234 • Bulletin#109—October 1,2004 Page 1 of 1 k:\Handouts\Demolition Permit Contact List • • DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES /7� ��f 33325 8th Avenue South CITY OF `` 5PO Box 9718 r' ( C/ � </ (Federal Way WA 98063-9718 Federal \ Jy .__.727 r 253-835-2607;Fax 253-835-2609 www.cityoffederalway.com 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. LI 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. j51.ASBESTOS ABATEMENT 6. ELECTRICITY (Copy of approval form and asbestos survey from Puget Sound Clean Air (Electricity to be shut off and meter removed) Agency provided) (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 removed under Fire epartment permit priori to any ismantle//eexcavation) (Puget Sound Energy) �� - ?° _l2` / lm /'Z`L — (Federal Wa Fire District# 3.SEPTIC.SYSTEM 8.WATER- Public Source (Check applicable box) PR.ty r S t�^t (Tan to be rem or tank to b drairaed-3nd f ell d) o Meter to be removed and final utility bill paid 5t"L"C is (l1����--,fl --j �. o Meter main and b protected �- • Coun Environal Services) / (Water Supplier) ******OR******/ 4. SANITARY SEWER (Check applicable box) 9. WATER •rivate Well --ck applic.# e box) o ewer line capped at property line o Private wel filled . c`:_..v •-� Existing sewer e train and be used by proposed new structure o Private be tr :'•,,,t\purposes l-.4.1ct. (. lVt..- LtA (.LID,sr Zr 1 (Sewer District) - 1� ��, ( 1 ., C...•�- viro Rental Services) 5.GAR AGE (All household .arbage disco-•d off and fi b'I paid) ir IIIL -' if /ir ,p (•` Disposal/Federal ay Disposa 7 -_ ❑ Completed Construction Permit Application form ID Provide the following fees: 1. Demolition Permit Fee $65.50 2. Automation Fee 5.00-- 3. WA State Surcharge 4.50"- 4. Cash Bond Deposit 500.00 (Refundable upon Completed Final Inspection) $575.00 Bulletin#122—January 1,2006 Page 1 of 1 k:\Handouts\Demolition Permit Requirements 01-03-2007 11:20 From-SK NG +25343767 1• 1-891 P 002/002 F-270 r DEPARTEN OF COMMIJl�ITTY•D i► LOPM'FdV.T SERVXCES ` 33325 86°Avenue South -7Z_.-7 r PO Box 97,18 CITY DF . .':,i 1 0 G ' cFcdacal:Way,WA 98063=9718 .,�-�* C,7253-835-21507;PeX x.53-$3S•2609 Federal .-F-� (1 www&ityoffederaly_vov-cora Y DEMOLITIONP�ERM•IT REQUIREMENTS. : • •' • A demolition permit is required to re/nove: .structure or structures on a subject property Check:with the.City's.Planning ••',; Division to see if the proposal eXceeds tlitii tt Olds:that tr ggea`4an eiiviromrteutal review.Ali enviebrittental review and submittal of an environmental checklist z be.required,which will'extend the time period before a demolition permit can be issued. 0 Prios'to submitting a demolition p sthe:fallowiag,ltems'(*s�appiicable)Inst be signed-by the respective agency(see attached Demolition-Pe ^Gout Ct List). :;is Norr TO APPLICANT: Utilities shall be duconnecrt �asd services perj?rnied,rcipplrcable,prior to issuance of the dsriob11ahpe lull:All applicable trams below ors to be ligatats1124,AterLbys the rarj04*:aaeney repreuentatives, • • ,, > 2i ASBESTOS ABATEMENT G.ELECTRICITY .. . (Copy of approval 1orin end asbestos survey from l Sound peon Air :Electrid t shur'eff and m removed) � Agency provided) ._ ..•l get Soul Energy)`.. (City of Federal Way Building IMt • • '.;-• ,2.GAS SUPPLY 7.FUEL STORAGE TANKS '° .,:t (c,s • be strut •ff,mei/ "J oked and final billpeed}'. •" '(Above•or"below grade fuel tanks, have been pumped or removed OP % -4 , , under Fire epartment pe it prior to any nantle/excavation) (Puget Soon- Energy)• ,, , „.. (Federal W re.Dit;tr `''' 3.SE' STEM ': :;;;;:: . B.WATER-Public Source (Check appieabIe box ►vir •c" 's?) �� (Tan to bbe e cern• ,• or tank to d nQ frli�:;,�;.;', in Meter to be rcrnaveQ and final utllity;blll palc4 Arts A / o Meter,: •main and, pro •.. • , 14~ /V ' r#;:'� �:�_ • •r •,•r•` 4;___A �.,... . / r— ,t,- *tun 4 favlron • f se ale ,'' • .. Supplier):; . . *****a.OR ssttw*. •• 4.SANITARY SEWER (Check applicable'bei';,),";,..:: 9.WAT :. vats .. jell C apPiic'� sbox) • ewer line capped;3t property line to Plivatewef'-Elle• - % '• - M• - �, lstiltg sewer line to remain and,be used by prgpd :r♦ew aevch,re n Private 'IA. be 11�j ;, -ePurjw .' r` _ _ sewer t3lstric#) Tic• octroi Pervices — S.GARBAGE (All household •arbage d,,,-, . off and fl • .iv •. Pe•,%3I/Federal ay 01 ...7,,A5,7•1116 • 0 Completed Construction Permit Applin form ' • 0 Provide the following fees: 1.f Deaeplition.Permit Fee 5655.50 • •' • 2.A mAiion Fee 5.006- 3.1 x'. i>1tle Surcharge 4:S0 4•`C Blond Deposit 5(0.00 (Refundable upon Completed'Fluid Inspection) SS')5'0O • Bulletin if122-J 1 2006 '- ' �^ Y . ''r�'.7' ' Page I el 1. kMilladoutb YeinOliii Permit Acquirements Agency Case No. PUGET SOUND CLEIIRR Da a - e -Puget Sound AGENCY Clean Air Agency 110 Union Street, Suite 500 ( !� (1 i��6 '200600966 pscleanair org Seattle, WA 98101-2038 v pout I L)ulvo uLtAN NOTICE OF INTENT f ` Type or print clearly A.Project Type: 1. ❑ Friable Asbestos Removal 2. Friable Asbestos Removal &Demolition 3. ❑ Demolition Only B.Property Owner: <�te 0e/i 0 �(�i(A-/) Phone: 5- 3 SD — , 7z7 Mailing Address: I CityState 2 ( d ( c, 3 2� Mfr "(� K 11 �gdr wA/ wA . Zt ? a C. Asbestos Contractor: Owner/CEO: , ,el. F Mailing Address: Phone: Contractor Job No.: City: I State: I_Zip: Fax: D. Site Address: City: 2 ( 0 . ,}, 3Z �ft�Stt 1�� =e�� u1 � � � 70O3 Contact Person: I Local Phone: E. ❑ Asbestos Survey or I No. of Structures: Date of Asbestos Survey: ❑ Mat'l Presumed i N 0 11- ( _ 0 Was Friable Asbestos Identified? Yes ❑No RA Idir Inspector: Was Nonfriable Asbestos Identified? ❑Yes ❑No O / e Certification#: I ©22 .12 1' CExp.Date: /h/j/1. / i-f 2O0 An AHERA Survey is required before all demolition projects J F. Demolition I StartNo. Information: Date: Z —� �(� ( • LI Training Fire(List Fire Dept.) Structures:of ll / 12.1 ❑ Ordered Demolition (attach copy of Order) Demolition Insert demolition contractor's mailing address on back. Will nonfriable asbestos be left in place during demo? ❑ Yes \No Contractor: eA,G,q,,(- 467 ,_ Celvt' If yes, list type and qty. Note disposal requirements in Step 6 (on back). G. Friable Asbestos Start Date: Completion Date:r-0 Work Days: M T W Th F 6a-,giti. Project Information: I IHours: ,r 00 A Total Qty.to be Removed: Linear Ft. rj_. q Will all&able asbestos O y s 5--L.-- F � Square Ft. materials be removed? ❑ o H. Asbestos/Demolition Project Categories: Amoutv]- ta0 Notification Period Project Demolition 1. Single-Family Residence(owner-occupied): at No. a O` A. Prior Notice Fee Surcharge A. aAsbestos Removal Project Only RCPT. 410 B. 10 Days* A. $25 B. emolition Project(with or without asbestos removal projeb B. $50 *(Asbestos removal can begin upon notification;demolition must wait 10 days Note:If the single family residence is owned by one family who has been or will be using the residence as their domicile, the above boxes IA or IB may be checked. If this is not an owner-occupied residence, one of the categories listed below must be used instead. A single family residence does not include rental property, multi family units, or any mixed-use building. 2. ❑ All Other Demolitions (with no Asbestos removal or Nonfriable Asbestos 10 Days $50 only or less than 10 linear feet and/or 48 square feet of friable Asbestos) Friable Asbestos Projects (other than Single Family Residence): Asbestos Demo 3. ❑ >_ 10-259 linear feet and/or>_48 - 159 square feet of asbestos Prior Notice 10 Days $50 $50 4. LI 260-999 linear feet and/or 160-4,999 square feet of asbestos 10 Days $200 $50 5. ❑ >1,000 linear feet and/or>5,000 square feet of asbestos 10 Days $600 $50 6. ❑ Emergency Asbestos Project or ❑ Emergency Demolition Project Prior Notice J $50 Emergency Fee (Single-Family Residences are exempt from emergency fee;however,property owners must provide a written emergency request) I. I certi at the• formation cont ' ed' ification&supplemental data is,to the best of my knowledge,accurate&complete. Agency Use Only ''tel' " —L C � Signature `( �V Representing Date 66-160 Notice of Intent(Revised 11/06)LSS 1 of 2