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14-103242D:,melit1Uri City & FedEcon. al Dev. y Permit #: 14-103242-00-D E Community &Econ. Dev. Services 33325 8th Ave S Federal Way, WA 98003 Inspection Request Line: (253) 835-3050 Ph: (253) 835-2607 Fax: (253) 835-2609 Project Name: BETHEL CHRISTIAN CENTER OF FEDERAL WAY Project Address: 130 MIRROR LAKE PARK Parcel Number: 072104 9003 Project Description: Demolition of single family residence Owner Applicant Contractor BETHEL CHRISTIAN CENT DENNIS AUSTIN OWNER IS CONTRACTOR 414 SW 312TH PL \ 1205 S 360TH ST FEDERAL WAY WA 98023 FEDERAL WAY WA 98023 Additional Permit Information Demolition Valuation.............................................500.00 PERMIT EXPIRES Friday, July 1, 2016 Permit Issued on Wednesday, July 2, 2014 1 hereby certify that the above information is correct and that the construction on the above described property and the occupancy and the u e -will be in accordance with the laws, rules and regulations of the State of Washington a th%e�City of F deral Way. Owner oragent: L �L Date: CITY OF Federal Way PERMIT #: 14 -103242 -00 -DE THIS CARD IS TO SWAIN ON-SITE Construction Inction Record INSPECTION REQUMS: (253) 835-3050 Address: 130 MIRROR LAKE PARK Project: BETHEL CHRISTIAN CENTER FEDERAL WAY, WA 98023 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 Approved By 1,� Date ❑ Rough Electrical Approved Final Electrical Approved Right of Way Approved By Date By Date By Date DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES 33325 8`h Avenue South W Federal Way, WA 98003-6325 CITY OF 253-835-2607; Fax 253-835-2609 Federal Way 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. 1. A; (Copy 2. GAS SUPPLY (Gas to be shut off, meter 3. SEPTIC SYSTEM (Tank to be removed or to nd filled) (icing County Environmental Services) Clean Air 4. SANITARY SEWER (Ch ck applicable box) ❑ Sewer line capped at pr f o Existing sewer line to a ai by proposed new structure (Lakeh ven Utility District) S. GARBAGE (All household garbage do�se d -final bill paid) (Waste Management/Other Company) ❑ Completed Construction Permit Application form ❑ Provide the following fees: 1. Demolition Permit Fee 2. Automation Fee 3. WA State Surcharge 6. ELECTRICITY (Electricity to be shut off a er removed) (Puget Sound Energy) 7. FUEL STORAGE TA K (Above or below grad fu I ks, hav pumped or removed under Fire Depart p r or to any dismantle/excavation) (South King Fre and Rescue) S. WATER - Public Source (Check applicable box) ❑ Meter to be removed and final utility bill paid ❑ Meter to remain and be protected (Water Supplier) * **** OR****** 9. W>weliflilled el ec icable box) ❑ Privdo Privr other purposes (King County Environmental Services) Based on valuation. See table on pg 4 of the construction permit application. $6.00 $4.50 Bulletin #122 — January 1, 2011 Page I of I kAHandouts\Demolition Permit Requirements 0 DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES 33325 8"' Avenue South Federal Way, WA 98003-6325 253-835-2607; Fax 253-835-2609 wwRy.citvoffedcralway.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 JG ,1 e t 110 Union Street, Suite 500 Seattle, WA 98101-2038 206-343-8800 —OR— 800-552-3565 www.pscleanair.org 2. Electricity: Puget Sound Energy Tacoma Public Utilities Attn: Construction Coordinator Customer Service 22828 68`h Avenue South, Suite #102 —OR— 747 Market Street Kent, WA 98032 Tacoma, WA 98402 888-225-5773 253-383-9600 or 253-383-2471 3. Gas: Puget Sound Energy 805 156h Avenue NE Bellevue, WA 98004 888-225-5773 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 655 Second NW 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 14350 SE Eastgate Way Bellevue, WA 98007 206-296-4932 9. Fire Department: South King Fire & Rescue 333258 th Avenue South Federal Way, WA 98003 253-946-7248 Bulletin #109 — January 1, 2011 Page I of 1 k:\Handouts\Demolition Permit Contact List Approved Transaction Page 1 of 1 pseleanair.org Puget Sound Clean Air Agency Single -Family Notification Case #: 201501976 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 # AT0FD2A3E569 Transaction Date 05/15/15 Owner's Name Bethel Christian Center of Federal Way Phone (253) 839 2486 Project Street Address 154 Mirror Lake Park City Federal Way Zip 98023 Contact Person Sue Austin Phone (253) 839 2486 Mailing Address 414 SW 312th Street Federal Way, WA 98023 This project includes a demolition. Demolition Start Date 06/01/15 Completion Date 07/31/15 Demolition will be completed by the home owner 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 View History If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. Log Out https://secure.pscleanair.org/Asbestos/Approved.aspx 5/15/2015 Xoa 0 w ENVIRONMENTAL SERVICES, INC. Environmental Consulting & Compliance May 8, 2015 Tom VanArsdell Bethel Christian Center of Federal Way 414 SW 312th St Federal Way, WA 98023 RE: Asbestos consulting at the residence located at 154 Mirror Lake Park in Federal Way, WA Dear Mr. VanArsdell, NOW Environmental Services is pleased to present this survey report for suspect asbestos -containing building materials analysis conducted at the residence located at 154 Mirror Lake Park in Federal Way, Washington. We appreciate the opportunity to have been of service to you. If you have any questions regarding this report, please feel free to contact me at (253) 927-5233. Sincerely, N - -A 03�ww�� Todd Rickert AHERA Building Inspector Accreditation No. BIMP/R/NES-052814-01 (Exp. 5-27-15) NOW Environmental Services Enclosure: Asbestos Survey Report 34004 9th Avenue South, Suite 12, Federal Way, Washington 98003 Phone: (253) 927-5233 Fax: (253) 924-0323 www.nowenvironmental.com Jr0 0 oawENVIRONMENTAL SERVICES, INC. Limitedvkg6es os ur elting & Compliance Prepared For: Bethel Christian Center of Federal Way 414 SW 312th St Federal Way, WA 98023 May 8, 2015 Subject Property: Residence 154 Mirror Lake Park Federal Way, WA 98023 Prepared By: Now Environmental Services 34004 9th Avenue South, Suite 12 Federal Way, Washington 98003 Contents Section Introduction 1.0 Executive Summary 2.0 Regulatory Compliance 3.0 Sampling Plan and Laboratory Analysis 4.0 Survey Results 5.0 Conclusions and Recommendations 6.0 Limits of Survey 7.0 Appendices Laboratory Results A Field Notes B Certification(s) C 34004 9th Avenue South, Suite 12, Federal Way, Washington 98003 Phone: (253) 927-5233 Fax: (253) 924-0323 www.nowenvironmental. com Section 1.0 - Introduction On May 5, 2015, AHERA Building Inspectors Todd Rickert of NOW Environmental Services conducted a limited inspection for suspected asbestos -containing building materials at the residence located at 154 Mirror Lake Park in Federal Way, WA. Mr. Rickert is an Environmental Protection Agency (EPA) Accredited Building Inspector Accreditation No. BIMP/R/NES-052814-01 (Exp. 5-27-15). Accessible areas were visited and samples were taken of building materials suspected to contain asbestos (vinyl floor tile, gypsum wallboard, roofing etc.). These samples were analyzed for the presence of asbestos. In addition, the quantities of asbestos -containing materials were estimated.** Please see Table 1 for an inventory of sampled suspect building materials. Sample locations are indicated on the attached site drawings. ** QUANTITIES ARE APPROXIMATE AND ARE NOT TO BE USED FOR BIDDING PURPOSES. PROSPECTIVE BIDDERS MUST SITE VERIFY QUANTITIES AND SITE CONDITIONS. RESIDENCE - LOCATED AT 154 MIRROR LAKE PARK IN FEDERAL WAY, WA PROJECT # N15-0202 L_J Section 2.0 - Executive Summary Building Description 0 The structure is a one story residence 1,000 square feet. The structure was built in approximately the 1920's and is a wood structure on a concrete foundation. Interior wall systems are wood and gypsum wallboard over wood framing. Other interior finishes include hardwood floors. The exterior finishes include wood siding and a 3 -tab and rolled composition roofing system. Asbestos No asbestos containing building materials were found in any samples taken. Please see Table 2 for an inventory of sampled suspect building materials found at the residence located at 154 Mirror Lake Park in Federal Way, WA during this survey. Table I Summary of Asbestos Containing Building Materials sampled at the residence located at 154 Mirror Lake Park in Federal Way, WA Material Description Sample Number' MaterialSample Location Analytics : 1 No Regulated Asbestos Building Materials Identified RESIDENCE - LOCATED AT 154 MIRROR LAKE PARK IN FEDERAL WAY, WA PROJECT # N15-0202 0 • Section 3.0 - Regulatory Compliance Asbestos The intent of the asbestos survey is to comply with governing asbestos regulations required by the State of Washington and Puget Sound Clean Air Agency (PSCAA). Currently, the State of Washington requires a written "good faith inspection" for identification of asbestos -containing materials prior to any remodeling or demolition work. During demolition and construction work it is the responsibility of the owner and the contractors to make this survey document available to all concerned parties who may be handling the building materials. In addition, PSCAA requires that a copy of the written asbestos survey be made available on-site for inspection by a PSCAA Control Officer during construction and demolition work. The survey is required to be performed in accordance with 40 CFR 763.86. These federal standards require inspections to be conducted by an EPA Accredited Building Inspector with analysis to be provided by an asbestos laboratory certified by the National Bureau of Standards. The requirements are described in Article 1 and Article 4, of PSCAA's Asbestos Control Standards. All survey work was conducted in compliance with the above mentioned standards. Asbestos -containing materials are required to be removed and disposed of in accordance with Washington State Regulation 296-155 WAC, Part S prior to any demolition, renovation, or remodeling that would disturb these materials. Washington State Department of Labor and Industries and PSCAA require that the abatement be performed using Certified Asbestos Workers under the direct on-site supervision of a Certified Asbestos Supervisor in accordance with 296-65 WAC. Also see 296-62 WAC, Part 1-1—General requirements for handling asbestos. RESIDENCE - LOCATED AT 154 MIRROR LAKE PARK IN FEDERAL WAY, WA PROJECT # N15-0202 0 0 Section 4.0 - Sampling Plan and Laboratory Analysis Asbestos Obiectives The objective of the survey was to determine the quantity and location of building materials (vinyl floor tile, roofing, gypsum wallboard, etc.) that contain asbestos within areas to be impacted by planned renovation work. Asbestos Sampling Plan Protocol This survey was conducted using a protocol adapted from the Asbestos Hazard Emergency Response Act (AHERA). The protocol is as follows: 1. Group materials into homogeneous sampling areas. 2. Quantify each homogeneous sampling area and collect samples from each area using the "3-5-7" criteria for surfacing material to determine the number of samples needed. Quantify and collect a minimum of three samples of each thermal system insulation (the number of samples collected of miscellaneous materials was determined by the inspector). 3. Samples of each material were taken to the substrate, ensuring that all components of the material were included. 4. Sampling was performed by a Certified Building Inspector, and the use of proper protective equipment and procedures was followed. Asbestos Sampling Procedure 1. Spread the plastic drop cloth (if needed) and set up other equipment, e.g., ladder. 2. Put on protective equipment (respirator and protective clothing if needed). 3. Label sample container with its identification number and record number. Record sample location, and type of material sampled on a sampling data form. 4. Moisten area where sample is to be extracted (spray the immediate area with water). 5. Extract sample using a clean knife, drill capsule, or cork boring tool to cut out or scrape off approximately one tablespoon of the material. Penetrate all layers of material. 6. Place sample in a container and tightly seal it. 7. Wipe the exterior of the container with a wet wipe to remove any material that may have adhered to it during sampling. 8. Clean tools with wet wipes and wet mop or vacuum area with HEPA vacuum to clean all debris. 9. Seal the sampling location with caulking compound, spackle or duct tape. 10. Discard protective clothing, wet wipes and rags, cartridge filters, and drop cloth in a labeled plastic waste bag. Asbestos Laboratory Analysis The bulk samples were analyzed in our laboratory using polarized light microscopy (PLM) with dispersion staining in accordance with US EPA method 600/R-93/116 as specified in 40 CFR Chapter 1(7-1-93 edition) Part 763, Subpart F, Appendix A, pages 499-504. Polarizing light microscopy quantifies asbestos concentrations at between 100% and 1 % detection levels. Levels below 1 % can only be stated as "trace." For samples containing more than one separable layer of materials, the report will include findings for each layer (labeled L-1 for layer one and L-2 for layer two, etc.) and a total percentage for the entire sample. The asbestos concentration in the sample is determined by visual estimation. For those samples with asbestos concentrations between 1 and 10 percent based on visual estimation, the EPA recommends a procedure known as point counting (NESHAPS, 40 CFR Part 61). Point counting is a statistically more accurate means of quantification for samples with low concentrations of asbestos. RESIDENCE - LOCATED AT 154 MIRROR LAKE PARK IN FEDERAL WAY, WA PROJECT # N15-0202 i Section 5.0 - Survey Results Asbestos Table II L� Summary of suspect Asbestos Containing Building Materials sampled at the residence located at 154 Mirror Lake Park in Federal Way, WA RESIDENCE - LOCATED AT 154 MIRROR LAKE PARK IN FEDERAL WAY, WA PROJECT # N15-0202 'A Window Putty N15-0202-001 Exterior Non -Detect Attic Insulation N15-0202-002 Attic Non -Detect Dark Exterior Vapor Barrier (Siding) N15-0202-003 Exterior Non -Detect White 3 -Tab Composition Roofing N15-0202-004 Roof Non -Detect White Rolled Composition Roofing N15-0202-005 Roof Non -Detect Gypsum Wallboard N15-0202-006 Bathroom Non -Detect Hardwood Squeak Sheet N15-0202-007 Living Room Non -Detect RESIDENCE - LOCATED AT 154 MIRROR LAKE PARK IN FEDERAL WAY, WA PROJECT # N15-0202 11 11 Section 6.0 - Conclusions and Recommendations NOW Environmental Services is not responsible for materials which require destructive means to access, or materials which are hidden from sight, those materials hidden behind walls, or materials which cannot be found with reasonable diligence. Extreme caution should be used during renovation or demolition to ensure that additional unidentified materials are not disturbed. In the event that additional materials are discovered, the material should be sampled by an EPA Accredited AHERA Building Inspector and analyzed to determine if it contains asbestos prior to disturbance. Asbestos According to Washington Administrative Code (WAC) 296-62-07721, prior to the start of work, a building owner must identify the presence, location, and quantity of ACM and/or presumed ACM (PACM) prior to renovation and demolition. This information must be communicated to contractors bidding on work, contractors performing other work, employees and tenants in or adjacent to the work area. The Puget Sound Clean Air Agency Regulation III, Article 4 requires that an asbestos survey be conducted prior to any renovation or demolition of existing buildings. This survey was intended to meet these regulatory requirements. Asbestos -containing materials are required to be removed and disposed of in accordance with Washington State Regulations prior to any demolition, renovation, or remodeling that would disturb these materials. Washington State Department of Labor and Industries and PSCAA require that the abatement be performed using Certified Asbestos Workers under the direct on-site supervision of a Certified Asbestos Supervisor. The only exemption is for resident owners performing removal of asbestos -containing materials other than furnace interiors and direct applied mudded asbestos insulation. ACM is identified as those building materials containing greater than one percent (>1.0%) of asbestos as verified by laboratory analysis. All building materials fabricated prior to 1980 are assumed to contain asbestos unless proven otherwise by a licensed building inspector. Materials that contain 1.0% or less asbestos are not regulated for disposal purposes. However, removal of materials containing 1.0% or less asbestos is considered an unclassified asbestos operation by OSHA and WISHA. Unclassified asbestos operations cover employees likely to be exposed in excess of the permissible exposure limit (PEL), and who are performing operations not covered by Class I through IV. For construction work involving unclassified asbestos the applicable requirements will include: an exposure assessment, use of vacuum cleaners equipped with HEPA filters, use of wet methods and prompt cleanup of debris, use of respirators and protective clothing, training, and record keeping. Asbestos -containing joint compound associated with non -asbestos gypsum wallboard (GWB) assemblies is sometimes found in specific locations of a building. The presence of asbestos in this material requires personnel impacting the material to adhere to regulatory requirement outlined in WAC 296-62-17712(2) and training as outlined in WAC 296-62-07722(5) and WAC 296-62-07728. Personal protect equipment and proper work practices are required pending completion of a negative exposure assessment. Such an assessment may include air monitoring of workers' breathing zones. Refer to WISHA Regional Directive 23.30 for additional information. The possibility exists that additional ACMs may be present in wall and ceiling cavities. Any previously unidentified material encountered during construction activities should be sampled prior to impact. Work that may be impact asbestos should be performed by personnel having proper training and utilizing proper worker protection according WISHA standards. NOW Environmental Services recommends that a Certified Asbestos Project Designer design any asbestos abatement project to ensure that the job is completed according to regulatory standards. RESIDENCE - LOCATED AT 154 MIRROR LAKE PARK IN FEDERAL WAY, WA PROJECT # N15-0202 0 0 Section 7.0 - Limits of Survey Asbestos surveys are non -comprehensive by nature and subject to many limitations including those presented below. Our assessment has considered risks pertaining to asbestos; however, this survey is limited to only those locations sampled. This survey was not designed to identify all potential concerns or eliminate all risk associated with asbestos. Materials sampled were limited by the scope of work as defined by the drawings provided. Lead based paint & TCLP testing, mercury light tubes and/or other hazardous materials were not included in the scope of work during the course of this survey. Other risks that were not evaluated with this survey; Risks such as 1) toxic and hazardous substances in (or in contact with or associated with) soil or ground water; 2) risks associated with structural, electrical, or mechanical working of the building; 3) risks associated with radon gas, slope stability, building settlement, moisture, or site drainage and flooding have not been evaluated during this survey. No warranty, expressed or implied, is made. The site visit consisted of a thorough visual walk-through of building for the purpose of viewing and sampling potential asbestos -containing material. A TCLP sample was not collected of the building to determine levels of leachable lead in building debris. Suspect PCB containing light ballasts were not estimated. Fluorescent bulbs were not quantified for recycling purposes. Mercury vapor lamps were not identified during the survey. NOW Environmental Services performed this survey in accordance with the generally accepted standards of care that exist in the industrial hygiene profession in Washington State at the time of this study. The asbestos survey was performed in preparation for removal of asbestos -containing materials in accordance with NESHAPS regulations. This survey is not intended for use as plans and specifications. These estimates are for approximating actual bid prices from contractors only, and may not reflect the actual final costs of asbestos and/or lead abatement. They do not include sales tax, or Owner costs such as abatement project oversight and monitoring for compliance to law and/or compliance to project plans and specifications. These estimates assume that adequate, professional plans and specifications are prepared and the abatement costs are minimized by professional project management, and that all asbestos containing materials are abated during one project by the same asbestos contractor. Written By: Todd Rickert Project Manager AHERA Building Inspector/Management Planner Accreditation No. BIMP/R/NES-052814-01 (Exp. 5-27-15) Reviewed By: 3 �+ Donna McNeal Laboratory Director, CEO RESIDENCE - LOCATED AT 154 MIRROR LAKE PARK IN FEDERAL WAY, WA PROJECT # N15-0202 s APPENDIX A Laboratory Results is ! 0 ORION Environmental Services 34004 Ninth Avenue South, Suite Al2, Federal Way, WA 98003 Phone: (253) 952-6717 • Fax: (253) 927-4714 Email: info@oriones.net • Web: www.oriones.net WBE W21`9219763 Polarized Light Microscopy Test Report EPA Method 600/R-98/116 Client: Bethel Christian Center of Federal Way Tom VanArsdell Address: 414 SW 312th St, Federal Way, WA 98023 Attention: Tom VanArsdell Project Name: Residence 154 Mirror Lake Park, Fed Way ASBIN Project Number: N15-0202 Rpt. Date: 5/5/2015 Page: 1 of 1 Invoice: 152344 Date Rcvd: 5/5/2015 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) Dennis Rauschenberg Date 5/8/2015 Reviewed By (Print) Donna McNeal Date 5/8/2015 I zed B (Signature) Time Re ew By (Signature) Time Client Orion Material Sample Asbestos ' Asbestos Other Sample ID Sample ID Treatment Containing material Type Fibers 001 20150505-87 Window Putty crush ND cellulose 002 20150505-88 Attic Insulation ND fiberglass 003 20150505-89 Exterior Vapor Barrier (Siding) chloroform ND cellulose 004 20150505-90 3 -Tab Composition Roofing, ash ND fiberglass, White cellulose 005 20150505-91 Rolled Composition Roofing, ash ND fiberglass, White cellulose 006 20150505-92 Gypsum Wallboard ND cellulose 007 20150505-93 Hardwood Squeak Sheet chloroform 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. 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W ry W ry �U iAa E C ire � O : 0 O r— O C L U -� d N L W •� W E � O � U �O O � C4 CEJ u Q ® Z"3 O C u L O } U U uj mrw • et LU z 9L cc C 0 u U EA c� c� N LO r" N c'7 Ln N co O O cc Cl C O C a r� N Q O O C O Q �r 0 0 �r Cl) U C O C N E 0 c LU O Z 'Al CITY 0'� 0 PERMI*APPLICATION Federal Way REGEIM PERMIT NUMBER _ 1 O Z4 2_ DE J U L 0 2 2014 — TARGET DATE SITE ADDRESS ��Vep_AL WAY SUITE/UN .30 rel P_R_®fZ_ ice -«G N 2k, I PROJECT VALUATION ZONING ASSESSOR'S TAR/PARCEL # X003 TYPE OF PERMIT BUILDING ❑ PLUMBING ElECHANICAA`L MECHANICALDEMOLITION 11ENGINEERINGC3 FIRE PREVENTION NAME OF PROJECT �❑ C" O � F (gid/"1/j6A PROJECT DESCRIPTION kciu putE` L r -p— 7 /I'1 0 Detailed description of work to be included on this permit only PROPERTY OWNER NAME //' r�l Cl1 � F -1a AR1 PRIMARY PHONE %� 5 ?� 7 —2—ll8 MAILG DREi -� fit✓ r �J l Z� �en;�r� Ne`sf-f l STATE ZIP .� NAME PHONE MAILING ADDRESS �� E-MAIL CONTRACTOR CITY STATE ZIPCT FAX WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE # NAME PRIMARY PHONE APPLICANT MAILING ADDRESS �t, S ) LU E-MAIL CITY Fe- , << l GI STATE ZI'R FAX NAME PRIMARY PHONE PROJECT CONTACT (The individual to receive and MAILING ADDR EL respond to all correspondence CITY STATE ZIP FAX concerning this application) PROJECT FINANCING NAME OWNER -FINANCED Required value of $5,000 or more (RCW 19.27095) MAILING ADDRESS, CITY, STATE, ZIP PHONE 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 t city as a part of this application. SIGNATURE: �� rat'JI '712- 2- / Lt DATE PRINT NAME: !rl l ` ► `✓1 Bulletin # 100 -January 1, 2013 Page I of 3 k:\l-Iandouts\Permit Application r DEPARTMEOF COMMUNITY DEVELOPMENT SERVICES 33325 81h Avenue South CITY OF Federal Way, WA 98003-6325 253-835-2607; Fax 253-835-2609 Federal www.ciNoffederalway.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 Wined and dated by the respective agency representatives. 1.ASBESTOC/ABATEMENT (Copy of appr orm and as urvey from Puget Sound Clean Air Ag provi r ity of Federal Way uil in fficial) 6. ELECTRICITY (Electricity tshut off a/pd ter Crpbved)' (Puget Sound Energy) 2. GAS SUPPLY 7. FUEL STORAGE T (Gas to be shut off, me r mo d final bill paid) (Above or below r �rmitprior ve been pumped or removed under Fire Depar any dismantle/excavation) (Puget Sound Energy) (South King Fire and Rescue) 3. SEPTIC SYSTEM (Tank to be removed or tank tobe dra ed and filled) A ��1 (King County Environmental Services) 4. SANITARY R (Check icable box) ❑ Sewer line cap pe ne ❑ Existing sewer 1 r ain and be used by proposed new structure i (Lakehaven Utility District) S. GARBAGE (All household garba6 off and final bill paid) ./(Waste Management/Other Company) ❑ Completed Construction Permit Application form 8. WATER - Public Source (Check applicable box) ❑ Meter to be removed and final utility bill aid ❑ Meilerto remain and be rote e w��r �� n.� T � .gas (Water Supplier) ****** OR ****** 9. WATER - Private Well (Check applicable box) ❑ Private well filled and capped ❑ Private well to be used f other pur (i ounty Environmental Services) ❑ Provide the following fees: 1. Demolition Permit Fee Based on valuation. See table on pg 4 of the construction permit application. 2. Automation Fee $6.00 3. WA State Surcharge $4.50 Bulletin #122 — January 1, 2011 Page l of 1 k:\Handouts\Demolition Permit Requirements Approved Transaction Page 1 of I pscleanair.org Puget Sound c'�,, n hzr Agency Single -Family Notification Case #: 201402589 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 # VUYFBFDEE286 Transaction Date 07/02/14 Owner's Name Bethel Christian Center of Federal Way Phone (253) 839 2486 Project Street Address 130 Mirror Lake Park City Federal Way Zip 98023 Contact Person Sue Austin Phone (253) 839 2486 Mailing Address 414 SW 312th Street Federal Way, WA 98023 This project includes a demolition. Demolition Start Date 07/14/14 Completion Date 08/31/14 Demolition will be completed by the home owner 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 View History If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. Loa Out https://secure.pscleanair.org/Asbestos/Approved.aspx 7/2/2014 iFc 0V. AEM'ALSERYiri^, ANG, U[.1YNG & COR�IIANCF - 34004 9�h Avenue South Al2, Federal Way, Washington 98003 Telephone (253) 927-5233 Fax (253) 924-0323 WBE W2F5912535 Report Date: November 13, 2013 Executive Summary Bethel Christian Center of Federal Way Attn: Tom Van Arsdell 414 SW 312`" Street Federal Way, WA 98023 RE: Asbestos Survey Report — 130 Mirror Lake Park, Federal Way, WA Dear Mr. VanArsdell On October 29, 2013 under an agreement with your organization, we performed an asbestos survey on the house at 130 Mirror Lake Park, Federal Way, Washington. At your request, the purpose of this survey was to ascertain the existence of asbestos containing materials associated with any structure being demolished, as well as providing characterization and quantities. This survey was performed in conformance with procedures and methods outlined in applicable federal, state, and local regulations. This survey was performed by accredited AHERA Building Inspector Allen Clark (BIR -NES -01- 1413-03; Expiration Date: January 13, 2014). Investigating Protocol and Findings All samples were homogenized, collected, processed, and analyzed for content by Polarized Light Microscopy. AHERA protocol provides guidance for the number of samples of each material to be collected depending on its category and amount of material present. The goal of AHERA is to ensure statistically reliable data and it accomplishes this by requiring or suggesting a minimum number of samples to be collected, and in some cases, by using random sampling techniques to determine sampling locations. Building materials that contain asbestos fibers in the amounts greater than 1 percent (1%) is regulated by the Occupational Safety and Health Administration (OSHA) and Puget Sound Clean Air Agency. Material(s) meeting this criterion are noted in the table below: Material Inventory (Positive) Vinyl Tile2a and Associated Dark Mastic 2b Sample Numbers • 20131029-42a & b Material Description: Vinyl Tile with Associated Black Mastic; Non -Friable Material Location: Material located in the bedroom area of the house Range Asbestos Content: 3 % Chrysotile Fibers found in Associated Dark Mastic; Vinyl Tile Layer — Non -Detect for Asbestos Estimated Quantity: Approximately 150 square feet. Recommendation: Remove prior to demolition. Positive ACM Table Contractors should perform a site visit to validate the location, amount and difficulty of removal for any given material. Suspect materials processed and found non -detect or containing < 1% for containing asbestos are listed in the table below: Material Inventory (Negative) 90m Vinyl Sheeting with Grey Felt Backing Vinyl Sheeting in Kitchen area Wall System 1 (WS1) Wallboard fragments; Associated Joint Compound in house Wire insulation Black insulated wiring throughout house _Roofing Material RM Three -Tab Roofing; Associated Vapor Barrier on house Negative for ACM Table Please note that should additional materials (not referenced in this report) be discovered as a result of remodeling or demolition, they are to be presumed asbestos containing unless subsequent sampling by an accredited inspector proves otherwise. Inaccessible Locations NOW Environmental Services cannot make statements as to the potential presence or absence of asbestos containing materials in inaccessible areas or areas not considered. Now Environmental Report N13-0450 November 13, 2013 130 Mirror Lake Park, Federal Way, WA Page 2 of 3 0 • Disclaimer NOW Environmental Services has conducted a survey for asbestos containing materials on the house at 130 Mirror Lake Park, Federal Way, Washington in conformance with the requirements established by the United States Environmental Protection Agency and the Occupational Safety and Health Administration prior to the engagement of renovation or demolition of the building. The sampling strategy and analytical method employed conform to existing and enforceable standards and methods. This Executive Summary of the investigation performed at the subject site is intended to describe asbestos containing materials with the potential of being impacted. We represent that our services were performed within the limits prescribed by applicable regulations and in a manner consistent with the level of care and skill ordinarily exercised by other professional consultants under similar circumstances. No other representation is made to the client, expressed or implied, and no warranty or guarantee is included or intended. The opinions presented herein apply to the site conditions existing at the time of our investigation, and interpretation of current regulations pertaining to asbestos containing material. Therefore, our opinions and recommendations may not apply to future conditions that may exist at the site we have not had the opportunity to evaluate. Future regulations pertaining to these materials may impose stricter restrictions on renovation or demolition work. The regulations should always be verged prior to any work involving these materials. The inspector is not held responsible or liable for any repairs or replacements with regards to this property, systems, components, or the contents therein. The acceptance of this report by the client acknowledges the client's agreement to all of the terms and conditions of the inspection contract. NOW retains active copies of reports for a period of not less than one year. Retained copies of reports, field data, field notes, laboratory test data, calculations, estimates, and other documents prepared by NOW as instruments of service, shall remain the property of NOW. Other than the Client, other agencies of the U.S. Federal Government, and the Owner, reports submitted with respect to services performed under this contract may not be extended to third parties without prior written consent. Questions concerning this Executive Summary may be addressed the undersigned. Thank you for the opportunity to serve you. I hope we can be of assistance to you on future projects. If there is anything additional I can do to expedite your operation, please do not hesitate to let me know. NOW Environmental Services, Inc. Building Inspector Allen Clark AHERA Building Inspector NOW Environmental Services Now Environmental Report N13-0490 130 Mirror lake Park, Federal Way, WA Revieyver Donna McNeal AHERA Building Inspector, CEO NOW Environmental Services November 13, 2013 Page 3 of 3 ORION Environmental Services 34004 Ninth Avenue South, Suite Al2, Federal Way, WA 98003 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: Bethel Christian Center of Federal Way Tom VanArsdell Address: 414 SW 312th St, Federal Way, WA 98023 Attention: Tom VanArsdell Project Name: House 130 Asbin Project Number: N13-0473 Rpt. Date: 10/30/2013 Page: 1 of 1 Invoice: 135373 Date Rcvd: 10/29/2013 Client Sample ID 1 2a 2b rrin Slitpfe ID " _,... 20131029-41 20131029-42 Material Description Vinyl Sheeting w/ Grey Felt Backing Vinyl Tile Dark Mastic Sample treatment _ Asbestos Containing Material I NO NO l 3 ND NO NO L NO NO I ND Asbestos Type _. Chrysotile ocher Fibet , I cellulose cellulose cellulose cellulose cellulose cellulose cellulose fiberl ass _ cellulose 3 20131029-43 Wall Board I 4 T20131029-44 5 6 — 7a 7b I 20131029-45 20131029-46 20131029-47 Wall Board Wall'Board 1 ILL I Wire Insulation Composition Roofing Slip Sheet 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 600/11-98/116.0Isclaimers: 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. 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I fJ1 I J rSCyI.J_1{fL - -- ---- -- --- ------- - r , I I � `' i i t -- -------------- ----------- Z---A 1 . f . • . •� r , I 1 1 I t � 1 1 ✓✓✓ 1 I 1 r I , 1 I .r r r r----'t---- r----r----r--------Y'---r----�-----r-__-r----i--_-'j, '7f''r - -r'-�r-/�^r- i----v---.i-..-_ - i.--_.�....T �-- ,•_•r_-_-i-_-_-i--...}___-i_--_i----- '-'i--- rf rl ' ' 1 1 1 ! I I f r 1 t t I . , 1 I I I I 1 1..........L....1----------L.... 1 1 t 1 L....JL----J-----1- - - ___ �\ --b--..1----1-----� _-______-...J........._,....J.....,.........-------1L ----1---_�___-.' ....;----I---- __-_�--•-j--_ I . . \\1 r 1 / 1 1 1/ r 1 1 r 1 ' ' 1 . 1 1 I 1 . • 1 ' /LFJIy I . 1 I r . . . I I I r . , . 1 � L----- J--_-J-----Y__--L----•1-•-- •_ Y----J----r.-L-...J.....L....Y....J.....1.-...L-...i.........._.Y_._.J....J.._._I..._.Y..--..........._Y...rJ..-. r.....Y....r... r I r 1 1 1 r 1 1 I f I I T� t i 1 1 1 1 1 t --__._.-_..................--..-----r_..-r. �r...r..-._----------•----•---------------'--------.--------- NOW ENIIiRONMENTAL SERVICES, INC. Job #: i3 � p Da�Ye: 0 bL j 34004 - 90' Ave. S., Ste # 12 die �rou Federal Way, WA 98003 Si#e Address: City: a IgAdf mll state: I ZIP: l;:,%m;,"sem„r-cn�` a'o'•� � ;� I I I I NOW Environmental Services � 34004 9'4 Ave S Suite A-12 Of Federal Way, Washington 98003 certifies to all that On January 14, 2013 has fulfilled the requirements of AHERA Building Inspector ector Refresher Has attended and satisfactorily completed all requirements to maintain accreditation as an AHERA BUILDING INSPECTOR in accordance with the Toxic Substance Control Act Title (Section 206) and 40 CFR 763 ACCREDITATION NO. BIR -NES -01-1413-03 Expiration January 13, 2014 L. Donna McNeal - CEO Provider ID # 944 l;:,%m;,"sem„r-cn�` a'o'•� � ;� .. - --' o. , Hoe;no 943 l�odaa noA, as - ttep u9nas u! 09$ a an!aoaJ o 11e II!q 3Sd JnoA uo 11pafo } a!q!g!la aq Rew no j96uo!e4o�no a }.Paco OZL fo} }no s! ao!nlas 0!a}091,1 inoR }! :uo!; uOl . 4 n!}noasuoo '10'"00 Jno PuOA9 aornJas otJ}9913 6uunp (!dde suoildsox q sluana }U0041U6!s Jo sw�o}s Jofew 6u!;s!xa;oauuooaf ao me 10 se6 !e1n}au }oadsu! ao ao!nJas 9nn 4! l!Iq 3Sci Jno�( uo Ile;sU! o};U9w;u!odde;Gs a d9a }IPa10 09$ a 8n!a0,1J !!t y no � lou op --- - - - 1. is;uatu;ulodd - - ---- - ---...------------------- -S-W0J3n� �ueaeng aa!tn�a Baur, -------------_888-1 IIeD 'se6en6uel,ay;o Jo a _..- oHh01Az)0VJAdu811.9-9- _......., �HO(�aval OU a114H08E 'plM aH pa V� hen u 8 a819daCIaU O WvW `W"WJdaHeodl)tavE NVN WOEeJ W!9H----- 4dU O l40HHQ8I58J `NNd98B ----------...-----...-- ----- ------ 90 91Nm _ goon to PO4n/pb/Paloaaao0 - W100 . Pa}eJad JO pa}e"IS3 - WIS3 . SaP03 ivawa e --- .. - � 3S 1118 Aep!a3-(epu0!n! •w•d :sfnoy ssau!sng 7"t -a99 -008-L s�osln �(ep'-4_Aepuoy� .w.d _ Pd �(Btau3 3Sd . 6LLL-LZE-S88-L sa0rn�a 9 .w•e L :slnoy ss9ulsn8 1919-LE8- S not;ona;suo0.tatuo 86" -Z96 -008 -ll. ao!'u9S Aelaa suo!;eo!untuwooan0 3Sd • Z96 -008-L slapJos!P 4oaads76ul1eay do pJey 1101 Sal • ELLS-SZZ-988-L a,,AJ 4 aawo4 J 3 A.1,1 • --- - - -------------- -. .--------- .. _. _ f/ t7 - ................sn y�eaa a - �� i � ! suo!;e001;uawh - ---- - - sl(gM - tuo 3 _899_ ------------------ _......- - 6 , d Sd ,1as `uof e s edea; £L P!P0!ou;oa!a o seB a EUS-gZZ-888-L auie } },ted zuoy� 9 ZZl I� Jo sll!q;no Uan9 sd a ue;e uo --- ..._. ---------------- P ollg3 laP e!oua6Jawa a II `e!P le seaoy tiZ -- - - 19.Igos 1ew�o - --------..__._------ HL0108 6u��ssaooad 6 906 60086 y lay ugld;uawFe M `anna a d } 9 '0- • a6e;no Jannod a 10 ELLS-SZZ-888-L ........... _ -} ------.- uaw (e 11 9 6 d ` 3 O IIS iSe d fsa!!dde aa; uo! oesuea d 'A6�au Od toua6Jawa ou;oa!a Jo se6 !eJn}e a sJno4 bZ 1) Quo 3 PunoS da6n d�oda�_o1 dun000e d �q Jo au!Iu0 }uasu�(e W R13 • - )fueq ono c d e;e!pauitul Page 1 of 1 STATEMENT SUMMARY AS OF Nov 12, 2013 Account No. 200022000430 Account Balance Balance as of last billing $8.51 Thank you for your payment(s) $8.51 CR Balance Forward $0.00 Current Charges $8.51 CURRENT TOTAL AS OF Nov 12, 2013 $8.51 Statement Due Date Dec 2, 2013 AMOUNT DUE THIS STATEMENT $8.51 Electric Detail: 130 MIRROR LAKE PARK, FEDERAL WAY Rate/Meter Pres Prev Pres Prev Mult KWH Bill KVAR Code Amount Dates Number Read Read Date Date (Usage) Demand Hours lE B035166024 6333 6333 10/22 10/16 10 10/17/13 10/22/13 Basic Charge 10/17/13 10/22/13 Electric Energy Charge 10/17/13 10/22/13 Energy Exchange Credit 10/17113 10/22/13 Electric Cons. Program Charge 10/17/13 10/22/13 Power Cost Adjustment 10/17/13 10/22/13 Merger Credit 10/17/13 10/22/13 Federal Wind Power Credit 10/17/13 10/22/13 Regulatory Asset Tracker 10/17/13 10/22/13 Renewable Energy Credit 10/17/13 10/22/13 Effect of Federal Way, City Tax Current Electric Charges 0 kWh @ $0 091414 Per kWh 0 kWh @ $0.009279CR Per kWh 0 kWh @ $0 004632 Per kWh 0 kWh @ $0.000000 Per kWh 0 kWh @ $0.000335CR Per kWh 0 kWh @ $0.003323CR Per kWh 0 kWh @ $0 000000 Per kWh 0 kWh @ $0 000348CR Per kWh $7.87 @ $0.080800 Per Dollar F -STM $787 $0.00 $000 $0.00 $000 $0.00 $0.00 $0.00 $0.00 $064 $8.51 ="� This is the final charge for your current electric service at this address. A late fee of 1% will apply to overdue charges, if any. Please see the reverse side for details on late payment charges. A 3.873% state utility tax is included in electric rates charged, approximately $0.33. A 2.2 v 2 G 18 1.6 K 1.4 W 1.2 H 1 P 0.8 E 0.6 R 0.4 02 D 0 OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP OCT 2012 Months 2013 ENERGY USAGE COMPARISON For Bill Period This Year SEP -OCT No.ofdays 35 KWH 0.0 Avg KWH per day 0.0 Avg. temp. per day 43F P k/14-1 For information, emergencies, to report an outage or for changes to your account, please call 1-888-225-5773. When Davina in person, please present both Portions. When mailing remittance, please mail to Puget Sound Energy, BOT -01H, P.O. Box 91269, Bellevue, WA 98009-9269 ELI 10AP 4 I rTrrT-.M I a rlrfT%T. 45 WIF, *'.4Z 46i.e SOW' Is, r. tv• a l� t ph • ,if . I 0 • Public Health Seattle & King County Return completed form to Public Health — Seattle & King County, Environmental Health Division, 14350 SE Eastgate Way, Bellevue, WA, 98007, Tel. 206 296-4932. Faxed copies will not be accepted due to data entry purposes. DATE: r%�%/ � �7 PARCEL (APN): !)Mc)3 Instructions for completing form: This form is to be completed by any persons permanently removing a septic tank, seepage pit, cesspool, or other on-site sewage system wastewater tanks from service. Complete and submit this report to the health officer within thirty (30) days of the abandonment. Authority: Chapter 13.04.054, the Code of King County Board of Health, Title 13. General Information (Please print): f Name of Owner/Occupant of Property: C ¢-i e / Crlr,4 4feA rer F Aek_=. t, Address: / 3 0 1771�it�� F 3 Wastewater Tank Data: Type of Sewage Tank: _X Septic Tank _ Pump Tank _ Holding Tank Other: Number of Compartments Pumped: % Number of Gallons Pumped: Ijv �' Checklist Item Yes No Not Applicable Comments Se to e removed by an approved um er?* Tank lid removed or destroyed? Tank void filled with compacted soil or ravel? f *OSS Pumper Name: Cci- l/ S1 � M_ /< SC—¢v 1 C_ ,I' King County Certification Number: H // 2 - Reason for wastewater tank abandonment: Property being served by public sewers _ Property being served by replacement tank Structure being demolished Comments: Report of Wastewater Tank Abandonment Revised 11/9/2012 G&N Septic Tank Service ESTABLISHED IN 1950 505 F ST. S.E. Auburn, Washington 98002 (253) 838-1028 (253) 927-2860 (425) 255-9111 Fax: (253) 838-7971 www.gnseptic.com Name: Addre: w 30743 Date: t f 1 City: A-�- -fin � ,��a «Ai Zip: at Phone: Mailing Address: Description of Services: Amount -: Ub i' SubTotal: 070 Type of tank: Septic ❑ Pump ❑ Holding Tank Size: 75(=�, Tank Material: System Type:cyll'i •. Tank Depth (in): ❑ Other ` Tax %--t a: Total: �% % Z, } Scum/Sludge Gallons pumped: —6c.> Risers to grade: �, / 1st comp. (in.): Inlet baffle condition: t Effluent screen cleaned: 2nd comp. (in.): t} / Outlet baffle condition: Other: Pump tank (in.): Water level " at above below the invert of outlet pipe. Tech onsite:�yr,. Repairs needed: ❑ Property Owner Notified Additional info (quotes, access, tank location, recommendations, directions): Technician Signature: Customer Signature: If this account is not paid as agreed, I agree to pay in addition to the foregoing, a reasonable attorney's fee, and if this account is placed in the hands of a collection agency, I agree to pay any and all collection charges and fees not to exceed 50% fifty percent of the amount unpaid. $25 returned check fee. Licensed in King & Pierce County -- Bonded & Insured-GNSEPNS940BD Thank you for your business! Page 1 of 1 Bethel Christian Center From: Baker, Jarone [Jarone.Baker@kingcounty.gov] Sent: Tuesday, November 19, 2013 6:46 AM To: 'Bethel Christian Center' Subject: RE: Septic Tank removal Required by Demolition Permit I does not require a permit but must submit a completed wastewater tank abandonment form, and a final pump receipt for the abandoned tank to the King County Health Department here at Eastgate. The tank must be backfilled with pea gravel then covered over with fill dirt. Here is a link the wastewater tank abandonment form. http://www.kingcounty.gov/healthservices/health/ehs/wastewater/pros/—/media/health/publichealth/documents/wastewater/tan[ Regards, Jarone Jarone Baker, RS Heolth and Environmental Investigator 11 Community Environmental Health 14350 Southeast Eastgate Way Bellevue, WA 98007-6458 PH: 206-296-9738 FX: 206-296-9792 jarone.baker@kingcounty.gov Waste Water Program From: Bethel Christian Center[mailto:bethelcenter@comcast.net] Sent: Monday, November 18, 2013 9:48 PM To: Baker, Jarone Subject: Septic Tank removal Required by Demolition Permit Jarone, We are in the process of meeting the requirements to demolish the structure at 130 Mirror Lake, Federal Way WA 98023. The City of Federal Way Demolition Permit Requirements lists "Septic System.(Tank to be removed or tank to be drained and filled)" Is this an action we would get a permit from King County Environmental Services (form contact list refers us there)? Could you briefly describe the process? Thank You, Tom VanArsdell Administration 11/19/2013