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17-103439 i ,.,t E Demolition City of Federal way Permit #:17-103439-00-DE Community Development Dept. 33325 8th Ave S Federal Way,WA 98003 Inspection Request Line: (253)835-3050 Ph:(253)835-2607 Fax:(253)835-2609 Project Name: CAVANAUGH HOMES Project Address: 34004 37TH AVE SW Parcel Number: 147330 0010 Project Description: Demolition and removal of manufactured home. Owner Applicant Contractor CAVANAUGH HOMES INDIGO ENTERPRISES LLC INDIGO ENTERPRISES LLC PO BOX 1977 26828 MAPLE VALLEY HWY SUITE 308 INDIGEL975LW(6/17/19) LYNNWOOD WA 98046 MAPLE VALLEY WA 98038 26828 MAPLE VALLEY HWY SUITE 308 MAPLE VALLEY WA 98038 Additional permit Information PERMIT EXPIRES Thursday, 18 July,2019 Permit Issued on Tuesday,July 18,2017 I hereby certify that the above information is correct and that the construction on the above described property and the occupancy the --- will be in accordance with the laws, rules and regulations of the State of / ashington and the City of Federal Way. Owner or age A I�_ i..', , I/ Ari - rr Date: f' (Cf i) Z (64, GLfrpoAci THIS CARD IS TO REMAIN ON-SITE CITY Construction Inspection Record Federal Way INSPECTION REQUESTS:(253)835-3050 PERMIT#: 17 103439 00 Address: 34004 37TH AVE SW Project: CAVANAUGH HOMES FEDERAL WAY WA 98023-2942 Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as possible (read left to right,top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card. ® Final-Building(4050) Approved By SQA Date t t l 1I y l 0 Rough Electrical ❑ Final Electrical 0 Right of Way Approved Approved Approved By Date By Date By Date RECEIVED JUL82017 _ PERMIT APPLICATION C`OD CITY OF Y FEDERAL WAY PERMIT CENTER+33325 8t Avenue South+Federal Way,WA 98003-6325 DEVELOPMENT 253-835-2607+FAX 253-835-2609+permitcentetftitvoffederalway,com PERMIT NUMBER_L/ 7- - / o 3 g7 .�I� �/ _ TARGET DATE ` ) SITE ADDRESS SUITE/UNIT# PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# $ 16ZY I LI '- 3 3 b _ os--o f c TYPE OF PERMIT ❑BUILDING 0 PLUMBING 0 MECHANICAL 1�4 )EMOLITION 0 ENGINEERING 0 FIRE PREVENTION NAME OF PROJECT �va tau v( � y PROJECT DESCRIPTION + i NIAPL -e " 6I"' �-Q � �C Li) nek_o Detailed description of work to ( �('i( ''[el.81/4- �� Z�� lX X� g.1 j(let4e4AXt be included on this permit only `� NAME PRIMARY PHONE -3-0\1(\\C\nQbrir\\CoArvyky5 \. , PROPERTY OWNER "ommMOS scrum 1. C Y\1A��A CL STATE rf--t 6, NAME G �+ PHONE �/\al PY S (-6, -/9CONTRACTOR a ( pls_1 ),) ,3 4 0 riZejb-M1--trpft5t ` "t°' BT TE g WA � A6'. 3Wvf of ATE CONTRA LICENSE# TION DATE FEDERAL WAY BUSINESS LICENSE# (Via i9e/471-G -2 /// NAME PRIMARY PHONE APPLICANT MAILING ADDRESS E-MAIL CITY STATE ZIP FAX NAME I PRIMARY ')( PROJECT CONTACT J t��A1 �� (The individual to receive and MAMING ADDRESS -E `MAIL I respond to all correspondence ( FA1I a pTp �y�,,;`i k concerning this application) CITY STATE ZIP 11141 De J .- �� i t NAME_ ,� PROJECT FINANCING nn�//I��/'7771 0 OWNER-FINANCED When vnhh.is$5,000 or more MAE,BSGADDRESS,cm,STATE,ZIP PHONE (ROW 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.,n••-• to the city as a part of this application. SIGNA di L %= ,+V DATE l 'I 1'1 i PRINT NAME: f tell / ,►( • Bulletin#100–January 29,2016 Page 1 of 2 k:\Handouts\Permit Application COMMUNITY DEVELOPMENT DEPARTMENT 33325 8th Avenue South Federal Way,WA 98003 CITY OF 411111110 253-835-2607;Fax 253-835-2609 Federal ' � www.citvoffederalway.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: DtMLA cl & „,011 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. XA completed Construction Permit Application form is also required. 1.ASBESTOS ABATEMENT (Prov'- .••y of Notice of Intent fro uget Sound Clean Air Agency 5.ELECTRICITY *� and .. inspection report -c- �f • inspector) /,4 4 � '% s:.'��rt ,,f �I,�!,1, , �� •, (Cityof F-h eery fief (Puget Sou d nergy ac• a Power) b `=y Building 0 tial) 2. FUEL STORAGE TANKS 6.NATURAL GAS ❑Under grade tank(s)is/are present o Above grade tank(s)are present !V i4, ❑Tank(s)has been pumped or removed under South King Fire&Rescue (Puget Sound Energy) permit prior to any dismantling or excavation (South King Fire and Rescue) 7.WATER-Public Source (24711,v1/1 I. aven still Di • ct 3.SEPTIC SYSTEM DECOMISSIONING 8.WATER-Private Well (King County Environmental Services) (King County Environmental Services) 4.SANITARY SEWER l RECEI Lakehaven Utility District) VE® JUL 18 2017 Please Note: Erosion control meas a st be in place during the demolition Aid$throu_ggh completion of the site clean-up. COMMUNE FEV1 WAY //^; DEVELOPMENT 1).OrraPe4W-- pli nt) Bulletin#122-March 16,2017 Page 1 of 1 k:\Handouts\Demolition Permit Requirements 6/29/2017 Approved Transaction pscIeaaa r.o g Put Sound(lean Air Agency Single-Family Notification Case #: 201703146 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 # AQOFEA1AED28 Transaction Date 06/29/17 Owner's Name John Urban Phone (206) 501-6379 Project Street Address 34004 37th Ave SW City Federal Way Zip 98023 Contact Person Peter Krenzke Phone (206) 501-6379 Mailing Address 26828 Maple Valley, WA 98038 This project includes a demolition. Demolition Start Date 07/15/17 Completion Date 07/20/17 Demolition will be completed by a demolition contractor I certify that: (1) This is a single-family residence project. The structure is used by one family who owns the property as their domicile. (2) The information I have provided is to the best of my knowledge accurate and complete. (3) I understand the fee for this Notification is nonrefundable. Create Another Notification If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. https://secure.pscleanair.org/Asbestos/Approved.aspx 1/1 7/12/2017 Gmail-DISCONNECTED AT TRANSFORMER/34004 37TH AVE SW FEDERAL WAY "?r a l Indigo Enterprises<indigoenterprises@gmail.com> DISCONNECTED AT TRANSFORMER 134004 37TH AVE SW FEDERAL WAY 1 message Ekeroma, Rose <Rose.Ekeroma@pse.com> Tue, Jut 11,2017 at 3:54 PM To: "indigoenterprises@gmail.com" <indigoenterprises@gmail.com> Hi Michelle, Please be advised that the electric service and meter to the above address have been removed. This was confirmed on Notification # 504793040. Feel free to speak to the first available Construction Representative at 1-888-321-7779 if you have other concerns or questions about this property. Thank you, Rose Ekeroma Puget Sound Energy Construction Services Ph# 1-888-321-7779 i Construction Office Hours: Monday-Friday, 7am to 5pm Ccc&Ep'\ I/1 https://mail.aooale.com/mailhIV?!tic?Riie=cmrhaa.n Q.ic.,m.—wnv„ns_o,a 7/7/2017 Gmail-FW:Certificate of Water Availability We're applying for a demolition permit at this location and need confirmation that the water has been disconnected--Can you verify this for me? On Fri, Jul 7,2017 at 11:31 AM, Gerken, Karen <kgerken@ci.tacoma.wa.us>wrote: [Quoted text hidden] Thank you, *Indigo Enterprises* 26828 Maple Valley Hwy,Suite 308 Maple Valley,WA 98038 (206)501-6379 (360)886-5116 fax indigoenterprises@gmail.com Indigo Enterprises Your Modular/Manufactured Home Site Preparation Specialists Gerken, Karen<kgerken@ci.tacoma.wa.us> Fri, Jul 7, 2017 at 4:24 PM To: Indigo Enterprises <indigoenterprises@gmail.com> The service has been turned off at the meter. You would need to disconnect the property side pipe from the bottom of the yoke on the customer side to ensure you do not rip out the corp/meter assembly. Utility Services Representative II Tacoma Water (253) 502-8236 From: Indigo Enterprises [mailto:indigoenterprises@gmail.com] Sent: Friday, July 07, 2017 4:09 PM To: Gerken, Karen Subject: Re: FW: Certificate of Water Availability [Quoted text hidden] Indigo Enterprises<indigoenterprises@gmail.com> Fri, Jul 7, 2017 at 4:39 PM To: "Gerken, Karen"<kgerken@ci.tacoma.wa.us> Thank you [Quoted text hidden] httos://maitoonnla.cnm/mail/nllt/9��i_9R�_5fn�nooanaQ �Qc;� civrn— o..._...__. __ 7/7/2017 Gmail-FW:Certificate of Water Availability Mrn it Indigo Enterprises<indigoenterprises@gmail.com> FW: Certificate of Water Availability 5 messages Gerken, Karen <kgerken@ci.tacoma.wa.us> Fri,Jul 7, 2017 at 11:31 AM To: "indigoenterprises@gmail.com"<indigoenterprises@gmail.com> Attached please find the requested certificate for 34004 37th Ave SW Regards, K.Cirev. cert ew Utility Services Representative II Tacoma Water (253)502-8236 20170707_I11206.pdf 898K Indigo Enterprises<indigoenterprises@gmail.com> Fri, Jul 7, 2017 at 12:15 PM To: "Gerken, Karen"<kgerken@ci.tacoma.wa.us> thank you! [Quoted text hidden] Thank you, *Indigo Enterprises* 26828 Maple Valley Hwy, Suite 308 Maple Valley, WA 98038 (206)501-6379 (360)886-5116 fax indigoenterprises@gmaii.com Indigo Enterprises Your Modular/Manufactured Home Site Preparation Specialists Indigo Enterprises<indigoenterprises@gmail.com> Fri, Jul 7, 2017 at 4:09 PM To: "Gerken, Karen" <kgerken@ci.tacoma.wa.us> Hi Karen https://mail.google.com/mail/u/0/?ui=2&ik=5fOcb99eO1&isver=7BEilyEIYTQ.en.&view=pt&search=inbox&th=15d1 f6c82aa7ed8O&siml=15d 1 e52557c35... 1/2 **v.4 AFFORDABLE ENVIRONMENTAL, INC, P.O. BOX 40 MOUNTLAKE TERRACE,WA 98043 44407 (425) 512-8750 FAX(425) 212-9805 CERTIFICATE OF COMPLETION Affordable Environmental,Inc.performed asbestos removal and disposal services at the following address: 34004 37th Ave. SW, Unit#1 federal Way, WA 98023 Be assured that all activities performed were conducted in accordance with all current and applicable environmental regulations and contract specifications. Any air monitoring required by statutes was performed.Clearance air sampling verified air was clean by current state and national standards. Regulated waste was deposited in accordance with EPA guidelines. An approved landfill facility is required to forward documentation of this within 45 days of disposal. Asbestos liability insurance and a contractor's surety bond were in effect during these operations. Note: Affordable Environmental,Inc. summited notification to Puget Sound Clean Air Agency(PSCAA) and the Department of Labor&Industries,Division of Occupational Safety&Health prior to starting this project. Please contact our customer service representative at (425) 512-8750 between 7:00 AM and 3:30 PM Monday through Friday if you have any questions or need additional documentation. Sincerely, Anthony M Chase President AEI WA State Contractors License#:AFFORE1942DT WA State Asbestos Contractor Certification.#:1427 A-T - Asbesto-Test, Inc. - 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040 www.ashestoiestconi into(Aashestotest.corn ASBESTOS SURVEY DW Manufactured Home(a,34004 37th Ave.SW, Unit#1, Federal Way,King County, Washington 98023 Page 1 of 8 March 15,2017 B2170310 Brekenridge Homes Inc P.O.Box 1977 Lynnwood,WA 98046 Attn:John Urban 425-770-0632 Johnurban 12(&Yahoo.com On March 9,2017,Asbesto-Test personnel conducted an Asbestos survey(per U.S.E.P.A.IA.H.E.R.A.guidelines as designated and specified by Puget Sound Clean Air Agency and Washington State)of the double wide manufactured home (a,34004 37th Aye. SW, Unit#1,Federal Way,King County, Washington 98023. This survey purpose is to identify asbestos containing materials,prior to demolition. NOTE:THERE ARE VAGRANTS CAMPED IN/AROUND THIS HOUSE. NARRATIVE OF FINDINGS BASIC CONSTRUCTION: The manufactured home is wood frame with metal and fiberglass siding. The structure is on a steel chassis and blocks. There is an addition. The composition roofing materials were sampled. The siding vapor barrier materials were also sampled. INTERIOR CONSTRUCTION, FINISHES, AND FLOORINGS: The interior is wood, and drywall.The drywallltaping materials were sampled. The vinyl and tile flooring materials were sampled. The misc.mastic materials were sampled. INSULATION: There was no relating suspect ACM located. ELECTRICAL SYSTEM: The electrical wiring insulation is not of the kind to be ACM. continue to page 2 1, 410- , BBB rmirro c‘.SUMP � NAT 4Cv3'...r. Page 2 of 8 March 15,2017 B2170310 Asbesto-Test,Inc. 425-489-4040 DW Mobile Home na,34004 37th Ave.SW, Unit#1. Federal Way, Washinyiton 98023 HEATING AND VENTILATION SYSTEM: There is an electric forced air furnace in the structure. There was no relating suspect ACM located. Note:It was not possible to dismantle the furnace and ducting to locate and/or evaluate any additional suspect ACM that may be concealed, inside the unit, or associated in hidden areas. It is our opinion any further handling of the furnace system should be coordinated by the project manager and/or abatement contractor. If any additional relating suspect materials are located prior to and/or during any demolition or renovation, any and all additional related suspect asbestos containing materials should be considered to be ACM(Asbestos Containing Material), unless determined to be otherwise by laboratory analysis. Any TSI that may be present inside or outside the furnace and/or ducting system including but not limited to all gaskets,joint compounds,sealants, and/or insulations, are PACM unless tested otherwise by laboratory analysis. • There is a fireplace in the house.The fire brick materials were sampled. The fireplace decorative brick and mortar materials were also sampled. MISC.: None. ADDITIONAL STRUCTURES ON SITE INCLUDED IN SURVEY: There are two sheds on the property. The composition roofing materials were sampled.There is unfinished drywall in the east shed.There is also some sheet vinyl flooring in the east shed.These materials were also sampled. #of structures included in survey: one double wide with 2 sheds Requested by: John Urban 5mWbW*II95R#313 4C4.di±,33r, y (iE. TivK cO+tIf tMt. win R.Hutso it Nm am y t4 4*Gum 4$tt fD.sh@P t1W.N�l�;itiw Wrf Asbostat Want w*Pli vcAt,'MA TtS9NsNT44CCR 743( ). J e c.r *i4au ._�..._._«««_.._ Cdtw A*Feb x2.23a'r tAv. ea�««.a lwn z i.Keh 2x,T#t William R.Hutson II Inspector,Certified A.H.E.R.A. Accred.# 161243 exp.Feb.22,2018 continue to page 3 SEM 7).4—T 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040,f 775-665-0420 www.acbestotest.corn;info(ciash/es,olesl.corn Page 3 of 8 March 15,2017 B2170310 Asbesto-Test,Inc. 425-489-4040 DW Mobile Home(1i 34004 37th Ave.SW, Unit#1,Federal Way, Washington 98023 Any and all materials identified as ACM or PACM in this report(and/or additional materials associated with the structure that may be discovered and later identified as ACM or PACM),must be professionally abated prior to demolition.ASSESSMENT AND QUANTIFICATION OF ACM FOR ABATEMENT PURPOSES AND/OR PRICING FOR REMOVAL SHOULD BE DETERMINED BY ON SITE EVALUATION. SAMPLES#1-#3 ARE ASBESTOS CONTAINING MATERIALS ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL 1.0 SHEET VINYL FLOORING yes//chrysotile//38% non-fibrous materials, FRIABLE ACM cellulose "PLATE"VINYL—BOTTOM LAYER OF VINYL IS THROUGHOUT COLOR:ORANGE NOTE:THE ASBESTOS IS IN THE GRAY/WHITE VINYL BACKING. THE MASTIC IS ALSO ACM AS IT CANNOT BE SEPARATED FROM THE FRIABLE VINYL BACKING MATERIAL. ON PARTICLE BOARD 2.0 SHEET VINYL FLOORING yes//chrysotile//38% non-fibrous materials, FRIABLE ACM cellulose BATHROOM/LAUNDRY 2ND LAYER—COLOR:WHITE NOTE:THE ASBESTOS IS IN THE GRAY/WHITE VINYL BACKING. THE MASTIC IS ALSO ACM AS IT CANNOT BE SEPARATED FROM THE FRIABLE VINYL BACKING MATERIAL. ON ORANGE ACM SHEET VINYL AS PREVIOUSLY LSITED 3.0 FLOOR TILE yes//chrysotile//2% non-fibrous materials TILE IS NON-FRIABLE ACM SW BEDROOM SURFACE—COLOR:TAN/GREEN MOSAIC 4.0 mastic NAD cellulose,adhesive beneath previous sample ESTIMATED SQ. FT.OF DOUBLE WIDE FLOORING AREA IS APPROX. 1650 SQ. FT. THE FLOORING QUANTITIES SHOULD BE DETERMINED BY ON SITE EVALUATION.THE ACM PLATE VINYL LIKELY EXTENDS BENEATH THE WALL PLATES THROUGHOUT.-ON PARTICLE BOARD NOTE:ANY ADDITIONAL COLORS OR KINDS OF VINYL FLOORING AND/OR TILE WITH ANY RELATING MASTICS/BACKINGS THAT WERE NOT DISCOVERED IN THIS SURVEY AND MAY LATER BE LOCATED IN THIS STRUCTURE ARE ALSO PRESUMED TO CONTAIN ASBESTOS UNLESS TESTED OTHERWISE BY LABORATORY ANALYSIS continue to page 4 410 —err. .o'i erns • UMW NO 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040,f775-665-0420 vos.ashestote.rl.corn,info(ashle.stotest.coin Page 4 of 8 March 15,2017 B2170310 Asbesto-Test,Inc. 425-489-4040 DW Mobile Home(a,34004 37th Ave.SW, Unit#1, Federal Way, Washington 98023 ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL THERE WAS NO ASBESTOS DETECTED IN ANY OF THE REMAINING SAMPLES 5.0 floor tile NAD non-fibrous materials kitchen surface layer—color:tan 6.0 mastic NAD adhesive beneath previous sample 7.0 mastic NAD adhesive,cellulose kitchen holding wood pattern laminate on countertops 8.0 sheet vinyl flooring NAD non-fibrous materials, bathroom surface layer-color:brown 9.0 mastic NAD adhesive beneath previous sample 10.0 floor tile NAD non-fibrous materials bathroom,laundry,hall 2'layer-color: tan 11.0 mastic NAD adhesive beneath previous sample 12.0 backer board NAD non-fibrous materials beneath previous sample cellulose On 2 layers of ACM sheet vinyl flooring materials as previously listed 13.0 masonry tile NAD non-fibrous materials fireplace hearth-color:red 14.0 mortar/mastic NAD adhesive,cellulose, holding previous sample non-fibrous materials 15.0 decorative brick NAD non-fibrous materials fireplace face 15.1 mortar NAD non-fibrous materials, holding previous sample 1 cellulose 15.2 mortar NAD non-fibrous materials, holding previous sample 2 cellulose 15.3 mortar NAD non-fibrous materials, holding previous sample 3 cellulose 16.0 firebrick NAD non-fibrous materials inside fireplace continue to page 5 4116. BBB i ® sr01, T 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f 775-665-0420 wive:asbestolest.coin info(' ash/etotestcoin Page 5 of 8 March 15,2017 B2170310 Asbesto-Test,Inc. 425-489-4040 DW Mobile Home(&,34004 37th Ave. SW, Unit#1,Federal Way, Washington 98023 ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL 17.0 sheet vinyl flooring NAD non-fibrous materials, master bathroom surface layer—color:bluish gray cellulose,fiberglass 18.0 mastic NAD adhesive beneath previous sample NOTE:ODDLY,THIS IS OVER A DRYWALL-LIKE PANEL ON THE FLOOR ON TOP OF ORANGE ACM PLATE VINYL AS PREVIOUSLY LISTED 19.0 mastic NAD adhesive,cellulose master bathroom holding dark brown laminate on countertops 20.0 drywall/taping compound/paint NAD non-fibrous materials sample 1 composite cellulose,fiberglass 20.1 drywall/taping compound/paint NAD non-fibrous materials sample 2 composite cellulose,fiberglass 20.2 drywall/taping compound/paint NAD non-fibrous materials sample 3 composite cellulose,fiberglass EXTERIOR: 21.0 vapor barrier NAD cellulose,tar beneath metal siding exterior 22.0 composition roofing NAD cellulose,tar, non-fibrous materials 23.0 vapor barrier NAD cellulose,tar beneath composition roofing 24.0 mastic NAD cellulose,adhesive holding composition roofing WEST SHED: 25.0 composition roofing NAD cellulose,tar, non-fibrous materials 26.0 vapor barrier NAD cellulose,tar beneath composition roofing 27.0 mastic NAD cellulose,adhesive holding composition roofing continue to page 6 40 BSB ViiMil C.:7:4) 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040,f775-665-0420 wW%s.a.shea7otest.corn,info��ashte.stotest.coin Page 6 of 8 March 15,2017 B2170310 Asbesto-Test,Inc. 425-489-4040 DW Mobile Home(a,34004 37th Ave.SW, Unit#1, Federal Way, Washington 98023 ANALYSIS ID ASBESTOS//TYPE//QUANTITY OTHER MATERIAL EAST SHED: 28.0 composition roofing NAD cellulose,tar, non-fibrous materials 29.0 vapor barrier NAD cellulose,tar beneath composition roofing 30.0 mastic NAD cellulose,adhesive holding composition roofing 31.0 sheet vinyl flooring NAD non-fibrous materials in back of shed—color:white cellulose,fiberglass 32.0 mastic NAD adhesive beneath previous sample 33.0 drywall/taping compound NAD non-fibrous materials interior—not finished-composite cellulose,fiberglass 33.1 drywall/taping compound NAD non-fibrous materials interior—not finished-composite cellulose,fiberglass 32.0 drywall/taping compound NAD non-fibrous materials interior—not finished-composite cellulose,fiberglass continue to page 7 BBE?t n 4441410 IMMO WO 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040,f 775-665-0420 wwic.asbestoiest.coin,info(aasbtestotest.coin Page 7 of 8 March 15,2017 B2170310 Asbesto-Test,Inc. 425-489-4040 DW Mobile Home(a,34004 37"`Ave. SW, Unit#1,Federal Way. Washington 98023 o i h, //rj j�///r yr/r��'�' /%//.ri//r////////✓y /�/%//a/o�iai�ioii/ice%///%a/i/% r %' %i//o ri/ i%fi j / r//�y,viii/, , r/r //iia j, �% r j r rraa/ai/'j o %�/ �amm�raiii�p'oiio0aoi�/o%/ �///iii ��/�i/G j /;r arrr,, j /% 4'"',,,‘g:,„4//,5,;,,,',//', /r/i%%/ii%i ice!/; =SHEDS ,,,,,,0,/ =DOUBLE WIDE MOBILE continue to page 8 ..00r WOIMUNIF 1429 AD. ,Shmish,WA 98290 425-489-4040ve. ;f775-6o65-0420 vww.ashes[aest#187.com;inno(o(c¢osbleaToles/.(orrr Page 8 of 8 March 15,2017 B2170310 Asbesto-Test,Inc. 425-489-4040 DW Mobile Home(a,34004 37th Ave.SW, Unit#1.Federal Way, Washington 98023 Samples taken are listed with their corresponding analyses.If asbestos is detected,those samples containing asbestos are listed first and noted with the initials"ACM". Some sample analyses listed may be a representative analysis of individual and separate samplings and analysis of homogenous materials,as prescribed by A.H.E.R.A.guideline. If,during demolition or renovation,any additional suspect asbestos containing materials are located[may include but not limited to: sheet vinyl flooring,tile flooring,wall or ceiling texturings or paints,concrete siding or skirting,cement pipes,cement wallboard, electrical cloth,electrical wiring insulation,thermal paper,wallboard,joint compounds,vinyl wall coverings,spackling compounds,or any other suspect TSI(Thermal System Insulation)],those materials are presumed Asbestos Containing Materials unless determined to be non-asbestos by laboratory analysis. Asbesto-Test,Inc.does not guarantee approximations of quantities of ACM,which may be listed with the analyses.It is therefore recommended professional abatement price and/or disposal quotes be obtained by inquiring as to fees per area of specific ACM material(i.e.square or linear foot,etc.),or by on site assessment. Any and all materials identified as ACM and/or PACM in this report must be abated prior to disturbance in renovation or demolition. PLM(polarized light microscopy)has been known to miss asbestos in small percentages of some samples,which contain asbestos, thus negative PLM results cannot be guaranteed. Floor tiles and wipes should be tested with SEM(scanning electron microscope)or TEM(transmitting electron microscope),to insure analytical accuracy when asbestos is reported in small percentages Analytical test method:USEPA 600/R93/116""(PLM);WAC 296-62-07753 App.l "One percent is the USEPA regulatory limit for asbestos in bulk samples. xev: "FRIABLE"signifies"Easily Airborne" ACM signifies"Asbestos Containing Material" PACM signifies"Presumed Asbestos Containing Material" CAB signifies"Concrete Asbestos Board" o signifies"less than" TSI signifies"Thermal System Insulation" HVAC signifies"Heating Ventilating Air-Conditioning" NAD signifies"No Asbestos Detected" END OF REPORT ArLynn Hammond, Pres., BSc. Analytical Chemist, AIHA proficient Inspector, certified A.H.E.R.A. accred.#158283 (Expires July 27,2017) 4147 ! f 1429 Ave.D.#187,Snohomish,WA 98290 425-489-4040;f775-665-0420 uwir.asheeloiesl.com;info@ashlestolest.coin LAKEHA'VEN UTILITY DISTRICT SEWER SERVICE CONNECTION PERMIT SERVICE NO.1 19022 STATUS ISSUED PERMIT PERMIT NO. 28153 APPLICATION DATE I SUPERSEDES 12038 STUB SIZE) STUB INSTALL DATE # STUB TYPE STUB INSTALLED BY 1 STUB MATERIAL I ISSUED DATE) ROUTE I 3060 SERVICE House# Street Name Suite ID City State Zip Cod ADDRESS 34004 i3' "'AVE SW FEDERAL WAY WA 198023-2942 LOT#(S) I BLOCK#(S) PLAT/BSPIBLA 'CENTENNIAL ESTATES DIV NO 1 TAX PARCEL NO. 1473300010 GRID D-11 OWNER CAVANAUGH HOMES INC PHONE ext. J BILLING House# Street Name Suite ID City State Zip Cod ADDRESS PO BOX 1977 � LYNNWOOD 411.11.111•1111111011. .WA 198046- .�. CONTRACTOR JOHN URBAN PHONE)(425)770-0632 ext. AUTHORIZED CONTRACTOR PHONE) ext. 1 CLASSIFICATION RESIDENTIAL NUMBER OF UNITS SIC ERU CREDITS 1 la TREATMENT PLANTOT PUMP STATIONS 10 f -- n- SEWER ULM I SVC TYPE 'DISCONNECT TMP SWR SVC E PRIVATE PUMP E CHK VALVE REQ [' GRINDER PUMP MAKE I GRINDER PUMP MODEL b-tiECIAL t. **ANY tt DIFICATI TO SEWER SYSTEM MUST HAVE APPROVAL OF nit:,D!STRICT** Issued by Issued Date ? Permits not valid unless signed by District representative Permit valid for six(6)months. ( 1 I BOX IS CHECKED: A connection is being made to a pressure sewer system AND a private grinder pump system is being 'alma installed. The pressure sewer system is designed fo installation of a pump,model number ,ONLY. Inspector's Report ..."`17 This permit is granted subject If applicable,existing on-site sewage disposal systems,septic tanks,holding tanks,or to the conditions set forth on cesspools,shall be abandoned in accordance with the approved standards and the reverse side of the permit regulations of the King County Health Department,Environmental Health Services CAUTION *PIPE BEDDING SHALL BE 5/8 MINUS CRUSHED ROCK *NO GLUE JOINTS-RUBBER GASKETED ONLY BUILDINGS/STRUCTURES *DEWATER DITCH BEFORE INSPECTION PROHIBITED ON SEWER * DISTRICT INSPECTION BEFORE BACKFILL CALL FOR INSPECTION AT:(253)945-1622 EASEMENTS 24 HOUR NOTICE REQUIRED JOB SITE COPY