10-102786 ' • Demolition -
City of Federal Way
Community Development Services Permit #: 10-102786-00-DE
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection Request Line: (253) 835-3050
Ph:(253)835-2607 Fax (253)835-2609 p q
Project Name: LAKOTA MIDDLE SCHOOL k ....
Project Address: 1415 SW 314TH ST Parcel Number: 072104 9143
Project Description: Demolition of existing school to allow for construction of new school
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Owner Applicant Contractor
ROD LELAND WM DICKSON CO WM DICKSON CO
FEDERAL WAY PUBLIC SCHOOLS 3315 S PINE ST WMDICC*108J7(4/1/11)
31405 18TH AVE S TACOMA WA 98409 3315 S PINE ST
FEDERAL WAY WA 98003-5433 TACOMA WA 98409
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Demolition Valuation 120000
CONDITIONS:
PERMIT EXPIRES Friday, June 29, 2012
Permit Issued on Wednesday, June 30, 2010
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: i , Date: '"
RW 4L 1413/1°
THIS CARD IS TO REMAIN ON-SITE
CITY OF Federal Way • Construction Ii ection Record
INSPECTION REQUESTS: (253) 835-3050
PERMIT#: 10-102786-00-DE Address: 1415 SW 314TH ST
Owner: ROD LELAND FEDERAL WAY, WA 98023-4518
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.
El Final-Building(4050)
Approved
By ,fbate 45744
Rough Electrical Final Electrical CI Right of Way
Approved Approved Approved
By Date By Date By Date
/ o - D Z- EL.
(..._,,,, „,:7N.,_ PERMIT
Federal WayRECEIVfffN FP
COMM UNITY DEVELOPMENT SERVICES APPLICATION
253-835-2607-FAX 253-835-2609 JUN I/57�1� `A'
���-1,,;il,;r;;.,.A^iu:,,•:::�.�rr., 3 0 20".Q
SITE ADDRESS CITY OF FElrA .#WAY
L. A ko fel l#Allci L\E ca ) ) 415' 54) 3/Y yS,/ CDS
$ PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
ilibUL-
('Tenant Name/T-Homeowner Last Name) ` /
PROJECT DESCRIPTION •�6`"a t5 bt� AKol !N/IJ/e Se mo ! -
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER --Fe:C-,.,-‘A` tin S L CO
0/ I :,
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME _._-. PHONE
l� G.1im (b.c..k5t�..4 (;o . '2_s-3- r'�3- � 2.•44Y65
MAILING ADDRESS '5-L- E-MAIL
t(_.
C NTRACTOR 3 1 SQ. P "...1
!~ Ll f?, l'1 wl AN W kiwi...,d ,A-,0 d , M1/F F
CITY STATE ZIPS FAX
7'A Carr. �Jh ) 1. 'i=7 -r 253' y77-•WSL 1
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
-----------
lAC)tM OH- C- . i 0 3 J t / / / _/ ( Zo-- `(- I o( 412.8-r°^64,-,
NAME PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
PROJECT CONTACT NA ._..
PHONE
(The individual to receive and ""S0 a o5 A 1_,,S-3- y 7 L Li4$'q
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application) 3 3 1 $ So i),Al E
CITY STATE ZIP FAX
1A, W ni 5'8401 2s'3 . 4)2. OS Z/
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME
A.,
Required value of$5.000 or more cc-at' ►J A 1.d L 4Y 1 ()LS S, OWNER-FINANCED
(RCW 19.27.095) MAILING ADDRESS,C�,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 to the city as a part of this application. /,/�
SIGNATURE: tA,".......--- eArd*".."'-` �" ' 3 /O
DATE
PRINT NAME: s. ..% N t+v o 4 S
Bulletin#100-April 14,2010 Page 1 of 3 k:\Handouts\Permit Application
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VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must be provided)
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercial(
BOILERS FURNACES HOT WATER TANKS(cosi
COMPRESSORS GAS LOG SETS REFRIGERATION SYST •
DUCTING GAS PIPING WOODSTOVES
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Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not incl %e existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Rand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER'SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREA RS
DRINKING FOUNTAINS SINKS(xiuhen/tnility) WATER HEA RS(Electric)
WASHING ACHINES ">'i' `` +' O?�ip;Ei;?i`E
HOSE BIBBS SUMPS •''•''ifb'"'-'
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEY() VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTIN IRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes❑ No ❑ Yes n No
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AREA DESCRIPTION(in square feet) EXISTING ROPOSED TOTAL FOR OFFICE USE
FIRST FLOOR (or Mobile Home)
COVERED .'...!!!!!E!!!
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ENTRY
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GARAGE 0 CARPORT 0
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EXLSTIQG PROPOSED TOTAL —'---_—'--..—'—.•'_.._—
Area Totals
......................................... .
ESTIMATED SELLING PRICE '• #OF BEDROOMS
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Area Construction #of
AREA DESCRIPTION• Occupancy Group(s) Additional Information
In Square Feet Type Stories
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AREA DES RIPTION Occu anc Grou s Additional Information
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Bulletin#100—April 14,2010 Page 2 of 3 k:\Handouts\Permit Application
, Approved Transaction Page 1 of 1
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pscleanair.org
Puget Sound Agency
Notification Case #: 201001646
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 $75.00
Credit Card Transaction # VQEF5C281E4A
Transaction Date 06/18/10
Owner's Name Federal Way School District Phone (253) 945-2000
Project Street Address 1415 SW 314th Street
City Federal Way Zip 98023
Contact Person Les Bridgewater w/Lydig Construction Phone (206) 249-8365
Mailing Address 31405 18th Avenue South
Federal Way,WA 98003
This project includes a demolition.
Demolition Start Date 06/29/10 Completion Date 07/30/10
Demolition will be completed by a demolition contractor
Demo Contractor Wm. Dickson Co. Contractor Job #
Contact Jason Roosa Phone (253)472-4489
Mailing Address 3315 South Pine Street
Tacoma,WA 98409
(1) I certify that the information I have provided is to the best of my knowledge true and accurate.
(2) I understand that I must file an Amendment to this Notification if:
• The type of project has changed.The project types are asbestos and demolition.
• The quantity of friable asbestos to be removed meets a larger project category.
• The project's start or completion date has changed.
(3) I understand one Notification must be filed for each structure.The only exception is for a single-family residence that includes
multiple ancillary structures,such as a detached garage or other outbuildings having the same street address. If there is no street
address, I have used a building number.
(4) I understand the fees for this Notification are nonrefundable.
Create Another Notification View History Loa Out
If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058.
https://secure.pscleanair.org/Asbestos/Approved.aspx 6/18/2010 ,
0 •
4._ F 0 WE 1 RO SERVICES, INC.
Environmental Consulting - Compliance
To: City of Federal Way WA.
From: Dennis Rauschenberg
Now Environmental Services
34004 9th Ave S
Federal Way,WA
To Whom It May Concern:
This letter is to verify that prior to the final air clearances taken on 6-29-10 a walk
through visual inspection was performed with Specialty Environmental to verify that all
asbestos and other hazardous materials were removed that were identified in the original
survey completed by Now Environmental. All floor tile and mastic,asbestos fittings and
mercury switches in the area to be demolished was removed and all air clearances were
below<0.003 f/cc.
If you require any additional information or have any questions please feel free to
contact me.
Sincerely,
Dennis au chen erg
Now Environmental Services
253-927-5233
34004 9th Avenue South,Suite 12,Federal Way,Washington 98003
Phone: (253)927-5233 Fax: (253)924-0323
www.nowenvironmental.com
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DEPARTMENT OF COMMUNITY 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 i tvoffederalway.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.ASBESTOS ABATE .T"w 6. ELECTRICI
(Copy of approval for frim Ptet Sound Clean Air (Electricity to Ike s off a d removed)
Agency provided) �%
(Puget ound Energy)
949
(City of Federal Way Building Official)
2.GAS SUPPLY 7. FUEL STORAGE TANKS
opas tp bg shu ff m er removed and fix, bill .aid) (Above or below grade fuee tanks, have been pumped or removed
fj'S �' -+�l�Fre( `' under Fire Department permit prior to any dismantle/excavation)
to • (Puget Sound Energy �/
(South King Fire and Rescue)
3.SEPTIC SYSTEM 8.WATER-Public Source (Check applicable box)
(Tank to be removed or tank to be drained and filled) ❑Meter to be removed and final utility bill paid
NIR n Metp to remain and be protected
(King County Environmental Services) �� (Water Supplier)
******OR******
4.SANITARY SEWER (Check applicable box) 9.WATER-Private Well(Check applicable box)
Sewer line capped at property line n Private well filled and capped
n Existing se er line to remai and be use..y proposed new . Private well to be used for other purposes
ructure n_/ N��,—.
a aven Utility District) (King County Environmental Services)
5.GARBAGE
(All household garbage disposed off and final bill paid)
(Waste Management/Other Company)
0 Completed Construction Permit Application form
CI 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 26,2010 Page 1 of 1 k:\Handouts\Demolition Permit Requirements