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09-100872 Demolition City of Federal Way Community Development Services Permit #: 09.100872-00-DE P.O.Box 9718 Federal Way,WA 98063-9718 Ins ection Re uest Line: (253)835-3050 Ph:(253)835-2607 Fax:(253)835-2609 r , ,, T - p q Project Name: HENDERSON - t....',.; . Project Address: 30440 28TH AVE S Parcel Number: 092104 9259 Project Description: Demolition of detached 400-square foot storage shed. Owner Applicant Contractor MAX E HENDERSON MAX E HENDERSON OWNER IS CONTRACTOR DEBRA L HENDERSON 5131 SE 116T- ,, 15131 SE 116TH ST J '16 TO 1 RENTON WA 98059-603 so fi"`., " /r o \ i .s tii �� r r ,,,,,,,:t1--,„- % ^%''s:41, Ff r it Info "ti i' ''1,-',,,' '1 \ tie�� / ,aPp `,�', r A.. :��1.. �,s..,., /„ a�oQ._..,rs. PERMIT EX R� held ` h 9, 2011 Peri, •.u)io 'i�"ch ' 2009 I hereby certify that the ab' e inform- i-,,"• -ct and tha .. uction on the above described property and the occupancy and the se will be in acco ance with the laws, r =. --- regulations of the State of Washington and the City of Federa -y. Owner or agent , I Date: Zd ' • 4Nak6. THIS CARD IS TO REMAIN ON-SITE CITY OF Community Development Inspection Record Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050 PERMIT#: 09-100872-00-DE Owner: MAX E HENDERSON Address: 30440 28TH AVE S FEDERAL WAY, WA 98003-4801 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 Date 1 i • For inspector reference only 0 Rough Electrical 0 FINAL-Electrical Approved Approved By Date By Date RACI�l [ �?,- o o g 3 Federal Way MAR o 9 2009 PERMIT 5 g / 61 y COMMUNITY DEVELOPMENT SERVICES T SF MF CO ME EL P D EN FP 33325 81H r r—t--------------/-- 25383AL AVENUE z �3 FEDE�, LI CATI O N FEDERAL WAY, 71 uww.dtu .lxiu.com CDS The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type. • PROPERTY INFORMATION SITE ADDRESS- 7041.D 216** A4e 6 SUITE/UNIT# ASSESSOR'S TAX/PARCEL# O 1 Z 1 0 - 1 Z Cj_1_ LOT SIZE(s) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) V fi (Attach sewatepagefer 1,404 legal desawdonl • PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING ❑MECHANICAL DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit only) Der/taut-no J par2A4 1 r Fog 5H-e-o 5H-e- fog c,A 4t' OS t 03197 -. bo - 5V PROJECT NAME(Name of Business or Owner Last Name) ! 0 LSO • PEOPLE INFORMATION PROPERTY NAME PRIMARY PHONE owNER isvlibi I.Et1J0eLSpri (2b6) 736 -487k MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS (SV $1 56 I l(Q+4i S* J1-DvJ (,JqPr; 0 c CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE O(I1/4IJ N 4 ( ) - MAILING ADDRESS CITY,STATE,ZIP CELL PHONE CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER ( ) — CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE M i -i Nr I So --j- (20 L ) ?3e - Is 76 MAILING ADDRESS CITY,STATE,ZIP CELL PHONE 15)S3 IHIP�Se I I SC nw . %051 ( )TRELATIONY NUMBER 0 Architect ❑Tenant ❑Agent ❑ Other ( ) - PROJECT NAME PRIMARY, PHONE E-MAIL ADDRESS CONTACT MArX !'�� e� DteS00 (�C ) 730- 4$1 4 LENDER NAME Per RCW 19.27.095: IN/Pt' Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) — L • DETAILED BUILDING INFORMATION EXISTING USE 514 0 PROPOSED USE ik1 R EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ (000. 00 SPRINKLERED BUILDING? ❑YES XNO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑YES 0 NO WATER SERVICE PROVIDER ❑LAKEHAVEN 0 HIGHLINE ❑ TACOMA 0 PRIVATE(WELL) /4 SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC) r • 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 NUMBER OF FLOORS =WINO rswoam TOTAL TOTAL EXISIDIO sr TOTAL PROPOSED Sr TOTALS? **NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ 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. MECIIAMCAL 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 tcommssonq COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG.SYSTEMS PLUMBING BATHTUBS(or Tub/Shower Combo) LAVS(9sehmom Sinks) URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS WATER CLOSETS(row ELECTRIC WATER HEATERS SINKS WASHING MACHINES HOSE BIBBS SUMPS SIGNATURE 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 sup of this permit application is true and correct.I certify that I will comply with all applicable City of Federal Way ns pertaining the work authorised by the issuance of a permit.I understand that the issuance of this permit does not remove the owner's nsibility fo compliance with local,state,or federal laws regulating construction or environmental laws. I further agree to hold the of Federal Mg/as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense o such claim), w may be made by any person, including the undersigned, and filed against the city, but only where such claim arises o the reliance the city,including its officers and employees,upon the accuracy o the information supplied to the city as a part of this tion. A 2 SIGNATURE: DATE 3 t Property Own and/or Authorized Agent Sa=aft a a NEW a ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT BUILDING SRPJ.T,ONLY? a YES a NOBASIC PLAN? a YES oNO ZONING DESIGNATION CHANGE OF USE? ❑YES a NO NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? a YES a NO PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? a YES o NO Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Permit Application '�p� 2? t AVE. o Ut"Ft. 0 1k16, DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES 33325 8'h Avenue South r PO Box 9718 4 CITY OF Federal Way WA 98063-9718 Federal Way 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. 'rior 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 ABATEMENT 6.ELECTRIC (Copy of approval form and „>- �'•! - - om Pu'- Sound Clean Air (Electricity to t and meter removed) Agency provided) IV �) I'1 r (Puget Sound Energy) (City of Fe eral Way Builds •ii; /� I Dil 2.GAS SUPPLY 7.FUEL STORAGE TANKS (Gas to be shut off,meter(r o ed and final bill paid) (Above or below gr de fuel tanks,have been pumped or removed N under Fire De At permit prior to any dismantle/excavation) (P and Energy) �1 (South King Fire and Rescue) 3.SEPTIC SYSTEM 8.WATER-Public Source (Check applicable box) (Tank to be removed or tan to be drained and filled) o Meter to be remov and final utility bill paid 1 I o Meter to remaiq n bilrotected (King Cou Environmental Services) �V (Water Supplier) ******OR****** 4.SANITARY SEWER (Check applicable box) 9.WATER-Private Well(Check applicable box) o Sewer line capped at prop line o Private well filled and capped o Existing sewer line tort n rd be used by proposed new structure o Private well to be lefor other purposes (Lake1laven Utility District) (Ki ig"Cbunty Environmental Services) 5.GARBAGE (All household garbage distpofe ofd final bill paid) (Waste I dna emen Other Company) ompleted Construction Permit Application form ❑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 RECEIVED 4.Cash Bond Deposit 120%of calculated building permit fee Refundable upon Completed Final Inspection MAR 09 ? ":9 Bulletin#122—January 1,2009 Page 1 of 1 1c an o 1lFo i tte utet?Yent , +r`' C C.._:S. • • Certified Asbestos Survey 25744 135 'Place SE Kent,WA 98042 Phone: (253)630-3996 March 3,2009 Invoice#022609 Max Henderson 30440 28`h Ave. S. Federal Way, WA 98003 206-730-4876 Dear Max Henderson, On February 26, 2009 a survey for asbestos contained in building materials of a shed located at 30440 28th Ave. S.,Federal Way, WA 98003 was completed. The shed is approximately 400 square feet. The shed will be demolished. No Asbestos greater than 1%was detected in any of the samples. The survey was done without limitations.No hidden or inaccessible areas were found and all area measurements are approximate. International Asbestos Testing Labs,9000 Commerce Parkway,Suite B,Mt.Laurel,NJ 08054 conducted the analysis using Polarized Light Microscopy(PLM)and Point Counting(PC). The survey was done by Certified Asbestos Survey,25744— 135th Place SE,Kent, WA 98042, phone(253)630-3996. John Bastanchury AHERA building inspector certification#1029466 expiring May 21,2009 did the survey in accordance with sampling protocol outlined in the CFR 763.86 by PSAPCA Reg. III Article 4. Sincerely, John Bastanchury Certified Asbestos Survey Approved Transaction https://secure.pscleanair.org/Asbestos/Appr... https://secure.pscleanair.org/Asbestos/Appr... • pscleanatr.org Puget Sound Clean Air Agency Single-Family Notification Case #: 200900404 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 #VS3F3B49A1ED Transaction Date 03/05/09 Owner's Name Debbie and Max Henderson Phone (206) 730-4876 Site Address 30440 28th ave s Site City Federal Way Zip 98003 Contact Person Max Phone (206) 730-4876 Mailing Address This project includes a demoktion. Demolition Start Date 03/15/09 Completion Date 03/15/09 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 Loa out If you have questions,contact us at asbestos@pscleanair.org or 206.689.4058. 1 of 1 3/6/2009 8:00 AM • • % / wq - o % U -40) % kw 141 N.) -4 -4 -4amm & A � � � 1:13@ 00 2 a CD E c 2 7J ■ - 0 0 m § ■ ■ O « m $ k £ ©s 0 0 O. CD O 73 a7 w © � 0 0 ® k " 2 © ? o k > E co 2 c kK § j EC 2q � sa) qQ Ff2221:17m R ] c 0 Cl) � wkeLU ¢ ® c 0 al ° 0 / cq 73 c — ET CD 03 a) rn 0 � @ qq § % % § U) o c > k A co a. 0 0 . . vv ƒ q 005 0- CI S CO g2 < E ■ 4, • ELECTRICAL PERMIT INFORMATION *NOTE: an automation fee of$6.00 will be charged for all permits. RESIDENTIAL COMMERCIAL NEW RESIDENTIAL SERVICE NEW COMMERCIAL/INDUSTRIAL SERVICE ❑ Single Family Square Feet Service or Feeder Each Add'n (First 1300 IV-$121.00;Each add'n 500 tt2-$39.00) ❑ 0 to 100 amp $131.50 $80.00 0 101-200 amp 163.00 103.00 ❑ Detached outbuilding or garage(w/service) $51.00 ❑ 201-400 amp 305.50 120.50 ❑ Detached outbuilding or garage(inspected separately) $80.00 ❑ 401-600 amp 356.00 142.50 ❑ Swimming pool(w/service) $80.00 ❑ 601-800 amp 460.50 195.00 ❑ Swimming pool(inspected separately) $120.50 C:1Hot tub/spa/sauna(w/service) $51 El 801- 1000 amp 562.50 235.50 ❑ Hot tub/spa/sauna(inspected separately) $80.00 ❑ Over 1000 amp 613.00 327.00 ❑ Septic pumping system(w/service) $51.00 U Over 600 volts surcharge $103.00 ❑ Septic pumping system(inspected separately) $80.00 ❑ Mast or meter repair $111.00 NEW MULTI-FAMILY(three units or more) ALTERED COMMERCIAL/INDUSTRIAL Service Feeder (Does not include circuits.) Service or Feeders ❑ Up to 200 amp $131.50 $39.00 ❑ 0 to 200 amp $131.50 0 201 -400 amp 163.00 80.00 0 201 -600 amp 305.50 0 401-600 amp 223.00 111.00 0 601 - 1000 amp 460.50 ❑ 601 -800 amp 285.50 152.50 ❑ over 1000 amp 513.00 ❑ Over 800 amp 408.50 305.50 ❑ #of circuits to be added/altered ALTERED SINGLE/MULTI FAMILY (1-5 circuits-$103.00;Add'n circuits,$8.00/ea) Service or Feeder COMMERCIAL/INDUSTRIAL PLAN REVIEW ❑ 0 to 200 amp $100.50 $103.00 plus 35%of Permit Fee ❑ 201 -600 amp 163.00 ❑ Service- 1,000 amps or greater ❑ Medical/Educational/Institutional Facility ❑ over 600 amp 245.50 ❑ Additional plan review for ❑ #of circuits to be added/altered modified submittals $115.00/per hour (1-4 circuits-$80.00;Add'n circuits$8.00/ea) ❑ Mast or meter repair $60.50 TEMPORARY SERVICE Service or Feeder Each Add'n MANUFACTURED HOMES ❑ 0 to 60 amp $ 71.00 $32.00 ❑ Service or feeder only $80.00 ❑ 61-100 amp 80.00 39.00 ❑ Service and feeder $131.50 0 101-200 amp 103.50 51.00 O 201-400 amp 120.00 60.50 MOBILE HOME/RV PARK ❑ 401-600 amp 163.50 80.00 ❑ #of service or feeders ❑ Over 600 amp 183.00 92.00 (First service/feeder-$80.00;each add'n-$52.50) MISCELLANEOUS SERVICE/EQUIPMENT Cl #of Thermostats (First-$60.50;add'n-$18.50/ea) ❑ #of Signs ❑ Low Voltage (First sign-$60.50;add'n sign$28.50/ea) Square Feet to be served by system(s) U Yard Pole/meter loops/pedestal $80.00 ❑ Fire Alarm System ❑ Portable Generator(transfer equipment) $100.50 ❑ Security Alarm System ❑ Ditch cover/inspection ❑ Voice Cabling only $120.50 ❑ Data Cabling 0 1"2500 fn-$71.00; For fees not listed,contact the Permit Center at Each add'n 2500 ft2-$18.50) 253-835-2607 Bulletin#100-January 1,2009 Page 3 of 4 k\Handouts\Permit Application