07-105718 e�z
City of Federal Way • Demolition Permit /1/07-105718-00-DE
Community Development Services
P.O.Box 9718
y,
Ph:(253)
Federal 835-26Wa07WA Fax:(253)98063-9718 835-2609 Inspection Request Line: (253) 835-3050
Project Name: URIOSTE
Project Address: 33504 18TH AVE Si Parcel Number: 412940 0030
Project Description: Complete demo of(1) single family residence
Owner Applicant Contractor ,
BENITO URIOSTE BENITO URIOSTE BENITO URIOSTE
350 SW 296TH ST 350 SW 296TH ST 350 SW 296TH ST
FEDERAL WAY WA 98023 FEDERAL WAY WA 98023 FEDERAL WAY WA 98023
Additional Permit Information
CONDITIONS:
After final inspection is complete and approved,please contact Kari Cimmer by e-mail at
Karic@cityoffederalway.com OR by fax at 253-835-2609 to receive a refund of cash bond.
PERMIT EXPIRES Thursday, October 15, 2009
Permit Issued on Tuesday, October 16, 2007
I hereby certify that the abgye information is correct and that the construction on the above described property and
the occupancy and the 0 se will b; in accordance with the laws, rules and regulations of the State of Washington
/ and the City of Federal Way.
Owner or agent!4Iti•• 7 ✓Li Date: E,/// °
ej)7(--
er(C)C��
DATE INSPECTOR s ' ,. AREA AND TYPE Oi INSPECTION
•
f.
6./0 es ,i N!t . Oe ,o4_Gr9_ �o � 4: tz
t--
2 �«h_,
• THIS CARD IS T4EMAIN ON-SITE - .
Community Development Inspection Record
CITY OF
Federal Way IVR INSPECTION REQUEST PHONE # (253) 8353050
PERMIT #: 07-105713-00-DE
Owner: BENITO URIOSTE
Address: 33504 18TH AVE S
FEDERAL WAY, WA 98003-6822
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
( J Date 4/ ''wIQ
�, ept,1
*Fig. to
1,1,,tr- _use' 6brok, vot- hoirto
CKri vpitot " 44°
9tirl 0,r )(,/v
Forinspector reference only _ j_
❑ Rough Electrical ❑ FINAL-Electrical
Approved Approved
By Date By Date
CITY or - 1 0 5_ I
Federal Way
PERMIT J�' '''
GOMMUMTYDEVELOPMENT SEEVICES j ?fln7' a SF MF CO ME EL P G EN FP
33325 FEDERni AL
WA ,WA 98•PO BOX 9718 e TT P LI C AT I O ND 1'/i y
FEDERAL WAY,FAX
53-8 3-9718 D / /
253-835.2607.idofTederaLoa,coni j Y OF FE(](:(�!{i(. AY.
y BUILDING DEPT IV .
The following is required Information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
/�J■ PROPERTY INFORMATION
SITE ADDRESS --5:5-7513 Y ler." /1i --'. -5-- _ .
SUITE/UNIT#_
ASSESSOR'S TAX/PARCEL# T 7 J_ / , ,n - O ti LOT SIZE(sf) ,-'-- ,;,/-''
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) 2-4.,7"--
(Attach
T(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING. . 0 MECHANICAL
7` DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlll) //
PROJECT NAME(Name of Business or Owner Last Name) 4 l8-Sl
IN PEOPLE INFORMATION
PROPERTY NAME
� " PRIMARY PHONE
OWNER f��j� JtX05C
wI3) si---0 -2 , 'CS MAILING ADDRESS CITY,S ATE,ZIP E-MAIL ADDRESS
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
`� 1-41e
1 eY.
/.1 p„t-` MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
l�! CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
APPLICANT COMPANY NAMEAPPLICANT NAME
'.1t/ f �� /`OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
RELATIONSHIP TO PROJECT FAX NUMB ER
0 Architect 0 Tenant 0 Agent 0 Other ( ) _
PROJECTTNAME `, _ / PRIMARY HONE - E-MAIL ADDRESS
CONTACT /Jw/vArcv
I
LENDER NAME Per RCW 19.2.7.095:
Lender information is req ed if project value exceeds$5,000
MAILING ADDRESS CITY,ST Tib S,ZIP \., PHONE
.. :. ■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES 0 NO FI SSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS
AREA DESCRI )N 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 ixo PROPOSED TOTAL a �ST TOTAL PROPOSED G,TOTAL SP
/404
•
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type of attire to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ .• COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EV ••• TIVE COOLERS -AS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE I ERTS HOODS(Commerda])
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG S ►: REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/ShowcrCombo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAI SHOWERS WATER CLOSETS goo
ELECTRIC WAT R HEATERS SINKS ASHING 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 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 .f the reliance of the city, including its officers and employees,upon the accuracy of the information supplied to
the city as apart of this .plication.
SIGNATURE: f DATE
Property Owner and/or Authorized Agent
o NEW o ADDITION ❑ALTERATION a REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES o NO BASIC PLAN? a YES o NO
ZONING DESIGNATION CHANGE OF USE? n YES o NO
NEW ADDRESS REQUIRED? o YES a NO UP/SEPA/SU? n YES a NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES a NO
,
Bulletin#100-August 16,2007 Page 2 of 4 . k\Handouts\Permit Application
,
?.?_Ci9iiii l tt17 "9/4 ,','
fraW / '^� ay/ " 44 ?IV 0 DEPARTM TQ I'OF COMMUNITY DEVELOPMENT SERVICES
33325 8" Avenue South
RECEIVE® PO Box 9718
CITY OF , -. Federal Way WA 98063-9718
'Federal Wayr� 253-835-2607;Fax 253-835-2609
OCT 1 6 2007 www.citvoffederalway.com
C! �F FEDFRq�Wq
DEMOLITION PERMIT it' C 11IREMENTS
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 ABATEMENT 6. ELECTRICITY
(Copy of approval form and asbestos survey from Puget Sound Clean Air (Electricity to be shut off and meter rem9ved)
Agency provided)
G 67
(Puget Sound Energy)
(dty of Federal Way Building Official)
2. GAS SUPPLY 7. FUEL STORAGE TANKS
(Gas to be shut offm��r removed and final bill paid) (Above or below grade fuel tanks, have been pumped or removed
b-- under Fire Department„permit prior to any dismantle/excavation)
(Puget Sound Energy) X511 (
r (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
4/ Meter to remain and be protected
_ _ if ' U:1J L-• IL 2 ► S c-'j'
(King County Environmental Services) G A. 67 (Water Supplier)
******OR******
4.SANITARY SEWER (Check applicable box) 9.WATER- Private Well (Check applicable box)
o Sewer line capped at property line o Private well filled and capped
tat Exi sew lin to remain and bbeoused by proposed new structure o Private well to be user other purposes
(Sewer District)i U77�. ParirC�,��
�.Ofj ) (King County Environmental Services)
5. GAFAGE
(All household garbage disposed off and final bill paid)
(RST ial/Federal Way Disposal)
❑ Completed Construction Permit Application form
El Provide the following fees: 1. Demolition Permit Fee $67.50
2. Automation Fee 5.00
3. WA State Surcharge 4.50
4. Cash Bond Deposit 500.00 (Refundable upon Completed Final Inspection)
$577.00
Bulletin#122—January I,2007 Page I of I k:\Handouts\Demolition Permit Requirements
i1111,
AIL
DEPARTMENT OF COMMUNITY DEVELOPM `VT SERVICES
33325 8th Avenue South
CITY OF PO Box 9718
Federal Way Federal Way WA 98063-9718
�/�/ 253-835-2607;Fax 253-835-2609
www.cityoffederalway.com
DEMOLITION PERMIT CONTACT LIST
This list of agencies may assist you in expediting the demolition permit process.Refer to the demolition permit
requirements for signature blocks.All applicable signatures are required prior to permit approval.
1. Asbestos Removal: Puget Sound Clean Air Agency
110 Union Street,Suite 500
Seattle,WA 98101-2038
206-343-8800—OR—800-552-3565
www.pscleanair.org
2. Electricity: Puget Sound Energy Tacoma Public Utilities
Attn: Construction Coordinator Customer Service
22828 68th Avenue South, Suite#102 —OR— 747 Market Street
Kent,WA 98032 6,1r Tacoma,WA 98402
888-225-5773 &t• 253-383-9600 or 253-383-2471
a53 39r• (72.f�
3. Gas: Puget Sound Energy
805 156t 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 Szlvice
31623 First Avenue South —OR— 747 Mark,•t Street
Federal Way,WA 98003 Tacoma,WA 98402
253-941-2288 253-383-9600 or 253-381-2471
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
33325 8th Avenue South/PO Box 9718
Federal Way,WA 98063
253-946-7248 •
Bulletin#109—March 1,2007 Page 1 of 1 k:\Handouts\Demolition Permit Contact List
i s •
DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES
33325 8th Avenue South
�° PO Box 9718
CITY OF Federal Way WA 98063-9718
FederalWaywww.cityoffederalway.eom
DEMOLITION PERMIT REQUIREMENTS
35( A- . AN S,
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.
0 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 AB) M i 6. LE RICITY
(Copy of approval m .n•l.sbesti.s . P Sound Clean Airci t but o err ov¢d)
Agency provided , '
(Puget Sound Energy
(City of Federal Way Building Official)
2.GAS SUPPLY 7. FUEL STORAGE TANKS
(Gas to be shut off,meter removed and final bill paid) (Above or below grade fuel tanks, have been pumped or removed
under Fire Department pefmit prior to any dismantle/excavation)
(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 bed jrained and filled) o Meter to be removed and final utility bill paid
AMeter to remain and be protected
iir . : UIL, -c a. 5 c-T
(King County Environmental Services) 6/9767 (Water Supplier)
******OR******
4.SANITARY SEWER (Check applicable box) 9.WATER- Private Well(Check applicable box)
o Sewer line capped at property line o Private well filled and capped
*Existing sewer line to remain and be used by proposed new structure o Private well to be ul for other purposes
(Sewer District) (King County Environmental Services)
5.GARBAGE
(All household garbage disposed off and final bill paid)
(RST Disposal/Federal Way Disposal)
0 Completed Construction Permit Application form
0 Provide the following fees: 1. Demolition Permit Fee $67.50
2. Automation Fee 5.00
3. WA State Surcharge 4.50
4. Cash Bond Deposit 500.00 (Refundable upon Completed Final Inspection)
$577.00
Bulletin#122.—January 1,2007 Page 1 of 1 k:\Handouts\Demolition Permit Requirements
•
Page,1 of 1
SEATTLE ASBESTOS TEST, LLC NAMAtireefliftn lats Codi 2037604
19711%tar t.**Ad,8+dee a Lfnara*WA 960%;Tt 424.411.$ ;1,FQ 425.673,94110 AllA Pronciency LAID 10.41559
140mom. .E-Mi+t aaa^
ASBESTOS & OTHER FIBER ANALYSIS
By MOSH 7400(ACM)
CReit;A I F Services Safi 0:200791135
AliOnsee:2 208111 Pt.SW
Lynnwood,WA 911034 Mitt ProoJdebIP.N/A
Project fdtatiosar:Mr.Fraiw ivoo Carrara SIT * 08IfId;3
Project LacMka1:33SO4 11 Ave.S. gm* :3
LAB ID: 200T201V WOG'ID:Oen01 TiPAE;Setd PROTECT: MARC iW1 OR 7/1912007
LOCADON:Outalie tam WON:
AQ1W1TT'CA0 t Rut=A.
T1 ��. RAT 11114 LOQ RC FD./ f0./ �.l
START E10 MITI 81Mr ENO r Atl1i MD_ MAXMa 100Ri1 Nina Cc
1190 0010 40 3.0 3.0 10 1111a 0.322 4.101 0.022 03/100 t 1.0 < 0.1322
LAA IO. 22Q0ntv24 worm 00142 TYPE:Ferraeall PROTECT: '4"-PtTe>1Pt-LF-02 TE: 711980o7
LOCADDit.&IWO Mama DB:0k OM*
ACT ADA.CADMOM
TIE fdAi<F umiak Reber 4. FS/
MAT Bo NRII SIAM MD AVil M01 $M 03/Cti 1,00PW ovn2 CC
OtGtO 13190 ?4C1 ��3.0 3 0 3.0 070.0 0.044 0.1176 0.009 31/10Pl9FOt 0 30,. .6,, 0.011
1.MJO; 2007 +G23b (1. lfllr0en47 TYi+ AA! ��� POTfE1c:T: - PtfNtDA 71498007
LO0A1100t Oottti.Reams MOW BMW:
ACTIVITY:CASviciixi t firteeA,TIM
--- E -.._. nutsLOQ ltLrr�R./ FBI •/
--vie—asp , ee01 ESQ Avg —tow WA F0/OC y08Pib CC._.._.._.
0900 1330 210 4.0 4,0 4.0 1000.0 e.me 0.4453 0.002 12/100 16.3 0.005
'at telt merpin indicates rush erefricel 110004,
Woo
0.0 0.00735 306 16 .1- 10%tr-
LOG:tints d Cuen4 ;RL toe Repa ing UJrt,tt
SORROW by:Mt.wraacfscoCo .--
Anafyzod by:Weiloos Tai r ' � Daft: 7/19/2007
Rery ew•d by;Sieve(Faure)2 lam°6,President: Data: 7119/2007
Ns wad arrant net be ractdwaed, n tW,+ria ttra WSW> '0(4 S1ATTLE XSEESTOS TEST,
d 170h9SSt7SZP « bSLEt+LLS?:P 3OVd VNII r_%b1 9L-OL-LO0,-'..
c(", ) - 4
vitt
_____ _________________
JUL 05:00 PM DAN CIL,'FARMERS INS 858 760 0166 P.02
i `.i:.
7 a {,.
1 '1.
�� 1j
f •ri, , 3+ 1
A and F Services t i
i,,.. : 2102208hp1 sw '
1' L nnwood,WA 98036 '
r',' 2O6-786 6667
-0 1:
,
--�- 2 Date 7119107 it r
�,w tr.
trom-maarigmea r--
�_ ` P To wumb it may concern,
ii On th date of 7115/07,A and F services removed 1500st>;t of asbestos tat paper from the ;
...��N , '.. location of 13504 1 ti"'avc s federal way,WA 9809:1 Ina workman like manner.All work
•
-� was performed in strict compliance with all federal,trate,and local regulations.All x
▪ _ �' •
perrnits •
were present at location during work.Permits are available upon request. • i'•IO;.
._...._ r t is I
.. •
� Attached is the clearance which indicates the ushestos is no longer In the area and also !
.,,,.�,;_o I�1 ar[aehed is a c ca} ol`the contract in which was pivcr�to lien Urioste the home owner. •
P...; i .ii::i. 1
- - tl : ,
Owner ; it.r
_____ t;',4; Tina Page it i.:r'i
LiW",s; •••---raiii • f:±; 4. 1 • i.' 1'..,:.
.7.11- -.7wir.ii-az e...2.---T -7-'-'0*. .-----.._ : • :‘,, i•-,
I/
.i a, 1 isXI▪MPRIVIi.
..IM,OMMI .st: 't •'.:.
NIVRIMIN•61111.1111Mg .. 4. ,
`'
--- • #. • ''
, _ i aj
i
. {.
1•i
; i1:
; s{` 1; .
• Icl;•:
f;:' t is
,: .:
t
3j•
1';
r, ;
1I. `'S. ;;i'.
•
4.
clot rt nal F1413 < pSl6ULL5ZP (`da t/MJIL 2''9t E51-40-400Z --I
__et__
Page 1 of 1
.„_,..ft,,
Single-Family Notification Case#: 200702366
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 25.00
Credit Card Transaction # VUJF1B53264C
Transaction Date 07/07/07
Owner's Name Ben Urioste Phone (253) 880-2225
Site Address 33504 18th ave s 03
Site City federal way Zip 98093
Contact Person Ben Phone (253) 880-2225
Mailing Address
,AK
This project includes asbestos removal.
Project Size linear feet / 1500 square feet
Project Start Date 07/15/07 Completion Date 07/17/07
Asbestos will be removed by a licensed asbestos abatement 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 View History Log Out
If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058.
https://secure.pscleanair.org/Asbestos/Approved.aspx 7/7/2007